Sample records for studies reporting increased

  1. Consistency in adult reporting of adverse childhood experiences.

    PubMed

    Colman, I; Kingsbury, M; Garad, Y; Zeng, Y; Naicker, K; Patten, S; Jones, P B; Wild, T C; Thompson, A H

    2016-02-01

    Many studies have used retrospective reports to assess the long-term consequences of early life stress. However, current individual characteristics and experiences may bias the recall of these reports. In particular, depressed mood may increase the likelihood of recall of negative experiences. The aim of the study was to assess whether specific factors are associated with consistency in the reporting of childhood adverse experiences. The sample comprised 7466 adults from Canada's National Population Health Survey who had reported on seven childhood adverse experiences in 1994/1995 and 2006/2007. Logistic regression was used to explore differences between those who consistently reported adverse experiences and those whose reports were inconsistent. Among those retrospectively reporting on childhood traumatic experiences in 1994/1995 and 2006/2007, 39% were inconsistent in their reports of these experiences. The development of depression, increasing levels of psychological distress, as well as increasing work and chronic stress were associated with an increasing likelihood of reporting a childhood adverse experience in 2006/2007 that had not been previously reported. Increases in mastery were associated with reduced likelihood of new reporting of a childhood adverse experience in 2006/2007. The development of depression and increases in chronic stress and psychological distress were also associated with reduced likelihood of 'forgetting' a previously reported event. Concurrent mental health factors may influence the reporting of traumatic childhood experiences. Studies that use retrospective reporting to estimate associations between childhood adversity and adult outcomes associated with mental health may be biased.

  2. Copycat effects after media reports on suicide: a population-based ecologic study.

    PubMed

    Niederkrotenthaler, Thomas; Till, Benedikt; Kapusta, Nestor D; Voracek, Martin; Dervic, Kanita; Sonneck, Gernot

    2009-10-01

    This study aimed to investigate whether the risk of increased suicide occurrence after reports on suicide is associated with the social characteristics of the reported suicides and whether this varies with similarity between the reported suicides and suicides in the population. We collected reports on all 179 individual suicides named in the 13 largest Austrian nationwide newspapers from 1996 to 2006. Information on social status and sociodemographic characteristics of the reported suicides, on certainty of labelling the death as a suicide, and on the suicide methods applied were extracted from the articles. We conducted logistic regression analyses, with the increase of post-report suicides within 28 days after the reports as dependent variable. In model 1, the increase of suicides that matched the reported individual suicide with regard to age group, sex and suicide method was used as outcome variable. In model 2, the increase of suicides that were different from the reported suicide with regard to these characteristics was the outcome. In model 3, the post-report increase of total suicides was the dependent variable. Celebrity status of the reported suicide, age of the reported suicide between 30 and 64 years, and definitive labelling as a suicide were associated with an increased risk of a post-report increase of similar suicides; criminality (i.e. the individual was reported as suspected or convicted of crime) of the reported suicide was associated with a lower risk of a post-report increase. In dissimilar suicides, none of the variables was associated with a post-report increase of suicides. Celebrity status of the reported suicide was the only predictor of a post-report increase of total suicides. The findings support the hypothesis that social variables of reported suicides impact the risk of post-report copycat behaviour. Evidence of copycat effects seemed to be strongest in suicides that were similar to the respective model with regard to age group, sex, and suicide method.

  3. Self-reported shift work, recall bias, and belief about disease causation in a case-control study of breast cancer.

    PubMed

    Lizama, Natalia; Heyworth, Jane; Thomson, Allyson; Slevin, Terry; Fritschi, Lin

    2017-10-01

    Recall bias is a potential source of misclassification in case-control studies. Studies have shown that the association between exposure and disease can differ according to participants' beliefs or knowledge about the effect of that exposure on disease. We investigated the association between belief about breast cancer causation and self-reported shift work exposure in a case-control study. Women completed a questionnaire asking whether they believed that shift work caused cancer either before or after reporting their history of shift work. We measured: whether belief modified the association between reported shift work and disease; whether belief was associated with reported shift work exposure; and whether being prompted to recall shift work exposure was associated with an increased likelihood of believing that shift work increased breast cancer risk. There was a significant association between believing shift work increased breast cancer risk and reporting exposure to shift work. Being prompted to recall shift work was not associated with a belief that shift work increased risk. The association between pre-existing belief about breast cancer risk and reported shift work is likely to be due to exposed individuals believing that exposure increases risk, rather than resulting from recall bias. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Promoting spontaneous adverse drug reaction reporting in hospitals using a hyperlink to the online reporting form: an ecological study in Portugal.

    PubMed

    Ribeiro-Vaz, Inês; Santos, Cristina; da Costa-Pereira, Altamiro; Cruz-Correia, Ricardo

    2012-05-01

    Spontaneous adverse drug reaction (ADR) reporting has been described as an efficient method to detect drug safety signals. However, under-reporting is a major issue undermining the effectiveness of spontaneous reports. Among hospitalized patients, ADRs are a particularly serious problem because these patients are often treated with more than one drug, and these drugs are often new and aggressive. To promote spontaneous ADR reporting by healthcare professionals working in hospitals in the northern regions of Portugal, we propose the inclusion of a hyperlink to an online ADR reporting form on hospitals' electronic patient records (EPRs). The main aim of this study was to evaluate the impact of these hyperlinks on the number of spontaneous ADR reports to the Northern Pharmacovigilance Centre (UFN - Unidade de Farmacovigilância do Norte). We also assess the number of daily UFN website visits before and after the inclusion of the hyperlinks. An ecological study was performed in northern Portuguese hospitals from 2006 to 2010. The hyperlinks were included in either EPRs or on computer desktops. The median of spontaneous ADR reports (total and online) per month and the respective ranges were presented before and after the intervention in all hospitals in this study. The comparisons were performed using the Mann-Whitney U-test. Sixteen hospital centres were involved in the study (27 hospitals). Eleven centres (18 hospitals) included the hyperlinks. Considering the hospitals with hyperlink access to the EPRs, the median ADR reports per month significantly increased, from two (range 0-12) to five reports (range 1-17). The median of ADR reports per month using the online form also increased significantly, from one (range 0-5) before the intervention to four (range 1-17) after it. Moreover, serious ADRs increased 3-fold, and non-previously described ADRs increased 4.5-fold. None of these significant increases were observed in the hospitals where the hyperlink was not installed. We also found a significant increase in daily UFN website visits, from ten before the intervention to 27 after it (p < 0.001). The increase in ADR reporting shows that the inclusion of hyperlinks to online ADR reporting forms is an easy and cost-effective way to change health professional behaviours with regard to spontaneous ADR reports.

  5. Increasing the Use of Skilled Health Personnel Where Traditional Birth Attendants Were Providers of Childbirth Care: A Systematic Review

    PubMed Central

    Vieira, Claudia; Portela, Anayda; Miller, Tina; Coast, Ernestina; Leone, Tiziana; Marston, Cicely

    2012-01-01

    Background Improved access to skilled health personnel for childbirth is a priority strategy to improve maternal health. This study investigates interventions to achieve this where traditional birth attendants were providers of childbirth care and asks what has been done and what has worked? Methods and Findings We systematically reviewed published and unpublished literature, searching 26 databases and contacting experts to find relevant studies. We included references from all time periods and locations. 132 items from 41 countries met our inclusion criteria and are included in an inventory; six were intervention evaluations of high or moderate quality which we further analysed. Four studies report on interventions to deploy midwives closer to communities: two studies in Indonesia reported an increase in use of skilled health personnel; another Indonesian study showed increased uptake of caesarean sections as midwives per population increased; one study in Bangladesh reported decreased risk of maternal death. Two studies report on interventions to address financial barriers: one in Bangladesh reported an increase in use of skilled health personnel where financial barriers for users were addressed and incentives were given to skilled care providers; another in Peru reported that use of emergency obstetric care increased by subsidies for preventive and maternity care, but not by improved quality of care. Conclusions The interventions had positive outcomes for relevant maternal health indicators. However, three of the studies evaluate the village midwife programme in Indonesia, which limits the generalizability of conclusions. Most studies report on a main intervention, despite other activities, such as community mobilization or partnerships with traditional birth attendants. Many authors note that multiple factors including distance, transport, family preferences/support also need to be addressed. Case studies of interventions in the inventory illustrate how different countries attempted to address these complexities. Few high quality studies that measure effectiveness of interventions exist. PMID:23110138

  6. Increasing the use of skilled health personnel where traditional birth attendants were providers of childbirth care: a systematic review.

    PubMed

    Vieira, Claudia; Portela, Anayda; Miller, Tina; Coast, Ernestina; Leone, Tiziana; Marston, Cicely

    2012-01-01

    Improved access to skilled health personnel for childbirth is a priority strategy to improve maternal health. This study investigates interventions to achieve this where traditional birth attendants were providers of childbirth care and asks what has been done and what has worked? We systematically reviewed published and unpublished literature, searching 26 databases and contacting experts to find relevant studies. We included references from all time periods and locations. 132 items from 41 countries met our inclusion criteria and are included in an inventory; six were intervention evaluations of high or moderate quality which we further analysed. Four studies report on interventions to deploy midwives closer to communities: two studies in Indonesia reported an increase in use of skilled health personnel; another Indonesian study showed increased uptake of caesarean sections as midwives per population increased; one study in Bangladesh reported decreased risk of maternal death. Two studies report on interventions to address financial barriers: one in Bangladesh reported an increase in use of skilled health personnel where financial barriers for users were addressed and incentives were given to skilled care providers; another in Peru reported that use of emergency obstetric care increased by subsidies for preventive and maternity care, but not by improved quality of care. The interventions had positive outcomes for relevant maternal health indicators. However, three of the studies evaluate the village midwife programme in Indonesia, which limits the generalizability of conclusions. Most studies report on a main intervention, despite other activities, such as community mobilization or partnerships with traditional birth attendants. Many authors note that multiple factors including distance, transport, family preferences/support also need to be addressed. Case studies of interventions in the inventory illustrate how different countries attempted to address these complexities. Few high quality studies that measure effectiveness of interventions exist.

  7. The effects of implementing synoptic pathology reporting in cancer diagnosis: a systematic review.

    PubMed

    Sluijter, Caro E; van Lonkhuijzen, Luc R C W; van Slooten, Henk-Jan; Nagtegaal, Iris D; Overbeek, Lucy I H

    2016-06-01

    Pathology reporting is evolving from a traditional narrative report to a more structured synoptic report. Narrative reporting can cause misinterpretation due to lack of information and structure. In this systematic review, we evaluate the impact of synoptic reporting on completeness of pathology reports and quality of pathology evaluation for solid tumours. Pubmed, Embase and Cochrane databases were systematically searched to identify studies describing the effect of synoptic reporting implementation on completeness of reporting and quality of pathology evaluation of solid malignant tumours. Thirty-three studies met the inclusion criteria. All studies, except one, reported an increased overall completeness of pathology reports after introduction of synoptic reporting (SR). Most frequently studied cancers were breast (n = 9) and colorectal cancer (n = 16). For breast cancer, narrative reports adequately described 'tumour type' and 'nodal status'. Synoptic reporting resulted in improved description of 'resection margins', 'DCIS size', 'location' and 'presence of calcifications'. For colorectal cancer, narrative reports adequately reported 'tumour type', 'invasion depth', 'lymph node counts' and 'nodal status'. Synoptic reporting resulted in increased reporting of 'circumferential margin', 'resection margin', 'perineural invasion' and 'lymphovascular invasion'. In addition, increased numbers of reported lymph nodes were found in synoptic reports. Narrative reports of other cancer types described the traditional parameters adequately, whereas for 'resection margins' and '(lympho)vascular/perineural invasion', implementation of synoptic reporting was necessary. Synoptic reporting results in improved reporting of clinical relevant data. Demonstration of clinical impact of this improved method of pathology reporting is required for successful introduction and implementation in daily pathology practice.

  8. Rural providers' access to online resources: a randomized controlled trial

    PubMed Central

    Hall, Laura J.; McElfresh, Karen R.; Warner, Teddy D.; Stromberg, Tiffany L.; Trost, Jaren; Jelinek, Devin A.

    2016-01-01

    Objective The research determined the usage and satisfaction levels with one of two point-of-care (PoC) resources among health care providers in a rural state. Methods In this randomized controlled trial, twenty-eight health care providers in rural areas were stratified by occupation and region, then randomized into either the DynaMed or the AccessMedicine study arm. Study participants were physicians, physician assistants, and nurses. A pre- and post-study survey measured participants' attitudes toward different information resources and their information-seeking activities. Medical student investigators provided training and technical support for participants. Data analyses consisted of analysis of variance (ANOVA), paired t tests, and Cohen's d statistic to compare pre- and post-study effects sizes. Results Participants in both the DynaMed and the AccessMedicine arms of the study reported increased satisfaction with their respective PoC resource, as expected. Participants in both arms also reported that they saved time in finding needed information. At baseline, both arms reported too little information available, which increased to “about right amounts of information” at the completion of the study. DynaMed users reported a Cohen's d increase of +1.50 compared to AccessMedicine users' reported use of 0.82. DynaMed users reported d2 satisfaction increases of 9.48 versus AccessMedicine satisfaction increases of 0.59 using a Cohen's d. Conclusion Participants in the DynaMed arm of the study used this clinically oriented PoC more heavily than the users of the textbook-based AccessMedicine. In terms of user satisfaction, DynaMed users reported higher levels of satisfaction than the users of AccessMedicine. PMID:26807050

  9. Trends in reporting of mechanisms and incidence of hip injuries in males playing minor ice hockey in Canada: a cross-sectional study.

    PubMed

    Ayeni, Olufemi R; Kowalczuk, Marcin; Farag, Jordan; Farrokhyar, Forough; Chu, Raymond; Bedi, Asheesh; Willits, Kevin; Bhandari, Mohit

    2014-01-01

    There has been a noted increase in the diagnosis and reporting of sporting hip injuries and conditions in the medical literature but reporting at the minor hockey level is unknown. The purpose of this study is to investigate the trend of reporting hip injuries in amateur ice hockey players in Canada with a focus on injury type and mechanism. A retrospective review of the Hockey Canada insurance database was performed and data on ice hockey hip injuries reported between January 2005 and June 2011 were collected. The study population included all male hockey players from Peewee (aged 11-12 years) to Senior (aged 20+ years) participating in amateur level competition sanctioned by Hockey Canada. Reported cases of ice hockey hip injuries were analyzed according to age, mechanism of injury, and injury subtype. Annual injury reporting rates were determined and using a linear regression analysis trended to determine the change in ice hockey hip injury reporting rate over time. One hundred and six cases of ice hockey-related hip injuries were reported in total. The majority of injuries (75.5%) occurred in players aged 15-20 years playing at the Junior level. Most injuries were caused by a noncontact mechanism (40.6%) and strains were the most common subtype (50.0%). From 2005 to 2010, the number of reported hip injuries increased by 5.31 cases per year and the rate of reported hip injury per 1,000 registered players increased by 0.02 cases annually. Reporting of hip injuries in amateur ice hockey players is increasing. A more accurate injury reporting system is critical for future epidemiologic studies to accurately document the rate and mechanism of hip injury in amateur ice hockey players.

  10. The impact of news media on child abuse reporting.

    PubMed

    McDevitt, S

    1996-04-01

    This study explores the relationship between news stories on child abuse and neglect and reports of child abuse and neglect made to a mandated agency. Academic literature on crime news is reviewed to provide a context for interpretation. News stories from metropolitan daily newspapers were compared with child maltreatment reports made to mandated agencies on a local and national basis were surveyed over 25 years. The results suggested that both child maltreatment reports and news coverage increased over the period surveyed. However, rather than media stories increasing prior to increases in mandated reports and therefore contributing to the rise in reported cases, they appeared to increase at the same time. It is suggested that the initial cause of both increases may be national policy changes. More recent increases in child abuse reports may be due to economic downturns and other widespread societal changes rather than media attention.

  11. [Are mental disorders increasing? Update of a systematic review on repeated cross-sectional studies].

    PubMed

    Richter, Dirk; Berger, Klaus

    2013-05-01

    Throughout the western world, an increasing demand for psychiatric services is reported. However, a systematic review published in 2008 came to the conclusion that there is no sufficient evidence for increasing mental disorders in the recent decades. A systematic review on studies with repeating cross-sectional surveys in the general population, published since 2008, was conducted. 33 study results were included into the review. The majority of publications did not report increasing mental health problems in the general population. The increasing demand for psychiatric services is not associated with increasing mental disorders in the general population. © Georg Thieme Verlag KG Stuttgart · New York.

  12. The stigmatisation of 'ice' and under-reporting of meth/amphetamine use in general population surveys: A case study from Australia.

    PubMed

    Chalmers, Jenny; Lancaster, Kari; Hughes, Caitlin

    2016-10-01

    Stigmatisation of illicit drug use is known to discourage people from reporting their use of illicit drugs. In the context of Australia's two recent "ice-epidemics" this study examines whether rapid increases in community concern about meth/amphetamine concurrent with increased stigmatising media reporting about meth/amphetamine "epidemics" are associated with increased under-reporting of its use in population surveys. We examined the relationship between general population trends in self-reported lifetime use of and attitudes towards meth/amphetamine between 2001 and 2013, contextualised against related stimulants and heroin, using five waves of Australia's National Drug Strategy Household Survey (NDSHS), alongside trends in print media reporting on meth/amphetamine from 2001 to 2014. Analysis of NDSHS data showed significant increases in community concern about meth/amphetamine between 2004 and 2007, and 2010 and 2013 in all birth cohorts and age groups. In both periods self-reported lifetime use of meth/amphetamine fell in many birth cohorts. The falls were only statistically significant in the first period, for birth cohorts from 1961-1963 to 1973-1975. Falls in lifetime use within a cohort from one period to the next are incongruous and we did not observe them in the other drugs considered. Equally, increases in concern were specific to meth/amphetamine. We counted substantial and rapid increase in the number of newspaper reports about meth/amphetamine in both periods, particularly reports including the term 'epidemic'. Rapid increases in the quantum of media reporting stigmatising a drug (through its construction as an 'epidemic') accompanying increased general public concerns about the drug may increase the tendency to under-report lifetime use. This may make it difficult to rely upon household surveys to observe trends in patterns of use and suggests that policy makers, media and others in the AOD sector should avoid stigmatisation of drugs, particularly during periods of heightened concern. Copyright © 2016 Elsevier B.V. All rights reserved.

  13. Developmental changes in conflict resolution styles in parent-adolescent relationships: a four-wave longitudinal study.

    PubMed

    Van Doorn, Muriel D; Branje, Susan J T; Meeus, Wim H J

    2011-01-01

    In this study, changes in three conflict resolution styles in parent-adolescent relationships were investigated: positive problem solving, conflict engagement, and withdrawal. Questionnaires about these conflict resolution styles were completed by 314 early adolescents (M = 13.3 years; 50.6% girls) and both parents for four consecutive years. Adolescents' reported use of positive problem solving increased with mothers, but did not change with fathers. Fathers reported an increase of positive problem solving with adolescents, whereas mothers reported no change. Adolescents' use of conflict engagement was found to temporarily increase with mothers, but showed no change with fathers. Mothers and fathers reported a decrease in conflict engagement with adolescents. Adolescents' use of withdrawal with parents increased, although this increase was temporarily with mothers. Mothers reported no change in withdrawal, whereas fathers' use of withdrawal increased. Generally, we found that both adolescents and their parents changed in their use of conflict resolution from early to middle adolescence. These results show that conflict resolution in parent-adolescent relationships gradually change in favor of a more horizontal relationship.

  14. Developmental Changes in Conflict Resolution Styles in Parent–Adolescent Relationships: A Four-Wave Longitudinal Study

    PubMed Central

    Branje, Susan J. T.; Meeus, Wim H. J.

    2010-01-01

    In this study, changes in three conflict resolution styles in parent–adolescent relationships were investigated: positive problem solving, conflict engagement, and withdrawal. Questionnaires about these conflict resolution styles were completed by 314 early adolescents (M = 13.3 years; 50.6% girls) and both parents for four consecutive years. Adolescents’ reported use of positive problem solving increased with mothers, but did not change with fathers. Fathers reported an increase of positive problem solving with adolescents, whereas mothers reported no change. Adolescents’ use of conflict engagement was found to temporarily increase with mothers, but showed no change with fathers. Mothers and fathers reported a decrease in conflict engagement with adolescents. Adolescents’ use of withdrawal with parents increased, although this increase was temporarily with mothers. Mothers reported no change in withdrawal, whereas fathers’ use of withdrawal increased. Generally, we found that both adolescents and their parents changed in their use of conflict resolution from early to middle adolescence. These results show that conflict resolution in parent–adolescent relationships gradually change in favor of a more horizontal relationship. PMID:20177961

  15. Changing Relationship Growth Belief: Intrapersonal and Interpersonal Consequences of Compassionate Goals

    PubMed Central

    Canevello, Amy; Crocker, Jennifer

    2010-01-01

    The belief that difficulties can lead to growth in relationships, or growth belief, has consequences for relationships (e.g., Knee, 1998). But what predicts change in this belief? We hypothesized that compassionate goals to support others (Crocker & Canevello, 2008) predict increased growth belief through increased need satisfaction. In Study 1, 199 college freshmen reported their friendship growth belief and goals. In Study 2, 65 roommate pairs reported their roommate growth belief, goals, and need satisfaction. Across studies, compassionate goals predicted increased growth belief. In Study 2, goals predicted increased perceived mutual need satisfaction, which predicted increased growth belief. Additionally, partners’ compassionate goals predicted actors’ increased growth belief. Results suggest that growth beliefs are shaped by goals – own and others’. PMID:21949478

  16. The increase in symptoms of anxiety and depressed mood among Icelandic adolescents: time trend between 2006 and 2016.

    PubMed

    Thorisdottir, Ingibjorg E; Asgeirsdottir, Bryndis B; Sigurvinsdottir, Rannveig; Allegrante, John P; Sigfusdottir, Inga D

    2017-10-01

    Both research and popular media reports suggest that adolescent mental health has been deteriorating across societies with advanced economies. This study sought to describe the trends in self-reported symptoms of depressed mood and anxiety among Icelandic adolescents. Data for this study come from repeated, cross-sectional, population-based school surveys of 43 482 Icelandic adolescents in 9th and 10th grade, with six waves of pooled data from 2006 to 2016. We used analysis of variance, linear regression and binomial logistic regression to examine trends in symptom scores of anxiety and depressed mood over time. Gender differences in trends of high symptoms were also tested for interactions. Linear regression analysis showed a significant linear increase over the course of the study period in mean symptoms of anxiety and depressed mood for girls only; however, symptoms of anxiety among boys decreased. The proportion of adolescents reporting high depressive symptoms increased by 1.6% for boys and 6.8% for girls; the proportion of those reporting high anxiety symptoms increased by 1.3% for boys and 8.6% for girls. Over the study period, the odds for reporting high depressive symptoms and high anxiety symptoms were significantly higher for both genders. Girls were more likely to report high symptoms of anxiety and depressed mood than boys. Self-reported symptoms of anxiety and depressed mood have increased over time among Icelandic adolescents. Our findings suggest that future research needs to look beyond mean changes and examine the trends among those adolescents who report high symptoms of emotional distress. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  17. Self-reported musculoskeletal pain predicts long-term increase in general health care use: a population-based cohort study with 20-year follow-up.

    PubMed

    Hartvigsen, Jan; Davidsen, Michael; Søgaard, Karen; Roos, Ewa M; Hestbaek, Lise

    2014-11-01

    Musculoskeletal pain and disability is a modern epidemic and a major reason for seeking health care. The aim of this study is to determine absolute and relative rates of care seeking over 20 years for adults reporting musculoskeletal complaints. Interview data on musculoskeletal pain reported during the past two weeks from the Danish National Cohort Study were merged with data from the Danish National Health Insurance Registry and the National Patient Registry containing information on consultations in the Danish primary and secondary care sector. Absolute and relative rates for all seeking of care with general practitioners, physiotherapists, chiropractors, outpatient hospital contacts and hospital admissions are reported for persons reporting no musculoskeletal pain and for persons reporting pain in the neck, shoulder, wrist/hands, mid back, low back, hips, knees and ankles/feet. Regardless of site, persons experiencing a musculoskeletal complaint had a statistically increased risk of consulting a general practitioner when compared with persons reporting no musculoskeletal complaint. For physiotherapists and chiropractors, only persons complaining of neck pain and back pain had an increased risk of seeking care. Regardless of pain site, except for shoulder pain, persons reporting musculoskeletal pain had a statistically significant increased risk of outpatient hospital consultations and hospital admissions. Few differences were found between pain sites in relation to any of the outcomes. Self-report of musculoskeletal pain reported within the past two weeks predicts a statistically significant long-term increase in general use of health care services in both the primary and the secondary health care sector. © 2014 the Nordic Societies of Public Health.

  18. Sleep, sleepiness and school start times: a preliminary study.

    PubMed

    Dexter, Donn; Bijwadia, Jagdeep; Schilling, Dana; Applebaugh, Gwendolyn

    2003-01-01

    High school students are reported to be excessively sleepy, resulting in decreased academic performance, increased psycho-social problems and increased risk of morbidity and mortality from accidents. Early school start times have been noted to contribute to this problem. This report attempts to confirm the relationship of early school start times with decreased sleep and increased sleepiness. We examined sophomore and junior students in 2 local high schools with different start times and measured the amount of time slept and sleepiness. We found that students at the early start school reported reduced sleep time and more sleepiness than their counterparts at the later starting school. Early school start times are associated with student reports of less sleep and increased sleepiness. Further studies in larger groups are recommended in view of the potential significant impact of sleep deprivation in this age group.

  19. Factors associated with self-assessed increase in tobacco consumption among over-indebted individuals in Germany: a cross-sectional study.

    PubMed

    Rueger, Heiko; Weishaar, Heide; Ochsmann, Elke B; Letzel, Stephan; Muenster, Eva

    2013-03-13

    Over-indebtedness is an increasing phenomenon in industrialised nations causing individual hardship and societal problems. Nonetheless, few studies have explored smoking among over-indebted individuals. A cross-sectional survey (n=949) on retrospectively assessed changes in tobacco consumption was carried out in 2006 and 2007 among clients of 84 officially approved debt and insolvency counselling centres in Germany (response rate 39.7%). Logistic regressions were performed to explore factors associated with reports of increased smoking after onset of over-indebtedness. 63% of all respondents stated daily or occasional tobacco consumption. Almost one fifth reported an increase in smoking after becoming over-indebted. Females were less likely to report increased smoking than men (aOR 0.66, 95% CI 0.44-0.99) whereas respondents who had been over-indebted for more than 10 years were more likely to report increased smoking than those who had been over-indebted for less than five years (aOR 1.66; 95%-CI 1.00-2.76). The odds of increased smoking were also elevated among those who reported that their families and friends had withdrawn from them as a consequence of their over-indebtedness (aOR 1.82; 95%-CI 1.06-3.14). The study identifies over-indebted individuals and particularly over-indebted men as a high-risk group of smokers. Low levels of social embeddedness/support were associated with a further increase in smoking after becoming over-indebted. Given recent increases of over-indebtedness, the findings highlight the need to develop appropriate public health policies.

  20. Living-donor vs deceased-donor liver transplantation for patients with hepatocellular carcinoma.

    PubMed

    Akamatsu, Nobuhisa; Sugawara, Yasuhiko; Kokudo, Norihiro

    2014-09-27

    With the increasing prevalence of living-donor liver transplantation (LDLT) for patients with hepatocellular carcinoma (HCC), some authors have reported a potential increase in the HCC recurrence rates among LDLT recipients compared to deceased-donor liver transplantation (DDLT) recipients. The aim of this review is to encompass current opinions and clinical reports regarding differences in the outcome, especially the recurrence of HCC, between LDLT and DDLT. While some studies report impaired recurrence - free survival and increased recurrence rates among LDLT recipients, others, including large database studies, report comparable recurrence - free survival and recurrence rates between LDLT and DDLT. Studies supporting the increased recurrence in LDLT have linked graft regeneration to tumor progression, but we found no association between graft regeneration/initial graft volume and tumor recurrence among our 125 consecutive LDLTs for HCC cases. In the absence of a prospective study regarding the use of LDLT vs DDLT for HCC patients, there is no evidence to support the higher HCC recurrence after LDLT than DDLT, and LDLT remains a reasonable treatment option for HCC patients with cirrhosis.

  1. Increase of Foreign-Born Engineers in U.S. Studied.

    ERIC Educational Resources Information Center

    Krieger, James

    1988-01-01

    Summarizes the report of a National Research Council committee. Reports on three basic findings: the proportion of foreign born engineers in the United States has increased over the last 15 years; the increase is disproportionate in the academic sector; and large numbers of students are culturally different. (CW)

  2. Higher Education. Students Have Increased Borrowing and Working To Help Pay Higher Tuitions. Report to the Honorable Carol Mosely-Braun, U.S. Senate.

    ERIC Educational Resources Information Center

    General Accounting Office, Washington, DC. Health, Education, and Human Services Div.

    This report analyzes data from the National Postsecondary Student Aid Study for 1992-93 and 1995-96. The study found that students have turned increasingly to borrowing to cope with rising education costs. The percentage of postsecondary students who borrowed to complete a bachelor's or lower degree increased from 41 percent in 1992-93 to 52…

  3. Effects of Brief Messages About Antiretroviral Therapy and Condom Use Benefits Among Black and Latino MSM in Three U.S. Cities.

    PubMed

    Herbst, Jeffrey H; Mansergh, Gordon; Pitts, Nicole; Denson, Damian; Mimiaga, Matthew J; Holman, Jeremy

    2018-01-01

    This pilot study examined effects of HIV prevention messages about self and partner benefits of antiretroviral therapy (ART) and condom effectiveness on increased intentions for behavior change. Data were from Messages4Men, a study examining prevention messages among 320 HIV-positive and 605 HIV-negative Black and Latino MSM. Men completed a computer-based assessment after message exposure, and multivariable models controlled for risky sex and demographics. A majority of HIV-positive men reported increased intentions for ART use; 22% reported partner benefit information was new. HIV-positive men with a detectable viral load had significantly greater adjusted odds of reporting intentions for ART use. Over half of HIV-negative MSM reported ART benefit information was new, and 88% reported increased intentions to discuss ART use with infected partners. Black MSM anticipated they would increase condom use in response to the self and partner benefit messages. Tailored messages on benefits of ART are needed for MSM.

  4. Speak softly--and forget the stick. Corporal punishment and child physical abuse.

    PubMed

    Zolotor, Adam J; Theodore, Adrea D; Chang, Jen Jen; Berkoff, Molly C; Runyan, Desmond K

    2008-10-01

    Previous studies have shown an association between spanking and child physical abuse. However, the relationship between more frequent and severe corporal punishment and abuse remains unknown. The objective of this study was to examine the associations between reported spanking, spanking frequency, or spanking with an object and the odds of physical abuse in a representative sample of mothers from North and South Carolina. This study is a cross-sectional, anonymous telephone survey of adult mothers with children aged<18 years living in the Carolinas in 2002. The analysis was conducted in 2007. Survey responses were used to determine the association between corporal punishment (spanking, spanking frequency, and spanking with an object) and an index of harsh physical punishment consistent with physical abuse (beating, burning, kicking, hitting with an object somewhere other than the buttocks, or shaking a child aged<2 years). Mothers who report that the child was spanked are 2.7 (95% CI=1.2, 6.3) times more likely to report abuse. Increases in the frequency of reported spanking in the last year are also associated with increased odds of abuse (OR=1.03, 95% CI=1.01, 1.06). Mothers reporting spanking with an object are at markedly increased odds of reporting abuse (OR=8.9, 95% CI=4.1, 19.6). Although reported spanking increases the odds of reported physical abuse, the relationship between the reported hitting of a child with an object and reported abuse is much stronger. Reduction in this form of discipline through media, educational, and legislative efforts may reduce child physical abuse.

  5. Patient safety event reporting in critical care: a study of three intensive care units.

    PubMed

    Harris, Carolyn B; Krauss, Melissa J; Coopersmith, Craig M; Avidan, Michael; Nast, Patricia A; Kollef, Marin H; Dunagan, W Claiborne; Fraser, Victoria J

    2007-04-01

    To increase patient safety event reporting in three intensive care units (ICUs) using a new voluntary card-based event reporting system and to compare and evaluate observed differences in reporting among healthcare workers across ICUs. Prospective, single-center, interventional study. A medical ICU (19 beds), surgical ICU (24 beds), and cardiothoracic ICU (17 beds) at a 1,371-bed urban teaching hospital. Adult patients admitted to these three study ICUs. Use of a new, internally designed, card-based reporting program to solicit voluntary anonymous reporting of medical errors and patient safety concerns. During a 14-month period, 714 patient safety events were reported using a new card-based reporting system, reflecting a significant increase in reporting compared with pre-intervention Web-based reporting (20.4 reported events/1,000 patient days pre-intervention to 41.7 reported events/1,000 patient days postintervention; rate ratio, 2.05; 95% confidence interval, 1.79-2.34). Nurses submitted the majority of reports (nurses, 67.1%; physicians, 23.1%; other reporters, 9.5%); however, physicians experienced the greatest increase in reporting among their group (physicians, 43-fold; nurses, 1.7-fold; other reporters, 4.3-fold) relative to pre-intervention rates. There were significant differences in the reporting of harm by job description: 31.1% of reports from nurses, 36.2% from other staff, and 17.0% from physicians described events that did not reach/affect the patient (p = .001); and 33.9% of reports from physicians, 27.2% from nurses, and 13.0% from other staff described events that caused harm (p = .005). Overall reported patient safety events per 1,000 patient days differed by ICU (medical ICU = 55.5, cardiothoracic ICU = 25.3, surgical ICU = 40.2; p < .001). This card-based reporting system increased reporting significantly compared with pre-intervention Web-based reporting and revealed significant differences in reporting by healthcare worker and ICU. These differences may reveal important preferences and priorities for reporting medical errors and patient safety events.

  6. Explaining the increase in the prevalence of autism spectrum disorders: the proportion attributable to changes in reporting practices.

    PubMed

    Hansen, Stefan N; Schendel, Diana E; Parner, Erik T

    2015-01-01

    The prevalence of autism spectrum disorders (ASDs) has increased markedly in recent decades, which researchers have suggested could be caused in part by nonetiologic factors such as changes in diagnosis reporting practices. To our knowledge, no study has quantified the degree to which changes in reporting practices might explain this increase. Danish national health registries have undergone a change in diagnostic criteria in 1994 and the inclusion of outpatient contacts to health registries in 1995. To quantify the effect of changes in reporting practices in Denmark on reported ASD prevalence. We used a population-based birth cohort approach that includes information on all individuals with permanent residence in Denmark. We assessed all children born alive from January 1, 1980, through December 31, 1991, in Denmark (n=677915). The children were followed up from birth until ASD diagnosis, death, emigration, or the end of follow-up on December 31, 2011, whichever occurred first. The analysis uses a stratified Cox proportional hazards regression model with the changes in reporting practices modeled as time-dependent covariates. The change in diagnostic criteria in 1994 and the inclusion of outpatient diagnoses in 1995. Autism spectrum disorders. For Danish children born during the study period, 33% (95% CI, 0%-70%) of the increase in reported ASD prevalence could be explained by the change in diagnostic criteria alone; 42% (95% CI, 14%-69%), by the inclusion of outpatient contacts alone; and 60% (95% CI, 33%-87%), by the change in diagnostic criteria and the inclusion of outpatient contacts. Changes in reporting practices can account for most (60%) of the increase in the observed prevalence of ASDs in children born from 1980 through 1991 in Denmark. Hence, the study supports the argument that the apparent increase in ASDs in recent years is in large part attributable to changes in reporting practices.

  7. Changes in waist circumference and body mass index in the US CARDIA cohort: fixed-effects associations with self-reported experiences of racial/ethnic discrimination.

    PubMed

    Cunningham, Timothy J; Berkman, Lisa F; Kawachi, Ichiro; Jacobs, David R; Seeman, Teresa E; Kiefe, Catarina I; Gortmaker, Steven L

    2013-03-01

    Prior studies examining the association between self-reported experiences of racial/ethnic discrimination and obesity have had mixed results and primarily been cross-sectional. This study tests the hypothesis that an increase in self-reported experiences of racial/ethnic discrimination predicts gains in waist circumference and body mass index in Black and White women and men over eight years. In race/ethnicity- and gender-stratified models, this study examined whether change in self-reported experiences of racial/ethnic discrimination predicts changes in waist circumference and body mass index over time using a fixed-effects regression approach in SAS statistical software, providing control for both measured and unmeasured time-invariant covariates. Between 1992-93 and 2000-01, self-reported experiences of racial/ethnic discrimination decreased among 843 Black women (75% to 73%), 601 Black men (80% to 77%), 893 White women (30% to 23%) and 856 White men (28% to 23%). In fixed-effects regression models, controlling for all time-invariant covariates, social desirability bias, and changes in education and parity (women only) over time, an increase in self-reported experiences of racial/ethnic discrimination over time was significantly associated with an increase in waist circumference (β=1.09, 95% CI: 0.00-2.19, p=0.05) and an increase in body mass index (β=0.67, 95% CI: 0.19-1.16, p=0.007) among Black women. No associations were observed among Black men and White women and men. These findings suggest that an increase in self-reported experiences of racial/ethnic discrimination may be associated with increases in waist circumference and body mass index among Black women over time.

  8. Understanding the impact of supervision on reducing medication risks: an interview study in long-term elderly care.

    PubMed

    Vermeulen, J A; Kleefstra, S M; Zijp, E M; Kool, R B

    2017-07-06

    In 2009, the Dutch Health Care Inspectorate (IGZ) observed several serious risks to safety involving medication within elderly care facilities. However, by 2011, high risks had been reduced in almost all the organisations we visited. And yet the IGZ analysed too the alarming increase in the number of incidents arising in the self-reported national indicator of medication safety between 2009 and 2010. The aim of this study was to understand the factors that can explain this contradiction between the increase in self-reported medication incidents and the observation of the IGZ in reducing the risks to medication safety through supervision. We interviewed health care professionals of ten care facilities, visited by the IGZ, who were involved in, or responsible for, the improvement of medication safety in their institutions. As outcome measures we used the rate of medication safety risk per facility; the perceptions of the participant with regard to the reports of medication incidents; the level of medication safety of the facility; the measures used to improve medication safety; and the supervision of medication safety. This was a mixed methods study, qualitative in that we used semi-structured interviews, and quantitative, by calculating risks for the different organisations we visited. The findings from both study methods resulted in a comprehensive view and an in-depth understanding of this contradiction. The contradiction between the increase in self-reported medication incidents and the observation of reduced risks was explained by three themes: activities designed to improve medication safety, the reporting of medication incidents, and, lastly, the impact of supervision. The focus of the IGZ on issues of medication safety stimulated most elderly care facilities to reduce medication risks. Also, a change in the culture of reporting incidents caused an increase in the number of reported incidents. Supervision contributed to an improvement in actions geared towards reducing the risks associated with the safety of medication. It also increased a willingness to report such incidents. The more incidents reported are therefore not necessarily a sign of an increase in the risks, but can also be considered as a sign of a safer culture.

  9. The evaluation of a web-based incident reporting system.

    PubMed

    Kuo, Ya-Hui; Lee, Ting-Ting; Mills, Mary Etta; Lin, Kuan-Chia

    2012-07-01

    A Web-based reporting system is essential to report incident events anonymously and confidentially. The purpose of this study was to evaluate a Web-based reporting system in Taiwan. User satisfaction and impact of system use were evaluated through a survey answered by 249 nurses. Incident events reported in paper and electronic systems were collected for comparison purposes. Study variables included system user satisfaction, willingness to report, number of reports, severity of the events, and efficiency of the reporting process. Results revealed that senior nurses were less willing to report events, nurses on internal medicine units had higher satisfaction than others, and lowest satisfaction was related to the time it took to file a report. In addition, the Web-based reporting system was used more often than the paper system. The percentages of events reported were significantly higher in the Web-based system in laboratory, environment/device, and incidents occurring in other units, whereas the proportions of reports involving bedsores and dislocation of endotracheal tubes were decreased. Finally, moderate injury event reporting decreased, whereas minor or minimal injury event reporting increased. The study recommends that the data entry process be simplified and the network system be improved to increase user satisfaction and reporting rates.

  10. Indian women of childbearing age do not metabolically conserve arginine as do American and Jamaican women

    USDA-ARS?s Scientific Manuscript database

    In a previous study in pregnant American women, we reported that arginine flux and nitric oxide synthesis increased in trimester 2. More recently, we reported that Indian women do not increase arginine flux during pregnancy as their American or Jamaican counterparts do. The purpose of this study was...

  11. Weapons and Tactics Instructor Course 2-16 Sleep and Performance Study

    DTIC Science & Technology

    2017-03-01

    assessments showed a significant increase in self-reported fatigue as the course progressed. This thesis outlines a detailed methodology and lessons...increase in self-reported fatigue as the course progressed. This thesis outlines a detailed methodology and lessons learned for follow-on studies of...Performance as a Result of Insufficient Sleep .........23  III.  METHODOLOGY

  12. Predicting Psychotic-Like Experiences during Sensory Deprivation

    PubMed Central

    Daniel, Christina; Mason, Oliver J.

    2015-01-01

    Aims. This study aimed to establish the contribution of hallucination proneness, anxiety, suggestibility, and fantasy proneness to psychotic-like experiences (PLEs) reported during brief sensory deprivation. Method. Twenty-four high and 22 low hallucination-prone participants reported on PLEs occurring during brief sensory deprivation and at baseline. State/trait anxiety, suggestibility, and fantasy proneness were also measured. Results. Both groups experienced a significant increase in PLEs in sensory deprivation. The high hallucination prone group reported more PLEs both at baseline and in sensory deprivation. They also scored significantly higher on measures of state/trait anxiety, suggestibility, and fantasy proneness, though these did not explain the effects of group or condition. Regression analysis found hallucination proneness to be the best predictor of the increase in PLEs, with state anxiety also being a significant predictor. Fantasy proneness and suggestibility were not significant predictors. Conclusion. This study suggests the increase in PLEs reported during sensory deprivation reflects a genuine aberration in perceptual experience, as opposed to increased tendency to make false reports due to suggestibility of fantasy proneness. The study provides further support for the use of sensory deprivation as a safe and effective nonpharmacological model of psychosis. PMID:25811027

  13. Relationship between QT Interval Dispersion in acute stroke and stroke prognosis: A Systematic Review

    PubMed Central

    Lederman, Yitzchok S.; Balucani, Clotilde; Lazar, Jason; Steinberg, Leah; Gugger, James; Levine, Steven R.

    2014-01-01

    Background QT dispersion (QTd) has been proposed as an indirect ECG measure of heterogeneity of ventricular repolarization. The predictive value of QTd in acute stroke remains controversial. We aimed to clarify the relationship between QTd and acute stroke and stroke prognosis. Methods A systematic review of the literature was performed using pre-specified medical subjects heading (MeSH) terms, Boolean logic and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Eligible studies (a) included ischemic or hemorrhagic stroke and (b) provided QTd measurements. Results Two independent reviewers identified 553 publications. Sixteen articles were included in the final analysis. There were a total of 888 stroke patients: 59% ischemic and 41% hemorrhagic. There was considerable heterogeneity in study design, stroke subtypes, ECG assessment-time, control groups and comparison groups. Nine studies reported a significant association between acute stroke and baseline QTd. Two studies reported that QTd increases are specifically related to hemorrhagic strokes, involvement of the insular cortex, right-side lesions, larger strokes, and increases in 3, 4-dihydroxyphenylethylene glycol in hemorrhagic stroke. Three studies reported QTd to be an independent predictor of stroke mortality. One study each reported increases in QTd in stroke patients who developed ventricular arrhythmias and cardiorespiratory compromise. Conclusions There are few well-designed studies and considerable variability in study design in addressing the significance of QTd in acute stroke. Available data suggest that stroke is likely to be associated with increased QTd. While some evidence suggests a possible prognostic role of QTd in stroke, larger and well-designed studies need to confirm these findings. PMID:25282188

  14. Factors associated with self-assessed increase in tobacco consumption among over-indebted individuals in Germany: a cross-sectional study

    PubMed Central

    2013-01-01

    Background Over-indebtedness is an increasing phenomenon in industrialised nations causing individual hardship and societal problems. Nonetheless, few studies have explored smoking among over-indebted individuals. Methods A cross-sectional survey (n=949) on retrospectively assessed changes in tobacco consumption was carried out in 2006 and 2007 among clients of 84 officially approved debt and insolvency counselling centres in Germany (response rate 39.7%). Logistic regressions were performed to explore factors associated with reports of increased smoking after onset of over-indebtedness. Results 63% of all respondents stated daily or occasional tobacco consumption. Almost one fifth reported an increase in smoking after becoming over-indebted. Females were less likely to report increased smoking than men (aOR 0.66, 95% CI 0.44-0.99) whereas respondents who had been over-indebted for more than 10 years were more likely to report increased smoking than those who had been over-indebted for less than five years (aOR 1.66; 95%-CI 1.00-2.76). The odds of increased smoking were also elevated among those who reported that their families and friends had withdrawn from them as a consequence of their over-indebtedness (aOR 1.82; 95%-CI 1.06-3.14). Conclusions The study identifies over-indebted individuals and particularly over-indebted men as a high-risk group of smokers. Low levels of social embeddedness/support were associated with a further increase in smoking after becoming over-indebted. Given recent increases of over-indebtedness, the findings highlight the need to develop appropriate public health policies. PMID:23497337

  15. A review of routinely collected data studies in urology: Methodological considerations, reporting quality, and future directions.

    PubMed

    Welk, Blayne; Kwong, Justin

    2017-01-01

    Studies using routinely collected data (RCD) are common in the urological literature; however, there are important considerations in the creation and review of RCD discoveries. A recent reporting guideline (REporting of studies Conducted using Observational Routinely-collected health Data, RECORD) was developed to improve the reporting of these studies. This narrative review examines important considerations for RCD studies. To assess the current level of reporting in the urological literature, we reviewed all the original research articles published in Journal of Urology and European Urology in 2014, and determined the proportion of the RECORD checklist items that were reported for RCD studies. There were 56 RCD studies identified among the 608 articles. When the RECORD items were considered applicable to the specific study, they were reported in 52.5% of cases. Studies most consistently (>80% of them) reported the names of the data sources, the study time frame, the extent to which the authors could access the database source, the patient selection, and discussed missing data. Few studies (<25%) discussed validation of key coding elements, details on data-linkage, data-cleaning, the impact of changing eligibility over time, or provided the complete list of coding elements used to define key study variables. Reporting factors specifically relevant in RCD studies may serve to increase the quality of these studies in the urological literature. With increased technological integration in healthcare and the proliferation of electronic medical records, RCD will continue to be an important source for urological research.

  16. Reasons for recent marijuana use in relation to use of other illicit drugs among high school seniors in the United States.

    PubMed

    Palamar, Joseph J; Griffin-Tomas, Marybec; Kamboukos, Dimitra

    2015-01-01

    Studies show that illicit cannabis (marijuana) use is related to use of other illicit drugs and that reasons for use are related to frequency of marijuana use. However, research is needed to examine whether specific reasons for marijuana use are associated with use of other illicit drugs. Data from recent marijuana-using high school seniors were examined from 12 cohorts of Monitoring the Future (Weighted n = 6481) to examine whether reasons for recent marijuana use are associated with use of eight other illicit drugs. Using "to experiment" decreased odds of reporting use of each drug and using to decrease effects of other drugs increased odds of reporting use of each drug. In multivariable models, using marijuana "to experiment" decreased the odds for reporting use of hallucinogens other than LSD and narcotics other than heroin. Using marijuana for "insight" increased the odds for use of hallucinogens other than LSD, and use due to "boredom" increased the odds for reporting use of powder cocaine and hallucinogens other than LSD. Using marijuana to increase effects of other drugs increased odds of reporting use of each of the eight drugs, and using it to decrease other drug effects increased odds of reporting use of crack, hallucinogens other than LSD, and amphetamine/stimulants. This study helped identify illicit marijuana users who are more likely to report use of other illicit drugs. Prevention efforts need to focus on students who report certain reasons for marijuana use as they may be at risk for use of other illicit drugs.

  17. Innovation to motivation--pilot study of a mobile phone intervention to increase physical activity among sedentary women.

    PubMed

    Fukuoka, Yoshimi; Vittinghoff, Eric; Jong, So Son; Haskell, William

    2010-01-01

    This uncontrolled pilot study assessed changes in pedometer-measured step counts and self-reported physical activity during a 3-week mobile phone-based intervention. We also explored whether age, BMI, and psychosocial factors were associated with changes in step counts. Forty-one sedentary adult women in San Francisco, California were asked to report their pedometer steps using a study-supplied mobile phone from June to September 2008. In the second and third weeks, daily prompts delivered by the mobile phone encouraged participants to increase steps by 20% from the previous week. Mean age was 48 years. Average daily total steps increased by approximately 800 or 15% over three weeks (p<0.001). Lower BMI, no antidepressant use, and lower self-reported health status were associated with higher step counts at baseline. Improvements in self-reported will-power were associated with increases in step counts (p<0.001). Neither age (p=0.55) nor BMI (p=0.13) was significantly associated with changes in activity over the 3 weeks. The intervention appeared to motivate sedentary women to increase their physical activity. A randomized controlled clinical trial is warranted and feasible. Copyright © 2010 Elsevier Inc. All rights reserved.

  18. The influence of media reporting of the suicide of a celebrity on suicide rates: a population-based study.

    PubMed

    Cheng, Andrew T A; Hawton, Keith; Lee, Charles T C; Chen, Tony H H

    2007-12-01

    The impact of media reporting of suicides of entertainment celebrities may affect suicide rates due to an imitation effect. We investigated the impact on suicides of the media reporting of the suicide of a male television celebrity. All suicides during 2003-2005 in Taiwan (n = 10,945) were included in this study. A Poisson time series autoregression analysis was conducted to examine whether there was an increase in suicides during the 4-week period after extensive media reporting of the celebrity suicide. After controlling for seasonal variation, calendar year, temperature, humidity and unemployment rate, there was a marked increase in the number of suicides during the 4-week period after media reporting (relative risk = 1.17, 95% CI 1.04-1.31). The increase was in men (relative risk = 1.30, 95% CI 1.14-1.50) and for the individuals using the same highly lethal method (hanging) as the TV actor did (relative risk = 1.51, 95% CI 1.25-1.83). However, the age groups in which the increase occurred were younger than the age of the celebrity. The extensive media reporting of the celebrity suicide was followed by an increase in suicides with a strong implication of a modelling effect. The results provide further support for the need for more restrained reporting of suicides as part of suicide prevention strategies to decrease the imitation effect.

  19. Sex-specific association between serum uric acid and self-reported snoring in rural China: a cross-sectional study.

    PubMed

    Wang, Haoyu; Li, Zhao; Chen, Yintao; Ye, Ning; Wang, Pengbo; Sun, Yingxian

    2017-12-01

    Until now, information has been rare on the association of serum uric acid (SUA) with self-reported snoring. Therefore, the purpose of this study was to explore the sex-specific relationship between SUA and self-reported snoring in a general Chinese population. A large cross-sectional study of 10,912 participants aged ≥35 years old were recruited from rural areas of Liaoning Province in China during 2012 to 2013. SUA were divided into quartiles separated for males and females. Anthropometric measurements and blood biochemical indexes were examined according to standard protocols. Sleep duration and self-reported snoring status were investigated by trained personnel using a structured questionnaire. The prevalence of self-reported snoring was 37.9% (n = 2197) among females and 47.4% (n = 2420) among males, respectively. The proportion of self-reported snoring presented a significant linear increase across the quartile of SUA level in both sexes. In multivariate logistic regression analysis adjusted for possible confounders, the odds ratio (OR) for SUA with regard to self-reported snoring was significantly higher in females. The OR of self-reported snoring associated with per 1 SD increase in SUA was 1.208 (95%CI 1.118-1.305, P<0.001). The highest quartile of SUA (>293 μmol/L) conferred an independently increased risk for self-reported snoring with OR of 1.643 (95%CI 1.384-1.950, p < 0.001) compared to the lowest quartile of SUA (<209 μmol/L). However, there were no significant relationships between SUA and self-reported snoring among males in all the models. Our study showed that in rural China, SUA was positively correlated with an increased risk for self-reported snoring in females but not in males. The strong association of SUA levels with self-reported snoring in females emphasizes the necessity of stratifying the sex in investigations of self-reported snoring and encourages exploration of SUA as an effective clinical tool of self-reported snoring risk.

  20. [Neurological sciences based on evidence].

    PubMed

    Ceballos, C; Almárcegui, C; Artal, A; García-Campayo, J; Valdizán, J R

    An exhaustive search of reported metanalysis from any medical speciality is described. Search of papers included in MEDLINE or EMBASE between 1973-1998. A descriptive analysis of the reported papers (frequency tables and graphics) is described, including differences of mean of reported metanalysis papers by medical speciality and year. 1,514 papers were selected and classified. Between 1977-1987 overall mean of reported studies of neurologic metanalysis (1.20 +/- 1.10) was significatively inferior to the 1988-1998 (11.20 +/- 7.85) (p < 0.001). Global number of neurologic metanalysis was positively correlated (p < 0.05) with the number of studies about fundamentals and methodology during the study period. A progressive increase in the number of reported neurologic metanalysis since 1977 can be demonstrated. Diffusion of knowledge about fundamentals and methodology of metanalysis seems to have drawn and increase in performing and reporting this kind of analysis.

  1. Changes in the prevalence of vocal symptoms among teachers during a twelve-year period.

    PubMed

    Simberg, Susanna; Sala, Eeva; Vehmas, Kirsti; Laine, Anneli

    2005-03-01

    Vocal symptoms and voice disorders among teachers were studied in 1988 using a questionnaire designed to obtain information on six vocal symptoms that had appeared during the past 2 years. Twelve percent of the 478 respondents reported vocal symptoms occurring weekly or more often. The study was repeated using the same questionnaire in 2001. The results of this second study (n=241) indicate that vocal symptoms had increased considerably. Twenty-nine percent of the teachers reported symptoms occurring weekly or more often, and 20% reported two symptoms or more occurring at least once a week, which is significantly more than in 1988. Accordingly, voice disorders are probably a growing problem among teachers. Several factors may explain these increases. In 2001, the teachers complained more often about increases in the size of their classes. Factors that disturbed normal work routines, such as noisy or misbehaving pupils, had also increased significantly. A growing number of misbehaving pupils probably cause increased background noise and stress and, thus, increase the vocal symptoms in teachers.

  2. Understanding Ecological Factors Associated With Bullying Across the Elementary to Middle School Transition in the United States.

    PubMed

    Espelage, Dorothy L; Hong, Jun Sung; Rao, Mrinalini A; Thornberg, Robert

    2015-01-01

    This study examines sociodemographic characteristics and social-environmental factors associated with bullying during the elementary to middle school transition from a sample of 5th-grade students (n = 300) in 3 elementary schools at Time 1. Of these, 237 participated at Time 2 as 6th-grade students. Using cluster analyses, we found groups of students who reported no increase in bullying, some decrease in bullying, and some increase in bullying. Students who reported increases in bullying also reported decreases in school belongingness and teacher affiliation and increases in teacher dissatisfaction. Students who reported decreases in bullying also reported decreases in victimization. These findings suggest that changes across the transition in students' relations to school and their teachers are predictive of changes in bullying.

  3. Diesel engine performance and emissions with fuels derived from waste tyres.

    PubMed

    Verma, Puneet; Zare, Ali; Jafari, Mohammad; Bodisco, Timothy A; Rainey, Thomas; Ristovski, Zoran D; Brown, Richard J

    2018-02-06

    The disposal of waste rubber and scrap tyres is a significant issue globally; disposal into stockpiles and landfill poses a serious threat to the environment, in addition to creating ecological problems. Fuel production from tyre waste could form part of the solution to this global issue. Therefore, this paper studies the potential of fuels derived from waste tyres as alternatives to diesel. Production methods and the influence of reactor operating parameters (such as reactor temperature and catalyst type) on oil yield are outlined. These have a major effect on the performance and emission characteristics of diesel engines when using tyre derived fuels. In general, tyre derived fuels increase the brake specific fuel consumption and decrease the brake thermal efficiency. The majority of studies indicate that NOx emissions increase with waste tyre derived fuels; however, a few studies have reported the opposite trend. A similar increasing trend has been observed for CO and CO 2 emissions. Although most studies reported an increase in HC emission owing to lower cetane number and higher density, some studies have reported reduced HC emissions. It has been found that the higher aromatic content in such fuels can lead to increased particulate matter emissions.

  4. A mixed method pilot study: the researchers' experiences.

    PubMed

    Secomb, Jacinta M; Smith, Colleen

    2011-08-01

    This paper reports on the outcomes of a small well designed pilot study. Pilot studies often disseminate limited or statistically meaningless results without adding to the body knowledge on the comparative research benefits. The design a pre-test post-test group parallel randomised control trial and inductive content analysis of focus group transcripts was tested specifically to increase outcomes in a proposed larger study. Strategies are now in place to overcome operational barriers and recruitment difficulties. Links between the qualitative and quantitative arms of the proposed larger study have been made; it is anticipated that this will add depth to the final report. More extensive reporting on the outcomes of pilot studies would assist researchers and increase the body of knowledge in this area.

  5. Effect of Couples Counselling on Reported HIV Risk Behaviour among HIV Serodiscordant Couples by ART Use, HIV Status and Gender in Rural Uganda

    PubMed Central

    King, Rachel; Min, Jeong; Birungi, Josephine; Nyonyintono, Maureen; Muldoon, Katherine A.; Khanakwa, Sarah; Kaleebu, Pontiano; Moore, David M.

    2015-01-01

    Background We examined several measures of self-reported HIV risk behaviour in mutually disclosed sero-discordant couples over time to see if a couples counselling intervention was associated with changes in these behaviors. Methods We analysed data from a prospective cohort study of HIV sero-discordant couples in Jinja, Uganda collected between June 2009 and December 2011. Participants received couples counselling, at 3-monthly intervals. We examined trends in reported condom-use, number of concurrent sexual partners, knowledge of HIV serostatus of concurrent partners and condom use of concurrent partners using Generalized Estimating Equation models, comparing responses at study enrollment with responses at six, 12 18 and 24 months of follow-up. Results A total of 586 couples were enrolled and the female member was HIV positive in 255 (44%) of them. The median age for female participants was 35 years and 42 years for men. Reported condom use at last sex with spouse increased over time (p<0.001) with the largest increases found among couples where the positive participant never received ART during the study(an increase from 68.8% at enrollment to 97.1% at 24 months). Male participants reported reductions in the number of concurrent sexual partners (p<0.001), increase in the knowledge of the HIV serostatus of these partners (p = 0.001) and a trend towards improved condom-use among non-primary partners (p = 0.070). Reported reduced risky behaviors did not wane over the study period. Conclusion Couples counselling resulted in increased condom use among all participants and among men the intervention resulted in reductions in risk behaviour with concurrent sexual partners. Routine counselling for serodiscordant couples should be integrated in routine ART care programs. PMID:26384103

  6. Mean-level personality development across childhood and adolescence: a temporary defiance of the maturity principle and bidirectional associations with parenting.

    PubMed

    Van den Akker, Alithe L; Deković, Maja; Asscher, Jessica; Prinzie, Peter

    2014-10-01

    In this study, we investigated mean-level personality development in children from 6 to 20 years of age. Additionally, we investigated longitudinal, bidirectional associations between child personality and maternal overreactive and warm parenting. In this 5-wave study, mothers reported on their child's personality from Time 1 (T1) through Time 4 (T4), and children provided self-reports from Time 2 (T2) through Time 5 (T5). Mothers reported on their levels of overreactive and warm parenting from T2 through T4. Using cohort-sequential latent growth curve modeling, we investigated mother reported child personality from 6 to 17 years of age and child reported personality from 9 to 20 years of age. Extraversion decreased linearly across the entire study. Benevolence and conscientiousness increased from middle to late childhood, temporarily declined from late childhood to mid-adolescence, and increased again thereafter. Imagination decreased from middle childhood to mid-adolescence and also increased thereafter. Mothers reported a temporary decline in emotional stability with an increase thereafter, whereas children did not. Boys and girls differed in mean-levels of the personality dimensions and, to a lesser extent, in the degree and direction of changes. Latent difference score modeling showed that child personality predicted changes in parenting and that, to a lesser extent, parenting predicted changes in child traits. Additionally, changes in child personality were associated with changes in maternal parenting. Results of the present study show that personality change is not directed at increasing maturity from childhood to mid-adolescence and that it elicits and is shaped by both positive and negative parenting. 2014 APA, all rights reserved

  7. Reduction of fibromyalgia symptoms through intravenous nutrient therapy: results of a pilot clinical trial.

    PubMed

    Massey, Patrick B

    2007-01-01

    To evaluate the effectiveness of a modified Myers' formula of intravenous nutrient therapy (IVNT) on the symptoms of fibromyalgia (FM) in therapy-resistant FM patients. In this pilot clinical trial, 7 participants with therapy resistant FM were given IVNT once per week for 8 weeks. Patient's pain levels, fatigue, and activities of daily living were evaluated weekly. All participants reported decreased pain levels, decreased fatigue, and increased activities of daily living. Participants noted increased energy levels within 24-48 hours of the initial infusion. At the end of the study, all participants reported increased energy and activities of daily living as well as a 60% reduction in pain (P=.005) and an 80% decrease in fatigue (P=-.005). No participants, however, reported complete or lasting resolution of pain or fatigue. No side effects were reported. Anecdotal reports have indicated benefit for IVNT for patients with chronic pain, including FM. However, except for 2 reports, the medical literature is devoid of any studies of IVNT for the treatment of FM. In this pilot study, 7 participants received IVNT once a week for 8 weeks. All participants had long-standing FM (at least 8 years) and had tried conventional therapies, such as antidepressants, nonsteroidal anti-inflammatory drugs, and exercise, without significant or lasting relief. All had improvement in symptoms and increases in their activities of daily living, although no participant reported complete resolution of symptoms. IVNT appears to be safe to reduce FM symptoms.

  8. Are recreational SCUBA divers with asthma at increased risk?

    PubMed

    Ustrup, Amalie S; Ulrik, Charlotte S

    2017-10-01

    Asthma has traditionally been regarded as a contraindication to self-contained underwater breathing apparatus (SCUBA) diving, although large numbers of patients with asthma dive. The aim of the review is to provide an update on current knowledge on potential disease-related hazards in SCUBA divers with asthma. Systematic literature review based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Seven studies met the criteria for inclusion in the review (comprising a total of 560 subjects). Five studies reported an increased risk for developing diving-related injuries in divers with asthma, based on case reports (n = 1), case history combined with objective assessment (n = 1), and dives and/or simulated dives (n = 3). The remaining studies (n = 2) were based on self-reported diving habits in divers suffering from asthma, obtained from anonymous questionnaires in diving magazines, reported no diving-related injuries among respondents. Due to limited evidence it is difficult to draw valid conclusions, but there are indications that recreational divers with asthma may be at increased risk for diving-related injuries compared to non-asthmatic divers. However, it is of at most importance to obtain further evidence from large-scale, well-designed studies.

  9. Steroidal contraceptives and bone fractures in women: evidence from observational studies.

    PubMed

    Lopez, Laureen M; Chen, Mario; Mullins Long, Sarah; Curtis, Kathryn M; Helmerhorst, Frans M

    2015-07-21

    Age-related decline in bone mass increases the risk of skeletal fractures, especially those of the hip, spine, and wrist. Steroidal contraceptives have been associated with changes in bone mineral density in women. Whether such changes affect the risk of fractures later in life is unclear. Hormonal contraceptives are among the most effective and most widely-used contraceptives. Concern about fractures may limit the use of these effective contraceptives. Observational studies can collect data on premenopausal contraceptive use as well as fracture incidence later in life. We systematically reviewed the evidence from observational studies of hormonal contraceptive use for contraception and the risk of fracture in women. Through June 2015, we searched for observational studies. The databases included PubMed, POPLINE, Cochrane Central Register of Controlled Trials (CENTRAL), LILACS, EMBASE, CINAHL, and Web of Science. We also searched for recent clinical trials through ClinicalTrials.gov and the ICTRP. For other studies, we examined reference lists of relevant articles and wrote to investigators for additional reports. We included cohort and case-control studies of hormonal contraceptive use. Interventions included comparisons of a hormonal contraceptive with a non-hormonal contraceptive, no contraceptive, or another hormonal contraceptive. The primary outcome was the risk of fracture. Two authors independently extracted the data. One author entered the data into RevMan, and a second author verified accuracy. We examined the quality of evidence using the Newcastle-Ottawa Quality Assessment Scale (NOS), developed for case-control and cohort studies. Sensitivity analysis included studies of moderate or high quality based on our assessment with the NOS.Given the need to control for confounding factors in observational studies, we used adjusted estimates from the models as reported by the authors. Where we did not have adjusted analyses, we calculated the odds ratio (OR) with 95% confidence interval (CI). Due to varied study designs, we did not conduct meta-analysis. We included 14 studies (7 case-control and 7 cohort studies). These examined oral contraceptives (OCs), depot medroxyprogesterone acetate (DMPA), and the hormonal intrauterine device (IUD). This section focuses on the sensitivity analysis with six studies that provided moderate or high quality evidence.All six studies examined oral contraceptive use. We noted few associations with fracture risk. One cohort study reported OC ever-users had increased risk for all fractures (RR 1.20, 95% CI 1.08 to 1.34). However, a case-control study with later data from a subset reported no association except for those with 10 years or more since use (OR 1.55, 95% CI 1.03 to 2.33). Another case-control study reported increased risk only for those who had 10 or more prescriptions (OR 1.09, 95% CI 1.03 to 1.16). A cohort study of postmenopausal women found no increased fracture risk for OC use after excluding women with prior fracture. Two other studies found little evidence of association between OC use and fracture risk. A cohort study noted increased risk for subgroups, such as those with longer use or specific intervals since use. A case-control study reported increased risk for any fracture only among young women with less than average use.Two case-control studies also examined progestin-only contraceptives. One reported increased fracture risk for DMPA ever-use (OR 1.44, 95% CI 1.01 to 2.06), more than four years of use (OR 2.16, 95% CI 1.32 to 3.53), and women over 50 years old. The other reported increased risk for any past use, including one or two prescriptions (OR 1.17, 95% CI 1.07 to 1.29) and for current use of 3 to 9 prescriptions (OR 1.36, 95% CI 1.15 to 1.60) or 10 or more (OR 1.54, 95% CI 1.33 to 1.78). For the levonorgestrel-releasing IUD, one study reported reduced fracture risk for ever-use (OR 0.75, 95% CI 0.64 to 0.87) and for longer use. Observational studies do not indicate an overall association between oral contraceptive use and fracture risk. Some reported increased risk for specific user subgroups. DMPA users may have an increased fracture risk. One study indicated hormonal IUD use may be associated with decreased risk. Observational studies need adjusted analysis because the comparison groups usually differ. Investigators should be clear about the variables examined in multivariate analysis.

  10. Seizures and Epilepsy in Alzheimer’s Disease

    PubMed Central

    Friedman, Daniel; Honig, Lawrence S.; Scarmeas, Nikolaos

    2013-01-01

    Introduction Many studies have shown that patients with Alzheimer’s disease (AD) are at increased risk for developing seizures and epilepsy. However, reported prevalence and incidence of seizures and relationship of seizures to disease measures such as severity, outcome and progression vary widely between studies. Methods Literature review of the available clinical and epidemiological data on the topic of seizures in patients with AD. We review seizure rates and types, risk factors for seizures, electroencephalogram (EEG)studies, and treatment responses. Finally, we consider limitations and methodological issues. Results There is considerable variability in the reported prevalence and incidence of seizures in patients with AD - with reported lifetime prevalence rates of 1.5 - 64%. More recent, prospective, and larger studies in general report lower rates. Some, but not all, studies have noted increased seizure risk with increasing dementia severity or with younger age of AD onset. Generalized convulsive seizures are the most commonly reported type, but often historical information is the only basis used to determine seizure type and the manifestation of seizures may be difficult to distinguish from other behaviors common in demented patients. EEG has infrequently been performed and reported. Data on treatment of seizures in AD are extremely limited. Similarly, the relationship between seizures and cognitive impairment in AD is unclear. Conclusions The literature on seizures and epilepsy in AD, including diagnosis, risk factors, and response to treatment suffers from methodological limitations and gaps. PMID:22070283

  11. Heat treatment of organics for increasing anaerobic biodegradability. Annual progress report, June 1, 1976-May 31, 1977. Civil engineering technical report No. 222

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

    Healy, J.B. Jr.; Owen, W.F.; Stuckey, D.C.

    1977-06-30

    This report represents the results of the first year of study on the heat treatment of organics to increase its biodegradability by anaerobic bacteria for the microbial production of methane. The purpose of this study is to develop a means for increasing the yield and reducing the cost of methane, a useful energy source. The procedures being evaluated are heat treatment at temperatures up to 250/sup 0/C, under pH ranges of 1 to 13. Included in this report are results on: (1) lignocellulose digestion and acclimation to its products from heat treatment; (2) the fate of waste activated sludge andmore » its cellular nitrogenous compounds; and (3) the biodegradability of model compounds likely to be formed during heat treatment.« less

  12. Daily Physical Activity and Hot Flashes in the Study of Women's Health Across the Nation FLASHES Study

    PubMed Central

    Gibson, Carolyn; Matthews, Karen; Thurston, Rebecca

    2014-01-01

    Objective To examine the role of physical activity in menopausal hot flashes. Competing models conceptualize physical activity as a risk or protective factor for hot flashes. Few studies have examined this relationship prospectively using physiologic measures of hot flashes and physical activity. Design Over two 48 hour-periods, 51 participants wore a physiologic hot flash monitor and activity monitor, and reported their hot flashes in an electronic diary. Physiologic hot flashes, reported hot flashes and reported hot flashes without physiological corroboration were related to activity changes using hierarchical generalized linear modeling, adjusting for potential confounders. Setting Community. Patients Midlife women. Interventions None. Main Outcome Measures Physiologically-detected hot flashes and reported hot flashes with and without physiologic corroboration. Results Hot flash reports without physiologic corroboration were more likely after activity increases (OR 1.04, 95% CI: 1.00-1.10, p=.01), particularly among women with higher levels of depressive symptoms (interaction p=.02). No other types of hot flashes were related to physical activity. Conclusion Acute increases in physical activity were associated with increased reporting of hot flashes lacking physiologic corroboration, particularly among women with depressive symptoms. Clinicians should consider the role of symptom perception and reporting in relations between physical activity and hot flashes. PMID:24491454

  13. Reasons for Recent Marijuana Use in Relation to Use of Other Illicit Drugs among High School Seniors in the United States

    PubMed Central

    Palamar, Joseph J.; Griffin-Tomas, Marybec; Kamboukos, Dimita

    2015-01-01

    Objectives Studies show that illicit cannabis (marijuana) use is related to use of other illicit drugs and that reasons for use are related to frequency of marijuana use. However, research is needed to examine whether specific reasons for marijuana use are associated with use of other illicit drugs. Methods Data from recent-marijuana-using high school seniors were examined from 12 cohorts of Monitoring the Future (Weighted N=6,481) to examine whether reasons for recent marijuana use are associated with use of eight other illicit drugs. Results Using “to experiment” decreased odds of reporting use of each drug and using to decrease effects of other drugs increased odds of reporting use of each drug. In multivariable models, using marijuana “to experiment” decreased the odds for reporting use of hallucinogens other than LSD and narcotics other than heroin. Using marijuana for “insight” increased the odds for use of hallucinogens other than LSD, and use due to “boredom” increased the odds for reporting use of powder cocaine and hallucinogens other than LSD. Using marijuana to increase effects of other drugs increased odds of reporting each of the eight drugs, and using it to decrease other drug effects increased odds of reporting use of crack, hallucinogens other than LSD, and amphetamine/stimulants. Conclusions This study helped identify illicit marijuana users who are more likely to report use of other illicit drugs. Prevention efforts need to focus on students who report certain reasons for marijuana use as they may be at risk for use of other illicit drugs. PMID:26115351

  14. Standard of treatment and outcomes of adults with lupus nephritis in Africa: a systematic review.

    PubMed

    Ameh, O I; Kengne, A P; Jayne, D; Bello, A K; Hodkinson, B; Gcelu, A; Okpechi, I G

    2016-10-01

    Lupus nephritis (LN) is a significant cause of mortality and morbidity in patients with systemic lupus erythematosus (SLE) and the severity of disease has been described to be increased in Africans. Observational studies have been conducted; however, the treatment and outcome of African patients with LN has not been rigorously assessed. We conducted a systematic review of studies selected from a PubMed search of outcome in Africans with biopsy-proven LN from 1 January 1990 to 30 June 2015. Studies that gave information on histology, treatment and outcome of patients were included. Sixteen studies were selected from a search that yielded 302 papers; half were from North Africa, 2/16 (12.5%) were prospective studies and 2/16 (12.5%) were multi-centre studies. The sample size of reported biopsies in the studies ranged from 22 to 246 patients. Only 3/16 (18.8%) studies used more recent criteria for the classification and reporting of renal histology, and proliferative LN (class III and IV) were reported with increased frequency from the studies. For induction therapy, all the studies reported use of corticosteroids while 15/16 (93.8%) of the studies also used cyclophosphamide (CYC) as an induction agent. Overall mortality rates ranged from 7.9% to 34.9% with increased disease activity, kidney failure and infections cited as common causes of mortality. Five-year renal survival was 48-84% while five-year patient survival was 54%-94%. Survival rates were higher for studies reported from North Africa. This analysis highlights diagnostic challenges in LN in Africa and shows that a CYC/glucocorticoid-based regimen remains the standard of treatment for adult patients. The contributions of this therapy to reported outcomes of LN in Africa require further exploration. © The Author(s) 2016.

  15. Confidence crisis of results in biomechanics research.

    PubMed

    Knudson, Duane

    2017-11-01

    Many biomechanics studies have small sample sizes and incorrect statistical analyses, so reporting of inaccurate inferences and inflated magnitude of effects are common in the field. This review examines these issues in biomechanics research and summarises potential solutions from research in other fields to increase the confidence in the experimental effects reported in biomechanics. Authors, reviewers and editors of biomechanics research reports are encouraged to improve sample sizes and the resulting statistical power, improve reporting transparency, improve the rigour of statistical analyses used, and increase the acceptance of replication studies to improve the validity of inferences from data in biomechanics research. The application of sports biomechanics research results would also improve if a larger percentage of unbiased effects and their uncertainty were reported in the literature.

  16. Impact of the 2008 economic and financial crisis on child health: a systematic review.

    PubMed

    Rajmil, Luis; Fernandez de Sanmamed, María-José; Choonara, Imti; Faresjö, Tomas; Hjern, Anders; Kozyrskyj, Anita L; Lucas, Patricia J; Raat, Hein; Séguin, Louise; Spencer, Nick; Taylor-Robinson, David

    2014-06-01

    The aim of this study was to provide an overview of studies in which the impact of the 2008 economic crisis on child health was reported. Structured searches of PubMed, and ISI Web of Knowledge, were conducted. Quantitative and qualitative studies reporting health outcomes on children, published since 2007 and related to the 2008 economic crisis were included. Two reviewers independently assessed studies for inclusion. Data were synthesised as a narrative review. Five hundred and six titles and abstracts were reviewed, from which 22 studies were included. The risk of bias for quantitative studies was mixed while qualitative studies showed low risk of bias. An excess of 28,000-50,000 infant deaths in 2009 was estimated in sub-Saharan African countries, and increased infant mortality in Greece was reported. Increased price of foods was related to worsening nutrition habits in disadvantaged families worldwide. An increase in violence against children was reported in the U.S., and inequalities in health-related quality of life appeared in some countries. Most studies suggest that the economic crisis has harmed children's health, and disproportionately affected the most vulnerable groups. There is an urgent need for further studies to monitor the child health effects of the global recession and to inform appropriate public policy responses.

  17. Impact of the 2008 Economic and Financial Crisis on Child Health: A Systematic Review

    PubMed Central

    Rajmil, Luis; Fernandez de Sanmamed, María-José; Choonara, Imti; Faresjö, Tomas; Hjern, Anders; Kozyrskyj, Anita L.; Lucas, Patricia J.; Raat, Hein; Séguin, Louise; Spencer, Nick; Taylor-Robinson, David

    2014-01-01

    The aim of this study was to provide an overview of studies in which the impact of the 2008 economic crisis on child health was reported. Structured searches of PubMed, and ISI Web of Knowledge, were conducted. Quantitative and qualitative studies reporting health outcomes on children, published since 2007 and related to the 2008 economic crisis were included. Two reviewers independently assessed studies for inclusion. Data were synthesised as a narrative review. Five hundred and six titles and abstracts were reviewed, from which 22 studies were included. The risk of bias for quantitative studies was mixed while qualitative studies showed low risk of bias. An excess of 28,000–50,000 infant deaths in 2009 was estimated in sub-Saharan African countries, and increased infant mortality in Greece was reported. Increased price of foods was related to worsening nutrition habits in disadvantaged families worldwide. An increase in violence against children was reported in the U.S., and inequalities in health-related quality of life appeared in some countries. Most studies suggest that the economic crisis has harmed children’s health, and disproportionately affected the most vulnerable groups. There is an urgent need for further studies to monitor the child health effects of the global recession and to inform appropriate public policy responses. PMID:25019121

  18. The agreement between self-reported cervical smear abnormalities and screening programme records.

    PubMed

    Canfell, Karen; Beral, Valerie; Green, Jane; Cameron, Rebecca; Baker, Krys; Brown, Anna

    2006-01-01

    The Million Women Study is a cohort study of women aged 50-64 years in England and Scotland. As a component of the follow-up questionnaire, participants were asked to indicate if they had an abnormal cervical smear in the previous five years. This study compared self-reported cervical abnormalities with screening records obtained from the National Health Service Cervical Screening Programme. For 1944 randomly selected Million Women Study participants in Oxfordshire, screening records were assessed over a six-year period prior to the date of self-reporting. The six-year period was chosen to allow for errors in the recall of timing of abnormal smears. A total of 68 women (3.5%) had a record of at least one equivocal or abnormal smear within the last six years, whereas 49 women (2.5%) self-reported an abnormality. There was a strong trend for an increased probability of self-reporting a history of an abnormal smear as the severity of the recorded abnormality increased (P <0.001). For women with an NHS record of borderline dyskaryosis, mild dyskaryosis, or moderate dyskaryosis/severe dyskaryosis/invasive cancer, the proportions reporting an abnormality were 40%, 58% and 77%, respectively. For women with negative and inadequate smears, the proportion self-reporting an abnormality were 0.6% and 0.7%, respectively. These results indicate that among women whose screening programme records show an abnormal smear, the proportion self-reporting an abnormality increases with the severity of the recorded lesion. Almost all women with a record of negative or inadequate smear(s) correctly interpret the result and do not self-report an abnormality.

  19. Dedicated mobile application for drug adverse reaction reporting by patients with relapsing remitting multiple sclerosis (Vigip-SEP study): study protocol for a randomized controlled trial.

    PubMed

    Defer, Gilles; Le Caignec, Florian; Fedrizzi, Sophie; Montastruc, François; Chevanne, Damien; Parienti, Jean-Jacques; Peyro-Saint-Paul, Laure

    2018-03-09

    The reporting of adverse drug reactions (ADR) by patients represents an interesting challenge in the field of pharmacovigilance, but the reporting system is not adequately implemented in France. In 2015, only 20 MS patients in France reported ADR due to first-line disease-modifying drugs (DMD), while more than 3000 patients were initiated on DMD. The aim of this study is to validate a proof-of-concept as to whether the use of a mobile application (App) increases ADR reporting among patients with relapsing-remitting multiple sclerosis (RR-MS) receiving DMD. We designed a multi-centric, open cluster-randomized controlled trial, called the Vigip-SEP study (NCT03029897), using the App My eReport France® to report ADR to the appropriate authorities in E2B language, in accordance with European regulations. RR-MS patients who were initiated on, or switched, first-line DMD will be included. In the experimental arm, a neurologist will introduce the patient to the App to report ADR to the appropriate French authorities. In the control arm, the patient will be informed of the existence of the App but will not be introduced to its use and will then report ADR according to the usual reporting procedures. Primary assessment criteria are defined as the average number of ADR per patient and per center. We assume that the App will increase patient reporting by 10-fold. Therefore, we will require 24 centers (12 per arm: 6 MS academic expert centers, 3 general hospitals, 3 private practice neurologists), allowing for an expected enrollment of 180 patients (alpha risk 5%, power 90% and standard deviation 4%). Increasing patient reporting of ADR in a real-life setting is extremely important for therapeutic management of RR-MS, particularly for monitoring newly approved DMD to gain better knowledge of their safety profiles. To increase patient involvement, teaching patients to use tools, such as mobile applications, should be encouraged, and these tools should be tested rigorously. ClinicalTrials.gov , ID: NCT03029897 . Registered on 20 January 2017.

  20. Intimate partner violence and Hurricane Katrina: predictors and associated mental health outcomes.

    PubMed

    Schumacher, Julie A; Coffey, Scott F; Norris, Fran H; Tracy, Melissa; Clements, Kahni; Galea, Sandro

    2010-01-01

    This study sought to establish the prevalence and correlates of intimate partner violence (IPV) victimization in the 6 months before and after Hurricane Katrina. Participants were 445 married or cohabiting persons who were living in the 23 southernmost counties of Mississippi at the time of Hurricane Katrina. Data for this study were collected as part of a larger, population-based, representative study. The percentage of women reporting psychological victimization increased from 33.6% prior to Hurricane Katrina to 45.2% following Hurricane Katrina (p < .001). The percentage of men reporting psychological victimization increased from 36.7% to 43.1% (p = .01). Reports of physical victimization increased from 4.2% to 8.3% for women (p = .01) but were unchanged for men. Significant predictors of post-Katrina victimization included pre-Katrina victimization, age, educational attainment, marital status, and hurricane-related stressors. Reports of IPV were associated with greater risk of post-Katrina depression and posttraumatic stress disorder. Data from the first population-based study to document IPV following a large-scale natural disaster suggest that IPV may be an important but often overlooked public health concern following disasters.

  1. Despite 2007 law requiring FDA hotline to be included in print drug ads, reporting of adverse events by consumers still low.

    PubMed

    Du, Dongyi; Goldsmith, John; Aikin, Kathryn J; Encinosa, William E; Nardinelli, Clark

    2012-05-01

    In 2007 the federal government began requiring drug makers to include in their print direct-to-consumer advertisements information for consumers on how to contact the Food and Drug Administration directly, either by phone or through the agency's website, to report any adverse events that they experienced after taking a prescription drug. Adverse events can range from minor skin problems like itching to serious injuries or illness that result in hospitalization, permanent disability, or even death. Even so, current rates of adverse event reporting are low. We studied adverse event reports about 123 drugs that came from patients before and after the enactment of the print advertising requirement and estimated that requirement's impact with model simulations. We found that if monthly spending on print direct-to-consumer advertising increased from zero to $7.7 million per drug, the presence of the Food and Drug Administration contact information tripled the increase in patient-reported adverse events, compared to what would have happened in the absence of the law. However, the absolute monthly increase was fewer than 0.24 reports per drug, suggesting that the public health impact of the increase was small and that the adverse event reporting rate would still be low. The study results suggest that additional measures, such as more publicity about the Adverse Event Reporting System or more consumer education, should be considered to promote patient reporting of adverse events.

  2. Assessing Changes in Counselor Trainees' Multicultural Competence Related to Service Learning

    ERIC Educational Resources Information Center

    Lee, Debbiesiu L.; Rosen, Adam D.; McWhirter, J. Jeffries

    2014-01-01

    This mixed methods study examined changes in self-reported multicultural competence and distress reactions of 32 counselor trainees engaged in service learning. Whereas 3 trainees significantly increased in self-reported multicultural competence, 5 significantly decreased. Trainees who significantly increased in multicultural competence reported…

  3. Impact of STROBE statement publication on quality of observational study reporting: interrupted time series versus before-after analysis.

    PubMed

    Bastuji-Garin, Sylvie; Sbidian, Emilie; Gaudy-Marqueste, Caroline; Ferrat, Emilie; Roujeau, Jean-Claude; Richard, Marie-Aleth; Canoui-Poitrine, Florence

    2013-01-01

    In uncontrolled before-after studies, CONSORT was shown to improve the reporting of randomised trials. Before-after studies ignore underlying secular trends and may overestimate the impact of interventions. Our aim was to assess the impact of the 2007 STROBE statement publication on the quality of observational study reporting, using both uncontrolled before-after analyses and interrupted time series. For this quasi-experimental study, original articles reporting cohort, case-control, and cross-sectional studies published between 2004 and 2010 in the four dermatological journals having the highest 5-year impact factors (≥ 4) were selected. We compared the proportions of STROBE items (STROBE score) adequately reported in each article during three periods, two pre STROBE period (2004-2005 and 2006-2007) and one post STROBE period (2008-2010). Segmented regression analysis of interrupted time series was also performed. Of the 456 included articles, 187 (41%) reported cohort studies, 166 (36.4%) cross-sectional studies, and 103 (22.6%) case-control studies. The median STROBE score was 57% (range, 18%-98%). Before-after analysis evidenced significant STROBE score increases between the two pre-STROBE periods and between the earliest pre-STROBE period and the post-STROBE period (median score2004-05 48% versus median score2008-10 58%, p<0.001) but not between the immediate pre-STROBE period and the post-STROBE period (median score2006-07 58% versus median score2008-10 58%, p = 0.42). In the pre STROBE period, the six-monthly mean STROBE score increased significantly, by 1.19% per six-month period (absolute increase 95%CI, 0.26% to 2.11%, p = 0.016). By segmented analysis, no significant changes in STROBE score trends occurred (-0.40%; 95%CI, -2.20 to 1.41; p = 0.64) in the post STROBE statement publication. The quality of reports increased over time but was not affected by STROBE. Our findings raise concerns about the relevance of uncontrolled before-after analysis for estimating the impact of guidelines.

  4. Impact of STROBE Statement Publication on Quality of Observational Study Reporting: Interrupted Time Series versus Before-After Analysis

    PubMed Central

    Bastuji-Garin, Sylvie; Sbidian, Emilie; Gaudy-Marqueste, Caroline; Ferrat, Emilie; Roujeau, Jean-Claude; Richard, Marie-Aleth; Canoui-Poitrine, Florence

    2013-01-01

    Background In uncontrolled before-after studies, CONSORT was shown to improve the reporting of randomised trials. Before-after studies ignore underlying secular trends and may overestimate the impact of interventions. Our aim was to assess the impact of the 2007 STROBE statement publication on the quality of observational study reporting, using both uncontrolled before-after analyses and interrupted time series. Methods For this quasi-experimental study, original articles reporting cohort, case-control, and cross-sectional studies published between 2004 and 2010 in the four dermatological journals having the highest 5-year impact factors (≥4) were selected. We compared the proportions of STROBE items (STROBE score) adequately reported in each article during three periods, two pre STROBE period (2004–2005 and 2006–2007) and one post STROBE period (2008–2010). Segmented regression analysis of interrupted time series was also performed. Results Of the 456 included articles, 187 (41%) reported cohort studies, 166 (36.4%) cross-sectional studies, and 103 (22.6%) case-control studies. The median STROBE score was 57% (range, 18%–98%). Before-after analysis evidenced significant STROBE score increases between the two pre-STROBE periods and between the earliest pre-STROBE period and the post-STROBE period (median score2004–05 48% versus median score2008–10 58%, p<0.001) but not between the immediate pre-STROBE period and the post-STROBE period (median score2006–07 58% versus median score2008–10 58%, p = 0.42). In the pre STROBE period, the six-monthly mean STROBE score increased significantly, by 1.19% per six-month period (absolute increase 95%CI, 0.26% to 2.11%, p = 0.016). By segmented analysis, no significant changes in STROBE score trends occurred (−0.40%; 95%CI, −2.20 to 1.41; p = 0.64) in the post STROBE statement publication. Interpretation The quality of reports increased over time but was not affected by STROBE. Our findings raise concerns about the relevance of uncontrolled before-after analysis for estimating the impact of guidelines. PMID:23990867

  5. Vulnerability Risk Index Profile for Elder Abuse in Community-Dwelling Population

    PubMed Central

    Dong, XinQi; Simon, Melissa A.

    2013-01-01

    Objectives Elder abuse is associated with increased morbidity and mortality. This study aims to develop a vulnerability index for elder abuse in a community-dwelling population. Design Population-based study Setting Geographically defined community in Chicago. Participants A population-based study was conducted in Chicago of community-dwelling older adults who participated in the Chicago Health and Aging Project (CHAP). Of the 8,157 participants in the CHAP study, 213 participants were reported to social services agency for suspected elder abuse. Measurements A vulnerability index for elder abuse was constructed from sociodemographic, health-related, and psychosocial factors. The outcomes of interest were reported and confirmed elder abuse. Logistic regression models were used to determine the accuracy of the index with respect to elder abuse outcomes. Results Out of the selected risk index for elder abuse, every one point increase in the 9 item vulnerability index items, there was a two fold increase in the risk for reported elder abuse (OR, 2.19 (2.00–2.40) and confirmed elder abuse (OR, 2.19 (1.94–2.47). Compared to the reference group, older adults with 3–4 vulnerability index items had increased risk for reported elder abuse (OR, 2.98 (1.98–4.49) and confirmed elder abuse (OR, 3.90, (2.07–7.36); and older adults with 5 or more risk index items, there was an 18 fold increase in risk for reported elder abuse (OR, 18.46 (12.15–28.04) and confirmed elder abuse (OR, 26.79 (14.18–50.61). Receiver Operating Characteristic (ROC) statistically derived curves for identifying reported elder abuse ranged between 0.77–0.84 and for predicting confirmed elder abuse ranged between 0.79–0.86. Conclusion The vulnerability risk index demonstrates value for identifying individuals at risk for elder abuse. Additional studies are needed to validate this index in other community dwelling populations. PMID:25180376

  6. Temporal trends in adolescents’ self-reported psychosomatic health complaints from 1980-2016: A systematic review and meta-analysis

    PubMed Central

    Potrebny, Thomas; Wiium, Nora; Lundegård, Margrethe Moss-Iversen

    2017-01-01

    Objective There is increasing concern that mental health may be deteriorating in recent generations of adolescents. It is unclear whether this is the case for self-reported psychosomatic health complaints (PSHC). Method We conducted a systematic review and meta-analysis of published primary studies on PSHC in the general adolescent population over time. The primary databases were MEDLINE, Embase and PsycINFO, which were searched from inception to November 2016. Studies were included if they involved an observational design, presented self-reported data from participants aged 10–19 years and included data from at least two time points, five years apart. Inclusion and study quality were assessed by two independent reviewers. Results Twenty-one studies were included; 18 reported trends on the prevalence of PSHC in a single country, while three studies reported on multiple countries. In total, over seven million adolescents from 36 countries in Europe, North America, Israel and New Zealand were represented, covering the period 1982–2013. In the descriptive analysis, 10 studies indicated a trend of increasing PSHC, eight showed a stable trend and three showed a decreasing trend at certain points in time. The results from the meta-analysis showed a mean odds ratio (OR) of 1.04 (K = 139, 95% CI 1.01–1.08) for PSHC from 1982 to 2013, thus indicating a minor increase in general. In the subgroup analysis, this minor increase was observed mainly between the 1980s and 2000s, while the trend appeared to be more stable between the 2000s and 2010s. Some differences were also found between multinational subregions. Findings from subgroup analysis, however, only supported a significant increasing trend in Northern Europe. Conclusion There may have been a minor increasing trend in adolescent self-rated PSHC between the 1980 and 2000s, but has become more stable since the 2010s, from a multinational perspective. Northern Europe was the only region to show a clearly significant minor increasing trend, without being the region with the highest total prevalence of PSHC at the present time. The discrepant trends regarding PSHC between regions and the reliance on self-reported data may reflect true changes in the occurrence of PSHC in the adolescent population. However, they may also reflect changes in how adolescents perceive and report health complaints. Other PROSPERO registration 2016: CRD42016048300. PMID:29182644

  7. The Role of Protein Kinase-C in Breast Cancer Invasion and Metastasis

    DTIC Science & Technology

    1997-09-01

    relatively new reporter molecule that is being increasingly used in a variety of studies is the green fluorescent protein (GFP) from the jellyfish Aequorea ...Calf Serum GFP Green Fluorescent Protein IHC Immunohistochemistry IRB Institutional Review Board MAPK Mitogen Activated Protein Kinase MMP...and in vivo. A relatively new reporter molecule that is being increasingly used in a variety of studies is the green fluorescent protein (GFP) from

  8. Review Article: Increasing physical activity with point-of-choice prompts--a systematic review.

    PubMed

    Nocon, Marc; Müller-Riemenschneider, Falk; Nitzschke, Katleen; Willich, Stefan N

    2010-08-01

    Stair climbing is an activity that can easily be integrated into everyday life and has positive health effects. Point-of-choice prompts are informational or motivational signs near stairs and elevators/escalators aimed at increased stair climbing. The aim of this review was to assess the effectiveness of point-of-choice prompts for the promotion of stair climbing. In a systematic search of the literature, studies that assessed the effectiveness of point-of-choice prompts to increase the rate of stair climbing in the general population were identified. No restrictions were made regarding the setting, the duration of the intervention, or the kind of message. A total of 25 studies were identified. Point-of-choice prompts were predominantly posters or stair-riser banners in public traffic stations, shopping malls or office buildings. The 25 studies reported 42 results. Of 10 results for elevator settings, only three reported a significant increase in stair climbing, whereas 28 of 32 results for escalator settings reported a significant increase in stair climbing. Overall, point-of-choice prompts are able to increase the rate of stair climbing, especially in escalator settings. In elevator settings, point-of-choice prompts seem less effective. The long-term efficacy and the most efficient message format have yet to be determined in methodologically rigorous studies.

  9. The effect of maternal psychopathology on parent-child agreement of child anxiety symptoms: A hierarchical linear modeling approach.

    PubMed

    Affrunti, Nicholas W; Woodruff-Borden, Janet

    2015-05-01

    The current study examined the effects of maternal anxiety, worry, depression, child age and gender on mother and child reports of child anxiety using hierarchical linear modeling. Participants were 73 mother-child dyads with children between the ages of 7 and 10 years. Reports of child anxiety symptoms, including symptoms of specific disorders (e.g., social phobia) were obtained using concordant versions of the Screen for Anxiety and Related Emotional Disorders (SCARED). Children reported significantly higher levels of anxiety symptoms relative to their mothers. Maternal worry and depression predicted for significantly lower levels of maternal-reported child anxiety and increasing discrepant reports. Maternal anxiety predicted for higher levels of maternal-reported child anxiety and decreasing discrepant reports. Maternal depression was associated with increased child-reported child anxiety symptoms. No significant effect of child age or gender was observed. Findings may inform inconsistencies in previous studies on reporter discrepancies. Implications and future directions are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Voluntary Medication Error Reporting by ED Nurses: Examining the Association With Work Environment and Social Capital.

    PubMed

    Farag, Amany; Blegen, Mary; Gedney-Lose, Amalia; Lose, Daniel; Perkhounkova, Yelena

    2017-05-01

    Medication errors are one of the most frequently occurring errors in health care settings. The complexity of the ED work environment places patients at risk for medication errors. Most hospitals rely on nurses' voluntary medication error reporting, but these errors are under-reported. The purpose of this study was to examine the relationship among work environment (nurse manager leadership style and safety climate), social capital (warmth and belonging relationships and organizational trust), and nurses' willingness to report medication errors. A cross-sectional descriptive design using a questionnaire with a convenience sample of emergency nurses was used. Data were analyzed using descriptive, correlation, Mann-Whitney U, and Kruskal-Wallis statistics. A total of 71 emergency nurses were included in the study. Emergency nurses' willingness to report errors decreased as the nurses' years of experience increased (r = -0.25, P = .03). Their willingness to report errors increased when they received more feedback about errors (r = 0.25, P = .03) and when their managers used a transactional leadership style (r = 0.28, P = .01). ED nurse managers can modify their leadership style to encourage error reporting. Timely feedback after an error report is particularly important. Engaging experienced nurses to understand error root causes could increase voluntary error reporting. Published by Elsevier Inc.

  11. Daily reports of witnessing and experiencing peer harassment in middle school.

    PubMed

    Nishina, Adrienne; Juvonen, Jaana

    2005-01-01

    Two studies examined daily incidents of peer harassment in urban middle schools. Sixth-grade students (M age = 11 years) described their daily personal experiences and witnessed accounts of peer harassment, and rated their negative feelings across a 2-week period. In Study 1 (n = 95), within-subject analyses across 4 days revealed that both personally experienced and witnessed harassment were associated with increases in daily anxiety, whereas witnessing harassment buffered students against increases in humiliation on days when they personally experienced harassment. Evidence for witnessing as a buffer against increases in humiliation and anger was also found in Study 2 (n = 97) that included 5 daily reports. Witnessing harassment also protected students against increases in negative self-perceptions.

  12. Cognitive aging and the distinction between intentional and unintentional mind wandering

    PubMed Central

    Seli, Paul; Maillet, David; Smilek, Daniel; Oakman, Jonathan M.; Schacter, Daniel L.

    2017-01-01

    A growing number of studies have reported age-related reductions in the frequency of mind wandering. Here, at both the trait (Study 1) and state (Study 2) levels, we re-examined this association while distinguishing between intentional (deliberate) and unintentional (spontaneous) mind wandering. Based on research demonstrating age-accompanied deficits in executive functioning, we expected to observe increases in unintentional mind wandering with increasing age. Moreover, because aging is associated with increased task motivation, we reasoned that older adults might be more engaged in their tasks, and hence, show a more pronounced decline in intentional mind wandering relative to young adults. In both studies, we found that older adults did indeed report lower rates of intentional mind wandering compared with young adults. However, contrary to our expectations, we also found that older adults reported lower rates of unintentional mind wandering (Studies 1 and 2). We discuss the implications of these findings for theories of age-related declines in mind wandering. PMID:28471215

  13. Effects of Compensation Methods and Physician Group Structure on Physicians' Perceived Incentives to Alter Services to Patients

    PubMed Central

    Reschovsky, James D; Hadley, J ack; Landon, Bruce E

    2006-01-01

    Objective To examine how health plan payment, group ownership, compensation methods, and other practice management tools affect physician perceptions of whether their overall financial incentives tilt toward increasing or decreasing services to patients. Data Source Nationally representative data on physicians are from the 2000–2001 Community Tracking Study Physician Survey (N = 12,406). Study Design Ordered and multinomial logistic regression were used to explore how physician, group, and market characteristics are associated with physician reports of whether overall financial incentives are to increase services, decrease services, or neither. Principal Findings Seven percent of physicians report financial incentives are to reduce services to patients, whereas 23 percent report incentives to increase services. Reported incentives to reduce services were associated with reports of lower ability to provide quality care. Group revenue in the form of capitation was associated with incentives to reduce services whereas practice ownership and variable compensation and bonuses for employee physicians were mostly associated with incentives to increase services to patients. Full ownership of groups, productivity incentives, and perceived competitive markets for patients were associated with incentives to both increase and reduce services. Conclusions Practice ownership and the ways physicians are compensated affect their perceived incentives to increase or decrease services to patients. In the latter case, this adversely affects perceived quality of care and satisfaction, although incentives to increase services may also have adverse implications for quality, cost, and insurance coverage. PMID:16899003

  14. Vegan-vegetarian diets in pregnancy: danger or panacea? A systematic narrative review.

    PubMed

    Piccoli, G B; Clari, R; Vigotti, F N; Leone, F; Attini, R; Cabiddu, G; Mauro, G; Castelluccia, N; Colombi, N; Capizzi, I; Pani, A; Todros, T; Avagnina, P

    2015-04-01

    Although vegan-vegetarian diets are increasingly popular, no recent systematic reviews on vegan-vegetarian diets in pregnancy exist. To review the literature on vegan-vegetarian diets and pregnancy outcomes. PubMed, Embase, and the Cochrane library were searched from inception to September 2013 for pregnancy and vegan or vegetarian Medical Subject Headings (MeSH) and free-text terms. Vegan or vegetarian diets in healthy pregnant women. We excluded case reports and papers analysing vegan-vegetarian diets in poverty and malnutrition. Searching, paper selection, and data extraction were performed in duplicate. The high heterogeneity of the studies led to a narrative review. We obtained 262 full texts from 2329 references; 22 selected papers reporting maternal-fetal outcomes (13) and dietary deficiencies (nine) met the inclusion criteria. None of the studies reported an increase in severe adverse outcomes or in major malformations, except one report of increased hypospadias in infants of vegetarian mothers. Five studies reported vegetarian mothers had lower birthweight babies, yet two studies reported higher birthweights. The duration of pregnancy was available in six studies and was similar between vegan-vegetarians and omnivores. The nine heterogeneous studies on microelements and vitamins suggest vegan-vegetarian women may be at risk of vitamin B12 and iron deficiencies. The evidence on vegan-vegetarian diets in pregnancy is heterogeneous and scant. The lack of randomised studies prevents us from distinguishing the effects of diet from confounding factors. Within these limits, vegan-vegetarian diets may be considered safe in pregnancy, provided that attention is paid to vitamin and trace element requirements. © 2015 Royal College of Obstetricians and Gynaecologists.

  15. Psychosocial factors and theory in physical activity studies in minorities.

    PubMed

    Mama, Scherezade K; McNeill, Lorna H; McCurdy, Sheryl A; Evans, Alexandra E; Diamond, Pamela M; Adamus-Leach, Heather J; Lee, Rebecca E

    2015-01-01

    To summarize the effectiveness of interventions targeting psychosocial factors to increase physical activity (PA) among ethnic minority adults and explore theory use in PA interventions. Studies (N = 11) were identified through a systematic review and targeted African American/Hispanic adults, specific psychosocial factors, and PA. Data were extracted using a standard code sheet and the Theory Coding Scheme. Social support was the most common psychosocial factor reported, followed by motivational readiness, and self-efficacy, as being associated with increased PA. Only 7 studies explicitly reported using a theoretical framework. Future efforts should explore theory use in PA interventions and how integration of theoretical constructs, including psychosocial factors, increases PA.

  16. Comparison of Self-Reported Sleep Duration With Actigraphy: Results From the Hispanic Community Health Study/Study of Latinos Sueño Ancillary Study

    PubMed Central

    Cespedes, Elizabeth M.; Hu, Frank B.; Redline, Susan; Rosner, Bernard; Alcantara, Carmela; Cai, Jianwen; Hall, Martica H.; Loredo, Jose S.; Mossavar-Rahmani, Yasmin; Ramos, Alberto R.; Reid, Kathryn J.; Shah, Neomi A.; Sotres-Alvarez, Daniela; Zee, Phyllis C.; Wang, Rui; Patel, Sanjay R.

    2016-01-01

    Most studies of sleep and health outcomes rely on self-reported sleep duration, although correlation with objective measures is poor. In this study, we defined sociodemographic and sleep characteristics associated with misreporting and assessed whether accounting for these factors better explains variation in objective sleep duration among 2,086 participants in the Hispanic Community Health Study/Study of Latinos who completed more than 5 nights of wrist actigraphy and reported habitual bed/wake times from 2010 to 2013. Using linear regression, we examined self-report as a predictor of actigraphy-assessed sleep duration. Mean amount of time spent asleep was 7.85 (standard deviation, 1.12) hours by self-report and 6.74 (standard deviation, 1.02) hours by actigraphy; correlation between them was 0.43. For each additional hour of self-reported sleep, actigraphy time spent asleep increased by 20 minutes (95% confidence interval: 19, 22). Correlations between self-reported and actigraphy-assessed time spent asleep were lower with male sex, younger age, sleep efficiency <85%, and night-to-night variability in sleep duration ≥1.5 hours. Adding sociodemographic and sleep factors to self-reports increased the proportion of variance explained in actigraphy-assessed sleep slightly (18%–32%). In this large validation study including Hispanics/Latinos, we demonstrated a moderate correlation between self-reported and actigraphy-assessed time spent asleep. The performance of self-reports varied by demographic and sleep measures but not by Hispanic subgroup. PMID:26940117

  17. Can Patient Safety Incident Reports Be Used to Compare Hospital Safety? Results from a Quantitative Analysis of the English National Reporting and Learning System Data.

    PubMed

    Howell, Ann-Marie; Burns, Elaine M; Bouras, George; Donaldson, Liam J; Athanasiou, Thanos; Darzi, Ara

    2015-01-01

    The National Reporting and Learning System (NRLS) collects reports about patient safety incidents in England. Government regulators use NRLS data to assess the safety of hospitals. This study aims to examine whether annual hospital incident reporting rates can be used as a surrogate indicator of individual hospital safety. Secondly assesses which hospital characteristics are correlated with high incident reporting rates and whether a high reporting hospital is safer than those lower reporting hospitals. Finally, it assesses which health-care professionals report more incidents of patient harm, which report more near miss incidents and what hospital factors encourage reporting. These findings may suggest methods for increasing the utility of reporting systems. This study used a mix methods approach for assessing NRLS data. The data were investigated using Pareto analysis and regression models to establish which patients are most vulnerable to reported harm. Hospital factors were correlated with institutional reporting rates over one year to examine what factors influenced reporting. Staff survey findings regarding hospital safety culture were correlated with reported rates of incidents causing harm; no harm and death to understand what barriers influence error disclosure. 5,879,954 incident reports were collected from acute hospitals over the decade. 70.3% of incidents produced no harm to the patient and 0.9% were judged by the reporter to have caused severe harm or death. Obstetrics and Gynaecology reported the most no harm events [OR 1.61(95%CI: 1.12 to 2.27), p<0.01] and pharmacy was the hospital location where most near-misses were captured [OR 3.03(95%CI: 2.04 to 4.55), p<0.01]. Clinicians were significantly more likely to report death than other staff [OR 3.04(95%CI: 2.43 to 3.80) p<0.01]. A higher ratio of clinicians to beds correlated with reduced rate of harm reported [RR = -1.78(95%Cl: -3.33 to -0.23), p = 0.03]. Litigation claims per bed were significantly negatively associated with incident reports. Patient satisfaction and mortality outcomes were not significantly associated with reporting rates. Staff survey responses revealed that keeping reports confidential, keeping staff informed about incidents and giving feedback on safety initiatives increased reporting rates [r = 0.26 (p<0.01), r = 0.17 (p = 0.04), r = 0.23 (p = 0.01), r = 0.20 (p = 0.02)]. The NRLS is the largest patient safety reporting system in the world. This study did not demonstrate many hospital characteristics to significantly influence overall reporting rate. There were no association between size of hospital, number of staff, mortality outcomes or patient satisfaction outcomes and incident reporting rate. The study did show that hospitals where staff reported more incidents had reduced litigation claims and when clinician staffing is increased fewer incidents reporting patient harm are reported, whilst near misses remain the same. Certain specialties report more near misses than others, and doctors report more harm incidents than near misses. Staff survey results showed that open environments and reduced fear of punitive response increases incident reporting. We suggest that reporting rates should not be used to assess hospital safety. Different healthcare professionals focus on different types of safety incidents and focusing on these areas whilst creating a responsive, confidential learning environment will increase staff engagement with error disclosure.

  18. Rate and Loudness Manipulations in Dysarthria: Acoustic and Perceptual Findings.

    ERIC Educational Resources Information Center

    Tjaden, Kris; Wilding, Gregory E.

    2004-01-01

    Both rate reduction and increased loudness reportedly are associated with an increase in the size of the articulatory-acoustic working space and improved acoustic distinctiveness for speakers with dysarthria. Improved intelligibility also has been reported. Few studies have directly compared rate and loudness effects for speakers with dysarthria,…

  19. Potential Pitfalls of Reporting and Bias in Observational Studies With Propensity Score Analysis Assessing a Surgical Procedure: A Methodological Systematic Review.

    PubMed

    Lonjon, Guillaume; Porcher, Raphael; Ergina, Patrick; Fouet, Mathilde; Boutron, Isabelle

    2017-05-01

    To describe the evolution of the use and reporting of propensity score (PS) analysis in observational studies assessing a surgical procedure. Assessing surgery in randomized controlled trials raises several challenges. Observational studies with PS analysis are a robust alternative for comparative effectiveness research. In this methodological systematic review, we identified all PubMed reports of observational studies with PS analysis that evaluated a surgical procedure and described the evolution of their use over time. Then, we selected a sample of articles published from August 2013 to July 2014 and systematically appraised the quality of reporting and potential bias of the PS analysis used. We selected 652 reports of observational studies with PS analysis. The publications increased over time, from 1 report in 1987 to 198 in 2013. Among the 129 reports assessed, 20% (n = 24) did not detail the covariates included in the PS and 77% (n = 100) did not report a justification for including these covariates in the PS. The rate of missing data for potential covariates was reported in 9% of articles. When a crossover by conversion was possible, only 14% of reports (n = 12) mentioned this issue. For matched analysis, 10% of articles reported all 4 key elements that allow for reproducibility of a PS-matched analysis (matching ratio, method to choose the nearest neighbors, replacement and method for statistical analysis). Observational studies with PS analysis in surgery are increasing in frequency, but specific methodological issues and weaknesses in reporting exist.

  20. Real-world data to assess changes in low-density lipoprotein cholesterol and predicted cardiovascular risk after ezetimibe discontinuation post reporting of the Ezetimibe and Simvastatin in Hypercholesterolemia Enhances Atherosclerosis Regression trial.

    PubMed

    Bays, Harold E; Patel, Mehul D; Mavros, Panagiotis; Ramey, Dena R; Tomassini, Joanne E; Tershakovec, Andrew M; Baxter, Carl A

    The 2008 Ezetimibe and Simvastatin in Hypercholesterolemia Enhances Atherosclerosis Regression (ENHANCE) study demonstrated ezetimibe + simvastatin vs simvastatin alone had a neutral effect on the surrogate endpoint of carotid intima-media thickness. Subsequent media portrayal of the study prompted ezetimibe discontinuation in many patients. The objective of the study was to assess the impact of ENHANCE reporting on ezetimibe discontinuation, low-density lipoprotein cholesterol (LDL-C) changes, and potential cardiovascular disease (CVD) risk. This analysis used claims data in a retrospective, observational study of patients receiving ezetimibe + statin and compared LDL-C for patients who discontinued ezetimibe (n = 970) vs those who continued ezetimibe + statins (n = 3706) after ENHANCE results disclosure. Change in relative CVD risk was estimated from the absolute LDL-C difference between groups per the Cholesterol Treatment Trialists' meta-analysis of statin trials. The rate of ezetimibe discontinuation was 2% in the 6 months before and 21% in the 6 months after reporting of ENHANCE results. Among patients who ultimately discontinued vs continued ezetimibe, respective mean LDL-C levels were 79.8 and 78.3 mg/dL 6 months before reporting of the ENHANCE results and 93.5 and 78.1 mg/dL 6 months after reporting of ENHANCE. Predictive application of the Cholesterol Treatment Trialists' meta-analysis suggested the 13.9 mg/dL increase in mean LDL-C translated to a 9.4% increase in relative CVD risk for those who discontinued ezetimibe. After reporting of the neutral ENHANCE results, ezetimibe discontinuation rate increased, LDL-C levels increased, and predicted CVD risk increased among those who discontinued ezetimibe. Characterization of clinical outcomes regarding lipid-altering agents based on surrogate biomarker studies not designed to assess CVD outcomes may be misleading, potentially placing patients at increased CVD risk. Copyright © 2017 National Lipid Association. Published by Elsevier Inc. All rights reserved.

  1. Obesity and the cardiovascular health effects of fine particulate air pollution.

    PubMed

    Weichenthal, Scott; Hoppin, Jane A; Reeves, Francois

    2014-07-01

    This review examines evidence related to the potential impact of obesity on the cardiovascular health effects of fine particulate air pollution (PM₂.₅). A PubMed search was conducted in December, 2013 and studies were included if they examined the relationship between PM₂.₅ and cardiovascular health as well as effect modification by obesity. One hundred twenty-one citations were reviewed; three large prospective cohort studies and 14 panel studies with short-term follow-up met the above criteria. All three cohort studies reported stronger associations between PM₂.₅ and cardiovascular mortality among obese subjects and one reported a significant trend of increased risk with increased body mass index. Similarly, 11 of 14 panel studies reported stronger associations between PM₂.₅ and acute changes in physiological measures of cardiovascular health among obese subjects including outcomes such as blood pressure and arrhythmia. Although interactions were not always statistically significant, the consistent pattern of stronger associations among obese subjects suggests that obesity may modify the impact of PM2.5 on cardiovascular health. Epidemiological evidence suggests that obesity may increase susceptibility to the cardiovascular health effects of PM₂.₅. This an important area of research as the public health impacts of air pollution could increase with increasing prevalence of obesity. Copyright © 2014 The Obesity Society.

  2. Recent reports of Wi-Fi and mobile phone-induced radiation on oxidative stress and reproductive signaling pathways in females and males.

    PubMed

    Nazıroğlu, Mustafa; Yüksel, Murat; Köse, Seyit Ali; Özkaya, Mehmet Okan

    2013-12-01

    Environmental exposure to electromagnetic radiation (EMR) has been increasing with the increasing demand for communication devices. The aim of the study was to discuss the mechanisms and risk factors of EMR changes on reproductive functions and membrane oxidative biology in females and males. It was reported that even chronic exposure to EMR did not increase the risk of reproductive functions such as increased levels of neoantigens abort. However, the results of some studies indicate that EMR induced endometriosis and inflammation and decreased the number of follicles in the ovarium or uterus of rats. In studies with male rats, exposure caused degeneration in the seminiferous tubules, reduction in the number of Leydig cells and testosterone production as well as increases in luteinizing hormone levels and apoptotic cells. In some cases of male and female infertility, increased levels of oxidative stress and lipid peroxidation and decreased values of antioxidants such as melatonin, vitamin E and glutathione peroxidase were reported in animals exposed to EMR. In conclusion, the results of current studies indicate that oxidative stress from exposure to Wi-Fi and mobile phone-induced EMR is a significant mechanism affecting female and male reproductive systems. However, there is no evidence to this date to support an increased risk of female and male infertility related to EMR exposure.

  3. Impact of high ambient temperature on unintentional injuries in high-income countries: a narrative systematic literature review

    PubMed Central

    Otte im Kampe, Eveline; Kovats, Sari; Hajat, Shakoor

    2016-01-01

    Objectives Given the likelihood of increased hot weather due to climate change, it is crucial to have prevention measures in place to reduce the health burden of high temperatures and heat waves. The aim of this review is to summarise and evaluate the evidence on the effects of summertime weather on unintentional injuries in high-income countries. Design 3 databases (Global Public Health, EMBASE and MEDLINE) were searched by using related keywords and their truncations in the title and abstract, and reference lists of key studies were scanned. Studies reporting heatstroke and intentional injuries were excluded. Results 13 studies met our inclusion criteria. 11 out of 13 studies showed that the risk of unintentional injuries increases with increasing ambient temperatures. On days with moderate temperatures, the increased risk varied between 0.4% and 5.3% for each 1°C increase in ambient temperature. On extreme temperature days, the risk of injuries decreased. 2 out of 3 studies on occupational accidents found an increase in work-related accidents during high temperatures. For trauma hospital admissions, 6 studies reported an increase during hot weather, whereas 1 study found no association. The evidence for impacts on injuries by subgroups such as children, the elderly and drug users was limited and inconsistent. Conclusions The present review describes a broader range of types of unintentional fatal and non-fatal injuries (occupational, trauma hospital admissions, traffic, fire entrapments, poisoning and drug overdose) than has previously been reported. Our review confirms that hot weather can increase the risk of unintentional injuries and accidents in high-income countries. The results are useful for injury prevention strategies. PMID:26868947

  4. Systems Analysis for Educational Change: The Republic of Korea. Final Report.

    ERIC Educational Resources Information Center

    Morgan, Robert M., Ed.; Chadwick, Clifton B., Ed.

    This report describes the activities and recommendations of a study team that attempted to reform the Korean educational system to increase its efficiency and make it more responsive to the nation's needs. Using a systems approach, the study team collected historical, cultural, and educational data, including demographic reports, economic…

  5. A Mindfulness-Based Group for Young People with Learning Disabilities: A Pilot Study

    ERIC Educational Resources Information Center

    Thornton, Victoria; Williamson, Rachel; Cooke, Bronwen

    2017-01-01

    Background: Mindfulness is becoming increasingly reported as an effective way to support well-being and reduce mental health difficulties. Materials and Methods: This study reports on the development and pilot of a mindfulness-based group for young people with learning disabilities and their carers. Results: Group participants reported that the…

  6. U.S. Metric Study Interim Report: Education.

    ERIC Educational Resources Information Center

    National Bureau of Standards (DOC), Washington, DC.

    This report is another in the series being prepared on the numerous investigations comprising the U. S. Metric Study, by the U. S. National Bureau of Standards. This report concerns the effects of increasing worldwide use of the metric system on education in the United States. Its purpose is to present the educational advantages and disadvantages…

  7. Seizures and epilepsy in Alzheimer's disease.

    PubMed

    Friedman, Daniel; Honig, Lawrence S; Scarmeas, Nikolaos

    2012-04-01

    Many studies have shown that patients with Alzheimer's disease (AD) are at increased risk for developing seizures and epilepsy. However, reported prevalence and incidence of seizures and relationship of seizures to disease measures such as severity, outcome, and progression vary widely between studies. We performed a literature review of the available clinical and epidemiological data on the topic of seizures in patients with AD. We review seizure rates and types, risk factors for seizures, electroencephalogram (EEG) studies, and treatment responses. Finally, we consider limitations and methodological issues. There is considerable variability in the reported prevalence and incidence of seizures in patients with AD-with reported lifetime prevalence rates of 1.5-64%. More recent, prospective, and larger studies in general report lower rates. Some, but not all, studies have noted increased seizure risk with increasing dementia severity or with younger age of AD onset. Generalized convulsive seizures are the most commonly reported type, but often historical information is the only basis used to determine seizure type and the manifestation of seizures may be difficult to distinguish from other behaviors common in demented patients. EEG has infrequently been performed and reported. Data on treatment of seizures in AD are extremely limited. Similarly, the relationship between seizures and cognitive impairment in AD is unclear. We conclude that the literature on seizures and epilepsy in AD, including diagnosis, risk factors, and response to treatment suffers from methodological limitations and gaps. © 2011 Blackwell Publishing Ltd.

  8. The administrative population report on children with developmental delays in Taiwan, 2003 through 2007.

    PubMed

    Lin, Jin-Ding; Yen, Chia-Feng; Wu, Jia-Ling; Kang, Shih-Wan

    2009-01-01

    This paper was a population study with developmental delays and it included an examination of the trends the overtime change trend and reported channels of this group of people in Taiwan. We analyzed data for the present study mainly from the Department of Statistics, Ministry of the Interiors, Taipei, Taiwan: "Number of early intervention for children with developmental delays in Taiwan" from 2003 through 2007. The reported number of children with developmental delays slightly increased from 13,231 to 14,250 (increase rate=7.7%) from the year of 2003 through 2007 in Taiwan. More than one-half of children with developmental delays were reported during the age 3-5 years. Aged 0-2 group has the highest increasing reported numbers in the previous 5 years which changed dramatically increased from 4139 (31.3%) in 2003 to 6201 (43.5%) in 2007 (increase rate=49.8%). The medical care setting was the main reported channel of the children with developmental delays and the results also showed that the reported prevalence of the aged 0-2 developmentally delayed children was 57.4-102.2 per 10,000 children; aged 3-5 was 79.0-105.1 per 10,000 children from the year 2003-2007 in Taiwan. The present concluded that early intervention based on the precise affected population would provide important supports for families of children with developmental delays. Therefore, the health care system should be strengthened to increase the proportion of children identified at the earlier age and to decrease the variability in the age at identification for most of the conditions of children with developmental delays.

  9. Longitudinal trajectories of posttraumatic stress disorder symptoms and binge drinking among adolescent girls: the role of sexual victimization.

    PubMed

    Walsh, Kate; Danielson, Carla Kmett; McCauley, Jenna; Hanson, Rochelle F; Smith, Daniel W; Resnick, Heidi S; Saunders, Benjamin E; Kilpatrick, Dean G

    2012-01-01

    Many studies have documented associations among sexual victimization (SV), posttraumatic stress disorder (PTSD) symptoms, and alcohol use; however, few have examined these associations longitudinally among adolescents. The present study evaluated the effect of SV on the longitudinal trajectory of PTSD symptoms and binge drinking (BD) among adolescent girls, a population known to have high rates of SV and alcohol use. Participants (N = 1,808 at wave 1) completed interviews regarding PTSD symptoms, BD, and SV experiences over approximately 3 years. Multilevel modeling revealed decreases in PTSD symptoms over the course of the study; however, compared with nonvictims, adolescents who were sexually victimized reported greater PTSD symptoms at wave 1 and maintained higher levels of PTSD symptoms over the course of the study after controlling for age. SV reported during the study also predicted an acute increase in PTSD symptoms at that occasion. BD increased significantly over the course of the study; however, SV did not predict initial BD or increases over time. SV reported during the study was associated with acute increases in BD at that occasion, although this effect diminished when participants reporting substance-involved rape were excluded. SV was associated with immediate and long-lasting elevations in PTSD symptoms, but not with initial or lasting elevations in BD over time, suggesting that adolescent victims have yet to develop problematic patterns of alcohol use to cope with SV. However, SV was associated with acute increases in PTSD symptoms and BD, suggesting a need for BD interventions to reduce alcohol-related SV. Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  10. When low self-esteem encourages behaviors that risk rejection to increase interdependence: the role of relational self-construal [corrected].

    PubMed

    Baker, Levi R; McNulty, James K

    2013-06-01

    [Correction Notice: An Erratum for this article was reported in Vol 104(6) of Journal of Personality and Social Psychology (see record 2013-18890-002). The title of the article is incorrect.] Increasing interdependence in an intimate relationship requires engaging in behaviors that risk rejection, such as expressing affection and asking for support. Who takes such risks and who avoids them? Although several theoretical perspectives suggest that self-esteem plays a crucial role in shaping such behaviors, they can be used to make competing predictions regarding the direction of this effect. Six studies reconcile these contrasting predictions by demonstrating that the effects of self-esteem on behaviors that risk rejection to increase interdependence depend on relational self-construal-that is, the extent to which people define themselves by their close relationships. In Studies 1 and 2, participants were given the opportunity to disclose negative personal information (Study 1) and feelings of intimacy (Study 2) to their dating partners. In Study 3, married couples reported the extent to which they confided in one another. In Study 4, we manipulated self-esteem and relational self-construal, and participants reported their willingness to engage in behaviors that increase interdependence. In Studies 5 and 6, we manipulated the salience of interpersonal risk, and participants reported their willingness to engage in behaviors that risk rejection to increase interdependence. In all 6 studies, self-esteem was positively associated with behaviors that can increase interdependence among people low in relational self-construal but negatively associated with those behaviors among people high in relational self-construal. Accordingly, theoretical descriptions of the role of self-esteem in relationships will be most complete to the extent that they consider the degree to which people define themselves by their close relationships. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  11. Suspected adverse drug reaction reports with oral anticoagulants in Portugal: a pharmacovigilance study.

    PubMed

    Caldeira, Daniel; Rodrigues, Raquel; Abreu, Daisy; Anes, Ana Marta; Rosa, Mário M; Ferreira, Joaquim J

    2018-04-01

    In this pharmacovigilance study, we aimed to determine the incidence of spontaneously reported suspected adverse drug reactions (ADRs) related to oral anticoagulants: non-vitamin K antagonist oral anticoagulants (NOACs; apixaban, dabigatran, edoxaban, rivaroxaban) and vitamin K antagonists (VKA) Research design and methods: In this retrospective observational study, we extracted all the individual case safety reports related to oral anticoagulants recorded in the Portuguese Pharmacovigilance Database (January 2010 to April 2015). The annual incidence of suspected ADRs was estimated using drug exposure data. Disproportionality of reporting ADR was addressed through reporting odds ratio (ROR) and 99% confidence intervals. We appraised 794 suspected ADR (78% related to NOACs). The annual number of ADRs increased overtime with 9 ADRs/million Defined Daily Dose (DDD) at the end of 2014. The incidence of NOACs ADRs decreased from 2012 onwards. VKA showed a disproportion in 'Investigation' (ROR 0.10, 99%CI 0.05-0.22) and 'Injury, poisoning and procedural complications' (ROR 0.36, 99%CI 0.19-0.69) ADRs compared with NOACs. NOACs had a higher significant disproportion of 'Nervous system disorders' related ADRs (ROR 3.98, 99%CI 1.50-10.53). Reporting of ADRs associated with oral anticoagulants (mainly NOACs), is increasing. Exploratory disproportion analyses showed an increase of reports of nervous system ADRs with NOACs, and INR-related ADRs with VKA.

  12. Somatic symptoms beyond those generally associated with a whiplash injury are increased in self-reported chronic whiplash. A population-based cross sectional study: the Hordaland Health Study (HUSK)

    PubMed Central

    2012-01-01

    Background Chronic whiplash leads to considerable patient suffering and substantial societal costs. There are two competing hypothesis on the etiology of chronic whiplash. The traditional organic hypothesis considers chronic whiplash and related symptoms a result of a specific injury. In opposition is the hypothesis that chronic whiplash is a functional somatic syndrome, and related symptoms a result of society-induced expectations and amplification of symptoms. According to both hypotheses, patients reporting chronic whiplash are expected to have more neck pain, headache and symptoms of anxiety and depression than the general population. Increased prevalence of somatic symptoms beyond those directly related to a whiplash neck injury is less investigated. The aim of this study was to test an implication derived from the functional hypothesis: Is the prevalence of somatic symptoms as seen in somatization disorder, beyond symptoms related to a whiplash neck injury, increased in individuals self-reporting chronic whiplash? We further aimed to explore recall bias by comparing the symptom profile displayed by individuals self-reporting chronic whiplash to that among those self-reporting a non-functional injury: fractures of the hand or wrist. We explored symptom load, etiologic origin could not be investigated in this study. Methods Data from the Norwegian population-based “Hordaland Health Study” (HUSK, 1997–99); N = 13,986 was employed. Chronic whiplash was self-reported by 403 individuals and fractures by 1,746. Somatization tendency was measured using a list of 17 somatic symptoms arising from different body parts and organ systems, derived from the research criteria for somatization disorder (ICD-10, F45). Results Chronic whiplash was associated with an increased level of all 17 somatic symptoms investigated (p<0.05). The association was moderately strong (group difference of 0.60 standard deviation), only partly accounted for by confounding. For self-reported fractures symptoms were only slightly elevated. Recent whiplash was more commonly reported than whiplash-injury a long time ago, and the association of interest weakly increased with time since whiplash (r = 0.016, p = 0.032). Conclusions The increased prevalence of somatic symptoms beyond symptoms expected according to the organic injury model for chronic whiplash, challenges the standard injury model for whiplash, and is indicative evidence of chronic whiplash being a functional somatic syndrome. PMID:22935146

  13. Annual physical examination reports vary by gender once teenagers become sexually active

    PubMed Central

    Marcell, Arik V.; Matson, Pam; Ellen, Jonathan M.; Ford, Carol A.

    2010-01-01

    Introduction Few sexually active male adolescents receive sexual/reproductive health (SRH) services. We examine whether the association between adolescents’ sexual behavior status and physical examination over time can help us understand why. Methods We conducted longitudinal cohort analysis of the National Longitudinal Study of Adolescent Health with 9239 adolescents who completed the baseline school (1994/95) and Wave 2 (1996) follow-up surveys approximately 1.5 years later (retention rate=71%). We fit logistic regression models with random effects to estimate individual odds of reporting a physical examination in the past 12 months at follow-up, as compared to baseline, stratified by sexual behavior status and gender, and adjusting for sociodemographic and healthcare access factors. Results 34.5% males and 38.2% females reported experiencing vaginal intercourse by follow-up, and 22.4% males and 24.7% females reported first experiencing intercourse during the study. Among sexually active adolescents, about half reported annual exams and one-fifth no exams. Among females, baseline to follow-up exam reports significantly increased in: sex initiators (adjusted Odds Ratio [95% confidence interval]=2.09 [1.66–2.64]); those reporting sex at both times (2.16 [1.51–3.09]); and those reporting no sex either time (2.47 [2.00–3.04]). Among males, baseline to follow-up exam reports significantly increased in those reporting no sex either time (1.57 [1.26–1.96]) and showed increasing trends in sex initiators (1.27 [0.92–1.76]). Discussion A majority of sexually active adolescents report annual physical exams over time. Providers should not miss opportunities to deliver evidence-based SRH to sexually active adolescents. Future efforts are needed to increase all adolescents’ access to SRH services. PMID:21700156

  14. Formaldehyde exposures from tobacco smoke: a review.

    PubMed Central

    Godish, T

    1989-01-01

    Reports of formaldehyde levels in mainstream, sidestream, and environmental tobacco smoke from nine studies are reviewed. Considerable disparity exists between formaldehyde production rates determined from mainstream-sidestream studies and those reporting levels in environmental tobacco smoke. Tobacco smoke does not appear to increase vapor-phase formaldehyde levels significantly in indoor environments, but formaldehyde exposure in mainstream smoke may pose a risk of upper respiratory system cancer and increase the risk of cancer in smokers. PMID:2665532

  15. Breaking the news or fueling the epidemic? Temporal association between news media report volume and opioid-related mortality.

    PubMed

    Dasgupta, Nabarun; Mandl, Kenneth D; Brownstein, John S

    2009-11-18

    Historical studies of news media have suggested an association between reporting and increased drug abuse. Period effects for substance use have been documented for different classes of legal and illicit substances, with the suspicion that media publicity may have played major roles in their emergence. Previous analyses have drawn primarily from qualitative evidence; the temporal relationship between media reporting volume and adverse health consequences has not been quantified nationally. We set out to explore whether we could find a quantitative relationship between media reports about prescription opioid abuse and overdose mortality associated with these drugs. We assessed whether increases in news media reports occurred before or after increases in overdose deaths. Our ecological study compared a monthly time series of unintentional poisoning deaths involving short-acting prescription opioid substances, from 1999 to 2005 using multiple cause-of-death data published by the National Center for Health Statistics, to monthly counts of English-language news articles mentioning generic and branded names of prescription opioids obtained from Google News Archives from 1999 to 2005. We estimated the association between media volume and mortality rates by time-lagged regression analyses. There were 24,272 articles and 30,916 deaths involving prescription opioids during the seven-year study period. Nationally, the number of articles mentioning prescription opioids increased dramatically starting in early 2001, following prominent coverage about the nonmedical use of OxyContin. We found a significant association between news reports and deaths, with media reporting preceding fatal opioid poisonings by two to six months and explaining 88% (p<0.0001, df 78) of the variation in mortality. While availability, structural, and individual predispositions are key factors influencing substance use, news reporting may enhance the popularity of psychoactive substances. Albeit ecological in nature, our finding suggests the need for further evaluation of the influence of news media on health. Reporting on prescription opioids conforms to historical patterns of news reporting on other psychoactive substances.

  16. Knowledge, attitude, and concussion-reporting behaviors among high school athletes: a preliminary study.

    PubMed

    Register-Mihalik, Johna K; Guskiewicz, Kevin M; McLeod, Tamara C Valovich; Linnan, Laura A; Mueller, Frederick O; Marshall, Stephen W

    2013-01-01

    Many athletes continue to participate in practices and games while experiencing concussion-related symptoms, potentially predisposing them to subsequent and more complicated brain injuries. Limited evidence exists about factors that may influence concussion-reporting behaviors. To examine the influence of knowledge and attitude on concussion-reporting behaviors in a sample of high school athletes. Cross-sectional study. Participants completed a validated survey instrument via mail. A total of 167 high school athletes (97 males, 55 females, 5 sex not indicated; age = 15.7 ± 1.4 years) participating in football, soccer, lacrosse, or cheerleading. Athlete knowledge and attitude scores served as separate predictor variables. We examined the proportion of athletes who reported continuing to participate in games and practices while symptomatic from possible concussion and the self-reported proportion of recalled concussion and bell-ringer events disclosed after possible concussive injury. Only 40% of concussion events and 13% of bell-ringer recalled events in the sample were disclosed after possible concussive injury. Increased athlete knowledge of concussion topics (increase of 1 standard deviation = 2.8 points) was associated with increased reporting prevalence of concussion and bell-ringer events occurring in practice (prevalence ratio [PR] = 2.27, 95% confidence interval [CI] = 1.60, 3.21) and the reporting prevalence of bell-ringer-only events overall (PR = 1.87, 95% CI = 1.38, 2.54). Athlete attitude scores (increase of 1 standard deviation = 11.5 points) were associated with decreases in the proportion of athletes stating they participated in games (PR = 0.74, 95% CI = 0.66, 0.82) and practices (PR = 0.67, 95% CI = 0.59, 0.77) while symptomatic from concussions. Most recalled concussion events in our study were not reported to a supervising adult. Clinicians should be aware that knowledge and attitude influence concussion reporting. Clinicians and administrators should make concussion education a priority and encourage an optimal reporting environment to better manage and prevent concussive injuries in young athletes.

  17. The Effect of a Pedometer-based Program Improvement of Physical Activity in Tabriz University Employees.

    PubMed

    Baghianimoghaddam, Mohammad Hossein; Bakhtari-Aghdam, Fatemeh; Asghari-Jafarabadi, Mohammad; Allahverdipour, Hamid; Dabagh-Nikookheslat, Saeed; Nourizadeh, Roghaiyeh

    2016-01-01

    Regular physical activity (PA) has been shown to reduce risk of morbidity and overall mortality. A study has displayed that achieving 10,000 steps/day is associated with important health outcomes and have been used to promote PA. Pedometers are a popular tool for PA interventions in different setting. This study investigated the effects on pedometer-based and self-reported PA among Tabriz University employees. This experimental study assessed the effects of 16 weeks pedometer-based workplace intervention. Participants (n = 154) were employees of two worksites. Pedometer-based and self-reported PA from one intervention worksite was compared with the data of a comparison workplace. International Physical Activity Questionnaire (IPAQ) for self-reported measure of PA, and demographic (age, marital status, educational level, employment status, and stage of change) variables were obtained. To measure PA objectively pedometer was used. Participants reported to increase the step counts from baseline (end of summer) to posttest (winter). The intervention effect revealed significant increase in the intervention group (8279 ± 2759 steps/day than in the comparison work place (4118 ± 1136). Self-reported based on IPAQ concluded women in intervention worksite had a significant increase in the leisure time domain, but similar finding was not found in the comparison worksite. Pedometer used might rather benefit those individuals who want feedback on their current PA, also walking should be considered to increase PA in employee women.

  18. When Low Self-Esteem Encourages Behaviors that Risk Rejection to Increase Interdependence: The Role of Relational Self-Control

    PubMed Central

    Baker, Levi R.; McNulty, James K.

    2013-01-01

    Increasing interdependence in an intimate relationship requires engaging in behaviors that risk rejection, such as expressing affection and asking for support. Who takes such risks and who avoids them? Although several theoretical perspectives suggest that self-esteem plays a crucial role in shaping such behaviors, they can be used to make competing predictions regarding the direction of this effect. Six studies reconcile these contrasting predictions by demonstrating that the effects of self-esteem on behaviors that risk rejection to increase interdependence depend on relational self-construal— i.e., the extent to which people define themselves by their close relationships. In Studies 1 and 2, participants were given the opportunity to disclose negative personal information (Study 1) and feelings of intimacy (Study 2) to their dating partners. In Study 3, married couples reported the extent to which they confided in one another. In Study 4, we manipulated self-esteem and relational self-construal and participants reported their willingness to engage in behaviors that increase interdependence. In Studies 5 and 6, we manipulated the salience of interpersonal risk and participants reported their willingness to engage in behaviors that risk rejection to increase interdependence. In all six studies, self-esteem was positively associated with behaviors that can increase interdependence among people low in relational self-construal but negatively associated with those behaviors among people high in relational self-construal. Accordingly, theoretical descriptions of the role of self-esteem in relationships will be most complete to the extent that they consider the degree to which people define themselves by their close relationships. PMID:23586411

  19. Is “Football for All” Safe for All? Cross-Sectional Study of Disparities as Determinants of 1-Year Injury Prevalence in Youth Football Programs

    PubMed Central

    Dahlström, Örjan; Backe, Stefan; Ekberg, Joakim; Janson, Staffan; Timpka, Toomas

    2012-01-01

    Background Football (soccer) is endorsed as a health-promoting physical activity worldwide. When football programs are introduced as part of general health promotion programs, equal access and limitation of pre-participation disparities with regard to injury risk are important. The aim of this study was to explore if disparity with regard to parents’ educational level, player body mass index (BMI), and self-reported health are determinants of football injury in community-based football programs, separately or in interaction with age or gender. Methodology/Principal Findings Four community football clubs with 1230 youth players agreed to participate in the cross-sectional study during the 2006 season. The study constructs (parents’ educational level, player BMI, and self-reported health) were operationalized into questionnaire items. The 1-year prevalence of football injury was defined as the primary outcome measure. Data were collected via a postal survey and analyzed using a series of hierarchical statistical computations investigating associations with the primary outcome measure and interactions between the study variables. The survey was returned by 827 (67.2%) youth players. The 1-year injury prevalence increased with age. For youths with parents with higher formal education, boys reported more injuries and girls reported fewer injuries than expected; for youths with lower educated parents there was a tendency towards the opposite pattern. Youths reporting injuries had higher standardized BMI compared with youths not reporting injuries. Children not reporting full health were slightly overrepresented among those reporting injuries and underrepresented for those reporting no injury. Conclusion Pre-participation disparities in terms of parents’ educational level, through interaction with gender, BMI, and self-reported general health are associated with increased injury risk in community-based youth football. When introduced as a general health promotion, football associations should adjust community-based youth programs to accommodate children and adolescents with increased pre-participation injury risk. PMID:22928035

  20. Is "football for all" safe for all? Cross-sectional study of disparities as determinants of 1-year injury prevalence in youth football programs.

    PubMed

    Dahlström, Örjan; Backe, Stefan; Ekberg, Joakim; Janson, Staffan; Timpka, Toomas

    2012-01-01

    Football (soccer) is endorsed as a health-promoting physical activity worldwide. When football programs are introduced as part of general health promotion programs, equal access and limitation of pre-participation disparities with regard to injury risk are important. The aim of this study was to explore if disparity with regard to parents' educational level, player body mass index (BMI), and self-reported health are determinants of football injury in community-based football programs, separately or in interaction with age or gender. Four community football clubs with 1230 youth players agreed to participate in the cross-sectional study during the 2006 season. The study constructs (parents' educational level, player BMI, and self-reported health) were operationalized into questionnaire items. The 1-year prevalence of football injury was defined as the primary outcome measure. Data were collected via a postal survey and analyzed using a series of hierarchical statistical computations investigating associations with the primary outcome measure and interactions between the study variables. The survey was returned by 827 (67.2%) youth players. The 1-year injury prevalence increased with age. For youths with parents with higher formal education, boys reported more injuries and girls reported fewer injuries than expected; for youths with lower educated parents there was a tendency towards the opposite pattern. Youths reporting injuries had higher standardized BMI compared with youths not reporting injuries. Children not reporting full health were slightly overrepresented among those reporting injuries and underrepresented for those reporting no injury. Pre-participation disparities in terms of parents' educational level, through interaction with gender, BMI, and self-reported general health are associated with increased injury risk in community-based youth football. When introduced as a general health promotion, football associations should adjust community-based youth programs to accommodate children and adolescents with increased pre-participation injury risk.

  1. Effectiveness of and User Experience With Web-Based Interventions in Increasing Physical Activity Levels in People With Multiple Sclerosis: A Systematic Review.

    PubMed

    Dennett, Rachel; Gunn, Hilary; Freeman, Jennifer A

    2018-05-15

    Supporting people with multiple sclerosis (MS) to achieve and maintain recommended levels of physical activity is important but challenging. Web-based interventions are increasingly being used to deliver targeted exercise programs and promote physical activity. The purpose of this study was to systematically review current evidence regarding the effectiveness and user experience of web-based interventions in increasing physical activity in people with MS. MEDLINE, EMBASE, CINAHL, AMED, PEDro, PsychInfo, Web of Sciences, The Cochrane Library, and gray literature were searched from 1990 to September 2016. English language articles reporting the use of web-based interventions to increase physical activity in adults with MS were included. Eligible quantitative studies were of any design and reported a measure of physical activity. Qualitative studies exploring users' experiences in any context were included. Of the 881 articles identified, 9 met the inclusion criteria. Two reviewers independently assessed methodological quality and extracted data using standardized critical appraisal and data extraction tools from the Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI). Meta-analysis of self-reported physical activity questionnaire data from 4 studies demonstrated a standardized mean difference of 0.67 (95% CI = 0.43-0.92), indicating a positive effect in favor of the web-based interventions. Narrative review of accelerometry data from 3 studies indicated increases in objectively measured physical activity. No qualitative studies met the inclusion criteria. In the 9 included articles, only 2 different interventions (used with people who were ambulant) were reported. Web-based interventions had a short-term positive effect on self-reported physical activity in people who had MS and were ambulant. Evidence is not currently available to support or refute their use in the long-term or with people who are not ambulant.

  2. Strategies to reverse bone loss in women with functional hypothalamic amenorrhea: a systematic review of the literature.

    PubMed

    Vescovi, J D; Jamal, S A; De Souza, M J

    2008-04-01

    Functional hypothalamic amenorrhea (FHA) impairs the attainment of peak bone mass and as such can increase the risk of fractures later in life. To document available treatment strategies, we conducted a systematic review of the literature. We report that hormonal therapies have limited effectiveness in increasing bone mass, whereas increased caloric intake resulting in weight gain and/or resumption of menses is an essential strategy for restoring bone mass in women with FHA. Women with functional hypothalamic amenorrhea (FHA) may not achieve peak bone mass (PBM), which increases the risk of stress fractures, and may increase the risk of osteoporotic fractures in later life. To identify effective treatment strategies for women with FHA, we conducted a systematic review of the literature. We included randomized controlled trials (RCTs), cross-sectional studies, and case studies that reported on the effects of pharmacological and non-pharmacological interventions on bone mineral density (BMD) or bone turnover in women with FHA. Most published studies (n=26) were designed to treat the hormonal abnormalities observed in women with FHA (such as low estrogen, leptin, insulin-like growth factor-1, and DHEA); however none of these treatments demonstrated consistent improvements in BMD. Therapies containing an estrogen given for 8-24 months resulted in variable improvements (1.0-19.0%) in BMD, but failed to restore bone mass to that of age-matched controls. Three studies reported on the use of bisphosphonates (3-12 months) in anorexic women, which appear to have limited effectiveness to improve BMD compared to nutritional treatments. Another three investigations showed no improvements in BMD after androgen therapy (DHEA and testosterone) in anorexic women. In contrast, reports (n=9) describing an increase in caloric intake that results in weight gain and/or the resumption of menses reported a 1.1-16.9% increase in BMD concomitant with an improvement in bone formation and reduction in bone resorption markers. Our literature review indicates that the most successful, and indeed essential strategy for improving BMD in women with FHA is to increase caloric intake such that body mass is increased and there is a resumption of menses. Further long-term studies to determine the persistence of this effect and to determine the effects of this and other strategies on fracture risk are needed.

  3. Hyperventilation in anticipatory music performance anxiety.

    PubMed

    Studer, Regina Katharina; Danuser, Brigitta; Hildebrandt, Horst; Arial, Marc; Wild, Pascal; Gomez, Patrick

    2012-09-01

    Self-report studies have shown an association between music performance anxiety (MPA) and hyperventilation complaints. However, hyperventilation was never assessed physiologically in MPA. This study investigated the self-reported affective experience, self-reported physiological symptoms, and cardiorespiratory variables including partial pressure of end-tidal CO(2) (Petco(2)), which is an indicator for hyperventilation, in 67 music students before a private and a public performance. The response coherence between these response domains was also investigated. From the private to the public session, the intensity of all self-report variables increased (all p values < .001). As predicted, the higher the musician's usual MPA level, the larger were these increases (p values < .10). With the exception of Petco(2), the main cardiorespiratory variables also increased from the private to the public session (p values < .05). These increases were not modulated by the usual MPA level (p values > .10). Petco(2) showed a unique response pattern reflected by an MPA-by-session interaction (p < .01): it increased from the private to the public session for musicians with low MPA levels and decreased for musicians with high MPA levels. Self-reported physiological symptoms were related to the self-reported affective experience (p values < .05) rather than to physiological measures (p values > .17). These findings show for the first time how respiration is stimulated before a public performance in music students with different MPA levels. The hypothesis of a hyperventilation tendency in high-performance-anxious musicians is supported. The response coherence between physiological symptoms and physiological activation is weak.

  4. INTAKE OF SUGAR-SWEETENED BEVERAGES, MILK AND ITS ASSOCIATION WITH BODY MASS INDEX IN ADOLESCENCE: A SYSTEMATIC REVIEW

    PubMed Central

    Café, Ana Carolina Corrêa; Lopes, Carlos Alexandre de Oliveira; Novais, Rommel Larcher Rachid; Bila, Wendell Costa; da Silva, Daniely Karoline; Romano, Márcia Christina Caetano; Lamounier, Joel Alves

    2018-01-01

    ABSTRACT Objective: To systematize literature references addressing the association of sugar-sweetened beverage (SSB) and milk intake with body mass index (BMI) in adolescents. Data source: A search was carried out in PubMed (US National Library of Medicine National Institutes of Health) and BVS (Virtual Library in Health). The descriptors used were: adolescents, young adult, beverages, drinking, obesity, overweight, BMI, and nutritional status. The following filters were applied: age ranging from 10 to 19 years, studies published in Portuguese or English language between 2011-2015. Data synthesis: Thirty studies were selected (22 cross-sectional studies, 4 cohort studies, 1 randomized clinical trial, 1 case-control study, and 1 quasi-experimental study). There was association between the intake of these beverages and increase in BMI in 55% of all 20 studies that dealt with sugary drinks. When it came to soft drinks, 100% of studies reported association with increase in BMI. As to milk intake, only one article showed association with increased BMI. Three articles reported milk as a protection factor against increase in BMI; three studies found no association between this intake and BMI. Nineteen studies had representative samples and 20 surveys reported random samples. Among papers using questionnaires, 84% had been validated. Conclusions: There is no consensus in the literature about the association between SSB or milk intake and BMI in adolescents. PMID:29513855

  5. INTAKE OF SUGAR-SWEETENED BEVERAGES, MILK AND ITS ASSOCIATION WITH BODY MASS INDEX IN ADOLESCENCE: A SYSTEMATIC REVIEW.

    PubMed

    Café, Ana Carolina Corrêa; Lopes, Carlos Alexandre de Oliveira; Novais, Rommel Larcher Rachid; Bila, Wendell Costa; Silva, Daniely Karoline da; Romano, Márcia Christina Caetano; Lamounier, Joel Alves

    2018-01-01

    To systematize literature references addressing the association of sugar-sweetened beverage (SSB) and milk intake with body mass index (BMI) in adolescents. A search was carried out in PubMed (US National Library of Medicine National Institutes of Health) and BVS (Virtual Library in Health). The descriptors used were: adolescents, young adult, beverages, drinking, obesity, overweight, BMI, and nutritional status. The following filters were applied: age ranging from 10 to 19 years, studies published in Portuguese or English language between 2011-2015. Thirty studies were selected (22 cross-sectional studies, 4 cohort studies, 1 randomized clinical trial, 1 case-control study, and 1 quasi-experimental study). There was association between the intake of these beverages and increase in BMI in 55% of all 20 studies that dealt with sugary drinks. When it came to soft drinks, 100% of studies reported association with increase in BMI. As to milk intake, only one article showed association with increased BMI. Three articles reported milk as a protection factor against increase in BMI; three studies found no association between this intake and BMI. Nineteen studies had representative samples and 20 surveys reported random samples. Among papers using questionnaires, 84% had been validated. There is no consensus in the literature about the association between SSB or milk intake and BMI in adolescents.

  6. The triggering of myocardial infarction by fine particles is enhanced when particles are enriched in secondary species

    EPA Science Inventory

    Previous studies have reported an increased risk of myocardial infarction (MI) associated with acute increases in PM concentration. Recently, we reported that MI/fine particle (PM2.5) associations may be limited to transmural infarctions. We used PM2.5 speci...

  7. Organizational nostalgia lowers turnover intentions by increasing work meaning: The moderating role of burnout.

    PubMed

    Leunissen, Joost M; Sedikides, Constantine; Wildschut, Tim; Cohen, Taya R

    2018-01-01

    We report 3 studies addressing the relevance of organizational nostalgia for the meaning that employees ascribe to their work (work meaning). We hypothesized, and found, that organizational nostalgia enhances work meaning and thereby reduces turnover intentions. In Study 1, an employee survey, spontaneously experienced organizational nostalgia was associated with higher work meaning. In Study 2, an organizational-nostalgia induction increased work meaning, which subsequently predicted lowered turnover intentions. In Study 3, an organizational-nostalgia induction increased work meaning and thereby lowered turnover intentions, especially among employees who reported relatively high levels of burnout. When burnout is high, organizational nostalgia functions as a rich source of meaning that benefits employees' work experience. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  8. Flaws in animal studies exploring statins and impact on meta-analysis.

    PubMed

    Moja, Lorenzo; Pecoraro, Valentina; Ciccolallo, Laura; Dall'Olmo, Luigi; Virgili, Gianni; Garattini, Silvio

    2014-06-01

    Animal experiments should be appropriately designed, correctly analysed and transparently reported to increase their scientific validity and maximise the knowledge gained from each experiment. This systematic review of animal experiments investigating statins evaluates their quality of reporting and methodological aspects as well as their implications for the conduction of meta-analyses. We searched medline and embase for studies reporting research on statins in mice, rats and rabbits. We collected detailed information about the characteristics of studies, animals and experimental methods. We retrieved 161 studies. A little over half did not report randomisation (55%) and most did not describe blinding (88%). All studies reported details on the experimental procedure, although many omitted information about animal gender, age or weight. Four percent did not report the number of animals used. None reported the sample size. Fixed- and random-effects models gave different results (ratio of effect size increased by five folds). Heterogeneity was consistently substantial within animal models, for which accounting for covariates had minimal impact. Publication bias is highly suspected across studies. Although statins showed efficacy in animal models, preclinical studies highlighted fundamental problems in the way in which such research is conducted and reported. Results were often difficult to interpret and reproduce. Different meta-analytic approaches were highly inconsistent: a reliable approach to estimate the true parameter was imperceptible. Policies that address these issues are required from investigators, editors and institutions that care about the quality standards and ethics of animal research. © 2014 Stichting European Society for Clinical Investigation Journal Foundation.

  9. Interventions to promote cycling: systematic review

    PubMed Central

    Yang, Lin; Sahlqvist, Shannon; McMinn, Alison; Griffin, Simon J

    2010-01-01

    Objectives To determine what interventions are effective in promoting cycling, the size of the effects of interventions, and evidence of any associated benefits on overall physical activity or anthropometric measures. Design Systematic review. Data sources Published and unpublished reports in any language identified by searching 13 electronic databases, websites, reference lists, and existing systematic reviews, and papers identified by experts in the field. Review methods Controlled “before and after” experimental or observational studies of the effect of any type of intervention on cycling behaviour measured at either individual or population level. Results Twenty five studies (of which two were randomised controlled trials) from seven countries were included. Six studies examined interventions aimed specifically at promoting cycling, of which four (an intensive individual intervention in obese women, high quality improvements to a cycle route network, and two multifaceted cycle promotion initiatives at town or city level) were found to be associated with increases in cycling. Those studies that evaluated interventions at population level reported net increases of up to 3.4 percentage points in the population prevalence of cycling or the proportion of trips made by bicycle. Sixteen studies assessing individualised marketing of “environmentally friendly” modes of transport to interested households reported modest but consistent net effects equating to an average of eight additional cycling trips per person per year in the local population. Other interventions that targeted travel behaviour in general were not associated with a clear increase in cycling. Only two studies assessed effects of interventions on physical activity; one reported a positive shift in the population distribution of overall physical activity during the intervention. Conclusions Community-wide promotional activities and improving infrastructure for cycling have the potential to increase cycling by modest amounts, but further controlled evaluative studies incorporating more precise measures are required, particularly in areas without an established cycling culture. Studies of individualised marketing report consistent positive effects of interventions on cycling behaviour, but these findings should be confirmed using more robust study designs. Future research should also examine how best to promote cycling in children and adolescents and through workplaces. Whether interventions to promote cycling result in an increase in overall physical activity or changes in anthropometric measures is unclear. PMID:20959282

  10. Interventions to promote cycling: systematic review.

    PubMed

    Yang, Lin; Sahlqvist, Shannon; McMinn, Alison; Griffin, Simon J; Ogilvie, David

    2010-10-18

    To determine what interventions are effective in promoting cycling, the size of the effects of interventions, and evidence of any associated benefits on overall physical activity or anthropometric measures. Systematic review. Published and unpublished reports in any language identified by searching 13 electronic databases, websites, reference lists, and existing systematic reviews, and papers identified by experts in the field. Review methods Controlled "before and after" experimental or observational studies of the effect of any type of intervention on cycling behaviour measured at either individual or population level. Twenty five studies (of which two were randomised controlled trials) from seven countries were included. Six studies examined interventions aimed specifically at promoting cycling, of which four (an intensive individual intervention in obese women, high quality improvements to a cycle route network, and two multifaceted cycle promotion initiatives at town or city level) were found to be associated with increases in cycling. Those studies that evaluated interventions at population level reported net increases of up to 3.4 percentage points in the population prevalence of cycling or the proportion of trips made by bicycle. Sixteen studies assessing individualised marketing of "environmentally friendly" modes of transport to interested households reported modest but consistent net effects equating to an average of eight additional cycling trips per person per year in the local population. Other interventions that targeted travel behaviour in general were not associated with a clear increase in cycling. Only two studies assessed effects of interventions on physical activity; one reported a positive shift in the population distribution of overall physical activity during the intervention. Community-wide promotional activities and improving infrastructure for cycling have the potential to increase cycling by modest amounts, but further controlled evaluative studies incorporating more precise measures are required, particularly in areas without an established cycling culture. Studies of individualised marketing report consistent positive effects of interventions on cycling behaviour, but these findings should be confirmed using more robust study designs. Future research should also examine how best to promote cycling in children and adolescents and through workplaces. Whether interventions to promote cycling result in an increase in overall physical activity or changes in anthropometric measures is unclear.

  11. Associations of consumption of fruits and vegetables during pregnancy with infant birth weight or small for gestational age births: a systematic review of the literature

    PubMed Central

    Murphy, Mary M; Stettler, Nicolas; Smith, Kimberly M; Reiss, Richard

    2014-01-01

    Maternal nutrition is recognized as one of the determinants of fetal growth. Consumption of fruits and vegetables is promoted as part of a healthful diet; however, intakes are typically lower than recommended levels. The purpose of this study was to systematically review results from studies examining the relationship between maternal consumption of fruits and vegetables during pregnancy with infant birth weight or risk for delivering a small for gestational age baby. A comprehensive search of PubMed and EMBASE was conducted and abstracts were screened using predefined criteria. Eleven relevant studies were identified and systematically reviewed, including six prospective cohort studies, three retrospective cohort studies, and two case–control studies. Seven studies were conducted in cohorts from highly developed countries. One prospective study from a highly developed area reported increased risk for small for gestational age birth by women with low vegetable intakes (odds ratio 3.1; 95% confidence interval 1.4–6.9; P=0.01); another large prospective study reported a 10.4 g increase in birth weight per quintile increase in fruit intake (95% confidence interval 6.9–3.9; P<0.0001) and increases of 8.4 or 7.7 g per quintile intake of fruits and vegetables (combined) or fruits, vegetables, and juice (combined), respectively. One retrospective study reported an association between low fruit intake and birth weight. In less developed countries, increased vegetable or fruit intake was associated with increased birth weight in two prospective studies. Overall, limited inconclusive evidence of a protective effect of increased consumption of vegetables and risk for small for gestational age birth, and increased consumption of fruits and vegetables and increased birth weight among women from highly developed countries was identified. Among women in less developed countries, limited inconclusive evidence suggests that increased consumption of vegetables or fruits may be associated with higher infant birth weight. The available evidence supports maternal consumption of a variety of fruits and vegetables as part of a balanced diet throughout pregnancy. PMID:25349482

  12. Impact of Psychoeducational Content Delivered Online to a Positive Psychology Aware Community.

    PubMed

    Haeck, Carly; Schueller, Stephen M; Parks, Acacia C

    Happiness-increasing interventions demonstrate significant variation in outcomes, suggesting that the people who use them might be as important as the interventions themselves to determine efficacy. In light of this, instructive interventions might not be necessary to increase happiness given a population with knowledge of happiness-increasing strategies. We recruited 270 participants with knowledge of positive psychology to receive six weeks of online psychoeducation. We explored participants' use of the website, reported use of happiness strategies, and changes in well-being. Those who spent more time on the website reported smaller changes in well-being than those who spent less time on the website. Conversely, those who reported employing more happiness strategies reported greater increases in well-being than those who used fewer strategies. This shows that for those already familiar with positive psychology, information, rather than instruction, might increase well-being. This has implications for studies evaluating the efficacy of happiness-increasing interventions more broadly.

  13. A report on economic studies of Australian mental health issues.

    PubMed

    Williams, Ruth; Doessel, Darrel

    2006-06-01

    To report on economic studies of Australian mental health issues. Although the international literature on the economics of mental health issues is increasing, and although many Australian studies exist on one comorbid condition of mental illness, namely substance abuse, there are very few empirical studies by economists of Australia's mental health issues.

  14. A Multilevel Analysis of U.S. Hospital Patient Safety Culture Relationships With Perceptions of Voluntary Event Reporting.

    PubMed

    Burlison, Jonathan D; Quillivan, Rebecca R; Kath, Lisa M; Zhou, Yinmei; Courtney, Sam C; Cheng, Cheng; Hoffman, James M

    2016-11-03

    Patient safety events offer opportunities to improve patient care, but, unfortunately, events often go unreported. Although some barriers to event reporting can be reduced with electronic reporting systems, insight on organizational and cultural factors that influence reporting frequency may help hospitals increase reporting rates and improve patient safety. The purpose of this study was to evaluate the associations between dimensions of patient safety culture and perceived reporting practices of safety events of varying severity. We conducted a cross-sectional survey study using previously collected data from The Agency for Healthcare Research and Quality Hospital Survey of Patient Safety Culture as predictors and outcome variables. The dataset included health-care professionals in U.S. hospitals, and data were analyzed using multilevel modeling techniques. Data from 223,412 individuals, 7816 work areas/units, and 967 hospitals were analyzed. Whether examining near miss, no harm, or potential for harm safety events, the dimension feedback about error accounted for the most unique predictive variance in the outcome frequency of events reported. Other significantly associated variables included organizational learning, nonpunitive response to error, and teamwork within units (all P < 0.001). As the perceived severity of the safety event increased, more culture dimensions became significantly associated with voluntary reporting. To increase the likelihood that a patient safety event will be voluntarily reported, our study suggests placing priority on improving event feedback mechanisms and communication of event-related improvements. Focusing efforts on these aspects may be more efficient than other forms of culture change.

  15. A Multilevel Analysis of U.S. Hospital Patient Safety Culture Relationships with Perceptions of Voluntary Event Reporting

    PubMed Central

    Burlison, Jonathan D.; Quillivan, Rebecca R.; Kath, Lisa M.; Zhou, Yinmei; Courtney, Sam C.; Cheng, Cheng; Hoffman, James M.

    2016-01-01

    Objectives Patient safety events offer opportunities to improve patient care, but, unfortunately, events often go unreported. Although some barriers to event reporting can be reduced with electronic reporting systems, insight on organizational and cultural factors that influence reporting frequency may help hospitals increase reporting rates and improve patient safety. The purpose of this study was to evaluate the associations between dimensions of patient safety culture and perceived reporting practices of safety events of varying severity. Methods We conducted a cross-sectional survey study using previously collected data from The Agency for Healthcare Research and Quality Hospital Survey of Patient Safety Culture as predictors and outcome variables. The dataset included healthcare professionals in U.S. hospitals, and data were analyzed by using multilevel modeling techniques. Results Data from 223,412 individuals, 7816 work areas/units and 967 hospitals were analyzed. Whether examining Near-miss, No harm, or Potential for harm safety events, the dimension Feedback about error accounted for the most unique predictive variance in the outcome Frequency of events reported. Other significantly associated variables included Organizational learning, Nonpunitive response to error, and Teamwork within units (all p<.001). As the perceived severity of the safety event increased, more culture dimensions became significantly associated with voluntary reporting. Conclusions To increase the likelihood that a patient safety event will be voluntarily reported, our study suggests placing priority on improving event feedback mechanisms and communication of event-related improvements. Focusing efforts on these aspects may be more efficient than other forms of culture change. PMID:27820722

  16. Comparison of Self-Reported Sleep Duration With Actigraphy: Results From the Hispanic Community Health Study/Study of Latinos Sueño Ancillary Study.

    PubMed

    Cespedes, Elizabeth M; Hu, Frank B; Redline, Susan; Rosner, Bernard; Alcantara, Carmela; Cai, Jianwen; Hall, Martica H; Loredo, Jose S; Mossavar-Rahmani, Yasmin; Ramos, Alberto R; Reid, Kathryn J; Shah, Neomi A; Sotres-Alvarez, Daniela; Zee, Phyllis C; Wang, Rui; Patel, Sanjay R

    2016-03-15

    Most studies of sleep and health outcomes rely on self-reported sleep duration, although correlation with objective measures is poor. In this study, we defined sociodemographic and sleep characteristics associated with misreporting and assessed whether accounting for these factors better explains variation in objective sleep duration among 2,086 participants in the Hispanic Community Health Study/Study of Latinos who completed more than 5 nights of wrist actigraphy and reported habitual bed/wake times from 2010 to 2013. Using linear regression, we examined self-report as a predictor of actigraphy-assessed sleep duration. Mean amount of time spent asleep was 7.85 (standard deviation, 1.12) hours by self-report and 6.74 (standard deviation, 1.02) hours by actigraphy; correlation between them was 0.43. For each additional hour of self-reported sleep, actigraphy time spent asleep increased by 20 minutes (95% confidence interval: 19, 22). Correlations between self-reported and actigraphy-assessed time spent asleep were lower with male sex, younger age, sleep efficiency <85%, and night-to-night variability in sleep duration ≥1.5 hours. Adding sociodemographic and sleep factors to self-reports increased the proportion of variance explained in actigraphy-assessed sleep slightly (18%-32%). In this large validation study including Hispanics/Latinos, we demonstrated a moderate correlation between self-reported and actigraphy-assessed time spent asleep. The performance of self-reports varied by demographic and sleep measures but not by Hispanic subgroup. © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  17. Reports of child sexual abuse of boys and girls: Longitudinal trends over a 20-year period in Victoria, Australia.

    PubMed

    Mathews, Ben; Bromfield, Leah; Walsh, Kerryann; Cheng, Qinglu; Norman, Rosana E

    2017-04-01

    Although prevalence studies show girls are more frequently sexually abused than boys, a significant proportion of boys also experience child sexual abuse (CSA). The challenges for public policy are amplified for boys due to less developed public and professional sensitisation to boys' experiences, conceptions of masculinity, and less research on boys including into reporting trends and outcomes. We conducted a 20-year longitudinal time-trend analysis of government data to identify reporting trends and report outcomes for CSA in Victoria, Australia from 1993 to 2012. We stratified by child gender and reporter status. Results indicate a new sensitisation to CSA, especially for boys, although this trend was not stable. Marked change occurred in the last five years, likely influenced by major social and political events. Comparison over time revealed that from 1993 to 2012, the rate of reporting of boys increased 2.6-fold whereas there was a 1.5-fold increase for girls. Comparing genders, with regards to rate of reporting, in 1993, the sex ratio of girls to boys was 2:1, while by 2012 this ratio changed to 1.14:1. Reports by police and other mandated reporters accounted for the majority of the increase in reports over the 20-year period, suggesting unequal sensitisation. Positive report outcomes (i.e. substantiations, findings of harm, and referral to services) increased twelve-fold for boys, and nearly five-fold for girls, indicating the increased levels of reports were based in actual clinical need. Most of this increase occurred from 2009 to 2012, influenced by a compound of social, political and agency-related factors. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Intimate partner violence and Hurricane Katrina: Predictors and associated mental health outcomes

    PubMed Central

    Schumacher, Julie A.; Coffey, Scott F.; Norris, Fran H.; Tracy, Melissa; Clements, Kahni; Galea, Sandro

    2012-01-01

    This study sought to establish the prevalence and correlates of intimate partner violence (IPV) victimization in the six months before and after Hurricane Katrina. Participants were 445 married or cohabiting persons who were living in the 23 southernmost counties of Mississippi at the time of Hurricane Katrina. Data for this study were collected as part of a larger, population-based, representative study. The percentage of women reporting psychological victimization increased from 33.6% prior to Hurricane Katrina to 45.2 % following Hurricane Katrina (p < 0.001). The percentage of men reporting psychological victimization increased from 36.7% to 43.1% (p = 0.01). Reports of physical victimization increased from 4.2% to 8.3% for women (p=.01), but were unchanged for men. Significant predictors of post-Katrina victimization included pre-Katrina victimization, age, educational attainment, marital status and hurricane-related stressors. Reports of IPV were associated with greater risk of post-Katrina depression and posttraumatic stress disorder. Data from the first population-based study to document IPV following a large scale natural disaster suggest that IPV may be an important, but often overlooked public health concern following disasters. PMID:21061866

  19. Psychosocial Factors and Theory in Physical Activity Studies in Minorities

    PubMed Central

    Mama, Scherezade K.; McNeill, Lorna H.; McCurdy, Sheryl A.; Evans, Alexandra E.; Diamond, Pamela M.; Adamus-Leach, Heather J.; Lee, Rebecca E.

    2015-01-01

    Objectives To summarize the effectiveness of interventions targeting psychosocial factors to increase physical activity (PA) among ethnic minority adults and explore theory use in PA interventions. Methods Studies (N = 11) were identified through a systematic review and targeted African American/Hispanic adults, specific psychosocial factors, and PA. Data were extracted using a standard code sheet and the Theory Coding Scheme. Results Social support was the most common psychosocial factor reported, followed by motivational readiness, and self-efficacy, as being associated with increased PA. Only 7 studies explicitly reported using a theoretical framework. Conclusions Future efforts should explore theory use in PA interventions and how integration of theoretical constructs, including psychosocial factors, increases PA. PMID:25290599

  20. Increases and decreases in drug use attributed to housing status among street-involved youth in a Canadian setting.

    PubMed

    Cheng, Tessa; Wood, Evan; Nguyen, Paul; Kerr, Thomas; DeBeck, Kora

    2014-04-10

    Among a cohort of drug-using street-involved youth, we sought to identify the prevalence of reporting increases and decreases in illicit drug use due to their current housing status and to identify factors associated with reporting these changes. This longitudinal study was based on data collected between June 2008 and May 2012 from a prospective cohort of street-involved youth aged 14-26 in Vancouver, Canada. At semi-annual study follow-up visits, youth were asked if their drug use was affected by their housing status. Using generalized estimating equations, we identified factors associated with perceived increases and decreases in drug use attributed to housing status. Among our sample of 536 participants at baseline, 164 (31%) youth reported increasing their drug use due to their housing situation and 71 (13%) reported decreasing their drug use. In multivariate analysis, factors that were positively associated with perceived increases in drug use attributed to housing status included the following: being homeless, engaging in sex work and drug dealing. Regular employment was negatively associated with increasing drug use due to housing status. Among those who reported decreasing their drug use, only homelessness was significant in bivariate analysis. Perceived changes in drug use due to housing status were relatively common in this setting and were associated with being homeless and, among those who increased their drug use, engaging in risky income generation activities. These findings suggest that structural factors, particularly housing and economic opportunities, may be crucial interventions for reducing or limiting drug use among street-involved youth.

  1. Increases and decreases in drug use attributed to housing status among street-involved youth in a Canadian setting

    PubMed Central

    2014-01-01

    Background Among a cohort of drug-using street-involved youth, we sought to identify the prevalence of reporting increases and decreases in illicit drug use due to their current housing status and to identify factors associated with reporting these changes. Findings This longitudinal study was based on data collected between June 2008 and May 2012 from a prospective cohort of street-involved youth aged 14–26 in Vancouver, Canada. At semi-annual study follow-up visits, youth were asked if their drug use was affected by their housing status. Using generalized estimating equations, we identified factors associated with perceived increases and decreases in drug use attributed to housing status. Among our sample of 536 participants at baseline, 164 (31%) youth reported increasing their drug use due to their housing situation and 71 (13%) reported decreasing their drug use. In multivariate analysis, factors that were positively associated with perceived increases in drug use attributed to housing status included the following: being homeless, engaging in sex work and drug dealing. Regular employment was negatively associated with increasing drug use due to housing status. Among those who reported decreasing their drug use, only homelessness was significant in bivariate analysis. Conclusion Perceived changes in drug use due to housing status were relatively common in this setting and were associated with being homeless and, among those who increased their drug use, engaging in risky income generation activities. These findings suggest that structural factors, particularly housing and economic opportunities, may be crucial interventions for reducing or limiting drug use among street-involved youth. PMID:24721725

  2. Financial Strain, Parental Smoking, and the Great Recession: An Analysis of the UK Millennium Cohort Study.

    PubMed

    McKenna, Caoimhe S; Law, Catherine; Pearce, Anna

    2017-11-07

    During the recent "Great Recession," many families in the United Kingdom experienced increased financial strain (FS). The aim of this study was to determine if increases in FS, occurring over the period of the "Great Recession," were associated with increased risks of persistent and relapsed tobacco use among parents. We analyzed the Millennium Cohort Study, a longitudinal study of 18819 children born in the United Kingdom between 2000 and 2002. Surveys at 7 (T1, 2008) and 11 years (T2, 2012) spanned the "Great Recession." Three measures of increased FS were defined; "became income poor" (self-reported household income dropped below the "poverty line" between T1 and T2); "developed difficulty managing" (parental report of being "financially comfortable" at T1 and finding it "difficult to manage" at T2); "felt worse off" (parental report of feeling financially "worse off" at T2, compared to T1). Poisson regression was used to estimate risk ratios (RR), adjusted RRs (aRR), and 95% confidence intervals for three outcomes: "persistent tobacco use," "new reported tobacco use," and "relapsed tobacco use." Parents in households which "became income poor" over the period of the "Great Recession" were significantly more likely to report "persistent tobacco use" (aRR = 2.17 [1.83-2.57]) or "new reported tobacco use" (aRR = 1.72 [1.04-2.83]). Ninety-five percent of "new reported tobacco users" had evidence of prior tobacco use suggesting the majority were "relapsed tobacco users." Similar patterns were seen for those who "developed difficulty managing" and "felt worse off." Increased tobacco use among financially strained families has the potential to widen inequalities and undermine the public health policies that have had positive impacts on tobacco consumption in the United Kingdom. While several studies have shown that FS is associated with a higher prevalence of tobacco use, heavier smoking, and relapsed tobacco use, most of this work used cross-sectional data and none has focused on parents. We used longitudinal data from the UK Millennium Cohort Study, between 2008 and 2012, to examine the association between FS and parental smoking. We show that parents who experienced increased FS, over the period of the "Great Recession," were more likely to continue using tobacco or to relapse. © The Author 2016. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco.

  3. Autism and Belonging

    ERIC Educational Resources Information Center

    Laursen, Erik K.; Yazdgerdi, Sasha

    2012-01-01

    Recently, the Center for Disease Control released the findings of a study estimating that 1 in 88 children in the U. S. has been identified with an autism spectrum disorder (ASD) representing a 78% increase over the last decade. The study also reports that Hispanic and African-American children represent the largest increase. An increasing number…

  4. Fatigue and training of obstetrics and gynaecology trainees in Australia and New Zealand.

    PubMed

    Tucker, Paige E; Cohen, Paul A; Bulsara, Max K; Acton, Jade

    2017-10-01

    Several studies have linked doctor fatigue with adverse patient events and an increase in risk to doctors' personal safety and wellbeing. The present study assesses the rostering structure of Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) trainees and its association with trainees' reported fatigue levels, training opportunities and wellbeing, which were secondary outcomes of a larger study of trainee working hours which has been separately reported. An anonymous, online survey of RANZCOG trainees was conducted. Demographic data collected included: age, gender, level of training and current rotation. Data were also collected on hours worked per week, long shifts (>12 h), self-reported fatigue levels, and opinions regarding current rostering and training. A majority (72.9%) of respondents regularly felt fatigued, with higher fatigue levels being associated with more hours worked per week (P = <0.001) and working long shifts (>12 h) (P = 0.007). Fatigue was associated with an increased risk of dozing while driving (P = 0.028), with 56.1% of respondents reporting that this occurs. Trainees appeared to be less confident in achieving their technical skill requirements, with increasing hours not increasing confidence in achieving these skills (P = 0.594). Trainees who worked under 50 h per week were less likely to report fatigue (P = <0.001) and more likely to report greater work enjoyment (P = 0.043), and working hours being conducive to learning (P = 0.015). Fatigue was frequently reported by RANZCOG trainees with increased working hours and long shifts being significant factors in fatigue levels. Strategies should be developed and trialled to enable trainees to obtain adequate case exposure and teaching without compromising patient and doctor safety. © 2017 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  5. Evaluation of the Endorsement of the STrengthening the REporting of Genetic Association Studies (STREGA) Statement on the Reporting Quality of Published Genetic Association Studies

    PubMed Central

    Nedovic, Darko; Panic, Nikola; Pastorino, Roberta; Ricciardi, Walter; Boccia, Stefania

    2016-01-01

    The STrengthening the REporting of Genetic Association studies (STREGA) statement was based on the STrengthening the REporting of OBservational studies in Epidemiology (STROBE) statement, and it was published in 2009 in order to improve the reporting of genetic association (GA) studies. Our aim was to evaluate the impact of STREGA endorsement on the quality of reporting of GA studies published in journals in the field of genetics and heredity (GH). Quality of reporting was evaluated by assessing the adherence of papers to the STREGA checklist. After identifying the GH journals that endorsed STREGA in their instructions for authors, we randomly appraised papers published in 2013 from journals endorsing STREGA that published GA studies (Group A); in GH journals that never endorsed STREGA (Group B); in GH journals endorsing STREGA, but in the year preceding its endorsement (Group C); and in the same time period as Group C from GH journals that never endorsed STREGA (Group D). The STREGA statement was referenced in 29 (18.1%) of 160 GH journals, of which 18 (62.1%) journals published GA studies. Among the 18 journals endorsing STREGA, we found a significant increase in the overall adherence to the STREGA checklist over time (A vs C; P < 0.0001). Adherence to the STREGA checklist was significantly higher in journals endorsing STREGA compared to those that did not endorse the statement (A vs B; P = 0.04). No significant improvement was detected in the adherence to STREGA items in journals not endorsing STREGA over time (B vs D; P > 0.05). The endorsement of STREGA resulted in an increase in quality of reporting of GA studies over time, while no similar improvement was reported for journals that never endorsed STREGA. PMID:27349199

  6. [Workers' Health Referral Centers and reporting of work-related injuries in Brazil].

    PubMed

    Galdino, Adriana; Santana, Vilma Sousa; Ferrite, Silvia

    2012-01-01

    This study examines the contribution of Workers' Health Referral Centers (CEREST) to the reporting of severe work-related injuries and those involving exposure to biological materials in the Brazilian National Health Reporting System (SINAN), under the Unified National Health System (SUS). The study used data from the Form-SUS and SINAN databases, aggregated for the CEREST coverage areas. Valid data were obtained for 125 CEREST (23 State and 102 regional). A majority of the CEREST were assessed as fully installed. The increase in the reporting of severe work-related accidents was greater when staffing was consistent with the demand, and when teams responded to external demands, including those of the media. For exposures to biological material, CEREST with good physical installations, those that responded to media demands, and those with trained personnel in the sentinel network showed a higher increase in reporting. Infrastructure, staff numbers and training, and responding to external demands are important for increasing notification of work-related accidents and should be prioritized in order to reduce the major underreporting of such accidents.

  7. Trends in P Value, Confidence Interval, and Power Analysis Reporting in Health Professions Education Research Reports: A Systematic Appraisal.

    PubMed

    Abbott, Eduardo F; Serrano, Valentina P; Rethlefsen, Melissa L; Pandian, T K; Naik, Nimesh D; West, Colin P; Pankratz, V Shane; Cook, David A

    2018-02-01

    To characterize reporting of P values, confidence intervals (CIs), and statistical power in health professions education research (HPER) through manual and computerized analysis of published research reports. The authors searched PubMed, Embase, and CINAHL in May 2016, for comparative research studies. For manual analysis of abstracts and main texts, they randomly sampled 250 HPER reports published in 1985, 1995, 2005, and 2015, and 100 biomedical research reports published in 1985 and 2015. Automated computerized analysis of abstracts included all HPER reports published 1970-2015. In the 2015 HPER sample, P values were reported in 69/100 abstracts and 94 main texts. CIs were reported in 6 abstracts and 22 main texts. Most P values (≥77%) were ≤.05. Across all years, 60/164 two-group HPER studies had ≥80% power to detect a between-group difference of 0.5 standard deviations. From 1985 to 2015, the proportion of HPER abstracts reporting a CI did not change significantly (odds ratio [OR] 2.87; 95% CI 1.04, 7.88) whereas that of main texts reporting a CI increased (OR 1.96; 95% CI 1.39, 2.78). Comparison with biomedical studies revealed similar reporting of P values, but more frequent use of CIs in biomedicine. Automated analysis of 56,440 HPER abstracts found 14,867 (26.3%) reporting a P value, 3,024 (5.4%) reporting a CI, and increased reporting of P values and CIs from 1970 to 2015. P values are ubiquitous in HPER, CIs are rarely reported, and most studies are underpowered. Most reported P values would be considered statistically significant.

  8. Results from the cognitive changes and retirement among senior surgeons self-report survey.

    PubMed

    Lee, H Jin; Drag, Lauren L; Bieliauskas, Linas A; Langenecker, Scott A; Graver, Christopher; O'Neill, Jillian; Greenfield, Lazar

    2009-11-01

    The Cognitive Changes and Retirement among Senior Surgeons (CCRASS) study suggested that although subjective cognitive awareness may play a role in surgeons' retirement decisions, self-perceived cognitive decline did not predict objective cognitive performance. This article summarizes results from all participants who completed the survey portion of the CCRASS study. A survey examining subjective cognitive changes, changes in caseload, involvement in new technology, and retirement decisions, was administered to 995 surgeons at annual meetings of the Clinical Congress of the American College of Surgeons between 2001 and 2006. Forty-five percent reported increased caseload volume and 48% reported increased caseload complexity during the previous 5 years. In addition, 75% and 73% denied any recent changes in memory recall or name recognition, respectively. Increasing age was associated with decreases in clinical caseload and complexity. The majority of respondents across all age groups reported active participation in either learning (64%) or contributing (13%) to new technology in the field. Among surgeons with no imminent plans for retirement, 58% reported that a retirement decision will be based on skill level. Increasing age was associated with decreases in caseload and case complexity. But a steady proportion of surgeons, even in the oldest age group, are active in new surgical innovations and challenging cases. Most reported no changes in perceived cognitive abilities. The majority of surgeons who had made no decision to retire reported that their decision will be based on skill level rather than age.

  9. Commentary: childhood cancer near nuclear power stations

    PubMed Central

    2009-01-01

    In 2008, the KiKK study in Germany reported a 1.6-fold increase in solid cancers and a 2.2-fold increase in leukemias among children living within 5 km of all German nuclear power stations. The study has triggered debates as to the cause(s) of these increased cancers. This article reports on the findings of the KiKK study; discusses past and more recent epidemiological studies of leukemias near nuclear installations around the world, and outlines a possible biological mechanism to explain the increased cancers. This suggests that the observed high rates of infant leukemias may be a teratogenic effect from incorporated radionuclides. Doses from environmental emissions from nuclear reactors to embryos and fetuses in pregnant women near nuclear power stations may be larger than suspected. Hematopoietic tissues appear to be considerably more radiosensitive in embryos/fetuses than in newborn babies. Recommendations for advice to local residents and for further research are made. PMID:19775438

  10. The benefits of otoplasty for children: further evidence to satisfy the modern NHS.

    PubMed

    Cooper-Hobson, G; Jaffe, W

    2009-02-01

    To take standards from, and revalidate an existing study which addressed the psychological and social outcomes following otoplasty in children [Bradbury E, Hewison J, Timmons M. Psychological and social outcome of prominent ear correction in children. Br J Plast Surg 1992;45:97-100]. The psychosocial experiences of children undergoing otoplasty at the University Hospital of North Staffordshire were retrospectively examined and compared to the cohort in the existing study. Retrospective questionnaires were sent to all children aged 5-16 (n=101) who were on the hospital records having undergone otoplasty between 1999 and 2003, investigating social experiences, and experience of surgery. This study found: 97% reported an increase in happiness; 92% reported an increase in self-confidence; 79% noted improved social experience; 100% reported bullying reduced or stopped. The Wilcoxon Rank Sum Test confirmed the statistical validity of these findings (P<0.001). The existing study found: 63% of children reported increase in happiness and confidence; 13% noted improved social experiences; 53% noted bullying had stopped entirely. Otoplasty is an effective procedure in alleviating psychosocial distress in the vast majority of children that undergo the operation, and hence this study supports the continued availability of otoplasty on the NHS for children with prominent ears.

  11. The effect of wind turbine noise on sleep and quality of life: A systematic review and meta-analysis of observational studies.

    PubMed

    Onakpoya, Igho J; O'Sullivan, Jack; Thompson, Matthew J; Heneghan, Carl J

    2015-09-01

    Noise generated by wind turbines has been reported to affect sleep and quality of life (QOL), but the relationship is unclear. Our objective was to explore the association between wind turbine noise, sleep disturbance and quality of life, using data from published observational studies. We searched Medline, Embase, Global Health and Google Scholar databases. No language restrictions were imposed. Hand searches of bibliography of retrieved full texts were also conducted. The reporting quality of included studies was assessed using the STROBE guidelines. Two reviewers independently determined the eligibility of studies, assessed the quality of included studies, and extracted the data. We included eight studies with a total of 2433 participants. All studies were cross-sectional, and the overall reporting quality was moderate. Meta-analysis of six studies (n=2364) revealed that the odds of being annoyed is significantly increased by wind turbine noise (OR: 4.08; 95% CI: 2.37 to 7.04; p<0.00001). The odds of sleep disturbance was also significantly increased with greater exposure to wind turbine noise (OR: 2.94; 95% CI: 1.98 to 4.37; p<0.00001). Four studies reported that wind turbine noise significantly interfered with QOL. Further, visual perception of wind turbine generators was associated with greater frequency of reported negative health effects. In conclusion, there is some evidence that exposure to wind turbine noise is associated with increased odds of annoyance and sleep problems. Individual attitudes could influence the type of response to noise from wind turbines. Experimental and observational studies investigating the relationship between wind turbine noise and health are warranted. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Aging: empirical contribution. A longitudinal analysis of personality disorder dimensions and personality traits in a community sample of older adults: perspectives from selves and informants.

    PubMed

    Cooper, Luke D; Balsis, Steve; Oltmanns, Thomas F

    2014-02-01

    Research has indicated that personality disorders (PDs) and normal-range personality traits generally "get better" with time, as evidenced by mean-level decreases in PD traits and mean-level increases in broad factors such as emotional stability, agreeableness, and conscientiousness. One limitation of many of these studies is their reliance on self reported data. In the current study, the authors analyzed the 2.5-year course of PD dimensions and normal personality traits in a representative sample of adults approaching later life (originally ages 55-65) by using a semistructured diagnostic interview as well as self- and informant-reported data from two personality inventories. Consistent with previous literature, many self-reported PD traits showed mean-level decreases over time, and self-reported normal-range personality traits generally showed positive aging effects (e.g., mean-level increases in emotional stability, agreeableness, and conscientiousness). Surprisingly, however, informant-reported PD traits often demonstrated small but significant increases over time, and informant-reported normal-range personality generally "worsened" with age (e.g., mean-level decreases in extraversion, agreeableness, and conscientiousness). Informant reports may challenge the finding that personality and PDs tend to "improve" over time.

  13. Appraising Two Techniques for Increasing the Honesty of Students' Answers to Self-Report Assessment Devices.

    ERIC Educational Resources Information Center

    Popham, W. James

    1993-01-01

    Techniques for increasing honesty of student self-report measures, the inaccessible coding system and the alphabet-soup response form, were investigated in a study involving over 1,200 high school students. Both techniques were regarded favorably by students. Because both enhance anonymity, it appears that they could be used jointly. (SLD)

  14. Risk factors and symptoms associated with xerostomia: a cross-sectional study.

    PubMed

    Villa, A; Abati, S

    2011-09-01

    The aim of this study was to examine the symptoms and risk factors associated with self-reported xerostomia. Data were collected from 601 self-administered questionnaires among dental clinic attendees. Logistic regression models to estimate odds ratios and 95% confidence intervals were used to investigate the association for exposures of interest, such as socio-demographic characteristics, self-reported symptoms, oral hygiene habits and xerostomia. Participants reported having dry mouth in 19.6% of cases. Xerostomia was associated with a significant increase in the odds of having dry lips, throat, eye, skin and nose. Patients with self-reported xerostomia were three times more likely to drink water to swallow food than were patients without xerstomia. Older individuals were significantly more likely to report dry mouth, and the prevalence of xerostomia increased with advancing age. The prevalence of xerostomia in patients taking one or more drugs was significantly higher compared to medication-free patients, and increased with increasing numbers of medications used. Finally, individuals with a nervous or mental disorder, or who wore removable dentures were five times more likely to develop xerostomia than patients without disorder or dentures. Dentists should be familiar with the symptoms of xerostomia and be prepared to take an active role in the diagnosis, management and treatment of the oral complications. © 2011 Australian Dental Association.

  15. Physical activity on prescription (PAP): self-reported physical activity and quality of life in a Swedish primary care population, 2-year follow-up.

    PubMed

    Rödjer, Lars; H Jonsdottir, Ingibjörg; Börjesson, Mats

    2016-12-01

    To study the self-reported level of physical activity (PA) and quality of life (QOL) in patients receiving physical activity on prescription (PAP) for up to 24 months. Observational study conducted in a regular healthcare setting. A primary care population in Sweden receiving physical activity on prescription as part of regular care was studied alongside a reference group. The group comprised 146 patients receiving PAP at two different primary care locations (n = 96 and 50, respectively). The reference group comprised 58 patients recruited from two different primary care centres in the same region. We used two self-report questionnaires - the four-level Saltin-Grimby Physical Activity Level Scale (SGPALS) to assess physical activity, and SF-36 to assess QOL. A significant increase in the PA level was found at six and 12 months following PAP, with an ongoing non-significant trend at 24 months (p = .09). A clear improvement in QOL was seen during the period. At 24 months, significant and clinically relevant improvements in QOL persisted in four out of eight sub-scale scores (Physical Role Limitation, Bodily Pain, General Health,Vitality) and in one out of two summary scores (Physical Component Summary). Patients receiving PAP showed an increased level of self-reported PA at six and 12 months and improved QOL for up to 24 months in several domains. The Swedish PAP method seems to be a feasible method for bringing about changes in physical activity in different patient populations in regular primary healthcare. While increased physical activity (PA) is shown to improve health, the implementation of methods designed to increase activity is still being developed. Key points The present study confirms that the Swedish physical activity on prescription (PAP) method increases the self-reported level of PA in the primary care setting at six and 12 months. Furthermore, this study shows that PAP recipients report a clinically relevant long-term improvement in quality of life, persisting for two years post-prescription, thus extending earlier findings. These findings have clinical implications for the implementation of PAP in healthcare.

  16. Changes in Patient-Reported Alcohol-Related Advice Following Veterans Health Administration Implementation of Brief Alcohol Interventions.

    PubMed

    Chavez, Laura J; Williams, Emily C; Lapham, Gwen T; Rubinsky, Anna D; Kivlahan, Daniel R; Bradley, Katharine A

    2016-05-01

    Brief alcohol interventions are recommended for primary care patients who screen positive for alcohol misuse, but implementation is challenging. The U.S. Veterans Health Administration (Veterans Affairs [VA]) implemented brief interventions for patients with alcohol misuse in 2008, and rates of brief interventions documented in the electronic medical record increased from 24% to 78% (2008-2011). This study examined whether an independent measure of brief interventions-patient-reported alcohol-related advice-also increased among VA outpatients who screened positive for alcohol misuse on a mailed survey. This retrospective cross-sectional study included VA outpatient respondents to the VA's Survey of Healthcare Experiences of Patients (SHEP; 2007-2011) who reported past-year alcohol use and answered a question about alcohol-related advice. Alcohol-related advice was defined as a report of past-year advice from a VA clinician to abstain from or reduce drinking. The adjusted prevalence of alcoholrelated advice among patients who screened positive for alcohol misuse (SHEP AUDIT-C ≥ 5) was estimated for each year. Among patients with alcohol misuse (n = 61,843), the adjusted prevalence of alcohol-related advice increased from 40.4% (95% CI [39.3%, 41.5%]) in 2007 to 55.5% (95% CI [53.3%, 57.8%]) in 2011. Rates of alcoholrelated advice increased significantly each year except the last. The VA's efforts to implement brief interventions were associated with increased patient-reported alcohol-related advice over time, with a majority of patients with alcohol misuse reporting its receipt. Other systems considering similar approaches to implementation may benefit from collecting patient-reported measures of brief interventions for an additional perspective on implementation.

  17. 22 Emergency department litigation and coroner's inquests: a ten year analysis.

    PubMed

    Tilbury, Nicholas; Tabner, Andrew; Johnson, Graham

    2017-12-01

    The burden of litigation within the NHS should not be underestimated. Indemnity costs rise in response to the rising frequency and costs of claims, with recent changes to the discount rate projected to increase NHS Litigation Authority (NHSLA) costs by £1 Billion per year. Litigation also has a significant psychological impact on staff. This study represents the first examination of litigation and Coroner's 'Prevention of Future Deaths' reports relating to emergency department care in the UK. Using the Freedom of Information (FOI) Act (2000) we submitted data requests to both the NHSLA and the Ministry of Justice (MoJ).The NHSLA provided data concerning ED litigation claims between 2006 and 2015 including:Number of claims by yearNumber of successful and unsuccessful claims by yearNumber of settled claimsCost of claims (including defence costs, claimant costs and damages awarded)The MoJ provided data concerning PFD reports issued to EDs between 2006 and 2016. Data concerning PFD reports issued between 2012 and 2015 were extracted from the MoJ website. Data included:Report dateAge and gender of the deceasedReport summary RESULTS: The total number of ED litigation claims made between 2006 and 2015 was 10,040; 5745 (57.2%) resulted in a financial settlement. The number of claims successfully settled ranged from 382 in 2005/06 to 830 in 2014/15 with an upward trend throughout the decade. The mean cost of a successful claim was £114,029; increasing from £66 754 in 2005/06 to £1 41 027 in 2014/15, a 111% increase. Delay/failure in diagnosis was the most common cause for litigation (4318 [44.5%]) and PFD reports (15 [21%]).A total of 70 PFD reports were issued within the study period; there was no trend in the number of reports issued per year. The greatest number of reports were issued in 2014 (18), far exceeding any other year. Annual claim numbers have increased by 117% over the study period and mean claim cost has increased by 111% (far in excess of any rise expected due to inflation). Causation cannot be determined by this observational study, but potentially contributory factors include: the increasingly litigious nature of society in general; rising patient expectations and the worsening crisis in staff retention, recruitment and morale.This analysis of litigation patterns and PFD reports provides an insight that enables further focus on the underlying causes, subsequent improvement in patient care and a reversal of current litigation trends. © 2017, 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.

  18. Midwifery Management of Pregnant Women Who Are Obese.

    PubMed

    Reither, Margi; Germano, Elaine; DeGrazia, Michele

    2018-05-19

    Obesity is associated with increased risks for adverse health outcomes during and after pregnancy in both the woman with obesity and her infant. This study was designed to investigate midwifery management of pregnant women with obesity. Certified midwives and certified nurse-midwives who were members of the American College of Nurse-Midwives were sent a survey. The survey instrument was divided into 4 sections: demographic characteristics; practice guidelines and protocols; the role of the 2015 Levels of Maternal Care guidelines for referral, including transfer to a higher level of care; and factors that influence management of pregnant women with obesity. Descriptive statistics were used to analyze data. In a sample of 546 midwives, 87% of respondents reported observing an increase in perinatal complications associated with obesity. Midwives reported increasing discomfort with the care of pregnant women with obesity as body mass index (BMI) increased. For pregnant women with extreme obesity, the respondents reported less frequent use of physiologic birth guidelines only and increased use of interventions, referral to physician care, and transfer to a higher level of care. Approximately half (270, 49.5%) reported having a guideline that addressed the care of women with obesity. Of these, 145 midwives (53.7%) reported that extreme obesity was the BMI threshold for identifying an increased or high risk for perinatal complications. Sixty percent (339) of midwives who participated requested guidance for management of laboring women who are obese. This study provides a greater understanding of midwifery management practices when caring for women with obesity and opportunities to improve care. The results suggest that midwifery management alters with increased BMI, specifically in the care of women with extreme obesity. Suggestions for future study include research on management of pregnant women with obesity and extreme obesity with outcome data examining management strategies that provide safe, satisfying care. © 2018 by the American College of Nurse-Midwives.

  19. COS-STAR: a reporting guideline for studies developing core outcome sets (protocol).

    PubMed

    Kirkham, Jamie J; Gorst, Sarah; Altman, Douglas G; Blazeby, Jane; Clarke, Mike; Devane, Declan; Gargon, Elizabeth; Williamson, Paula R

    2015-08-22

    Core outcome sets can increase the efficiency and value of research and, as a result, there are an increasing number of studies looking to develop core outcome sets (COS). However, the credibility of a COS depends on both the use of sound methodology in its development and clear and transparent reporting of the processes adopted. To date there is no reporting guideline for reporting COS studies. The aim of this programme of research is to develop a reporting guideline for studies developing COS and to highlight some of the important methodological considerations in the process. The study will include a reporting guideline item generation stage which will then be used in a Delphi study. The Delphi study is anticipated to include two rounds. The first round will ask stakeholders to score the items listed and to add any new items they think are relevant. In the second round of the process, participants will be shown the distribution of scores for all stakeholder groups separately and asked to re-score. A final consensus meeting will be held with an expert panel and stakeholder representatives to review the guideline item list. Following the consensus meeting, a reporting guideline will be drafted and review and testing will be undertaken until the guideline is finalised. The final outcome will be the COS-STAR (Core Outcome Set-STAndards for Reporting) guideline for studies developing COS and a supporting explanatory document. To assess the credibility and usefulness of a COS, readers of a COS development report need complete, clear and transparent information on its methodology and proposed core set of outcomes. The COS-STAR guideline will potentially benefit all stakeholders in COS development: COS developers, COS users, e.g. trialists and systematic reviewers, journal editors, policy-makers and patient groups.

  20. The Impact of Price Transparency for Surgical Services.

    PubMed

    Mehta, Ambar; Xu, Tim; Bai, Ge; Hawley, Kristy L; Makary, Martin A

    2018-04-01

    Increasing insurance deductibles have prompted some medical centers to initiate transparent pricing. However, the impact of price transparency (PT) on surgical volume, revenue, and patient satisfaction is unknown, along with the barriers to achieving PT. We identified ambulatory surgical centers in the Free Market Medical Association database that publicly list prices for surgical services online. Six of eight centers (75%) responded to our data collection inquiry. Among five centers that reported their patient volume and revenue after adopting PT, patient volume increased by a median of 50 per cent (range 10-200%) at one year. Four centers (80%) reported an increase in revenue by a median of 30 per cent (range 4-75%), whereas three centers (60%) experienced an increase in third-party administrator contracts with the average increase being seven new third-party administrator contracts (range = 2-12 contracts). Three centers (50%) reported a reduction in their administrative burden and five centers (83%) reported an increase in patient satisfaction and patient engagement after PT. The leading barrier reported to making prices transparent was discouragement from another practice, hospital, or insurance company. The findings of this preliminary study may help guide medical practices in designing and implementing PT strategies.

  1. Change in Self-Reported Health Status among Immigrants in the United States: Associations with Measures of Acculturation

    PubMed Central

    Lee, Sunmin; O’Neill, Allison H.; Ihara, Emily S.; Chae, David H.

    2013-01-01

    Although acculturation may have positive effects for immigrants, including better socioeconomic profiles and increased occupational opportunities, their health profiles deteriorate with longer duration in the U.S. Prior research indicates that increasing acculturation is associated with some poorer health outcomes among immigrants in the U.S. However, most of these studies have used length of stay or English language proficiency as proxies for acculturation, and have mainly examined self-reported “current” health outcomes. This study advances knowledge on associations between acculturation and health among immigrants by explicitly examining self-reported “change” in health since immigration, in relation to acculturation-related variables. We use data from the New Immigrant Survey (NIS; 2003-2004), a cross-sectional study of legal immigrants to the U.S. In addition to testing more conventionally examined proxies of acculturation (length of stay and English proficiency), we also examine English language use and self-reported change in diet. Multivariable logistic regression analyses on 5,982 participants generally supported previous literature indicating a deleterious impact of acculturation, with increasing duration of stay and greater self-reported change in diet being associated with a poorer change in health since moving to the U.S. Although English language proficiency and use were associated with greater odds of reporting a worse change in health when examined individually, they were non-significant in multivariable models including all acculturation measures. Findings from this study suggest that when taking into account multiple measures of acculturation, language may not necessarily indicate unhealthy assimilation and dietary change may be a pathway leading to declines in immigrant health. Increasing duration in the U.S. may also reflect the adoption of unhealthy behaviors, as well as greater exposure to harmful sources of psychosocial stress including racial and anti-immigrant discrimination. Our study suggests that multiple indicators of acculturation may be useful in examining the effect of acculturation on changes in health among immigrants. PMID:24098515

  2. Change in self-reported health status among immigrants in the United States: associations with measures of acculturation.

    PubMed

    Lee, Sunmin; O'Neill, Allison H; Ihara, Emily S; Chae, David H

    2013-01-01

    Although acculturation may have positive effects for immigrants, including better socioeconomic profiles and increased occupational opportunities, their health profiles deteriorate with longer duration in the U.S. Prior research indicates that increasing acculturation is associated with some poorer health outcomes among immigrants in the U.S. However, most of these studies have used length of stay or English language proficiency as proxies for acculturation, and have mainly examined self-reported "current" health outcomes. This study advances knowledge on associations between acculturation and health among immigrants by explicitly examining self-reported "change" in health since immigration, in relation to acculturation-related variables. We use data from the New Immigrant Survey (NIS; 2003-2004), a cross-sectional study of legal immigrants to the U.S. In addition to testing more conventionally examined proxies of acculturation (length of stay and English proficiency), we also examine English language use and self-reported change in diet. Multivariable logistic regression analyses on 5,982 participants generally supported previous literature indicating a deleterious impact of acculturation, with increasing duration of stay and greater self-reported change in diet being associated with a poorer change in health since moving to the U.S. Although English language proficiency and use were associated with greater odds of reporting a worse change in health when examined individually, they were non-significant in multivariable models including all acculturation measures. Findings from this study suggest that when taking into account multiple measures of acculturation, language may not necessarily indicate unhealthy assimilation and dietary change may be a pathway leading to declines in immigrant health. Increasing duration in the U.S. may also reflect the adoption of unhealthy behaviors, as well as greater exposure to harmful sources of psychosocial stress including racial and anti-immigrant discrimination. Our study suggests that multiple indicators of acculturation may be useful in examining the effect of acculturation on changes in health among immigrants.

  3. Alternative fuels study : a report to Congress on policy options for increasing the use of alternative fuels in transit vehicles, December 2006.

    DOT National Transportation Integrated Search

    2006-12-01

    This report presents the results of a study required by Section 3016(c) of the Safe, Accountable, Flexible, Efficient Transportation Equity Act: A Legacy for Users (SAFETEA-LU). That section directed the Secretary of Transportation to conduct a study...

  4. One Session of Autogenic Training Increases Acute Subjective Sexual Arousal in Premenopausal Women Reporting Sexual Arousal Problems.

    PubMed

    Stanton, Amelia M; Hixon, J Gregory; Nichols, Lindsey M; Meston, Cindy M

    2018-01-01

    Below average heart rate variability (HRV) has been associated with sexual arousal dysfunction and overall sexual dysfunction in women. Autogenic training, a psychophysiologic relaxation technique, has been shown to increase HRV. In a recent study, sexually healthy women experienced acute increases in physiologic (ie, genital) and subjective sexual arousal after 1 brief session of autogenic training. To build on these findings by testing the effects of a single session of autogenic training on sexual arousal in a sample of women who reported decreased or absent sexual arousal for at least 6 months. Genital sexual arousal, subjective sexual arousal, and perceived genital sensations were assessed in 25 women 20 to 44 years old before and after listening to a 22-minute autogenic training recording. HRV was assessed with electrocardiography. Change in genital sexual arousal, subjective sexual arousal, and perceived genital sensations from the pre-manipulation erotic film to the post-manipulation erotic film. Marginally significant increases in discrete subjective sexual arousal (P = .051) and significant increases in perceived genital sensations (P = .018) were observed. In addition, degree of change in HRV significantly moderated increases in subjective arousal measured continuously over time (P < .0001). There were no significant increases in genital arousal after the manipulation. The results of this study suggest that autogenic training, and other interventions that aim to increase HRV, could be a useful addition to treatment protocols for women who are reporting a lack of subjective arousal or decreased genital sensations. There are few treatment options for women with arousal problems. We report on a new psychosocial intervention that could improve arousal. Limitations include a relatively small sample and the lack of a control group. Our findings indicate that autogenic training significantly improves acute subjective arousal and increases perceived genital sensations in premenopausal women with self-reported arousal concerns. Stanton AM, Hixon JG, Nichols LM, Meston CM. One Session of Autogenic Training Increases Acute Subjective Sexual Arousal in Premenopausal Women Reporting Sexual Arousal Problems. J Sex Med 2018;15:64-76. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  5. Review and Analysis of Publication Trends over Three Decades in Three High Impact Medicine Journals.

    PubMed

    Ivanov, Alexander; Kaczkowska, Beata A; Khan, Saadat A; Ho, Jean; Tavakol, Morteza; Prasad, Ashok; Bhumireddy, Geetha; Beall, Allan F; Klem, Igor; Mehta, Parag; Briggs, William M; Sacchi, Terrence J; Heitner, John F

    2017-01-01

    Over the past three decades, industry sponsored research expanded in the United States. Financial incentives can lead to potential conflicts of interest (COI) resulting in underreporting of negative study results. We hypothesized that over the three decades, there would be an increase in: a) reporting of conflict of interest and source of funding; b) percentage of randomized control trials c) number of patients per study and d) industry funding. Original articles published in three calendar years (1988, 1998, and 2008) in The Lancet, New England Journal of Medicine and Journal of American Medical Association were collected. Studies were reviewed and investigational design categorized as prospective and retrospective clinical trials. Prospective trials were categorized into randomized or non-randomized and single-center or multi-center trials. Retrospective trials were categorized as registries, meta-analyses and other studies, mostly comprising of case reports or series. Study outcomes were categorized as positive or negative depending on whether the pre-specified hypothesis was met. Financial disclosures were researched for financial relationships and profit status, and accordingly categorized as government, non-profit or industry sponsored. Studies were assessed for reporting COI. 1,671 original articles were included in this analysis. Total number of published studies decreased by 17% from 1988 to 2008. Over 20 year period, the proportion of prospective randomized trials increased from 22 to 46% (p < 0.0001); whereas the proportion of prospective non-randomized trials decreased from 59% to 27% (p < 0.001). There was an increase in the percentage of prospective randomized multi-center trials from 11% to 41% (p < 0.001). Conversely, there was a reduction in non-randomized single-center trials from 47% to 10% (p < 0.001). Proportion of government funded studies remained constant, whereas industry funded studies more than doubled (17% to 40%; p < 0.0001). The number of studies with negative results more than doubled (10% to 22%; p<0.0001). While lack of funding disclosure decreased from 35% to 7%, COI reporting increased from 2% to 84% (p < 0.0001). Improved reporting of COI, clarity in financial sponsorship, increased publication of negative results in the setting of larger and better designed clinical trials represents a positive step forward in the scientific publications, despite the higher percentage of industry funded studies.

  6. Clinical trials in palliative care: a systematic review of their methodological characteristics and of the quality of their reporting.

    PubMed

    Bouça-Machado, Raquel; Rosário, Madalena; Alarcão, Joana; Correia-Guedes, Leonor; Abreu, Daisy; Ferreira, Joaquim J

    2017-01-25

    Over the past decades there has been a significant increase in the number of published clinical trials in palliative care. However, empirical evidence suggests that there are methodological problems in the design and conduct of studies, which raises questions about the validity and generalisability of the results and of the strength of the available evidence. We sought to evaluate the methodological characteristics and assess the quality of reporting of clinical trials in palliative care. We performed a systematic review of published clinical trials assessing therapeutic interventions in palliative care. Trials were identified using MEDLINE (from its inception to February 2015). We assessed methodological characteristics and describe the quality of reporting using the Cochrane Risk of Bias tool. We retrieved 107 studies. The most common medical field studied was oncology, and 43.9% of trials evaluated pharmacological interventions. Symptom control and physical dimensions (e.g. intervention on pain, breathlessness, nausea) were the palliative care-specific issues most studied. We found under-reporting of key information in particular on random sequence generation, allocation concealment, and blinding. While the number of clinical trials in palliative care has increased over time, methodological quality remains suboptimal. This compromises the quality of studies. Therefore, a greater effort is needed to enable the appropriate performance of future studies and increase the robustness of evidence-based medicine in this important field.

  7. Expert panel report on a study of Splenda in male rats.

    PubMed

    Brusick, David; Borzelleca, Joseph F; Gallo, Michael; Williams, Gary; Kille, John; Wallace Hayes, A; Xavier Pi-Sunyer, F; Williams, Christine; Burks, Wesley

    2009-10-01

    A recent study in rats investigated the retail sweetener product, Granulated SPLENDA No Calorie Sweetener (Splenda) (Abou-Donia et al., 2008. Splenda alters gut microflora and increases intestinal P-glycoprotein and cytochrome P-450 in male rats. J. Toxicol. Environ. Health A, 71, 1415-1429), which is composed of (by dry weight) maltodextrin ( approximately 99%) and sucralose ( approximately 1%). The investigators reported that Splenda increased body weight, decreased beneficial intestinal bacteria, and increased the expression of certain cytochrome P450 (CYP450) enzymes and the transporter protein, P-glycoprotein (P-gp), the latter of which was considered evidence that Splenda or sucralose might interfere with the absorption of nutrients and drugs. The investigators indicated that the reported changes were attributable to the sucralose present in the product tested. An Expert Panel conducted a rigorous evaluation of this study. In arriving at its conclusions, the Expert Panel considered the design and conduct of the study, its outcomes and the outcomes reported in other data available publicly. The Expert Panel found that the study was deficient in several critical areas and that its results cannot be interpreted as evidence that either Splenda, or sucralose, produced adverse effects in male rats, including effects on gastrointestinal microflora, body weight, CYP450 and P-gp activity, and nutrient and drug absorption. The study conclusions are not consistent with published literature and not supported by the data presented.

  8. Distance and near visual acuity improvement after implantation of multifocal intraocular lenses in cataract patients with presbyopia: a systematic review.

    PubMed

    Agresta, Blaise; Knorz, Michael C; Kohnen, Thomas; Donatti, Christina; Jackson, Daniel

    2012-06-01

    To evaluate uncorrected distance visual acuity (UDVA) as well as uncorrected near visual acuity (UNVA) as outcomes in treating presbyopic cataract patients to assist clinicians and ophthalmologists in their decision-making process regarding available interventions. Medline, Embase, and Evidence Based Medicine Reviews were systematically reviewed to identify studies reporting changes in UDVA and UNVA after cataract surgery in presbyopic patients. Strict inclusion/exclusion criteria were used to exclude any studies not reporting uncorrected visual acuity in a presbyopic population with cataracts implanted with multifocal intraocular lenses (IOLs). Relevant outcomes (UDVA and UNVA) were identified from the studies retrieved through the systematic review process. Twenty-nine studies were identified that reported uncorrected visual acuities, including one study that reported uncorrected intermediate visual acuity. Nine brands of multifocal IOLs were identified in the search. All studies identified in the literature search reported improvements in UDVA and UNVA following multifocal IOL implantation. The largest improvements in visual acuity were reported using the Rayner M-Flex lens (Rayner Intraocular Lenses Ltd) (UDVA, binocular: 1.05 logMAR, monocular: 0.92 logMAR; UNVA, binocular and monocular: 0.83 logMAR) and the smallest improvements were reported using the Acri.LISA lens (Carl Zeiss Meditec) (UDVA, 0.21 decimal; UNVA, 0.51 decimal). The results of this systematic review show the aggregate of studies reporting a beneficial increase in UDVA and UNVA with the use of multifocal IOLs in cataract patients with presbyopia, hence providing evidence to support the hypothesis that multifocal IOLs increase UDVA and UNVA in cataract patients. Copyright 2012, SLACK Incorporated.

  9. Trends in acute psychiatric inpatient care in Massachusetts.

    PubMed

    Hudson, Christopher G

    2004-11-01

    This report presents the preliminary results of a longitudinal study of acute psychiatric hospitalization in the Commonwealth of Massachusetts for fiscal years 1994 to 2000. The study was a secondary analysis of data obtained through the Commonwealth's mandated case-mix reporting system, covering 42 acute psychiatric facilities and 119,284 patients. Results include a 58.4 percent increase in the patient population, accompanied by declines in both length of stay and readmission rates; increases in the number of diagnoses of depression and in the number of patient deaths; and shifts to an older population increasingly supported by Medicaid and Medicare, especially managed care programs.

  10. Exploring the relationship between physical health, depressive symptoms, and depression diagnoses in Hispanic dementia caregivers.

    PubMed

    Cucciare, Michael A; Gray, Heather; Azar, Armin; Jimenez, Daniel; Gallagher-Thompson, Dolores

    2010-04-01

    The present study examined the relationship between self-reported physical health, depressive symptoms, and the occurrence of depression diagnosis in Hispanic female dementia caregivers. Participants were 89 Hispanic female dementia caregivers. This study used a cross-sectional design. Baseline depression and physical health data were collected from participants enrolled in the 'Reducing Stress in Hispanic Anglo Dementia Caregivers' study sponsored by the National Institute on Aging. Physical health was assessed using the Medical Outcome Study Short Form-36 (SF-36), a one-item self-report health rating, body mass index, and the presence or history of self-reported physical illness. Depressive symptoms were assessed using the Center for Epidemiologic Studies-Depression Scale (CES-D). The occurrence of depression diagnosis was assessed using the Clinical Interview for DSM-IV Axis I Disorders (SCID). Multiple linear and logistic regression analysis was used to examine the extent to which indices of physical health and depressive symptoms accounted for variance in participants' depressive symptoms and depressive diagnoses. Self-reported indices of health (e.g., SF-36) accounted for a significant portion of variance in both CES-D scores and SCID diagnoses. Caregivers who reported worsened health tended to report increased symptoms of depression on the CES-D and increased likelihood of an SCID diagnosis of a depressive disorder. Self-reported health indices are helpful in identifying Hispanic dementia caregivers at risk for clinical levels of depression.

  11. Strengthening the Reporting of Observational Studies in Epidemiology for Newborn Infection (STROBE-NI): an extension of the STROBE statement for neonatal infection research.

    PubMed

    Fitchett, Elizabeth J A; Seale, Anna C; Vergnano, Stefania; Sharland, Michael; Heath, Paul T; Saha, Samir K; Agarwal, Ramesh; Ayede, Adejumoke I; Bhutta, Zulfiqar A; Black, Robert; Bojang, Kalifa; Campbell, Harry; Cousens, Simon; Darmstadt, Gary L; Madhi, Shabir A; Meulen, Ajoke Sobanjo-Ter; Modi, Neena; Patterson, Janna; Qazi, Shamim; Schrag, Stephanie J; Stoll, Barbara J; Wall, Stephen N; Wammanda, Robinson D; Lawn, Joy E

    2016-10-01

    Neonatal infections are estimated to account for a quarter of the 2·8 million annual neonatal deaths, as well as approximately 3% of all disability-adjusted life-years. Despite this burden, few data are available on incidence, aetiology, and outcomes, particularly regarding impairment. We aimed to develop guidelines for improved scientific reporting of observational neonatal infection studies, to increase comparability and to strengthen research in this area. This checklist, Strengthening the Reporting of Observational Studies in Epidemiology for Newborn Infection (STROBE- NI), is an extension of the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) statement. STROBE-NI was developed following systematic reviews of published literature (1996-2015), compilation of more than 130 potential reporting recommendations, and circulation of a survey to relevant professionals worldwide, eliciting responses from 147 professionals from 37 countries. An international consensus meeting of 18 participants (with expertise in infectious diseases, neonatology, microbiology, epidemiology, and statistics) identified priority recommendations for reporting, additional to the STROBE statement. Implementation of these STROBE-NI recommendations, and linked checklist, aims to improve scientific reporting of neonatal infection studies, increasing data utility and allowing meta-analyses and pathogen-specific burden estimates to inform global policy and new interventions, including maternal vaccines. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Childhood cancers near German nuclear power stations: the ongoing debate.

    PubMed

    Fairlie, Ian

    2009-01-01

    In late 2007, the significant KiKK study (Kinderkrebs in der Umgebung von KernKraftwerken = Childhood Cancer in the Vicinity of Nuclear Power Plants) in Germany reported a 1.6-fold increase in all cancers and a 2.2-fold increase in leukaemias, among children living within 5 km of all German nuclear power stations. The KiKK study by Kaatsch et al. was extensively described in a recent edition of Medicine Conflict and Survival. It has triggered much discussion as to the cause(s) of these increased cancers. This article reports on recent developments on the KiKK study, including responses by German radiation agencies, and recent epidemiological studies near United Kingdom and French nuclear installations. It reflects the current debate and concludes with advice to policy-makers on radiation risks on the relative merits of the KiKK study. An accompanying article outlines a possible explanation for the increased cancers and makes recommendations for future research.

  13. [Tools to enhance the quality and transparency of health research reports: reporting guidelines].

    PubMed

    Galvão, Taís Freire; Silva, Marcus Tolentino; Garcia, Leila Posenato

    2016-01-01

    Scientific writing is the cornestone for publishing the results of research. Reporting guidelines are important tools for all those involved in the process of research production and report writing. These guidelines detail what is expected to be found in each section of a report for a given study design. The EQUATOR Network (Enhancing the QUAlity and Transparency Of health Research) is an international initiative that seeks to improve the reliability and the value of health research literature by promoting transparent and accurate reporting and wider use of robust reporting guidelines. The use of reporting guidelines has contributed to improved reports as well as increased quality of research methods. Reporting guidelines need to be publicized in order to increase knowledge about these essential tools among health researchers. Encouraging their use by journals is key to enhancing the quality of scientific publications.

  14. Challenges of self-reported medical conditions and electronic medical records among members of a large military cohort

    PubMed Central

    Smith, Besa; Chu, Laura K; Smith, Tyler C; Amoroso, Paul J; Boyko, Edward J; Hooper, Tomoko I; Gackstetter, Gary D; Ryan, Margaret AK

    2008-01-01

    Background Self-reported medical history data are frequently used in epidemiological studies. Self-reported diagnoses may differ from medical record diagnoses due to poor patient-clinician communication, self-diagnosis in the absence of a satisfactory explanation for symptoms, or the "health literacy" of the patient. Methods The US Department of Defense military health system offers a unique opportunity to evaluate electronic medical records with near complete ascertainment while on active duty. This study compared 38 self-reported medical conditions to electronic medical record data in a large population-based US military cohort. The objective of this study was to better understand challenges and strengths in self-reporting of medical conditions. Results Using positive and negative agreement statistics for less-prevalent conditions, near-perfect negative agreement and moderate positive agreement were found for the 38 diagnoses. Conclusion This report highlights the challenges of using self-reported medical data and electronic medical records data, but illustrates that agreement between the two data sources increases with increased surveillance period of medical records. Self-reported medical data may be sufficient for ruling out history of a particular condition whereas prevalence studies may be best served by using an objective measure of medical conditions found in electronic healthcare records. Defining medical conditions from multiple sources in large, long-term prospective cohorts will reinforce the value of the study, particularly during the initial years when prevalence for many conditions may still be low. PMID:18644098

  15. Registration status and outcome reporting of trials published in core headache medicine journals.

    PubMed

    Rayhill, Melissa L; Sharon, Roni; Burch, Rebecca; Loder, Elizabeth

    2015-11-17

    To evaluate randomized controlled trial (RCT) registration and outcome reporting compliance in core headache medicine journals. We identified RCTs published in core journals (Headache, Cephalalgia, and the Journal of Headache and Pain) from 2005 through 2014. We searched articles for trial registration numbers, which were verified in the corresponding trial registry. We categorized trial funding sources as industry, academic, government, or mixed. We contacted corresponding authors to assess reasons for nonregistration. We evaluated whether primary outcomes in trial registries matched those in corresponding publications. The journals published 225 RCTs over the study period. Fifty-eight of 225 (26%) reported a trial registration number in the article that could be linked to a corresponding registry entry. Trial registration rates increased over the 9 years of the study. Forty-six of 118 (39%) of industry-funded studies were registered compared with 27% of academic and 0% of government-funded studies. Only 5% of RCTs were prospectively registered, reported primary outcomes identical to those in the trial registry, and did not report unacknowledged post hoc outcomes. The most common reason for nonregistration was lack of awareness. Only about a quarter of the articles published in the core headache medicine journals are compliant with trial registration, but compliance has increased over time. Selective reporting of outcomes remains a problem, and very few trials met all 3 reporting standards assessed in this study. Efforts to improve the quality of trial reporting in the headache literature should continue. © 2015 American Academy of Neurology.

  16. High School Grade Inflation from 1991 to 2003. Research Report Series 2004-04

    ERIC Educational Resources Information Center

    Woodruff, David J.; Ziomek, Robert L.

    2004-01-01

    This report presents the results of a study investigating inflation in high school grade point average (HSGPA). Inflation was measured by comparing HSGPA to ACT Assessment (ACT) scores over the years 1991 to 2003. The results indicate the presence of grade inflation over the 13 years. That is, HSGPAs increased without a concomitant increase in…

  17. A systematic review and meta-analysis of quantitative interviewing tools to investigate self-reported HIV and STI associated behaviours in low- and middle-income countries.

    PubMed

    Phillips, Anna E; Gomez, Gabriella B; Boily, Marie-Claude; Garnett, Geoffrey P

    2010-12-01

    Studies identifying risks and evaluating interventions for human immunodeficiency virus (HIV) and other sexually transmitted infections often rely on self-reported measures of sensitive behaviours. Such self-reports can be subject to social desirability bias. Concerns over the accuracy of these measures have prompted efforts to improve the level of privacy and anonymity of the interview setting. This study aims to determine whether such novel tools minimize misreporting of sensitive information. Systematic review and meta-analysis of studies in low- and middle-income countries comparing traditional face-to-face interview (FTFI) with innovative tools for reporting HIV risk behaviour. Crude odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Cochran's chi-squared test of heterogeneity was performed to explore differences between estimates. Pooled estimates were determined by gender, region, education, setting and question time frame using a random effects model. We found and included 15 data sets in the meta-analysis. Most studies compared audio computer-assisted self interview (ACASI) with FTFI. There was significant heterogeneity across studies for three outcomes of interest: 'ever had sex' (I(2) = 93.4%, P < 0.001), non-condom use (I(2) = 89.3%, P < 0.001), and number of partners (I(2) = 75.3%, P < 0.001). For the fourth outcome, 'forced sex', there was homogenous increased reporting by non-FTFI methods (OR 1.47; 95% CI 1.11-1.94). Overall, non-FTFI methods were not consistently associated with a significant increase in the reporting of all outcomes. However, there was increased reporting associated with non-FTFI with region (Asia), setting (urban), education (>60% had secondary education) and a shorter question time frame. Contrary to expectation, differences between FTFI and non-interviewer-administered interview methods for the reported sensitive behaviour investigated were not uniform. However, we observed trends and variations in the level of reporting according to the outcome, study and population characteristics. FTFI may not always be inferior to innovative interview tools depending on the sensitivity of the question as well as the population assessed.

  18. Improving the Capture of Fall Events in Hospitals: Combining a Service for Evaluating Inpatient Falls with an Incident Report System

    PubMed Central

    Shorr, Ronald I.; Mion, Lorraine C.; Chandler, A. Michelle; Rosenblatt, Linda C.; Lynch, Debra; Kessler, Lori A.

    2008-01-01

    OBJECTIVES To determine the utility of a fall evaluation service to improve the ascertainment of falls in acute care. DESIGN Six-month observational study. SETTING Sixteen adult nursing units (349 beds) in an urban, academically affiliated, community hospital. PARTICIPANTS Patients admitted to the study units during the study period. INTERVENTION Nursing staff identifying falls were instructed to notify, using a pager, a trained nurse ‘‘fall evaluator.’’ Fall evaluators provided 24-hour-per-day 7-day-per-week coverage throughout the study. Data on patient falls gathered by fall evaluators were compared with falls data obtained through the hospital’s incident reporting system. RESULTS During 51,180 patient-days of observation, 191 falls were identified according to incident reports (3.73 falls/1,000 patient-days), whereas the evaluation service identified 228 falls (4.45 falls/1,000 patient-days). Combining falls reported from both data sources yielded 266 falls (5.20 falls/1,000 patient-days), a 39% relative rate increase compared with incident reports alone (P<.001). For falls with injury, combining data from both sources yielded 79 falls (1.54 injurious falls/1,000 patient-days), compared with 57 falls (1.11 injurious falls/1,000 patient-days) filed in incident reports—a 28% increase (P = .06). In the 16 nursing units, the relative percentage increase of captured fall events using the combined data sources versus the incident reporting system alone ranged from 13% to 125%. CONCLUSION Incident reports significantly underestimate both injurious and noninjurious falls in acute care settings and should not be used as the sole source of data for research or quality improvement initiatives. PMID:18205761

  19. Breaking the News or Fueling the Epidemic? Temporal Association between News Media Report Volume and Opioid-Related Mortality

    PubMed Central

    Dasgupta, Nabarun; Mandl, Kenneth D.; Brownstein, John S.

    2009-01-01

    Background Historical studies of news media have suggested an association between reporting and increased drug abuse. Period effects for substance use have been documented for different classes of legal and illicit substances, with the suspicion that media publicity may have played major roles in their emergence. Previous analyses have drawn primarily from qualitative evidence; the temporal relationship between media reporting volume and adverse health consequences has not been quantified nationally. We set out to explore whether we could find a quantitative relationship between media reports about prescription opioid abuse and overdose mortality associated with these drugs. We assessed whether increases in news media reports occurred before or after increases in overdose deaths. Methodology/Principal Findings Our ecological study compared a monthly time series of unintentional poisoning deaths involving short-acting prescription opioid substances, from 1999 to 2005 using multiple cause-of-death data published by the National Center for Health Statistics, to monthly counts of English-language news articles mentioning generic and branded names of prescription opioids obtained from Google News Archives from 1999 to 2005. We estimated the association between media volume and mortality rates by time-lagged regression analyses. There were 24,272 articles and 30,916 deaths involving prescription opioids during the seven-year study period. Nationally, the number of articles mentioning prescription opioids increased dramatically starting in early 2001, following prominent coverage about the nonmedical use of OxyContin. We found a significant association between news reports and deaths, with media reporting preceding fatal opioid poisonings by two to six months and explaining 88% (p<0.0001, df 78) of the variation in mortality. Conclusions/Significance While availability, structural, and individual predispositions are key factors influencing substance use, news reporting may enhance the popularity of psychoactive substances. Albeit ecological in nature, our finding suggests the need for further evaluation of the influence of news media on health. Reporting on prescription opioids conforms to historical patterns of news reporting on other psychoactive substances. PMID:19924221

  20. Knowledge, Attitude, and Concussion-Reporting Behaviors Among High School Athletes: A Preliminary Study

    PubMed Central

    Register-Mihalik, Johna K.; Guskiewicz, Kevin M.; McLeod, Tamara C. Valovich; Linnan, Laura A.; Mueller, Frederick O.; Marshall, Stephen W.

    2013-01-01

    Context: Many athletes continue to participate in practices and games while experiencing concussion-related symptoms, potentially predisposing them to subsequent and more complicated brain injuries. Limited evidence exists about factors that may influence concussion-reporting behaviors. Objective: To examine the influence of knowledge and attitude on concussion-reporting behaviors in a sample of high school athletes. Design: Cross-sectional study. Setting: Participants completed a validated survey instrument via mail. Patients or Other Participants: A total of 167 high school athletes (97 males, 55 females, 5 sex not indicated; age = 15.7 ± 1.4 years) participating in football, soccer, lacrosse, or cheerleading. Intervention(s): Athlete knowledge and attitude scores served as separate predictor variables. Main Outcome Measure(s): We examined the proportion of athletes who reported continuing to participate in games and practices while symptomatic from possible concussion and the self-reported proportion of recalled concussion and bell-ringer events disclosed after possible concussive injury. Results: Only 40% of concussion events and 13% of bell-ringer recalled events in the sample were disclosed after possible concussive injury. Increased athlete knowledge of concussion topics (increase of 1 standard deviation = 2.8 points) was associated with increased reporting prevalence of concussion and bell-ringer events occurring in practice (prevalence ratio [PR] = 2.27, 95% confidence interval [CI] = 1.60, 3.21) and the reporting prevalence of bell-ringer-only events overall (PR = 1.87, 95% CI = 1.38, 2.54). Athlete attitude scores (increase of 1 standard deviation = 11.5 points) were associated with decreases in the proportion of athletes stating they participated in games (PR = 0.74, 95% CI = 0.66, 0.82) and practices (PR = 0.67, 95% CI = 0.59, 0.77) while symptomatic from concussions. Conclusions: Most recalled concussion events in our study were not reported to a supervising adult. Clinicians should be aware that knowledge and attitude influence concussion reporting. Clinicians and administrators should make concussion education a priority and encourage an optimal reporting environment to better manage and prevent concussive injuries in young athletes. PMID:23848520

  1. Improvements in implant dentistry over the last decade: comparison of survival and complication rates in older and newer publications.

    PubMed

    Pjetursson, Bjarni E; Asgeirsson, Asgeir G; Zwahlen, Marcel; Sailer, Irena

    2014-01-01

    The objective of this systematic review was to assess and compare the survival and complication rates of implant-supported prostheses reported in studies published in the year 2000 and before, to those reported in studies published after the year 2000. Three electronic searches complemented by manual searching were conducted to identify 139 prospective and retrospective studies on implant-supported prostheses. The included studies were divided in two groups: a group of 31 older studies published in the year 2000 or before, and a group of 108 newer studies published after the year 2000. Survival and complication rates were calculated using Poisson regression models, and multivariable robust Poisson regression was used to formally compare the outcomes of older and newer studies. The 5-year survival rate of implant-supported prostheses was significantly increased in newer studies compared with older studies. The overall survival rate increased from 93.5% to 97.1%. The survival rate for cemented prostheses increased from 95.2% to 97.9%; for screw-retained reconstruction, from 77.6% to 96.8%; for implant-supported single crowns, from 92.6% to 97.2%; and for implant-supported fixed dental prostheses (FDPs), from 93.5% to 96.4%. The incidence of esthetic complications decreased in more recent studies compared with older ones, but the incidence of biologic complications was similar. The results for technical complications were inconsistent. There was a significant reduction in abutment or screw loosening by implant-supported FDPs. On the other hand, the total number of technical complications and the incidence of fracture of the veneering material was significantly increased in the newer studies. To explain the increased rate of complications, minor complications are probably reported in more detail in the newer publications. The results of the present systematic review demonstrated a positive learning curve in implant dentistry, represented in higher survival rates and lower complication rates reported in more recent clinical studies. The incidence of esthetic, biologic, and technical complications, however, is still high. Hence, it is important to identify these complications and their etiology to make implant treatment even more predictable in the future.

  2. Investigation of a Study Technique To Increase Learning Disabled Students' Reading Comprehension of Expository Text. Final Report.

    ERIC Educational Resources Information Center

    McCormick, Sandra; Cooper, John O.

    The study reported in this paper investigated the effects of a frequently recommended study technique on the comprehension of expository text by high-school students having learning disabilities. The instructional procedure studied was "Survey, Question, Read, Recite, Review" (SQ3R). Six experiments were conducted over a 3-year period,…

  3. Patients' online access to their electronic health records and linked online services: a systematic interpretative review.

    PubMed

    de Lusignan, Simon; Mold, Freda; Sheikh, Aziz; Majeed, Azeem; Wyatt, Jeremy C; Quinn, Tom; Cavill, Mary; Gronlund, Toto Anne; Franco, Christina; Chauhan, Umesh; Blakey, Hannah; Kataria, Neha; Barker, Fiona; Ellis, Beverley; Koczan, Phil; Arvanitis, Theodoros N; McCarthy, Mary; Jones, Simon; Rafi, Imran

    2014-09-08

    To investigate the effect of providing patients online access to their electronic health record (EHR) and linked transactional services on the provision, quality and safety of healthcare. The objectives are also to identify and understand: barriers and facilitators for providing online access to their records and services for primary care workers; and their association with organisational/IT system issues. Primary care. A total of 143 studies were included. 17 were experimental in design and subject to risk of bias assessment, which is reported in a separate paper. Detailed inclusion and exclusion criteria have also been published elsewhere in the protocol. Our primary outcome measure was change in quality or safety as a result of implementation or utilisation of online records/transactional services. No studies reported changes in health outcomes; though eight detected medication errors and seven reported improved uptake of preventative care. Professional concerns over privacy were reported in 14 studies. 18 studies reported concern over potential increased workload; with some showing an increase workload in email or online messaging; telephone contact remaining unchanged, and face-to face contact staying the same or falling. Owing to heterogeneity in reporting overall workload change was hard to predict. 10 studies reported how online access offered convenience, primarily for more advantaged patients, who were largely highly satisfied with the process when clinician responses were prompt. Patient online access and services offer increased convenience and satisfaction. However, professionals were concerned about impact on workload and risk to privacy. Studies correcting medication errors may improve patient safety. There may need to be a redesign of the business process to engage health professionals in online access and of the EHR to make it friendlier and provide equity of access to a wider group of patients. A1 SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42012003091. 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.

  4. Patients’ online access to their electronic health records and linked online services: a systematic interpretative review

    PubMed Central

    de Lusignan, Simon; Mold, Freda; Sheikh, Aziz; Majeed, Azeem; Wyatt, Jeremy C; Quinn, Tom; Cavill, Mary; Gronlund, Toto Anne; Franco, Christina; Chauhan, Umesh; Blakey, Hannah; Kataria, Neha; Barker, Fiona; Ellis, Beverley; Koczan, Phil; Arvanitis, Theodoros N; McCarthy, Mary; Jones, Simon; Rafi, Imran

    2014-01-01

    Objectives To investigate the effect of providing patients online access to their electronic health record (EHR) and linked transactional services on the provision, quality and safety of healthcare. The objectives are also to identify and understand: barriers and facilitators for providing online access to their records and services for primary care workers; and their association with organisational/IT system issues. Setting Primary care. Participants A total of 143 studies were included. 17 were experimental in design and subject to risk of bias assessment, which is reported in a separate paper. Detailed inclusion and exclusion criteria have also been published elsewhere in the protocol. Primary and secondary outcome measures Our primary outcome measure was change in quality or safety as a result of implementation or utilisation of online records/transactional services. Results No studies reported changes in health outcomes; though eight detected medication errors and seven reported improved uptake of preventative care. Professional concerns over privacy were reported in 14 studies. 18 studies reported concern over potential increased workload; with some showing an increase workload in email or online messaging; telephone contact remaining unchanged, and face-to face contact staying the same or falling. Owing to heterogeneity in reporting overall workload change was hard to predict. 10 studies reported how online access offered convenience, primarily for more advantaged patients, who were largely highly satisfied with the process when clinician responses were prompt. Conclusions Patient online access and services offer increased convenience and satisfaction. However, professionals were concerned about impact on workload and risk to privacy. Studies correcting medication errors may improve patient safety. There may need to be a redesign of the business process to engage health professionals in online access and of the EHR to make it friendlier and provide equity of access to a wider group of patients. A1. Systematic review registration number PROSPERO CRD42012003091. PMID:25200561

  5. Influences of natural menopause on health complaints: a prospective study of healthy Norwegian women.

    PubMed

    Holte, A

    1992-01-01

    As a continuation of a cross-sectional study in 1981 involving a representative sample of 1886 women between 45 and 55 years of age, 200 pre-menopausal subjects were selected randomly to take part in a follow-up study. Eighty-seven single measures covering 26 areas of health complaints which have been associated with the menopause in medical textbooks were investigated. A tentative method for relating health complaints at several time points to menopausal status is proposed. A significant number of women reported an increase in vasomotor complaints, vaginal dryness, heart palpitations and social dysfunction following the menopause, although many reported no change or even a reduction in these complaints. On the other hand, a decrease in headache and breast tenderness was noted. No significant differences were observed between the numbers of women reporting an increase or a decrease respectively on any of the other 69 measures (20 complaints), which included anxiety, depression and irritability. Further analyses indicated that the increase in social dysfunction was caused by hot flushes and sweating. This paper raises a number of issues regarding the methodology of longitudinal studies.

  6. Controlled human exposure to methyl tertiary butyl ether in gasoline: symptoms, psychophysiologic and neurobehavioral responses of self-reported sensitive persons.

    PubMed Central

    Fiedler, N; Kelly-McNeil, K; Mohr, S; Lehrer, P; Opiekun, R E; Lee, C; Wainman, T; Hamer, R; Weisel, C; Edelberg, R; Lioy, P J

    2000-01-01

    The 1990 Clean Air Act mandated oxygenation of gasoline in regions where carbon monoxide standards were not met. To achieve this standard, methyl tertiary butyl ether (MTBE) was increased to 15% by volume during winter months in many locations. Subsequent to the increase of MTBE in gasoline, commuters reported increases in symptoms such as headache, nausea, and eye, nose, and throat irritation. The present study compared 12 individuals selected based on self-report of symptoms (self-reported sensitives; SRSs) associated with MTBE to 19 controls without self-reported sensitivities. In a double-blind, repeated measures, controlled exposure, subjects were exposed for 15 min to clean air, gasoline, gasoline with 11% MTBE, and gasoline with 15% MTBE. Symptoms, odor ratings, neurobehavioral performance on a task of driving simulation, and psychophysiologic responses (heart and respiration rate, end-tidal CO(2), finger pulse volume, electromyograph, finger temperature) were measured before, during, and immediately after exposure. Relative to controls, SRSs reported significantly more total symptoms when exposed to gasoline with 15% MTBE than when exposed to gasoline with 11% MTBE or to clean air. However, these differences in symptoms were not accompanied by significant differences in neurobehavioral performance or psychophysiologic responses. No significant differences in symptoms or neurobehavioral or psychophysiologic responses were observed when exposure to gasoline with 11% MTBE was compared to clean air or to gasoline. Thus, the present study, although showing increased total symptoms among SRSs when exposed to gasoline with 15% MTBE, did not support a dose-response relationship for MTBE exposure nor the symptom specificity associated with MTBE in epidemiologic studies. Images Figure 1 Figure 2 PMID:10964796

  7. Costs of self-handicapping.

    PubMed

    Zuckerman, Miron; Tsai, Fen-Fang

    2005-04-01

    Four studies examined the relation of trait self-handicapping with health-related measures. Study 1 showed that, over time, self-handicapping and maladjustment reinforce each other. Study 2 showed that self-handicappers reported a loss in competence satisfaction which, in turn, mediated the relation of self-handicapping with negative mood. Study 3 found that, over time, self-handicappers report an increase in substance use. Study 4 showed that self-handicappers reported a loss in intrinsic motivation for their jobs. It was suggested that people with unstable (or contingent) self-esteem use self-handicapping to bolster a fragile self-concept.

  8. Nurses' attitude and intention of medication administration error reporting.

    PubMed

    Hung, Chang-Chiao; Chu, Tsui-Ping; Lee, Bih-O; Hsiao, Chia-Chi

    2016-02-01

    The Aims of this study were to explore the effects of nurses' attitudes and intentions regarding medication administration error reporting on actual reporting behaviours. Underreporting of medication errors is still a common occurrence. Whether attitude and intention towards medication administration error reporting connect to actual reporting behaviours remain unclear. This study used a cross-sectional design with self-administered questionnaires, and the theory of planned behaviour was used as the framework for this study. A total of 596 staff nurses who worked in general wards and intensive care units in a hospital were invited to participate in this study. The researchers used the instruments measuring nurses' attitude, nurse managers' and co-workers' attitude, report control, and nurses' intention to predict nurses' actual reporting behaviours. Data were collected from September-November 2013. Path analyses were used to examine the hypothesized model. Of the 596 nurses invited to participate, 548 (92%) completed and returned a valid questionnaire. The findings indicated that nurse managers' and co-workers' attitudes are predictors for nurses' attitudes towards medication administration error reporting. Nurses' attitudes also influenced their intention to report medication administration errors; however, no connection was found between intention and actual reporting behaviour. The findings reflected links among colleague perspectives, nurses' attitudes, and intention to report medication administration errors. The researchers suggest that hospitals should increase nurses' awareness and recognition of error occurrence. Regardless of nurse managers' and co-workers' attitudes towards medication administration error reporting, nurses are likely to report medication administration errors if they detect them. Management of medication administration errors should focus on increasing nurses' awareness and recognition of error occurrence. © 2015 John Wiley & Sons Ltd.

  9. Increasing Physical Activity in Preschool: A Pilot Study to Evaluate Animal Trackers

    ERIC Educational Resources Information Center

    Williams, Christine L.; Carter, Betty Jean; Kibbe, Debra L.; Dennison, David

    2009-01-01

    Objective: This report describes a pilot study to evaluate Animal Trackers (AT), a preschool program designed to (1) increase structured physical activity (PA) during the preschool day; (2) increase practice of gross motor skills; (3) provide teachers with an easy-to-use PA program regardless of teacher experience; and (4) implement a teacher…

  10. Self-reported previous knee injury and low knee function increase knee injury risk in adolescent female football.

    PubMed

    Clausen, M B; Tang, L; Zebis, M K; Krustrup, P; Hölmich, P; Wedderkopp, N; Andersen, L L; Christensen, K B; Møller, M; Thorborg, K

    2016-08-01

    Knee injuries are common in adolescent female football. Self-reported previous knee injury and low Knee injury and Osteoarthritis Outcome Score (KOOS) are proposed to predict future knee injuries, but evidence regarding this in adolescent female football is scarce. The aim of this study was to investigate self-reported previous knee injury and low KOOS subscale score as risk factors for future knee injuries in adolescent female football. A sample of 326 adolescent female football players, aged 15-18, without knee injury at baseline, were included. Data on self-reported previous knee injury and KOOS questionnaires were collected at baseline. Time-loss knee injuries and football exposures were reported weekly by answers to standardized text-message questions, followed by injury telephone interviews. A priori, self-reported previous knee injury and low KOOS subscale scores (< 80 points) were chosen as independent variables in the risk factor analyses. The study showed that self-reported previous knee injury significantly increased the risk of time-loss knee injury [relative risk (RR): 3.65, 95% confidence (CI) 1.73-7.68; P < 0.001]. Risk of time-loss knee injury was also significantly increased in players with low KOOS subscale scores (< 80 points) in Activities of Daily Living (RR: 5.0), Sport/Recreational (RR: 2.2) and Quality of Life (RR: 3.0) (P < 0.05). In conclusion, self-reported previous knee injury and low scores in three KOOS subscales significantly increase the risk of future time-loss knee injury in adolescent female football. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Prospective associations between televiewing at toddlerhood and later self-reported social impairment at middle school in a Canadian longitudinal cohort born in 1997/1998.

    PubMed

    Pagani, L S; Lévesque-Seck, F; Fitzpatrick, C

    2016-12-01

    Using a large Canadian population-based sample, this study aimed to verify whether televiewing in toddlerhood is prospectively associated with self-reported social impairment in middle school. Participants are from a prospective-longitudinal birth cohort of 991 girls and 1006 boys from the Quebec Longitudinal Study of Child Development. Child self-reported ratings of relational difficulties at age 13 years were linearly regressed on parent-reported televiewing at age 2 years while adjusting for potential confounders. Every additional 1 h of early childhood television exposure corresponded to an 11% s.d. unit increase in self-reported peer victimization [unstandardized β = 0.03, 95% confidence interval (CI) 0.02-0.04], a 10% s.d. unit increase in self-reported social isolation (unstandardized β = 0.04, 95% CI 0.03-0.05), a 9% s.d. unit increase in self-reported proactive aggression (unstandardized β = 0.02, 95% CI 0.01-0.03) and a 6% s.d. unit increase in self-reported antisocial behavior (unstandardized β = 0.01, 95% CI 0.01-0.01) at age 13 years. These results are above and beyond pre-existing individual and family factors. Televiewing in toddlerhood was prospectively associated with experiencing victimization and social withdrawal from fellow students and engaging in antisocial behavior and proactive aggression toward fellow students at age 13 years. Adolescents who experience relational difficulties are at risk of long-term health problems (like depression and cardiometabolic disease) and socio-economic problems (like underachievement and unemployment). These relationships, observed more than a decade later, and independent of key potential confounders, suggest a need for better parental awareness of how young children invest their limited waking hours.

  12. Data for Improvement and Clinical Excellence: a report of an interrupted time series trial of feedback in home care.

    PubMed

    Fraser, Kimberly D; Sales, Anne E; Baylon, Melba Andrea B; Schalm, Corinne; Miklavcic, John J

    2017-05-18

    There is substantial evidence about the effectiveness of audit with feedback, but none that we know have been conducted in home care settings. The primary purpose of the Data for Improvement and Clinical Excellence - Home Care (DICE-HC) project was to evaluate the effects of an audit and feedback delivered to care providers on home care client outcomes. The objective of this paper is to report the effects of feedback on four specific quality indicators: pain, falls, delirium, and hospital visits. A 10-month audit with feedback intervention study was conducted with care providers in seven home care offices in Alberta, Canada, which involved delivery of four quarterly feedback reports consisting of data derived from the Resident Assessment Instrument - Home Care (RAI-HC). The primary evaluation employed an interrupted time series design using segmented regression analysis to assess the effects of feedback reporting on the four quality indicators: pain, falls, delirium, and hospitalization. Changes in level and trend of the quality indicators were measured before, during, and after the implementation of feedback reports. Pressure ulcer reporting was analyzed as a comparator condition not included in the feedback report. Care providers were surveyed on responses to feedback reporting which informed a process evaluation. At initiation of feedback report implementation, the percentage of clients reporting pain and falls significantly increased. Though the percentage of clients reporting pain and falls tended to increase and reporting of delirium and hospital visits tended to decrease relative to the pre-intervention period, there was no significant effect of feedback reporting on quality indicators during the 10-month intervention. The percentage of clients reporting falls, delirium, and hospital visits significantly increased in the 6-month period following feedback reporting relative to the intervention period. About 50% of the care providers that read and understand the feedback reports found the reports useful to make changes to the way clients are cared for. Routinely collected data used over time for feedback is feasible in home care settings. A high proportion of care providers find feedback reports useful for informing how they care for clients. Since reporting on the frequency of quality indicators increased in the post-intervention period, this study suggests that ongoing use of audit with feedback to enhance health outcomes in home care may promote improved reporting on standardized instruments.

  13. The Effects of School-Based Condom Availability Programs (CAPs) on Condom Acquisition, Use and Sexual Behavior: A Systematic Review.

    PubMed

    Wang, Timothy; Lurie, Mark; Govindasamy, Darshini; Mathews, Catherine

    2018-01-01

    We conducted a systematic review to assess the impact of school-based condom availability programs (CAPs) on condom acquisition, use and sexual behavior. We searched PubMed to identify English-language studies evaluating school-based CAPs that reported process (i.e. number of condoms distributed or used) and sexual behavior measures. We identified nine studies that met our inclusion criteria, with the majority conducted in the United States of America. We judged most studies to have medium risk of bias. Most studies showed that school-based CAPs increased the odds of students obtaining condoms (odds ratios (ORs) for individual studies ranged between 1.81 and 20.28), and reporting condom use (OR 1.36-3.2). Three studies showed that school-based CAPs positively influenced sexual behavior, while no studies reported increase in sexual activity. Findings suggest that school-based CAPs may be an effective strategy for improving condom coverage and promoting positive sexual behaviors.

  14. Rejection Sensitivity and Executive Control: Joint predictors of Borderline Personality features

    PubMed Central

    Ayduk, Özlem; Zayas, Vivian; Downey, Geraldine; Cole, Amy Blum; Shoda, Yuichi; Mischel, Walter

    2008-01-01

    Two studies tested the hypothesis that rejection sensitivity (RS) and executive control (EC) jointly predict borderline personality (BP) features. We expected high RS to be related to increased vulnerability for BP features specifically in people who also had difficulties in executive control (EC). Study 1 tested this hypothesis using a sample of college students (N = 379) whereas Study 2 (N = 104) was conducted using a community sample of adults. Both studies operationalized EC by a self-report measure. For a subsample in Study 2 (N = 80), ability to delay gratification at age 4 was also used as an early behavioral precursor of EC in adulthood. In both studies, high RS was associated with increased BP features among people low in self-reported EC. Among those high in self-reported EC, the relationship between RS and BP features was attenuated. Study 2 found parallel findings using preschool delay ability as a behavioral index of EC. These findings suggest that EC may protect high RS people against BP features. PMID:18496604

  15. Echinocandin Resistance in Candida Species: a Review of Recent Developments.

    PubMed

    Wiederhold, Nathan P

    2016-12-01

    The echinocandins are important agents for the treatment of invasive fungal infections, especially those caused by Candida species. However, as with other antimicrobial agents, microbiologic resistance to this class of antifungal agents has emerged and can result in clinical failure. Several studies have recently reported an increase in echinocandin resistance in Candida glabrata isolates at various medical centers in different geographic regions of the USA. Recent studies have also reported that many of these isolates may also be fluconazole resistant, leaving few treatment options available for clinicians to use in patients with invasive candidiasis caused by this species. Our understanding of the clinical relevance of specific point mutations within the FKS genes that cause echinocandin resistance and risk factors for the development of microbiologic resistance and clinical failure have also increased. The purpose of this review is to discuss echinocandin resistance in Candida species and recent reports that have increased our understanding of this growing clinical problem.

  16. Non-resuscitative first-aid training for children and laypeople: a systematic review.

    PubMed

    He, Zhimin; Wynn, Persephone; Kendrick, Denise

    2014-09-01

    Relatively little is currently known about the effectiveness of first-aid training for children and laypeople. We have undertaken a systematic review to synthesise the evidence and inform policy and practice in this area. A range of bibliographic databases were searched. Studies were eligible if they used experimental designs, provided first-aid training to laypeople or children and reported first-aid knowledge, skills behaviours or confidence. Studies were selected for inclusion, data extracted and risk of bias assessed by two independent reviewers. Findings were synthesised narratively. 23 studies (14 randomised controlled trials and 9 non-randomised studies) were included, 12 of which recruited children or young people (≤19 years old). Most studies reported significant effects favouring the intervention group; 11 out of 16 studies reported significant increases in first-aid knowledge; 11 out of 13 studies reported significant increases in first-aid skills; 2 out of 5 studies reported significant improvements in helping behaviour; and 2 out of 3 studies reported significant increases in confidence in undertaking first aid. Only one study undertook an economic evaluation; finding an intensive instructor-led course was more effective, but had significantly higher costs than either a less-intensive instructor-led course or a video-delivered course. Most studies were at risk of bias, particularly selection, performance or detection bias. There is some evidence to support provision of first-aid training, particularly for children or young people, but many studies were judged to be at risk of bias. Conclusions cannot be drawn about which first-aid training courses or programmes are most effective or the age at which training can be most effectively provided. Few studies evaluated training in adult laypeople. High-quality studies are required assessing effectiveness and cost-effectiveness of standardised first-aid training to inform policy development and provision of first-aid training. 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.

  17. Childhood violence and adult chronic pain among indigenous Sami and non-Sami populations in Norway: a SAMINOR 2 questionnaire study

    PubMed Central

    Eriksen, Astrid M. A.; Schei, Berit; Hansen, Ketil Lenert; Sørlie, Tore; Fleten, Nils; Javo, Cecilie

    2016-01-01

    Background Internationally, studies have shown that childhood violence is associated with chronic pain in adulthood. However, to date, this relationship has not been examined in any indigenous population. Objective The main objectives of this study were to investigate the association between childhood violence and reported chronic pain, number of pain sites and the intensity of pain in adulthood in indigenous Sami and non-Sami adults, and to explore ethnic differences. Design The study is based on the SAMINOR 2 questionnaire study, a larger population-based, cross-sectional survey on health and living conditions in multiethnic areas with both Sami and non-Sami populations in Mid- and Northern Norway. Our study includes a total of 11,130 adult participants: 2,167 Sami respondents (19.5%) and 8,963 non-Sami respondents (80.5%). Chronic pain was estimated by reported pain located in various parts of the body. Childhood violence was measured by reported exposure of emotional, physical and/or sexual violence. Results Childhood violence was associated with adult chronic pain in several pain sites of the body regardless of ethnicity and gender. Childhood violence was also associated with increased number of chronic pain sites and higher pain intensity compared to those not exposed to childhood violence. However, among Sami men, this association was only significant for pain located in chest, hips/legs and back, and non-significant for increased number of chronic pain sites (adjusted model), and higher pain intensity. Conclusion Respondents exposed to childhood violence reported more chronic pain in several parts of the body, increased number of chronic pain sites and more intense pain in adulthood than respondents reporting no childhood violence. However, among Sami men, this association was weaker and also not significant for increased number of chronic pain sites and higher pain intensity. PMID:27802844

  18. On the origin of worries about modern health hazards: Experimental evidence for a conjoint influence of media reports and personality traits.

    PubMed

    Witthöft, Michael; Freitag, Ina; Nußbaum, Christiane; Bräscher, Anne-Kathrin; Jasper, Fabian; Bailer, Josef; Rubin, G James

    2018-03-01

    Worries about health threatening effects of potential health hazards of modern life (e.g. electric devices and pollution) represent a growing phenomenon in Western countries. Yet, little is known about the causes of this growing special case of affective risk perceptions termed Modern Health Worries (MHW). The purpose of this study is to examine a possible role of biased media reports in the formation of MHW. In two experiments, we investigated whether typical television reports affect MHW. In Study 1, 130 participants were randomly assigned to a film on idiopathic environmental intolerance (IEI) or a control film about cystic fibrosis. In Study 2, 82 participants were randomly assigned to either a film on the dangers of electromagnetic fields or a control condition. Increases in MHW after sensational media reports. In Study 1, only participants high on the personality trait of absorption revealed increased MHW after watching the IEI film. In Study 2, specifically worries about radiation were found to be elevated after watching the film on the dangers of electromagnetic fields compared to the control film. The results of both studies reveal a significant and specific influence of sensational short mass media reports on MHW. The influence of potential moderators such as absorption remains to be clarified.

  19. Improved population exposure factors in the meta-analysis of air pollution health effects

    EPA Science Inventory

    Numerous time-series studies have reported significant associations between ambient PM2.5 levels and increased mortality and morbidity. A recent mortality study conducted by Franklin et al. 2007 in 27 U.S. cities has reported significant heterogeneity among city-specific effect e...

  20. Pilot Study: Unit on White Racism.

    ERIC Educational Resources Information Center

    Hurwitz, Alan; Snook, Valerie

    This report is an attempt to explore approaches in which white people examine their own racism, understand its nature and its consequences, and then plan self-directed changes in the direction of increasingly anti-racist behavior. In the pilot study described and evaluated in the report, three general purposes indicated were: assisting…

  1. English for the Health Sciences: Special Projects Report.

    ERIC Educational Resources Information Center

    Gray-Richards, Barbara; Kirley, Elizabeth

    A study assessing the need for English instruction to increase the proficiency of nonnative speakers taking licensing examinations in 24 health sciences in British Columbia is described. Ten areas of study are reported: groups of potential learners, language screening used before the licensing examinations, why nonnative speakers fail the…

  2. Prevalence of upper limb disorders among female librarians.

    PubMed

    Pandy, R

    2013-09-01

    Work as a librarian involves exposure to potential risk factors for developing upper limb disorders. The prevalence of upper limb symptoms has, however, not previously been assessed in this occupational group. To estimate the 7-day and annual prevalence of self-reported neck and upper limb symptoms in librarians and to examine associations with specific tasks and ergonomic risk factors. A cross-sectional study using components of the standardized Nordic questionnaire. The study population consisted of librarians employed by a large local authority, and data collection was by means of a self-administered questionnaire. from studies on keyboard workers and on the general population were used as comparators. The 7-day prevalence of self-reported neck and upper limb pain in female librarians was 42% (95% confidence interval (CI) 33.7-50.5) and the annual prevalence was 65% (95% CI 56.6-72.8). The prevalence of reported wrist and hand pain increased with increased working involving a wide thumb-index span (P < 0.05) with a significant linear trend in prevalence with increasing exposure (P < 0.01). There was a strong association between reporting hand and/or wrist pain and awareness of work-related upper limb disorder (P < 0.05). The annual prevalence of self-reported upper limb symptoms among female librarians was high, but there was insufficient evidence to confirm whether the prevalence was higher than in the general population or among keyboard workers. Working with a wide thumb-index span was associated with reporting upper limb symptoms.

  3. Ambient air pollution and pregnancy-induced hypertensive disorders: a systematic review and meta-analysis.

    PubMed

    Pedersen, Marie; Stayner, Leslie; Slama, Rémy; Sørensen, Mette; Figueras, Francesc; Nieuwenhuijsen, Mark J; Raaschou-Nielsen, Ole; Dadvand, Payam

    2014-09-01

    Pregnancy-induced hypertensive disorders can lead to maternal and perinatal morbidity and mortality, but the cause of these conditions is not well understood. We have systematically reviewed and performed a meta-analysis of epidemiological studies investigating the association between exposure to ambient air pollution and pregnancy-induced hypertensive disorders including gestational hypertension and preeclampsia. We searched electronic databases for English language studies reporting associations between ambient air pollution and pregnancy-induced hypertensive disorders published between December 2009 and December 2013. Combined risk estimates were calculated using random-effect models for each exposure that had been examined in ≥4 studies. Heterogeneity and publication bias were evaluated. A total of 17 articles evaluating the impact of nitrogen oxides (NO2, NOX), particulate matter (PM10, PM2.5), carbon monoxide (CO), ozone (O3), proximity to major roads, and traffic density met our inclusion criteria. Most studies reported that air pollution increased risk for pregnancy-induced hypertensive disorders. There was significant heterogeneity in meta-analysis, which included 16 studies reporting on gestational hypertension and preeclampsia as separate or combined outcomes; there was less heterogeneity in findings of the 10 studies reporting solely on preeclampsia. Meta-analyses showed increased risks of hypertensive disorders in pregnancy for all pollutants except CO. Random-effect meta-analysis combined odds ratio associated with a 5-μg/m3 increase in PM2.5 was 1.57 (95% confidence interval, 1.26-1.96) for combined pregnancy-induced hypertensive disorders and 1.31 (95%confidence interval, 1.14-1.50) for preeclampsia [corrected]. Our results suggest that exposure to air pollution increases the risk of pregnancy-induced hypertensive disorders. © 2014 American Heart Association, Inc.

  4. Taste, Enjoyment, and Desire of Flavors Change After Sleeve Gastrectomy-Short Term Results.

    PubMed

    Van Vuuren, Michele A Janse; Strodl, Esben; White, Katherine M; Lockie, Philip David

    2017-06-01

    Laparoscopic sleeve gastrectomy (LSG) incidence continues to increase worldwide because of its efficacy and low surgical risks. This study aimed to investigate satisfaction with eating and the change in taste perception, desire, and enjoyment of flavor changes and associations with extent of percentage excess weight loss (%excess weight loss (EWL)) post-LSG. One hundred six participants completed an online questionnaire 4 to 6 weeks as well as 6 to 8 months post-LSG bariatric surgery. The questionnaire included study-specific questions about changes in taste, desire, and enjoyment of eight major categories of flavor, as well as the Suter Quality of Alimentation Questionnaire to measure satisfaction with eating. The majority of participants reported a post-surgery increase in the intensity of the flavor of sweet (60, 55%) and fatty (57, 70%) at both time points, respectively. Participants also reported a decreased enjoyment for sweet (77, 61%) and fatty (77, 83%) flavors and decreased desire for fatty (83, 84%) and sweet (82, 68%) flavors at both time periods. This study found an increase in intensity of flavor of all eight taste modalities and a decrease in desire and enjoyment of all taste modalities except salty and savory flavors following surgery. Participants reported an increased acuity of spicy flavors and fatty tastes over time, and the desire and enjoyment of sweet, bitter, and metallic flavors increased over time. Changes in savory enjoyment over a 6- to 8-month period post-LSG were weakly associated with extent of % EWL at 6 months post-surgery. The participants reported average (40, 37%), good (33, 42%), and excellent (15, 11%) satisfaction with eating at both time points. This preliminary study indicates that subjective changes in taste, desire, and enjoyment of flavors of eight taste modalities are very common after LSG.

  5. The puzzle of self-reported weight gain in a month of fasting (Ramadan) among a cohort of Saudi families in Jeddah, Western Saudi Arabia.

    PubMed

    Bakhotmah, Balkees Abed

    2011-08-10

    During Ramadan fast, approximately one billion Muslims abstain from food and fluid between the hours of sunrise to sunset, and usually eat a large meal after sunset and another meal before sunrise. Many studies reported good health-related outcomes of fasting including weight loss. The objective of this study is to identify the local pattern of expenditure on food consumption, dietary habits during Ramadan and correlate that to self-reported weight gain after Ramadan in a group of families in Jeddah, Western Saudi Arabia. A Cross-section study using a pre-designed questionnaire to identify the local pattern of expenditure on food consumption, dietary habits during Ramadan and correlate that to self-reported weight gain after Ramadan in a representative cohort of Saudis living in Jeddah. It was piloted on 173 nutrition students and administered by them to their families. A total of 173 Saudi families were interviewed. One out of 5 indicated that their expenditure increases during Ramadan. Approximately two thirds of the respondents (59.5%) reported weight gain after Ramadan. When asked about their perspective explanations for that: 40% attributed that to types of foods being rich in fat and carbohydrates particularly date in (Sunset meal) 97.7% and rice in (Dawn meal) 80.9%. One third (31.2%) indicated that it was due to relative lack of physical exercise in Ramadan and 14.5% referred that to increase in food consumption. Two thirds (65.2%) of those with increased expenditure reported weight gain. Surprisingly weight gain and not weight loss was reported after Ramadan by Saudis which indicates timely needed life-style and dietary modification programs for a population which reports one of the highest prevalence rates of diabetes.

  6. Frequency of self-reported COPD exacerbation and airflow obstruction in five Latin American cities: the Proyecto Latinoamericano de Investigacion en Obstruccion Pulmonar (PLATINO) study.

    PubMed

    Montes de Oca, Maria; Tálamo, Carlos; Halbert, Ronald J; Perez-Padilla, Rogelio; Lopez, Maria Victorina; Muiño, Adriana; Jardim, José Roberto B; Valdivia, Gonzalo; Pertuzé, Julio; Moreno, Dolores; Menezes, Ana Maria B

    2009-07-01

    Recurrent exacerbations are common in COPD patients. Limited information exists regarding exacerbation frequency in COPD patients from epidemiologic studies. We examined the frequency of self-reported exacerbations and the factors influencing exacerbation frequency among COPD patients in a population-based study conducted in Latin America. We used a post-bronchodilator FEV(1)/FVC ratio of < 0.70 to define COPD. Exacerbation was self-reported and defined by symptoms (deterioration of breathing symptoms that affected usual daily activities or caused missed work). Spirometry was performed in 5,314 subjects. There were 759 subjects with airflow limitation; of these, 18.2% reported ever having had an exacerbation, 7.9% reported having an exacerbation, and 6.2% reported having an exacerbation requiring at least a doctor visit within the past year. The proportion of individuals with an exacerbation significantly increased by Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages, from 4.2% in stage 1 to 28.9% in stages 3 and 4. The self-reported exacerbation rate was 0.58 exacerbations per year. The rate of exacerbations requiring at least a doctor visit and length of stay in hospital due to exacerbations also increased as COPD severity progressed. The factors associated with having an exacerbation in the past year were dyspnea, prior asthma diagnosis, receiving any respiratory therapy, and disease severity of GOLD stages 3 and 4. The proportion of individuals with airflow limitation and self-reported exacerbation increases as the disease severity progresses. Dyspnea, prior asthma diagnosis, receiving any respiratory therapy, and more severe obstruction were significantly associated with having an exacerbation in the past year.

  7. Trends in Disclosures of Industry Sponsorship

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

    Ahmed, Awad A.; Holliday, Emma B.; Fakhreddine, Mohamad

    Purpose: To examine trends in the reporting of industry funding of oncology trials by primary therapeutic intervention studied: local, targeted, or nontargeted systemic. Methods and Materials: We reviewed oncologic trials published in 10 journals for the years 1994, 2004, and 2014 to determine the frequency of declarations of industry funding for cancer research. Logistic modeling was used to assess associations between reported industry funding and investigation characteristics, such as type of primary intervention, cancer site, study endpoint, number of participants, geographic location of corresponding author, journal impact factor, trial phase, and year of publication. Results: Reporting of industry funding increased overmore » time (odds ratio [OR] 6.8; 95% confidence interval [CI] 3.82-12.35). Compared with systemic trials, those investigating local therapies were less likely to report industry funding (OR 0.08; 95% CI 0.14-0.15), whereas studies examining targeted interventions were more likely to report industry funding (OR 2.24; 95% CI 1.38-3.66). Studies investigating gynecologic (OR 0.37; 95% CI 0.15-0.88) and pediatric cancers (OR 0.08; 95% CI 0.02-0.27) were less likely to report funding by industry when compared with hematologic cancers. Phase 2 (OR 0.32, 95% CI 0.19-0.52) and phase 3 (OR 0.39, 95% CI 0.17-0.37) studies were less likely to report industry funding than phase 1 studies. Trials investigating interventions for metastatic disease (OR 2.55; 95% CI 1.73-3.79) were more likely to have reported industry funding compared with studies examining the primary/definitive disease setting. Conclusion: Industry funding was reported in more than one-third of oncology trials examined in this study, and the proportion of trials reporting industry funding increased over time. The potential ramifications for these patterns of funding for the future direction of cancer research should be examined, especially given the disproportionate distribution of industry funding among therapeutic intentions, cancer types, and treatment modalities.« less

  8. Trends in Disclosures of Industry Sponsorship.

    PubMed

    Ahmed, Awad A; Holliday, Emma B; Fakhreddine, Mohamad; Yoo, Stella K; Deville, Curtiland; Jagsi, Reshma

    2016-07-15

    To examine trends in the reporting of industry funding of oncology trials by primary therapeutic intervention studied: local, targeted, or nontargeted systemic. We reviewed oncologic trials published in 10 journals for the years 1994, 2004, and 2014 to determine the frequency of declarations of industry funding for cancer research. Logistic modeling was used to assess associations between reported industry funding and investigation characteristics, such as type of primary intervention, cancer site, study endpoint, number of participants, geographic location of corresponding author, journal impact factor, trial phase, and year of publication. Reporting of industry funding increased over time (odds ratio [OR] 6.8; 95% confidence interval [CI] 3.82-12.35). Compared with systemic trials, those investigating local therapies were less likely to report industry funding (OR 0.08; 95% CI 0.14-0.15), whereas studies examining targeted interventions were more likely to report industry funding (OR 2.24; 95% CI 1.38-3.66). Studies investigating gynecologic (OR 0.37; 95% CI 0.15-0.88) and pediatric cancers (OR 0.08; 95% CI 0.02-0.27) were less likely to report funding by industry when compared with hematologic cancers. Phase 2 (OR 0.32, 95% CI 0.19-0.52) and phase 3 (OR 0.39, 95% CI 0.17-0.37) studies were less likely to report industry funding than phase 1 studies. Trials investigating interventions for metastatic disease (OR 2.55; 95% CI 1.73-3.79) were more likely to have reported industry funding compared with studies examining the primary/definitive disease setting. Industry funding was reported in more than one-third of oncology trials examined in this study, and the proportion of trials reporting industry funding increased over time. The potential ramifications for these patterns of funding for the future direction of cancer research should be examined, especially given the disproportionate distribution of industry funding among therapeutic intentions, cancer types, and treatment modalities. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Effect of pregnancy on the pharmacokinetics of paclitaxel: a case report.

    PubMed

    Lycette, Jennifer L; Dul, Carrie L; Munar, Myrna; Belle, Donna; Chui, Stephen Y; Koop, Dennis R; Nichols, Craig R

    2006-10-01

    Breast cancer during pregnancy is increasingly common as women delay childbearing until later in life. Safe administration of adjuvant chemotherapy during pregnancy has been reported. Physiologic and metabolic changes during pregnancy could alter the pharmacokinetics of these agents. This is a pilot study to prospectively study the pharmacokinetics of chemotherapeutic agents during pregnancy. Herein, we report the initial results with paclitaxel in the first patient.

  10. Increased risk of coronary heart disease among individuals reporting adverse impact of stress on their health: the Whitehall II prospective cohort study

    PubMed Central

    Nabi, Hermann; Kivimäki, Mika; Batty, G. David; Shipley, Martin J.; Britton, Annie; Brunner, Eric J.; Vahtera, Jussi; Lemogne, Cédric; Elbaz, Alexis; Singh-Manoux, Archana

    2013-01-01

    Aim Response to stress can vary greatly between individuals. However, it remains unknown whether perceived impact of stress on health is associated with adverse health outcomes. We examined whether individuals who report that stress adversely affects their health are at increased risk of coronary heart disease (CHD) compared with those who report that stress has no adverse health impact. Methods and results Analyses are based on 7268 men and women (mean age: 49.5 years, interquartile range: 11 years) from the British Whitehall II cohort study. Over 18 years of follow-up, there were 352 coronary deaths or first non-fatal myocardial infarction (MI) events. After adjustment for sociodemographic characteristics, participants who reported at baseline that stress has affected their health ‘a lot or extremely’ had a 2.12 times higher (95% CI 1.52–2.98) risk of coronary death or incident non-fatal MI when compared with those who reported no effect of stress on their health. This association was attenuated but remained statistically significant after adjustment for biological, behavioural, and other psychological risk factors including perceived stress levels, and measures of social support; fully adjusted hazard ratio: 1.49 (95% CI 1.01–2.22). Conclusions In this prospective cohort study, the perception that stress affects health, different from perceived stress levels, was associated with an increased risk of coronary heart disease. Randomized controlled trials are needed to determine whether disease risk can be reduced by increasing clinical attention to those who complain that stress greatly affects their health. PMID:23804585

  11. Self-Reported Obstacles to Regular Dental Care among Information Technology Professionals.

    PubMed

    Reddy, L Swetha; Doshi, Dolar; Reddy, B Srikanth; Kulkarni, Suhas; Reddy, M Padma; Satyanarayana, D; Baldava, Pavan

    2016-10-01

    Good oral health is important for an individual as well as social well-being. Occupational stress and work exhaustion in Information Technology (IT) professionals may influence the oral health and oral health related quality of life. To assess and compare self-reported obstacles for regular dental care and dental visits among IT professionals based on age, gender, dental insurance and working days per week. A cross-sectional study was conducted among 1,017 IT professionals to assess the self-reported obstacles to regular oral health care in Hyderabad city, Telangana, India. The Dental Rejection of Innovation Scale (DRI-S) was employed in this study. Comparison between means of DRI-S based on variables was done using t-test and ANOVA. The association between variables and DRI-S was determined using Chi-square test. A total of 1017 participants comprising of 574 (56%) males and 443 (44%) females participated in the study. As age increased, a significant increase in mean DRI-S scores was seen for total and individual domains except for the "Situational" domain wherein higher mean score (9.42±2.5; p=0.0006) was observed among 30-39 years age group. Even though females reported higher mean scores for total and individual domains when compared to males, nevertheless significant difference was seen only for total (p=0.03) and "Lack of Knowledge" (p=0.001) domain. Self-reported obstacles to regular dental care was more with increasing age, increased number of working days per week, irregular dental visits and absence of dental insurance facility.

  12. Trends in methamphetamine use in young injection drug users in San Francisco from 1998 to 2004: the UFO Study.

    PubMed

    Inglez-Dias, Aline; Hahn, Judith A; Lum, Paula J; Evans, Jennifer; Davidson, Peter; Page-Shafer, Kimberly

    2008-05-01

    To describe temporal trends in methamphetamine use among young injection drug users (IDU) in San Francisco. Secondary analysis of cross-sectional baseline data collected for a longitudinal study of young IDU from 1998 to 2004. Participants were 1445 young IDU (<30 years old) who reported injection in the previous month, English-speaking, and recruited by street outreach methods. We examined trends for: lifetime (ever) and recent (30-day) methamphetamine use, including injected and non-injected, and by age group and sexual risk behaviour [men who have sex with men injecting drug users (MSM-IDU), male IDU (non-MSM) and female IDU]. In 1998, 1999, 2000, 2001, 2003 and 2004 we interviewed 237, 276, 431, 310, 147 and 44 participants, respectively. Overall, median age was 22 years [interquartile range (IQR) 20-25], 30.3% were women and median duration of injecting was 4.4 years (IQR 2-7). Prevalence of methamphetamine use was high, with 50.1% reporting recent injection, but overall there were no temporal increases in reported 'ever' injected use. Recent methamphetamine injection (past 30 days) increased significantly, and peaked at 60% in 2003. MSM-IDU had higher methamphetamine injection ever (92.3%) and recently (59.5%) compared to heterosexual male (non-MSM) IDU (81.6% and 47.3%, respectively) and to female IDU (78.4% and 46.1%, respectively). Despite reports of ubiquitous increases in methamphetamine use, there were no significant increases in 6 years in ever injecting methamphetamine overall among young IDU. MSM-IDU who reported the highest methamphetamine use overall reported some increases in recent injected use. The methamphetamine 'epidemic' was probably under way among young IDU earlier than other populations.

  13. Slowing of the HIV Epidemic in Ukraine: Evidence from Case Reporting and Key Population Surveys, 2005–2012

    PubMed Central

    Vitek, Charles R.; Čakalo, Jurja-Ivana; Kruglov, Yuri V.; Dumchev, Konstantin V.; Salyuk, Tetyana O.; Božičević, Ivana; Baughman, Andrew L.; Spindler, Hilary H.; Martsynovska, Violetta A.; Kobyshcha, Yuri V.; Abdul-Quader, Abu S.; Rutherford, George W.

    2014-01-01

    Background Ukraine developed Europe's most severe HIV epidemic due to widespread transmission among persons who inject drugs (PWID). Since 2004, prevention has focused on key populations; antiretroviral therapy (ART) coverage has increased. Recent data show increases in reported HIV cases through 2011, especially attributed to sexual transmission, but also signs of potential epidemic slowing. We conducted a data triangulation exercise to better analyze available data and inform program implementation. Methods and Findings We reviewed data for 2005 to 2012 from multiple sources, primarily national HIV case reporting and integrated biobehavioral surveillance (IBBS) studies among key populations. Annually reported HIV cases increased at a progressively slower rate through 2011 with recent increases only among older, more immunosuppressed individuals; cases decreased 2.7% in 2012. Among women <25 years of age, cases attributed to heterosexual transmission and HIV prevalence in antenatal screening declined after 2008. Reported cases among young PWID declined by three-fourths. In 2011, integrated biobehavioral surveillance demonstrated decreased HIV prevalence among young members of key populations compared with 2009. HIV infection among female sex workers (FSW) remains strongly associated with a personal history of injecting drug use (IDU). Conclusions This analysis suggests that Ukraine's HIV epidemic has slowed, with decreasing reported cases and older cases predominating among those diagnosed. Recent decreases in cases and in prevalence support decreased incidence among young PWID and women. Trends among heterosexual men and men who have sex with men (MSM) are less clear; further study and enhanced MSM prevention are needed. FSW appear to have stable prevalence with risk strongly associated with IDU. Current trends suggest the Ukrainian epidemic can be contained with enhanced prevention among key populations and increased treatment access. PMID:25251080

  14. Use of a 22-gauge Whitacre needle to reduce the incidence of side effects after lumbar myelography: a prospective randomised study comparing Whitacre and Quincke spinal needles.

    PubMed

    Pedersen, O N

    1996-01-01

    In a prospective study lumbar iohexol myelography was performed in 107 consecutive patients, randomised for lumbar puncture with a Quincke or Whitacre spinal needle. All patients answered a questionnaire about possible side effects. Data from 100 patients (58 men, 42 women) were evaluated. In the Quincke group (n = 53), 23 (43%) reported no side effects. In the 30 patients who reported various side effects, post-dural puncture headache (PDPH) occurred in 22 (42%), of whom 9 had mild, 6 moderate and 7 (13%) severe cephalalgia, 18 (34%) reported increased low back pain/sciatica, 5 nausea and 7 dizziness. In the Whitacre group (n = 47), 33 (70%) had no side effects. PDPH was reported by 9 patients (19%), of whom 2 had mild, 6 moderate and only 1 (2%) severe cephalalgia, 4 (9%) reported increased low back pain/sciatica, 5 nausea and 4 dizziness. The conclusion drawn from this study is that lumbar myelography performed with the Whitacre spinal needle reduces postspinal side effects.

  15. Congenital bladder exstrophy associated with Duogynon hormonal pregnancy tests-signal for teratogenicity or consumer report bias?

    PubMed

    Tümmler, Gregor; Rißmann, Anke; Meister, Reinhard; Schaefer, Christof

    2014-06-01

    A combination of ethinylestradiol and 10mg norethisterone under the brand names of Duogynon (Germany) or Primodos (UK) was used as a pregnancy test until the 1970s. Until very recently there was continuing public concern about the safety of these drugs and legal proceedings were instituted against the medicinal authorization holder. Given the lack of epidemiological studies focusing on Duogynon/Primodos, the present study evaluates 296 consumer reports of the German Duogynon database and compares the reported birth defects with data from a population based birth registry. The most striking result is an increase of bladder exstrophy (OR=37.27; 95%-CI 14.56-95.28). Neural tube defects (OR=2.99; 95%-CI 1.85-4.84) and renal agenesis (OR=2.53; 95%-CI 1.17-5.45) were also significantly increased. Bladder exstrophy may be a yet undetected teratogenic effect of Duogynon, but may also represent a reporting bias. The present study highlights the difficulties of evaluating consumer reports which may be influenced by public media. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. Patient-Reported Symptoms and Quality of Life in Adults With Acute Leukemia: A Systematic Review

    PubMed Central

    Bryant, Ashley Leak; Walton, AnnMarie L.; Shaw-Kokot, Julia; Mayer, Deborah K.; Reeve, Bryce B.

    2018-01-01

    Purpose/Objectives Systematically summarize findings from research conducted on adult acute leukemia survivors as they relate to symptoms and quality of life (QOL). Data Sources Systematic review of the literature from 1990–2013 found in the PubMed, PsycINFO®, EMBASE, and CINAHL® databases, as well as manual searches. Data Synthesis The review identified 16 quantitative studies and 1 qualitative study published from 1990–2013 that used a self-reported QOL or symptom questionnaire. Fatigue was the most commonly assessed and reported symptom, followed by depression. Conclusions Acute leukemia and its treatment have a significant impact in all QOL domains. Future studies should include longitudinal research, more than one recruitment site, increased minority representation, and home-based exercise interventions as ways to improve all domains of QOL. Implications for Nursing This review increases awareness of commonly reported symptoms faced by adults with acute leukemia. Oncology nurses are central in monitoring and reporting symptoms to the interdisciplinary team that may contribute to changes in function, with the overall goal of optimizing QOL over time. PMID:25806895

  17. Characterization of tobacco withdrawal: physiological and subjective effects.

    PubMed

    Hatsukami, D; Hughes, J R; Pickens, R

    1985-01-01

    In total, our studies show that changes which occur reliably and consistently in chronic smokers after tobacco deprivation include: decreased heart rate, increased caloric intake/eating, increased number of awakenings during sleep, increased craving for tobacco, and increased confusion, as measured by the POMS. Other changes that were found to occur after tobacco deprivation in some but not all of our studies include decreased orthostatic heart rate, increased irritability, and decreased vigor score on the POMS. Previous investigators have found a consistent effect of tobacco deprivation on heart rate (Gilbert and Pope 1982; Knapp et al. 1963; Parsons and Hamme 1975; Weybrew and Stark 1967; Glauser et al. 1970; Myrsten et al. 1977; Murphee and Schultz 1968). Although decreased blood pressure (Knapp et al. 1963; Murphee and Schultz 1968) and changes in other vital signs such as temperature (Gilbert and Pope 1982; Myrsten et al. 1977; Ague 1974) have been reported, our present studies and studies by others (Weybrew and Stark 1967; Glauser et al. 1970) failed to find a significant deprivation effect on these measures. Perhaps the contradictory findings are a function of the reliability of the measures themselves or of the population tested. Caloric intake has been found to increase in both animals and humans after nicotine or smoking cessation (Gruneberg 1982; Myrsten et al. 1977; Wack and Rodin 1982). These results are consistent with studies which have found that smoking cessation causes an increase in body weight (Wack and Rodin 1982). However, previous studies disagree on how smoking cessation causes weight gain. Our inpatient study is believed to be the first to simultaneously measure changes in caloric intake, fluid retention, and physical activity after tobacco deprivation. In the study, caloric intake increased but fluid retention and physical activity did not change. The increases in weight may not be accounted for solely by increases in caloric intake. There may be other factors such as decreased basal metabolic rate which cause the increase in weight. Other studies have also reported sleep disturbance or insomnia among tobacco-deprived smokers (Larson et al. 1961; Weybrew and Stark 1967). Studies directly monitoring sleep have found a decrease in duration awake (Soldatos et al. 1980), increased REM sleep (Soldatos et al. 1980; Kales et al. 1970; Parsons et al. 1975), and increased Stage IV (greater than 50% delta waves) sleep (Parson et al. 1975; Parsons and Hamme 1975). Thus, objective data indicate that after tobacco deprivation smokers actually sleep longer, which contradicts subjective reports of insomnia.(ABSTRACT TRUNCATED AT 400 WORDS)

  18. What Factors Influence States' Capacity to Report Children's Health Care Quality Measures? A Multiple-Case Study.

    PubMed

    Christensen, Anna L; Petersen, Dana M; Burton, Rachel A; Forsberg, Vanessa C; Devers, Kelly J

    2017-01-01

    Objectives The objective of this study was to describe factors that influence the ability of state Medicaid agencies to report the Centers for Medicare & Medicaid Services' (CMS) core set of children's health care quality measures (Child Core Set). Methods We conducted a multiple-case study of four high-performing states participating in the Children's Health Insurance Program Reauthorization Act (CHIPRA) Quality Demonstration Grant Program: Illinois, Maine, Pennsylvania, and Oregon. Cases were purposively selected for their diverse measurement approaches and used data from 2010 to 2015, including 154 interviews, semiannual grant progress reports, and annual public reports on Child Core Set measures. We followed Yin's multiple-case study methodology to describe how and why each state increased the number of measures reported to CMS. Results All four states increased the number of Child Core Set measures reported to CMS during the grant period. Each took a different approach to reporting, depending on the available technical, organizational, and behavioral inputs in the state. Reporting capacity was influenced by a state's Medicaid data availability, ability to link to other state data systems, past experience with quality measurement, staff time and technical expertise, and demand for the measures. These factors were enhanced by CHIPRA Quality Demonstration grant funding and other federal capacity building activities, as hypothesized in our conceptual framework. These and other states have made progress reporting the Child Core Set since 2010. Conclusion With financial support and investment in state data systems and organizational factors, states can overcome challenges to reporting most of the Child Core Set measures.

  19. Surveillance of STI risk behaviour among young people attending a music festival in Australia, 2005-08.

    PubMed

    Lim, Megan S C; Hellard, Margaret E; Aitken, Campbell K; Hocking, Jane S

    2009-10-01

    To explain rising rates of sexually transmitted infections it is necessary to monitor trends among high risk groups, such as youth. Surveillance of risk behaviours and testing among a variety of populations in different settings is required. We monitored self-reported sexual behaviour among music festival attendees. Cross-sectional studies of young people's behaviour were conducted annually at a music festival between 2005 and 2008 using self-administered questionnaires. Logistic regression, adjusted for age and gender, determined trends in risk behaviours. More than 5,000 questionnaires were completed. The proportion reporting multiple sexual partners in the past year remained stable from 2005 to 2008 and condom use with these partners increased. Reporting a new sexual partner in the past three months decreased, while condom use with new partners increased. Reporting a casual sexual partner increased and condom use with casual partners remained stable. Reporting a recent STI test increased from 23% in 2006 to 32% in 2008. Despite increases in STI notifications, most risk behaviours are decreasing in this group, possibly as a function of increased STI testing. Music festivals are a useful setting for monitoring behaviour trends within a sub-population of young people at relatively high risk of STIs.

  20. Bio-composites of cassava starch-green coconut fiber: part II-Structure and properties.

    PubMed

    Lomelí-Ramírez, María Guadalupe; Kestur, Satyanarayana G; Manríquez-González, Ricardo; Iwakiri, Setsuo; de Muniz, Graciela Bolzon; Flores-Sahagun, Thais Sydenstricker

    2014-02-15

    Development of any new material requires its complete characterization to find potential applications. In that direction, preparation of bio-composites of cassava starch containing up to 30 wt.% green coconut fibers from Brazil by thermal molding process was reported earlier. Their characterization regarding physical and tensile properties of both untreated and treated matrices and their composites were also reported. Structural studies through FTIR and XRD and thermal stability of the above mentioned composites are presented in this paper. FT-IR studies revealed decomposition of components in the matrix; the starch was neither chemically affected nor modified by either glycerol or the amount of fiber. XRD studies indicated increasing crystallinity of the composites with increasing amount of fiber content. Thermal studies through TGA/DTA showed improvement of thermal stability with increasing amount of fiber incorporation, while DMTA showed increasing storage modulus, higher glass transition temperature and lower damping with increasing fiber content. Improved interfacial bonding between the matrix and fibers could be the cause for the above results. Copyright © 2013 Elsevier Ltd. All rights reserved.

  1. Increasing value and reducing waste: addressing inaccessible research.

    PubMed

    Chan, An-Wen; Song, Fujian; Vickers, Andrew; Jefferson, Tom; Dickersin, Kay; Gøtzsche, Peter C; Krumholz, Harlan M; Ghersi, Davina; van der Worp, H Bart

    2014-01-18

    The methods and results of health research are documented in study protocols, full study reports (detailing all analyses), journal reports, and participant-level datasets. However, protocols, full study reports, and participant-level datasets are rarely available, and journal reports are available for only half of all studies and are plagued by selective reporting of methods and results. Furthermore, information provided in study protocols and reports varies in quality and is often incomplete. When full information about studies is inaccessible, billions of dollars in investment are wasted, bias is introduced, and research and care of patients are detrimentally affected. To help to improve this situation at a systemic level, three main actions are warranted. First, academic institutions and funders should reward investigators who fully disseminate their research protocols, reports, and participant-level datasets. Second, standards for the content of protocols and full study reports and for data sharing practices should be rigorously developed and adopted for all types of health research. Finally, journals, funders, sponsors, research ethics committees, regulators, and legislators should endorse and enforce policies supporting study registration and wide availability of journal reports, full study reports, and participant-level datasets. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. An Action Research Exploration Integrating Student Choice and Arts Activities in a Sixth Grade Social Studies Classroom

    ERIC Educational Resources Information Center

    Kosky, Courtney; Curtis, Reagan

    2008-01-01

    We report on an action research study undertaken to explore how integrating the Arts in social studies education can increase student participation and motivation, and impact student achievement through that increased motivation and participation. Initial lesson plans addressed multiple intelligences while integrating Arts activities and were…

  3. Enhancing Resilience in Youth through a 10-Day Developmental Voyage

    ERIC Educational Resources Information Center

    Hayhurst, Jill; Hunter, John A.; Kafka, Sarah; Boyes, Mike

    2015-01-01

    The present study sought to examine the potential for resilience to be enhanced in a group of youth participating in a developmental voyage, and to identify the factors that contribute to increased resilience following the voyage. Two studies are reported. Study 1 revealed that voyage participants experienced increased resilience over the course…

  4. A comparison of observed and self-reported helmet use and associated factors among motorcyclists in Hyderabad city, India.

    PubMed

    Wadhwaniya, S; Gupta, S; Mitra, S; Tetali, S; Josyula, L K; Gururaj, G; Hyder, A A

    2017-03-01

    India has a high burden of fatal road traffic injuries (RTIs). A large proportion of fatal RTIs in India are among motorcyclists. The overall goal of this study is to assess and compare observed and self-reported prevalence of helmet use; and to identify factors associated with helmet use and over-reporting in Hyderabad city, India. Roadside knowledge, attitude and practice interviews. Six rounds of roadside interviews were conducted with motorcyclists (drivers and pillion riders) between July 2011 and August 2013 using a structured tool developed for this study. Observations on helmet use were recorded and respondents were also asked if they 'always wear a helmet'. Prevalence of helmet use was calculated and a paired t-test was used to compare observed and self-reported helmet use proportions. Unadjusted and adjusted odds ratios were calculated to identify factors associated with helmet use and over-reporting. A total of 4872 respondents participated in the roadside interview. The response rate was 94.4%. The overall observed helmet use was 34.5% and 44.5% of respondents reported that they 'always wear a helmet'. As the observed helmet use increased, the over-reporting of helmet use was found to decrease. However, factors associated with observed and self-reported helmet use are similar. Male gender, youth (≤24 years), a lower level of education and non-ownership of helmet were associated with a higher risk of not wearing helmets. Male gender, youth (≤24 years), no schooling, riding a lower engine capacity motorcycle and using a motorcycle for purposes other than travelling to school/work were associated with over-reporting of helmet use. Self-reports provide an overestimate of helmet use that lessens as actual helmet use increases. Interviews also allow identification of factors associated with helmet use. Increasing helmet ownership and enhanced enforcement may help increase helmet use. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  5. Work schedules of long-distance truck drivers before and after 2004 hours-of-service rule change.

    PubMed

    McCartt, Anne T; Hellinga, Laurie A; Solomon, Mark G

    2008-01-01

    Federal rules regulate work hours of interstate commercial truck drivers. On January 4, 2004, a new work rule was implemented, increasing daily and weekly maximum driving limits and daily off-duty requirements. The present study assessed changes in long-distance truck drivers' reported work schedules and reported fatigued driving after the rule change. Associations between reported rule violations, fatigued driving, and schedule as well as other characteristics were examined. Samples of long-distance truck drivers were interviewed face-to-face in two states immediately before the rule change (November-December 2003) and about 1 year (November-December 2004) and 2 years (November-December 2005) after the change. Drivers reported substantially more hours of driving after the rule change. Most drivers reported regularly using a new restart provision, which permits a substantial increase in weekly driving. Reported daily off-duty and sleep time increased. Reported incidents of falling asleep at the wheel of the truck increased between 2003 (before the rule change) and 2004 and 2005 (after the change); in 2005 about one fifth of drivers reported falling asleep at the wheel in the past month. The frequency of reported rule violations under the old and new rules was similar. The percentage of trucks with electronic on-board recorders increased significantly to almost half the fleet; only a few drivers were using automated recorders to report rule compliance. More than half of drivers said that requiring automated recorders on all large trucks to enforce driving-hour limits would improve compliance with work rules. Based on the 2004-2005 survey data, drivers who reported more frequent rule violations were significantly more likely to report fatigued driving. Predictors of reported violations included having unrealistic delivery schedules, longer wait times to drop off or pick up loads, difficulty finding a legal place to stop or rest, and driving a refrigerated trailer. Reported truck driver fatigue increased after the new rule was implemented, suggesting that the rule change may not have achieved the goal of reducing fatigued driving. Reported violations of the work rules remain common. Because many trucks already have electronic recorders, requiring them as a means of monitoring driving hours appears feasible.

  6. Increasing the productivity of the nation's urban transportation infrastructure: Measures to increase transit use and carpooling. Final report

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

    Kain, J.F.; Gittell, R.; Daniere, A.

    1992-01-01

    The report surveys the growing use of bus and carpool priority measures to increase the productivity of the nation's transportation infrastructure. While it identifies a wide variety of priority measures, the report principally focuses on the planning and operation of exclusive and shared busways and high occupancy vehicle (HOV) facilities. It presents a variety of case studies describing the implementation of busways and transitways. The document also compares the cost effectiveness of exclusive busways and bus-HOV facilities with the cost effectiveness of recently completed light and heavy rail lines. It also explores the options and problems in serving large downtownmore » areas.« less

  7. Systematic review of the incremental costs of interventions that increase immunization coverage.

    PubMed

    Ozawa, Sachiko; Yemeke, Tatenda T; Thompson, Kimberly M

    2018-05-10

    Achieving and maintaining high vaccination coverage requires investments, but the costs and effectiveness of interventions to increase coverage remain poorly characterized. We conducted a systematic review of the literature to identify peer-reviewed studies published in English that reported interventions aimed at increasing immunization coverage and the associated costs and effectiveness of the interventions. We found limited information in the literature, with many studies reporting effectiveness estimates, but not providing cost information. Using the available data, we developed a cost function to support future programmatic decisions about investments in interventions to increase immunization coverage for relatively low and high-income countries. The cost function estimates the non-vaccine cost per dose of interventions to increase absolute immunization coverage by one percent, through either campaigns or routine immunization. The cost per dose per percent increase in absolute coverage increased with higher baseline coverage, demonstrating increasing incremental costs required to reach higher coverage levels. Future studies should evaluate the performance of the cost function and add to the database of available evidence to better characterize heterogeneity in costs and generalizability of the cost function. Copyright © 2018. Published by Elsevier Ltd.

  8. Strengthening the reporting of genetic risk prediction studies (GRIPS): explanation and elaboration

    PubMed Central

    Janssens, A Cecile JW; Ioannidis, John PA; Bedrosian, Sara; Boffetta, Paolo; Dolan, Siobhan M; Dowling, Nicole; Fortier, Isabel; Freedman, Andrew N; Grimshaw, Jeremy M; Gulcher, Jeffrey; Gwinn, Marta; Hlatky, Mark A; Janes, Holly; Kraft, Peter; Melillo, Stephanie; O'Donnell, Christopher J; Pencina, Michael J; Ransohoff, David; Schully, Sheri D; Seminara, Daniela; Winn, Deborah M; Wright, Caroline F; van Duijn, Cornelia M; Little, Julian; Khoury, Muin J

    2011-01-01

    The rapid and continuing progress in gene discovery for complex diseases is fueling interest in the potential application of genetic risk models for clinical and public health practice. The number of studies assessing the predictive ability is steadily increasing, but they vary widely in completeness of reporting and apparent quality. Transparent reporting of the strengths and weaknesses of these studies is important to facilitate the accumulation of evidence on genetic risk prediction. A multidisciplinary workshop sponsored by the Human Genome Epidemiology Network developed a checklist of 25 items recommended for strengthening the reporting of Genetic RIsk Prediction Studies (GRIPS), building on the principles established by previous reporting guidelines. These recommendations aim to enhance the transparency, quality and completeness of study reporting, and thereby to improve the synthesis and application of information from multiple studies that might differ in design, conduct or analysis. PMID:21407270

  9. A Systematic Review of Culturally Specific Interventions to Increase Physical Activity for Older Asian Americans.

    PubMed

    Katigbak, Carina; Flaherty, Erin; Chao, Ying-Yu; Nguyen, Tam; Cheung, Daphne; Yiu-Cho Kwan, Rick

    Physical activity (PA) is a significant modifiable risk factor for cardiovascular disease. For older adults, engaging in PA is shown to improve cardiac status, reduce cognitive, and functional decline, and improve overall quality of life. However, only 17% of Asian American adults meet the 2008 federal recommended guidelines for aerobic and muscle strengthening activity; and there is a paucity of data reporting on older Asian Americans - a rapidly growing, underserved group. While data pertaining to Asian Americans is frequently reported at the aggregate level, this masks differences (eg, language, culture, income) among Asian ethnic subgroups that may impact health behaviors. The purpose of this review was to identify intervention, and cultural adaptation strategies in studies promoting PA for older Asian Americans. A comprehensive literature search was performed to identify interventions published between 1996-2016 focused on improving PA among older Asian Americans (> 60 years old). Data were abstracted to examine intervention study designs, cultural adaptation strategies, theoretical frameworks, and physical activity measures. Nine studies met the review's inclusion criteria. Community-based recruitment approaches were widely used, and all studies employed cultural adaptation to varying degrees. Most studies reported improvements in PA outcomes, focused on Chinese Americans, and relied on self-reports of PA, while few aimed to increase PA using a multi-component approach. Future studies would benefit from larger sample sizes, a wider representation of Asian ethnic subgroups, and concentrated efforts to implement deep level adaptations that may increase the salience and sustainability of these interventions.

  10. I Am Right, You Are Wrong: How Biased Assimilation Increases the Perceived Gap between Believers and Skeptics of Violent Video Game Effects

    PubMed Central

    Greitemeyer, Tobias

    2014-01-01

    Background Despite hundreds of studies, there is continuing debate about the extent to which violent video games increase aggression. Believers argue that playing violent video games increases aggression, but this stance is disputed by skeptics. The present study addressed believers' and skeptics' responses to summaries of scientific studies that do or do not present evidence for increased aggression after violent video game play. Methods/Principal Findings Participants (N = 662) indicated whether they believed that violent video games increase aggression. Afterwards, they evaluated two opposing summaries of fictitious studies on the effects of violent video play. They also reported whether their initial belief had changed after reading the two summaries and indicated again whether they believed that violent video games increase aggression. Results showed that believers evaluated the study showing an effect more favorably than a study showing no effect, whereas the opposite was observed for skeptics. Moreover, both believers and skeptics reported to become more convinced of their initial view. In contrast, for actual attitude change, a depolarization effect was found. Conclusions/Significance These results suggest that biased assimilation of new information leads believers and skeptics to become more rather than less certain of their views. Hence, even when confronted with mixed and inconclusive evidence, the perceived gap between both sides of the argument increases. PMID:24722467

  11. I am right, you are wrong: how biased assimilation increases the perceived gap between believers and skeptics of violent video game effects.

    PubMed

    Greitemeyer, Tobias

    2014-01-01

    Despite hundreds of studies, there is continuing debate about the extent to which violent video games increase aggression. Believers argue that playing violent video games increases aggression, but this stance is disputed by skeptics. The present study addressed believers' and skeptics' responses to summaries of scientific studies that do or do not present evidence for increased aggression after violent video game play. Participants (N = 662) indicated whether they believed that violent video games increase aggression. Afterwards, they evaluated two opposing summaries of fictitious studies on the effects of violent video play. They also reported whether their initial belief had changed after reading the two summaries and indicated again whether they believed that violent video games increase aggression. Results showed that believers evaluated the study showing an effect more favorably than a study showing no effect, whereas the opposite was observed for skeptics. Moreover, both believers and skeptics reported to become more convinced of their initial view. In contrast, for actual attitude change, a depolarization effect was found. These results suggest that biased assimilation of new information leads believers and skeptics to become more rather than less certain of their views. Hence, even when confronted with mixed and inconclusive evidence, the perceived gap between both sides of the argument increases.

  12. Attitudes and perceived barriers influencing incident reporting by nurses and their correlation with reported incidents: A systematic review.

    PubMed

    Fung, Wing Mei; Koh, Serena Siew Lin; Chow, Yeow Leng

    Clinical incident reporting is an integral feature of risk management system in the healthcare sector. By reporting clinical incidents, nurses allow for learning from errors, identification of error patterns and development of error preventive strategies. The need to understand attitudes to reporting, perceived barriers and incident reporting patterns by nurses are the core highlights of this review. INCLUSION CRITERIA: This review considered descriptive quantitative studies that examined nurses' attitudes or perceived barriers towards incident reporting.The participants in this review were nurses working in acute care settings or step-down care settings. Studies that included non-nursing healthcare personnel were excluded.This review considered studies which examined nurses' attitudes towards incident reporting, perceived barriers and incident reporting practices.The outcomes of interest were the attitudes that nurses have towards incident reporting, perceived barriers and the types of reported incidents in correlation with nurses' attitudes and barriers. A three-step search strategy was utilised in this review. An initial limited search of CINAHL and MEDLINE was undertaken. Search strategies were then developed using identified keywords and index terms. Lastly, the reference lists of all identified articles were examined. All searches were limited to studies published in English, between 1991 and 2010. The studies were independently assessed by two reviewers using the Joanna Briggs Institute Critical Appraisal Checklist for Descriptive/ Case Series studies. The reviewers extracted data independently from included studies using the Joanna Briggs Institute Data Extraction Form for Descriptive/ Case Series studies. Due to the descriptive nature of the study designs, statistical pooling was not possible. Therefore, the findings of this systematic review are presented in a narrative summary. Fifty-five papers were identified from the searches based on their titles and abstracts. Nine studies were included in this review. Cultural and demographic factors were the most significant factors in affecting nurses' attitudes towards incident reporting. Major perceived barriers included fear, administrative issues, and the reporting process. Also, nurses were more likely to report incidents that caused direct harm, and if reporting was kept anonymous. This review demonstrated that attitudes of nurses towards incident reporting vary across different study settings, with perceived barriers hindering the reporting process. Using the findings, interventions can be customised to increase reporting rates can be developed to curb the problem of underreporting.A non-punitive culture towards incident reporting has to be cultivated, and nursing authorities should provide frequent positive feedback to staff who reported incidents. Investigating system errors should be the focus rather than individual blame.Further research should target the development and evaluation of strategies to increase rates of incident reporting. Any differences between actual and perceived reporting rates should also be explored.

  13. Subjective memory complaints in preclinical autosomal dominant Alzheimer disease.

    PubMed

    Norton, Daniel J; Amariglio, Rebecca; Protas, Hillary; Chen, Kewei; Aguirre-Acevedo, Daniel C; Pulsifer, Brendan; Castrillon, Gabriel; Tirado, Victoria; Munoz, Claudia; Tariot, Pierre; Langbaum, Jessica B; Reiman, Eric M; Lopera, Francisco; Sperling, Reisa A; Quiroz, Yakeel T

    2017-10-03

    To cross-sectionally study subjective memory complaints (SMC) in autosomal dominant Alzheimer disease (ADAD). We examined self-reported and study partner-based SMC in 52 young, cognitively unimpaired individuals from a Colombian kindred with early-onset ADAD. Twenty-six carried the PSEN-1 E280A mutation, averaging 7 years of age younger than the kindred's expected clinical onset. Twenty-six were age-matched noncarriers. Participants also underwent structural MRI and cognitive testing. Self-reported SMC were greater in carriers than noncarriers ( p = 0.02). Study partner-based SMC did not differ between groups ( p = 0.21), but in carriers increased with age ( r = 0.66, p < 0.001) and decreased with hippocampal volume ( r = -0.35, p = 0.08). Cognitively unimpaired PSEN-1 carriers have elevated SMC. Self-reported SMC may be a relatively early indicator of preclinical AD, while partner- reported SMC increases later in preclinical AD, closer to clinical onset. © 2017 American Academy of Neurology.

  14. The health effects of swimming at Sydney beaches. The Sydney Beach Users Study Advisory Group.

    PubMed Central

    Corbett, S J; Rubin, G L; Curry, G K; Kleinbaum, D G

    1993-01-01

    OBJECTIVES. The purpose of the study was to determine the health risks of swimming at ocean beaches in Sydney, Australia. METHODS. From people attending 12 Sydney beaches in the period from December 5, 1989 to February 26, 1990, we recruited a cohort of 8413 adults who agreed to participate in this study. Of these, 4424 were excluded either because they had been swimming in the previous 5 days or because they reported a current illness. Of the remainder, 2839 successfully completed a follow-up telephone interview conducted within 10 days after recruitment. We recorded reported respiratory, gastrointestinal, eye, and ear symptoms and fever that occurred within the 10 days between initial interview on the beach and the follow-up interview. RESULTS. A total of 683 participants (24.0%) reported experiencing symptoms in the 10 days following initial interview. Of these, 435 (63.7%) reported respiratory symptoms. Swimmers were almost twice as likely as nonswimmers to report symptoms. There was a linear relationship between water pollution and all reported symptoms with the exception of gastrointestinal complaints. CONCLUSIONS. Swimmers at Sydney ocean beaches are more likely to report respiratory, ear, and eye symptoms than beachgoers who do not swim. The incidence of these symptoms increases slightly with increasing levels of pollution. PMID:8259798

  15. Effects of caffeine on alcohol reinforcement: beverage choice, self-administration, and subjective ratings.

    PubMed

    Sweeney, Mary M; Meredith, Steven E; Evatt, Daniel P; Griffiths, Roland R

    2017-03-01

    Combining alcohol and caffeine is associated with increased alcohol consumption, but no prospective experimental studies have examined whether added caffeine increases alcohol consumption. This study examined how caffeine alters alcohol self-administration and subjective reinforcing effects in healthy adults. Thirty-one participants completed six double-blind alcohol self-administration sessions: three sessions with alcohol only (e.g., beverage A) and three sessions with alcohol and caffeine (e.g., beverage B). Participants chose which beverage to consume on a subsequent session (e.g., beverage A or B). The effects of caffeine on overall beverage choice, number of self-administered drinks, subjective ratings (e.g., Biphasic Alcohol Effects Scale), and psychomotor performance were examined. A majority of participants (65%) chose to drink the alcohol beverage containing caffeine on their final self-administration session. Caffeine did not increase the number of self-administered drinks. Caffeine significantly increased stimulant effects, decreased sedative effects, and attenuated decreases in psychomotor performance attributable to alcohol. Relative to nonchoosers, caffeine choosers reported overall lower stimulant ratings and reported greater drinking behavior prior to the study. Although caffeine did not increase the number of self-administered drinks, most participants chose the alcohol beverage containing caffeine. Given the differences in subjective ratings and pre-existing differences in self-reported alcohol consumption for caffeine choosers and nonchoosers, these data suggest that decreased stimulant effects of alcohol and heavier self-reported drinking may predict subsequent choice of combined caffeine and alcohol beverages. These predictors may identify individuals who would benefit from efforts to reduce risk behaviors associated with combining alcohol and caffeine.

  16. Effects of caffeine on alcohol reinforcement: Beverage choice, self-administration, and subjective ratings

    PubMed Central

    Sweeney, Mary M.; Meredith, Steven E.; Evatt, Daniel P.; Griffiths, Roland R.

    2017-01-01

    Rationale Combining alcohol and caffeine is associated with increased alcohol consumption, but no prospective experimental studies have examined whether added caffeine increases alcohol consumption. Objectives This study examined how caffeine alters alcohol self-administration and subjective reinforcing effects in healthy adults. Methods Thirty-one participants completed six double-blind alcohol self-administration sessions: three sessions with alcohol only (e.g., Beverage A) and three sessions with alcohol and caffeine (e.g., Beverage B). Participants chose which beverage to consume on a subsequent session (e.g., Beverage A or B). Effects of caffeine on overall beverage choice, number of self-administered drinks, subjective ratings (e.g., Biphasic Alcohol Effects Scale), and psychomotor performance were examined. Results A majority of participants (65%) chose to drink the alcohol beverage containing caffeine on their final self-administration session. Caffeine did not increase the number of self-administered drinks. Caffeine significantly increased stimulant effects, decreased sedative effects, and attenuated decreases in psychomotor performance attributable to alcohol. Relative to nonchoosers, caffeine choosers reported overall lower stimulant ratings, and reported greater drinking behavior prior to the study. Conclusions Although caffeine did not increase the number of self-administered drinks, most participants chose the alcohol beverage containing caffeine. Given the differences in subjective ratings and pre-existing differences in self-reported alcohol consumption for caffeine choosers and nonchoosers, these data suggest decreased stimulant effects of alcohol and heavier self-reported drinking may predict subsequent choice of combined caffeine and alcohol beverages. These predictors may identify individuals who would benefit from efforts to reduce risk behaviors associated with combining alcohol and caffeine. PMID:28108773

  17. Childhood herpes zoster: a clustering of ten cases.

    PubMed

    Prabhu, Smitha; Sripathi, H; Gupta, Sanjeev; Prabhu, Mukyaprana

    2009-01-01

    Herpes zoster occurs due to reactivation of the latent varicella zoster virus and is usually a disease of the elderly. Childhood herpes zoster is believed to be rare, though recent studies suggest increasing incidence in children. Here we report ten cases of childhood herpes zoster, seven of which occurred within a short span of six months, at a tertiary care level hospital in Pokhara, Nepal. Only three of the ten children reported previous history of varicella infection and none was immunized against varicella. Though childhood herpes zoster accounted for less than 1% of the total zoster cases in the past, recent reports show an increase in the number of cases in apparently healthy children. So far, no studies have been done linking childhood herpes zoster with HIV, though there are many studies linking it with other immunocompromised conditions.

  18. Increasing complexity of clinical research in gastroenterology: implications for the training of clinician-scientists.

    PubMed

    Scott, Frank I; McConnell, Ryan A; Lewis, Matthew E; Lewis, James D

    2012-04-01

    Significant advances have been made in clinical and epidemiologic research methods over the past 30 years. We sought to demonstrate the impact of these advances on published gastroenterology research from 1980 to 2010. Twenty original clinical articles were randomly selected from each of three journals from 1980, 1990, 2000, and 2010. Each article was assessed for topic, whether the outcome was clinical or physiologic, study design, sample size, number of authors and centers collaborating, reporting of various statistical methods, and external funding. From 1980 to 2010, there was a significant increase in analytic studies, clinical outcomes, number of authors per article, multicenter collaboration, sample size, and external funding. There was increased reporting of P values, confidence intervals, and power calculations, and increased use of large multicenter databases, multivariate analyses, and bioinformatics. The complexity of clinical gastroenterology and hepatology research has increased dramatically, highlighting the need for advanced training of clinical investigators.

  19. Validity of questionnaire self‐reports on computer, mouse and keyboard usage during a four‐week period

    PubMed Central

    Mikkelsen, Sigurd; Vilstrup, Imogen; Lassen, Christina Funch; Kryger, Ann Isabel; Thomsen, Jane Frølund; Andersen, Johan Hviid

    2007-01-01

    Objective To examine the validity and potential biases in self‐reports of computer, mouse and keyboard usage times, compared with objective recordings. Methods A study population of 1211 people was asked in a questionnaire to estimate the average time they had worked with computer, mouse and keyboard during the past four working weeks. During the same period, a software program recorded these activities objectively. The study was part of a one‐year follow‐up study from 2000–1 of musculoskeletal outcomes among Danish computer workers. Results Self‐reports on computer, mouse and keyboard usage times were positively associated with objectively measured activity, but the validity was low. Self‐reports explained only between a quarter and a third of the variance of objectively measured activity, and were even lower for one measure (keyboard time). Self‐reports overestimated usage times. Overestimation was large at low levels and declined with increasing levels of objectively measured activity. Mouse usage time proportion was an exception with a near 1:1 relation. Variability in objectively measured activity, arm pain, gender and age influenced self‐reports in a systematic way, but the effects were modest and sometimes in different directions. Conclusion Self‐reported durations of computer activities are positively associated with objective measures but they are quite inaccurate. Studies using self‐reports to establish relations between computer work times and musculoskeletal pain could be biased and lead to falsely increased or decreased risk estimates. PMID:17387136

  20. Validity of questionnaire self-reports on computer, mouse and keyboard usage during a four-week period.

    PubMed

    Mikkelsen, Sigurd; Vilstrup, Imogen; Lassen, Christina Funch; Kryger, Ann Isabel; Thomsen, Jane Frølund; Andersen, Johan Hviid

    2007-08-01

    To examine the validity and potential biases in self-reports of computer, mouse and keyboard usage times, compared with objective recordings. A study population of 1211 people was asked in a questionnaire to estimate the average time they had worked with computer, mouse and keyboard during the past four working weeks. During the same period, a software program recorded these activities objectively. The study was part of a one-year follow-up study from 2000-1 of musculoskeletal outcomes among Danish computer workers. Self-reports on computer, mouse and keyboard usage times were positively associated with objectively measured activity, but the validity was low. Self-reports explained only between a quarter and a third of the variance of objectively measured activity, and were even lower for one measure (keyboard time). Self-reports overestimated usage times. Overestimation was large at low levels and declined with increasing levels of objectively measured activity. Mouse usage time proportion was an exception with a near 1:1 relation. Variability in objectively measured activity, arm pain, gender and age influenced self-reports in a systematic way, but the effects were modest and sometimes in different directions. Self-reported durations of computer activities are positively associated with objective measures but they are quite inaccurate. Studies using self-reports to establish relations between computer work times and musculoskeletal pain could be biased and lead to falsely increased or decreased risk estimates.

  1. The effectiveness of a self-reporting bedside pain assessment tool for oncology inpatients.

    PubMed

    Kim, Eun Bi; Han, Hye-Suk; Chung, Jung Hwa; Park, Bo Ram; Lim, Sung-Nam; Yim, Kyoung Hoon; Shin, Young Duck; Lee, Ki Hyeong; Kim, Wun-Jae; Kim, Seung Taik

    2012-11-01

    Pain is common during cancer treatment, and patient self-reporting of pain is an essential first step for ideal cancer pain management. However, many studies on cancer pain management report that, because pain may be underestimated, it is often inadequately managed. The aim of this study was to evaluate the effectiveness of bedside self-assessment of pain intensity for inpatients using a self-reporting pain board. Fifty consecutive inpatients admitted to the Oncology Department of Chungbuk National University Hospital were included in this observational prospective study from February 2011 to December 2011. The medical staff performed pain assessments by asking patients questions and using verbal rated scales (VRS) over 3 consecutive days. Then, for 3 additional days, patients used a self-reporting pain board attached to the bed, which had movable indicators representing 0-10 on a numeric rating scale (NRS) and the frequency of breakthrough pain. Patient reliability over the medical staff's pain assessment increased from 74% to 96% after applying the self-reporting pain board (p=0.004). The gap (mean±standard deviation [SD]) between the NRS reported by patients and the NRS recorded on the medical records decreased from 3.16±2.08 to 1.00±1.02 (p<0.001), and the level of patient satisfaction with pain management increased from 54% to 82% (p=0.002). This study suggests that the self-reporting bedside pain assessment tool provides a reliable and effective means of assessing pain in oncology inpatients.

  2. Reporting of Randomized Trials in Common Cancers in the Lay Media.

    PubMed

    Ribnikar, Domen; Goldvaser, Hadar; Ocana, Alberto; Templeton, Arnoud J; Seruga, Bostjan; Amir, Eitan

    2018-01-01

    Limited data exist about the role of the lay media in the dissemination of results of randomized controlled trials (RCTs) in common cancers. Completed phase III RCTs evaluating new drugs in common cancers between January 2005 and October 2016 were identified from ClinicalTrials.gov. Lay media reporting was identified by searching LexisNexis Academic. Scientific reporting was defined as presentation at an academic conference or publication in full. Associations between reporting in the lay media before scientific reporting and study design and sponsorship were evaluated using logistic regression. Of 180 RCTs identified, 52% were reported in the lay media and in 27%, lay media reporting occurred before scientific reporting with an increasing trend over time (p = 0.009). Reporting in the lay media before scientific reporting was associated with positive results (OR: 2.10, p = 0.04), targeted therapy compared to chemotherapy (OR: 4.75, p = 0.006), immunotherapy compared to chemotherapy (OR: 7.60, p = 0.02), and prostate cancer compared to breast cancer (OR: 3.25, p = 0.02). Over a quarter of all RCTs in common cancers are reported in the lay media before they are reported scientifically with an increasing proportion over time. Positive trials, studies in prostate cancer, and trials of immunotherapy are associated with early reporting in the lay media. © 2017 S. Karger AG, Basel.

  3. Report on Legislative and Funding Recommendations, DoDDS Comprehensive Study [of Dependents Schools].

    ERIC Educational Resources Information Center

    Bartell, Ted; LeBlanc, Linda

    The final volume of a comprehensive study of the Department of Defense Dependents Schools (DoDDS), this report consists of a brief background description of the DoDDS system, followed by 10 legislative and funding recommendations based on the findings of the study: (1) increase funding in fiscal year 1984 and beyond to accommodate anticipated…

  4. Out of School Care: A Brief Review of the Literature. SCRE Research Report.

    ERIC Educational Resources Information Center

    Malcolm, Heather; Wilson, Valerie; Davidson, Julia

    Noting the increasing use of out of school care (school-age care outside of normal school hours) in Scotland, this report reviews research on : care-focused provision and study support. Considered in the review were 33 reports referring to work in the United Kingdom, 3 referring to Scandinavian practice, and 1 report on U.S. research. The report…

  5. A Study of the State of Budgetary Financial Reporting in Navy Medicine

    DTIC Science & Technology

    1998-12-01

    comply with financial reporting reform mandates from Congress and other federal agencies, while simultaneously optimizing the use of its financial...systems to improve financial management processes. This thesis describes and examines the effectiveness of budgetary financial reporting in Navy medicine...contributing to financial reporting reforms by increasing efficiencies of its systems through consolidation and integration. Additionally, BUMED has complied

  6. Technology use as a support tool by secondary students with autism.

    PubMed

    Hedges, Susan H; Odom, Samuel L; Hume, Kara; Sam, Ann

    2018-01-01

    The purpose of this study was to examine how secondary students with autism spectrum disorder use technology in supportive ways. In this self-report survey study, 472 adolescents with autism spectrum disorder enrolled in high school described the forms of technology they use and purposes for which they use it. Students reported the benefits as well as barriers to technology use at school. They reported using technology in school and home settings in a variety of supportive ways such as increasing their independence, reducing their anxiety, and increasing their social opportunities. Findings suggest that practitioners may benefit from learning how to integrate technology as an instructional and support tool for their students with autism spectrum disorder. Recommendations for future research are provided.

  7. Influence of BMI in nephrolithiasis in an Appalachian pediatric population: A single-center experience.

    PubMed

    Murphy, Margaret O; Erpelding, Scott G; Chishti, Aftab S; Dugan, Adam; Ziada, Ali; Kiessling, Stefan G

    2018-06-07

    The prevalence of pediatric nephrolithiasis has increased significantly in the past 20 years. Metabolic abnormalities predisposing adults to nephrolithiasis in obese patients include increased urinary sodium and uric acid excretion as well as low urine pH; however, limited data are available in the pediatric population. The aim was to investigate whether obese pediatric patients presenting with nephrolithiasis have a unique metabolic profile similar to reported findings in obese adults with nephrolithiasis. A retrospective chart review was performed in children aged 1-18 years seen at Kentucky Children's Hospital between 2010 and 2016. Inclusion criteria included all patients with documented stones confirmed by ultrasonography or computed tomography. A total of 111 patient charts were reviewed in the study with a mean age of 11.8 ± 4.2 years. Seventy patients (63%) had a normal BMI and 41 patients (37%) were considered overweight/obese. There was no statistically significant relationship between BMI and stone recurrence. Obese patients had significantly decreased levels of urinary citrate, oxalate, magnesium, and potassium with significant elevations of urinary urea nitrogen, ammonia, and low urine pH compared with normal weight patients (Summary Figure). Several groups have reported on metabolic findings within obese and non-obese pediatric patients. A Turkish study reported increased oxalate excretion and hypocitraturia in obese patients while a Korean study also reported increased rates of hypocitraturia in recurrent stone formers. Similar to these studies, we did find significant differences in citrate within our study population; however, we found significantly lower levels of urinary oxalate in obese patients. The majority of these studies do not report an association with BMI and urine pH although this has been reported in the adult population and our findings support an inverse relationship between body mass index (BMI) and pH. Our group found a higher level of calcium phosphate stones, supporting of Eisner's findings that high BMI is associated with increased supersaturation of calcium phosphate. Limitations of our study include being a single center and retrospective in nature. Our study demonstrates differences in types of stones and urinary metabolites in an obese pediatric population suggestive of different metabolic profiles contributing to stone disease. We report similar association between BMI and urine pH, urinary potassium, and citrate. This study confirmed our primary hypothesis that obese pediatric patients would have a different urinary mineral profile as evidenced by lower levels of citrate and potassium and low urine pH; however, obese patients did not exhibit significantly elevated urinary sodium and uric acid when normalized to weight, as described in the adult population. Our study did not confirm our secondary hypothesis that stone composition would be associated with BMI status or stone recurrence. Copyright © 2018 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  8. Physical activity on prescription (PAP): self-reported physical activity and quality of life in a Swedish primary care population, 2-year follow-up

    PubMed Central

    Rödjer, Lars; H. Jonsdottir, Ingibjörg; Börjesson, Mats

    2016-01-01

    Objective To study the self-reported level of physical activity (PA) and quality of life (QOL) in patients receiving physical activity on prescription (PAP) for up to 24 months. Design Observational study conducted in a regular healthcare setting. Setting A primary care population in Sweden receiving physical activity on prescription as part of regular care was studied alongside a reference group. Subjects The group comprised 146 patients receiving PAP at two different primary care locations (n = 96 and 50, respectively). The reference group comprised 58 patients recruited from two different primary care centres in the same region. Main outcome measurements We used two self-report questionnaires – the four-level Saltin-Grimby Physical Activity Level Scale (SGPALS) to assess physical activity, and SF-36 to assess QOL. Results A significant increase in the PA level was found at six and 12 months following PAP, with an ongoing non-significant trend at 24 months (p = .09). A clear improvement in QOL was seen during the period. At 24 months, significant and clinically relevant improvements in QOL persisted in four out of eight sub-scale scores (Physical Role Limitation, Bodily Pain, General Health,Vitality) and in one out of two summary scores (Physical Component Summary). Conclusion Patients receiving PAP showed an increased level of self-reported PA at six and 12 months and improved QOL for up to 24 months in several domains. The Swedish PAP method seems to be a feasible method for bringing about changes in physical activity in different patient populations in regular primary healthcare. While increased physical activity (PA) is shown to improve health, the implementation of methods designed to increase activity is still being developed. Key points The present study confirms that the Swedish physical activity on prescription (PAP) method increases the self-reported level of PA in the primary care setting at six and 12 months. Furthermore, this study shows that PAP recipients report a clinically relevant long-term improvement in quality of life, persisting for two years post-prescription, thus extending earlier findings. These findings have clinical implications for the implementation of PAP in healthcare. PMID:27978781

  9. Patient-reported safety incidents in older patients with long-term conditions: a large cross-sectional study

    PubMed Central

    Panagioti, Maria; Blakeman, Thomas; Hann, Mark; Bower, Peter

    2017-01-01

    Background Increasing evidence suggests that patient safety is a serious concern for older patients with long-term conditions. Despite this, there is a lack of research on safety incidents encountered by this patient group. In this study, we sought to examine patient reports of safety incidents and factors associated with reports of safety incidents in older patients with long-term conditions. Methods The baseline cross-sectional data from a longitudinal cohort study were analysed. Older patients (n=3378 aged 65 years and over) with a long-term condition registered in general practices were included in the study. The main outcome was patient-reported safety incidents including availability and appropriateness of medical tests and prescription of wrong types or doses of medication. Binary univariate and multivariate logistic regression analyses were undertaken to examine factors associated with patient-reported safety incidents. Results Safety incidents were reported by 11% of the patients. Four factors were significantly associated with patient-reported safety incidents in multivariate analyses. The experience of multiple long-term conditions (OR=1.09, 95% CI 1.05 to 1.13), a probable diagnosis of depression (OR=1.36, 95% CI 1.06 to 1.74) and greater relational continuity of care (OR=1.28, 95% CI 1.08 to 1.52) were associated with increased odds for patient-reported safety incidents. Perceived greater support and involvement in self-management was associated with lower odds for patient-reported safety incidents (OR=0.95, 95% CI 0.93 to 0.97). Conclusions We found that older patients with multimorbidity and depression are more likely to report experiences of patient safety incidents. Improving perceived support and involvement of patients in their care may help prevent patient-reported safety incidents. PMID:28559454

  10. SPEEDIER Project. Preliminary Report on Social Studies Pilot Projects.

    ERIC Educational Resources Information Center

    Myers, Charles B.; And Others

    This preliminary report describes five social studies pilot programs in the counties of Dauphin, Lancaster, Lebanon, and York, Pennsylvania. It is expected that these pilot endeavors will affect educators in the counties served by SPEEDIER as follows: 1) increase understanding of the newer content, ideas, and strategies in the pilot programs; 2)…

  11. A Resource-Constrained Approach to Implementing Analytics in an Institution of Higher Education: An Experience Report

    ERIC Educational Resources Information Center

    Buerck, John P.; Mudigonda, Srikanth P.

    2014-01-01

    Academic analytics and learning analytics have been increasingly adopted by academic institutions of higher learning for improving student performance and retention. While several studies have reported the implementation details and the successes of specific analytics initiatives, relatively fewer studies exist in literature that describe the…

  12. The Influence of Social Threat on Pain, Aggression, and Empathy in Women.

    PubMed

    Karos, Kai; Meulders, Ann; Goubert, Liesbet; Vlaeyen, Johan W S

    2018-03-01

    Only one published study has investigated the effect of a threatening social context on the perception and expression of pain, showing that social threat leads to increased pain reports but reduced nonverbal pain expression. The current study aimed to replicate and extend these findings to further explore the effects of a threatening social context. Healthy, female participants (N = 71) received 10 electrocutaneous stimuli delivered by a confederate. They were led to believe that the confederate was requested to administer 10 painful stimuli (control group) or that the confederate deliberately chose to deliver 10 painful stimuli when given the choice to deliver between 1 to 10 painful stimuli (social threat group). Self-reported pain intensity, unpleasantness, threat value of pain, and painful facial expression were assessed. Additionally, empathy and aggression toward the confederate were investigated. Social threat did not affect painful facial expression or self-reported pain intensity, but led to increased aggression toward the confederate. Moreover, perceived social threat predicted the threat value of pain and reduced empathy toward the confederate. We were not able to replicate the previously reported dissociation between pain reports and pain expression as a result of social threat. However, social threat was associated with an increased threat value of pain, increased aggression, and reduced empathy. A threatening social context affects how threatening pain is perceived and has interpersonal consequences such as increased aggression and reduced empathy, thereby creating a double burden on the individual suffering from pain. Copyright © 2017 The American Pain Society. Published by Elsevier Inc. All rights reserved.

  13. Improving adverse drug reaction reporting in hospitals: results of the French Pharmacovigilance in Midi-Pyrénées region (PharmacoMIP) network 2-year pilot study.

    PubMed

    Gony, Mireille; Badie, Kattalin; Sommet, Agnès; Jacquot, Julien; Baudrin, Dominique; Gauthier, Pierre; Montastruc, Jean Louis; Bagheri, Haleh

    2010-05-01

    Spontaneous reporting of adverse drug reactions (ADRs) is fundamental to drug safety surveillance (pharmacovigilance); however, substantial under-reporting exists and is the main limitation of the system. Several factors could favour under-reporting. The aim of this pilot study was to assess the effect of regular visits of a Clinical Research Assistant (CRA) on the improvement of ADR reporting in non-university hospitals. We set up an ADR report collecting system that involved regular visits by a CRA to non-university hospitals, which was similar to a system that already existed in university hospitals in Toulouse, France. Two areas in our region were chosen: Haute Garonne and Gers. We compared firstly the reporting rate (number of reports/number of beds) of total ADRs (i.e. spontaneously reported ADRs plus solicited ADRs collected by the CRA) and secondly, the percentage of serious ADRs reported by non-university hospitals in these two areas, in 2005 (the year prior to CRA visits) and after the start of CRA visits (2006 until the end of December 2008). We also compared the reporting rate of total ADRs in Haute Garonne and Gers non-university hospitals with those reported during the same period with a control group (the Ariège area, which has a similar number of beds to Gers and that was not visited by the CRA). The characteristics of ADRs collected by the CRA were also described. A total of 687 reports were collected by the CRA: 40% were classified as serious, including two deaths. The number of ADRs and the reporting rate increased significantly between 2005 and 2008 in non-university hospitals of Haute-Garonne and Gers, but not in Ariège. In Gers, the reporting rate was 3% in 2005 and 25% in 2008. In Haute-Garonne, the reporting rate was 11% in 2005 and 40% in 2008. The difference between the number of spontaneous and solicited reports also increased. This study shows that regular visits by a CRA increases the number of ADRs collected by a Regional Pharmacovigilance Centre. Another interesting consequence was the rise in spontaneous reporting by healthcare professionals following the set-up of this system. Further assessment of this procedure is necessary for the long-term evaluation of its effectiveness.

  14. [Trend analysis of acquired syphilis in Mexico from 2003 to 2013].

    PubMed

    Herrera-Ortiz, Antonia; Uribe-Salas, Felipe J; Olamendi-Portugal, Ma Leonidez; García-Cisneros, Santa; Conde-Glez, Carlos Jesús; Sánchez-Alemán, Miguel A

    2015-01-01

    To identify the population group in which syphilis increase was concentrated. The information was collected from the Mexico health statistical yearbooks. The information disaggregated by sex, age group and state during the period 2003 to 2013 was used to form different databases. Linear regression analysis with confidence interval at 95% was used to evaluate changes over time in different population groups. An increase of 0.67 cases per 100,000 population (95%CI 0.30-1.04) in men was detected from 2010. The increase was concentrated in each group of 20-24 and 25-44. The highest incidence of acquired syphilis was reported in the last two years: 2012 and 2013. The last year reported a 1.85 times higher incidence than reported in 2003. Aguascalientes, Distrito Federal, Durango, Mexico, Oaxaca, Puebla, Quintana Roo, Yucatan and Zacatecas reported that syphilis increased during the study period. Acquired syphilis may be reemerging in our country among young men; this increase is not uniform across the country, it is necessary to focus intervention measures for this sexually transmitted infection.

  15. Sex Differences in Landing Biomechanics and Postural Stability During Adolescence: A Systematic Review with Meta-Analyses.

    PubMed

    Holden, Sinéad; Boreham, Colin; Delahunt, Eamonn

    2016-02-01

    The adolescent 'growth spurt' results in rapid growth of the skeletal system. It has been theorised that absence of a concomitant increase in muscular adaptations in female athletes may predispose them to an increased risk of anterior cruciate ligament injuries. To determine if sex differences exist in landing biomechanics and postural stability of adolescent athletes; with a further objective of determining if such differences are propagated during adolescence. The following databases were searched: MEDLINE, EMBASE, CINAHL, PEDro, PubMed, SPORTDiscus and Web of Science. Research papers were identified by including search terms for neuromuscular control, lower limb and pubertal development. Studies were required to be written in English; report on biomechanical analyses; include landing or postural control tasks; be cross-sectional or longitudinal; and include healthy adolescent/pubertal subjects. A modified version of the Strengthening the Reporting of Observational studies in Epidemiology checklist was used to rate methodological quality. Meta-analyses were performed when more than one study reported on an outcome measure. Sixteen articles were included. The overall methodological quality of evaluated studies was low (mean score = 5.75/10 points). Adolescent females exhibited increased knee valgus with increasing maturity. There was no consensus on sex differences in postural stability. With increasing maturation, females are characterized by increased knee valgus during landing tasks. To date, no research has longitudinally investigated postural stability development during adolescence in females, despite the importance of postural control training in injury prevention programmes. Therefore, further research on this topic is warranted.

  16. Global mesothelioma deaths reported to the World Health Organization between 1994 and 2008

    PubMed Central

    Delgermaa, Vanya; Park, Eun-Kee; Le, Giang Vinh; Hara, Toshiyuki; Sorahan, Tom

    2011-01-01

    Abstract Objective To carry out a descriptive analysis of mesothelioma deaths reported worldwide between 1994 and 2008. Methods We extracted data on mesothelioma deaths reported to the World Health Organization mortality database since 1994, when the disease was first recorded. We also sought information from other English-language sources. Crude and age-adjusted mortality rates were calculated and mortality trends were assessed from the annual percentage change in the age-adjusted mortality rate. Findings In total, 92 253 mesothelioma deaths were reported by 83 countries. Crude and age-adjusted mortality rates were 6.2 and 4.9 per million population, respectively. The age-adjusted mortality rate increased by 5.37% per year and consequently more than doubled during the study period. The mean age at death was 70 years and the male-to-female ratio was 3.6:1. The disease distribution by anatomical site was: pleura, 41.3%; peritoneum, 4.5%; pericardium, 0.3%; and unspecified sites, 43.1%. The geographical distribution of deaths was skewed towards high-income countries: the United States of America reported the highest number, while over 50% of all deaths occurred in Europe. In contrast, less than 12% occurred in middle- and low-income countries. The overall trend in the age-adjusted mortality rate was increasing in Europe and Japan but decreasing in the United States. Conclusion The number of mesothelioma deaths reported and the number of countries reporting deaths increased during the study period, probably due to better disease recognition and an increase in incidence. The different time trends observed between countries may be an early indication that the disease burden is slowly shifting towards those that have used asbestos more recently. PMID:22084509

  17. Temporal changes of under-reporting of cigarette consumption in population-based studies.

    PubMed

    Gallus, Silvano; Tramacere, Irene; Boffetta, Paolo; Fernandez, Esteve; Rossi, Silvia; Zuccaro, Piergiorgio; Colombo, Paolo; La Vecchia, Carlo

    2011-01-01

    To monitor trends in under-reporting of smoking in Italy over the last two decades. A total of 9 representative population-based surveys on smoking conducted in Italy in 1990 and annually between 2001 and 2008, covering 26,397 individuals, were studied. The number of cigarettes per day per person aged 15 years or over, obtained from these interview-based surveys, was compared with official data from legal sales. Over the last two decades, self-reported smoking prevalence progressively decreased from 32% in 1990 to 22% in 2008. Self-reported daily per capita consumption of cigarettes also showed a reduction between 1990 and 2008, notably so over the last few years (from 5.2 in 1990 to 4.0 in 2004 to 3.2 in 2008). According to data from legal sales, number of cigarettes per day per person decreased from 5.3 in 1990 to 5.0 in 1992, levelled off from 1992 to 1997, subsequently increased from 5.0 in 1997 to 5.8 in 2002 (likely due to control of smuggling), and decreased over the last 6 years (to 4.9 in 2008). These figures correspond to an under-reporting of approximately 1% in 1990, 25% in 2001 and up to 35% in 2008. The difference in cigarette consumption between legal sale and self-reported data has substantially increased over the last two decades in Italy, reflecting increasing under-reporting of cigarette consumption mainly due to a decreasing social acceptability of smoking. Comparisons between interview-based and legal sale data are complicated by factors such as smuggling control and changes in the population (eg, increased proportion of immigrants); however these are able to justify only a small proportion of the gap found in Italy.

  18. Self-reports of safe driving behaviors in relationship to sex, age, education and income in the US adult driving population.

    PubMed

    Shinar, D; Schechtman, E; Compton, R

    2001-01-01

    This study analyzed the data of a health and safety survey conducted on a representative sample of the adult driving population. The analysis focused on the relationships between self-reported safe driving behaviors (including belt use, observing speed limits, and abstaining from drinking and driving), and demographic characteristics (including sex, age, education and income). The results showed that the three behaviors are quite independent of each other, and, contrary to some stereotypes, there is no single high-risk group that is most likely to violate all three safe driving behaviors. The only consistent effect was that of sex: women reported higher observance rates of all three behaviors. Reported use of safety belts increases with age and education for both men and women. However while for women the reported use increases with income, for males the reported use does not change with income. Complete avoidance of drinking and driving was reported by most drivers in all groups, and the high rates hardly varied across the different age, education, and income groups. The number of people who reported that they observe the speed limit all the time increased with age, but decreased with increasing education and income. The results have implications for identifying violation-specific high-risk groups, and stressing different factors for each.

  19. A longitudinal study of conversations with parents about sex and dating during college.

    PubMed

    Morgan, Elizabeth M; Thorne, Avril; Zurbriggen, Eileen L

    2010-01-01

    Emerging adulthood is a time of sexual and romantic relationship development as well as change in the parent-child relationship. This study provides a longitudinal analysis of 30 young adults' (17 women, 13 men) sexual experiences, attitudes about sexuality and dating, and reported conversations with parents about sexuality and dating from the 1st and 4th years of college. Self-report questionnaires revealed increases in general closeness with parents, increases in sexual and dating experiences, and more sexually permissive as well as more gender stereotyped attitudes. Qualitative analyses of individual interviews indicated a movement from unilateral and restrictive sex-based topics to more reciprocal and relationship-focused conversations over time. Gender analyses revealed that young women reported more restrictive sex messages and young men more positive sex messages. Participants also described increased openness and comfort in talking about sexual topics with both mothers and fathers from the 1st to 4th year of college. Overall, the results suggest that prior findings of increased mutuality with parents during the college years extend to the traditionally taboo topic of sexuality. Copyright 2009 APA, all rights reserved.

  20. Dental service trends for older US adults, 1998-2006.

    PubMed

    Skaar, Daniel D; O'Connor, Heidi

    2012-03-01

    This study of the Medicare Current Beneficiary Survey (MCBS) updates trends in utilization of dental services between 1998 and 2006 for community-dwelling U.S. adults of age 65 years and older. Bivariate comparisons were made between dependent variables (annual dental visits and types of dental procedures) and independent variables (age, gender, race, income, education, population density, marital status, U.S. Census Bureau regions, and self-reported health). The estimated percentage of community-dwelling Medicare beneficiaries with a dental visit for the years studied increased from 45.0% in 1998 to 46.3% in 2006. The age group of respondents who were 85 years and older had the greatest percentage increase in dental visits. Those reporting visits with preventive procedures increased from 87.8% to 91.2% whereas those reporting visits with nonpreventive procedures declined from 63.9% to 58.4%. The prevalence of dental visits continues to trend upward for this population of older adults. Increasing delivery of preventive services will likely impact the future mix of dental services as U.S. adults live longer. © 2012 Special Care Dentistry Association and Wiley Periodicals, Inc.

  1. Aerodynamic Control-Augmentation Devices For Saturn-Class Launch Vehicles With Aft Centers Of Gravity

    NASA Technical Reports Server (NTRS)

    Barret, Chris

    1995-01-01

    Report describes study of aerodynamic flight-control-augmentation devices proposed for use in increasing payload capabilities of future launch vehicles by allowing more aft centers of gravity. Proposed all-movable devices not only provide increased control authority during ascent trajectory, but also reduce engine gimballing requirements and enhance crew safety. Report proposes various aerodynamic control surfaces mounted fore and aft on Saturn-class launch vehicle.

  2. Rapid increase in cystic volume of an anaplastic astrocytoma misdiagnosed as neurocysticercosis: A case report

    PubMed Central

    Li, Hong-Jiang; Han, Hong-Xiu; Feng, Dong-Fu

    2016-01-01

    Reports describing a rapid increase in the cystic volume of anaplastic astrocytoma (AA) in a short time frame are rare. The present study reports the case of a 68-year-old male who was admitted to the No. 9 People's Hospital, Shanghai Jiaotong University School of Medicine (Shanghai, China), with a small cystic brain lesion and positive immunological testing for cysticercosis. Head magnetic resonance imaging (MRI) showed a cystic lesion, 6 mm in diameter, in the left frontal lobe. Neurocysticercosis was suspected and the patient was treated with a clinical trial of albendazole and steroids. A period of 25 days later, the patient's condition had deteriorated, and MRI revealed a cystic lesion in the left frontal lobe; thereafter, the cystic lesion was removed and a diagnosis of AA was established. The tumor was soft, ivory white and gelatinous due to myxoid degeneration. In this case, tumor-related angiogenesis and microvascular extravasation (blood-brain barrier disruption) may have been the main cause of the rapid increase in the cystic volume in such a short time frame. The similarity of the glioma and cysticercus antigens may have been the cause of the positive reactions in the cystic fluid. The present study reports the rare occurrence of a rapid increase of cystic volume and potential diagnostic difficulties. PMID:27698865

  3. Associations between childhood trauma, bullying and psychotic symptoms among a school-based adolescent sample.

    PubMed

    Kelleher, Ian; Harley, Michelle; Lynch, Fionnuala; Arseneault, Louise; Fitzpatrick, Carol; Cannon, Mary

    2008-11-01

    Children and adolescents who report psychotic symptoms appear to be at increased risk for psychotic disorders in adulthood - a putative ;symptomatic' high-risk group. However, little research has investigated whether those in this high-risk population have increased rates of exposure to traumatic events in childhood, as seen in patients who have a psychotic illness. To examine whether adolescents with psychotic symptoms have an increased rate of traumatic experiences. Psychiatric interviews were carried out with 211 adolescents aged between 12 and 15 years and their parents as part of a population-based study. The interview enquired about a number of early traumatic events including physical and sexual abuse, exposure to domestic violence and bullying. Fourteen adolescents (6.6% of those interviewed) reported experiencing at least one psychotic symptom. Adolescents who reported psychotic symptoms were significantly more likely to have been physically abused in childhood, to have been exposed to domestic violence and to be identified as a bully/victim (that is, both a perpetrator and victim of bullying) than those who did not report such symptoms. These findings were not confounded by comorbid psychiatric illness or family history of psychiatric history. Our findings suggest that childhood trauma may increase the risk of psychotic experiences. The characteristics of bully/victims deserve further study.

  4. Modelling the effect on injuries and fatalities when changing mode of transport from car to bicycle.

    PubMed

    Nilsson, Philip; Stigson, Helena; Ohlin, Maria; Strandroth, Johan

    2017-03-01

    Several studies have estimated the health effects of active commuting, where a transport mode shift from car to bicycle reduces risk of mortality and morbidity. Previous studies mainly assess the negative aspects of bicycling by referring to fatalities or police reported injuries. However, most bicycle crashes are not reported by the police and therefore hospital reported data would cover a much higher rate of injuries from bicycle crashes. The aim of the present study was to estimate the effect on injuries and fatalities from traffic crashes when shifting mode of transport from car to bicycle by using hospital reported data. This present study models the change in number of injuries and fatalities due to a transport mode change using a given flow change from car to bicycle and current injury and fatality risk per distance for bicyclists and car occupants. show that bicyclists have a much higher injury risk (29 times) and fatality risk (10 times) than car occupants. In a scenario where car occupants in Stockholm living close to their work place shifts transport mode to bicycling, injuries, fatalities and health loss expressed in Disability-Adjusted Life Years (DALY) were estimated to increase. The vast majority of the estimated DALY increase was caused by severe injuries and fatalities and it tends to fluctuate so that the number of severe crashes may exceed the estimation with a large margin. Although the estimated increase of traffic crashes and DALY, a transport mode shift is seen as a way towards a more sustainable society. Thus, this present study highlights the need of strategic preventive measures in order to minimize the negative impacts from increased bicycling. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Longitudinal changes in sexual functioning as women transition through menopause: results from the Study of Women's Health Across the Nation.

    PubMed

    Avis, Nancy E; Brockwell, Sarah; Randolph, John F; Shen, Shunhua; Cain, Virginia S; Ory, Marcia; Greendale, Gail A

    2009-01-01

    Sexual functioning is an important component of women's lives. The extent to which the menopausal transition is associated with decreased sexual functioning remains inconclusive. This study seeks to determine if advancing through the menopausal transition is associated with changes in sexual functioning. This was a prospective, longitudinal cohort study of women aged 42 to 52 years at baseline recruited at seven US sites (N = 3,302) in the Study of Women's Health Across the Nation (SWAN). Cohort-eligible women had an intact uterus, had at least one ovary, were not currently using exogenous hormones, were either premenopausal or early perimenopausal, and self-identified as one of the study's designated racial/ethnic groups. Data from the baseline interview and six annual follow-up visits are reported. Outcomes are self-reported ratings of importance of sex; frequency of sexual desire, arousal, masturbation, sexual intercourse, and pain during intercourse; and degree of emotional satisfaction and physical pleasure. With adjustment for baseline age, chronological aging, and relevant social, health, and psychological parameters, the odds of reporting vaginal or pelvic pain increased and desire decreased by late perimenopause. Masturbation increased at early perimenopause but declined during postmenopause. The menopausal transition was unrelated to other outcomes. Health, psychological functioning, and importance of sex were related to all sexual function outcomes. Age, race/ethnicity, marital status, change in relationship, and vaginal dryness were also associated with sexual functioning. Pain during sexual intercourse increases and sexual desire decreases over the menopausal transition. Masturbation increases during the early transition, but then declines in postmenopause. With adjustment for other factors, the menopausal transition was not independently associated with reports of the importance of sex, sexual arousal, frequency of sexual intercourse, emotional satisfaction with partner, or physical pleasure.

  6. Annual physical examination reports vary by gender once teenagers become sexually active.

    PubMed

    Marcell, Arik V; Matson, Pam; Ellen, Jonathan M; Ford, Carol A

    2011-07-01

    Few sexually active male adolescents receive sexual and reproductive health (SRH) services. To understand this, we examined the association between sexual behavior status and physical examination of the adolescents over time. We conducted longitudinal cohort analysis of the National Longitudinal Study of Adolescent Health with 9,239 adolescents who completed the baseline school (1994/1995) and wave 2 (1996) follow-up surveys approximately 1.5 years later (retention rate = 71%). The logistic regression models were fitted with random effects to estimate individual odds of reporting a physical examination in the past 12 months at follow-up, compared with baseline, stratified by sexual behavior status and gender, and adjusting for sociodemographic and healthcare access factors. In all, 34.5% of male and 38.2% of female adolescents reported experiencing vaginal intercourse by follow-up, and 22.4% of male and 24.7% of female adolescents reported first experiencing intercourse during the study period. Among sexually active adolescents, about half reported having annual physical examinations and one-fifth reported not having any physical examinations. Among female adolescents, baseline to follow-up examination reports significantly increased in the following: sex initiators (adjusted odds ratio [OR] = 2.09, 95% confidence interval [CI] = 1.66-2.64); those reporting sex at both times (OR = 2.16, CI = 1.51-3.09); and those reporting no sex either time (OR = 2.47, CI = 2.00-3.04). Among male adolescents, baseline to follow-up examination reports significantly increased in those reporting no sex either time (OR = 1.57, CI = 1.26-1.96) and showed increasing trends in sex initiators (OR = 1.27, CI = .92-1.76). A majority of sexually active adolescents report annual physical examinations over time. Providers should not miss opportunities to deliver evidence-based SRH to sexually active adolescents. Future efforts are needed to increase access of all adolescents to SRH services. MESH TERMS: Health Services Accessibility, Male, Female. Copyright © 2011 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  7. Self-reported impulsivity in Huntington's disease patients and relationship to executive dysfunction and reward responsiveness.

    PubMed

    Johnson, Patricia L; Potts, Geoffrey F; Sanchez-Ramos, Juan; Cimino, Cynthia R

    2017-09-01

    Few studies have directly investigated impulsivity in Huntington's disease (HD) despite known changes in dopaminergic and frontal functioning, changes that have been associated with impulsivity in other disorders and in the normal population. This study sought to further categorize impulsivity in HD through examining differences in self-reported impulsivity between community controls and HD patients, the relationship between executive dysfunction and impulsivity, and the relationship of a reward/punishment behavioral inhibition task in relation to these self-report measures. It was expected that HD patients would report higher impulsivity and executive dysfunction and that these measures would relate to a reward/punishment behavioral inhibition task. The Barratt Impulsivity Scale (BIS-11) and Behavioral Inhibition/Behavioral Activation Scale (BIS/BAS) were completed, and the Mini-Mental State Examination (MMSE) and a reward-based flanker task with punishing and rewarding conditions were administered to 22 HD patients and 14 control participants. HD patients reported higher trait impulsivity (BIS-11) and executive dysfunction (Frontal Systems Behavior Scale, FrSBE) but not increased impulsivity on the BIS/BAS relative to controls. Higher BIS-11 scores were related to increased self-reported executive dysfunction and the attention/working memory factor of the MMSE. On a reward/punishment behavioral inhibition task, BAS was uniquely related to increased accuracy on rewarding trials of the flanker task, but was not related to punishing trials in HD patients. The relationships found suggest that trait impulsivity is reported higher in HD and may not be driven by altered reward evaluation and the appetitive nature of stimuli but rather by increased executive dysfunction and lack of sensitivity to punishment. Impulsivity in HD may represent a combination of trait impulsivity, altered dopaminergic circuitry, and executive dysfunction. Understanding impulsivity in HD is important as it is related to increased risk to the patient and difficult behaviors for the caregiver, and sheds light on the disease process.

  8. Occurrence of Amblyomma dissimile on wild crocodylians in southern Mexico.

    PubMed

    Charruau, Pierre; Pérez-Flores, Jonathan; Cedeño-Vázquez, J Rogelio; Gonzalez-Solis, David; González-Desales, Giovany A; Monroy-Vilchis, Octavio; Desales-Lara, Marco A

    2016-09-26

    Ticks are common ectoparasites of amphibians and reptiles but very few reports of such parasites on crocodylians exist worldwide. Herein, we report the first detailed observations of Amblyomma dissimile Koch, 1844 on the 3 crocodylian species present in Mexico, with the first report of tick parasitism on Crocodylus acutus and the second on Caiman crocodilus chiapasius. This is also the first report of A. dissimile in the state of Quintana Roo. Proportions of infested individuals found in this study ranged from 0.51 to 1.96%, suggesting that tick parasitism in crocodylians is likely opportunistic and occurs when individuals leave the water for terrestrial activities. Tick parasitism does not represent a major threat to crocodylians. The increasing habitat destruction/fragmentation and cattle expansion in southeastern Mexico, however, could increase tick populations and trigger tick parasitism and tick-borne diseases in herpetofauna and other vertebrates, including humans. Thus, studies are needed to better understand these relationships.

  9. Public reporting of colonoscopy quality is associated with an increase in endoscopist adenoma detection rate.

    PubMed

    Abdul-Baki, Heitham; Schoen, Robert E; Dean, Katie; Rose, Sherri; Leffler, Daniel A; Kuganeswaran, Eliathamby; Morris, Michele; Carrell, David; Mehrotra, Ateev

    2015-10-01

    Colonoscopy is the predominant method for colorectal cancer screening in the United States. Previous studies have documented variation across physicians in colonoscopy quality as measured by the adenoma detection rate (ADR). ADR is the primary quality measure of colonoscopy examinations and an indicator of the likelihood of subsequent colorectal cancer. There is interest in mechanisms to improve the ADR. In Central Illinois, a local employer and a quality improvement organization partnered to publically report physician colonoscopy quality. We assessed whether this initiative was associated with an improvement in the ADR. We compared ADRs before and after public reporting at a private practice endoscopy center with 11 gastroenterologists in Peoria, Illinois, who participated in the initiative. To generate the ADR, colonoscopy and pathology reports from examinations performed over 4 years at the endoscopy center were analyzed by using previously validated natural language processing software. A central Illinois endoscopy center. The ADR in the pre-public reporting period was 34.3% and 39.2% in the post-public reporting period (an increase of 4.9%, P < .001). The increase in the right-sided ADR was 5.1% (P < .01), whereas the increase in the left-sided ADR was 2.1% (P < .05). The increase in the ADR was 7.8% for screening colonoscopies (P < 0.05) and 3.5% for nonscreening colonoscopies (P < .05). All but 1 physician's ADR increased (range -2.7% to 10.5%). There was no statistically significant change in the advanced ADR (increase of 0.8%, P = .22). There was no concurrent control group to assess whether the increased ADR was due to a secular trend. A public reporting initiative on colonoscopy quality was associated with an increase in ADR. Copyright © 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  10. Too Much Television? Prospective Associations Between Early Childhood Televiewing and Later Self-reports of Victimization by Sixth Grade Classmates.

    PubMed

    Watt, Emmalyne; Fitzpatrick, Caroline; Derevensky, Jeffrey L; Pagani, Linda S

    2015-01-01

    Using a birth cohort, this study aimed to verify whether televiewing at 29 months, a common early childhood pastime, is prospectively associated with self-reported victimization at age 12. Participants are 991 girls and 1006 boys from the Quebec Longitudinal Study of Child Development. The main predictor comprised parent-reported daily televiewing by their children at 29 months. In the sixth grade, children reported how often they experienced victimization by classmates in the past year. The authors conducted multivariate linear regression, in which child self-reports of victimization were linearly regressed on early televiewing and potential confounders. Every SD unit increase (0.88 hours) in daily televiewing at 29 months predicted an 11% SD unit increase in self-reported peer victimization by sixth grade classmates (unstandardized B = .031, p < .001, 95% confidence interval = 0.014-0.042). This relationship was adjusted for child characteristics (gender, preexisting externalizing behaviors, baseline cognitive abilities, and televiewing at age 12) and family characteristics (family configuration, income, and functioning, and maternal education). Daily televiewing time at 29 months was associated with a subsequent increased risk of victimization by classmates at the end of sixth grade, a period which represents a critical developmental transition to middle school. Youth who experience peer victimization are at an increased risk of long-term mental health issues, such as depression, underachievement, and low self-esteem. This prospective association, across a 10-year period, suggests the need for better parental awareness, acknowledgement, and compliance with existing recommendations put forth by the American Academy of Pediatrics.

  11. Secondary analysis of a scoping review of health promotion interventions for persons with disabilities: Do health promotion interventions for people with mobility impairments address secondary condition reduction and increased community participation?

    PubMed

    White, Glen W; Gonda, Chiaki; Peterson, Jana J; Drum, Charles E

    2011-04-01

    Secondary conditions can have very serious outcomes for people with physical disabilities. Such consequences can range from immobility due to pressure sores to withdrawal and isolation due to depression, decreasing participation in the community. To further investigate these assumptions, we conducted a review of the literature on health promotion interventions that include physical activity for adults with disabilities to determine whether they have a positive effect on the reduction of secondary conditions and increased community participation. We conducted a secondary analysis of the results of a scoping review of health promotion programs containing physical activity for people with mobility impairments (N = 5). This secondary analysis examined the relationship between health promotion containing physical activity and prevention of secondary conditions among people with various physical disabilities. We further examined evidence and effects of independent variables on the outcome of increased community participation for study participants. The outcomes from this investigation are varied, with 2 studies providing evidence of reducing secondary conditions while another shared anecdotal statements referencing a decrease in secondary conditions. Of the remaining 2 studies in this paper, 1 showed no intervention effect on reducing secondary conditions while the remaining study reported an increase in secondary conditions. Regarding increased participation in the community, 2 of 5 studies directly reported on these outcomes, while increased community participation was referenced in another 2 articles, but without any data presented. The final study did not report on any post intervention in the community. This review demonstrates that research on health promotion interventions containing physical activity lack description about whether such interventions help reduce or prevent secondary conditions. Additionally, the review shows that further work is needed in terms of sustaining health programs effects beyond the initial proximal activity gains, with attention given toward more distal outcomes of increased participant participation in the community. Copyright © 2011. Published by Elsevier Inc.

  12. How are changes in exposure to job demands and job resources related to burnout and engagement? A longitudinal study among Chinese nurses and police officers.

    PubMed

    Hu, Qiao; Schaufeli, Wilmar B; Taris, Toon W

    2017-12-01

    This study used a person-centered approach to examine the across-time relationships between job demands and job resources on the one hand and employee well-being (burnout and work engagement) on the other. On the basis of the job demands-resources model and conservation of resources (COR) theory, increases in demands and decreases in resources across time were expected to result in unfavorable changes in well-being across time. The results of a 2-wave study among 172 nurses and 273 police officers showed several common patterns across both samples: (a) participants who experienced an increase of demands showed a significant increase in burnout, whereas participants who reported having low resources at both measurement times also showed a significant increase in burnout; (b) participants who experienced decreasing resources reported a significant increase in burnout and a significant decrease in engagement; (c) participants who were exposed to chronic low job resources in a highly demanding environment showed a significant increase in burnout; and (d) participants who were exposed to decreased job resources in a highly demanding environment showed a significant increase in burnout. Copyright © 2017 John Wiley & Sons, Ltd.

  13. National Security Education Act of 1991: Summary and Analysis. CRS Report for Congress.

    ERIC Educational Resources Information Center

    Riddle, Wayne Clifton

    This report analyzes and summarizes the National Security Education Act of 1991 (NSEA) which authorizes a new program of aid for foreign language and area studies. The report discusses the legislation's aim to increase future national security through enhanced foreign language abilities and knowledge of other countries, the NSEA's authorized…

  14. Development of new physical activity and sedentary behavior change self-efficacy questionnaires using item response modeling

    USDA-ARS?s Scientific Manuscript database

    Theoretically, increased levels of physical activity self-efficacy (PASE) should lead to increased physical activity, but few studies have reported this effect among youth. This failure may be at least partially attributable to measurement limitations. In this study, Item Response Modeling (IRM) was...

  15. Packaging interventions to increase medication adherence: systematic review and meta-analysis

    PubMed Central

    Conn, Vicki S.; Ruppar, Todd M.; Chan, Keith C.; Dunbar-Jacob, Jacqueline; Pepper, Ginette A.; De Geest, Sabina

    2015-01-01

    Objective Inadequate medication adherence is a widespread problem that contributes to increase chronic disease complications and health care expenditures. Packaging interventions using pill boxes and blister packs have been widely recommended to address the medication adherence issue. This meta-analysis review determined the overall effect of packaging interventions on medication adherence and health outcomes. In addition, we tested whether effects vary depending on intervention, sample, and design characteristics. Research design and methods Extensive literature search strategies included examination of 13 computerized databases and 19 research registries, hand searches of 57 journal, and author and ancestry searches. Eligible studies included either pill-boxes or blister packaging interventions to increase medication adherence. Primary study characteristics and outcomes were reliably coded. Random-effects analyses were used to calculate overall effect sizes and conduct moderator analyses. Results Data were synthesized across 22,858 subjects from 52 reports. The overall mean weighted standardized difference effect size for two-group comparisons was 0.593 (favoring treatment over control), which is consistent with the mean of 71% adherence for treatment subjects compared to 63% among control subjects. We found using moderator analyses that interventions were most effective when they used blister packs and were delivered in pharmacies, while interventions were less effective when studies included older subjects and those with cognitive impairment. Methodological moderator analyses revealed significantly larger effect sizes in studies reporting continuous data outcomes instead of dichotomous results and in studies using pharmacy refill medication adherence measures as compared to studies with self-report measures. Conclusions Overall, meta-analysis findings support the use of packaging interventions to effectively increase medication adherence. Limitations of the study include the exclusion of packaging interventions other than pill boxes and blister packs, evidence of publication bias, and primary study sparse reporting of health outcomes and potentially interesting moderating variables such as the number of prescribed medications. PMID:25333709

  16. Stable or improved health status in the population 65 years and older in Stockholm, Sweden - an 8-year follow-up of self-reported health items.

    PubMed

    Modig, Karin; Virtanen, Suvi; Ahlbom, Anders; Agahi, Neda

    2016-07-01

    Previous studies have reached different conclusions about whether health is improving in the ageing population. More studies with narrow age groups analyzed separately for men and women will contribute to the literature. To describe trends in self-reported indicators of health and health-related quality of life between 2002 and 2010, focusing on differences between gender and age groups. A population-based survey of individuals 65+ in the Stockholm County was used. Prevalence of health problems increased with age both among men and women. Men generally reported having no health problems to a larger extent than women, but the proportions reporting severe problems were similar. The larger picture is one of stability in health-related quality of life, even if several items developed for the better, especially among women. While the proportions reporting no health/functional problems increased for many items, the proportions reporting severe problems remained unchanged among men and improved only for two items among women. CONCLUSIONS OVERALL, IMPROVEMENTS WERE SEEN IN MANY OF THE HEALTH-RELATED QUALITY OF LIFE ITEMS AS WELL AS FOR SELF-RATED HEALTH AMONG WOMEN THE PROPORTIONS REPORTING LONG-TERM ILLNESS OR PERSISTENT HEALTH PROBLEMS INCREASED, BUT FEWER SEEM TO BE LIMITED IN THEIR DAILY ACTIVITIES BY THESE PROBLEMS THE STABLE PROPORTIONS OF POOR SELF-RATED HEALTH INDICATES THAT WHILE HEALTH AND FUNCTIONING SEEM TO BE IMPROVING FOR THE MAJORITY OF THE OLDER POPULATION, SOME GROUPS MAY BE LAGGING BEHIND FUTURE STUDIES SHOULD PAY ATTENTION TO CHANGES BOTH IN THE UPPER AND LOWER ENDS OF THE HEALTH SPECTRUM. © 2016 the Nordic Societies of Public Health.

  17. Psychiatric disorder in veterans of the Persian Gulf War of 1991. Systematic review.

    PubMed

    Stimpson, Nicola J; Thomas, Hollie V; Weightman, Alison L; Dunstan, Frank; Lewis, Glyn

    2003-05-01

    Veterans of the Persian Gulf War of 1991 have reported symptoms attributed to their military service. To review all studies comparing the prevalence of psychiatric disorders in Gulf War veterans and in a comparison group of service personnel not deployed to the Gulf War. Studies of military personnel deployed to the Gulf published between 1990 and 2001 were identified from electronic databases. Reference lists and websites were searched and key researchers were contacted for information. A total of 2296 abstracts and 409 complete articles were reviewed and data were extracted independently by two members of the research team. The prevalence of psychiatric disorder in 20 studies of Gulf War veterans was compared with the prevalence in the comparison group. Prevalence of post-traumatic stress disorder (PTSD) and common mental disorder were higher in the Gulf War veterans. Heterogeneity between studies was significant, but all reported this increased prevalence. Veterans of the Persian Gulf War reported an increased prevalence of PTSD and common mental disorder compared with other active service personnel not deployed to the Gulf. These findings are attributable to the increase in psychologically traumatic events in wartime.

  18. Rapid Increase in Scrub Typhus Incidence in Mainland China, 2006-2014.

    PubMed

    Wu, Yi-Cheng; Qian, Quan; Magalhaes, Ricardo J Soares; Han, Zhi-Hai; Haque, Ubydul; Weppelmann, Thomas A; Hu, Wen-Biao; Liu, Yun-Xi; Sun, Yan-Song; Zhang, Wen-Yi; Li, Shen-Long

    2016-03-01

    Scrub typhus is a vector-borne disease, which has recently reemerged in China. In this study, we describe the distribution and incidence of scrub typhus cases in China from 2006 to 2014 and quantify differences in scrub typhus cases with respect to sex, age, and occupation. The results of our study indicate that the annual incidence of scrub typhus has increased during the study period. The number of cases peaked in 2014, which was 12.8 times greater than the number of cases reported in 2006. Most (77.97%) of the cases were reported in five provinces (Guangdong, Yunnan, Anhui, Fujian, and Shandong). Our study also demonstrates that the incidence rate of scrub typhus was significantly higher in females compared to males (P < 0.001) and was highest in the 60-69 year age group, and that farmers had a higher incidence rate than nonfarmers (P < 0.001). Different seasonal trends were identified in the number of reported cases between the northern and southern provinces of China. These findings not only demonstrate that China has experienced a large increase in scrub typhus incidence, but also document an expansion in the geographic distribution throughout the country. © The American Society of Tropical Medicine and Hygiene.

  19. Increase and decrease of other substance use during recovery from cannabis use disorders.

    PubMed

    Hodgins, David C; Kim, Hyoun S; Stea, Jonathan N

    2017-09-01

    Little is known about whether recovery from one addiction is associated with increased or decreased risk of subsequent other addictions. This study explored self-reported increases and decreases in other substance use among individuals who have recovered from cannabis use disorder. Media recruitment was used to obtain a sample of 119 individuals with lifetime but not past year cannabis use disorder (30% female). The median length of recovery was 5.0 years. Results showed that both increase and decrease in the use of other substances is very common in recovery from cannabis use. In general, other substance use decreased more than it increased. Individuals who reported only a decrease in other substance use (39%) and individuals who reported both increases and decreases in various substances (21%) reported a greater degree of cannabis-related problems and treatment-seeking than individuals who only reported an increase (26%) or no change (14%). Individuals who only increased use of other substances reported fewer cannabis-related problems and were more likely to have had self-directed recoveries. They were also less likely to use helping relationships (e.g., friends, family) as a recovery process and self-help group involvement as a maintenance strategy. Their recoveries seem to have been less socially influenced and socially imbedded than individuals who reduced other substance use. The findings suggest that treatment involvement and social influences may successfully discourage use of other substances upon recovery from cannabis. However, the impact of such use or lack of use on individuals' functioning needs to be clarified in future research. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  20. The Nightmares of Sleep Apnea: Nightmare Frequency Declines with Increasing Apnea Hypopnea Index

    PubMed Central

    Pagel, J. F.; Kwiatkowski, Carol

    2010-01-01

    Objective: To clarify the association of reported nightmare recall with polysomnographically defined obstructive sleep apnea (OSA) in a sleep laboratory population. Methods: This study included 393 individuals undergoing clinical polysomnography including a general intake questionnaire with questions on dream and nightmare recall frequency. Mean age was 50.5 and a range of 13 to 82 years, with 33% of the sample female and 67% male. Reported dream and nightmare recall were classified as infrequent when reported at less than once a month, or frequent when reported at a frequency greater than once per week. Results: Mean Apnea-hypopnea Index AHI was 34.9 (std. 32.0) indicating a high frequency of severe (AHI > 30) OSA in this clinical study population. Both AHI and Apnea Index (AI) were significantly higher (p = 0.000) for the grouping reporting infrequent nightmare recall. As the AHI score increased, the percent of participants with frequent nightmare recall decreased linearly. Conclusion: Patients with higher AHI report a lower nightmare frequency, indicating that significant OSA suppresses the cognitive experience of nightmare recall. Depressed nightmare recall may occur secondary to the REMS suppression know to occur in patients with significant OSA. Citation: Pagel JF; Kwiatkowski C. The nightmares of sleep apnea: nightmare frequency declines with increasing apnea hypopnea index. J Clin Sleep Med 2010;6(1):69-73. PMID:20191941

  1. Genetic Correlation Analysis Suggests Association between Increased Self-Reported Sleep Duration in Adults and Schizophrenia and Type 2 Diabetes.

    PubMed

    Byrne, Enda M; Gehrman, Philip R; Trzaskowski, Maciej; Tiemeier, Henning; Pack, Allan I

    2016-10-01

    We sought to examine how much of the heritability of self-report sleep duration is tagged by common genetic variation in populations of European ancestry and to test if the common variants contributing to sleep duration are also associated with other diseases and traits. We utilized linkage disequilibrium (LD)-score regression to estimate the heritability tagged by common single nucleotide polymorphisms (SNPs) in the CHARGE consortium genome-wide association study (GWAS) of self-report sleep duration. We also used bivariate LD-score regression to investigate the genetic correlation of sleep duration with other publicly available GWAS datasets. We show that 6% (SE = 1%) of the variance in self-report sleep duration in the CHARGE study is tagged by common SNPs in European populations. Furthermore, we find evidence of a positive genetic correlation (rG) between sleep duration and type 2 diabetes (rG = 0.26, P = 0.02), and between sleep duration and schizophrenia (rG = 0.19, P = 0.01). Our results show that increased sample sizes will identify more common variants for self-report sleep duration; however, the heritability tagged is small when compared to other traits and diseases. These results also suggest that those who carry variants that increase risk to type 2 diabetes and schizophrenia are more likely to report longer sleep duration. © 2016 Associated Professional Sleep Societies, LLC.

  2. A Conceptual Framework for Inclusive Digital Storytelling to Increase Diversity and Motivation for Cultural Tourism in Thailand.

    PubMed

    Kasemsarn, Kittichai; Nickpour, Farnaz

    2016-01-01

    Cultural tourism is considered to be a niche market and little attention has been paid to it, as compared with mass tourism. Moreover, visitors have little motivation to visit actual historical sites and read the story displayed behind the exhibitions. These issues highlight a good opportunity to increase further potential extended tourism and increase the motivation of visitors. To broaden and increase the potential market, this study applies inclusive design principles as 'understanding and designing for diversity' and presents reports on the first study. To increase the motivation of tourists, this study adopts digital storytelling as 'the guideline to increase motivation' and illustrates this in the second study.

  3. [Effects of interviews during body weight checks in general population surveys].

    PubMed

    Kroh, M

    2005-01-01

    While surveying actually measured body weight is largely impractical in national surveys, self-reported weight is a simple and inexpensive method of collecting data. Previous research shows that data on reported body weight are falsified by systematic mis-reporting. This bias is said to be the consequence of the sensitive nature of information on body weight. Numerous studies on survey response suggest that certain modes of data collection are more conducive than others for probing sensitive information. This paper investigates the effect of the anonymous interviews, characteristics of the interviewer and respondents' familiarity with the survey, as factors that may impinge on reported body weight. Findings of this paper show that refusals to state the body weight are rare. Moreover, characteristics of interviewers account for only a small fraction of the variance in reported body weight. Yet the hypothesis that the absence of an interviewer in self-administered interviews increases reported body weight can be confirmed. This interview effect, however, occurred in men only. On average, male respondents in anonymous interview settings report on a body weight which is 1 kg more than they would report in other settings. The repeated participation of respondents in the Socio-Economic Panel Study (SOEP) increases their reported body weight accuracy which suggests a positive panel effect on respondents' willingness to disclose sensitive information.

  4. Dental patients' self-reports of xerostomia and associated risk factors.

    PubMed

    Villa, Alessandro; Polimeni, Antonella; Strohmenger, Laura; Cicciù, Domenico; Gherlone, Enrico; Abati, Silvio

    2011-07-01

    Most studies regarding xerostomia focus on elderly people. Therefore, the authors conducted a study of dental patients 18 years or older to determine the prevalence of self-reported xerostomia and associated risk factors. The authors sent a total of 2,200 questionnaires to four dental clinics to assess patients' self-reported xerostomia. They also collected sociodemographic data and information regarding personal behavior. They used logistic regression models to estimate odds ratios (OR) and 95 percent confidence intervals (CI) to explore the relationship between self-reported xerostomia and risk factors that reasonably might be expected to be associated with self-reported xerostomia. The overall prevalence of xerostomia in participants was 7 percent. Participants with burning-mouth sensations were associated with having higher odds of experiencing dry mouth (OR, 2.1; 95 percent CI, 0.9-5.2). Participants 51 years or older were significantly more likely to report having dry mouth than were younger participants (P < .04). The prevalence of self-reported xerostomia increased with increasing numbers of medications patients reported using. The authors found that medication use and age were highly significant risk factors for dental patients reporting xerostomia. Clinicians should interview their patients carefully regarding their use of medications and provide proper oral health care to improve xerostomia resulting from medication use.

  5. Metabolic syndrome and self-reported history of kidney stones: the National Health and Nutrition Examination Survey (NHANES III) 1988-1994.

    PubMed

    West, Bradford; Luke, Amy; Durazo-Arvizu, Ramon A; Cao, Guichan; Shoham, David; Kramer, Holly

    2008-05-01

    Metabolic syndrome affects approximately 25% of the American population. Components of metabolic syndrome, such as obesity, hypertension, and diabetes, were associated with kidney stone disease, but no published large-scale study examined the association between metabolic syndrome and history of kidney stones. Cross-sectional analysis. The American Heart Association and National Heart, Lung, and Blood Institute statement on metabolic syndrome was used to define metabolic syndrome. A national probability sample of the US population National Health and Nutrition Examination Survey aged 20 years and older. Metabolic syndrome as defined by the American Heart Association and National Heart, Lung, and Blood Institute. Self-reported history of kidney stones. Of all adults older than 20 years, 4.7% reported a history of kidney stones. The prevalence of self-reported history of kidney stones increased with the number of metabolic syndrome traits from 3% with 0 traits to 7.5% with 3 traits to 9.8% with 5 traits. After adjustment for age and other covariates, the presence of 2 or more traits significantly increased the odds of self-reported kidney stone disease. The presence of 4 or more traits was associated with an approximate 2-fold increase in odds of self-reported kidney stone disease. Cross-sectional design, absence of dietary data. Metabolic syndrome traits are associated with a self-reported history of kidney stones. This association should be verified in prospective studies.

  6. Excessive computer game playing among Norwegian adults: self-reported consequences of playing and association with mental health problems.

    PubMed

    Wenzel, H G; Bakken, I J; Johansson, A; Götestam, K G; Øren, Anita

    2009-12-01

    Computer games are the most advanced form of gaming. For most people, the playing is an uncomplicated leisure activity; however, for a minority the gaming becomes excessive and is associated with negative consequences. The aim of the present study was to investigate computer game-playing behaviour in the general adult Norwegian population, and to explore mental health problems and self-reported consequences of playing. The survey includes 3,405 adults 16 to 74 years old (Norway 2007, response rate 35.3%). Overall, 65.5% of the respondents reported having ever played computer games (16-29 years, 93.9%; 30-39 years, 85.0%; 40-59 years, 56.2%; 60-74 years, 25.7%). Among 2,170 players, 89.8% reported playing less than 1 hr. as a daily average over the last month, 5.0% played 1-2 hr. daily, 3.1% played 2-4 hr. daily, and 2.2% reported playing > 4 hr. daily. The strongest risk factor for playing > 4 hr. daily was being an online player, followed by male gender, and single marital status. Reported negative consequences of computer game playing increased strongly with average daily playing time. Furthermore, prevalence of self-reported sleeping problems, depression, suicide ideations, anxiety, obsessions/ compulsions, and alcohol/substance abuse increased with increasing playing time. This study showed that adult populations should also be included in research on computer game-playing behaviour and its consequences.

  7. Phthalate Exposure and Children’s Health

    PubMed Central

    Braun, Joseph M.; Sathyanarayana, Sheela; Hauser, Russ

    2013-01-01

    Purpose of Review Phthalates are multifunctional chemicals used in personal care products, medications, and plastics. We reviewed the epidemiological literature examining the relationship between early life phthalate exposure and pediatric health outcomes. Recent Findings Five studies from Asia, Europe, and the US suggest that childhood exposure to di-2-ethylhexyl phthalate (DEHP) and butylbenzyl phthalate (BBzP) may increase the risk of allergic diseases including asthma and eczema. Six studies from four different prospective cohorts report that gestational BBzP, DEHP, di-butyl phthalate (DBP), and di-ethyl phthalate (DEP) exposures are associated with alterations in infant/toddler physical development as well as parent-reported externalizing, internalizing, and autistic-like child behavior. However, there are inconsistencies related to the specific phthalates and behavioral domains. Two small studies report shorter anogenital distance among male infants with higher gestational phthalate exposure. Summary Several epidemiological studies suggest fetal and childhood exposure to some phthalates may perturb normal development, with several studies consistently reporting increased risk of allergic diseases with DEHP and BBzP exposure. While anticipatory guidance is not evidence-based at this time, providers can counsel concerned patients to reduce phthalate exposures in order to protect the developing fetus and child from potential adverse health outcomes. PMID:23429708

  8. Impact of statin adherence on cardiovascular disease and mortality outcomes: a systematic review

    PubMed Central

    De Vera, Mary A; Bhole, Vidula; Burns, Lindsay C; Lacaille, Diane

    2014-01-01

    Aims While suboptimal adherence to statin medication has been quantified in real-world patient settings, a better understanding of its impact is needed, particularly with respect to distinct problems of medication taking. Our aim was to synthesize current evidence on the impacts of statin adherence, discontinuation and persistence on cardiovascular disease and mortality outcomes. Methods We conducted a systematic review of peer-reviewed studies using a mapped search of Medline, Embase and International Pharmaceutical Abstracts databases. Observational studies that met the following criteria were included: defined patient population; statin adherence exposure; defined study outcome [i.e. cardiovascular disease (CVD), mortality]; and reporting of statin-specific results. Results Overall, 28 studies were included, with 19 studies evaluating outcomes associated with statin adherence, six with statin discontinuation and three with statin persistence. Among adherence studies, the proportion of days covered was the most widely used measure, with the majority of studies reporting increased risk of CVD (statistically significant risk estimates ranging from 1.22 to 5.26) and mortality (statistically significant risk estimates ranging from 1.25 to 2.54) among non-adherent individuals. There was greater methodological variability in discontinuation and persistence studies. However, findings of increased CVD (statistically significant risk estimates ranging from 1.22 to 1.67) and mortality (statistically significant risk estimates ranging from 1.79 to 5.00) among nonpersistent individuals were also consistently reported. Conclusions Observational studies consistently report an increased risk of adverse outcomes associated with poor statin adherence. These findings have important implications for patients and physicians and emphasize the importance of monitoring and encouraging adherence to statin therapy. PMID:25364801

  9. The elusive baseline of marine disease: Are diseases in ocean ecosystems increasing?

    USGS Publications Warehouse

    Ward, Jessica R.; Lafferty, Kevin D.

    2004-01-01

    Disease outbreaks alter the structure and function of marine ecosystems, directly affecting vertebrates (mammals, turtles, fish), invertebrates (corals, crustaceans, echinoderms), and plants (seagrasses). Previous studies suggest a recent increase in marine disease. However, lack of baseline data in most communities prevents a direct test of this hypothesis. We developed a proxy to evaluate a prediction of the increasing disease hypothesis: the proportion of scientific publications reporting disease increased in recent decades. This represents, to our knowledge, the first quantitative use of normalized trends in the literature to investigate an ecological hypothesis. We searched a literature database for reports of parasites and disease (hereafter “disease”) in nine marine taxonomic groups from 1970 to 2001. Reports, normalized for research effort, increased in turtles, corals, mammals, urchins, and molluscs. No significant trends were detected for seagrasses, decapods, or sharks/rays (though disease occurred in these groups). Counter to the prediction, disease reports decreased in fishes. Formulating effective resource management policy requires understanding the basis and timing of marine disease events. Why disease outbreaks increased in some groups but not in others should be a priority for future investigation. The increase in several groups lends urgency to understanding disease dynamics, particularly since few viable options currently exist to mitigate disease in the oceans.

  10. Hospital malnutrition in Latin America: A systematic review.

    PubMed

    Correia, Maria Isabel T D; Perman, Mario Ignacio; Waitzberg, Dan Linetzky

    2017-08-01

    Disease-related malnutrition is a major public health issue in both industrialised and emerging countries. The reported prevalence in hospitalised adults ranges from 20% to 50%. Initial reports from emerging countries suggested a higher prevalence compared with other regions, with limited data on outcomes and costs. We performed a systematic literature search for articles on disease-related malnutrition in Latin American countries published between January 1995 and September 2014. Studies reporting data on the prevalence, clinical outcomes, or economic costs of malnutrition in an adult (≥18 years) inpatient population with a sample size of ≥30 subjects were eligible for inclusion. Methodological quality of the studies was assessed by two independent reviewers using published criteria. We identified 1467 citations; of these, 66 studies including 29 ,474 patients in 12 Latin American countries met the criteria for inclusion. There was considerable variability in methodology and in the reported prevalence of disease-related malnutrition; however, prevalence was consistently in the range of 40%-60% at the time of admission, with several studies reporting an increase in prevalence with increasing duration of hospitalisation. Disease-related malnutrition was associated with an increase in infectious and non-infectious clinical complications, length of hospital stay, and costs. Disease-related malnutrition is a highly prevalent condition that imposes a substantial health and economic burden on the countries of Latin America. Further research is necessary to characterise screening/assessment practices and identify evidence-based solutions to this persistent and costly public health issue. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  11. Evaluation of an osteoporosis and fall risk intervention program for community-dwelling elderly. A quasi-experimental study of behavioral modifications.

    PubMed

    Grahn Kronhed, Ann-Charlotte; Blomberg, Carina; Löfman, Owe; Timpka, Toomas; Möller, Margareta

    2006-06-01

    Osteoporosis and fall fractures are increasing problems amongst the elderly. The aim of this study was to explore whether combined population-based and individual interventions directed at risk factors for osteoporosis and falls result in behavioral changes in an elderly population. A quasi-experimental design was used for the study. Persons aged >or=65 years were randomly selected in the intervention and control community. An intervention program was managed from the primary health care center and delivered to the community. Health education was designed to increase awareness of risk factors for the development of osteoporosis and falling. Questionnaires about lifestyle, health, previous fractures, safety behavior and physical activity level were distributed at baseline in 1989 and at the follow-ups in 1992 and 1994 in both communities. There was a difference of 17.7% between the dual intervention (receiving both population-based and individual interventions) and the control samples regarding the self-reported use of shoe/cane spikes, and a difference of 20.5% regarding the reported "moderate level" of physical activity in 1994. There was an increase in the number of participants in the dual intervention sample who, at baseline, had not reported equipping their homes with non-slip mats and removing loose rugs but who did report these changes in 1994. The increase in the reported use of shoe/cane spikes in the dual intervention sample was observed mainly for the period 1992-1994. A public health intervention model, including both population-based and individual interventions, can contribute to behavioral changes in the prevention of falls and changed physical activity patterns amongst elderly people.

  12. A longitudinal study of well-being, confidence and competence in junior doctors and the impact of emergency medicine placements.

    PubMed

    Mason, Suzanne; O'Keeffe, Colin; Carter, Angela; Stride, Chris

    2016-02-01

    To measure levels of, and change in junior doctor well-being, confidence and self-reported competence over their second postgraduate training year and the impact of emergency department (ED) placements on these outcomes. A longitudinal study using an online survey administered at four time points (2010-2011). 28 Acute Hospital Trusts, drawn from nine participating Postgraduate Deaneries in England. Junior doctors who had a placement in an ED as part of their second postgraduate training year. Levels of anxiety, depression, motivation, job satisfaction, confidence and self-reported competence, collected at four time points spread over the period of the doctor's second training year (F2). 217 junior doctors were recruited to the study. Over the year there was a significant increase in their overall job satisfaction, confidence and self-reported competence. Junior doctors also reported significantly increased levels of motivation and anxiety, and significantly decreased levels of extrinsic job satisfaction when working in ED compared with other specialties. There were also significant increases in both junior doctor confidence and self-reported competence after their placement in ED relative to other specialties. While elements of junior doctor well-being worsened in their ED placement compared with their time spent in other specialties, the increased levels of anxiety and reduced extrinsic job satisfaction were within the normal range for other healthcare workers. These deficits were also balanced by greater improvements in motivation, confidence in managing common acute clinical conditions and perceived competence in performing acute procedures compared with benefits offered by placements in other specialties. 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/

  13. A longitudinal study of well-being, confidence and competence in junior doctors and the impact of emergency medicine placements

    PubMed Central

    Mason, Suzanne; O'Keeffe, Colin; Carter, Angela; Stride, Chris

    2016-01-01

    Objectives To measure levels of, and change in junior doctor well-being, confidence and self-reported competence over their second postgraduate training year and the impact of emergency department (ED) placements on these outcomes. Design A longitudinal study using an online survey administered at four time points (2010–2011). Setting 28 Acute Hospital Trusts, drawn from nine participating Postgraduate Deaneries in England. Participants Junior doctors who had a placement in an ED as part of their second postgraduate training year. Main outcome measures Levels of anxiety, depression, motivation, job satisfaction, confidence and self-reported competence, collected at four time points spread over the period of the doctor's second training year (F2). Results 217 junior doctors were recruited to the study. Over the year there was a significant increase in their overall job satisfaction, confidence and self-reported competence. Junior doctors also reported significantly increased levels of motivation and anxiety, and significantly decreased levels of extrinsic job satisfaction when working in ED compared with other specialties. There were also significant increases in both junior doctor confidence and self-reported competence after their placement in ED relative to other specialties. Conclusions While elements of junior doctor well-being worsened in their ED placement compared with their time spent in other specialties, the increased levels of anxiety and reduced extrinsic job satisfaction were within the normal range for other healthcare workers. These deficits were also balanced by greater improvements in motivation, confidence in managing common acute clinical conditions and perceived competence in performing acute procedures compared with benefits offered by placements in other specialties. PMID:26338523

  14. Cross-sectional and longitudinal associations of functional and health status with institutional care use: results from the Survey of Health and Living Status of the Elderly in Taiwan.

    PubMed

    Tsai, Hsin-Jen

    2013-07-01

    This study evaluated the cross-sectional and longitudinal associations of functional and health status with institutional care, and examined determinants of institutional care use over time. Data of this study were obtained from the Survey of Health and Living Status of the Elderly in Taiwan (SHLSET), which was launched in 1989 and involved a nationally representative sample of nearly-old and old Taiwanese. The baseline data in this present study were collected in 1999, and followed in 2003 and 2007. Participants with institutional care use had a higher activities of daily living (ADL) score, more self-reported diseases and poorer self-reported health status than participants without institutional care use (all P<0.05). Cross-sectional analysis showed that a higher ADL score, having heart diseases and having a stroke were positively associated with institutional care use (P<0.05); whereas the number of self-reported diseases and poor self-reported health status were not associated with institutional care use. Longitudinal analysis showed that increased ADL scores and the number of self-reported diseases over 4- and 8 years were associated with an increased likelihood of subsequent institutional care use (all P<0.05). Worsening health status over 4 years was associated with an increased likelihood of subsequent institutional care use, but this association did not exist over 8 years. Only ADL and ADL deterioration over time are cross-sectionally and longitudinally associated with increased institutional care use. Declining functional status is a major determinant of institutional care use for Taiwanese aged over 53 years. © 2012 Japan Geriatrics Society.

  15. Depression and risk of fracture and bone loss: an updated meta-analysis of prospective studies.

    PubMed

    Wu, Q; Liu, B; Tonmoy, S

    2018-03-12

    This meta-analysis pooled results from 23 qualifying individual cohort studies and found that depression was significantly associated with an increased risk of fractures and bone loss. The association between depression and risk of fracture remains controversial. We conducted a comprehensive meta-analysis to examine the effect of depression on the risk of osteoporotic fractures and bone loss. We searched databases and reviewed citations in relevant articles for eligible cohort studies. Two investigators independently conducted study selection, appraisal, and data abstraction through the use of a standardized protocol. Random effect models were used for meta-analysis. Cochrane Q and I 2 statistics were used to assess heterogeneity. Funnel plots and rank correlation tests were used to evaluate publication bias. Twenty-three studies were included for meta-analysis. In studies that reported hazard ratio (HR) as the outcome (nine studies [n = 309,862]), depression was associated with 26% increase in fracture risk (HR = 1.26, 95% CI, 1.10-1.43, p < 0.001). Studies that reported risk ratio (RR) as the outcome (seven studies [n = 64,975]) suggested that depression was associated with 39% increase in fracture risk (RR = 1.39, 95% CI, 1.19-1.62, p < 0.001). Among studies that reported hip bone mineral density (BMD) as an outcome (eight studies [n = 15,442]), depression was associated with a reduced mean annual bone loss rate of 0.35% (0.18-0.53%, p < 0.001). The increased risk of fracture and bone loss associated with depression was consistent in all meta-analysis having modified inclusion criteria and in different subgroup analyses as well. Significant heterogeneity was observed in the meta-analysis; however, no significant publication bias was detected. Depression is associated with a significant increased risk in fracture and bone loss. Effective prevention may decrease such risk.

  16. Detection of medical errors in kidney transplantation: a pilot study comparing proactive clinician debriefings to a hospital-wide incident reporting system.

    PubMed

    McElroy, Lisa M; Daud, Amna; Lapin, Brittany; Ross, Olivia; Woods, Donna M; Skaro, Anton I; Holl, Jane L; Ladner, Daniela P

    2014-11-01

    Rates of medical errors and adverse events remain high for patients who undergo kidney transplantation; they are particularly vulnerable because of the complexity of their disease and the kidney transplantation procedure. Although institutional incident-reporting systems are used in hospitals around the country, they often fail to capture a substantial proportion of medical errors. The goal of this study was to assess the ability of a proactive, web-based clinician safety debriefing to augment the information about medical errors and adverse events obtained via traditional incident reporting systems. Debriefings were sent to all individuals listed on operating room personnel reports for kidney transplantation surgeries between April 2010 and April 2011, and incident reports were collected for the same time period. The World Health Organization International Classification for Patient Safety was used to classify all issues reported. A total of 270 debriefings reported 334 patient safety issues (179 safety incidents, 155 contributing factors), and 57 incident reports reported 92 patient safety issues (56 safety incidents, 36 contributing factors). Compared with incident reports, more attending physicians completed the debriefings (32.0 vs 3.5%). The use of a proactive, web-based debriefing to augment an incident reporting system in assessing safety risks in kidney transplantation demonstrated increased information, more perspectives of a single safety issue, and increased breadth of participants. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. Systematic review: Laparoscopic fundoplication for gastroesophageal reflux disease in partial responders to proton pump inhibitors

    PubMed Central

    Lundell, Lars; Bell, Martin; Ruth, Magnus

    2014-01-01

    AIM: To assess laparoscopic fundoplication (LF) in partial responders to proton pump inhibitors (PPIs) for gastroesophageal reflux disease (GERD). METHODS: We systematically searched PubMed and Embase (1966-Dec 2011) for articles reporting data on LF efficacy in partial responders. Due to a lack of randomized controlled trials, observational studies were included. Of 558 articles screened, 17 were eligible for inclusion. Prevalence data for individual symptoms were collated across studies according to mutually compatible time points (before and/or after LF). Where suitable, prevalence data were presented as percentage of patients reporting symptoms of any frequency or severity. RESULTS: Due to a lack of standardized reporting of symptoms, the proportion of patients experiencing symptoms was recorded across studies where possible. After LF, the proportion of partial responders with heartburn was reduced from 93.1% (5 studies) to 3.8% (5 studies), with similar results observed for regurgitation [from 78.4% (4 studies) to 1.9% (4 studies)]. However, 10 years after LF, 35.8% (2 studies) of partial responders reported heartburn and 29.1% (1 study) reported regurgitation. The proportion using acid-suppressive medication also increased, from 8.8% (4 studies) in the year after LF to 18.2% (2 studies) at 10 years. In the only study comparing partial responders to PPI therapy with complete responders, higher symptom scores and more frequent acid-suppressive medication use were seen in partial responders after LF. CONCLUSION: GERD symptoms improve after LF, but subsequently recur, and acid-suppressive medication use increases. LF may be less effective in partial responders than in complete responders. PMID:24574753

  18. Associations between Self-Reported Gastrointestinal Illness and Water System Characteristics in Community Water Supplies in Rural Alabama: A Cross-Sectional Study.

    PubMed

    Stauber, Christine E; Wedgworth, Jessica C; Johnson, Pauline; Olson, Julie B; Ayers, Tracy; Elliott, Mark; Brown, Joe

    2016-01-01

    Community water supplies in underserved areas of the United States may be associated with increased microbiological contamination and risk of gastrointestinal disease. Microbial and health risks affecting such systems have not been systematically characterized outside outbreak investigations. The objective of the study was to evaluate associations between self-reported gastrointestinal illnesses (GII) and household-level water supply characteristics. We conducted a cross-sectional study of water quality, water supply characteristics, and GII in 906 households served by 14 small and medium-sized community water supplies in Alabama's underserved Black Belt region. We identified associations between respondent-reported water supply interruption and any symptoms of GII (adjusted odds ratio (aOR): 3.01, 95% confidence interval (CI) = 1.65-5.49), as well as low water pressure and any symptoms of GII (aOR: 4.51, 95% CI = 2.55-7.97). We also identified associations between measured water quality such as lack of total chlorine and any symptoms of GII (aOR: 5.73, 95% CI = 1.09-30.1), and detection of E. coli in water samples and increased reports of vomiting (aOR: 5.01, 95% CI = 1.62-15.52) or diarrhea (aOR: 7.75, 95% CI = 2.06-29.15). Increased self-reported GII was associated with key water system characteristics as measured at the point of sampling in a cross-sectional study of small and medium water systems in rural Alabama in 2012 suggesting that these water supplies can contribute to endemic gastro-intestinal disease risks. Future studies should focus on further characterizing and managing microbial risks in systems facing similar challenges.

  19. Pain in thalassaemia: the effects of age on pain frequency and severity.

    PubMed

    Haines, Dru; Martin, Marie; Carson, Susan; Oliveros, Olivia; Green, Sage; Coates, Thomas; Eile, Jennifer; Schilling, Leann; Dinu, Bogan; Mendoza, Tito; Gerstenberger, Eric; Trachtenberg, Felicia; Vichinsky, Elliott

    2013-03-01

    Pain is not a symptom generally associated with thalassaemia. However, providers have noted increasing patient reports of pain, creating an impetus for this prospective, observational assessment of pain in thalassaemia patients. The primary study goals were to assess pain prevalence, severity, location, and potential risk factors. This was a multicentre, prospective study of thalassaemia patients receiving care at 12 Thalassaemia Clinical Research Network sites. Pain was assessed using the Brief Pain Inventory. Two hundred and fifty-two thalassaemia patients ranging in age from 12 to 71 years (mean 28.8) were enrolled. Sixty-four per cent reported experiencing pain during the last 4 weeks, 22% of whom reported pain on a daily basis. Ordinal regression analysis of pain ratings demonstrated significant (P < 0.001) correlation of increased age with increased pain, irrespective of diagnosis, transfusion status, gender, bone density, chelator type or iron overload. Eighty-one per cent reported having pain for 1 year or longer and 31% reported pain for five or more years. Pain is a major cause of morbidity and an unrecognized problem for patients with thalassaemia. Age is the strongest predictor of frequency and severity. Little else is known about the aetiology and predictors of this pain syndrome. © 2012 Blackwell Publishing Ltd.

  20. Widowhood and Depression Among Older Europeans—The Role of Gender, Caregiving, Marital Quality, and Regional Context

    PubMed Central

    2013-01-01

    Objectives. This study investigates the role of gender, caregiving, and marital quality in the correlation between widowhood and depression among older people within a European context by applying the theory of Social Production Functions as a theoretical framework. Method. Fixed-effects linear regression models are estimated using the first 2 waves (2004, 2006) of “The Survey of Health, Ageing and Retirement in Europe” (SHARE). A subsample of 7,844 respondents aged 50 and older in 11 countries, who were married at baseline and are either continuously married or widowed at follow-up, is analyzed. Results. Respondents who experienced widowhood between the 2 waves report significantly more depressive symptoms than those continuously married, with respondents living in Denmark and Sweden reporting a lower increase in depressive symptoms than those living in Greece, Spain, or Italy. There is no statistically significant interaction between gender and widowhood. Widowed persons who report higher marital quality at baseline show a larger increase in the number of symptoms of depression than those with low marital quality; widowed persons who report being a caregiver for their partner at baseline report smaller increase in the symptoms of depression compared with widowed noncaregivers. Discussion. The results support the results of previous studies using longitudinal data. Furthermore, the effect of widowhood varies among the 11 countries in the subsample although only a small amount of the variation in the increase of depressive symptoms after becoming widowed can be explained by such contextual factors. PMID:23591571

  1. Prospective associations between peer victimization and aggression.

    PubMed

    Ostrov, Jamie M

    2010-01-01

    The current study involved a short-term longitudinal study of young children (M = 44.56 months, SD = 11.88, N = 103) to test the prospective associations between peer victimization and aggression subtypes. Path analyses documented that teacher-reported physical victimization was uniquely associated with increases in observed physical aggression over time. The path model also revealed that teacher-reported relational victimization was uniquely associated with statistically significant increases in observed relational aggression over time. Ways in which these findings extend the extant developmental literature are discussed. © 2010 The Author. Child Development © 2010 Society for Research in Child Development, Inc.

  2. Coagulopathy induced by saw palmetto: a case report.

    PubMed

    Villanueva, Salvador; González, Jenniffer

    2009-01-01

    Saw palmetto is the most popular herbal supplement used to treat symptoms of benign prostatic hyperplasia (BPH). The safety and efficacy of saw palmetto has been established in the literature. While the majority of studies document the efficacy and safety of saw palmetto, some studies document the adverse side effects, including increased risk of bleeding. There are no reports in the literature about increased prothombin time (PT), partial thromboplastin time (PTT) or international normalized ratio (INR) while using saw palmetto. We present a case of hematuria and coagulopathy in a patient who was using saw palmetto.

  3. A new safety event reporting system improves physician reporting in the surgical intensive care unit.

    PubMed

    Schuerer, Douglas J E; Nast, Patricia A; Harris, Carolyn B; Krauss, Melissa J; Jones, Rebecca M; Boyle, Walter A; Buchman, Timothy G; Coopersmith, Craig M; Dunagan, W Claiborne; Fraser, Victoria J

    2006-06-01

    Medical errors are common, and physicians have notably been poor medical error reporters. In the SICU, reporting was generally poor and reporting by physicians was virtually nonexistent. This study was designed to observe changes in error reporting in an SICU when a new card-based system (SAFE) was introduced. Before implementation of the SAFE reporting system, education was given to all SICU healthcare providers. The SAFE system was introduced into the SICU for a 9-month period from March 2003 through November 2003, to replace an underused online system. Data were collected from the SAFE card reports and the online reporting systems during introduction, removal, and reimplementation of these cards. Reporting rates were calculated as number of reported events per 1,000 patient days. Reporting rates increased from 19 to 51 reports per 1,000 patient days after the SAFE cards were introduced into the ICU (p

  4. The association between drinking water turbidity and gastrointestinal illness: a systematic review

    PubMed Central

    Mann, Andrea G; Tam, Clarence C; Higgins, Craig D; Rodrigues, Laura C

    2007-01-01

    Background Studies suggest that routine variations in public drinking water turbidity may be associated with endemic gastrointestinal illness. We systematically reviewed the literature on this topic. Methods We searched databases and websites for relevant studies in industrialized countries. Studies investigating the association between temporal variations in drinking water turbidity and incidence of acute gastrointestinal illness were assessed for quality. We reviewed good quality studies for evidence of an association between increased turbidity and gastrointestinal illness. Results We found six relevant good quality studies. Of five studies investigating effluent water turbidity, two found no association. Two studies from Philadelphia reported increased paediatric and elderly hospital use on specific days after increased turbidity. A fifth study reported more telephone health service calls on specific days after peak turbidity. There were differences between studies affecting their comparability, including baseline turbidity and adjustment for seasonal confounders. Conclusion It is likely that an association between turbidity and GI illness exists in some settings or over a certain range of turbidity. A pooled analysis of available data using standard methods would facilitate interpretation. PMID:17888154

  5. The association between drinking water turbidity and gastrointestinal illness: a systematic review.

    PubMed

    Mann, Andrea G; Tam, Clarence C; Higgins, Craig D; Rodrigues, Laura C

    2007-09-21

    Studies suggest that routine variations in public drinking water turbidity may be associated with endemic gastrointestinal illness. We systematically reviewed the literature on this topic. We searched databases and websites for relevant studies in industrialized countries. Studies investigating the association between temporal variations in drinking water turbidity and incidence of acute gastrointestinal illness were assessed for quality. We reviewed good quality studies for evidence of an association between increased turbidity and gastrointestinal illness. We found six relevant good quality studies. Of five studies investigating effluent water turbidity, two found no association. Two studies from Philadelphia reported increased paediatric and elderly hospital use on specific days after increased turbidity. A fifth study reported more telephone health service calls on specific days after peak turbidity. There were differences between studies affecting their comparability, including baseline turbidity and adjustment for seasonal confounders. It is likely that an association between turbidity and GI illness exists in some settings or over a certain range of turbidity. A pooled analysis of available data using standard methods would facilitate interpretation.

  6. Gray Matter Increase in Motor Cortex in Pediatric ADHD: A Voxel-Based Morphometry Study.

    PubMed

    Sutcubasi Kaya, Bernis; Metin, Baris; Tas, Zeynep Cubukcuoglu; Buyukaslan, Ayse; Soysal, Aysegul; Hatiloglu, Deniz; Tarhan, Nevzat

    2018-05-01

    Several studies report that ADHD is associated with reduced gray matter (GM), whereas others report no differences in GM volume between ADHD patients and controls, and some even report more GM volume in individuals with ADHD. These conflicting findings suggest that reduced GM is not a universal finding in ADHD, and that more research is needed to delineate with greater accuracy the range of GM alterations. The present study aimed to identify GM alterations in ADHD using pediatric templates. 19 drug-naïve ADHD patients and 18 controls, all aged 7 to 14 years, were scanned using magnetic resonance imaging. Relative to the controls, the ADHD patients had more GM, predominantly in the precentral and supplementary motor areas. Moreover, there were positive correlations between GM volume in these areas and ADHD scale scores. The clinical and pathophysiological significance of increased GM in the motor areas remains to be elucidated by additional research.

  7. Educational services in health sciences libraries: a content analysis of the literature, 1987-1994.

    PubMed Central

    Dimitroff, A

    1995-01-01

    The recent literature (1987-1994) describing educational services of health sciences librarians was analyzed for content. Variables examined included publication journal, country, type of article (description, review, or advocacy), target audience of education services, and subject of article. Articles that reported research results also were identified. Of 123 articles studied, 82.1% were descriptive, 14.6% advocacy, and 3.3% reviews. Library users were the primary target audience (85.1%), an increase over the percentage reported in an earlier study of the 1975-1986 literature. Librarians were the target audience in 12.8% of the articles, a decrease from the previous study's findings. There was an increase in educational offerings by academic libraries, which sponsored 83.2% of programs, while hospital libraries' sponsorship decreased to 5% of programs reported in the literature. The analysis identified a major need for research related to educational activities in health sciences libraries. PMID:8547899

  8. Children’s Dietary Recalls from Three Validation Studies: Types of Intrusion Vary with Retention Interval

    PubMed Central

    Baxter, Suzanne Domel; Hardin, James W.; Smith, Albert F.; Royer, Julie A.; Guinn, Caroline H.

    2008-01-01

    SUMMARY Using previously collected data of fourth-grade children observed eating school meals and then interviewed, we categorized intrusions (food items reported but not observed eaten) as stretches (on the child’s tray) or confabulations (not on the child’s tray). We investigated intrusions, confabulations, and stretches, and the role of liking, at different retention intervals (morning interviews about the previous day’s intake; evening interviews about that day’s intake) and under different reporting-order prompts (forward; reverse). As retention interval between consumption and report increased, the likelihood 1) increased that reported items were intrusions, that reported items were confabulations, and that intrusions were confabulations; and 2) was constant that reported items were stretches. Results concerning reporting-order prompts were inconclusive. Liking ratings were higher for matches (reports of items observed eaten) than stretches, for confabulations than stretches, and for matches than omissions (unreported items observed eaten), but did not vary by retention interval or reporting-order prompts. PMID:19023454

  9. Calcium and Bone Homeostasis During 4-6 Months Space Flight

    NASA Technical Reports Server (NTRS)

    Smith, Scott M.; OBrien, K.; Wastney, M.; Morukov, B.; Larina, I.; Abrams, S.; Lane, H.; Nillen, J.; Davis-Street, J.; Paloski, W. H. (Technical Monitor)

    2000-01-01

    Bone and calcium homeostasis are altered by weightlessness. We previously reported calcium studies on three subjects from the first joint US/Russian mission to Mir. We report here data on an additional three male subjects, whose stays on Mir were 4 (n= 1) and 6 (n=2) mos. Data were collected before, during, and after the missions. Inflight studies were conducted at 2-3 mos. Endocrine and biochemical indices were measured, along with 3-wk calcium tracer studies. Percent differences are reported compared to preflight. Ionized calcium was unchanged (2.8 +/-2.1 %) during flight. Calcium absorption was variable inflight, but was decreased after landing. Vitamin D stores were decreased 35 +/-24% inflight, similar to previous reports. Serum PTH was decreased 59 +/-9% during flight (greater than we previously reported), while 1,25(OH)(sub 2)-Vitamin D was decreased in 2 of 3 subjects. Markers of bone resorption (e.g., crosslinks) were increased in all subjects. Bone-specific alkaline phosphatase was decreased (n=1) or unchanged (n=2), while osteocalcin was decreased 34 +/-23%. Previously presented data showed that inflight bone loss is associated with increased resorption and unchanged/decreased formation. The data reported here support these earlier findings. These studies will help to extend our understanding of space flight-induced bone loss, and of bone loss associated with diseases such as osteoporosis or paralysis.

  10. Residential Light and Risk for Depression and Falls: Results from the LARES Study of Eight European Cities

    PubMed Central

    Brown, Mary Jean; Jacobs, David E.

    2011-01-01

    Objectives. We examined the relationship between self-reported inadequate residential natural light and risk for depression or falls among adults aged 18 years or older. Methods. Generalized estimating equations were used to calculate the odds of depression or falls in participants with self-reported inadequate natural residential light vs. those reporting adequate light (n=6,017) using data from the World Health Organization's Large Analysis and Review of European Housing and Health Survey, a large cross-sectional study of housing and health in representative populations from eight European cities. Results. Participants reporting inadequate natural light in their dwellings were 1.4 times (95% confidence interval [CI] 1.2,1.7) as likely to report depression and 1.5 times (95% CI 1.2, 1.9) as likely to report a fall compared with those satisfied with their dwelling's light. After adjustment for major confounders, the likelihood of depression changed slightly, while the likelihood of a fall increased to 2.5 (95% CI 1.5, 4.2). Conclusion. Self-reported inadequate light in housing is independently associated with depression and falls. Increasing light in housing, a relatively inexpensive intervention, may improve two distinct health conditions. PMID:21563721

  11. Residential light and risk for depression and falls: results from the LARES study of eight European cities.

    PubMed

    Brown, Mary Jean; Jacobs, David E

    2011-01-01

    We examined the relationship between self-reported inadequate residential natural light and risk for depression or falls among adults aged 18 years or older. Generalized estimating equations were used to calculate the odds of depression or falls in participants with self-reported inadequate natural residential light vs. those reporting adequate light (n = 6,017) using data from the World Health Organization's Large Analysis and Review of European Housing and Health Survey, a large cross-sectional study of housing and health in representative populations from eight European cities. Participants reporting inadequate natural light in their dwellings were 1.4 times (95% confidence interval [CI] 1.2,1.7) as likely to report depression and 1.5 times (95% CI 1.2, 1.9) as likely to report a fall compared with those satisfied with their dwelling's light. After adjustment for major confounders, the likelihood of depression changed slightly, while the likelihood of a fall increased to 2.5 (95% CI 1.5, 4.2). Self-reported inadequate light in housing is independently associated with depression and falls. Increasing light in housing, a relatively inexpensive intervention, may improve two distinct health conditions.

  12. Feasibility Study of Economics and Performance of Solar Photovoltaics in Nitro, West Virginia

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

    Lisell, L.; Mosey, G.

    2010-08-01

    The study described in this report assessed brownfield sites designated by the City of Nitro, West Virginia for solar photovoltaic (PV) installations. The study analyzed three different types of PV systems for eight sites. The report estimates the cost, performance, and site impacts of thin film technology and crystalline silicon panels (both fixed-axis tracking and single-axis tracking systems). Potential job creation and electrical rate increases were also considered, and the report recommends financing options that could assist in the implementation of a system.

  13. U.S. Metric Study Interim Report: The Consumer.

    ERIC Educational Resources Information Center

    National Bureau of Standards (DOC), Washington, DC.

    This is the seventh in a series of reports from the U. S. Metric Study, conducted by the National Bureau of Standards, focusing on the effects of increasing metric usage on the consumer American. Information on three areas--the level of knowledge of the American about the metric system, problems which would be encountered with a national policy of…

  14. Occupational Stress in UK Higher Education Institutions: A Comparative Study of All Staff Categories

    ERIC Educational Resources Information Center

    Tytherleigh, M. Y.; Webb, C.; Cooper, C. L.; Ricketts, C.

    2005-01-01

    The higher education sector in the UK continues to experience significant change. This includes restructuring, use of short-term contracts, external scrutiny and accountability, and major reductions in funding. In line with this, reports of stress at work in higher education institutions have also increased. The study reported here was carried out…

  15. Why University Students Don't Read: What Professors Can Do to Increase Compliance

    ERIC Educational Resources Information Center

    Hoeft, Mary E.

    2012-01-01

    This article reports findings from two studies assessing reading compliance among first semester freshmen at a small Midwestern two-year liberal arts university. The first study assessed reading compliance of students enrolled in two sections of First Year Seminar, finding that 46% of students reported that they read assignments, yet only 55% of…

  16. Effects of voice training and voice hygiene education on acoustic and perceptual speech parameters and self-reported vocal well-being in female teachers.

    PubMed

    Ilomaki, Irma; Laukkanen, Anne-Maria; Leppanen, Kirsti; Vilkman, Erkki

    2008-01-01

    Voice education programs may help in optimizing teachers' voice use. This study compared effects of voice training (VT) and voice hygiene lecture (VHL) in 60 randomly assigned female teachers. All 60 attended the lecture, and 30 completed a short training course in addition. Text reading was recorded in working environments and analyzed for fundamental frequency (F0), equivalent sound level (Leq), alpha ratio, jitter, shimmer, and perceptual quality. Self-reports of vocal well-being were registered. In the VHL group, increased F0 and difficulty of phonation and in the VT group decreased perturbation, increased alpha ratio, easier phonation, and improved perceptual and self-reported voice quality were found. Both groups equally self-reported increase of voice care knowledge. Results seem to indicate improved vocal well-being after training.

  17. Sibling differentiation: sibling and parent relationship trajectories in adolescence.

    PubMed

    Feinberg, Mark E; McHale, Susan M; Crouter, Ann C; Cumsille, Patricio

    2003-01-01

    Studied here were the links between sibling differences in trajectories of change in the qualities of parent-child relationships and the qualities of sibling relationships across a 2-year period in adolescence. Participants were first- and second-born siblings (M age = 14.94 years for firstborns and M age = 12.46 years for secondborns) from 185 predominantly White, working and middle-class families. In home interviews, siblings reported on their dyadic family relationships. For reports of parent-child warmth but not parent-child conflict, results were consistent with sibling differentiation theory: Increasing differences between siblings over time in parent-child warmth were linked to trajectories of increasing warmth and decreasing conflict in the sibling relationship as reported by firstborns, and increasing warmth in the sibling relationship as reported by secondborns. The findings support the view that sibling differentiation may be a strategy for managing sibling conflict and rivalry.

  18. Standards for the Reporting of Genetic Counseling Interventions in Research and Other Studies (GCIRS): an NSGC Task Force Report.

    PubMed

    Hooker, Gillian W; Babu, D; Myers, M F; Zierhut, H; McAllister, M

    2017-06-01

    As the demand for evidence to support the value of genetic counseling increases, it is critical that reporting of genetic counseling interventions in research and other types of studies (e.g. process improvement or service evaluation studies) adopt greater rigor. As in other areas of healthcare, the appraisal, synthesis, and translation of research findings into genetic counseling practice are likely to be improved if clear specifications of genetic counseling interventions are reported when studies involving genetic counseling are published. To help improve reporting practices, the National Society of Genetic Counselors (NSGC) convened a task force in 2015 to develop consensus standards for the reporting of genetic counseling interventions. Following review by the NSGC Board of Directors, the NSGC Practice Guidelines Committee and the editorial board of the Journal of Genetic Counseling, 23 items across 8 domains were proposed as standards for the reporting of genetic counseling interventions in the published literature (GCIRS: Genetic Counseling Intervention Reporting Standards). The authors recommend adoption of these standards by authors and journals when reporting studies involving genetic counseling interventions.

  19. Extrafloral nectar in an apple ecosystem to enhance biological control

    USDA-ARS?s Scientific Manuscript database

    A common goal of conservation biological control is to enhance biodiversity to increase abundance and effectiveness of predators and parasitoids. Although many studies report an increase in abundance of natural enemies, it has been difficult to document increases in rates of biological control. To...

  20. Selected medical conditions and risk of pancreatic cancer.

    PubMed

    Olson, Sara H

    2012-01-01

    We review the current evidence for associations of several medical conditions with risk of pancreatic cancer, including allergies, pancreatitis, gall bladder disease, cholecystectomy, ulcers, gastrectomy, appendectomy, and tonsillectomy. There are consistent findings of reduced risk associated with presence of self-reported allergies, particularly hay fever but not asthma; data on other allergies are limited and inconclusive. Several studies provide evidence that patients with pancreatic cancer are more likely than comparison groups to report pancreatitis. Those studies that investigated the time between onset of pancreatitis and diagnosis of pancreatic cancer found that risk estimates declined with longer periods of time; however, increased risks were noted for long-term pancreatitis, indicating that this condition is both a risk factor and a sign of early disease. Increased risk was reported in association with cholelithiasis, but the few studies that considered time before diagnosis of cancer did not find increased risk for cholelithiasis diagnosed in the more distant past. There is weak evidence that cholecystectomy 2 or more years before cancer diagnosis is related to risk, but this is based on only a few studies. There is no consistent association between ulcers and risk, while gastrectomy may increase risk. Overall, study of these conditions, particularly those that are rare, presents methodologic challenges. Time between diagnoses is likely to be important but is not considered in most studies. Lack of adequate control in several studies for risk factors such as smoking and heavy alcohol use also makes it difficult to draw firm conclusions about these results. Copyright © 2011 Wiley Periodicals, Inc.

  1. No evidence of critical slowing down in two endangered Hawaiian honeycreepers

    PubMed Central

    Camp, Richard J.; Reed, J. Michael

    2017-01-01

    There is debate about the current population trends and predicted short-term fates of the endangered forest birds, Hawai`i Creeper (Loxops mana) and Hawai`i `Ākepa (L. coccineus). Using long-term population size estimates, some studies report forest bird populations as stable or increasing, while other studies report signs of population decline or impending extinction associated with introduced Japanese White-eye (Zosterops japonicus) increase. Reliable predictors of impending population collapse, well before the collapse begins, have been reported in simulations and microcosm experiments. In these studies, statistical indicators of critical slowing down, a phenomenon characterized by longer recovery rates after population size perturbation, are reported to be early warning signals of an impending regime shift observable prior to the tipping point. While the conservation applications of these metrics are commonly discussed, early warning signal detection methods are rarely applied to population size data from natural populations, so their efficacy and utility in species management remain unclear. We evaluated two time series of state-space abundance estimates (1987–2012) from Hakalau Forest National Wildlife Refuge, Hawai`i to test for evidence of early warning signals of impending population collapse for the Hawai`i Creeper and Hawai`i `Ākepa. We looked for signals throughout the time series, and prior to 2000, when white-eye abundance began increasing. We found no evidence for either species of increasing variance, autocorrelation, or skewness, which are commonly reported early warning signals. We calculated linear rather than ordinary skewness because the latter is biased, particularly for small sample sizes. Furthermore, we identified break-points in trends over time for both endangered species, indicating shifts in slopes away from strongly increasing trends, but they were only weakly supported by Bayesian change-point analyses (i.e., no step-wise changes in abundance). The break-point and change-point test results, in addition to the early warning signal analyses, support that the two populations do not appear to show signs of critical slowing down or decline. PMID:29131835

  2. No evidence of critical slowing down in two endangered Hawaiian honeycreepers

    USGS Publications Warehouse

    Rozek, Jessica C.; Camp, Richard J.; Reed, J. Michael

    2017-01-01

    There is debate about the current population trends and predicted short-term fates of the endangered forest birds, Hawai`i Creeper (Loxops mana) and Hawai`i `Ākepa (L. coccineus). Using long-term population size estimates, some studies report forest bird populations as stable or increasing, while other studies report signs of population decline or impending extinction associated with introduced Japanese White-eye (Zosterops japonicus) increase. Reliable predictors of impending population collapse, well before the collapse begins, have been reported in simulations and microcosm experiments. In these studies, statistical indicators of critical slowing down, a phenomenon characterized by longer recovery rates after population size perturbation, are reported to be early warning signals of an impending regime shift observable prior to the tipping point. While the conservation applications of these metrics are commonly discussed, early warning signal detection methods are rarely applied to population size data from natural populations, so their efficacy and utility in species management remain unclear. We evaluated two time series of state-space abundance estimates (1987–2012) from Hakalau Forest National Wildlife Refuge, Hawai`i to test for evidence of early warning signals of impending population collapse for the Hawai`i Creeper and Hawai`i `Ākepa. We looked for signals throughout the time series, and prior to 2000, when white-eye abundance began increasing. We found no evidence for either species of increasing variance, autocorrelation, or skewness, which are commonly reported early warning signals. We calculated linear rather than ordinary skewness because the latter is biased, particularly for small sample sizes. Furthermore, we identified break-points in trends over time for both endangered species, indicating shifts in slopes away from strongly increasing trends, but they were only weakly supported by Bayesian change-point analyses (i.e., no step-wise changes in abundance). The break-point and change-point test results, in addition to the early warning signal analyses, support that the two populations do not appear to show signs of critical slowing down or decline.

  3. Non-health care facility anticonvulsant medication errors in the United States.

    PubMed

    DeDonato, Emily A; Spiller, Henry A; Casavant, Marcel J; Chounthirath, Thitphalak; Hodges, Nichole L; Smith, Gary A

    2018-06-01

    This study provides an epidemiological description of non-health care facility medication errors involving anticonvulsant drugs. A retrospective analysis of National Poison Data System data was conducted on non-health care facility medication errors involving anticonvulsant drugs reported to US Poison Control Centers from 2000 through 2012. During the study period, 108,446 non-health care facility medication errors involving anticonvulsant pharmaceuticals were reported to US Poison Control Centers, averaging 8342 exposures annually. The annual frequency and rate of errors increased significantly over the study period, by 96.6 and 76.7%, respectively. The rate of exposures resulting in health care facility use increased by 83.3% and the rate of exposures resulting in serious medical outcomes increased by 62.3%. In 2012, newer anticonvulsants, including felbamate, gabapentin, lamotrigine, levetiracetam, other anticonvulsants (excluding barbiturates), other types of gamma aminobutyric acid, oxcarbazepine, topiramate, and zonisamide, accounted for 67.1% of all exposures. The rate of non-health care facility anticonvulsant medication errors reported to Poison Control Centers increased during 2000-2012, resulting in more frequent health care facility use and serious medical outcomes. Newer anticonvulsants, although often considered safer and more easily tolerated, were responsible for much of this trend and should still be administered with caution.

  4. Results of a greenhouse study investigating the phytoextraction of lead from contaminated soils obtained from the Sunflower Army Ammunition Plant, Desoto, Kansas

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

    Bader, D.F.; Behel, A.D.; Almond, R.A.

    1998-08-01

    This report describes the results of greenhouse studies conducted to determine if phytoextraction methods could be enhanced by increasing ionic lead`s solubility in water. Soil acidifiers and chelating agents were used to increase lead`s solubility in water. The study was conducted using lead contaminated soil from the Sunflower Army Ammunition Plant near Desoto, Kansas. These soils were shipped to the Tennessee Valley Authority`s Environmental Research Facility in Muscle Shoals, Alabama, where the study was conducted. The report concludes that phytoextraction methods may be enhanced by these techniques and that the risk of leaching lead out of the soil`s root zonemore » is minimal.« less

  5. Children's moral motivation, sympathy, and prosocial behavior.

    PubMed

    Malti, Tina; Gummerum, Michaela; Keller, Monika; Buchmann, Marlis

    2009-01-01

    Two studies investigated the role of children's moral motivation and sympathy in prosocial behavior. Study 1 measured other-reported prosocial behavior and self- and other-reported sympathy. Moral motivation was assessed by emotion attributions and moral reasoning following hypothetical transgressions in a representative longitudinal sample of Swiss 6-year-old children (N = 1,273). Prosocial behavior increased with increasing sympathy, especially if children displayed low moral motivation. Moral motivation and sympathy were also independently related to prosocial behavior. Study 2 extended the findings of Study 1 with a second longitudinal sample of Swiss 6-year-old children (N = 175) using supplementary measures of prosocial behavior, sympathy, and moral motivation. The results are discussed in regard to the precursors of the moral self in childhood.

  6. Increased household financial strain, the Great Recession and child health-findings from the UK Millennium Cohort Study.

    PubMed

    McKenna, Caoimhe; Law, Catherine; Pearce, Anna

    2017-03-09

    There is a growing body of evidence associating financial strain (FS) with poor health but most of this research has been cross-sectional and adult-focused. During the 'Great Recession' many UK households experienced increased FS. The primary aim of this study was to determine the impact of increased FS on child health. We analysed the Millennium Cohort Study, a longitudinal study of children born in the UK between 2000 and 2002. Surveys at 7 years (T1, 2008) and 11 years (T2, 2012) spanned the 'Great Recession'. Three measures of increased FS were defined; 'became income poor' (self-reported household income dropped below the 'poverty line' between T1 and T2); 'developed difficulty managing' (parental report of being 'financially comfortable' at T1 and finding it 'difficult to manage' at T2); 'felt worse off' (parental report of feeling financially 'worse off' at T2 compared with T1). Poisson regression was used to estimate risk ratios (RR), adjusted risk ratios (aRR) and 95% CIs for six child health outcomes: measured overweight/obesity, problematic behaviour as scored by parents and teachers, and parental reports of fair/poor general health, long-standing illness and bedwetting at T2 (N=13 112). In subanalyses we limited our sample to those who were above the poverty line at T2. Compared with those who were not financially strained at both time points, children in households which experienced increased FS were at an increased risk of all unhealthy outcomes examined. In most cases, these increased risks persisted after adjustment for confounding and when limiting the sample to those above the poverty line. FS is associated with a range of new or continued poor child health outcomes. During times of widespread economic hardship, such as the 'Great Recession', measures should be taken to buffer children and their families from the impact of FS, and these should not be limited to those who are income poor. 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/.

  7. Increased household financial strain, the Great Recession and child health—findings from the UK Millennium Cohort Study

    PubMed Central

    Law, Catherine; Pearce, Anna

    2017-01-01

    Background There is a growing body of evidence associating financial strain (FS) with poor health but most of this research has been cross-sectional and adult-focused. During the ‘Great Recession’ many UK households experienced increased FS. The primary aim of this study was to determine the impact of increased FS on child health. Methods We analysed the Millennium Cohort Study, a longitudinal study of children born in the UK between 2000 and 2002. Surveys at 7 years (T1, 2008) and 11 years (T2, 2012) spanned the ‘Great Recession’. Three measures of increased FS were defined; ‘became income poor’ (self-reported household income dropped below the ‘poverty line’ between T1 and T2); ‘developed difficulty managing’ (parental report of being ‘financially comfortable’ at T1 and finding it ‘difficult to manage’ at T2); ‘felt worse off’ (parental report of feeling financially ‘worse off’ at T2 compared with T1). Poisson regression was used to estimate risk ratios (RR), adjusted risk ratios (aRR) and 95% CIs for six child health outcomes: measured overweight/obesity, problematic behaviour as scored by parents and teachers, and parental reports of fair/poor general health, long-standing illness and bedwetting at T2 (N=13 112). In subanalyses we limited our sample to those who were above the poverty line at T2. Results Compared with those who were not financially strained at both time points, children in households which experienced increased FS were at an increased risk of all unhealthy outcomes examined. In most cases, these increased risks persisted after adjustment for confounding and when limiting the sample to those above the poverty line. Conclusions FS is associated with a range of new or continued poor child health outcomes. During times of widespread economic hardship, such as the ‘Great Recession’, measures should be taken to buffer children and their families from the impact of FS, and these should not be limited to those who are income poor. PMID:28280000

  8. [Evaluation of a Self-Help Supported Counseling Concept for Children and Adolescents with Disproportional Short Stature].

    PubMed

    Rohenkohl, A C; Sommer, R; Kahrs, S; Bullinger, M; Klingebiel, K-H; Quitmann, J H

    2016-01-01

    Disproportionate short stature may impair the quality of life (QoL) of patients and their families. This study aimed to evaluate a self-help supported counseling concept to increase the QoL of the participants. QoL data from 58 children/adolescents (8-17 years) with a diagnosis of achondroplasia was collected at 2 measurement points during one year using the the QoLISSY questionnaire (self-/parental report). Differences before and after participation vs. non-participation in the intervention were evaluated using a linear mixed model. The longitudinal results show a greater increase of QoL in the active intervention group compared to a passive control group (p=0,005). The increase in the self-reported QoL of affected patients was significantly higher than for the parent-report (p=0,048). The study shows that patients with achondroplasia benefit from a self-help supported counseling concept. However, this should be tested in a randomized trial. © Georg Thieme Verlag KG Stuttgart · New York.

  9. Use of multiple patient simulators to enhance prioritizing and delegating skills for senior nursing students.

    PubMed

    Kaplan, Barbara; Ura, Darla

    2010-07-01

    The student clinical experience is rich, yet challenges arise in providing experiences where leadership skills can be developed and used in nursing practice. To increase student confidence and enhance student ability to safely and effectively prioritize, delegate, and implement care for numerous patients, a simulation-based learning (SBL) experience was developed. The SBL experience involves multiple patient simulators, case study analysis, and a debriefing session. Ninety-seven senior nursing students participated in this program. Students reported through Likert surveys to either "agree" or "strongly agree" that the SBL was well organized (87%, n = 84), prompted realistic expectations (59%, n = 57), the scenarios were believable (73%, n = 71), case studies increased understanding (66%, n = 64), and that the SBL experience increased understanding of prioritizing and delegating care (69%, n = 67). Seventy-eight percent (n = 76) reported "more confidence in ability to work as a team" and 55% (n = 52) reported "more confidence in prioritizing and delegating care." Copyright 2010, SLACK Incorporated.

  10. Obesity interventions in African American faith-based organizations: a systematic review.

    PubMed

    Lancaster, K J; Carter-Edwards, L; Grilo, S; Shen, C; Schoenthaler, A M

    2014-10-01

    African Americans, especially women, have higher obesity rates than the general US population. Because of the importance of faith to many African Americans, faith-based organizations (FBOs) may be effective venues for delivering health messages and promoting adoption of healthy behaviours. This article systematically reviews interventions targeting weight and related behaviours in faith settings. We searched literature published through July 2012 for interventions in FBOs targeting weight loss, diet and/or physical activity (PA) in African Americans. Of 27 relevant articles identified, 12 were randomized controlled trials; seven of these reported a statistically significant change in an outcome. Four of the five quasi-experimental and single-group design studies reported a statistically significant outcome. All 10 pilot studies reported improvement in at least one outcome, but most did not have a comparison group. Overall, 70% of interventions reported success in reducing weight, 60% reported increased fruit and vegetable intake and 38% reported increased PA. These results suggest that interventions in African American FBOs can successfully improve weight and related behaviours. However, not all of the findings about the success of certain approaches were as expected. This review identifies gaps in knowledge and recommends more rigorous studies be conducted to strengthen the comparative methodology and evidence. © 2014 World Obesity.

  11. Methodology or method? A critical review of qualitative case study reports.

    PubMed

    Hyett, Nerida; Kenny, Amanda; Dickson-Swift, Virginia

    2014-01-01

    Despite on-going debate about credibility, and reported limitations in comparison to other approaches, case study is an increasingly popular approach among qualitative researchers. We critically analysed the methodological descriptions of published case studies. Three high-impact qualitative methods journals were searched to locate case studies published in the past 5 years; 34 were selected for analysis. Articles were categorized as health and health services (n=12), social sciences and anthropology (n=7), or methods (n=15) case studies. The articles were reviewed using an adapted version of established criteria to determine whether adequate methodological justification was present, and if study aims, methods, and reported findings were consistent with a qualitative case study approach. Findings were grouped into five themes outlining key methodological issues: case study methodology or method, case of something particular and case selection, contextually bound case study, researcher and case interactions and triangulation, and study design inconsistent with methodology reported. Improved reporting of case studies by qualitative researchers will advance the methodology for the benefit of researchers and practitioners.

  12. Effect of GH/IGF-1 on Bone Metabolism and Osteoporsosis

    PubMed Central

    Locatelli, Vittorio; Bianchi, Vittorio E.

    2014-01-01

    Background. Growth hormone (GH) and insulin-like growth factor (IGF-1) are fundamental in skeletal growth during puberty and bone health throughout life. GH increases tissue formation by acting directly and indirectly on target cells; IGF-1 is a critical mediator of bone growth. Clinical studies reporting the use of GH and IGF-1 in osteoporosis and fracture healing are outlined. Methods. A Pubmed search revealed 39 clinical studies reporting the effects of GH and IGF-1 administration on bone metabolism in osteopenic and osteoporotic human subjects and on bone healing in operated patients with normal GH secretion. Eighteen clinical studies considered the effect with GH treatment, fourteen studies reported the clinical effects with IGF-1 administration, and seven related to the GH/IGF-1 effect on bone healing. Results. Both GH and IGF-1 administration significantly increased bone resorption and bone formation in the most studies. GH/IGF-1 administration in patients with hip or tibial fractures resulted in increased bone healing, rapid clinical improvements. Some conflicting results were evidenced. Conclusions. GH and IGF-1 therapy has a significant anabolic effect. GH administration for the treatment of osteoporosis and bone fractures may greatly improve clinical outcome. GH interacts with sex steroids in the anabolic process. GH resistance process is considered. PMID:25147565

  13. Recall bias in the assessment of exposure to mobile phones.

    PubMed

    Vrijheid, Martine; Armstrong, Bruce K; Bédard, Daniel; Brown, Julianne; Deltour, Isabelle; Iavarone, Ivano; Krewski, Daniel; Lagorio, Susanna; Moore, Stephen; Richardson, Lesley; Giles, Graham G; McBride, Mary; Parent, Marie-Elise; Siemiatycki, Jack; Cardis, Elisabeth

    2009-05-01

    Most studies of mobile phone use are case-control studies that rely on participants' reports of past phone use for their exposure assessment. Differential errors in recalled phone use are a major concern in such studies. INTERPHONE, a multinational case-control study of brain tumour risk and mobile phone use, included validation studies to quantify such errors and evaluate the potential for recall bias. Mobile phone records of 212 cases and 296 controls were collected from network operators in three INTERPHONE countries over an average of 2 years, and compared with mobile phone use reported at interview. The ratio of reported to recorded phone use was analysed as measure of agreement. Mean ratios were virtually the same for cases and controls: both underestimated number of calls by a factor of 0.81 and overestimated call duration by a factor of 1.4. For cases, but not controls, ratios increased with increasing time before the interview; however, these trends were based on few subjects with long-term data. Ratios increased by level of use. Random recall errors were large. In conclusion, there was little evidence for differential recall errors overall or in recent time periods. However, apparent overestimation by cases in more distant time periods could cause positive bias in estimates of disease risk associated with mobile phone use.

  14. Bowel morbidity following radiochemotherapy and image-guided adaptive brachytherapy for cervical cancer: Physician- and patient reported outcome from the EMBRACE study.

    PubMed

    Jensen, Nina Boje Kibsgaard; Pötter, Richard; Kirchheiner, Kathrin; Fokdal, Lars; Lindegaard, Jacob Christian; Kirisits, Christian; Mazeron, Renaud; Mahantshetty, Umesh; Jürgenliemk-Schulz, Ina Maria; Segedin, Barbara; Hoskin, Peter; Tanderup, Kari

    2018-06-01

    This study describes late bowel morbidity prospectively assessed in the multi-institutional EMBRACE study on MRI-guided adaptive brachytherapy in locally advanced cervical cancer (LACC). A total of 1176 patients were analyzed. Physician reported morbidity (CTCAE v.3.0) and patient reported outcome (PRO) (EORTC QLQ C30/CX24) were assessed at baseline and at regular follow-up. At 3/5 years the actuarial incidence of bowel morbidity grade 3-4 was 5.0%/5.9%, including incidence of stenosis/stricture/fistula of 2.0%/2.6%. Grade 1-2 morbidity was pronounced with prevalence rates of 28-33% during follow-up. Diarrhea and flatulence were most frequently reported, significantly increased after 3 months and remained elevated during follow-up. Incontinence gradually worsened with time. PRO revealed high prevalence rates. Diarrhea ≥"a little" increased from 26% to 37% at baseline to 3 months and remained elevated, difficulty in controlling bowel increased from 11% to 26% at baseline to 3 months gradually worsening with time. Constipation and abdominal cramps improved after treatment. Bowel morbidity reported in this large cohort of LACC patients was limited regarding severe/life-threatening events. Mild-moderate diarrhea, flatulence and incontinence were prevalent after treatment with PROs indicating a considerable and clinically relevant burden. Critical knowledge based on the extent and manifestation pattern of treatment-related morbidity will serve future patient management. Copyright © 2018 Elsevier B.V. All rights reserved.

  15. Self-Reported Benefits and Adverse Outcomes of Hot Yoga Participation.

    PubMed

    Mace, Casey; Eggleston, Brandon

    2016-01-01

    There is little to no scientific data about the health benefits or risks to participating in hot yoga, in particular distinguishing it from the practice of non-hot yoga. This study aims to provide some preliminary evidence about the risks and benefits of participating in hot yoga. Future studies will be able to build off the findings herein. This study utilized online survey software (Qualtrics) and recruited participants through convenience sampling (n = 157) by targeting yoga websites and online forums. As there is currently no known questionnaire that has been developed to assess the risks and benefits of hot yoga participation, an exploratory measure was designed to gain more detailed responses from participants. Descriptive epidemiological analyses we re conducted. Participants of hot yoga had a number of pre-existing health conditions. Both benefits and adverse outcomes were reported. The most frequently reported health benefits of hot yoga in this sample included increased flexibility (63%), improved mood (58%), increased fitness (43%), and improved stamina (42%). Just over half of the participants reported some sort of adverse event during a hot yoga session (n = 82). The most commonly reported adverse events included dizziness (60%), feeling light headed (61%), nausea (35%), and dehydration (34%), amongst others. Further study on the risks and benefits of hot yoga participation is required.

  16. Self-Reported Benefits and Adverse Outcomes of Hot Yoga Participation.

    PubMed

    Mace, Casey; Eggleston, Brandon

    2016-08-15

    There is little to no scientific data about the health benefits or risks to participating in hot yoga, in particular distinguishing it from the practice of non-hot yoga. This study aims to provide some preliminary evidence about the risks and benefits of participating in hot yoga. Future studies will be able to build off the findings herein. This study utilized online survey software (Qualtrics) and recruited participants through convenience sampling (n = 157) by targeting yoga websites and online forums. As there is currently no known questionnaire that has been developed to assess the risks and benefits of hot yoga participation, an exploratory measure was designed to gain more detailed responses from participants. Descriptive epidemiological analyses we re conducted. Participants of hot yoga had a number of pre-existing health conditions. Both benefits and adverse outcomes were reported. The most frequently reported health benefits of hot yoga in this sample included increased flexibility (63%), improved mood (58%), increased fitness (43%), and improved stamina (42%). Just over half of the participants reported some sort of adverse event during a hot yoga session (n = 82). The most commonly reported adverse events included dizziness (60%), feeling light headed (61%), nausea (35%), and dehydration (34%), amongst others. Further study on the risks and benefits of hot yoga participation is required.

  17. Impact of a new mandatory reporting law on reporting and identification of child sexual abuse: A seven year time trend analysis.

    PubMed

    Mathews, Ben; Lee, Xing Ju; Norman, Rosana E

    2016-06-01

    Child sexual abuse is widespread and difficult to detect. To enhance case identification, many societies have enacted mandatory reporting laws requiring designated professionals, most often police, teachers, doctors and nurses, to report suspected cases to government child welfare agencies. Little research has explored the effects of introducing a reporting law on the number of reports made, and the outcomes of those reports. This study explored the impact of a new legislative mandatory reporting duty for child sexual abuse in the State of Western Australia over seven years. We analyzed data about numbers and outcomes of reports by mandated reporters, for periods before the law (2006-2008) and after the law (2009-2012). Results indicate that the number of reports by mandated reporters of suspected child sexual abuse increased by a factor of 3.7, from an annual mean of 662 in the three year pre-law period to 2448 in the four year post-law period. The increase in the first two post-law years was contextually and statistically significant. Report numbers stabilized in 2010-2012, at one report per 210 children. The number of investigated reports increased threefold, from an annual mean of 451 in the pre-law period to 1363 in the post-law period. Significant decline in the proportion of mandated reports that were investigated in the first two post-law years suggested the new level of reporting and investigative need exceeded what was anticipated. However, a subsequent significant increase restored the pre-law proportion, suggesting systemic adaptive capacity. The number of substantiated investigations doubled, from an annual mean of 160 in the pre-law period to 327 in the post-law period, indicating twice as many sexually abused children were being identified. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Reported behavior of eating anything at anytime and risk of colorectal cancer in women.

    PubMed

    Bao, Ying; Nimptsch, Katharina; Chan, Andrew T; Ng, Kimmie; Meyerhardt, Jeffrey A; Willett, Walter C; Giovannucci, Edward; Fuchs, Charles S

    2012-03-15

    Although numerous studies have assessed the effect of foods and nutrients on colorectal carcinogenesis, few studies have investigated human eating behavior in relation to risk of colorectal cancer. In our study, we assessed whether the reported behavior of eating anything at anytime influenced colorectal cancer risk and related plasma biomarkers. We prospectively followed up 55,540 women in the Nurses' Health Study who were aged 48-73 years, had no history of cancer, ulcerative colitis or diabetes and responded to the item "I eat anything I want, anytime I want" in the 1994 questionnaire. We also analyzed blood samples for 1,994 women, which were collected in 1989-1990. During 12 years of follow-up, 552 colorectal cancer cases were documented. After adjusting for age, smoking, body mass index, physical activity, red and processed meat and other known risk factors for colorectal cancer, women who reported eating anything at anytime experienced an increased risk of colorectal cancer (relative risk = 1.28, 95% confidence interval = 1.06-1.56) compared to those who did not report this behavior. In addition, reporting eating anything at anytime was associated with higher fasting plasma levels of insulin (p = 0.04) and C-peptide (p = 0.05). In conclusion, reports of eating anything at anytime are associated with an increased risk of colorectal cancer in this large prospective cohort study, independent of other potential risk factors for colorectal cancer. Copyright © 2011 UICC.

  19. The prevalence of pain in pediatric human immunodeficiency virus/acquired immunodeficiency syndrome as reported by participants in the Pediatric Late Outcomes Study (PACTG 219).

    PubMed

    Gaughan, Denise M; Hughes, Michael D; Seage, George R; Selwyn, Peter A; Carey, Vincent J; Gortmaker, Steven L; Oleske, James M

    2002-06-01

    As the life expectancy of children with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) increases, quality-of-life outcomes are of increasing concern. The prevalence of pain in adults with AIDS ranges from 40% to 60%, depending on stage of illness. There is limited research concerning pain in HIV-infected children and youth. The General Health Assessment for Children was administered to caregivers of HIV-infected children and youth enrolled in the Pediatric Late Outcomes Study (PACTG 219), a prospective cohort study. Pain is assessed over the previous month with 7 questions. For the purpose of this analysis, we defined pain as the presence of pain of at least moderate intensity. Participants were observed from January 1, 1996, to December 31, 1999. A total of 985 HIV-positive participants had a baseline pain evaluation in 1995. The prevalence of pain remained relatively constant during each year of observation, averaging 20%. Lower CD4+ T-lymphocyte percentage, female gender, and an HIV/AIDS-related diagnosis were highly associated with an increased risk of reported pain. Pain was also independently associated with increased risk of death. After adjusting for CD4 percentage, use of combination therapy including protease inhibitors, comorbid diagnoses, and other sociodemographic characteristics, individuals reporting pain were over 5 times more likely to die than those not reporting pain (hazard ratio = 5.07; 95% confidence interval = 3.23-7.95). Pain is a frequently encountered symptom in children and youth with HIV disease and is also associated with increased mortality. These findings emphasize the importance of pain management in this population.

  20. The spinal posture of computing adolescents in a real-life setting

    PubMed Central

    2014-01-01

    Background It is assumed that good postural alignment is associated with the less likelihood of musculoskeletal pain symptoms. Encouraging good sitting postures have not reported consequent musculoskeletal pain reduction in school-based populations, possibly due to a lack of clear understanding of good posture. Therefore this paper describes the variability of postural angles in a cohort of asymptomatic high-school students whilst working on desk-top computers in a school computer classroom and to report on the relationship between the postural angles and age, gender, height, weight and computer use. Methods The baseline data from a 12 month longitudinal study is reported. The study was conducted in South African school computer classrooms. 194 Grade 10 high-school students, from randomly selected high-schools, aged 15–17 years, enrolled in Computer Application Technology for the first time, asymptomatic during the preceding month, and from whom written informed consent were obtained, participated in the study. The 3D Posture Analysis Tool captured five postural angles (head flexion, neck flexion, cranio-cervical angle, trunk flexion and head lateral bend) while the students were working on desk-top computers. Height, weight and computer use were also measured. Individual and combinations of postural angles were analysed. Results 944 Students were screened for eligibility of which the data of 194 students are reported. Trunk flexion was the most variable angle. Increased neck flexion and the combination of increased head flexion, neck flexion and trunk flexion were significantly associated with increased weight and BMI (p = 0.0001). Conclusions High-school students sit with greater ranges of trunk flexion (leaning forward or reclining) when using the classroom computer. Increased weight is significantly associated with increased sagittal plane postural angles. PMID:24950887

  1. The Effectiveness of a Self-Reporting Bedside Pain Assessment Tool for Oncology Inpatients

    PubMed Central

    Kim, Eun Bi; Chung, Jung Hwa; Park, Bo Ram; Lim, Sung-nam; Yim, Kyoung Hoon; Shin, Young Duck; Lee, Ki Hyeong; Kim, Wun-Jae; Kim, Seung Taik

    2012-01-01

    Abstract Background Pain is common during cancer treatment, and patient self-reporting of pain is an essential first step for ideal cancer pain management. However, many studies on cancer pain management report that, because pain may be underestimated, it is often inadequately managed. Objective The aim of this study was to evaluate the effectiveness of bedside self-assessment of pain intensity for inpatients using a self-reporting pain board. Methods Fifty consecutive inpatients admitted to the Oncology Department of Chungbuk National University Hospital were included in this observational prospective study from February 2011 to December 2011. The medical staff performed pain assessments by asking patients questions and using verbal rated scales (VRS) over 3 consecutive days. Then, for 3 additional days, patients used a self-reporting pain board attached to the bed, which had movable indicators representing 0–10 on a numeric rating scale (NRS) and the frequency of breakthrough pain. Results Patient reliability over the medical staff's pain assessment increased from 74% to 96% after applying the self-reporting pain board (p=0.004). The gap (mean±standard deviation [SD]) between the NRS reported by patients and the NRS recorded on the medical records decreased from 3.16±2.08 to 1.00±1.02 (p<0.001), and the level of patient satisfaction with pain management increased from 54% to 82% (p=0.002). Conclusion This study suggests that the self-reporting bedside pain assessment tool provides a reliable and effective means of assessing pain in oncology inpatients. PMID:22974435

  2. Chronic idiopathic pain in adolescence--high prevalence and disability: the young HUNT Study 2008.

    PubMed

    Hoftun, Gry Børmark; Romundstad, Pål Richard; Zwart, John-Anker; Rygg, Marite

    2011-10-01

    The aim of this study was to determine the prevalence of self-reported chronic idiopathic pain among adolescents in relation to age and gender, and to explore how pain interferes with daily activities. The study was performed in Nord-Trøndelag County, Norway in 2006-2008. All adolescents were invited to participate; the response rate was 78%. Participants completed a comprehensive questionnaire, including questions about pain and interference with everyday life. Chronic idiopathic pain was defined as pain at least once a week during the last 3 months, not related to any known disease or injury. The final study population, with complete pain questionnaires, consisted of 7373 adolescents aged 13-18 years. Chronic pain was reported by 44.4% of the participants, and 25.5% reported pain in at least 2 locations. Chronic idiopathic musculoskeletal pain was most prevalent (33.4%), and the neck/shoulder was most commonly affected. Musculoskeletal pain in 3 or more locations was reported by 8.5%. Pain almost daily was reported by 10.2%. More girls than boys reported pain. In girls, the prevalence of pain increased with age. A high number of pain-associated disabilities were reported, and 58.5% described difficulties doing daily activities in leisure time. Subjective disabilities were higher in girls, and increased with the frequency of pain and the number of pain locations, as shown by high disability in adolescents with musculoskeletal pain in 3 or more locations. Chronic idiopathic pain, especially multisite pain, is common among adolescents, and those suffering from it report a major impact on several areas of daily living. Copyright © 2011 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  3. The incidence and aetiology of acute pancreatitis across Europe.

    PubMed

    Roberts, Stephen E; Morrison-Rees, Sian; John, Ann; Williams, John G; Brown, Tim H; Samuel, David G

    Acute pancreatitis is increasingly one of the most important acute gastrointestinal conditions throughout much of the world, although incidence and aetiology varies across countries and regions. This study investigated regional and national patterns in the incidence and aetiology of acute pancreatitis, demographic patterns in incidence and trends over time in incidence across Europe. A structured review of acute pancreatitis incidence and aetiology from studies of hospitalised patient case series, cohort studies or other population based studies from 1989 to 2015 and a review of trends in incidence from 1970 to 2015 across all 51 European states. The incidence of acute pancreatitis was reported from 17 countries across Europe and ranged from 4.6 to 100 per 100 000 population. Incidence was usually highest in eastern or northern Europe, although reported rates often varied according to case ascertainment criteria. Of 20 studies that reported on trends in incidence, all but three show percentage increases over time (overall median increase = 3.4% per annum; range = -0.4%-73%). The highest ratios of gallstone to alcohol aetiologies were identified in southern Europe (Greece, Turkey, Italy and Croatia) with lowest ratios mainly in eastern Europe (Latvia, Finland, Romania, Hungary, Russia and Lithuania). The incidence of acute pancreatitis varies across Europe. Gallstone is the dominant aetiology in southern Europe and alcohol in eastern Europe with intermediate ratios in northern and western Europe. Acute pancreatitis continues to increase throughout most of Europe. Copyright © 2017. Published by Elsevier B.V.

  4. Pilot study of the Korean Parent Training Program using a partial group randomized experimental study

    PubMed Central

    Kim, Eunjung; Cain, Kevin; Boutain, Doris; Chun, Jin-Joo; Kim, Sangho; Im, Hyesang

    2017-01-01

    Problems Korean American (KA) children experience mental health problems due to difficulties in parenting dysfunction complicated by living in two cultures. Methods Korean Parent Training Program (KPTP) was pilot tested with 48 KA mothers of children (ages 3–8) using partial group randomized controlled experimental study design. Self-report survey and observation data were gathered. Findings Analyses using generalized estimating equation indicated the intervention group mothers increased effective parenting and their children decreased behavior problems and reported less acculturation conflict with mothers. Conclusions The KPTP is a promising way to promote effective parenting and increase positive child mental health in KA families. PMID:24645901

  5. Shale gas activity and increased rates of sexually transmitted infections in Ohio, 2000-2016.

    PubMed

    Deziel, Nicole C; Humeau, Zoe; Elliott, Elise G; Warren, Joshua L; Niccolai, Linda M

    2018-01-01

    The growing shale gas ("fracking") industry depends on a mobile workforce, whose influx could have social impacts on host communities. Sexually transmitted infections (STIs) can increase through sexual mixing patterns associated with labor migration. No prior studies have quantified the relationship between shale gas activity and rates of three reportable STIs: chlamydia, gonorrhea, and syphilis. We conducted a longitudinal, ecologic study from 2000-2016 in Ohio, situated in a prolific shale gas region in the United States (US). Data on reported cases of chlamydia, gonorrhea, and syphilis by county and year were obtained from the Ohio Department of Health. All 88 counties were classified as none, low, and high shale gas activity in each year, using data from the Ohio Department of Natural Resources. Annual rate ratios (RR) and 95% confidence intervals (95% CIs) were calculated from mixed-effects Poisson regression models evaluating the relationship between shale gas activity and reported annual STI rates while adjusting for secular trends and potential confounders obtained from the US Census. Compared to counties with no shale gas activity, counties with high activity had 21% (RR = 1.21; 95%CI = 1.08-1.36) increased rates of chlamydia and 19% (RR = 1.27; 95%CI 0.98-1.44) increased rates of gonorrhea, respectively. No association was observed for syphilis. This first report of a link between shale gas activity and increased rates of both chlamydia and gonorrhea may inform local policies and community health efforts.

  6. Older Adult Consumer Knowledge, Attitudes, and Self-Reported Storage Practices of Ready-to-Eat Food Products and Risks Associated with Listeriosis.

    PubMed

    Evans, Ellen W; Redmond, Elizabeth C

    2016-02-01

    Consumer implementation of recommended food safety practices, specifically relating to time and temperature control of ready-to-eat (RTE) food products associated with listeriosis are crucial. This is particularly the case for at-risk consumers such as older adults, given the increased listeriosis incidence reported internationally among adults aged ≥60 years. However, data detailing older adults' cognitive risk factors associated with listeriosis are lacking. Combining data about knowledge, self-reported practices, and attitudes can achieve a cumulative multilayered in-depth understanding of consumer food safety behavior and cognition. This study aims to ascertain older adults' cognition and behavior in relation to domestic food handling and storage practices that may increase the risks associated with L. monocytogenes. Older adults (≥60 years) (n = 100) participated in an interview and questionnaire to determine knowledge, self-reported practices, and attitudes toward recommended practices. Although the majority (79%) had positive attitudes toward refrigeration, 84% were unaware of recommended temperatures (5°C) and 65% self-reported "never" checking their refrigerator temperature. Although most (72%) knew that "use-by" dates indicate food safety and 62% reported "always" taking note, neutral attitudes were held, with 67% believing it was safe to eat food beyond use-by dates and 57% reporting doing so. Attitudes toward consuming foods within the recommended 2 days of opening were neutral, with 55% aware of recommendations and , 84% reporting that they consume RTE foods beyond recommendations. Although knowledgeable of some key practices, older adults self-reported potentially unsafe practices when storing RTE foods at home, which may increase risks associated with L. monocytogenes. This study has determined that older adults' food safety cognition may affect their behaviors; understanding consumer food safety cognition is essential for developing targeted food safety education.

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

    PubMed

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

    2017-03-01

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

  8. The Study of the Character of Civil Rights Crimes in Massachusetts (1983-1987).

    ERIC Educational Resources Information Center

    McDevitt, Jack

    This report presents results of a research project designed to increase understanding of civil rights crime through a systematic description of the characteristics of incidents that occurred in Boston (Massachusetts) between 1983 and 1987. Data were taken from police incident reports and are limited to only those cases that were reported to the…

  9. Determination of University Athletes Character through Sport Participation in Niger Delta of Nigeria

    ERIC Educational Resources Information Center

    Dada, Benson Olu

    2016-01-01

    There are increasing reports concerning the character displayed by athletes on and off the field of play. These reports are not far different from the ones observed in Nigerian University sports. This worrisome report has necessitated this study carried out on determining the character of university athletes in Niger Delta region of Nigeria. The…

  10. Teachers' Reports of Outreach to School-Based Providers of Mental Health Services Following the 2013 Boston Marathon Attack

    ERIC Educational Resources Information Center

    Green, Jennifer Greif; Xuan, Ziming; Kwong, Lana; Holt, Melissa K.; Comer, Jonathan S.

    2016-01-01

    After mass crises, trauma-exposed children report increased psychological distress, yet most receive no mental health (MH) services and supports. This study identifies factors associated with teachers' reports of outreach to school-based MH providers (such as social workers, psychologists, and counselors) as well as provision of informal supports…

  11. Accuracy of self-reported intake of signature foods in a school meal intervention study: comparison between control and intervention period.

    PubMed

    Biltoft-Jensen, Anja; Damsgaard, Camilla Trab; Andersen, Rikke; Ygil, Karin Hess; Andersen, Elisabeth Wreford; Ege, Majken; Christensen, Tue; Sørensen, Louise Bergmann; Stark, Ken D; Tetens, Inge; Thorsen, Anne-Vibeke

    2015-08-28

    Bias in self-reported dietary intake is important when evaluating the effect of dietary interventions, particularly for intervention foods. However, few have investigated this in children, and none have investigated the reporting accuracy of fish intake in children using biomarkers. In a Danish school meal study, 8- to 11-year-old children (n 834) were served the New Nordic Diet (NND) for lunch. The present study examined the accuracy of self-reported intake of signature foods (berries, cabbage, root vegetables, legumes, herbs, potatoes, wild plants, mushrooms, nuts and fish) characterising the NND. Children, assisted by parents, self-reported their diet in a Web-based Dietary Assessment Software for Children during the intervention and control (packed lunch) periods. The reported fish intake by children was compared with their ranking according to fasting whole-blood EPA and DHA concentration and weight percentage using the Spearman correlations and cross-classification. Direct observation of school lunch intake (n 193) was used to score the accuracy of food-reporting as matches, intrusions, omissions and faults. The reporting of all lunch foods had higher percentage of matches compared with the reporting of signature foods in both periods, and the accuracy was higher during the control period compared with the intervention period. Both Spearman's rank correlations and linear mixed models demonstrated positive associations between EPA+DHA and reported fish intake. The direct observations showed that both reported and real intake of signature foods did increase during the intervention period. In conclusion, the self-reported data represented a true increase in the intake of signature foods and can be used to examine dietary intervention effects.

  12. The secret lives of experiments: methods reporting in the fMRI literature.

    PubMed

    Carp, Joshua

    2012-10-15

    Replication of research findings is critical to the progress of scientific understanding. Accordingly, most scientific journals require authors to report experimental procedures in sufficient detail for independent researchers to replicate their work. To what extent do research reports in the functional neuroimaging literature live up to this standard? The present study evaluated methods reporting and methodological choices across 241 recent fMRI articles. Many studies did not report critical methodological details with regard to experimental design, data acquisition, and analysis. Further, many studies were underpowered to detect any but the largest statistical effects. Finally, data collection and analysis methods were highly flexible across studies, with nearly as many unique analysis pipelines as there were studies in the sample. Because the rate of false positive results is thought to increase with the flexibility of experimental designs, the field of functional neuroimaging may be particularly vulnerable to false positives. In sum, the present study documented significant gaps in methods reporting among fMRI studies. Improved methodological descriptions in research reports would yield significant benefits for the field. Copyright © 2012 Elsevier Inc. All rights reserved.

  13. Risk for late-life re-injury, dementia and death among individuals with traumatic brain injury: a population-based study.

    PubMed

    Dams-O'Connor, Kristen; Gibbons, Laura E; Bowen, James D; McCurry, Susan M; Larson, Eric B; Crane, Paul K

    2013-02-01

    To determine the association of self-reported traumatic brain injury (TBI) with loss of consciousness (LOC) with late-life re-injury, dementia diagnosis and mortality. Ongoing longitudinal population-based prospective cohort study. Seattle-area integrated health system. 4225 dementia-free individuals age 65 and older were randomly selected and enrolled between 1994 and 2010. Participants were seen every 2 years, with mean (range) follow-up of 7.4 (0-16) years. 606 (14%) participants reported a lifetime history of TBI with LOC at enrolment. 3466 participants provided information regarding lifetime history of TBI and completed at least one follow-up visit. Self-reported TBI with LOC after study entry, incident all-cause dementia and Alzheimer's disease (AD), and all-cause mortality. There were 25 567 person-years of follow-up. History of TBI with LOC reported at study enrolment was associated with increased risk for TBI with LOC during follow-up, with adjusted HRs ranging from 2.54 (95% CI 1.42 to 4.52) for those reporting first injury before age 25 to 3.79 (95% CI 1.89 to 7.61) for those with first injury after age 55. History of TBI with LOC was not associated with elevated risk for developing dementia or AD. There was no association between baseline history of TBI with LOC and mortality, though TBI with LOC since the previous study visit ('recent TBI') was associated with increased mortality (HR 2.12, 95% CI 1.62 to 2.78). Individuals aged 65 or older who reported a history of TBI with LOC at any time in their lives were at elevated risk of subsequent re-injury. Recent TBI with LOC sustained in older adulthood was associated with increased risk for mortality. Findings support the need for close clinical monitoring of older adults who sustain a TBI with LOC.

  14. Use of Ergonomic Measures Related to Musculoskeletal Complaints among Construction Workers: A 2-year Follow-up Study

    PubMed Central

    Boschman, Julitta S.; Frings-Dresen, Monique H.W.; van der Molen, Henk F.

    2015-01-01

    Background The physical work demands of construction work can be reduced using ergonomic measures. The aim of this study was to evaluate the use of ergonomic measures related to musculoskeletal disorders (MSDs) among construction workers. Methods A questionnaire was sent at baseline and 2 years later to 1,130 construction workers. We established (1) the proportion of workers reporting an increase in their use of ergonomic measures, (2) the proportion of workers reporting a decrease in MSDs, (3) the relative risk for an increase in the use of ergonomic measures and a decrease in MSDs, and (4) workers' knowledge and opinions about the use of ergonomic measures. Results At follow-up, response rate was 63% (713/1,130). The proportion of workers using ergonomic measures for vertical transport increased (34%, 144/419, p < 0.01); for measures regarding horizontal transport and the positioning of materials, no change was reported. The proportion of workers reporting shoulder complaints decreased (28%, 176/638, p = 0.02). A relationship between the use of ergonomic measures and MSDs was not found; 83% (581/704) of the workers indicated having sufficient knowledge about ergonomic measures. Lightening the physical load was reported to be the main reason for using them. Conclusion Only the use of ergonomic measures for vertical transport increased over a 2-year period. No relationship between the use of ergonomic measures and MSDs was found. Strategies aimed at improving the availability of ergonomic equipment complemented with individualized advice and training in using them might be the required next steps to increase the use of ergonomic measures. PMID:26106507

  15. Infectious Disease in a Warming World: How Weather Influenced West Nile Virus in the United States (2001–2005)

    PubMed Central

    Soverow, Jonathan E.; Wellenius, Gregory A.; Fisman, David N.; Mittleman, Murray A.

    2009-01-01

    Background The effects of weather on West Nile virus (WNV) mosquito populations in the United States have been widely reported, but few studies assess their overall impact on transmission to humans. Objectives We investigated meteorologic conditions associated with reported human WNV cases in the United States. Methods We conducted a case–crossover study to assess 16,298 human WNV cases reported to the Centers for Disease Control and Prevention from 2001 to 2005. The primary outcome measures were the incidence rate ratio of disease occurrence associated with mean weekly maximum temperature, cumulative weekly temperature, mean weekly dew point temperature, cumulative weekly precipitation, and the presence of ≥ 1 day of heavy rainfall (≥ 50 mm) during the month prior to symptom onset. Results Increasing weekly maximum temperature and weekly cumulative temperature were similarly and significantly associated with a 35–83% higher incidence of reported WNV infection over the next month. An increase in mean weekly dew point temperature was significantly associated with a 9–38% higher incidence over the subsequent 3 weeks. The presence of at least 1 day of heavy rainfall within a week was associated with a 29–66% higher incidence during the same week and over the subsequent 2 weeks. A 20-mm increase in cumulative weekly precipitation was significantly associated with a 4–8% increase in incidence of reported WNV infection over the subsequent 2 weeks. Conclusions Warmer temperatures, elevated humidity, and heavy precipitation increased the rate of human WNV infection in the United States independent of season and each others’ effects. PMID:19654911

  16. Self-Reported and Observed Punitive Parenting Prospectively Predicts Increased Error-Related Brain Activity in Six-Year-Old Children.

    PubMed

    Meyer, Alexandria; Proudfit, Greg Hajcak; Bufferd, Sara J; Kujawa, Autumn J; Laptook, Rebecca S; Torpey, Dana C; Klein, Daniel N

    2015-07-01

    The error-related negativity (ERN) is a negative deflection in the event-related potential (ERP) occurring approximately 50 ms after error commission at fronto-central electrode sites and is thought to reflect the activation of a generic error monitoring system. Several studies have reported an increased ERN in clinically anxious children, and suggest that anxious children are more sensitive to error commission--although the mechanisms underlying this association are not clear. We have previously found that punishing errors results in a larger ERN, an effect that persists after punishment ends. It is possible that learning-related experiences that impact sensitivity to errors may lead to an increased ERN. In particular, punitive parenting might sensitize children to errors and increase their ERN. We tested this possibility in the current study by prospectively examining the relationship between parenting style during early childhood and children's ERN approximately 3 years later. Initially, 295 parents and children (approximately 3 years old) participated in a structured observational measure of parenting behavior, and parents completed a self-report measure of parenting style. At a follow-up assessment approximately 3 years later, the ERN was elicited during a Go/No-Go task, and diagnostic interviews were completed with parents to assess child psychopathology. Results suggested that both observational measures of hostile parenting and self-report measures of authoritarian parenting style uniquely predicted a larger ERN in children 3 years later. We previously reported that children in this sample with anxiety disorders were characterized by an increased ERN. A mediation analysis indicated that ERN magnitude mediated the relationship between harsh parenting and child anxiety disorder. Results suggest that parenting may shape children's error processing through environmental conditioning and thereby risk for anxiety, although future work is needed to confirm this hypothesis.

  17. Assessing Latina/o Undergraduates' Depressive Symptomatology: Comparisons of the Beck Depression Inventory-II, the Center for Epidemiological Studies-Depression Scale, and the Self-Report Depression Scale

    ERIC Educational Resources Information Center

    Gloria, Alberta M.; Castellanos, Jeanett; Kanagui-Munoz, Marlen; Rico, Melissa A.

    2012-01-01

    The use of depression scales as screening tools at university and college centers is increasing and thus, the question of whether scales are culturally valid for different student groups is increasingly more relevant with increased severity of depression for students and changing student demographics. As such, this study examined the reliability…

  18. Brave New Worlds: The Expanding Universe of Lyme Disease.

    PubMed

    Stone, Brandee L; Tourand, Yvonne; Brissette, Catherine A

    2017-09-01

    Projections around the globe suggest an increase in tick-vectored disease incidence and distribution, and the potential for emergence of novel tick-borne pathogens. Lyme disease is the most common reported tick-borne illness in the Unites States and is prevalent throughout much of central Europe. In recent years, the worldwide burden of Lyme disease has increased and extended into regions and countries where the disease was not previously reported. In this review, we discuss the trends for increasing Lyme disease, and examine the factors driving Lyme disease expansion, including the effect of climate change on the spread of vector Ixodid ticks and reservoir hosts; and the impacts of increased awareness on disease reporting and diagnosis. To understand the growing threat of Lyme disease, we need to study the interplay between vector, reservoir, and pathogen. In addition, we need to understand the contributions of climate conditions to changes in disease risk.

  19. Background Paper on State and Local Taxation.

    ERIC Educational Resources Information Center

    McLoone, Eugene

    This paper represents part of a comprehensive study of the existing New York State school support formulae. The report consists of (1) analysis of the 1969 State revenue increases -- wage increases and inflation, expansion of State and local government services, property tax relief, and increased annual revenue needs; (2) explication of factors…

  20. Adverse drug reactions of non-opioid and opioid analgesics reported to Croatian national authority from 2007 to 2014.

    PubMed

    Sunara, Petra; Krnic, Darko; Puljak, Livia

    2017-11-01

    Adverse drug reactions (ADRs) are commonly observed in the health services because of system weaknesses and individual errors. Analgesics are widely used and it can be expected that with the increased use one can expect increased number of ADRs of analgesics. The aim of this study was to analyze ADRs of non-opioid and opioid analgesics reported to the Croatian Agency for Medicinal Products and Medical Devices (HALMED) from 2007 to 2014. HALMED provided data on generic drug name, year of the ADR report, type of report, institution, reporting person, patient's age, sex and ADR type. In the analyzed period 796 ADRs of analgesics were reported, of which 367 (46%) were serious ADRs. Number of ADR reports was continuously increasing during the analyzed period. There were 20 analgesics that had ≥5 reports, making 597 (75%) of all ADR reports for analgesics. The most common adverse reaction reports of those 20 analgesics referred to individual drugs (n=16; 80%). Most of the ADR reports were filed by physicians (n=257; 43%), followed by pharmacists (n=252; 42%). Most side effects (n=572; 96%) were reported spontaneously through appropriate forms by patients or health professionals. ADRs were most commonly reported in women (n=352; 59%) and most of them have occurred in adults (n=354; 59%). The most common ADRs of opioid and non-opioid analgesics have been reported on the skin and mucous membranes. Most serious ADRs were result of action of opioid analgesics. Number of ADR reports in Croatia is continuously increasing and a considerable number of them refers to serious ADRs. To keep better track of medications and ADRs it is necessary to educate and encourage health professionals and patients in reporting side effects. Copyright © 2017 by Academy of Sciences and Arts of Bosnia and Herzegovina.

  1. Can Building Design Impact Physical Activity? A Natural Experiment.

    PubMed

    Eyler, Amy A; Hipp, Aaron; Valko, Cheryl Ann; Ramadas, Ramya; Zwald, Marissa

    2018-05-01

    Workplace design can impact workday physical activity (PA) and sedentary time. The purpose of this study was to evaluate PA behavior among university employees before and after moving into a new building. A pre-post, experimental versus control group study design was used. PA data were collected using surveys and accelerometers from university faculty and staff. Accelerometry was used to compare those moving into the new building (MOVERS) and those remaining in existing buildings (NONMOVERS) and from a control group (CONTROLS). Survey results showed increased self-reported PA for MOVERS and NONMOVERS. All 3 groups significantly increased in objectively collected daily energy expenditure and steps per day. The greatest steps per day increase was in CONTROLS (29.8%) compared with MOVERS (27.5%) and NONMOVERS (15.9%), but there were no significant differences between groups at pretest or posttest. Self-reported and objectively measured PA increased from pretest to posttest in all groups; thus, the increase cannot be attributed to the new building. Confounding factors may include contamination bias due to proximity of control site to experimental site and introduction of a university PA tracking contest during postdata collection. Methodology and results can inform future studies on best design practices for increasing PA.

  2. Increased growth and germination success in plants following hydrogen sulfide administration.

    PubMed

    Dooley, Frederick D; Nair, Suven P; Ward, Peter D

    2013-01-01

    This study presents a novel way of enhancing plant growth through the use of a non-petroleum based product. We report here that exposing either roots or seeds of multicellular plants to extremely low concentrations of dissolved hydrogen sulfide at any stage of life causes statistically significant increases in biomass including higher fruit yield. Individual cells in treated plants were smaller (~13%) than those of controls. Germination success and seedling size increased in, bean, corn, wheat, and pea seeds while time to germination decreases. These findings indicated an important role of H2S as a signaling molecule that can increase the growth rate of all species yet tested. The increased crop yields reported here has the potential to effect the world's agricultural output.

  3. Longitudinal Changes in Sexual Functioning as Women Transition Through Menopause: Results from the Study of Women’s Health Across the Nation (SWAN)

    PubMed Central

    Avis, Nancy E.; Brockwell, Sarah; Randolph, John F.; Shen, Shunhua; Cain, Virginia S.; Ory, Marcia; Greendale, Gail A.

    2009-01-01

    Objective Sexual functioning is an important component of women’s lives. The extent to which the menopause transition is associated with decreased sexual functioning remains inconclusive. This study seeks to determine if advancing through the menopause transition is associated with changes in sexual functioning. Design A prospective, longitudinal cohort study of women aged 42–52 at baseline recruited at 7 US sites (N=3302) in the Study of Women’s Health Across the Nation (SWAN). Cohort eligible women had an intact uterus, at least one ovary, were not currently using exogenous hormones, were either pre- or early perimenopausal, and self-identified as one of the study’s designated racial/ethnic groups. Data from the baseline interview and six annual follow-up visits are reported. Outcomes are self-reported ratings of importance of sex; frequency of sexual desire, arousal, masturbation, sexual intercourse, and pain during intercourse; degree of emotional satisfaction and physical pleasure. Results Adjusting for baseline age, chronological aging, and relevant social, health, and psychological parameters, the odds of reporting vaginal or pelvic pain increased and desire decreased by late perimenopause. Masturbation increased at early perimenopause, but declined during postmenopause. Menopausal transition was unrelated to other outcomes. Health, psychological functioning, and importance of sex were related to all sexual function outcomes. Age, race/ethnicity, marital status, change in relationship, and vaginal dryness were also associated with sexual functioning. Conclusions Pain during sexual intercourse increases and sexual desire decreases over the menopausal transition. Masturbation increases during the early transition, but then declines in postmenopause. Adjusting for other factors, the menopausal transition was not independently associated with reports of the importance of sex, sexual arousal, frequency of sexual intercourse, emotional satisfaction with partner, or physical pleasure. PMID:19212271

  4. Moderate High Fat Diet Increases Sucrose Self-Administration In Young Rats

    PubMed Central

    Figlewicz, Dianne P.; Jay, Jennifer L.; Acheson, Molly A.; Magrisso, Irwin J.; West, Constance H.; Zavosh, Aryana; Benoit, Stephen C.; Davis, Jon F.

    2012-01-01

    We have previously reported that a moderately high fat diet increases motivation for sucrose in adult rats. In this study, we tested the motivational, neurochemical, and metabolic effects of the high fat diet in male rats transitioning through puberty, during 5-8 weeks of age. We observed that the high fat diet increased motivated responding for sucrose, which was independent of either metabolic changes or changes in catecholamine neurotransmitter metabolites in the nucleus accumbens. However, AGRP mRNA levels in the hypothalamus were significantly elevated. We demonstrated that increased activation of AGRP neurons is associated with motivated behavior, and that exogenous (third cerebroventricular) AGRP administration resulted in significantly increased motivation for sucrose. These observations suggest that increased expression and activity of AGRP in the medial hypothalamus may underlie the increased responding for sucrose caused by the high fat diet intervention. Finally, we compared motivation for sucrose in pubertal vs. adult rats and observed increased motivation for sucrose in the pubertal rats, which is consistent with previous reports that young animals and humans have an increased preference for sweet taste, compared with adults. Together, our studies suggest that background diet plays a strong modulatory role in motivation for sweet taste in adolescent animals. PMID:23023044

  5. Smoking and depressive symptoms in a college population.

    PubMed

    Lee Ridner, S; Staten, Ruth R; Danner, Fred W

    2005-08-01

    A number of studies have documented the relationship between smoking and depression in adolescent and adult populations. The purpose of this study was to examine the level of depressive symptoms among college-age smokers and to determine whether or not increases in cigarette use were associated with increases in the number of depressive symptoms. A non-experimental cross-sectional design was used. Of the random sample (N = 895), 28% were current smokers, and more than 26% of the total sample reported high levels of depressive symptoms. Current smokers were more likely to report an increased level of depressive symptoms than nonsmokers were. Correlates of depressive symptoms included grade point average, marijuana use, and increased work hours. When controlling for these variables, the number of days smoked was predictive of depressive symptoms. School nurses have an important role in preventing smoking and treating smokers, as well as in preparing adolescents for the transition to college where many begin smoking.

  6. The association between self-reported versus nicotine metabolite-confirmed smoking status and coronary artery calcification.

    PubMed

    Kim, Byung Jin; Han, Ji Min; Kang, Jung Gyu; Kim, Bum Soo; Kang, Jin Ho

    2018-05-01

    There are no data comparing the relationship between coronary artery calcification and self-reported and cotinine-verified smoking. This study was carried out to evaluate the relationship between coronary artery calcium (CAC) and urinary cotinine or self-reported smoking status in Korean adults. Study participants included 22 797 individuals (19 181 men; mean age±SD 39.2±7.1 years) who were enrolled in the Kangbuk Samsung Health Study and Kangbuk Samsung Cohort Study between 2011 and 2013, and who had urinary cotinine and CAC measurements. Cotinine-verified current smokers were defined as having a urinary cotinine level of above 50 ng/ml. The prevalence of never smokers, former smokers, and current smokers according to the self-reported questionnaires was 44.6, 24.2, and 31.2%, respectively, and that of cotinine-verified current smokers was 30.2%. The prevalence of the presence of CAC in self-reported current smokers was higher than that in self-reported never/former smokers (13.7 vs. 10.2%, P<0.001), and that in cotinine-verified current smokers was higher than that in cotinine-verified never smokers (14.0 vs. 10.2%, P<0.001). A multivariate logistic regression model adjusted for the variables with univariate relationships showed that self-reported former smokers and current smokers had significantly increased odds ratio (OR) for the presence of CAC compared with self-reported never smokers [OR (95% confidence interval): 1.20 (1.03-1.40) in former smokers and 1.29 (1.11-1.50) in current smokers]. Cotinine-verified current smokers also showed a significant association with the presence of CAC [1.23 (1.12-1.35)]. Furthermore, log-transformed cotinine levels increased the OR for the presence of CAC [1.03 (1.01-1.05)]. This study is the first large cohort study to show that both self-reported and cotinine-verified smoking is associated independently with the presence of CAC in Korean adults.

  7. The effect of speaking rate on supersegmentals: An acoustic and perceptual analysis

    NASA Astrophysics Data System (ADS)

    Chiou, Hsin-Huei; Watson, Peter

    2005-09-01

    Rate manipulation has been used to study change in prosodic contrasts such as emphatic stress. Timing contrasts in stressed words are reduced or eliminated when speaking rate is increased. However, reports of intonation and rate change are mixed. Some studies have reported an increase of F0 movement [M. Steppling and A. Montgomery, J. Phonetics 64, 451-461 (2002)], and other reports have found that F0 movement is decreased at faster speaking rates [C. Fougeron and S. Jun, Percept. Psychophys. 26, 45-69 (1998)]. This study examined the effect of speaking rate on F0 and duration in sentences produced with emphatic stress in different sentential position and in declarative and interrogative forms. Essentially, durational contrasts were reduced at faster speaking rates and were more pronounced at slower speaking rates. Intonation, on the other hand, was more pronounced for the fast rate and somewhat reduced for the slow rate. A perceptual component will also be reported that examines a listener's ability to recognize stressed words and mode of sentence production (declarative and interrogative) at different speaking rates.

  8. The effect of organic farming systems on species diversity

    NASA Astrophysics Data System (ADS)

    Leksono, Amin Setyo

    2017-11-01

    Organic farming systems have been well known to support the diversity of a wide range of taxa, including microorganisms, arable flora, invertebrates, birds, and mammals, which benefit from organic management leading to increases in abundance and/or species richness. The objective of this paper is to review the effect of organic farming on species diversity reported in several articles and compare this with the current study in Gondanglegi, Malang. A review of several studies showed that organic farming systems have been reported to increase species diversity, including that of mammals, birds, arthropods, vascular plants and arbuscular mycorrhizal fungi. The researchers about arthropod groups consisted of carabid beetles, butterflies, wasps, predators, and bees. Agricultural landscape, habitat type, farming system, landscape composition and connectivity all contribute to explaining species biodiversity and richness. Moreover, based on current and relevant studies, the results showed that the application of refugia blocks has increased arthropod diversity and composition.

  9. Effectiveness of one-time psychoeducational programming for students with high levels of eating concerns.

    PubMed

    Tillman, Kathleen S; Sell, Darcie M; Yates, Lindsay A; Mueller, Nichole

    2015-12-01

    This study investigated the effectiveness of on-campus programming for National Eating Disorder Awareness Week at increasing knowledge of available treatment options and help-seeking intentions for participants with low and high levels of eating concerns. Program attendees were approached as they entered the space reserved for programming and were asked to participate in the study. One hundred thirty-six college students completed the study questionnaire both immediately before attending programming (pre-test) and immediately after attending programming (post-test). Results indicate that after programming both populations reported significantly greater knowledge of on-campus resources and help-seeking intentions for themselves. Only low eating concern participants reported significantly increased help-seeking intentions for a friend. Psychoeducational programming for eating disorders can be effective at increasing access to treatment and encouraging help seeking behaviors for students. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Instructions to rate genital vasocongestion increases genital and self-reported sexual arousal but not coherence between genital and self-reported sexual arousal.

    PubMed

    Prause, Nicole; Barela, James; Roberts, Verena; Graham, Cynthia

    2013-09-01

    Women are often reported to have a low coherence (often referred to as "discordance" in sexuality literature) between their genital response and self-reported sexual arousal. The purpose of this study was to determine whether differing instructions for rating sexual arousal would increase the coherence between genital response and self-reported arousal in women. Genital responses were recorded, using vaginal photoplethysmography, from 32 young women while they fantasized in three different conditions. Conditions instructed women to rate their overall sexual arousal, any physical cues, and genital blood flow. The primary outcome measure was the coherence of vaginal pulse amplitude (VPA) and reported sexual response in the three conditions. Unexpectedly, both VPA response and self-reported sexual arousal were higher when women were asked to rate their genital blood flow. Examining only participants who reported at least some sexual arousal in all conditions (n = 17), coherence was highest when women were instructed to rate overall sexual arousal. Results suggest that focusing on genital blood flow during sexual fantasy may increase women's (self-reported and genital) sexual response. Focusing on any physical arousal cues during sexual fantasy was associated with lower coherence of women's genital response and self-reported arousal compared with when they were instructed to rate their overall sexual arousal. © 2013 International Society for Sexual Medicine.

  11. Posttraumatic stress disorder, alcohol use, and perceived safety after the terrorist attack on the pentagon.

    PubMed

    Grieger, Thomas A; Fullerton, Carol S; Ursano, Robert J

    2003-10-01

    The authors examined posttraumatic stress disorder (PTSD), alcohol use, and perceptions of safety in a sample of survivors of the September 11, 2001, terrorist attack on the Pentagon. Analyses were conducted to examine the effect of past traumatic experience, trauma exposure, initial emotional response, and peritraumatic dissociation on probable PTSD, substance use, and perceived safety among 77 survivors seven months after the attack. Eleven respondents (14 percent) had PTSD. Those with PTSD reported higher levels of initial emotional response and peritraumatic dissociation. Ten respondents (13 percent) reported increased use of alcohol. Women were more than five times as likely as men to have PTSD and almost seven times as likely to report increased use of alcohol. Persons with higher peritraumatic dissociation were more likely to develop PTSD and report increased alcohol use. Those with lower perceived safety at seven months had higher initial emotional response and greater peritraumatic dissociation and were more likely to have PTSD, to have increased alcohol use, and to be female. The association of perceived safety with gender, the presence of PTSD, and increased alcohol use among survivors of the terrorist attack on the Pentagon warrants further study.

  12. [Patient safety: a comparison between handwritten and computerized voluntary incident reporting].

    PubMed

    Capucho, Helaine Carneiro; Arnas, Emilly Rasquini; Cassiani, Silvia Helena De Bortoli

    2013-03-01

    This study's objective was to compare two types of voluntary incident reporting methods that affect patient safety, handwritten (HR) and computerized (CR), in relation to the number of reports, type of incident reported the individual submitting the report, and quality of reports. This was a descriptive, retrospective and cross-sectional study. CR were more frequent than HR (61.2% vs. 38.6%) among the 1,089 reports analyzed and were submitted every day of the month, while HR were submitted only on weekdays. The highest number of reports referred to medication, followed by problems related to medical-hospital material and the professional who most frequently submitted reports were nurses in both cases. Overall CR presented higher quality than HR (86.1% vs. 61.7%); 36.8% of HR were illegible, a problem that was eliminated in CR. Therefore, the use of computerized incident reporting in hospitals favors qualified voluntary reports, increasing patient safety.

  13. The puzzle of self-reported weight gain in a month of fasting (Ramadan) among a cohort of Saudi families in Jeddah, Western Saudi Arabia

    PubMed Central

    2011-01-01

    Background During Ramadan fast, approximately one billion Muslims abstain from food and fluid between the hours of sunrise to sunset, and usually eat a large meal after sunset and another meal before sunrise. Many studies reported good health-related outcomes of fasting including weight loss. The objective of this study is to identify the local pattern of expenditure on food consumption, dietary habits during Ramadan and correlate that to self-reported weight gain after Ramadan in a group of families in Jeddah, Western Saudi Arabia. Methods A Cross-section study using a pre-designed questionnaire to identify the local pattern of expenditure on food consumption, dietary habits during Ramadan and correlate that to self-reported weight gain after Ramadan in a representative cohort of Saudis living in Jeddah. It was piloted on 173 nutrition students and administered by them to their families. Results A total of 173 Saudi families were interviewed. One out of 5 indicated that their expenditure increases during Ramadan. Approximately two thirds of the respondents (59.5%) reported weight gain after Ramadan. When asked about their perspective explanations for that: 40% attributed that to types of foods being rich in fat and carbohydrates particularly date in (Sunset meal) 97.7% and rice in (Dawn meal) 80.9%. One third (31.2%) indicated that it was due to relative lack of physical exercise in Ramadan and 14.5% referred that to increase in food consumption. Two thirds (65.2%) of those with increased expenditure reported weight gain. Conclusion Surprisingly weight gain and not weight loss was reported after Ramadan by Saudis which indicates timely needed life-style and dietary modification programs for a population which reports one of the highest prevalence rates of diabetes. PMID:21831261

  14. Reporting and Guidelines in Propensity Score Analysis: A Systematic Review of Cancer and Cancer Surgical Studies.

    PubMed

    Yao, Xiaoxin I; Wang, Xiaofei; Speicher, Paul J; Hwang, E Shelley; Cheng, Perry; Harpole, David H; Berry, Mark F; Schrag, Deborah; Pang, Herbert H

    2017-08-01

    : Propensity score (PS) analysis is increasingly being used in observational studies, especially in some cancer studies where random assignment is not feasible. This systematic review evaluates the use and reporting quality of PS analysis in oncology studies. : We searched PubMed to identify the use of PS methods in cancer studies (CS) and cancer surgical studies (CSS) in major medical, cancer, and surgical journals over time and critically evaluated 33 CS published in top medical and cancer journals in 2014 and 2015 and 306 CSS published up to November 26, 2015, without earlier date limits. The quality of reporting in PS analysis was evaluated. It was also compared over time and among journals with differing impact factors. All statistical tests were two-sided. More than 50% of the publications with PS analysis from the past decade occurred within the past two years. Of the studies critically evaluated, a considerable proportion did not clearly provide the variables used to estimate PS (CS 12.1%, CSS 8.8%), incorrectly included non baseline variables (CS 3.4%, CSS 9.3%), neglected the comparison of baseline characteristics (CS 21.9%, CSS 15.6%), or did not report the matching algorithm utilized (CS 19.0%, CSS 36.1%). In CSS, the reporting of the matching algorithm improved in 2014 and 2015 ( P  = .04), and the reporting of variables used to estimate PS was better in top surgery journals ( P  = .008). However, there were no statistically significant differences for the inclusion of non baseline variables and reporting of comparability of baseline characteristics. The use of PS in cancer studies has dramatically increased recently, but there is substantial room for improvement in the quality of reporting even in top journals. Herein we have proposed reporting guidelines for PS analyses that are broadly applicable to different areas of medical research that will allow better evaluation and comparison across studies applying this approach. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  15. Repeat dose NRPT (nicotinamide riboside and pterostilbene) increases NAD+ levels in humans safely and sustainably: a randomized, double-blind, placebo-controlled study.

    PubMed

    Dellinger, Ryan W; Santos, Santiago Roel; Morris, Mark; Evans, Mal; Alminana, Dan; Guarente, Leonard; Marcotulli, Eric

    2017-01-01

    NRPT is a combination of nicotinamide riboside (NR), a nicotinamide adenine dinucleotide (NAD +) precursor vitamin found in milk, and pterostilbene (PT), a polyphenol found in blueberries. Here, we report this first-in-humans clinical trial designed to assess the safety and efficacy of a repeat dose of NRPT (commercially known as Basis). NRPT was evaluated in a randomized, double-blind, and placebo-controlled study in a population of 120 healthy adults between the ages of 60 and 80 years. The study consisted of three treatment arms: placebo, recommended dose of NRPT (NRPT 1X), and double dose of NRPT (NRPT 2X). All subjects took their blinded supplement daily for eight weeks. Analysis of NAD + in whole blood demonstrated that NRPT significantly increases the concentration of NAD + in a dose-dependent manner. NAD + levels increased by approximately 40% in the NRPT 1X group and approximately 90% in the NRPT 2X group after 4 weeks as compared to placebo and baseline. Furthermore, this significant increase in NAD + levels was sustained throughout the entire 8-week trial. NAD + levels did not increase for the placebo group during the trial. No serious adverse events were reported in this study. This study shows that a repeat dose of NRPT is a safe and effective way to increase NAD + levels sustainably.

  16. Genetic risk of major depressive disorder: the moderating and mediating effects of neuroticism and psychological resilience on clinical and self-reported depression.

    PubMed

    Navrady, L B; Adams, M J; Chan, S W Y; Ritchie, S J; McIntosh, A M

    2017-11-29

    Polygenic risk scores (PRS) for depression correlate with depression status and chronicity, and provide causal anchors to identify depressive mechanisms. Neuroticism is phenotypically and genetically positively associated with depression, whereas psychological resilience demonstrates negative phenotypic associations. Whether increased neuroticism and reduced resilience are downstream mediators of genetic risk for depression, and whether they contribute independently to risk remains unknown. Moderating and mediating relationships between depression PRS, neuroticism, resilience and both clinical and self-reported depression were examined in a large, population-based cohort, Generation Scotland: Scottish Family Health Study (N = 4166), using linear regression and structural equation modelling. Neuroticism and resilience were measured by the Eysenck Personality Scale Short Form Revised and the Brief Resilience Scale, respectively. PRS for depression was associated with increased likelihood of self-reported and clinical depression. No interaction was found between PRS and neuroticism, or between PRS and resilience. Neuroticism was associated with increased likelihood of self-reported and clinical depression, whereas resilience was associated with reduced risk. Structural equation modelling suggested the association between PRS and self-reported and clinical depression was mediated by neuroticism (43-57%), while resilience mediated the association in the opposite direction (37-40%). For both self-reported and clinical diagnoses, the genetic risk for depression was independently mediated by neuroticism and resilience. Findings suggest polygenic risk for depression increases vulnerability for self-reported and clinical depression through independent effects on increased neuroticism and reduced psychological resilience. In addition, two partially independent mechanisms - neuroticism and resilience - may form part of the pathway of vulnerability to depression.

  17. Do later wake times and increased sleep duration of 12th graders result in more studying, higher grades, and improved SAT/ACT test scores?

    PubMed

    Cole, James S

    2016-09-01

    The aim of this study was to investigate the relationship between sleep duration, wake time, and hours studying on high school grades and performance on the Scholastic Aptitude Test (SAT)/ American College Testing (ACT) college entrance exams. Data were collected from 13,071 recently graduated high school seniors who were entering college in the fall of 2014. A column proportions z test with a Bonferroni adjustment was used to analyze proportional differences. Analysis of covariance (ANCOVA) was used to examine mean group differences. Students who woke up prior to 6 a.m. and got less than 8 h of sleep (27 %) were significantly more likely to report studying 11 or more hours per week (30 %), almost double the rate compared to students who got more than 8 h of sleep and woke up the latest (16 %). Post hoc results revealed students who woke up at 7 a.m. or later reported significantly higher high school grades than all other groups (p < 0.001), with the exception of those students who woke up between 6:01 a.m. and 7:00 a.m. and got eight or more hours of sleep. The highest reported SAT/ACT scores were from the group that woke up after 7 a.m. but got less than 8 h sleep (M = 1099.5). Their scores were significantly higher than all other groups. This study provides additional evidence that increased sleep and later wake time are associated with increased high school grades. However, this study also found that students who sleep the longest also reported less studying and lower SAT/ACT scores.

  18. Multispecies, Integrative GWAS for Focal Segmental Glomerulosclerosis

    DTIC Science & Technology

    2017-09-01

    project are to identify genetic determinants of focal segmental glomerulosclerosis (FSGS) using genomewide association studies in mouse strains. We have... methodology used shall be provided. As the project progresses to completion, the emphasis in reporting in this section should shift from reporting...development” activities result in increased knowledge or skill in one’s area of expertise and may include workshops, conferences, seminars, study

  19. Sexuality, Substance Use, and Susceptibility to Victimization: Risk for Rape and Sexual Coercion in a Prospective Study of College Women

    ERIC Educational Resources Information Center

    Messman-Moore, Terri L.; Coates, Aubrey A.; Gaffey, Kathryn J.; Johnson, Carrie F.

    2008-01-01

    An 8-month prospective study examined behavioral, personality, and psychological variables thought to increase vulnerability for college women's experience of rape and verbal sexual coercion. Participants were 276 college women who completed self-report surveys. During 1 academic year, 9.5% of women were raped and 11.7% reported verbal sexual…

  20. To Determine the Effectiveness of Board Game Simulations in the Grade Five Social Studies Program. Final Report 80-7.

    ERIC Educational Resources Information Center

    Green, Vicki A.

    The report describes a study designed to ascertain the effectiveness of 12 board game simulations developed and used in a fifth grade Canadian history program. Questions examined include: 1) Does the use of board game simulations increase group participation and cultural, environmental, and historical awareness? 2) Does use of the games promote…

  1. Systematic review of communication technologies to promote access and engagement of young people with diabetes into healthcare.

    PubMed

    Sutcliffe, Paul; Martin, Steven; Sturt, Jackie; Powell, John; Griffiths, Frances; Adams, Ann; Dale, Jeremy

    2011-01-06

    Research has investigated whether communication technologies (e.g. mobile telephony, forums, email) can be used to transfer digital information between healthcare professionals and young people who live with diabetes. The systematic review evaluates the effectiveness and impact of these technologies on communication. Nine electronic databases were searched. Technologies were described and a narrative synthesis of all studies was undertaken. Of 20,925 publications identified, 19 met the inclusion criteria, with 18 technologies assessed. Five categories of communication technologies were identified: video-and tele-conferencing (n = 2); mobile telephony (n = 3); telephone support (n = 3); novel electronic communication devices for transferring clinical information (n = 10); and web-based discussion boards (n = 1). Ten studies showed a positive improvement in HbA1c following the intervention with four studies reporting detrimental increases in HbA1c levels. In fifteen studies communication technologies increased the frequency of contact between patient and healthcare professional. Findings were inconsistent of an association between improvements in HbA1c and increased contact. Limited evidence was available concerning behavioural and care coordination outcomes, although improvement in quality of life, patient-caregiver interaction, self-care and metabolic transmission were reported for some communication technologies. The breadth of study design and types of technologies reported make the magnitude of benefit and their effects on health difficult to determine. While communication technologies may increase the frequency of contact between patient and health care professional, it remains unclear whether this results in improved outcomes and is often the basis of the intervention itself. Further research is needed to explore the effectiveness and cost effectiveness of increasing the use of communication technologies between young people and healthcare professionals.

  2. Systematic review of communication technologies to promote access and engagement of young people with diabetes into healthcare

    PubMed Central

    2011-01-01

    Background Research has investigated whether communication technologies (e.g. mobile telephony, forums, email) can be used to transfer digital information between healthcare professionals and young people who live with diabetes. The systematic review evaluates the effectiveness and impact of these technologies on communication. Methods Nine electronic databases were searched. Technologies were described and a narrative synthesis of all studies was undertaken. Results Of 20,925 publications identified, 19 met the inclusion criteria, with 18 technologies assessed. Five categories of communication technologies were identified: video-and tele-conferencing (n = 2); mobile telephony (n = 3); telephone support (n = 3); novel electronic communication devices for transferring clinical information (n = 10); and web-based discussion boards (n = 1). Ten studies showed a positive improvement in HbA1c following the intervention with four studies reporting detrimental increases in HbA1c levels. In fifteen studies communication technologies increased the frequency of contact between patient and healthcare professional. Findings were inconsistent of an association between improvements in HbA1c and increased contact. Limited evidence was available concerning behavioural and care coordination outcomes, although improvement in quality of life, patient-caregiver interaction, self-care and metabolic transmission were reported for some communication technologies. Conclusions The breadth of study design and types of technologies reported make the magnitude of benefit and their effects on health difficult to determine. While communication technologies may increase the frequency of contact between patient and health care professional, it remains unclear whether this results in improved outcomes and is often the basis of the intervention itself. Further research is needed to explore the effectiveness and cost effectiveness of increasing the use of communication technologies between young people and healthcare professionals. PMID:21210964

  3. Patriotism's Impact on Cooperation with the State: An Experimental Study on Tax Compliance.

    PubMed

    Gangl, Katharina; Torgler, Benno; Kirchler, Erich

    2016-12-01

    Although it seems reasonable to assume that activating patriotism might motivate citizens to cooperate with the state in reaching societal goals, the empirical evidence supporting this contention is based mostly on correlational rather than experimental studies. In addition, little is known on whether patriotism can be manipulated without simultaneously triggering nationalism and on the psychological processes which determine the patriotism-cooperation relation. This current article reports results of one survey and three experiments that manipulate patriotism by displaying either a national flag or national landscapes or by priming national achievements. The outcomes indicate that reported and manipulated patriotism indirectly increase tax compliance, although the national flag also increases nationalism. National achievements, on the other hand, seemingly increases trust in national public institutions and the voluntary motivation to cooperate, whereas national landscapes only increase the voluntary motivation to cooperate. Hence, it is possible to increase social capital in the form of trust and cooperation through patriotism without fostering nationalism as well.

  4. Patriotism's Impact on Cooperation with the State: An Experimental Study on Tax Compliance

    PubMed Central

    Torgler, Benno; Kirchler, Erich

    2015-01-01

    Although it seems reasonable to assume that activating patriotism might motivate citizens to cooperate with the state in reaching societal goals, the empirical evidence supporting this contention is based mostly on correlational rather than experimental studies. In addition, little is known on whether patriotism can be manipulated without simultaneously triggering nationalism and on the psychological processes which determine the patriotism‐cooperation relation. This current article reports results of one survey and three experiments that manipulate patriotism by displaying either a national flag or national landscapes or by priming national achievements. The outcomes indicate that reported and manipulated patriotism indirectly increase tax compliance, although the national flag also increases nationalism. National achievements, on the other hand, seemingly increases trust in national public institutions and the voluntary motivation to cooperate, whereas national landscapes only increase the voluntary motivation to cooperate. Hence, it is possible to increase social capital in the form of trust and cooperation through patriotism without fostering nationalism as well. PMID:27980350

  5. United States Data Center Energy Usage Report

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

    Shehabi, Arman; Smith, Sarah; Sartor, Dale

    This report estimates historical data center electricity consumption back to 2000, relying on previous studies and historical shipment data, and forecasts consumption out to 2020 based on new trends and the most recent data available. Figure ES-1 provides an estimate of total U.S. data center electricity use (servers, storage, network equipment, and infrastructure) from 2000-2020. In 2014, data centers in the U.S. consumed an estimated 70 billion kWh, representing about 1.8% of total U.S. electricity consumption. Current study results show data center electricity consumption increased by about 4% from 2010-2014, a large shift from the 24% percent increase estimated frommore » 2005-2010 and the nearly 90% increase estimated from 2000-2005. Energy use is expected to continue slightly increasing in the near future, increasing 4% from 2014-2020, the same rate as the past five years. Based on current trend estimates, U.S. data centers are projected to consume approximately 73 billion kWh in 2020.« less

  6. Report on Multicultural Education in "Pesantren"

    ERIC Educational Resources Information Center

    Raihani

    2012-01-01

    This article aims to report a single case study of how an Islamic boarding school ("pesantren") in Yogyakarta, Indonesia, prepared students for a multicultural Indonesia. Despite negative portrayal by the Western media about increasing Islamic radicalism in some "pesantren", many "pesantren" are in fact transforming…

  7. Malnutrition as an underlying cause of childhood deaths associated with infectious diseases in developing countries.

    PubMed Central

    Rice, A. L.; Sacco, L.; Hyder, A.; Black, R. E.

    2000-01-01

    INTRODUCTION: Recent estimates suggest that malnutrition (measured as poor anthropometric status) is associated with about 50% of all deaths among children. Although the association between malnutrition and all-cause mortality is well documented, the malnutrition-related risk of death associated with specific diseases is less well described. We reviewed published literature to examine the evidence for a relation between malnutrition and child mortality from diarrhoea, acute respiratory illness, malaria and measles, conditions that account for over 50% of deaths in children worldwide. METHODS: MEDLINE was searched for suitable review articles and original reports of community-based and hospital-based studies. Findings from cohort studies and case-control studies were reviewed and summarized. RESULTS: The strongest and most consistent relation between malnutrition and an increased risk of death was observed for diarrhoea and acute respiratory infection. The evidence, although limited, also suggests a potentially increased risk for death from malaria. A less consistent association was observed between nutritional status and death from measles. Although some hospital-based studies and case-control studies reported an increased risk of mortality from measles, few community-based studies reported any association. DISCUSSION: The risk of malnutrition-related mortality seems to vary for different diseases. These findings have important implications for the evaluation of nutritional intervention programmes and child survival programmes being implemented in settings with different disease profiles. PMID:11100616

  8. Sleep Loss Exacerbates Fatigue, Depression, and Pain in Rheumatoid Arthritis

    PubMed Central

    Irwin, Michael R.; Olmstead, Richard; Carrillo, Carmen; Sadeghi, Nina; FitzGerald, John D.; Ranganath, Veena K.; Nicassio, Perry M.

    2012-01-01

    Study Objectives: Disturbances of sleep are hypothesized to contribute to pain. However, experimental data are limited to healthy pain-free individuals. This study evaluated the effect of sleep loss during part of the night on daytime mood symptoms and pain perceptions in patients with rheumatoid arthritis in comparison with control subjects. Design: A between-groups laboratory study with assessment of mood symptoms and pain perception before and after partial night sleep deprivation (PSD; awake 23:00 hr to 03:00 hr). Setting: General clinical research center. Participants: Patients with rheumatoid arthritis (n = 27) and volunteer comparison control subjects (n = 27). Measurements: Subjective reports of sleep, mood symptoms and pain, polysomnographic assessment of sleep continuity, and subjective and objective assessment of rheumatoid arthritis-specific joint pain. Results: PSD induced differential increases in self-reported fatigue (P < 0.09), depression (P < 0.04), anxiety (P < 0.04), and pain (P < 0.01) in patients with rheumatoid arthritis compared with responses in control subjects, in whom differential increases of self-reported pain were independent of changes in mood symptoms, subjective sleep quality, and objective measures of sleep fragmentation. In the patients with rheumatoid arthritis, PSD also induced increases in disease-specific activity as indexed by self-reported pain severity (P < 0.01) and number of painful joints (P < 0.02) as well as clinician-rated joint counts (P < 0.03). Conclusion: This study provides the first evidence of an exaggerated increase in symptoms of mood and pain in patients with rheumatoid arthritis after sleep loss, along with an activation of rheumatoid arthritis-related joint pain. Given the reciprocal relationship between sleep disturbances and pain, clinical management of pain in patients with rheumatoid arthritis should include an increased focus on the prevention and treatment of sleep disturbance in this clinical population. Citation: Irwin MR; Olmstead R; Carrillo C; Sadeghi N; FitzGerald JD; Ranganath VK; Nicassio PM. Sleep loss exacerbates fatigue, depression, and pain in rheumatoid arthritis. SLEEP 2012;35(4):537-543. PMID:22467992

  9. Effectiveness of a Parent Health Report in Increasing Fruit and Vegetable Consumption Among Preschoolers and Kindergarteners.

    PubMed

    Hunsaker, Sanita L; Jensen, Chad D

    2017-05-01

    To determine the effectiveness of a parent health report on fruit and vegetable consumption among preschoolers and kindergarteners. Pre-post open design trial and a randomized controlled trial. A university-sponsored preschool and kindergarten. A total of 63 parents of preschool and kindergarten students participated in the pre-post open design trial and 65 parents participated in the randomized controlled trial. Parents in intervention groups were given a parent health report providing information about their child's fruit and vegetable intake as well as recommendations for how to increase their child's fruit and vegetable consumption. Change in fruit and vegetable consumption. Latent growth curve modeling with Bayesian estimation. Vegetable consumption increased by 0.3 servings/d in the open trial and 0.65 servings/d in the randomized trial. Fruit consumption did not increase significantly in either study. Results from both an open trial and a randomized controlled trial suggested that the parent health report may be a beneficial tool to increase vegetable consumption in preschoolers and kindergarteners. Increases in vegetable consumption can lead to the establishment of lifelong habits of healthy vegetable intake and decrease risk for chronic diseases. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  10. Self-perception of body fat changes and HAART adherence in the Women's Interagency HIV Study.

    PubMed

    Plankey, Michael; Bacchetti, Peter; Jin, Chengshi; Grimes, Barbara; Hyman, Charles; Cohen, Mardge; Howard, Andrea A; Tien, Phyllis C

    2009-02-01

    To determine the association of self-perceived fat gain or fat loss in central and peripheral body sites with adherence to highly active antiretroviral therapy (HAART) in HIV-seropositive women. 1,671 women from the Women's Interagency HIV Study who reported HAART use between April 1999 and March 2006 were studied. Adherence was defined as report of taking HAART >/= 95% of the time during the prior 6 months. Participant report of any increase or decrease in the chest, abdomen, or upper back in the prior 6 months defined central fat gain and central fat loss, respectively. Report of any increase or decrease in the face, arms, legs or buttocks in the prior 6 months defined peripheral fat gain or peripheral fat loss. Younger age, being African-American (vs. White non-Hispanic), a history of IDU, higher HIV RNA at the previous visit, and alcohol consumption were significant predictors of HAART non-adherence (P < 0.05). After multivariate adjustment, self-perception of central fat gain was associated with a 1.5-fold increased odds of HAART non-adherence compared to no change. Self-perception of fat gain in the abdomen was the strongest predictor of HAART non-adherence when the individual body sites were studied. Women who perceive central fat gain particularly in the abdomen are at risk for decreased adherence to HAART despite recent evidence to suggest that HIV and specific antiretroviral drugs are more commonly associated with fat loss than fat gain.

  11. Gauging the influence of increased search effort on reporting rates of bottlenose dolphin (Tursiops truncatus) strandings following the deepwater horizon oil spill.

    PubMed

    Pitchford, Jonathan L; Garcia, Michael; Pulis, Eric E; Ambert, Ashley Millan; Heaton, Andrew J; Solangi, Moby

    2018-01-01

    The co-occurrence of the Deepwater Horizon oil spill and the northern Gulf of Mexico cetacean Unusual Mortality Event have raised questions about the stability of inshore bottlenose dolphin (Tursiops truncatus) populations throughout the region. Several factors could have contributed to the ongoing event, but little attention has been paid to the potential effects of increased search effort and reporting of strandings associated with oil spill response activities, which were widespread for an extended period. This study quantified the influence of increased search effort by estimating the number of bottlenose dolphin strandings reported by oil spill responders and comparing monthly stranding rates with and without response-related records. Results showed that response teams reported an estimated 58% of strandings during the Active Response period within the study area. Comparison of Poisson rates tests showed that when responder-influenced stranding records were removed, the monthly stranding rates from the Active Response period (May 2010 -April 2014) were similar to the Post-Removal Actions Deemed Complete period (May 2013 -March 2015) (e.g., p = 0.83 for remote areas in Louisiana). Further, analyses using the Getis-Ord Gi* spatial statistic showed that when response-related stranding reports were removed from the Active Response period, significant spatial clustering of strandings (p < 0.05) was reduced by 48% in coastal Louisiana. Collectively, these results suggest that increased search effort resulting from the Deepwater Horizon oil spill response throughout remote portions of the Unusual Mortality Event geographic region had the capacity to increase reporting and recovery of marine mammal strandings to unusually high levels. To better understand how stranding data relates to actual mortality, more work is needed to quantify dolphin population size, population trends, and carcass detection rates including the role of search effort. This is vital for understanding the status of a protected species within the northern Gulf of Mexico.

  12. The power of friendship: protection against an escalating cycle of peer victimization.

    PubMed

    Hodges, E V; Boivin, M; Vitaro, F; Bukowski, W M

    1999-01-01

    This study examined 2 aspects of friendship (presence and perceived qualities of a best friend) as moderators of behavioral antecedents and outcomes of peer victimization. A total of 393 children (188 boys and 205 girls) in the 4th and 5th grades (mean age = 10 years 7 months) participated during each of 2 waves of data collection in this 1-year longitudinal study. Results indicated that teacher-reported internalizing and externalizing behaviors predicted increases in peer-reported victimization, but the relation of internalizing behaviors to increases in victimization was attenuated for children with a protective friendship. Victimization predicted increases in internalizing and externalizing behaviors but only for children without a mutual best friendship. Results highlight the importance of peer friendships in preventing an escalating cycle of peer abuse.

  13. Increased choline kinase activity in 1,2-dimethylhydrazine-induced rat colon cancer.

    PubMed

    Nakagami, K; Uchida, T; Ohwada, S; Koibuchi, Y; Morishita, Y

    1999-11-01

    Cancer cells acquire particular characteristics that benefit their proliferation. We previously reported that human colon cancers examined had increased choline kinase activity and phosphocholine levels. The elevated phosphocholine levels were in part due to both activation of choline kinase and increased choline kinase alpha protein levels. In this report, we analyzed choline kinase, which catalyzes the phosphorylation of choline to produce phosphocholine, in rat 1,2-dimethylhydrazine (DMH)-induced colon cancer. This study is the first to demonstrate increased choline kinase alpha enzymatic activity, protein levels, and mRNA levels in DMH-induced colon cancer as well as human colon cancer, although phosphocholine was not increased in DMH-induced rat cancer. The increase in the mRNA level was partly due to an increase in the transcription of the choline kinase alpha gene. The increased choline kinase activity may be a specific characteristic acquired by cancer cells that benefits their proliferation.

  14. Euthanasia in Belgium: trends in reported cases between 2003 and 2013.

    PubMed

    Dierickx, Sigrid; Deliens, Luc; Cohen, Joachim; Chambaere, Kenneth

    2016-11-01

    In 2002, the Belgian Act on Euthanasia came into effect, regulating the intentional ending of life by a physician at the patient's explicit request. We undertook this study to describe trends in officially reported euthanasia cases in Belgium with regard to patients' sociodemographic and clinical profiles, as well as decision-making and performance characteristics. We used the database of all euthanasia cases reported to the Federal Control and Evaluation Committee on Euthanasia in Belgium between Jan. 1, 2003, and Dec. 31, 2013 (n = 8752). The committee collected these data with a standardized registration form. We analyzed trends in patient, decision-making and performance characteristics using a χ 2 technique. We also compared and analyzed trends for cases reported in Dutch and in French. The number of reported euthanasia cases increased every year, from 235 (0.2% of all deaths) in 2003 to 1807 (1.7% of all deaths) in 2013. The rate of euthanasia increased significantly among those aged 80 years or older, those who died in a nursing home, those with a disease other than cancer and those not expected to die in the near future (p < 0.001 for all increases). Reported cases in 2013 most often concerned those with cancer (68.7%) and those under 80 years (65.0%). Palliative care teams were increasingly often consulted about euthanasia requests, beyond the legal requirements to do so (p < 0.001). Among cases reported in Dutch, the proportion in which the person was expected to die in the foreseeable future decreased from 93.9% in 2003 to 84.1% in 2013, and palliative care teams were increasingly consulted about the euthanasia request (from 34.0% in 2003 to 42.6% in 2013). These trends were not significant for cases reported in French. Since legalization of euthanasia in Belgium, the number of reported cases has increased each year. Most of those receiving euthanasia were younger than 80 years and were dying of cancer. Given the increases observed among non-terminally ill and older patients, this analysis shows the importance of detailed monitoring of developments in euthanasia practice. © 2016 Canadian Medical Association or its licensors.

  15. Euthanasia in Belgium: trends in reported cases between 2003 and 2013

    PubMed Central

    Dierickx, Sigrid; Deliens, Luc; Cohen, Joachim; Chambaere, Kenneth

    2016-01-01

    Background: In 2002, the Belgian Act on Euthanasia came into effect, regulating the intentional ending of life by a physician at the patient’s explicit request. We undertook this study to describe trends in officially reported euthanasia cases in Belgium with regard to patients’ sociodemographic and clinical profiles, as well as decision-making and performance characteristics. Methods: We used the database of all euthanasia cases reported to the Federal Control and Evaluation Committee on Euthanasia in Belgium between Jan. 1, 2003, and Dec. 31, 2013 (n = 8752). The committee collected these data with a standardized registration form. We analyzed trends in patient, decision-making and performance characteristics using a χ2 technique. We also compared and analyzed trends for cases reported in Dutch and in French. Results: The number of reported euthanasia cases increased every year, from 235 (0.2% of all deaths) in 2003 to 1807 (1.7% of all deaths) in 2013. The rate of euthanasia increased significantly among those aged 80 years or older, those who died in a nursing home, those with a disease other than cancer and those not expected to die in the near future (p < 0.001 for all increases). Reported cases in 2013 most often concerned those with cancer (68.7%) and those under 80 years (65.0%). Palliative care teams were increasingly often consulted about euthanasia requests, beyond the legal requirements to do so (p < 0.001). Among cases reported in Dutch, the proportion in which the person was expected to die in the foreseeable future decreased from 93.9% in 2003 to 84.1% in 2013, and palliative care teams were increasingly consulted about the euthanasia request (from 34.0% in 2003 to 42.6% in 2013). These trends were not significant for cases reported in French. Interpretation: Since legalization of euthanasia in Belgium, the number of reported cases has increased each year. Most of those receiving euthanasia were younger than 80 years and were dying of cancer. Given the increases observed among non–terminally ill and older patients, this analysis shows the importance of detailed monitoring of developments in euthanasia practice. PMID:27620630

  16. Self-reported mindfulness and cortisol during a Shamatha meditation retreat.

    PubMed

    Jacobs, Tonya L; Shaver, Phillip R; Epel, Elissa S; Zanesco, Anthony P; Aichele, Stephen R; Bridwell, David A; Rosenberg, Erika L; King, Brandon G; Maclean, Katherine A; Sahdra, Baljinder K; Kemeny, Margaret E; Ferrer, Emilio; Wallace, B Alan; Saron, Clifford D

    2013-10-01

    Cognitive perseverations that include worry and rumination over past or future events may prolong cortisol release, which in turn may contribute to predisease pathways and adversely affect physical health. Meditation training may increase self-reported mindfulness, which has been linked to reductions in cognitive perseverations. However, there are no reports that directly link self-reported mindfulness and resting cortisol output. Here, the authors investigate this link. In an observational study, we measured self-reported mindfulness and p.m. cortisol near the beginning and end of a 3-month meditation retreat (N = 57). Mindfulness increased from pre- to post-retreat, F(1, 56) = 36.20, p < .001. Cortisol did not significantly change. However, mindfulness was inversely related to p.m. cortisol at pre-retreat, r(53) = -.31, p < .05, and post-retreat, r(53) = -.30, p < .05, controlling for age and body mass index. Pre to postchange in mindfulness was associated with pre to postchange in p.m. cortisol, β = -.37, t(49) = 2.30, p < .05: Larger increases in mindfulness were associated with decreases in p.m. cortisol, whereas smaller increases (or slight decreases) in mindfulness were associated with an increase in p.m. cortisol. These data suggest a relation between self-reported mindfulness and resting output of the hypothalamic-pituitary-adrenal system. Future work should aim to replicate this finding in a larger cohort and determine stronger inference about causality by using experimental designs that include control-group conditions. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

  17. Increasing value and reducing waste: addressing inaccessible research

    PubMed Central

    Chan, An-Wen; Song, Fujian; Vickers, Andrew; Jefferson, Tom; Dickersin, Kay; Gøtzsche, Peter C.; Krumholz, Harlan M.; Ghersi, Davina; van der Worp, H. Bart

    2015-01-01

    The study protocol, publications, full study report detailing all analyses, and participant-level dataset constitute the main documentation of methods and results for health research. However, journal publications are available for only half of all studies and are plagued by selective reporting of methods and results. The protocol, full study report, and participant-level dataset are rarely available. The quality of information provided in study protocols and reports is variable and often incomplete. Inaccessibility of full information for the vast majority of studies wastes billions of dollars, introduces bias, and has a detrimental impact on patient care and research. To help improve this situation at a systemic level, three main actions are warranted. Firstly, it is important that academic institutions and funders reward investigators who fully disseminate their research protocols, reports, and participant-level datasets. Secondly, standards for the content of protocols, full study reports, and data sharing practices should be rigorously developed and adopted for all types of health research. Finally, journals, funders, sponsors, research ethics committees, regulators, and legislators should implement and enforce policies supporting study registration and availability of journal publications, full study reports, and participant-level datasets. PMID:24411650

  18. Gender Differences in the Relationship between Discrimination and Substance Use Disorder among Latinos

    PubMed Central

    Ornelas, India J.; Hong, Seunghye

    2013-01-01

    Using data from the National Latino and Asian American Study collected in 2002–2003 (N=2,554), we assessed the adjusted odds of lifetime substance use disorder (SUD) associated with report of both unfair treatment and racial/ethnic discrimination. Among men, SUD was increased for those reporting low, moderate, and high levels of unfair treatment compared to those reporting no unfair treatment and patterns were similar for racial/ethnic discrimination. Among women, only those reporting high levels of unfair treatment were at increased risk of lifetime SUD and no associations were observed between racial/ethnic discrimination and lifetime SUD. Future research should examine the role discrimination plays in the development of substance misuse among Latinos. PMID:22950437

  19. Performing Well on Nursing Home Report Cards: Does It Pay Off?

    PubMed Central

    Park, Jeongyoung; Konetzka, R Tamara; Werner, Rachel M

    2011-01-01

    Objective To examine whether high performance or improvement on quality measures leads to economic rewards for nursing homes in the presence of public reporting. Data Sources Data from 6,286 freestanding Medicare-certified nursing homes between 1999 and 2005 were identified in Medicare Cost Reports, Minimum Data Set, and Online Survey and Certification Reporting System. Study Design Using a facility-level fixed-effects model, the effect of public reporting on financial performance was measured by comparing each of four financial outcomes (revenues, expenses, operating, and total profit margins) before (1999–2002) to after (2003–2005) public reporting was initiated. The effects were estimated separately by level of performance and improvement over time. Principal Findings Facilities that improved on publicly reported performance had increased revenues and higher profit margins after public reporting, mainly through increased Medicare admissions. High-scoring facilities showed similar patterns, though differences were not statistically significant. Conclusions Providers that improve their performance under public reporting may receive a return on their investment in quality improvement. This supports the business case for public reporting. PMID:21029093

  20. Negative mood and interference control in nonsuicidal self-injury.

    PubMed

    Allen, Kenneth J D; Hooley, Jill M

    2017-02-01

    People who engage in nonsuicidal self-injury (NSSI) often report high levels of impulsivity. However, results from behavioral tasks measuring impulsivity have been mixed: those with a history of NSSI generally perform comparably to healthy controls. Recent research suggests, however, that people who self-injure have specific deficits in response inhibition to negative emotional stimuli. Here, we extend this work by testing whether negative mood impairs interference control in NSSI. 33 participants reporting a history of NSSI (approximately half in the past year) and 31 age- and gender-matched healthy controls completed the multi-source interference task before and after a written negative mood induction designed to increase feelings of worthlessness, guilt, and shame. After the induction, the NSSI group reported increased negative mood but did not show worse interference control. In other words, increased negative mood did not correspond to increased behavioral impulsivity in participants reporting NSSI. Consistent with past research, the NSSI and healthy control groups showed equivalent task performance. This study adds to evidence that NSSI is not characterized by behavioral impulsivity, even in the context of negative mood. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Hypnotic Medications and Suicide: Risk, Mechanisms, Mitigation, and the FDA.

    PubMed

    McCall, W Vaughn; Benca, Ruth M; Rosenquist, Peter B; Riley, Mary Anne; McCloud, Laryssa; Newman, Jill C; Case, Doug; Rumble, Meredith; Krystal, Andrew D

    2017-01-01

    Insomnia is associated with increased risk for suicide. The Food and Drug Administration (FDA) has mandated that warnings regarding suicide be included in the prescribing information for hypnotic medications. The authors conducted a review of the evidence for and against the claim that hypnotics increase the risk of suicide. This review focused on modern, FDA-approved hypnotics, beginning with the introduction of benzodiazepines, limiting its findings to adults. PubMed and Web of Science were searched, crossing the terms "suicide" and "suicidal" with each of the modern FDA-approved hypnotics. The FDA web site was searched for postmarketing safety reviews, and the FDA was contacted with requests to provide detailed case reports for hypnotic-related suicide deaths reported through its Adverse Event Reporting System. Epidemiological studies show that hypnotics are associated with an increased risk for suicide. However, none of these studies adequately controlled for depression or other psychiatric disorders that may be linked with insomnia. Suicide deaths have been reported from single-agent hypnotic overdoses. A separate concern is that benzodiazepine receptor agonist hypnotics can cause parasomnias, which in rare cases may lead to suicidal ideation or suicidal behavior in persons who were not known to be suicidal. On the other hand, ongoing research is testing whether treatment of insomnia may reduce suicidality in adults with depression. The review findings indicate that hypnotic medications are associated with suicidal ideation. Future studies should be designed to assess whether increases in suicidality result from CNS impairments from a given hypnotic medication or whether such medication decreases suicidality because of improvements in insomnia.

  2. Dextromethorphan Abuse in Adolescence

    PubMed Central

    Bryner, Jodi K.; Wang, Uerica K.; Hui, Jenny W.; Bedodo, Merilin; MacDougall, Conan; Anderson, Ilene B.

    2008-01-01

    Objectives To analyze the trend of dextromethorphan abuse in California and to compare these findings with national trends. Design A 6-year retrospective review. Setting California Poison Control System (CPCS), American Association of Poison Control Centers (AAPCC), and Drug Abuse Warning Network (DAWN) databases from January 1, 1999, to December 31, 2004. Participants All dextromethorphan abuse cases reported to the CPCS, AAPCC, and DAWN. The main exposures of dextromethorphan abuse cases included date of exposure, age, acute vs long-term use, coingestants, product formulation, and clinical outcome. Main Outcome Measure The annual proportion of dextromethorphan abuse cases among all exposures reported to the CPCS, AAPCC, and DAWN databases. Results A total of 1382 CPCS cases were included in the study. A 10-fold increase in CPCS dextromethorphan abuse cases from 1999 (0.23 cases per 1000 calls) to 2004 (2.15 cases per 1000 calls) (odds ratio, 1.48; 95% confidence interval, 1.43–1.54) was identified. Of all CPCS dextromethorphan abuse cases, 74.5% were aged 9 to 17 years; the frequency of cases among this age group increased more than 15-fold during the study (from 0.11 to 1.68 cases per 1000 calls). Similar trends were seen in the AAPCC and DAWN databases. The highest frequency of dextromethorphan abuse occurred among adolescents aged 15 and 16 years. The most commonly abused product was Coricidin HBP Cough & Cold Tablets. Conclusions Our study revealed an increasing trend of dextromethorphan abuse cases reported to the CPCS that is paralleled nationally as reported to the AAPCC and DAWN. This increase was most evident in the adolescent population. PMID:17146018

  3. The Effect of Multiprofessional Simulation-Based Obstetric Team Training on Patient-Reported Quality of Care: A Pilot Study.

    PubMed

    Truijens, Sophie E M; Banga, Franyke R; Fransen, Annemarie F; Pop, Victor J M; van Runnard Heimel, Pieter J; Oei, S Guid

    2015-08-01

    This study aimed to explore whether multiprofessional simulation-based obstetric team training improves patient-reported quality of care during pregnancy and childbirth. Multiprofessional teams from a large obstetric collaborative network in the Netherlands were trained in teamwork skills using the principles of crew resource management. Patient-reported quality of care was measured with the validated Pregnancy and Childbirth Questionnaire (PCQ) at 6 weeks postpartum. Before the training, 76 postpartum women (sample I) completed the questionnaire 6 weeks postpartum. Three months after the training, another sample of 68 postpartum women (sample II) completed the questionnaire. In sample II (after the training), the mean (SD) score of 108.9 (10.9) on the PCQ questionnaire was significantly higher than the score of 103.5 (11.6) in sample I (before training) (t = 2.75, P = 0.007). The effect size of the increase in PCQ total score was 0.5. Moreover, the subscales "personal treatment during pregnancy" and "educational information" showed a significant increase after the team training (P < 0.001). Items with the largest increase in mean scores included communication between health care professionals, clear leadership, involvement in planning, and better provision of information. Despite the methodological restrictions of a pilot study, the preliminary results indicate that multiprofessional simulation-based obstetric team training seems to improve patient-reported quality of care. The possibility that this improvement relates to the training is supported by the fact that the items with the largest increase are about the principles of crew resource management, used in the training.

  4. Auditory driving of the autonomic nervous system: Listening to theta-frequency binaural beats post-exercise increases parasympathetic activation and sympathetic withdrawal.

    PubMed

    McConnell, Patrick A; Froeliger, Brett; Garland, Eric L; Ives, Jeffrey C; Sforzo, Gary A

    2014-01-01

    Binaural beats are an auditory illusion perceived when two or more pure tones of similar frequencies are presented dichotically through stereo headphones. Although this phenomenon is thought to facilitate state changes (e.g., relaxation), few empirical studies have reported on whether binaural beats produce changes in autonomic arousal. Therefore, the present study investigated the effects of binaural beating on autonomic dynamics [heart rate variability (HRV)] during post-exercise relaxation. Subjects (n = 21; 18-29 years old) participated in a double-blind, placebo-controlled study during which binaural beats and placebo were administered over two randomized and counterbalanced sessions (within-subjects repeated-measures design). At the onset of each visit, subjects exercised for 20-min; post-exercise, subjects listened to either binaural beats ('wide-band' theta-frequency binaural beats) or placebo (carrier tones) for 20-min while relaxing alone in a quiet, low-light environment. Dependent variables consisted of high-frequency (HF, reflecting parasympathetic activity), low-frequency (LF, reflecting sympathetic and parasympathetic activity), and LF/HF normalized powers, as well as self-reported relaxation. As compared to the placebo visit, the binaural-beat visit resulted in greater self-reported relaxation, increased parasympathetic activation and increased sympathetic withdrawal. By the end of the 20-min relaxation period there were no observable differences in HRV between binaural-beat and placebo visits, although binaural-beat associated HRV significantly predicted subsequent reported relaxation. Findings suggest that listening to binaural beats may exert an acute influence on both LF and HF components of HRV and may increase subjective feelings of relaxation.

  5. Hypnotic medications and suicide: risk, mechanisms, mitigation, and the FDA

    PubMed Central

    McCall, W. Vaughn; Benca, Ruth M.; Rosenquist, Peter B.; Riley, Mary Anne; McCloud, Laryssa; Newman, Jill C.; Case, Doug; Rumble, Meredith; Krystal, Andrew D.

    2016-01-01

    Objective Insomnia is associated with increased risk for suicide. The Food and Drug Administration (FDA) has warnings regarding suicide in the prescribing information of hypnotics. We conducted a review of the evidence for and against hypnotics increasing the risk of suicide. Method This review focused on modern, FDA-approved hypnotics, beginning with the introduction of benzodiazepines, limiting its findings to adults. PubMed and Web of Science were searched, crossing the terms ‘suicide’ and ‘suicidal’ with each of the modern FDA-approved hypnotics. The FDA website was searched for post-marketing safety reviews, and the FDA was contacted to provide detailed case reports for hypnotic-related suicide deaths reported through its Adverse Event Report system. Results The epidemiological studies show that hypnotics are associated with increased risk for suicide. However, none of these studies adequately controlled for depression or other psychiatric disorders that may be linked with insomnia. Suicide deaths have been reported from single-agent hypnotic overdoses. A separate concern is that benzodiazepine receptor agonist hypnotics can cause parasomnias, which in rare cases may lead to suicidal ideation or suicidal behavior in persons who were not known to be previously suicidal. On the other hand, ongoing research is testing whether treatment of insomnia might reduce suicidality in depressed adults. Conclusions This review indicates hypnotic medications are associated with suicidal ideation. Future studies should be designed to assess both types of possible effects: 1) an increase in suicidality due to central nervous system impairments from a given hypnotic medication; and 2) a decrease in suicidality due to improving insomnia. PMID:27609243

  6. Occlusal wear and occlusal condition in a convenience sample of young adults.

    PubMed

    Van't Spijker, A; Kreulen, C M; Bronkhorst, E M; Creugers, N H J

    2015-01-01

    To study progression of tooth wear quantitatively in a convenient sample of young adults and to assess possible correlations with occlusal conditions. Twenty-eight dental students participated in a three-year follow up study on tooth wear. Visible wear facets on full arch gypsum casts were assessed using a flatbed scanner and measuring software. Regression analyses were used to assess possible associations between the registered occlusal conditions 'occlusal guidance scheme', 'vertical overbite', 'horizontal overbite', 'depth of sagittal curve', 'canine Angle class relation', 'history of orthodontic treatment', and 'self-reported grinding/clenching' (independent variables) and increase of wear facets (dependent variable). Mean increase in facet surface areas ranged from 1.2 mm2 (premolars, incisors) to 3.4 mm2 (molars); the relative increase ranged from 15% to 23%. Backward regression analysis showed no significant relation for 'group function', 'vertical overbite', 'depth of sagittal curve', 'history of orthodontic treatment' nor 'self-reported clenching. The final multiple linear regression model showed significant associations amongst 'anterior protected articulation' and 'horizontal overbite' and increase of facet surface areas. For all teeth combined, only 'anterior protected articulation' had a significant effect. 'Self reported grinding' did not have a significant effect (p>0.07). In this study 'anterior protected articulation' and 'horizontal overbite', were significantly associated with the progression of tooth wear. Self reported grinding was not significantly associated with progression of tooth wear. Occlusal conditions such as anterior protected articulation and horizontal overbite seem to have an effect on the progression of occlusal tooth wear in this convenient sample of young adults. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Enhanced Area of Secondary Hyperalgesia in Women with Multiple Stressful Life Events: A Pilot Study.

    PubMed

    You, Dokyoung S; Creech, Suzannah K; Meagher, Mary W

    2016-10-01

    Stressful life events are associated with increased pain severity and chronicity. However, the mechanism underlying this association remains disputed. Recent animal studies suggest that chronic stress increases pain sensitivity and persistence by enhancing peripheral and central sensitization mechanisms. To test this hypothesis in humans, the authors examined whether sensitization is enhanced in healthy women reporting more stressful life events using the topical capsaicin test. Thirty-two healthy young women reporting varying levels of stressful life events were invited for laboratory pain testing. Capsaicin was applied topically to the volar forearm. Measurements included capsaicin-induced spontaneous pain and area of secondary hyperalgesia in the region surrounding capsaicin application. Physiological (heart rate and skin conductance) and self-reported affective (emotional valence and arousal) states were also measured. The results indicate that more stressful life events predicted a linear increase in the area of secondary hyperalgesia (β = 0.40, p = 0.023, R 2 = 0.16), but not the intensity of secondary hyperalgesia nor capsaicin-induced spontaneous pain. These findings suggest that life stressors may be associated with heightened central sensitization manifested by an increased area of secondary hyperalgesia. Additionally, life stressors were related to greater sympathetic cardiac, but not to affective responses to capsaicin-induced pain. This study shows that women reporting more stressful life events show a larger area of secondary mechanical hyperalgesia. These preliminary findings suggest that life stressors may facilitate pain processing by enhancing central sensitization. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  8. "Low Testosterone Levels in Body Fluids Are Associated With Chronic Periodontitis".

    PubMed

    Kellesarian, Sergio Varela; Malmstrom, Hans; Abduljabbar, Tariq; Vohra, Fahim; Kellesarian, Tammy Varela; Javed, Fawad; Romanos, Georgios E

    2017-03-01

    There is a debate over the association between low testosterone levels in body fluids and the occurrence of chronic periodontitis (CP). The aim of the present systematic review was to assess whether low testosterone levels in body fluids reflect CP. In order to identify studies relevant to the focus question: "Is there a relationship between low testosterone levels in body fluids and CP?" an electronic search without time or language restrictions was conducted up to June 2016 in indexed databases using different keywords: periodontitis, chronic periodontitis, periodontal diseases, testosterone, and gonadal steroid hormones. A total of eight studies were included in the present systematic review. The number of study participants ranged from 24 to 1,838 male individuals with ages ranging from 15 to 95 years. Seven studies measured testosterone levels in serum, two studies in saliva, and one study in gingiva. Four studies reported a negative association between serum testosterone levels and CP. Two studies reported a positive association between decreased testosterone levels in serum and CP. Increased levels of salivary testosterone among patients with CP were reported in one study; whereas one study reported no significant difference in the concentration of salivary testosterone between patients with and without CP. One study identified significant increase in the metabolism of testosterone in the gingiva of patients with CP. Within the limits of the evidence available, the relationship between low testosterone levels and CP remains debatable and further longitudinal studies and control trials are needed.

  9. “Low Testosterone Levels in Body Fluids Are Associated With Chronic Periodontitis”

    PubMed Central

    Kellesarian, Sergio Varela; Malmstrom, Hans; Abduljabbar, Tariq; Vohra, Fahim; Kellesarian, Tammy Varela; Javed, Fawad; Romanos, Georgios E.

    2016-01-01

    There is a debate over the association between low testosterone levels in body fluids and the occurrence of chronic periodontitis (CP). The aim of the present systematic review was to assess whether low testosterone levels in body fluids reflect CP. In order to identify studies relevant to the focus question: “Is there a relationship between low testosterone levels in body fluids and CP?” an electronic search without time or language restrictions was conducted up to June 2016 in indexed databases using different keywords: periodontitis, chronic periodontitis, periodontal diseases, testosterone, and gonadal steroid hormones. A total of eight studies were included in the present systematic review. The number of study participants ranged from 24 to 1,838 male individuals with ages ranging from 15 to 95 years. Seven studies measured testosterone levels in serum, two studies in saliva, and one study in gingiva. Four studies reported a negative association between serum testosterone levels and CP. Two studies reported a positive association between decreased testosterone levels in serum and CP. Increased levels of salivary testosterone among patients with CP were reported in one study; whereas one study reported no significant difference in the concentration of salivary testosterone between patients with and without CP. One study identified significant increase in the metabolism of testosterone in the gingiva of patients with CP. Within the limits of the evidence available, the relationship between low testosterone levels and CP remains debatable and further longitudinal studies and control trials are needed. PMID:27645514

  10. Yoga and heart rate variability: A comprehensive review of the literature

    PubMed Central

    Tyagi, Anupama; Cohen, Marc

    2016-01-01

    Heart rate variability (HRV) has been used as a proxy for health and fitness and indicator of autonomic regulation and therefore, appears well placed to assess the changes occurring with mind.-body practices that facilitate autonomic balance. While many studies suggest that yoga influences HRV, such studies have not been systematically reviewed. We aimed to systematically review all published papers that report on yoga practices and HRV. A comprehensive search of multiple databases was conducted and all studies that reported a measure of HRV associated with any yoga practice were included. Studies were categorized by the study design and type of yoga practice. A total of 59 studies were reviewed involving a total of 2358 participants. Most studies were performed in India on relatively small numbers of healthy male yoga practitioners during a single laboratory session. Of the reviewed studies, 15 were randomized controlled trials with 6 having a Jadad score of 3. The reviewed studies suggest that yoga can affect cardiac autonomic regulation with increased HRV and vagal dominance during yoga practices. Regular yoga practitioners were also found to have increased vagal tone at rest compared to non-yoga practitioners. It is premature to draw any firm conclusions about yoga and HRV as most studies were of poor quality, with small sample sizes and insufficient reporting of study design and statistical methods. Rigorous studies with detailed reporting of yoga practices and any corresponding changes in respiration are required to determine the effect of yoga on HRV. PMID:27512317

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

    PubMed Central

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

    2005-01-01

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

  12. Significantly Increased Odds of Reporting Previous Shoulder Injuries in Female Marines Based on Larger Magnitude Shoulder Rotator Bilateral Strength Differences

    PubMed Central

    Eagle, Shawn R.; Connaboy, Chris; Nindl, Bradley C.; Allison, Katelyn F.

    2018-01-01

    Background: Musculoskeletal injuries to the extremities are a primary concern for the United States (US) military. One possible injury risk factor in this population is side-to-side strength imbalance. Purpose: To examine the odds of reporting a previous shoulder injury in US Marine Corps Ground Combat Element Integrated Task Force volunteers based on side-to-side strength differences in isokinetic shoulder strength. Study Design: Cohort study; Level of evidence, 3. Methods: Male (n = 219) and female (n = 91) Marines were included in this analysis. Peak torque values from 5 shoulder internal/external rotation repetitions were averaged and normalized to body weight. The difference in side-to-side strength measurements was calculated as the absolute value of the limb difference divided by the mean peak torque of the dominant limb. Participants were placed into groups based on the magnitude of these differences: <10%, 10% to 20%, and >20%. Odds ratios (ORs) and 95% CIs were calculated. Results: When separated by sex, 13.2% of men reported an injury, while 5.5% of women reported an injury. Female Marines with >20% internal rotation side-to-side strength differences demonstrated increased odds of reporting a previous shoulder injury compared with female Marines with <10% strength differences (OR, 15.4; 95% CI, 1.4-167.2; P = .03 ) and female Marines with 10% to 20% strength differences (OR, 13.9; 95% CI, 1.3-151.2; P = .04). No significant ORs were demonstrated in male Marines. Conclusion: Marines with larger magnitude internal rotation strength differences demonstrated increased odds of reporting a previous shoulder injury compared with those with lesser magnitude differences. Additionally, female sex appears to drastically affect the increased odds of reporting shoulder injuries (OR, 13.9-15.4) with larger magnitude differences (ie, >20%) compared with those with lesser magnitude differences (ie, <10% and 10%-20%). The retrospective cohort design of this study cannot delineate cause and effect but establishes a relationship between female Marines and greater odds of larger magnitude strength differences after returning from an injury. PMID:29497623

  13. A nursing pilot study on bedside reporting to promote best practice and patient/family-centered care.

    PubMed

    Tidwell, Tracy; Edwards, Jessica; Snider, Emily; Lindsey, Connie; Reed, Ann; Scroggins, Iva; Zarski, Christy; Brigance, Joe

    2011-08-01

    The purpose of this study was to evaluate the effectiveness of bedside nursing report implementation on a pediatric neuroscience unit. The change-of-shift nursing report often involves only nurse-to-nurse communication, occurs far away from the patient's bedside, and includes little or no patient/family involvement. Studies show that the bedside nursing report is a more comprehensive and patient-centered approach (C. D. Anderson & R. R. Mangino, 2006). Patient and nurse satisfaction and nursing overtime were measured 6 months before and 6 months after the implementation of bedside reporting. Data were analyzed using paired t test, chi-square test, and Fisher's exact tests to determine significant changes. Patients, families, and nurses reported an increase in satisfaction after the implementation of bedside reporting. Overtime decreased and represented a potential cost savings of nearly $13,000 annually. Bedside reporting saves money, improves patient and nurse satisfaction, and is a more comprehensive approach to change-of-shift reporting.

  14. Methicillin-resistant Staphylococcus aureus (MRSA) is increasing in Norway: a time series analysis of reported MRSA and methicillin-sensitive S. aureus cases, 1997-2010.

    PubMed

    Moxnes, John F; de Blasio, Birgitte Freiesleben; Leegaard, Truls Michael; Moen, Aina E Fossum

    2013-01-01

    Accurate estimates of the incidence and prevalence of methicillin-resistant Staphylococcus aureus (MRSA) infections are needed to inform public health policies. In Norway, where both MRSA infection and carriage are notifiable conditions, the reported incidence of MRSA is slowly increasing. However, the proportion of MRSA in relation to all S. aureus isolates is unknown, making it difficult to determine if the rising incidence is real or an artifact of an increasing number of tests performed. To characterize recent trends in MRSA infections and obtain a more complete understanding of the MRSA level in Norway. All reported cases of MRSA and methicillin-sensitive S. aureus (MSSA) from Oslo County (1997-2010) and Health Region East (2008-2008), representing approximately 11% and 36% of the Norwegian population, respectively, were analyzed using a stochastic time series analysis to characterize trends. In Oslo County, the proportion of methicillin-resistant cases increased from 0.73% to 3.78% during the study period and was well modeled by an exponential growth with a doubling constant of 5.7 years (95% CI 4.5-7.4 years). In Health Region East, the proportion of MRSA cases increased from 0.4% to 2.1% from 2002 to 2008, with a best-fitting linear increase of 0.26% (95% CI 0.21-0.30%) per year. In both cases, the choice of a linear or exponential model for the time trend produced only marginally different model fits. We found no significant changes due to revised national MRSA guidelines published in June 2009. Significant variations in the increasing time trend were observed in the five hospitals within the region. The yearly reported incidence of MSSA was relatively stable in both study areas although we found seasonal patterns with peaks in August. The level of MRSA is increasing in Norway, and the proportion of methicillin resistance in all S. aureus isolates are higher than the reported proportion of MRSA in invasive infections.

  15. Methicillin-Resistant Staphylococcus aureus (MRSA) Is Increasing in Norway: A Time Series Analysis of Reported MRSA and Methicillin-Sensitive S. aureus Cases, 1997–2010

    PubMed Central

    Moxnes, John F.; de Blasio, Birgitte Freiesleben; Leegaard, Truls Michael; Moen, Aina E. Fossum

    2013-01-01

    Background Accurate estimates of the incidence and prevalence of methicillin-resistant Staphylococcus aureus (MRSA) infections are needed to inform public health policies. In Norway, where both MRSA infection and carriage are notifiable conditions, the reported incidence of MRSA is slowly increasing. However, the proportion of MRSA in relation to all S. aureus isolates is unknown, making it difficult to determine if the rising incidence is real or an artifact of an increasing number of tests performed. Aim To characterize recent trends in MRSA infections and obtain a more complete understanding of the MRSA level in Norway. Methods All reported cases of MRSA and methicillin-sensitive S. aureus (MSSA) from Oslo County (1997–2010) and Health Region East (2008–2008), representing approximately 11% and 36% of the Norwegian population, respectively, were analyzed using a stochastic time series analysis to characterize trends. Results In Oslo County, the proportion of methicillin-resistant cases increased from 0.73% to 3.78% during the study period and was well modeled by an exponential growth with a doubling constant of 5.7 years (95% CI 4.5–7.4 years). In Health Region East, the proportion of MRSA cases increased from 0.4% to 2.1% from 2002 to 2008, with a best-fitting linear increase of 0.26% (95% CI 0.21–0.30%) per year. In both cases, the choice of a linear or exponential model for the time trend produced only marginally different model fits. We found no significant changes due to revised national MRSA guidelines published in June 2009. Significant variations in the increasing time trend were observed in the five hospitals within the region. The yearly reported incidence of MSSA was relatively stable in both study areas although we found seasonal patterns with peaks in August. Conclusion The level of MRSA is increasing in Norway, and the proportion of methicillin resistance in all S. aureus isolates are higher than the reported proportion of MRSA in invasive infections. PMID:23936442

  16. The impact of peer victimization on later maladjustment: Mediating and moderating effects of hostile and self-blaming attributions

    PubMed Central

    Perren, Sonja; Ettekal, Idean; Ladd, Gary

    2012-01-01

    Background Evidence indicates that being a victim of bullying or peer aggression has negative short- and long-term consequences. In this study, we investigated the mediating and moderating role of two types of attributional mechanisms (hostile and self-blaming attributions) on children’s maladjustment (externalizing and internalizing problems). Methods In total, 478 children participated in this longitudinal study from grade 5 to grade 7. Children, parents and teachers repeatedly completed questionnaires. Peer victimization was assessed through peer reports (T1). Attributions were assessed through self-reports using hypothetical scenarios (T2). Parents and teachers reported on children’s maladjustment (T1 and T3). Results Peer victimization predicted increases in externalizing and internalizing problems. Hostile attributions partially mediated the impact of victimization on increases in externalizing problems. Self-blame was not associated with peer victimization. However, for children with higher levels of self-blaming attributions, peer victimization was linked more strongly with increases in internalizing problems. Conclusions Results imply that hostile attributions may operate as a potential mechanism through which negative experiences with peers lead to increases in children’s aggressive and delinquent behavior, whereas self-blame exacerbates victimization’s effects on internalizing problems. PMID:23057732

  17. Nonmedical Prescription Opioid Use Among Victimized Women On Probation And Parole

    PubMed Central

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

    2015-01-01

    Background Nonmedical prescription opioid use (NPOU) is a major public health concern and few studies have described this phenomenon among victimized women involved in the criminal justice system. Objective This study will describe the relationship between victimization, psychological distress, health status and NPOU among the vulnerable population of victimized women on probation and parole. Methods A sample of 406 women on probation and parole responded to items assessing victimization history, self-reported health status, physical pain, psychological distress, and post-traumatic stress disorder. Multiple logistic regression analysis was utilized to differentiate NPOUs versus nonusers. Results Overall, 169 (41.6%) women reported lifetime NPOU, and 20% reported use in the past year. Compared to women who did not report NPOU, NPOUs were more likely to be White, have poorer general health, and more severe psychological distress across nine symptom domains. In multiple logistic regression models, each year of age reduced the odds of NPOU by 4%; White women were twice as likely as women of other races to report NPOU; each unit increase in the measure for physical pain was associated with a 30% increase in the odds of NPOU; and participants who met diagnostic criteria for PTSD were 60% more likely to report NPOU compared to individuals who did not. Conclusion Victimized women on probation and parole report high rates of NPOU and comorbid mental and physical health problems. The criminal justice system should routinely screen for NPOU, as well as untreated or poorly managed physical pain and psychological distress, which may increase risk of NPOU. PMID:26476007

  18. Lifetime leisure music exposure associated with increased frequency of tinnitus.

    PubMed

    Moore, David R; Zobay, Oliver; Mackinnon, Robert C; Whitmer, William M; Akeroyd, Michael A

    2017-04-01

    Tinnitus has been linked to noise exposure, a common form of which is listening to music as a leisure activity. The relationship between tinnitus and type and duration of music exposure is not well understood. We conducted an internet-based population study that asked participants questions about lifetime music exposure and hearing, and included a hearing test involving speech intelligibility in noise, the High Frequency Digit Triplets Test. 4950 people aged 17-75 years completed all questions and the hearing test. Results were analyzed using multinomial regression models. High exposure to leisure music, hearing difficulty, increasing age and workplace noise exposure were independently associated with increased tinnitus. Three forms of music exposure (pubs/clubs, concerts, personal music players) did not differ in their relationship to tinnitus. More males than females reported tinnitus. The objective measure of speech reception threshold had only a minimal relationship with tinnitus. Self-reported hearing difficulty was more strongly associated with tinnitus, but 76% of people reporting usual or constant tinnitus also reported little or no hearing difficulty. Overall, around 40% of participants of all ages reported never experiencing tinnitus, while 29% reported sometimes, usually or constantly experiencing tinnitus that lasted more than 5 min. Together, the results suggest that tinnitus is much more common than hearing loss, but that there is little association between the two, especially among the younger adults disproportionately sampled in this study. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  19. The effect of interval tubal sterilization on sexual interest and pleasure.

    PubMed

    Costello, Caroline; Hillis, Susan D; Marchbanks, Polly A; Jamieson, Denise J; Peterson, Herbert B

    2002-09-01

    To determine if interval tubal sterilization leads to a change in female sexual interest or pleasure and to identify predictors of a positive or negative effect. Our study population comprised 4576 women enrolled in a prospective, multicenter cohort study between 1978 and 1983. Potential demographic, clinical, and surgical predictors of sexual outcome were tested for significant variation from the overall pattern of unchanged, increased, and decreased sexual interest and pleasure. Over 80% of the 4576 study women reported no consistent change in either sexual interest (80.0%) or pleasure (81.7%) after interval tubal sterilization. Among women with consistent change, positive effects were reported ten and 15 times more often than negative effects for sexual interest and pleasure, respectively. All subgroups of women, except for those with poststerilization regret, were significantly (P <.05) more likely to experience increased rather than decreased interest or pleasure. Women with poststerilization regret were the subgroup most likely to have a negative effect; in multivariate analyses, poststerilization regret was the only factor to be a predictor for decreased interest (odds ratio 4.0) and decreased pleasure (odds ratio 5.1). Similarly, women reporting regret were significantly less likely to report increased interest or pleasure. Whether the regret or the decreased sexual interest or pleasure occurred first is unclear. Interval tubal ligation is unlikely to result in changed sexual interest or pleasure. Among those with change, the majority experienced positive sexual effects.

  20. Interventions to improve hand hygiene compliance in patient care.

    PubMed

    Gould, Dinah J; Moralejo, Donna; Drey, Nicholas; Chudleigh, Jane H

    2010-09-08

    Health care-associated infection is a major cause of morbidity and mortality. Hand hygiene is regarded as an effective preventive measure. To update the review done in 2007, to assess the short and longer-term success of strategies to improve hand hygiene compliance and to determine whether a sustained increase in hand hygiene compliance can reduce rates of health care-associated infection. We conducted electronic searches of: the Cochrane Central Register of Controlled Trials; the Cochrane Effective Practice and Organisation of Care Group specialised register of trials; MEDLINE; PubMed; EMBASE; CINAHL; and the BNI. Originally searched to July 2006, for the update databases were searched from August 2006 until November 2009. Randomised controlled trials, controlled clinical trials, controlled before and after studies, and interrupted time series analyses meeting explicit entry and quality criteria used by the Cochrane Effective Practice and Organisation of Care Group were eligible for inclusion. Studies reporting indicators of hand hygiene compliance and proxy indicators such as product use were considered. Self-reported data were not considered a valid measure of compliance. Studies to promote hand hygiene compliance as part of a care bundle approach were included, providing data relating specifically to hand hygiene were presented separately. Studies were excluded if hand hygiene was assessed in simulations, non-clinical settings or the operating theatre setting. Two reviewers independently extracted data and assessed data quality. Four studies met the criteria for the review: two from the original review and two from the update. Two studies evaluated simple education initiatives, one using a randomized clinical trial design and the other a controlled before and after design. Both measured hand hygiene compliance by direct observation. The other two studies were both interrupted times series studies. One study presented three separate interventions within the same paper: simple substitutions of product and two multifaceted campaigns, one of which included involving practitioners in making decisions about choice of hand hygiene products and the components of the hand hygiene program. The other study also presented two separate multifaceted campaigns, one of which involved application of social marketing theory. In these two studies follow-up data collection continued beyond twelve months, and a proxy measure of hand hygiene compliance (product use) was recorded. Microbiological data were recorded in one study. Hand hygiene compliance increased for one of the studies where it was measured by direct observation, but the results from the other study were not conclusive. Product use increased in the two studies in which it was reported, with inconsistent results reported for one initiative. MRSA incidence decreased in the one study reporting microbiological data. The quality of intervention studies intended to increase hand hygiene compliance remains disappointing. Although multifaceted campaigns with social marketing or staff involvement appear to have an effect, there is insufficient evidence to draw a firm conclusion. There remains an urgent need to undertake methodologically robust research to explore the effectiveness of soundly designed and implemented interventions to increase hand hygiene compliance.

  1. Public Service Broadcasting: The Challenges of the Twenty-first Century. Reports and Papers on Mass Communication No. 111.

    ERIC Educational Resources Information Center

    Atkinson, Dave; Raboy, Marc, Ed.

    This report presents a review of key research on public broadcasting and a synthesis of the actuality of public service broadcasting today in the face of increasing globalization, with case studies from 16 countries. Following the General Introduction (Pierre Juneau), the report is divided into two parts. Part 1--"Public Service Television in…

  2. Early Detection of Online Auction Opportunistic Sellers through the Use of Negative-Positive Feedback

    ERIC Educational Resources Information Center

    Reinert, Gregory J.

    2010-01-01

    Apparently fraud is a growth industry. The monetary losses from Internet fraud have increased every year since first officially reported by the Internet Crime Complaint Center (IC3) in 2000. Prior research studies and third-party reports of fraud show rates substantially higher than eBay's reported negative feedback rate of less than 1%. The…

  3. Mother-reported sleep, accelerometer-estimated sleep and weight status in Mexican American children: sleep duration is associated with increased adiposity and risk for overweight/obese status

    USDA-ARS?s Scientific Manuscript database

    We know of no studies comparing parent-reported sleep with accelerometer-estimated sleep in their relation to paediatric adiposity. We examined: (i) the reliability of mother-reported sleep compared with accelerometer-estimated sleep; and (ii) the relationship between both sleep measures and child a...

  4. Sibling Voices: The Self-Reported Mental Health of Siblings of Children with a Disability

    ERIC Educational Resources Information Center

    Giallo, Rebecca; Gavidia-Payne, Susana; Minett, Belinda; Kapoor, Aparna

    2012-01-01

    Background: There is increasing interest in the experiences and well-being of siblings growing up with a brother or sister with a disability in Australia. However, research to date has primarily obtained parent reports of sibling adjustment and mental health. Therefore, the aim of the current study was threefold: (1) to report on the mental health…

  5. Postsecondary Alternatives to Meet the Educational Needs of California's Adults. A Feasibility Study Prepared for the California Legislature. Final Report.

    ERIC Educational Resources Information Center

    Peterson, Richard E.; And Others

    This report explains why California should invest in the continued education of its adult citizens and recommends 17 steps as the most urgently needed investment now. The report has two main themes: First, California should increasingly conceive of providing accessible and diversified postsecondary learning alternatives to meet the educational…

  6. Self-Reported Stickiness of Mind-Wandering Affects Task Performance

    PubMed Central

    van Vugt, Marieke K.; Broers, Nico

    2016-01-01

    When asked to perform a certain task, we typically spend a decent amount of time thinking thoughts unrelated to that task–a phenomenon referred to as “mind-wandering.” It is thought that this mind-wandering is driven at least in part by our unfinished goals and concerns. Previous studies have shown that just after presenting a participant with their own concerns, their reports of task-unrelated thinking increased somewhat. However, effects of these concerns on task performance were somewhat inconsistent. In this study we take the opposite approach, and examine whether task performance depends on the self-reported thought content. Specifically, a particularly intriguing aspect of mind-wandering that has hitherto received little attention is the difficulty of disengaging from it, in other words, the “stickiness” of the thoughts. While presenting participants with their own concerns was not associated with clear effects on task performance, we showed that the reports of off-task thinking and variability of response times increased with the amount of self-reported stickiness of thoughts. This suggests that the stickiness of mind-wandering is a relevant variable, and participants are able to meaningfully report on it. PMID:27242636

  7. Drinking Patterns Among Older Couples: Longitudinal Associations With Negative Marital Quality.

    PubMed

    Birditt, Kira S; Cranford, James A; Manalel, Jasmine A; Antonucci, Toni C

    2018-04-16

    Research with younger couples indicates that alcohol use has powerful effects on marital quality, but less work has examined the effects of drinking among older couples. This study examined whether dyadic patterns of drinking status among older couples are associated with negative marital quality over time. Married participants (N = 4864) from the Health and Retirement Study reported on alcohol consumption (whether they drink alcohol and average amount consumed per week) and negative marital quality (e.g., criticism and demands) across two waves (Wave 1 2006/2008 and Wave 2 2010/2012). Concordant drinking couples reported decreased negative marital quality over time, and these links were significantly greater among wives. Wives who reported drinking alcohol reported decreased negative marital quality over time when husbands also reported drinking and increased negative marital quality over time when husbands reported not drinking. The present findings stress the importance of considering the drinking status rather than the amount of alcohol consumed of both members of the couple when attempting to understand drinking and marital quality among older couples. These findings are particularly salient given the increased drinking among baby boomers and the importance of marital quality for health among older couples.

  8. The experience of reading.

    PubMed

    Moore, Alan Tonnies; Schwitzgebel, Eric

    2018-05-03

    What do people consciously experience when they read? There has been almost no rigorous research on this question, and opinions diverge radically among both philosophers and psychologists. We describe three studies of the phenomenology of reading and its relationship to memory of textual detail and general cognitive abilities. We find three main results. First, there is substantial variability in reports about reading experience, both within and between participants. Second, reported reading experience varies with passage type: passages with dialogue prompted increased reports of inner speech, while passages with vivid visual detail prompted increased reports of visual imagery. Third, reports of visual imagery experiences, inner speech experiences, and experiences of conscious visual perception of the words on the page were at best weakly related to general cognitive abilities and memory of visual and auditory details. Copyright © 2018 Elsevier Inc. All rights reserved.

  9. Reporting Rape in a National Sample of College Women

    PubMed Central

    Wolitzky-Taylor, Kate B.; Resnick, Heidi S.; Amstadter, Ananda B.; McCauley, Jenna L.; Ruggiero, Kenneth J.; Kilpatrick, Dean G.

    2011-01-01

    Introduction Studies indicate that a small percentage of rapes are reported to law enforcement officials. Research also suggests that rapes perpetrated by a stranger are more likely to be reported and that rapes involving drugs and/or alcohol are less likely to be reported. College women represent a unique and understudied population with regard to reporting rape. Methods In the current study, we interviewed a national sample of 2,000 college women about rape experiences in 2006. Results Only 11.5% of college women in the sample reported their most recent/only rape experience to authorities, with only 2.7% of rapes involving drugs and/or alcohol reported. Minority status (i.e., non-white race) was associated with lower likelihood of reporting, whereas sustaining injuries during the rape was associated with increased likelihood of reporting. Discussion Reporting, particularly for rapes involving drugs and alcohol, is low among college women. Implications for policy are discussed. PMID:21823952

  10. Cyberbullying Among Adolescent Bystanders: Role of Affective Versus Cognitive Empathy in Increasing Prosocial Cyberbystander Behavior

    PubMed Central

    Barlińska, Julia; Szuster, Anna; Winiewski, Mikołaj

    2018-01-01

    The purpose of this study was to investigate if affective (vicarious sharing of emotions) and cognitive empathy (mental perspective taking) induction may stimulate adolescent online bystanders’ intervention in cyberbullying cases. The role of reporting the abuse is crucial because it is a form of active support to the victim, initiated by children, to stop the bullying. The effectiveness of empathy activation in decreasing negative cyberbystander reinforcing behavior has been proved in previous studies. The effects of affective and cognitive empathy activation on positive cyberbystander behavior, defined as reporting the bullying online, were explored in two follow-up studies N = 271 and N = 265. The influence of experiencing cyberbullying as perpetrator, victim, and as determined by gender on prosocial cyberbystander behavior was also controlled. The results indicate that only cognitive empathy activation increases the likelihood of intervening bystander behavior. Neither affective empathy induction, previous experience of cyberperpetration, cybervictimization, nor gender affected the engagement in prosocial bystander behavior. The conclusion of the research is that a program consequently activating more reflective cognitive empathy induction can contribute toward the establishment of healthier behavioral patterns among bystanders to cyberbullying, increasing the probability of their reporting the cyberbullying acts. PMID:29899715

  11. Cyberbullying Among Adolescent Bystanders: Role of Affective Versus Cognitive Empathy in Increasing Prosocial Cyberbystander Behavior.

    PubMed

    Barlińska, Julia; Szuster, Anna; Winiewski, Mikołaj

    2018-01-01

    The purpose of this study was to investigate if affective (vicarious sharing of emotions) and cognitive empathy (mental perspective taking) induction may stimulate adolescent online bystanders' intervention in cyberbullying cases. The role of reporting the abuse is crucial because it is a form of active support to the victim, initiated by children, to stop the bullying. The effectiveness of empathy activation in decreasing negative cyberbystander reinforcing behavior has been proved in previous studies. The effects of affective and cognitive empathy activation on positive cyberbystander behavior, defined as reporting the bullying online, were explored in two follow-up studies N = 271 and N = 265. The influence of experiencing cyberbullying as perpetrator, victim, and as determined by gender on prosocial cyberbystander behavior was also controlled. The results indicate that only cognitive empathy activation increases the likelihood of intervening bystander behavior. Neither affective empathy induction, previous experience of cyberperpetration, cybervictimization, nor gender affected the engagement in prosocial bystander behavior. The conclusion of the research is that a program consequently activating more reflective cognitive empathy induction can contribute toward the establishment of healthier behavioral patterns among bystanders to cyberbullying, increasing the probability of their reporting the cyberbullying acts.

  12. Community-based harm reduction substance abuse treatment with methamphetamine-using men who have sex with men.

    PubMed

    Carrico, Adam W; Flentje, Annesa; Gruber, Valerie A; Woods, William J; Discepola, Michael V; Dilworth, Samantha E; Neilands, Torsten B; Jain, Jennifer; Siever, Michael D

    2014-06-01

    Harm reduction approaches endeavor to assist individuals with avoiding the most detrimental consequences of risk taking behaviors, but limited research has documented the outcomes of harm reduction substance abuse treatment. In total, 211 methamphetamine-using men who have sex with men (MSM) enrolled in two outcome studies of substance abuse treatment programs that were implementing an evidence-based, cognitive-behavioral intervention (i.e., the Matrix Model) from a harm reduction perspective. Study 1 (N = 123) examined changes in self-reported substance use, Addiction Severity Index (ASI) composite scores, and HIV care indicators over a 12-month follow-up. Study 2 (N = 88) assessed changes in substance use, sexual risk taking, and HIV care indicators over a 6-month follow-up. Participants in study 1 reported reductions in cocaine/crack use as well as decreases in the ASI drug and employment composite scores. Among HIV-positive participants in study 1 (n = 75), 47 % initiated or consistently utilized anti-retroviral therapy and this was paralleled by significant increases in self-reported undetectable HIV viral load. Study 2 participants reported reductions in methamphetamine use, erectile dysfunction medication use in combination with other substances, and sexual risk-taking behavior while using methamphetamine. Participants in both studies reported concurrent increases in marijuana use. Taken together, these studies are among the first to observe that clients may reduce stimulant use and concomitant sexual risk-taking behavior during harm reduction substance abuse treatment. Randomized controlled trials are needed to examine the differential effectiveness of harm reduction and abstinence-based approaches to substance abuse treatment.

  13. Newspaper reporting and the emergence of charcoal burning suicide in Taiwan: A mixed methods approach.

    PubMed

    Chen, Ying-Yeh; Tsai, Chi-Wei; Biddle, Lucy; Niederkrotenthaler, Thomas; Wu, Kevin Chien-Chang; Gunnell, David

    2016-03-15

    It has been suggested that extensive media reporting of charcoal burning suicide was a key factor in the rapid spread of this novel method in many East Asian countries. But very few empirical studies have explored the relationship between media reporting and the emergence of this new method of suicide. We investigated the changing pattern of media reporting of charcoal burning suicides in Taiwan during 1998-2002 when this method of suicide increased most rapidly, assessing whether the characteristics of media reporting were associated with the changing incidence of suicide using this method. A mixed method approach, combining quantitative and qualitative analysis of newspaper content during 1998-2002 was used. We compared differences in reporting characteristics before and after the rapid increase in charcoal burning suicide. Point-biserial and Pearson correlation coefficients were calculated to quantify the associations between the media item content and changes in suicide rates. During the period when charcoal burning suicide increased rapidly, the number of reports per suicide was considerably higher than during the early stage (0.31 vs. 0.10). Detailed reporting of this new method was associated with a post-reporting increase in suicides using the method. Qualitative analysis of news items revealed that the content of reports of suicide by charcoal burning changed gradually; in the early stages of the epidemic (1999-2000) there was convergence in the terminology used to report charcoal burning deaths, later reports gave detailed descriptions of the setting in which the death occurred (2001) and finally the method was glamourized and widely publicized (2001-2002). Our analysis was restricted to newspaper reports and did not include TV or the Internet. Newspaper reporting was associated with the evolution and establishment of charcoal burning suicide. Working with media and close monitoring of changes in the incidence of suicide using a new method might help prevent a suicide epidemic such as charcoal burning suicide seen in Taiwan. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. Short-term ozone exposure and asthma severity: Weight-of-evidence analysis.

    PubMed

    Goodman, Julie E; Zu, Ke; Loftus, Christine T; Lynch, Heather N; Prueitt, Robyn L; Mohar, Isaac; Shubin, Sara Pacheco; Sax, Sonja N

    2018-01-01

    To determine whether evidence indicates that short-term exposure to ambient concentrations of ozone in the United States can affect asthma severity, we systematically reviewed published controlled human exposure, epidemiology, and animal toxicity studies. The strongest evidence for a potential causal relationship came from epidemiology studies reporting increased emergency department visits and hospital admissions for asthma following elevated ambient ozone concentrations. However, while controlled exposure studies reported lung function decrements and increased asthma symptoms following high ozone exposures 160-400 parts per billion [ppb]), epidemiology studies evaluating similar outcomes reported less consistent results. Animal studies showed changes in pulmonary function at high ozone concentrations (> 500ppb), although there is substantial uncertainty regarding the relevance of these animal models to human asthma. Taken together, the weight of evidence indicates that there is at least an equal likelihood that either explanation is true, i.e., the strength of the evidence for a causal relationship between short-term exposure to ambient ozone concentrations and asthma severity is "equipoise and above." Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Musculoskeletal disorders in a 3 year longitudinal cohort of dental hygiene students.

    PubMed

    Hayes, Melanie J; Smith, Derek R; Taylor, Jane A

    2014-02-01

    Musculoskeletal disorders (MSDs) are a significant occupational health issue for the dental hygiene profession. There is increasing evidence that these problems commence during undergraduate training; however, there is a surprising lack of studies investigating how MSD develops in student groups over the course of their study. The aim of this study was to determine the longitudinal MSD trends among a cohort of undergraduate dental hygiene students at an Australian university. A previously validated self-reporting questionnaire was distributed to dental hygiene students in 3 consecutive years from 2008 to 2010. MSDs were most commonly reported in the neck (ranging from 66 to 68%) and lower back (ranging from 61 to 68%), with a marked increase in reported lower back pain by the final year of study. This study not only supports mounting evidence that MSDs are a common problem for dental hygiene students, but further demonstrates the magnitude of this occupational health issue across the training program. These findings are concerning for a group yet to embark on their professional careers, given that it raises some serious questions about career longevity and the efficacy of preventive measures.

  16. Self-Reported Extremely Adverse Life Events and Longitudinal Changes in Five-Factor Model Personality Traits in an Urban Sample

    PubMed Central

    Löckenhoff, Corinna E.; Terracciano, Antonio; Patriciu, Nicholas S.; Eaton, William W.; Costa, Paul T.

    2009-01-01

    This study examined longitudinal personality change in response to extremely adverse life events in a sample (N = 458) drawn from the East Baltimore Epidemiologic Catchment Area study. Five-factor model personality traits were assessed twice over an average interval of 8 years. Twenty-five percent of the participants reported an extremely horrifying or frightening event within 2 years before the second personality assessment. Relative to the rest of the sample, they showed increases in neuroticism, decreases in the compliance facet of agreeableness, and decreases in openness to values. Baseline personality was unrelated to future events, but among participants who reported extreme events, lower extraversion and/or conscientiousness at baseline as well as longitudinal increases in neuroticism predicted lower mental health at follow-up. PMID:19230009

  17. Self-esteem in pure bullies and bully/victims: a longitudinal analysis.

    PubMed

    Pollastri, Alisha R; Cardemil, Esteban V; O'Donnell, Ellen H

    2010-08-01

    Past research on the self-esteem of bullies has produced equivocal results. Recent studies have suggested that the inconsistent findings may be due, in part, to the failure to account for bully/victims: those children who both bully and are victims of bullying. In this longitudinal study, we examined the distinctions among pure bullies, pure victims, bully/victims, and noninvolved children in a sample of 307 middle school students. Analyses of cross-sectional and longitudinal results supported the importance of distinguishing between pure bullies and bully/victims. In addition, results revealed some interesting sex differences: girls in the pure bully and bully/victim groups reported significant increases in self-esteem over time, with girls in the pure bully group reporting the greatest increase, whereas boys in these groups reported no significant changes in self-esteem over time.

  18. State-of-the-science of patient navigation as a strategy for enhancing minority clinical trial accrual.

    PubMed

    Ghebre, Rahel G; Jones, Lovell A; Wenzel, Jennifer A; Martin, Michelle Y; Durant, Raegan W; Ford, Jean G

    2014-04-01

    Patient navigation programs are emerging that aim to address disparities in clinical trial participation among medically underserved populations, including racial/ethnic minorities. However, there is a lack of consensus on the role of patient navigators within the clinical trial process as well as outcome measures to evaluate program effectiveness. A review of the literature was conducted of PubMed, Medline, CINHAL, and other sources to identify qualitative and quantitative studies on patient navigation in clinical trials. The search yielded 212 studies, of which only 12 were eligible for this review. The eligible studies reported on the development of programs for patient navigation in cancer clinical trials, including training and implementation among African Americans, American Indians, and Native Hawaiians. A low rate of clinical trial refusal (range, 4%-6%) was reported among patients enrolled in patient navigation programs. However, few studies reported on the efficacy of patient navigation in increasing clinical treatment trial enrollment. Outcome measures are proposed to assist in developing and evaluating the efficacy and/or effectiveness of patient navigation programs that aim to increase participation in cancer clinical trials. Future research is needed to evaluate the efficacy of patient navigators in addressing barriers to clinical trial participation and increasing enrollment among medically underserved cancer patients. © 2014 American Cancer Society.

  19. State-of-the-Science of Patient Navigation as a Strategy for Enhancing Minority Clinical Trial Accrual

    PubMed Central

    Ghebre, Rahel G.; Jones, Lovell A.; Wenzel, Jennifer; Martin, Michelle Y.; Durant, Raegan; Ford, Jean G.

    2014-01-01

    Background Patient navigation programs are emerging, that aim to address disparities in clinical trial participation among medically underserved populations, including racial/ethnic minorities. However, there is a lack of consensus on the role of patient navigators within the clinical trial process, as well as outcome measures to evaluate program effectiveness. Methods A review of the literature was conducted of PubMed, Medline, CINHAL, and other sources to identify qualitative and quantitative studies on patient navigation in clinical trials. The search yielded 212 studies, of which only 12 were eligible for this review. Results The eligible studies reported on development of programs for patient navigation in cancer clinical trials, including training and implementation among African American, American Indian and Native Hawaiians. Low clinical trial refusal, 4% to 6%, was reported among patients enrolled in patient navigation program. However, few studies reported on the efficacy of patient navigation on increasing clinical treatment trial enrollment. Conclusion Outcome measures are proposed to assist in developing and evaluating the efficacy and/or effectiveness of patient navigation programs that aim to increase participation in cancer clinical trials. Future research is needed to evaluate the efficacy of patient navigators in addressing barriers to clinical trial participation and increasing enrollment among medically underserved cancer patients. PMID:24643650

  20. Creating Well-Being: Increased Creativity and proNGF Decrease following Quadrato Motor Training

    PubMed Central

    Verdone, Loredana; Pesce, Caterina; Tocci, Nicoletta; Caserta, Micaela; Ben-Soussan, Tal Dotan

    2015-01-01

    Mind-body practices (MBP) are known to induce electrophysiological and morphological changes, whereas reports related to changes of neurotrophins are surprisingly scarce. Consequently, in the current paper, we focused on the Quadrato motor training (QMT), a newly developed whole-body movement-based MBP, which has been reported to enhance creativity. Here we report the effects of 4 weeks of daily QMT on creativity and proNGF level in two interrelated studies. In Study A, we examined the effects of QMT compared with a walking training (WT) in healthy adults, utilizing the alternate uses task. In contrast with the WT, QMT resulted in increased creativity. In addition, the change in creativity negatively correlated with the change in proNGF levels. In Study B, we examined QMT effects on creativity and additional metacognitive functions in children, using a nonintervention group as control. Similar to Study A, following QMT, we found a negative correlation of proNGF with creativity, as well as working memory updating and planning ability. Together, the current results point to the relationship between increased creativity and decreased proNGF following MBP. Thus, the current research emphasizes the importance of widening the scope of examination of “MBP in motion” in relation to metacognition and well-being. PMID:26137470

  1. Creating Well-Being: Increased Creativity and proNGF Decrease following Quadrato Motor Training.

    PubMed

    Venditti, Sabrina; Verdone, Loredana; Pesce, Caterina; Tocci, Nicoletta; Caserta, Micaela; Ben-Soussan, Tal Dotan

    2015-01-01

    Mind-body practices (MBP) are known to induce electrophysiological and morphological changes, whereas reports related to changes of neurotrophins are surprisingly scarce. Consequently, in the current paper, we focused on the Quadrato motor training (QMT), a newly developed whole-body movement-based MBP, which has been reported to enhance creativity. Here we report the effects of 4 weeks of daily QMT on creativity and proNGF level in two interrelated studies. In Study A, we examined the effects of QMT compared with a walking training (WT) in healthy adults, utilizing the alternate uses task. In contrast with the WT, QMT resulted in increased creativity. In addition, the change in creativity negatively correlated with the change in proNGF levels. In Study B, we examined QMT effects on creativity and additional metacognitive functions in children, using a nonintervention group as control. Similar to Study A, following QMT, we found a negative correlation of proNGF with creativity, as well as working memory updating and planning ability. Together, the current results point to the relationship between increased creativity and decreased proNGF following MBP. Thus, the current research emphasizes the importance of widening the scope of examination of "MBP in motion" in relation to metacognition and well-being.

  2. A cross-country comparison of rivaroxaban spontaneous adverse event reports and concomitant medicine use with the potential to increase the risk of harm.

    PubMed

    McDonald, Cameron J; Kalisch Ellett, Lisa M; Barratt, John D; Caughey, Gillian E

    2014-12-01

    Concerns with the safety profiles of the newer anticoagulants have been raised because of differences in treatment populations between pre-marketing studies (randomized controlled trials) and clinical practice. Little is known about the potential safety issues and the reporting in spontaneous adverse event databases associated with rivaroxaban. To analyse spontaneous adverse event reports associated with the oral anticoagulant rivaroxaban from Australia, Canada and the USA; and to examine concomitant medicine use that may increase the risk of adverse events. Spontaneous adverse event report databases from Australia, Canada and the USA were examined for all reports of adverse events associated with rivaroxaban and concomitant medicines from 1 August 2005 to 31 March 2013. Disproportionality analysis (the proportional reporting ratio [PRR] and reporting odds ratio [ROR]) was conducted for quantitative detection of signals, using the US database. There were 244 spontaneous adverse event reports associated with rivaroxaban from Australia, 536 from Canada and 1,638 from the USA. Reporting of haemorrhage (any type) was common, ranging from 30.7% for Australia to 37.5% for Canada. Gastrointestinal haemorrhage was the most commonly reported haemorrhage, accounting for 13.9% of Australian, 16.4% of Canadian and 11.1% of US adverse event reports. Positive signals were confirmed in the US data (haemorrhage [any type] PRR 11.93, χ (2) 4,414.78 and ROR 13.41, 95% confidence interval [CI] 12.13-14.81; gastrointestinal haemorrhage PRR 12.52, χ (2) 2,018.48 and ROR 13.15, 95% CI 11.36-15.21). Reporting of concomitant use of medicines with the potential to increase bleeding risk ranged from 63.7% in Australia to 89.2% in Canada. A large proportion of adverse event reports for rivaroxaban were associated with use of concomitant medicines, which may have increased the risk of adverse events-in particular, haemorrhage. Increased awareness of a patient's comorbidity and associated medicine use is needed when rivaroxaban is used in clinical practice.

  3. Increasing Confidence to Decrease Reticence: A Qualitative Action Research in Second Language Education

    ERIC Educational Resources Information Center

    Doqaruni, Vahid Rahmani

    2015-01-01

    This study reports on an action research on increasing the English as a Foreign Language (EFL) students' confidence in speaking. Participants involved in this study were 16 male university students who had an upper-intermediate level of English. Extra speaking activities were incorporated into the classroom for 8 successive weeks. Insights into…

  4. Breaking the Social Contract: The Fiscal Crisis in California Higher Education.

    ERIC Educational Resources Information Center

    Benjamin, Roger; Carroll, Stephen J.

    This report presents the results of a study of higher education in California, focusing on the impending fiscal crisis of increasing demand, tuition, and costs. The study found that at a time when the educational needs for productive employment are increasing, college costs and demand are rising faster than funding. Until now, institutions have…

  5. Increasing Social and Economic Inequalities among Suburban Schools: A Study in Educational Administration and Finance. Final Report.

    ERIC Educational Resources Information Center

    Hickrod, G. Alan; Sabulao, Cesar M.

    This study of five metropolitan areas indicates increasing social and economic inequalities among suburban schools. In addition, the metropolitan areas seemed to be developing contiguous sectors of "advantaged" school districts and "disadvantaged" school districts. Financial differences are at the base of the inequalities, with high income/low tax…

  6. Brief Report: Does Exposure to Violent Video Games Increase Moral Disengagement among Adolescents?

    ERIC Educational Resources Information Center

    Gabbiadini, Alessandro; Andrighetto, Luca; Volpato, Chiara

    2012-01-01

    Several studies have repeatedly shown that violent/action video games increase aggressive tendencies. The present study provides preliminary evidence that exposure to these games also affects the process of moral disengagement. High school students (N = 385) were recruited, and the impact of both recency and frequency of their exposure to the…

  7. [Why evidence-based medicine? 20 years of meta-analysis].

    PubMed

    Ceballos, C; Valdizán, J R; Artal, A; Almárcegui, C; Allepuz, C; García Campayo, J; Fernández Liesa, R; Giraldo, P; Puértolas, T

    2000-10-01

    Meta-analysis, described within evidence-based medicine, has become a frequent issue in recent medical literature. An exhaustive search of reported meta-analysis from any medical specialty is described. Search of papers included in Medline or Embase between 1973-1998. A study of intra and inter-reviewers liability about selection and classification have been performed. A descriptive analysis of the reported papers (frequency tables and graphics) is described, including differences of mean of reported meta-analysis papers by medical specialty and year. 1,518 papers were selected and classified. Most frequently found (45.91%) were: methodology (15.7%), psychiatry (11.79%), cardiology (10.01%) and oncology (8.36%). Inter personal agreement was 0.93 in selecting papers and 0.72 in classifying them. Between 1977-1987 overall mean of reported studies of meta-analysis (1.67 + 4.10) was significatively inferior to the 1988-1998 (49.54 + 56.55) (p < 0.001). Global number of meta-analysis was positively correlated (p < 0.05) with the number of studies about fundamentals and methodology during the study period. The method used to identify meta-analysis reports can be considered to be adequate; however, the agreement in classifying them in medical specialties was inferior. A progressive increase in the number of reported meta-analysis since 1977 can be demonstrated. Specialties with a greater number of meta-analysis published in the literature were: psychiatry, oncology and cardiology. Diffusion of knowledge about fundamentals and methodology of meta-analysis seems to have drawn and increase in performing and reporting this kind of analysis.

  8. Impact of a reengineered electronic error-reporting system on medication event reporting and care process improvements at an urban medical center.

    PubMed

    McKaig, Donald; Collins, Christine; Elsaid, Khaled A

    2014-09-01

    A study was conducted to evaluate the impact of a reengineered approach to electronic error reporting at a 719-bed multidisciplinary urban medical center. The main outcome of interest was the monthly reported medication errors during the preimplementation (20 months) and postimplementation (26 months) phases. An interrupted time series analysis was used to describe baseline errors, immediate change following implementation of the current electronic error-reporting system (e-ERS), and trend of error reporting during postimplementation. Errors were categorized according to severity using the National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) Medication Error Index classifications. Reported errors were further analyzed by reporter and error site. During preimplementation, the monthly reported errors mean was 40.0 (95% confidence interval [CI]: 36.3-43.7). Immediately following e-ERS implementation, monthly reported errors significantly increased by 19.4 errors (95% CI: 8.4-30.5). The change in slope of reported errors trend was estimated at 0.76 (95% CI: 0.07-1.22). Near misses and no-patient-harm errors accounted for 90% of all errors, while errors that caused increased patient monitoring or temporary harm accounted for 9% and 1%, respectively. Nurses were the most frequent reporters, while physicians were more likely to report high-severity errors. Medical care units accounted for approximately half of all reported errors. Following the intervention, there was a significant increase in reporting of prevented errors and errors that reached the patient with no resultant harm. This improvement in reporting was sustained for 26 months and has contributed to designing and implementing quality improvement initiatives to enhance the safety of the medication use process.

  9. Evaluating Retailer Behavior in Preventing Youth Access to Harmful Legal Products: A Feasibility Test*

    PubMed Central

    Courser, Matthew W.; Holder, Harold D.; Collins, David; Johnson, Knowlton; Ogilvie, Kristen A.

    2008-01-01

    This paper reports results from a feasibility study of a community effort to reduce the availability of legal products that youth can use to get “high”. The study evaluated the potential of youth purchase attempts to detect actual changes in retail availability of harmful legal products. These results were triangulated with self-reports from retailers themselves about their own policies and practices. Before the intervention less than half of retailers reported using any of six possible strategies identified as ways to reduce youth access to harmful products and less than 7% of baseline youth attempts to purchase potentially harmful legal products were refused or questioned. After the low dosage intervention, retailers reported increased use of three strategies and a statistically significant increase in the percentage of purchase attempts that were either questioned or refused by retail clerks. These findings (1) demonstrate the potential feasibility of retailer focused environmental strategies and (2) support continued use of youth purchase attempts as a measure of actual retailer behavior. PMID:18660467

  10. Number needed to treat is incorrect without proper time-related considerations.

    PubMed

    Suissa, Daniel; Brassard, Paul; Smiechowski, Brielan; Suissa, Samy

    2012-01-01

    The number needed to treat (NNT) is a simple measure of a treatment's impact, increasingly reported in randomized trials and observational studies. Its calculation in studies involving varying follow-up times or recurrent outcomes has been criticized. We discuss the NNT in these contexts, illustrating using several published studies. The computation of the NNT is founded on the cumulative incidence of the outcome. Instead, several published studies use simple proportions that do not account for varying follow-up times, or use incidence rates per person-time. We show that these approaches can lead to erroneous values of the NNT and misleading interpretations. For example, after converting the incidence rate to a cumulative incidence, we show that a trial reporting a NNT of 4 "to prevent one exacerbation in 1 year" should have reported a NNT of 9. A survey of all papers reporting NNT, published in four major medical journals in 2009, found that 6 out of all 10 papers involving varying follow-up times did not correctly estimate the NNT. As the "number needed to treat" becomes increasingly used in complex studies and in the comparative effectiveness of therapies, its accurate estimation and interpretation become crucial to avoid erroneous clinical and public health decisions. Copyright © 2012 Elsevier Inc. All rights reserved.

  11. Socio-Economic Status and Prevalence of Self-Reported Osteoporosis in Tehran: Results from a Large Population-Based Cross-Sectional Study (Urban HEART-2).

    PubMed

    Asadi-Lari, M; Salimi, Y; Vaez-Mahdavi, M R; Faghihzadeh, S; Haeri Mehrizi, A A; Jorjoran Shushtari, Z; Cheraghian, Bahman

    2018-04-10

    Osteoporosis is a widespread disease among older peoples. The aim of this study is to estimate the prevalence of self-reported osteoporosis and assessing its association with socio-economic status. A population-based cross-sectional study was conducted in Tehran, Iran in 2011. Participants were 45,990 individuals aged above 20 years from 22 urban districts. Osteoporosis was measured by self-administrative questionnaire. Wealth index was constructed using principal component analysis based on household assets. Chi-square test, chi square test for trend, and crude odds ratio were used to assess associations in univariate analysis. Multiple logistic regression utilized to estimate adjusted associations between self-reported osteoporosis and socio-economic status.The overall estimated prevalence of self-reported osteoporosis was 4% (95% CI 3.88-4.13), 1.19% in men, and 6.84% in women (P < 0.001). The prevalence increased considerably as age increased (P for trend < 0.001). In multivariable analysis, education and wealth status were negative, and smoking was positively associated with the prevalence of self-reported osteoporosis. No association was found between participants' skill levels and Townsend deprivation index with the prevalence of self-reported osteoporosis.The findings of the present study have improved understanding of the association between socioeconomic status and osteoporosis in the Iranian population. It is important to consider socioeconomic status in screening and prevention programs.

  12. Asthma and subjective sleep disordered breathing in a large cohort of urban adolescents.

    PubMed

    Zandieh, Stephanie O; Cespedes, Amarilis; Ciarleglio, Adam; Bourgeois, Wallace; Rapoport, David M; Bruzzese, Jean-Marie

    2017-01-02

    Sleep disordered breathing (SDB) has not been well studied in urban adolescents with asthma in community settings. Nor has the association of SDB symptoms and asthma severity been studied. We characterized self-reported symptoms suggesting SDB and investigated the association of SDB symptoms, probable asthma, and asthma severity. 9,565 adolescents from 21 inner-city high schools were screened for an asthma intervention study. Students reported on symptoms suggesting SDB using questions from the 2007 NHANES, if they were ever diagnosed with asthma, and on asthma symptoms. Using generalized linear mixed models with logit link with school as a random intercept and adjusting for age, gender, and race/ethnicity, we examined associations of SDB symptoms, and demographic characteristics, probable asthma, and asthma severity. 12% reported SDB symptoms. Older and bi-racial participants (compared to Caucasian) had higher odds of symptoms suggesting SDB (p <.001). Compared to those without probable asthma, adolescents with probable asthma had 2.63 greater odds of reporting SDB symptoms (p <.001). Among those with probable asthma, the odds of reporting SDB symptoms increased with asthma severity. When exploring daytime severity and severity due to night wakening separately, results were similar. All results remained significant when controlling for age, gender, and ethnicity. In a large urban community cohort of predominately ethnic minority adolescents, self-reported SDB symptoms were associated with probable asthma and increased asthma severity. This study highlights the importance of SDB as a modifiable co-morbidity of asthma.

  13. Asthma and Subjective Sleep Disordered Breathing in a Large Cohort of Urban Adolescents

    PubMed Central

    Zandieh, Stephanie O.; Cespedes, Amarilis; Ciarleglio, Adam; Bourgeois, Wallace; Rapoport, David M.; Bruzzese, Jean-Marie

    2017-01-01

    Objective Sleep disordered breathing (SDB) has not been well studied in urban adolescents with asthma in community settings. Nor has the association of SDB symptoms and asthma severity been studied. We characterized self-reported symptoms suggesting SDB and investigated the association of SDB symptoms, probable asthma, and asthma severity. Methods 9,565 adolescents from 21 inner-city high schools were screened for an asthma intervention study. Students reported on symptoms suggesting SDB using questions from the 2007 NHANES, if they were ever diagnosed with asthma, and on asthma symptoms. Using generalized linear mixed models with logit link with school as a random intercept and adjusting for age, gender, and race/ethnicity, we examined associations of SDB symptoms, and demographic characteristics, probable asthma, and asthma severity. Results 12% reported SDB symptoms. Older and biracial participants (compared to Caucasian) had higher odds of symptoms suggesting SDB (p<.001). Compared to those without probable asthma, adolescents with probable asthma had 2.63 greater odds of reporting SDB symptoms (p<.001). Among those with probable asthma, the odds of reporting SDB symptoms increased with asthma severity. When exploring daytime severity and severity due to night wakening separately, results were similar. All results remained significant when controlling for age, gender, and ethnicity. Conclusions In a large urban community cohort of predominately ethnic minority adolescents, self-reported SDB symptoms were associated with probable asthma and increased asthma severity. This study highlights the importance of SDB as a modifiable co-morbidity of asthma. PMID:27740900

  14. A systematic review of portable electronic technology for health education in resource-limited settings.

    PubMed

    McHenry, Megan S; Fischer, Lydia J; Chun, Yeona; Vreeman, Rachel C

    2017-08-01

    The objective of this study is to conduct a systematic review of the literature of how portable electronic technologies with offline functionality are perceived and used to provide health education in resource-limited settings. Three reviewers evaluated articles and performed a bibliography search to identify studies describing health education delivered by portable electronic device with offline functionality in low- or middle-income countries. Data extracted included: study population; study design and type of analysis; type of technology used; method of use; setting of technology use; impact on caregivers, patients, or overall health outcomes; and reported limitations. Searches yielded 5514 unique titles. Out of 75 critically reviewed full-text articles, 10 met inclusion criteria. Study locations included Botswana, Peru, Kenya, Thailand, Nigeria, India, Ghana, and Tanzania. Topics addressed included: development of healthcare worker training modules, clinical decision support tools, patient education tools, perceptions and usability of portable electronic technology, and comparisons of technologies and/or mobile applications. Studies primarily looked at the assessment of developed educational modules on trainee health knowledge, perceptions and usability of technology, and comparisons of technologies. Overall, studies reported positive results for portable electronic device-based health education, frequently reporting increased provider/patient knowledge, improved patient outcomes in both quality of care and management, increased provider comfort level with technology, and an environment characterized by increased levels of technology-based, informal learning situations. Negative assessments included high investment costs, lack of technical support, and fear of device theft. While the research is limited, portable electronic educational resources present promising avenues to increase access to effective health education in resource-limited settings, contingent on the development of culturally adapted and functional materials to be used on such devices.

  15. Training practices and ergogenic aids used by male bodybuilders.

    PubMed

    Hackett, Daniel A; Johnson, Nathan A; Chow, Chin-Moi

    2013-06-01

    Bodybuilding involves performing a series of poses on stage where the competitor is judged on aesthetic muscular appearance. The purpose of this study was to describe training practices and ergogenic aids used by competitive bodybuilders and to determine whether training practices comply with current recommendations for muscular hypertrophy. A web-based survey was completed by 127 competitive male bodybuilders. The results showed that during the off-season phase of training (OFF), the majority of respondents performed 3-6 sets per exercise (95.3%), 7-12 repetition maximum (RM) per set (77.0%), and 61- to 120-seconds recovery between sets and exercises (68.6%). However, training practices changed 6 weeks before competition (PRE), where there was an increased number of respondents who reported undertaking 3-4 sets per exercise at the expense of 5-6 sets per exercise (p < 0.001), an increase in the number reporting 10-15RM per set from 7-9RM per set (p < 0.001), and an increase in the number reporting 30-60 seconds vs. 61-180 seconds recovery between sets and exercises (p < 0.001). Anabolic steroid use was high among respondents competing in amateur competitions (56 of 73 respondents), whereas dietary supplementation was used by all respondents. The findings of this study demonstrate that competitive bodybuilders comply with current resistance exercise recommendations for muscular hypertrophy; however, these changed before competition during which there is a reduction resistance training volume and intensity. This alteration, in addition to an increase in aerobic exercise volume, is purportedly used to increase muscle definition. However, these practices may increase the risk of muscle mass loss in natural compared with amateur bodybuilders who reportedly use drugs known to preserve muscle mass.

  16. Correlation between Patient-Reported Symptoms and Ankle-Brachial Index after Revascularization for Peripheral Arterial Disease.

    PubMed

    Je, Hyung Gon; Kim, Bo Hyun; Cho, Kyoung Im; Jang, Jae Sik; Park, Yong Hyun; Spertus, John

    2015-05-18

    Improvement in quality of life (QoL) is a primary treatment goal for patients with peripheral arterial disease (PAD). The current study aimed to quantify improvement in the health status of PAD patients following peripheral revascularization using the peripheral artery questionnaire (PAQ) and ankle-brachial index (ABI), and to evaluate possible correlation between the two methods. The PAQ and ABI were assessed in 149 symptomatic PAD patients before, and three months after peripheral revascularization. Mean PAQ summary scores improved significantly three months after revascularization (+49.3 ± 15 points, p < 0.001). PAQ scores relating to patient symptoms showed the largest improvement following revascularization. The smallest increases were seen in reported treatment satisfaction (all p's < 0.001). As expected the ABI of treated limbs showed significant improvement post-revascularization (p < 0.001). ABI after revascularization correlated with patient-reported changes in the physical function and QoL domains of the PAQ. Twenty-two percent of PAD patients were identified as having a poor response to revascularization (increase in ABI < 0.15). Interestingly, poor responders reported improvement in symptoms on the PAQ, although this was less marked than in patients with an increase in ABI > 0.15 following revascularization. In conclusion, data from the current study suggest a significant correlation between improvement in patient-reported outcomes assessed by PAQ and ABI in symptomatic PAD patients undergoing peripheral revascularization.

  17. Correlation between Patient-Reported Symptoms and Ankle-Brachial Index after Revascularization for Peripheral Arterial Disease

    PubMed Central

    Je, Hyung Gon; Kim, Bo Hyun; Cho, Kyoung Im; Jang, Jae Sik; Park, Yong Hyun; Spertus, John

    2015-01-01

    Improvement in quality of life (QoL) is a primary treatment goal for patients with peripheral arterial disease (PAD). The current study aimed to quantify improvement in the health status of PAD patients following peripheral revascularization using the peripheral artery questionnaire (PAQ) and ankle-brachial index (ABI), and to evaluate possible correlation between the two methods. The PAQ and ABI were assessed in 149 symptomatic PAD patients before, and three months after peripheral revascularization. Mean PAQ summary scores improved significantly three months after revascularization (+49.3 ± 15 points, p < 0.001). PAQ scores relating to patient symptoms showed the largest improvement following revascularization. The smallest increases were seen in reported treatment satisfaction (all p’s < 0.001). As expected the ABI of treated limbs showed significant improvement post-revascularization (p < 0.001). ABI after revascularization correlated with patient-reported changes in the physical function and QoL domains of the PAQ. Twenty-two percent of PAD patients were identified as having a poor response to revascularization (increase in ABI < 0.15). Interestingly, poor responders reported improvement in symptoms on the PAQ, although this was less marked than in patients with an increase in ABI > 0.15 following revascularization. In conclusion, data from the current study suggest a significant correlation between improvement in patient-reported outcomes assessed by PAQ and ABI in symptomatic PAD patients undergoing peripheral revascularization. PMID:25993299

  18. Epidemiological evidence for a health risk from mobile phone base stations.

    PubMed

    Khurana, Vini G; Hardell, Lennart; Everaert, Joris; Bortkiewicz, Alicja; Carlberg, Michael; Ahonen, Mikko

    2010-01-01

    Human populations are increasingly exposed to microwave/radiofrequency (RF) emissions from wireless communication technology, including mobile phones and their base stations. By searching PubMed, we identified a total of 10 epidemiological studies that assessed for putative health effects of mobile phone base stations. Seven of these studies explored the association between base station proximity and neurobehavioral effects and three investigated cancer. We found that eight of the 10 studies reported increased prevalence of adverse neurobehavioral symptoms or cancer in populations living at distances < 500 meters from base stations. None of the studies reported exposure above accepted international guidelines, suggesting that current guidelines may be inadequate in protecting the health of human populations. We believe that comprehensive epidemiological studies of long-term mobile phone base station exposure are urgently required to more definitively understand its health impact.

  19. Hearing loss prevention education using adopt-a-band: changes in self-reported earplug use in two high school marching bands.

    PubMed

    Auchter, Melissa; Le Prell, Colleen G

    2014-06-01

    Hearing loss prevention has always been an important issue for audiologists. The importance of hearing loss prevention education for young musicians is now recognized by the National Association for Music Education as well as the National Association of Schools of Music. Adopt-a-Band is a commercial program designed to foster hearing loss prevention behavior in young musicians. This study assessed changes in earplug use, measured using self-report surveys, after Adopt-a-Band training. Participants were members of 2 high school marching bands who viewed an informational DVD and reviewed fact sheets. Flat-attenuation earplugs were distributed, and training was provided. In addition, study participants engaged in discussion of hearing loss with a doctor of audiology student. Before training, 23% of participants reported they had previously used hearing protection. Immediately after training, 94% of participants reported they planned to use hearing protection at least occasionally. In a final end-of-season survey, earplug use had reliably increased; 62% of participants reported they used earplugs at least occasionally. Earplug use increased, but self-reported behavioral change was not as robust as predicted from self-reported participant intentions. Participant comments regarding factors that influenced their earplug use decisions suggest opportunities to improve training.

  20. Facilitated Nurse Medication-Related Event Reporting to Improve Medication Management Quality and Safety in Intensive Care Units.

    PubMed

    Xu, Jie; Reale, Carrie; Slagle, Jason M; Anders, Shilo; Shotwell, Matthew S; Dresselhaus, Timothy; Weinger, Matthew B

    Medication safety presents an ongoing challenge for nurses working in complex, fast-paced, intensive care unit (ICU) environments. Studying ICU nurse's medication management-especially medication-related events (MREs)-provides an approach to analyze and improve medication safety and quality. The goal of this study was to explore the utility of facilitated MRE reporting in identifying system deficiencies and the relationship between MREs and nurses' work in the ICUs. We conducted 124 structured 4-hour observations of nurses in three different ICUs. Each observation included measurement of nurse's moment-to-moment activity and self-reports of workload and negative mood. The observer then obtained MRE reports from the nurse using a structured tool. The MREs were analyzed by three experts. MREs were reported in 35% of observations. The 60 total MREs included four medication errors and seven adverse drug events. Of the 49 remaining MREs, 65% were associated with negative patient impact. Task/process deficiencies were the most common contributory factor for MREs. MRE occurrence was correlated with increased total task volume. MREs also correlated with increased workload, especially during night shifts. Most of these MREs would not be captured by traditional event reporting systems. Facilitated MRE reporting provides a robust information source about potential breakdowns in medication management safety and opportunities for system improvement.

  1. Clinical and economic impact of non-adherence to antidepressants in major depressive disorder: A systematic review.

    PubMed

    Ho, Siew Ching; Chong, Huey Yi; Chaiyakunapruk, Nathorn; Tangiisuran, Balamurugan; Jacob, Sabrina Anne

    2016-03-15

    Medication non-adherence is one of the major challenges in treating patients with depression. This systematic review aims to determine the clinical and economic outcomes of non-adherence in depression. A systematic search was performed across the following databases: PubMed, EMBASE, DARE, CINAHL, PsycINFO, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews; from database inception to March 31, 2015. Studies must report on the association between adherence and outcomes, and English full texts needed to be available. The quality of each study was assessed using the Newcastle-Ottawa scale. A total of 11 articles were included, with eight reporting on clinical outcomes, two reporting on economic outcomes, and one reporting on both. The majority of studies were retrospective cohort studies. The mean quality of all included studies was 7, with a range from 3 to 9. Results clearly indicate that patients who were non-adherent were more likely to experience increased risks of relapse and/or recurrence, emergency department visits, and hospitalization rates; increased severity of depression, and a decrease in response and remission rates. The worsening of clinical outcomes in patients who were non-adherent subsequently translated to an increase in healthcare utilization and charges. No standardized adherence measurement tools were used, and few studies looked at the economic impact of non-adherence in depression. There is a strong association between non-adherence to antidepressants and a worsening of patients' clinical and economic outcomes. Cost-effective interventions should be directed to this group of patients to improve medication adherence. Copyright © 2015 Elsevier B.V. All rights reserved.

  2. Impact of an Information Technology-Enabled Initiative on the Quality of Prostate Multiparametric MRI Reports

    PubMed Central

    Silveira, Patricia C.; Dunne, Ruth; Sainani, Nisha I.; Lacson, Ronilda; Silverman, Stuart G.; Tempany, Clare M.; Khorasani, Ramin

    2015-01-01

    Rationale and Objectives Assess the impact of implementing a structured report template and a computer-aided diagnosis (CAD) tool on the quality of prostate multiparametric MRI (mp-MRI) reports. Materials and Methods Institutional Review Board approval was obtained for this HIPAA-compliant study performed at an academic medical center. The study cohort included all prostate mp-MRI reports (n=385) finalized 6 months before and after implementation of a structured report template and a CAD tool (collectively the IT tools) integrated into the PACS workstation. Primary outcome measure was quality of prostate mp-MRI reports. An expert panel of our institution’s subspecialty trained abdominal radiologists defined prostate mp-MRI report quality as optimal, satisfactory or unsatisfactory based on documentation of 9 variables. Reports were reviewed to extract the predefined quality variables and determine whether the IT tools were used to create each report. Chi-square and Student’s t-tests were used to compare report quality before and after implementation of IT tools. Results The overall proportion of optimal or satisfactory reports increased from 29.8% (47/158) to 53.3% (121/227) (p<0.001) after implementing the IT tools. While the proportion of optimal or satisfactory reports increased among reports generated using at least one of the IT tools (47/158=[29.8%] vs. 105/161=[65.2%]; p<0.001), there was no change in quality among reports generated without use of the IT tools (47/158=[29.8%] vs. 16/66=[24.2%]; p=0.404). Conclusion The use of a structured template and CAD tool improved the quality of prostate mp-MRI reports compared to free-text report format and subjective measurement of contrast enhancement kinetic curve. PMID:25863794

  3. Online reporting of adverse drug reactions: a study from a French regional pharmacovigilance center.

    PubMed

    Abadie, Delphine; Chebane, Leyla; Bert, Max; Durrieu, Geneviève; Montastruc, Jean-Louis

    2014-01-01

    In France, online reporting via a website is a new method for notifying adverse drug reactions (ADRs). The French Midi-Pyrénées Regional Pharmacovigilance Center (RPVC) set up in July, 2010 a Web-based ADR reporting tool in order to improve ADR reporting rate. To assess feasibility, use and performances of this new ADR reporting system. To evaluate the main characteristics of these online reports. In a retrospective study, we evaluated characteristics (numbers, ADR reporting and file processing times, type of reporters, suspected drugs, "seriousness" and nature of ADRs) of online notifications reported to the RPVC between July 7(th), 2010 (first online notification) and December 31(th), 2011. We performed comparisons to a random sample of "conventional" notifications, i.e. spontaneously reported to the RPVC via traditional tools (post, fax, e-mail or telephone) during the same period. The total number of online reports was 312 over the 18-month period. There was a 45% increase in numbers of reports from ambulatory healthcare professionals after the implementation of the new reporting tool. Online reports were transmitted to the French Medicine Agency on average almost one month (26 days) earlier than "conventional" ones. This difference was mainly due to a faster ADR notification process via the online form (on average, the reporting period was decreased by 19 days with the new tool). In comparison to "conventional" notifications, online reports came more often from ambulatory healthcare professionals, and involved more frequently neuropsychiatric drugs and neuropsychiatric ADRs. None difference was observed for "seriousness" of ADRs. It is feasible to deploy an online ADR reporting system used by health professionals in current practice. We underline the efficiency of this new online reporting tool for increasing ADRs reporting. Moreover, this is the first published study demonstrating that an online reporting tool can help to save time on the ADR reporting period and file processing, which is essential to generate early safety signals. © 2014 Société Française de Pharmacologie et de Thérapeutique.

  4. Gender Differences in Factors Associated with Unsheltered Status and Increased Risk of Premature Mortality among Individuals Experiencing Homelessness.

    PubMed

    Montgomery, Ann Elizabeth; Szymkowiak, Dorota; Culhane, Dennis

    Among individuals experiencing homelessness, unsheltered status is associated with poor health and access to care and an increased risk for premature death. Insufficient research has explored gender differences in these outcomes; the objective of this study was to address this gap in the research. This study used survey data collected during the 100,000 Homes Campaign. Chi-square tests identified differences in the characteristics of women, men, and transgender individuals. Generalized linear mixed models fit with demographic, homelessness, mental/behavioral health, institutional, and income characteristics were run separately for women and men to assess correlates of unsheltered status and increased risk of premature mortality. Men reported more frequently experiencing unsheltered homelessness while women and transgender participants more frequently met the criteria for risk of premature mortality. Women reported less frequently than men a history of or current substance use, but it significantly increased their likelihood of unsheltered homelessness; reports of mental health issues were rarer among men but significantly increased their odds of unsheltered homelessness. The experience of a violent attack while homeless was most strongly related to increased risk of premature mortality for both women and men. Interventions to reduce unsheltered homelessness among men should be particularly sensitive to mental health issues while for women there may need to be increased attention to substance use. A focus on experience of trauma and the provision of trauma-informed care is essential to address the increased risk of premature mortality among both men and women experiencing homelessness. Published by Elsevier Inc.

  5. Stress exposure and sensitivity in the clinical high-risk syndrome: initial findings from the North American Prodrome Longitudinal Study (NAPLS).

    PubMed

    Trotman, Hanan D; Holtzman, Carrie W; Walker, Elaine F; Addington, Jean M; Bearden, Carrie E; Cadenhead, Kristin S; Cannon, Tyrone D; Cornblatt, Barbara A; Heinssen, Robert K; Mathalon, Daniel H; Tsuang, Ming T; Perkins, Diana O; Seidman, Larry J; Woods, Scott W; McGlashan, Thomas H

    2014-12-01

    There is inconsistent evidence for increased stress exposure among individuals at clinical high risk (CHR) for psychosis. Yet similar to patients with a diagnosed psychotic illness, the preponderance of evidence suggests that CHR individuals tend to experience stressful life events (LE) and daily hassles (DH) as more subjectively stressful than healthy individuals. The present study utilizes data from the North American Prodrome Longitudinal Study Phase 2 (NAPLS-2) to test the hypotheses that (1) CHR individuals manifest higher self-reported stress in response to both LE and DH when compared to healthy controls (HC), (2) group differences in self-reported stress increase with age, (3) baseline self-reported stress is associated with follow-up clinical status, and (4) there is a sensitization effect of LE on the response to DH. In contrast to some previous research, the present findings indicate that the CHR group (N=314) reported exposure to more LE when compared to the HC group (N=162). As predicted, CHR participants rated events as more stressful, and those who progressed to psychosis reported a greater frequency of LE and greater stress from events compared to those whose prodromal symptoms remitted. There was also some evidence of stress-sensitization; those who experienced more stress from LE rated current DH as more stressful. The results indicate that the "prodromal" phase is a period of heightened stress and stress sensitivity, and elevated cumulative lifetime exposure to stressful events may increase reactions to current stressors. Copyright © 2014 Elsevier B.V. All rights reserved.

  6. Physical activity promotion in Latin American populations: a systematic review on issues of internal and external validity

    PubMed Central

    2014-01-01

    The purpose of this review was to determine the degree to which physical activity interventions for Latin American populations reported on internal and external validity factors using the RE-AIM framework (reach & representativeness, effectiveness, adoption, implementation, maintenance). We systematically identified English (PubMed; EbscoHost) and Spanish (SCIELO; Biblioteca Virtual en Salud) language studies published between 2001 and 2012 that tested physical activity, exercise, or fitness promotion interventions in Latin American populations. Cross-sectional/descriptive studies, conducted in Brazil or Spain, published in Portuguese, not including a physical activity/fitness/exercise outcome, and with one time point assessment were excluded. We reviewed 192 abstracts and identified 46 studies that met the eligibility criteria (34 in English, 12 in Spanish). A validated 21-item RE-AIM abstraction tool was used to determine the quality of reporting across studies (0-7 = low, 8-14 = moderate, and 15-21 = high). The number of indicators reported ranged from 3–14 (mean = 8.1 ± 2.6), with the majority of studies falling in the moderate quality reporting category. English and Spanish language articles did not differ on the number of indicators reported (8.1 vs. 8.3, respectively). However, Spanish articles reported more across reach indicators (62% vs. 43% of indicators), while English articles reported more across effectiveness indicators (69% vs 62%). Across RE-AIM dimensions, indicators for reach (48%), efficacy/effectiveness (67%), and implementation (41%) were reported more often than indicators of adoption (25%) and maintenance (10%). Few studies reported on the representativeness of participants, staff that delivered interventions, or the settings where interventions were adopted. Only 13% of the studies reported on quality of life and/or potential negative outcomes, 20% reported on intervention fidelity, and 11% on cost of implementation. Outcomes measured after six months of intervention, information on continued delivery and institutionalization of interventions, were also seldom reported. Regardless of language of publication, physical activity intervention research for Latin Americans should increase attention to and measurement of external validity and cost factors that are critical in the decision making process in practice settings and can increase the likelihood of translation into community or clinical practice. PMID:24938641

  7. Physical activity promotion in Latin American populations: a systematic review on issues of internal and external validity.

    PubMed

    Galaviz, Karla I; Harden, Samantha M; Smith, Erin; Blackman, Kacie Ca; Berrey, Leanna M; Mama, Scherezade K; Almeida, Fabio A; Lee, Rebecca E; Estabrooks, Paul A

    2014-06-17

    The purpose of this review was to determine the degree to which physical activity interventions for Latin American populations reported on internal and external validity factors using the RE-AIM framework (reach & representativeness, effectiveness, adoption, implementation, maintenance). We systematically identified English (PubMed; EbscoHost) and Spanish (SCIELO; Biblioteca Virtual en Salud) language studies published between 2001 and 2012 that tested physical activity, exercise, or fitness promotion interventions in Latin American populations. Cross-sectional/descriptive studies, conducted in Brazil or Spain, published in Portuguese, not including a physical activity/fitness/exercise outcome, and with one time point assessment were excluded. We reviewed 192 abstracts and identified 46 studies that met the eligibility criteria (34 in English, 12 in Spanish). A validated 21-item RE-AIM abstraction tool was used to determine the quality of reporting across studies (0-7 = low, 8-14 = moderate, and 15-21 = high). The number of indicators reported ranged from 3-14 (mean = 8.1 ± 2.6), with the majority of studies falling in the moderate quality reporting category. English and Spanish language articles did not differ on the number of indicators reported (8.1 vs. 8.3, respectively). However, Spanish articles reported more across reach indicators (62% vs. 43% of indicators), while English articles reported more across effectiveness indicators (69% vs 62%). Across RE-AIM dimensions, indicators for reach (48%), efficacy/effectiveness (67%), and implementation (41%) were reported more often than indicators of adoption (25%) and maintenance (10%). Few studies reported on the representativeness of participants, staff that delivered interventions, or the settings where interventions were adopted. Only 13% of the studies reported on quality of life and/or potential negative outcomes, 20% reported on intervention fidelity, and 11% on cost of implementation. Outcomes measured after six months of intervention, information on continued delivery and institutionalization of interventions, were also seldom reported. Regardless of language of publication, physical activity intervention research for Latin Americans should increase attention to and measurement of external validity and cost factors that are critical in the decision making process in practice settings and can increase the likelihood of translation into community or clinical practice.

  8. Daily iron supplementation for improving anaemia, iron status and health in menstruating women.

    PubMed

    Low, Michael Sze Yuan; Speedy, Joanna; Styles, Claire E; De-Regil, Luz Maria; Pasricha, Sant-Rayn

    2016-04-18

    Iron-deficiency anaemia is highly prevalent among non-pregnant women of reproductive age (menstruating women) worldwide, although the prevalence is highest in lower-income settings. Iron-deficiency anaemia has been associated with a range of adverse health outcomes, which restitution of iron stores using iron supplementation has been considered likely to resolve. Although there have been many trials reporting effects of iron in non-pregnant women, these trials have never been synthesised in a systematic review. To establish the evidence for effects of daily supplementation with iron on anaemia and iron status, as well as on physical, psychological and neurocognitive health, in menstruating women. In November 2015 we searched CENTRAL, Ovid MEDLINE, EMBASE, and nine other databases, as well as four digital thesis repositories. In addition, we searched the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) and reference lists of relevant reviews. We included randomised controlled trials (RCTs) and quasi-RCTs comparing daily oral iron supplementation with or without a cointervention (folic acid or vitamin C), for at least five days per week at any dose, to control or placebo using either individual- or cluster-randomisation. Inclusion criteria were menstruating women (or women aged 12 to 50 years) reporting on predefined primary (anaemia, haemoglobin concentration, iron deficiency, iron-deficiency anaemia, all-cause mortality, adverse effects, and cognitive function) or secondary (iron status measured by iron indices, physical exercise performance, psychological health, adherence, anthropometric measures, serum/plasma zinc levels, vitamin A status, and red cell folate) outcomes. We used the standard methodological procedures of Cochrane. The search strategy identified 31,767 records; after screening, 90 full-text reports were assessed for eligibility. We included 67 trials (from 76 reports), recruiting 8506 women; the number of women included in analyses varied greatly between outcomes, with endpoint haemoglobin concentration being the outcome with the largest number of participants analysed (6861 women). Only 10 studies were considered at low overall risk of bias, with most studies presenting insufficient details about trial quality.Women receiving iron were significantly less likely to be anaemic at the end of intervention compared to women receiving control (risk ratio (RR) 0.39 (95% confidence interval (CI) 0.25 to 0.60, 10 studies, 3273 women, moderate quality evidence). Women receiving iron had a higher haemoglobin concentration at the end of intervention compared to women receiving control (mean difference (MD) 5.30, 95% CI 4.14 to 6.45, 51 studies, 6861 women, high quality evidence). Women receiving iron had a reduced risk of iron deficiency compared to women receiving control (RR 0.62, 95% CI 0.50 to 0.76, 7 studies, 1088 women, moderate quality evidence). Only one study (55 women) specifically reported iron-deficiency anaemia and no studies reported mortality. Seven trials recruiting 901 women reported on 'any side effect' and did not identify an overall increased prevalence of side effects from iron supplements (RR 2.14, 95% CI 0.94 to 4.86, low quality evidence). Five studies recruiting 521 women identified an increased prevalence of gastrointestinal side effects in women taking iron (RR 1.99, 95% CI 1.26 to 3.12, low quality evidence). Six studies recruiting 604 women identified an increased prevalence of loose stools/diarrhoea (RR 2.13, 95% CI 1.10, 4.11, high quality evidence); eight studies recruiting 1036 women identified an increased prevalence of hard stools/constipation (RR 2.07, 95% CI 1.35 to 3.17, high quality evidence). Seven studies recruiting 1190 women identified evidence of an increased prevalence of abdominal pain among women randomised to iron (RR 1.55, 95% CI 0.99 to 2.41, low quality evidence). Eight studies recruiting 1214 women did not find any evidence of an increased prevalence of nausea among women randomised to iron (RR 1.19, 95% CI 0.78 to 1.82). Evidence that iron supplementation improves cognitive performance in women is uncertain, as studies could not be meta-analysed and individual studies reported conflicting results. Iron supplementation improved maximal and submaximal exercise performance, and appears to reduce symptomatic fatigue. Although adherence could not be formally meta-analysed due to differences in reporting, there was no evident difference in adherence between women randomised to iron and control. Daily iron supplementation effectively reduces the prevalence of anaemia and iron deficiency, raises haemoglobin and iron stores, improves exercise performance and reduces symptomatic fatigue. These benefits come at the expense of increased gastrointestinal symptomatic side effects.

  9. An Incidental Finding of a Talonavicular and Talocalcaneal Joint Coalition After a Tibial Pilon Fracture: A Case Report.

    PubMed

    Godoy, Heidi M; Micciche, Mark J

    It has been proposed that patients with talocalcaneal and talonavicular coalitions have decreased ankle joint range of motion. It has also been reported that rotational forces regularly absorbed by the talocalcaneal joint are transferred to the ankle joint in patients with coalitions, increasing the stress on the ankle joint after trauma. To the best of our knowledge, only 1 reported study has detailed the increased stress placed on the ankle joint secondary to a coalition. We present a case study of a 53-year-old female who experienced a traumatic fall and subsequent right ankle fracture. Advanced imaging studies revealed a comminuted tibial pilon fracture and talocalcaneal and talonavicular joint coalitions. She underwent open reduction and internal fixation for treatment of the fracture, and the coalitions were not treated because they were asymptomatic. She was kept non-weightbearing for 6 weeks postoperatively and was returned to a regular sneaker at 10 weeks postoperatively. The postoperative films revealed stable intact fixation and pain-free gait with no increased restriction in her ankle joint range of motion. The hardware was removed at 13 months postoperatively. She had not experienced increased pain or arthritic changes at 15 months postoperatively. Copyright © 2017 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  10. Frequency of infant stroking reported by mothers moderates the effect of prenatal depression on infant behavioural and physiological outcomes.

    PubMed

    Sharp, Helen; Pickles, Andrew; Meaney, Michael; Marshall, Kate; Tibu, Florin; Hill, Jonathan

    2012-01-01

    Animal studies find that prenatal stress is associated with increased physiological and emotional reactivity later in life, mediated via fetal programming of the HPA axis through decreased glucocorticoid receptor (GR) gene expression. Post-natal behaviours, notably licking and grooming in rats, cause decreased behavioural indices of fear and reduced HPA axis reactivity mediated via increased GR gene expression. Post-natal maternal behaviours may therefore be expected to modify prenatal effects, but this has not previously been examined in humans. We examined whether, according to self-report, maternal stroking over the first weeks of life modified associations between prenatal depression and physiological and behavioral outcomes in infancy, hence mimicking effects of rodent licking and grooming. From a general population sample of 1233 first time mothers recruited at 20 weeks gestation we drew a stratified random sample of 316 for assessment at 32 weeks based on reported inter-partner psychological abuse, a risk to child development. Of these 271 provided data at 5, 9 and 29 weeks post delivery. Mothers reported how often they stroked their babies at 5 and 9 weeks. At 29 weeks vagal withdrawal to a stressor, a measure of physiological adaptability, and maternal reported negative emotionality were assessed. There was a significant interaction between prenatal depression and maternal stroking in the prediction of vagal reactivity to a stressor (p = .01), and maternal reports of infant anger proneness (p = .007) and fear (p = .043). Increasing maternal depression was associated with decreasing physiological adaptability, and with increasing negative emotionality, only in the presence of low maternal stroking. These initial findings in humans indicate that maternal stroking in infancy, as reported by mothers, has effects strongly resembling the effects of observed maternal behaviours in animals, pointing to future studies of the epigenetic, physiological and behavioral effects of maternal stroking.

  11. Prevalence of self-reported comorbidities in HIV positive and HIV negative men who have sex with men over 55 years-The Australian Positive & Peers Longevity Evaluation Study (APPLES).

    PubMed

    Petoumenos, Kathy; Huang, Robin; Hoy, Jennifer; Bloch, Mark; Templeton, David J; Baker, David; Giles, Michelle; Law, Matthew G; Cooper, David A

    2017-01-01

    In Australia, almost half of HIV-positive people are now aged over 50 and are predominately gay and bisexual men (GBM). Compared to the general HIV-negative population, GBM engage more in behaviours that may increase the risk of age-related comorbidities, including smoking, high alcohol consumption and recreational drug use. The objective of APPLES was to compare comorbidities and risk factors in HIV-positive older GBM with an appropriate control group of HIV-negative GBM. We undertook a prospectively recruited cross-sectional sample of HIV-positive and HIV-negative GBM ≥ 55 years. Detailed data collection included clinic data, a health and lifestyle survey, and blood sample collection. We report key demographic, laboratory markers and self-reported comorbidities by HIV status. For selected comorbidities we also adjust HIV status a priori for age, smoking and body mass index. Over 16 months 228 HIV-positive and 218 HIV-negative men were recruited. Median age was 63 years (IQR: 59-67). Although more HIV-positive men reported having ever smoked, smoking status was not statistically different between HIV positive and HIV negative men (p = 0.081). Greater alcohol use was reported by HIV-negative men (p = 0.002), and recreational drug use reported more often by HIV-positive men (p<0.001). After adjustment, HIV-positive men had significantly increased odds of diabetes (adjusted Odds ratio (aOR): 1.97, p = 0.038), thrombosis (aOR: 3.08, p = 0.007), neuropathy (aOR: 34.6, P<0.001), and non-significantly increased odds for heart-disease (aOR: 1.71, p = 0.077). In conclusion, HIV-positive GBM have significantly increased odds for key self-reported comorbidities. This study underscores the importance of an appropriate HIV-negative control group for more accurate evaluation of the risk and attribution of age-related comorbidities in HIV-positive people.

  12. Shale gas activity and increased rates of sexually transmitted infections in Ohio, 2000–2016

    PubMed Central

    Humeau, Zoe; Elliott, Elise G.; Warren, Joshua L.; Niccolai, Linda M.

    2018-01-01

    Background The growing shale gas (“fracking”) industry depends on a mobile workforce, whose influx could have social impacts on host communities. Sexually transmitted infections (STIs) can increase through sexual mixing patterns associated with labor migration. No prior studies have quantified the relationship between shale gas activity and rates of three reportable STIs: chlamydia, gonorrhea, and syphilis. Methods We conducted a longitudinal, ecologic study from 2000–2016 in Ohio, situated in a prolific shale gas region in the United States (US). Data on reported cases of chlamydia, gonorrhea, and syphilis by county and year were obtained from the Ohio Department of Health. All 88 counties were classified as none, low, and high shale gas activity in each year, using data from the Ohio Department of Natural Resources. Annual rate ratios (RR) and 95% confidence intervals (95% CIs) were calculated from mixed-effects Poisson regression models evaluating the relationship between shale gas activity and reported annual STI rates while adjusting for secular trends and potential confounders obtained from the US Census. Results Compared to counties with no shale gas activity, counties with high activity had 21% (RR = 1.21; 95%CI = 1.08–1.36) increased rates of chlamydia and 19% (RR = 1.27; 95%CI 0.98–1.44) increased rates of gonorrhea, respectively. No association was observed for syphilis. Conclusion This first report of a link between shale gas activity and increased rates of both chlamydia and gonorrhea may inform local policies and community health efforts. PMID:29570712

  13. An on-line narrative of Colorado wilderness: Self-in-"cybernetic space"

    Treesearch

    Joseph G. Champ; Daniel R. Williams; Catherine M. Lundy

    2013-01-01

    The authors consider a new frontier for the study of wilderness recreation experience, an increasingly common form of blog known as online trip reports. Analysis and discussion in this article is the result of collecting and reflecting upon more than 300 trip reports focused on wilderness areas in the state of Colorado. The authors present a case study of one trip...

  14. Concurrent and Predictive Validity of Parent Reports of Child Language at Ages 2 and 3 Years

    ERIC Educational Resources Information Center

    Feldman, Heidi M.; Dale, Philip S.; Campbell, Thomas F.; Colborn, D. Kathleen; Kurs-Lasky, Marcia; Rockette, Howard E.; Paradise, Jack L.

    2005-01-01

    The MacArthur-Bates Communicative Development Inventories (CDI; Dale, 1996; Fenson et al., 1994), parent reports about language skills, are being used increasingly in studies of theoretical and public health importance. This study (N=113) correlated scores on the CDI at ages 2 and 3 years with scores at age 3 years on tests of cognition and…

  15. Hypercalcemia, hypercalciuria, and kidney stones in long-term studies of vitamin D supplementation: a systematic review and meta-analysis.

    PubMed

    Malihi, Zarintaj; Wu, Zhenqiang; Stewart, Alistair W; Lawes, Carlene Mm; Scragg, Robert

    2016-10-01

    Vitamin D supplementation is increasingly being used in higher doses in randomized controlled trials (RCTs). However, adverse events from very large annual doses of vitamin D have been shown in 2 RCTs, whereas in a third RCT, low-dose vitamin D, with calcium supplements, was shown to increase kidney stone risk. We analyzed the side effects related to calcium metabolism in RCTs, specifically hypercalcemia, hypercalciuria, and kidney stones, in participants who were given vitamin D supplements for ≥24 wk compared with in subjects in the placebo arm. The following 3 main online databases were searched: Ovid Medline (PubMed), EMBASE, and the Cochrane Library. Software was used for the meta-analysis. A total of 48 studies with 19,833 participants were identified, which reported ≥1 of the following side effects: hypercalcemia, hypercalciuria, or kidney stones. Of these studies, kidney stones were reported in only 9 trials with a tendency for fewer subjects reporting stones in the vitamin D arm than in the placebo arm (RR: 0.66, 95% CI: 0.41, 1.09; P = 0.10). In 37 studies, hypercalcemia was shown with increased risk shown for the vitamin D group (RR: 1.54; 95% CI: 1.09, 2.18; P = 0.01). Similar increased risk of hypercalciuria was shown in 14 studies for the vitamin D group (RR: 1.64; 95% CI: 1.06, 2.53; P = 0.03). In subgroup analyses, it was shown that the effect of vitamin D supplementation on risk of hypercalcemia, hypercalciuria, or kidney stones was not modified by baseline 25-hydroxyvitamin D, vitamin D dose and duration, or calcium co-supplementation. Long-term vitamin D supplementation resulted in increased risks of hypercalcemia and hypercalciuria, which were not dose related. However, vitamin D supplementation did not increase risk of kidney stones. Additional large RCTs of long-term vitamin D supplementation are required to confirm these findings. © 2016 American Society for Nutrition.

  16. Maternal Antidepressant Use During Pregnancy and the Risk of Attention-Deficit/Hyperactivity Disorder in Children: A Systematic Review of the Current Literature.

    PubMed

    Uguz, Faruk

    2018-06-01

    This study reviewed the current literature examining the potential relationship between use of antidepressants during pregnancy and attention-deficit/hyperactivity disorder (ADHD) in children. PubMed was searched for English language reports between January 1, 1995, and July 31, 2017, by using combinations of the key words pregnancy, antidepressants, selective serotonin reuptake inhibitors (SSRIs), selective serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), children, offspring, and ADHD. Studies that reported association between ADHD in children and use of antidepressant in pregnant women were included in the review. A total of 7 relevant studies that met the review criteria were examined. The studies reported that compared with nonusers adjusted risks of ADHD in children were 1.2 to 1.6 for the use of any antidepressant, 0.91 to 1.66 for selective serotonin reuptake inhibitors, 1.1 to 1.4 for selective serotonin-norepinephrine reuptake inhibitors, and 1.1 to 1.8 for tricyclic antidepressants. There was some scientific evidences suggesting a connection between antidepressant use during all trimesters of pregnancy and increased risk of ADHD in children. In addition, the study results suggest that underlying maternal anxiety or depressive disorders may also contribute to increased risk of ADHD. Although some studies have suggested a moderately increased risk of ADHD in children with maternal antidepressant use during pregnancy, based on limitations and results of the studies, this review concluded that there is no strong evidence to suggest a causal link.

  17. Effects of the 2011 duty hour reforms on interns and their patients: a prospective longitudinal cohort study.

    PubMed

    Sen, Srijan; Kranzler, Henry R; Didwania, Aashish K; Schwartz, Ann C; Amarnath, Sudha; Kolars, Joseph C; Dalack, Gregory W; Nichols, Breck; Guille, Constance

    2013-04-22

    In 2003, the first phase of duty hour requirements for US residency programs recommended by the Accreditation Council for Graduate Medical Education (ACGME) was implemented. Evidence suggests that this first phase of duty hour requirements resulted in a modest improvement in resident well-being and patient safety. To build on these initial changes, the ACGME recommended a new set of duty hour requirements that took effect in July 2011. To determine the effects of the 2011 duty hour reforms on first-year residents (interns) and their patients. As part of the Intern Health Study, we conducted a longitudinal cohort study comparing interns serving before (2009 and 2010) and interns serving after (2011) the implementation of the new duty hour requirements. Fifty-one residency programs at 14 university and community-based GME institutions. A total of 2323 medical interns. Self-reported duty hours, hours of sleep, depressive symptoms, well-being, and medical errors at 3, 6, 9, and 12 months of the internship year. Fifty-eight percent of invited interns chose to participate in the study. Reported duty hours decreased from an average of 67.0 hours per week before the new rules to 64.3 hours per week after the new rules were instituted (P < .001). Despite the decrease in duty hours, there were no significant changes in hours slept (6.8 → 7.0; P = .17), depressive symptoms (5.8 → 5.7; P = .55) or well-being score (48.5 → 48.4; P = .86) reported by interns. With the new duty hour rules, the percentage of interns who reported concern about making a serious medical error increased from 19.9% to 23.3% (P = .007). Although interns report working fewer hours under the new duty hour restrictions, this decrease has not been accompanied by an increase in hours of sleep or an improvement in depressive symptoms or well-being but has been accompanied by an unanticipated increase in self-reported medical errors.

  18. Reaching nearby sources: comparison between real and virtual sound and visual targets

    PubMed Central

    Parseihian, Gaëtan; Jouffrais, Christophe; Katz, Brian F. G.

    2014-01-01

    Sound localization studies over the past century have predominantly been concerned with directional accuracy for far-field sources. Few studies have examined the condition of near-field sources and distance perception. The current study concerns localization and pointing accuracy by examining source positions in the peripersonal space, specifically those associated with a typical tabletop surface. Accuracy is studied with respect to the reporting hand (dominant or secondary) for auditory sources. Results show no effect on the reporting hand with azimuthal errors increasing equally for the most extreme source positions. Distance errors show a consistent compression toward the center of the reporting area. A second evaluation is carried out comparing auditory and visual stimuli to examine any bias in reporting protocol or biomechanical difficulties. No common bias error was observed between auditory and visual stimuli indicating that reporting errors were not due to biomechanical limitations in the pointing task. A final evaluation compares real auditory sources and anechoic condition virtual sources created using binaural rendering. Results showed increased azimuthal errors, with virtual source positions being consistently overestimated to more lateral positions, while no significant distance perception was observed, indicating a deficiency in the binaural rendering condition relative to the real stimuli situation. Various potential reasons for this discrepancy are discussed with several proposals for improving distance perception in peripersonal virtual environments. PMID:25228855

  19. The effect of secondhand smoke exposure on the association between active cigarette smoking and colorectal cancer

    PubMed Central

    Peppone, Luke J.; Reid, Mary E.; Moysich, Kirsten B.; Morrow, Gary R.; Jean-Pierre, Pascal; Mohile, Supriya G.; Darling, Tom V.; Hyland, Andrew

    2011-01-01

    Background Studies published prior to 1980 failed to find an association between smoking and colorectal cancer, while subsequent studies reported an association after accounting for a three to four decade initiation period. The aims of this study were to determine the effect of accounting for secondhand smoke (SHS) exposure on the association between smoking and colorectal cancer and to determine the association between SHS and colorectal cancer. Methods Approximately 1,200 colorectal cancer cases treated at Roswell Park Cancer Institute between 1982 and 1998 were matched to 2,400 malignancy-free controls. The effect of accounting for SHS exposure was determined by comparing the odds ratios (OR) for each smoking variable in the overall sample and then for those who reported no current SHS exposure. Results A small, significant increase in colorectal cancer odds was noted for heavy, long-term smoking males when not accounting for SHS exposure (>45 PY: OR = 1.34; 95% CI 1.04–1.72). OR increased when the analyses were restricted to individuals reporting no current SHS exposure (>45 PY: OR = 2.40; 95% CI 1.36–4.23). Conclusions Accounting for SHS exposure resulted in a substantial increase in the odds of colorectal cancer for all smoking variables in this study. Future studies should account for SHS exposure when examining the association between smoking and colorectal cancer. PMID:20376547

  20. Interventions to increase the use of electronic health information by healthcare practitioners to improve clinical practice and patient outcomes.

    PubMed

    Fiander, Michelle; McGowan, Jessie; Grad, Roland; Pluye, Pierre; Hannes, Karin; Labrecque, Michel; Roberts, Nia W; Salzwedel, Douglas M; Welch, Vivian; Tugwell, Peter

    2015-03-14

    There is a large volume of health information available, and, if applied in clinical practice, may contribute to effective patient care. Despite an abundance of information, sub-optimal care is common. Many factors influence practitioners' use of health information, and format (electronic or other) may be one such factor. To assess the effects of interventions aimed at improving or increasing healthcare practitioners' use of electronic health information (EHI) on professional practice and patient outcomes. We searched The Cochrane Library (Wiley), MEDLINE (Ovid), EMBASE (Ovid), CINAHL (EBSCO), and LISA (EBSCO) up to November 2013. We contacted researchers in the field and scanned reference lists of relevant articles. We included studies that evaluated the effects of interventions to improve or increase the use of EHI by healthcare practitioners on professional practice and patient outcomes. We defined EHI as information accessed on a computer. We defined 'use' as logging into EHI. We considered any healthcare practitioner involved in patient care. We included randomized, non-randomized, and cluster randomized controlled trials (RCTs, NRCTs, CRCTs), controlled clinical trials (CCTs), interrupted time series (ITS), and controlled before-and-after studies (CBAs).The comparisons were: electronic versus printed health information; EHI on different electronic devices (e.g. desktop, laptop or tablet computers, etc.; cell / mobile phones); EHI via different user interfaces; EHI provided with or without an educational or training component; and EHI compared to no other type or source of information. Two review authors independently extracted data and assessed the risk of bias for each study. We used GRADE to assess the quality of the included studies. We reassessed previously excluded studies following our decision to define logins to EHI as a measure of professional behavior. We reported results in natural units. When possible, we calculated and reported median effect size (odds ratio (OR), interquartile ranges (IQR)). Due to high heterogeneity across studies, meta-analysis was not feasible. We included two RCTs and four CRCTs involving 352 physicians, 48 residents, and 135 allied health practitioners. Overall risk of bias was low as was quality of the evidence. One comparison was supported by three studies and three comparisons were supported by single studies, but outcomes across the three studies were highly heterogeneous. We found no studies to support EHI versus no alternative. Given these factors, it was not possible to determine the relative effectiveness of interventions. All studies reported practitioner use of EHI, two reported on compliance with electronic practice guidelines, and none reported on patient outcomes.One trial (139 participants) measured guideline adherence for an electronic versus printed guideline, but reported no difference between groups (median OR 0.85, IQR 0.74 to 1.08). One small cross-over trial (10 participants) reported increased use of clinical guidelines when provided with a mobile versus stationary, desktop computer (mean use per shift: intervention group (IG) 3.6, standard deviation (SD) 1.7 vs. control group (CG) 2.0 (SD 1.9), P value = 0.033). One cross-over trial (203 participants) reported that using a customized versus a generic interface had little impact on practitioners' use of EHI (mean difference in adjusted end-of-study rate: 0.77 logins/month/user, 95% confidence interval (CI) CI 0.43 to 1.11). Three trials included education or training and reported increased use of EHI by practitioners following training. This review provided no evidence that the use of EHI translates into improved clinical practice or patient outcomes, though it does suggest that when practitioners are provided with EHI and education or training, the use of EHI increases. We have defined use as the activity of logging into an EHI resource, but based on our findings use does not automatically translate to the application of EHI in practice. While using EHI may be an important component of evidence-based medicine, alone it is insufficient to improve patient care or clinical practices. For EHI to be applied in patient care, it will be necessary to understand why practitioners' are reluctant to apply EHI when treating people, and to determine the most effective way(s) to reduce this reluctance.

  1. Methodology or method? A critical review of qualitative case study reports

    PubMed Central

    Hyett, Nerida; Kenny, Amanda; Dickson-Swift, Virginia

    2014-01-01

    Despite on-going debate about credibility, and reported limitations in comparison to other approaches, case study is an increasingly popular approach among qualitative researchers. We critically analysed the methodological descriptions of published case studies. Three high-impact qualitative methods journals were searched to locate case studies published in the past 5 years; 34 were selected for analysis. Articles were categorized as health and health services (n=12), social sciences and anthropology (n=7), or methods (n=15) case studies. The articles were reviewed using an adapted version of established criteria to determine whether adequate methodological justification was present, and if study aims, methods, and reported findings were consistent with a qualitative case study approach. Findings were grouped into five themes outlining key methodological issues: case study methodology or method, case of something particular and case selection, contextually bound case study, researcher and case interactions and triangulation, and study design inconsistent with methodology reported. Improved reporting of case studies by qualitative researchers will advance the methodology for the benefit of researchers and practitioners. PMID:24809980

  2. Health-related quality of life surveillance--United States, 1993-2002.

    PubMed

    Zahran, Hatice S; Kobau, Rosemarie; Moriarty, David G; Zack, Matthew M; Holt, James; Donehoo, Ralph

    2005-10-28

    Population-based surveillance of health-related quality of life (HRQOL) is needed to promote the health and quality of life of U.S. residents and to monitor progress in achieving the two overall Healthy People 2010 goals: 1) increase the quality and years of healthy life and 2) eliminate health disparities. This report examines surveillance-based HRQOL data from 1993 through 2002. Survey data from a validated set of HRQOL measures (CDC HRQOL-4) were analyzed for 1993-2001 from the Behavioral Risk Factor Surveillance System (BRFSS) surveys for the 50 states and the District of Columbia (DC) and for 2001-2002 from the National Health and Nutrition Examination Survey (NHANES). These measures assessed self-rated health; physically unhealthy days (i.e., the number of days during the preceding 30 days for which physical health, including physical illness and injury, was not good); mentally unhealthy days (i.e., the number of days during the preceding 30 days for which mental health, including stress, depression, and problems with emotions, was not good); and days with activity limitation (i.e., number of days during the preceding 30 days that poor physical or mental health prevented normal daily activities). A summary measure of overall unhealthy days also was computed from the sum of a respondent's physically unhealthy and mentally unhealthy days, with a maximum of 30 days. During 1993-2001, the mean number of physically unhealthy days, mentally unhealthy days, overall unhealthy days, and activity limitation days was higher after 1997 than before 1997. During 1993-1997, the percentage of respondents with zero overall unhealthy days was stable (51%-53%) but declined to 48% by 2001. The percentage of respondents with >/=14 overall unhealthy days increased from 15%-16% during 1993-1997 to 18% by 2001. Adults increasingly rated their health as fair or poor and decreasingly rated it as excellent or very good. Women, American Indians/Alaska Natives, persons of "other races," separated or divorced persons, unmarried couples, unemployed persons, those unable to work, those with a <$15,000 annual household income, and those with less than a high school education reported worse HRQOL (i.e., physically unhealthy days, mentally unhealthy days, overall unhealthy days, and activity limitation days). Older adults reported more physically unhealthy days and activity limitation days, whereas younger adults reported more mentally unhealthy days. A seasonal pattern was observed in physically unhealthy days and overall unhealthy days. During 1993-2001, BRFSS respondents in 13 states reported increasing physically unhealthy days; respondents in 13 states and DC reported increasing mentally unhealthy days; respondents in Alabama, Connecticut, Maine, New Jersey, New Mexico, North Carolina, and Oregon reported both increasing physically and mentally unhealthy days; and respondents in 16 states and DC reported increasing activity limitation days. During 2001-2002, NHANES respondents with one or more medical conditions (e.g., arthritis or stroke) reported worse HRQOL than those without such conditions, and those with an increasing number of medical conditions reported increasingly worse HRQOL. Policy makers and researchers should continue to monitor HRQOL and its correlates in the U.S. population. In addition, public health professionals should expand monitoring to populations currently missed by existing surveys, including institutionalized and homeless persons, adolescents, and children. A key aspect is to study and identify the personal and community determinants of HRQOL in prevention research and population studies, to understand how to improve HRQOL, and to reduce HRQOL disparities. In addition, population health assessment professionals should continue to refine and validate HRQOL, functional status, and self-reported health measures.

  3. No improvement in the reporting of clinical trial subgroup effects in high-impact general medical journals.

    PubMed

    Gabler, Nicole B; Duan, Naihua; Raneses, Eli; Suttner, Leah; Ciarametaro, Michael; Cooney, Elizabeth; Dubois, Robert W; Halpern, Scott D; Kravitz, Richard L

    2016-07-16

    When subgroup analyses are not correctly analyzed and reported, incorrect conclusions may be drawn, and inappropriate treatments provided. Despite the increased recognition of the importance of subgroup analysis, little information exists regarding the prevalence, appropriateness, and study characteristics that influence subgroup analysis. The objective of this study is to determine (1) if the use of subgroup analyses and multivariable risk indices has increased, (2) whether statistical methodology has improved over time, and (3) which study characteristics predict subgroup analysis. We randomly selected randomized controlled trials (RCTs) from five high-impact general medical journals during three time periods. Data from these articles were abstracted in duplicate using standard forms and a standard protocol. Subgroup analysis was defined as reporting any subgroup effect. Appropriate methods for subgroup analysis included a formal test for heterogeneity or interaction across treatment-by-covariate groups. We used logistic regression to determine the variables significantly associated with any subgroup analysis or, among RCTs reporting subgroup analyses, using appropriate methodology. The final sample of 416 articles reported 437 RCTs, of which 270 (62 %) reported subgroup analysis. Among these, 185 (69 %) used appropriate methods to conduct such analyses. Subgroup analysis was reported in 62, 55, and 67 % of the articles from 2007, 2010, and 2013, respectively. The percentage using appropriate methods decreased over the three time points from 77 % in 2007 to 63 % in 2013 (p < 0.05). Significant predictors of reporting subgroup analysis included industry funding (OR 1.94 (95 % CI 1.17, 3.21)), sample size (OR 1.98 per quintile (1.64, 2.40), and a significant primary outcome (OR 0.55 (0.33, 0.92)). The use of appropriate methods to conduct subgroup analysis decreased by year (OR 0.88 (0.76, 1.00)) and was less common with industry funding (OR 0.35 (0.18, 0.70)). Only 33 (18 %) of the RCTs examined subgroup effects using a multivariable risk index. While we found no significant increase in the reporting of subgroup analysis over time, our results show a significant decrease in the reporting of subgroup analyses using appropriate methods during recent years. Industry-sponsored trials may more commonly report subgroup analyses, but without utilizing appropriate methods. Suboptimal reporting of subgroup effects may impact optimal physician-patient decision-making.

  4. Review: Assessment of completeness of reporting in intervention studies using livestock: an example from pain mitigation interventions in neonatal piglets.

    PubMed

    O'Connor, A; Anthony, R; Bergamasco, L; Coetzee, J F; Dzikamunhenga, R S; Johnson, A K; Karriker, L A; Marchant-Forde, J N; Martineau, G P; Millman, S T; Pajor, E A; Rutherford, K; Sprague, M; Sutherland, M A; von Borell, E; Webb, S R

    2016-04-01

    Accurate and complete reporting of study methods, results and interpretation are essential components for any scientific process, allowing end-users to evaluate the internal and external validity of a study. When animals are used in research, excellence in reporting is expected as a matter of continued ethical acceptability of animal use in the sciences. Our primary objective was to assess completeness of reporting for a series of studies relevant to mitigation of pain in neonatal piglets undergoing routine management procedures. Our second objective was to illustrate how authors can report the items in the Reporting guidElines For randomized controLled trials for livEstoCk and food safety (REFLECT) statement using examples from the animal welfare science literature. A total of 52 studies from 40 articles were evaluated using a modified REFLECT statement. No single study reported all REFLECT checklist items. Seven studies reported specific objectives with testable hypotheses. Six studies identified primary or secondary outcomes. Randomization and blinding were considered to be partially reported in 21 and 18 studies, respectively. No studies reported the rationale for sample sizes. Several studies failed to report key design features such as units for measurement, means, standard deviations, standard errors for continuous outcomes or comparative characteristics for categorical outcomes expressed as either rates or proportions. In the discipline of animal welfare science, authors, reviewers and editors are encouraged to use available reporting guidelines to ensure that scientific methods and results are adequately described and free of misrepresentations and inaccuracies. Complete and accurate reporting increases the ability to apply the results of studies to the decision-making process and prevent wastage of financial and animal resources.

  5. Mount Baker - Snoqualmie National Forest alternative transportation feasibility study : phase II final report

    DOT National Transportation Integrated Search

    2014-04-01

    The Mount Baker-Snoqualmie National Forest is located near the Puget Sound metro area and is facing a number of transportation issues, such as increasing congestion and lack of access, which were identified in the Volpe Centers Phase I report. Thi...

  6. Changes in clinical and hotel expenditures following publication of the nursing home compare report card.

    PubMed

    Mukamel, Dana B; Spector, William D; Zinn, Jacqueline; Weimer, David L; Ahn, Richard

    2010-10-01

    Nursing Home Compare first published clinical quality measures at the end of 2002. It is a quality report card that for the first time offers consumers easily accessible information about the clinical quality of nursing homes. It led to changes in consumers' demand, increasing the relative importance of clinical versus hotel aspects of quality in their search and choice of a nursing home. To examine the hypothesis that nursing homes responding to these changes in demand shifted the balance of resources from hotel to clinical activities. The study included 10,022 free-standing nursing homes nationwide during 2001 to 2006. RESEARCH DESIGN AND DATA: A retrospective multivariate statistical analysis of trends in the ratio of clinical to hotel expenditures, using Medicare cost reports, Minimum Data Set and Online Survey, Certification and Reporting data, controlling for changes in residents' acuity and facility fixed effects. Inference is based on robust standard errors. The ratio of clinical to hotel expenditures averaged 1.78. It increased significantly (P < 0.001) by 5% following the publication of the report card. The increase was larger and more significant among nursing homes with worse reported quality, lower occupancy, those located in more competitive markets, for-profit ownership and owned by a chain. The increase in the ratio of clinical to hotel expenditures following publication of the report card suggests that nursing homes responded as expected to the changes in the elasticity of demand with respect to clinical quality brought about by the public reporting of clinical quality measures. The response was stronger among nursing homes facing stronger incentives.

  7. Nonmedical opioid use and heroin use in a nationally representative sample of us high school seniors.

    PubMed

    Palamar, Joseph J; Shearston, Jenni A; Dawson, Eric W; Mateu-Gelabert, Pedro; Ompad, Danielle C

    2016-01-01

    Nonmedical use of opioids has become increasingly problematic in recent years with increases in overdoses, treatment admissions, and deaths. Use also appears to be contributing to heroin initiation, which has increased in recent years. Further research is needed to examine which adolescents are at highest risk for nonmedical use of opioids and heroin and to explore potential links between nonmedical opioid use and heroin use. Data were analyzed from a nationally representative sample of American high school seniors in the Monitoring the Future study (2009-2013, Weighted N=67,822). We examined associations between frequency and recency of nonmedical use of opioids and heroin. Sociodemographic correlates of use of each drug were also examined. 12.4% of students reported lifetime nonmedical opioid use and 1.2% reported lifetime heroin use. As frequency of lifetime nonmedical opioid use increased, so too did the odds for reporting heroin use, with over three-quarters (77.3%) of heroin users reporting lifetime nonmedical opioid use. Recent (30-day) nonmedical opioid use was a robust risk factor for heroin use and almost a quarter (23.2%) of students who reported using opioids ≥40 times reported lifetime heroin use. Black and Hispanic students were less likely to report nonmedical opioid or heroin use than white students, but they were more likely to report heroin use in absence of nonmedical opioid use. Recent and frequent nonmedical opioid use are risk factors for heroin use among adolescents. Prevention needs to be targeted to those at highest risk. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  8. Nonmedical Opioid Use and Heroin Use in a Nationally Representative Sample of US High School Seniors*

    PubMed Central

    Palamar, Joseph J.; Shearston, Jenni A.; Dawson, Eric W.; Mateu-Gelabert, Pedro; Ompad, Danielle C.

    2015-01-01

    Background Nonmedical use of opioids has become increasingly problematic in recent years with increases in overdoses, treatment admissions, and deaths. Use also appears to be contributing to heroin initiation, which has increased in recent years. Further research is needed to examine which adolescents are at highest risk for nonmedical use of opioids and heroin and to explore potential links between nonmedical opioid use and heroin use. Methods Data were analyzed from a nationally representative sample of American high school seniors in the Monitoring the Future study (2009–2013, Weighted N = 67,822). We examined associations between frequency and recency of nonmedical use of opioids and heroin. Sociodemographic correlates of use of each drug were also examined. Results 12.4% of students reported lifetime nonmedical opioid use and 1.2% reported lifetime heroin use. As frequency of lifetime nonmedical opioid use increased, so too did the odds for reporting heroin use, with over three-quarters (77.3%) of heroin users reporting lifetime nonmedical opioid use. Recent (30-day) nonmedical opioid use was a robust risk factor for heroin use and almost a quarter (23.2%) of students who reported using opioids ≥40 times reported lifetime heroin use. Black and Hispanic students were less likely to report nonmedical opioid or heroin use than white students, but they were more likely to report heroin use in absence of nonmedical opioid use. Discussion Recent and frequent nonmedical opioid use are risk factors for heroin use among adolescents. Prevention needs to be targeted to those at highest risk. PMID:26653341

  9. Quality of life in patients with proton-treated pediatric medulloblastoma: Results of a prospective assessment with 5-year follow-up.

    PubMed

    Kamran, Sophia C; Goldberg, Saveli I; Kuhlthau, Karen A; Lawell, Miranda P; Weyman, Elizabeth A; Gallotto, Sara L; Hess, Clayton B; Huang, Mary S; Friedmann, Alison M; Abrams, Annah N; MacDonald, Shannon M; Pulsifer, Margaret B; Tarbell, Nancy J; Ebb, David H; Yock, Torunn I

    2018-06-15

    To the authors' knowledge, health-related quality of life (HRQOL) outcomes are not well described in patients with medulloblastoma. The use of proton radiotherapy (RT) may translate into an improved HRQOL. In the current study, the authors report long-term HRQOL in patients with proton-treated pediatric medulloblastoma. The current study was a prospective cohort HRQOL study of patients with medulloblastoma who were treated with proton RT and enrolled between August 5, 2002, and October 8, 2015. Both child report and parent-proxy report Pediatric Quality of Life Inventory (PedsQL) surveys were collected at baseline during RT and annually thereafter (score range on surveys of 0-100, with higher scores indicating better HRQOL). Patients were dichotomized by clinical/treatment variables and subgroups were compared. Mixed-model analysis was performed to determine the longitudinal trajectory of PedsQL scores. The Student t test was used to compare long-term HRQOL measures with published means from a healthy child population. Survey data were evaluable for 116 patients with a median follow-up of 5 years (range, 1-10.6 years); the median age at the time of diagnosis was 7.6 years (range, 2.1-18.1 years). At baseline, children reported a total core score (TCS) of 65.9, which increased by 1.8 points annually (P<.001); parents reported a TCS of 59.1, which increased by 2.0 points annually. Posterior fossa syndrome adversely affected baseline scores, but these scores significantly improved with time. At the time of last follow-up, children reported a TCS of 76.3, which was 3.3 points lower than that of healthy children (P = .09); parents reported a TCS of 69, which was 11.9 points lower than that of parents of healthy children (P<.001). Increased follow-up time from diagnosis correlated with improved HRQOL scores. HRQOL scores appear to increase over time after treatment in children treated with proton RT for medulloblastoma but remain lower compared with those of parent-proxy reports as well as published means from a healthy normative sample of children. Additional follow-up may translate into continued improvements in HRQOL. Cancer 2018. © 2018 American Cancer Society. © 2018 American Cancer Society.

  10. Violence as a Barrier for HIV Prevention among Female Sex Workers in Argentina

    PubMed Central

    Pando, María A.; Coloccini, Romina S.; Reynaga, Elena; Rodriguez Fermepin, Marcelo; Gallo Vaulet, Lucia; Kochel, Tadeusz J.; Montano, Silvia M.; Avila, María M.

    2013-01-01

    Background Violence against female sex workers (FSWs) has been increasingly reported as an important determinant of HIV infection risk. This study explores the frequency of different violent experiences (sexual abuse, rejection, beating and imprisonment) among FSWs in Argentina and its association with condom use and HIV and T. pallidum prevalence. Methods A convenience sample of 1255 FSWs was included in a cross-sectional study conducted between October 2006 and November 2009. Results Sexual abuse was reported by 24.1% (219/907) of women. A total of 34.7% (42/1234) reported rejection experiences, 21.9% (267/1215) reported having been beaten and 45.4% (561/1236) stated having been arrested because of their sex work activity. There was a higher frequency of inconsistent condom use with clients among FSWs who had experienced sexual abuse, rejection, and police detention. A higher frequency of HIV and T. pallidum infection was detected among FSWs who reported having been arrested by the police. Conclusion The study shows for the first time the frequency of different violent situations among FSWs in Argentina. The association between violence against sex workers, condom use and STI prevalence demonstrated here calls for measures to reduce stigma and violence against FSWs. Such violent experiences may increase vulnerability to STI through coerced unprotected sex. PMID:23342092

  11. Effect of aircraft-cabin altitude on passenger discomfort.

    PubMed

    Muhm, J Michael; Rock, Paul B; McMullin, Dianne L; Jones, Stephen P; Lu, I L; Eilers, Kyle D; Space, David R; McMullen, Aleksandra

    2007-07-05

    Acute mountain sickness occurs in some unacclimatized persons who travel to terrestrial altitudes at which barometric pressures are the same as those in commercial aircraft during flight. Whether the effects are similar in air travelers is unknown. We conducted a prospective, single-blind, controlled hypobaric-chamber study of adult volunteers to determine the effect of barometric pressures equivalent to terrestrial altitudes of 650, 4000, 6000, 7000, and 8000 ft (198, 1219, 1829, 2134, and 2438 m, respectively) above sea level on arterial oxygen saturation and the occurrence of acute mountain sickness and discomfort as measured by responses to the Environmental Symptoms Questionnaire IV during a 20-hour simulated flight. Among the 502 study participants, the mean oxygen saturation decreased with increasing altitude, with a maximum decrease of 4.4 percentage points (95% confidence interval, 3.9 to 4.9) at 8000 ft. Overall, acute mountain sickness occurred in 7.4% of the participants, but its frequency did not vary significantly among the altitudes studied. The frequency of reported discomfort increased with increasing altitude and decreasing oxygen saturation and was greater at 7000 to 8000 ft than at all the lower altitudes combined. Differences became apparent after 3 to 9 hours of exposure. Persons older than 60 years of age were less likely than younger persons and men were less likely than women to report discomfort. Four serious adverse events, 1 of which may have been related to the study exposures, and 15 adverse events, 9 of which were related to study exposures, were reported. Ascent from ground level to the conditions of 7000 to 8000 ft lowered oxygen saturation by approximately 4 percentage points. This level of hypoxemia was insufficient to affect the occurrence of acute mountain sickness but did contribute to the increased frequency of reports of discomfort in unacclimatized participants after 3 to 9 hours. (ClinicalTrials.gov number, NCT00326703 [ClinicalTrials.gov].). Copyright 2007 Massachusetts Medical Society.

  12. Quantitative Computed Tomography (QCT) derived Bone Mineral Density (BMD) in finite element studies: a review of the literature.

    PubMed

    Knowles, Nikolas K; Reeves, Jacob M; Ferreira, Louis M

    2016-12-01

    Finite element modeling of human bone provides a powerful tool to evaluate a wide variety of outcomes in a highly repeatable and parametric manner. These models are most often derived from computed tomography data, with mechanical properties related to bone mineral density (BMD) from the x-ray energy attenuation provided from this data. To increase accuracy, many researchers report the use of quantitative computed tomography (QCT), in which a calibration phantom is used during image acquisition to improve the estimation of BMD. Since model accuracy is dependent on the methods used in the calculation of BMD and density-mechanical property relationships, it is important to use relationships developed for the same anatomical location and using the same scanner settings, as these may impact model accuracy. The purpose of this literature review is to report the relationships used in the conversion of QCT equivalent density measures to ash, apparent, and/or tissue densities in recent finite element (FE) studies used in common density-modulus relationships. For studies reporting experimental validation, the validation metrics and results are presented. Of the studies reviewed, 29% reported the use of a dipotassium phosphate (K 2 HPO 4 ) phantom, 47% a hydroxyapatite (HA) phantom, 13% did not report phantom type, 7% reported use of both K 2 HPO 4 and HA phantoms, and 4% alternate phantom types. Scanner type and/or settings were omitted or partially reported in 31% of studies. The majority of studies used densitometric and/or density-modulus relationships derived from different anatomical locations scanned in different scanners with different scanner settings. The methods used to derive various densitometric relationships are reported and recommendations are provided toward the standardization of reporting metrics. This review assessed the current state of QCT-based FE modeling with use of clinical scanners. It was found that previously developed densitometric relationships vary by anatomical location, scanner type and settings. Reporting of all parameters used when referring to previously developed relationships, or in the development of new relationships, may increase the accuracy and repeatability of future FE models.

  13. Increasing Consumer Engagement by Tailoring a Public Reporting Website on the Quality of Diabetes Care: A Qualitative Study

    PubMed Central

    Bednarz, Lauren; Nordby, Peter A; Fink, Jennifer; Greenlee, Robert T; Bolt, Daniel; Magnan, Elizabeth M

    2016-01-01

    Background The majority of health care utilization decisions in the United States are made by persons with multiple chronic conditions. Existing public reports of health system quality do not distinguish care for these persons and are often not used by the consumers they aim to reach. Objective Our goal was to determine if tailoring quality reports to persons with diabetes mellitus and co-occurring chronic conditions would increase user engagement with a website that publicly reports the quality of diabetes care. Methods We adapted an existing consumer-focused public reporting website using adult learning theory to display diabetes quality reports tailored to the user’s chronic condition profile. We conducted in-depth cognitive interviews with 20 individuals who either had diabetes and/or cared for someone with diabetes to assess the website. Interviews were audiotaped and transcribed, then analyzed using thematic content analysis. Results Three themes emerged that suggested increased engagement from tailoring the site to a user’s chronic conditions: ability to interact, relevance, and feeling empowered to act. Conclusions We conclude that tailoring can be used to improve public reporting sites for individuals with chronic conditions, ultimately allowing consumers to make more informed health care decisions. PMID:28003173

  14. Impact of melanoma genetic test reporting on perceived control over melanoma prevention.

    PubMed

    Aspinwall, Lisa G; Stump, Tammy K; Taber, Jennifer M; Kohlmann, Wendy; Leaf, Samantha L; Leachman, Sancy A

    2015-10-01

    To determine whether receiving melanoma genetic test results undermines perceived control over melanoma prevention, control-related beliefs were examined among 60 adults from melanoma-prone families receiving CDKN2A/p16 test results (27 unaffected noncarriers, 15 unaffected carriers, 18 affected carriers; response rate at 2 years = 64.9 % of eligible respondents). Multilevel modeling of perceived control ratings over a 2-year period revealed significant variation in individual trajectories: most participants showed increases (45 %) or no change (38.3 %), while 16.7 % showed decreases. At the group level, noncarriers reported sustained increases through the 2-year follow-up (ps < .05); unaffected carriers reported significant short-term increases (ps < .05); and affected carriers reported no change. Participants in all groups continued to rate photoprotection as highly effective in reducing melanoma risk and reported decreased beliefs that carrying the p16 mutation would inevitably lead to the development of melanoma. Qualitative responses immediately following counseling and test reporting corroborated these findings, as 93 % indicated it was possible to either prevent (64.9 %) or decrease the likelihood (28.1 %) of future melanomas. Thus, genetic test reporting does not generally undermine perceived control over melanoma prevention, though variability in response to positive results warrants future study.

  15. Incremental effects of reward on creativity.

    PubMed

    Eisenberger, R; Rhoades, L

    2001-10-01

    The authors examined 2 ways reward might increase creativity. First, reward contingent on creativity might increase extrinsic motivation. Studies 1 and 2 found that repeatedly giving preadolescent students reward for creative performance in 1 task increased their creativity in subsequent tasks. Study 3 reported that reward promised for creativity increased college students' creative task performance. Second, expected reward for high performance might increase creativity by enhancing perceived self-determination and, therefore, intrinsic task interest. Study 4 found that employees' intrinsic job interest mediated a positive relationship between expected reward for high performance and creative suggestions offered at work. Study 5 found that employees' perceived self-determination mediated a positive relationship between expected reward for high performance and the creativity of anonymous suggestions for helping the organization.

  16. WWC Review of the Report "Freshman Year Financial Aid Nudges: An Experiment to Increase FAFSA Renewal and College Persistence." What Works Clearinghouse Single Study Review

    ERIC Educational Resources Information Center

    What Works Clearinghouse, 2014

    2014-01-01

    The 2014 study, Freshman Year Financial Aid Nudges: An Experiment to Increase FAFSA Renewal and College Persistence, measured the impact of sending text message reminders regarding annual Free Application for Federal Student Aid (FAFSA) renewal to first-year college students who were already receiving financial aid. The study sample included 808…

  17. Childhood leukaemia and distance from power lines in California: a population-based case-control study.

    PubMed

    Crespi, Catherine M; Vergara, Ximena P; Hooper, Chris; Oksuzyan, Sona; Wu, Sheng; Cockburn, Myles; Kheifets, Leeka

    2016-06-28

    Studies have reported an increased risk of childhood leukaemia associated with living near high-voltage electric power transmission lines that extend to distances at which magnetic fields from lines are negligible. We conducted a large records-based case-control study of childhood leukaemia risk in the population living near power lines in California. The study included 5788 childhood leukaemia and 3308 central nervous system (CNS) cancer cases (for comparison) born in and diagnosed in California (1986-2008), and matched to population-based controls by age and sex. We geocoded birth address and estimated the distance from residence to transmission lines using geographic information systems, aerial imagery, and, for some residences, site visits. For leukaemia, there was a slight excess of cases within 50 m of a transmission line over 200 kV (odds ratio 1.4, 95% confidence interval 0.7-2.7). There was no evidence of increased risk for distances beyond 50 m, for lower-voltage lines, or for CNS cancers. Our findings did not clearly support an increased childhood leukaemia risk associated with close proximity (<50 m) to higher voltage lines, but could be consistent with a small increased risk. Reports of increased risk for distances beyond 50 m were not replicated.

  18. Increasing use of atypical antipsychotics and anticonvulsants during pregnancy

    PubMed Central

    Epstein, Richard A.; Bobo, William V.; Shelton, Richard C.; Arbogast, Patrick G.; Morrow, James A.; Wang, Wei; Chandrasekhar, Rameela; Cooper, William O.

    2013-01-01

    Purpose To quantify maternal use of atypical antipsychotics, typical antipsychotics, anticonvulsants and lithium during pregnancy. Methods Tennessee birth and death records were linked to Tennessee Medicaid data to conduct a retrospective cohort study of 296,817 women enrolled in Tennessee Medicaid throughout pregnancy who had a live birth or fetal death from 1985 to 2005. Results During the study time period, the adjusted rate of use of any study medication during pregnancy increased from nearly 14 to 31 per 1,000 pregnancies (β = 0.08, 95% CI = 0.07, 0.09). Significant increases were reported in use of anticonvulsants alone among mothers with pain and other psychiatric disorders, atypical antipsychotics alone among mothers with bipolar disorders, schizophrenia, unipolar depressive disorders, and other psychiatric disorders, and more than one studied medication for mothers with epilepsy, pain disorders, bipolar disorders, unipolar depressive disorders, and other psychiatric disorders. Significant decreases were reported in use of lithium alone and typical antipsychotics alone for all clinically meaningful diagnosis groups. Conclusions There was a substantial increase in use of atypical antipsychotics alone, anticonvulsants alone, and medications from multiple studied categories among Tennessee Medicaid-insured pregnant women during the study period. Further examination of the maternal and fetal consequences of exposure to these medications during pregnancy is warranted. PMID:23124892

  19. Increasing use of atypical antipsychotics and anticonvulsants during pregnancy.

    PubMed

    Epstein, Richard A; Bobo, William V; Shelton, Richard C; Arbogast, Patrick G; Morrow, James A; Wang, Wei; Chandrasekhar, Rameela; Cooper, William O

    2013-07-01

    To quantify maternal use of atypical antipsychotics, typical antipsychotics, anticonvulsants, and lithium during pregnancy. Tennessee birth and death records were linked to Tennessee Medicaid data to conduct a retrospective cohort study of 296,817 women enrolled in Tennessee Medicaid throughout pregnancy who had a live birth or fetal death from 1985 to 2005. During the study time period, the adjusted rate of use of any study medication during pregnancy increased from nearly 14 to 31 per 1000 pregnancies (β = 0.08, 95% CI = 0.07, 0.09). Significant increases were reported in use of anticonvulsants alone among mothers with pain and other psychiatric disorders, atypical antipsychotics alone among mothers with bipolar disorders, schizophrenia, unipolar depressive disorders, and other psychiatric disorders, and more than one studied medication for mothers with epilepsy, pain disorders, bipolar disorders, unipolar depressive disorders, and other psychiatric disorders. Significant decreases were reported in use of lithium alone and typical antipsychotics alone for all clinically meaningful diagnosis groups. There was a substantial increase in use of atypical antipsychotics alone, anticonvulsants alone, and medications from multiple studied categories among Tennessee Medicaid-insured pregnant women during the study period. Further examination of the maternal and fetal consequences of exposure to these medications during pregnancy is warranted. Copyright © 2012 John Wiley & Sons, Ltd.

  20. Eighth Grade Algebra Course Placement and Student Motivation for Mathematics

    PubMed Central

    Simzar, Rahila M.; Domina, Thurston; Tran, Cathy

    2016-01-01

    This study uses student panel data to examine the association between Algebra placement and student motivation for mathematics. Changes in achievement goals, expectancy, and task value for students in eighth grade Algebra are compared with those of peers placed in lower-level mathematics courses (N = 3,306). In our sample, students placed in Algebra reported an increase in performance-avoidance goals as well as decreases in academic self-efficacy and task value. These relations were attenuated for students who had high mathematics achievement prior to Algebra placement. Whereas all students reported an overall decline in performance-approach goals over the course of eighth grade, previously high-achieving students reported an increase in these goals. Lastly, previously high-achieving students reported an increase in mastery goals. These findings suggest that while previously high-achieving students may benefit motivationally from eighth grade Algebra placement, placing previously average- and low-performing students in Algebra can potentially undermine their motivation for mathematics. PMID:26942210

  1. Eighth Grade Algebra Course Placement and Student Motivation for Mathematics.

    PubMed

    Simzar, Rahila M; Domina, Thurston; Tran, Cathy

    2016-01-01

    This study uses student panel data to examine the association between Algebra placement and student motivation for mathematics. Changes in achievement goals, expectancy, and task value for students in eighth grade Algebra are compared with those of peers placed in lower-level mathematics courses (N = 3,306). In our sample, students placed in Algebra reported an increase in performance-avoidance goals as well as decreases in academic self-efficacy and task value. These relations were attenuated for students who had high mathematics achievement prior to Algebra placement. Whereas all students reported an overall decline in performance-approach goals over the course of eighth grade, previously high-achieving students reported an increase in these goals. Lastly, previously high-achieving students reported an increase in mastery goals. These findings suggest that while previously high-achieving students may benefit motivationally from eighth grade Algebra placement, placing previously average- and low-performing students in Algebra can potentially undermine their motivation for mathematics.

  2. Autograft versus nonirradiated allograft tissue for anterior cruciate ligament reconstruction: a systematic review.

    PubMed

    Mariscalco, Michael W; Magnussen, Robert A; Mehta, Divyesh; Hewett, Timothy E; Flanigan, David C; Kaeding, Christopher C

    2014-02-01

    An autograft has traditionally been the gold standard for anterior cruciate ligament reconstruction (ACLR), but the use of allograft tissue has increased in recent years. While numerous studies have demonstrated that irradiated allografts are associated with increased failure rates, some report excellent results after ACLR with nonirradiated allografts. The purpose of this systematic review was to determine whether the use of nonirradiated allograft tissue is associated with poorer outcomes when compared with autografts. Patients undergoing ACLR with autografts versus nonirradiated allografts will demonstrate no significant differences in graft failure risk, laxity on postoperative physical examination, or differences in patient-oriented outcome scores. Systematic review. A systematic review was performed to identify prospective or retrospective comparative studies (evidence level 1, 2, or 3) of autografts versus nonirradiated allografts for ACLR. Outcome data included graft failure based on clinical findings and instrumented laxity, postoperative laxity on physical examination, and patient-reported outcome scores. Studies were excluded if they did not specify whether the allograft had been irradiated. Quality assessment and data extraction were performed by 2 examiners. Nine studies comparing autografts and nonirradiated allografts were included. Six of the 9 studies compared bone-patellar tendon-bone (BPTB) autografts with BPTB allografts. Two studies compared hamstring tendon autografts to hamstring tendon allografts, and 1 study compared hamstring tendon autografts to tibialis anterior allografts. The mean patient age in 7 of 9 studies ranged from 24.5 to 32 years, with 1 study including only patients older than 40 years and another not reporting patient age. The mean follow-up duration was 24 to 94 months. Six of 9 studies reported clinical graft failure rates, 8 of 9 reported postoperative instrumented laxity measurements, 7 of 9 reported postoperative physical examination findings, and all studies reported patient-reported outcome scores. This review demonstrated no statistically significant difference between autografts and nonirradiated allografts in any outcome measure. No significant differences were found in graft failure rate, postoperative laxity, or patient-reported outcome scores when comparing ACLR with autografts to nonirradiated allografts in this systematic review. These findings apply to patients in their late 20s and early 30s. Caution is advised when considering extrapolation of these findings to younger, more active cohorts.

  3. Keeping Cool: Use of Air Conditioning by Australians with Multiple Sclerosis

    PubMed Central

    Summers, Michael P.; Simmons, Rex D.; Verikios, George

    2012-01-01

    Despite the known difficulties many people with MS have with high ambient temperatures, there are no reported studies of air conditioning use and MS. This study systematically examined air conditioner use by Australians with MS. A short survey was sent to all participants in the Australian MS Longitudinal Study cohort with a response rate of 76% (n = 2,385). Questions included hours of air-conditioner use, areas cooled, type and age of equipment, and the personal effects of overheating. Air conditioners were used by 81.9% of respondents, with an additional 9.6% who could not afford an air conditioner. Regional and seasonal variation in air conditioning use was reported, with a national annual mean of 1,557 hours running time. 90.7% reported negative effects from overheating including increased fatigue, an increase in other MS symptoms, reduced household and social activities, and reduced work capacity. Households that include people with MS spend between 4 and 12 times more on keeping cool than average Australian households. PMID:22548176

  4. Keeping cool: use of air conditioning by australians with multiple sclerosis.

    PubMed

    Summers, Michael P; Simmons, Rex D; Verikios, George

    2012-01-01

    Despite the known difficulties many people with MS have with high ambient temperatures, there are no reported studies of air conditioning use and MS. This study systematically examined air conditioner use by Australians with MS. A short survey was sent to all participants in the Australian MS Longitudinal Study cohort with a response rate of 76% (n = 2,385). Questions included hours of air-conditioner use, areas cooled, type and age of equipment, and the personal effects of overheating. Air conditioners were used by 81.9% of respondents, with an additional 9.6% who could not afford an air conditioner. Regional and seasonal variation in air conditioning use was reported, with a national annual mean of 1,557 hours running time. 90.7% reported negative effects from overheating including increased fatigue, an increase in other MS symptoms, reduced household and social activities, and reduced work capacity. Households that include people with MS spend between 4 and 12 times more on keeping cool than average Australian households.

  5. Challenging cell phone impact on reproduction: a review.

    PubMed

    Merhi, Zaher O

    2012-04-01

    The radiofrequency electromagnetic radiation (RF-EMR) produced by cell phones can enhance the excitability of the brain and has recently been classified as carcinogenic. The suggested use of hands-free kits lowers the exposure to the brain, but it might theoretically increase exposure to the reproductive organs. This report summarizes the potential effects of RF-EMR on reproductive potentials in both males and females. A critical review of the literature pertaining to the impact of cell phone RF-EMR on reproduction in male and female animals and humans was performed, with a focus on gonad metabolism, apoptosis of reproductive cells, fertility status, and serum reproductive hormones. While some animal and human studies revealed alterations in reproductive physiology in both males and females, others did not report any association. The in vitro and in vivo studies to date are highly diverse, very inconsistent in conduct and, in many cases, report different primary outcomes. The increasing use of cell phone warrants well-designed studies to ascertain the effect of their RF-EMR on reproduction.

  6. Human males appear more prepared than females to resolve conflicts with same-sex peers.

    PubMed

    Benenson, Joyce F; Kuhn, Melissa N; Ryan, Patrick J; Ferranti, Anthony J; Blondin, Rose; Shea, Michael; Charpentier, Chalice; Thompson, Melissa Emery; Wrangham, Richard W

    2014-06-01

    The aim of the study was to investigate sex differences in proximate mechanisms that precede the termination of conflicts. In Study 1, we asked women and men to report their intensity of anger in response to hypothetical, common transgressions involving a same-sex roommate. Direct verbal and physical aggression elicited the highest-intensity anger for both sexes, although overall women reported more intense anger than men to all transgressions. In Study 2, we examined sex differences in subjective and physiological reactions to a conflict using a role-playing scenario. Following recall of a conflict involving direct aggression and role-playing a reaction to it, compared with men, women reported their anger would dissipate less quickly and they would take longer to reconcile. Women also exhibited increased heart rate, but little change in cortisol, whereas men exhibited little change in heart rate but increased cortisol production. We interpret the results as indicating that women are less prepared than men to resolve a conflict with a same-sex peer.

  7. Self-reported stress among adolescent siblings of individuals with autism spectrum disorder and Down syndrome.

    PubMed

    Shivers, Carolyn M; McGregor, Casey; Hough, Ashlea

    2017-11-01

    Despite the prevalence of studies showing increased stress among mothers of individuals with autism spectrum disorders, few studies have examined general stress among typically developing siblings. This study used an online survey to compare the levels of self-reported stress between adolescent siblings of individuals with autism spectrum disorder and Down syndrome. Sibling of individuals with autism reported significantly more overall stress than did siblings of individuals with Down syndrome, as well as more stress specifically attributed to the brother/sister with autism. The two groups did not differ on perceived social support from family and friends. In linear regression models, the disability group (autism vs Down syndrome) was significantly related to sibling stress above and beyond target child behavior problems, perceived social support, and demographic factors. These results help shed light on the daily experiences of adolescent siblings of individuals with autism and call for more research into potential interventions to address increased stress levels.

  8. Threatened masculinity and muscularity: an experimental examination of multiple aspects of muscularity in men.

    PubMed

    Hunt, Christopher John; Gonsalkorale, Karen; Murray, Stuart B

    2013-06-01

    Two studies examined the threatened masculinity theory of male body dissatisfaction, which posits that threats to masculinity result in increased muscle dissatisfaction. In Study 1, a masculinity threat was followed by tasks examining confidence in physical ability and perceptions of current and ideal body shapes. Results showed that men who experienced a masculinity threat reported lower confidence in their physical ability and perceived themselves as less muscular than men who experienced an affirmation of their masculinity. In Study 2, men were asked to report their intention to increase muscularity and their appearance anxiety following a threat to masculinity. Results showed that men reported lower appearance anxiety and drive for muscularity when their masculinity was threatened than when their masculinity was affirmed. This apparent contradiction can be explained by noting that men may be motivated to deny appearance concerns following a threat to masculinity, as such concerns are equated with femininity. Copyright © 2013. Published by Elsevier Ltd.

  9. The etiologic role of infectious antigens in sarcoidosis pathogenesis

    PubMed Central

    Celada, Lindsay J.; Hawkins, Charlene; Drake, Wonder P.

    2015-01-01

    Sarcoidosis is a granulomatous disease of unknown etiology, characterized by a Th1 immunophenotype, most commonly involving the lung, skin, lymph node and eyes. Molecular and immunologic studies continue to strengthen the association of sarcoidosis with infectious antigens, particularly those derived from Propionibacterium and Mycobacterium species. Independent studies report the presence of microbial nucleic acids and proteins within sarcoidosis specimens. Complementary immunologic studies also support the role of infectious agents in sarcoidosis pathogenesis. Th-1 immune responses directed against mycobacterial virulence factors have been detected within sarcoidosis diagnostic bronchoalveolar lavage (BAL). Th1 and Th17 immune responses against propionibacteria have also been reported. More recently, case reports and clinical trials from Japanese, European and American investigators have emerged regarding the efficacy of antimicrobials against Propionibacterium and Mycobacterium species on pulmonary and cutaneous sarcoidosis. While these clinical investigations are not conclusive, they support increasing efforts to identify novel therapeutics, such as antimicrobials, that will impact the observed increase in sarcoidosis morbidity and mortality. PMID:26593133

  10. Assessment of timeliness, representativeness and quality of data reported to Italy's national integrated surveillance system for acute viral hepatitis (SEIEVA).

    PubMed

    Tosti, M E; Longhi, S; de Waure, C; Mele, A; Franco, E; Ricciardi, W; Filia, A

    2015-05-01

    Periodic assessment of surveillance systems is recommended to verify whether they are appropriately monitoring the public health problem under surveillance. The aim of this study was to evaluate timeliness, data quality and representativeness of data reported to the Italian Integrated Epidemiological System for Acute Viral Hepatitis (SEIEVA). Cross-sectional analysis of surveillance data. Quantitative indicators were used to evaluate representativeness of reported cases, data quality, and timeliness between surveillance steps, for reports of acute viral hepatitis cases with date of onset of symptoms from 2009 to 2012 (N = 4516). Representativeness was 75%. Over 95% of records reported information on age, sex, city of residence, risk factors for hepatitis A and vaccination status. Information on risk factors for hepatitis B and C were reported less consistently (83%), as was information on early outcome (60%). Wide delays were found between surveillance steps. The system collects high quality data on acute viral hepatitis cases in Italy. Timeliness was found to be the main limit and needs to be improved by optimizing web-based reporting procedures, increasing communication with participating centres, improving feedback and increasing dissemination of surveillance results. The study highlights the importance of reporting timeliness to detect outbreaks of acute viral hepatitis. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  11. A review of the Journal of Pediatrics: the first 75 years.

    PubMed

    Hellems, Martha A; Gurka, Kelly K; Hayden, Gregory F

    2009-07-01

    To assess changes in the format and content of articles published in The Journal of Pediatrics to aid in understanding the current state of pediatric research and to anticipate what to expect in the coming years. We conducted a retrospective review of case reports, research articles, and review articles published in volume 150 of The Journal. We noted components of study authorship, content, and design and compared these data with those in earlier volumes. The numbers of authors and grants per article and the proportion of studies with international authorship have all increased. Print circulation has dropped, but The Journal is now available in electronic format. Research topics shifted, with fewer articles devoted to infectious disease and general pediatrics. An increase in articles about endocrinology reflects a surge of interest in pediatric obesity. Most articles contain original research, reporting analyses from observational studies with few clinical trials. Recent trends suggest that readers of The Journal should expect more research articles with observational designs and increasing international authorship. The Journal's electronic presence will likely increase and provide greater readership globally.

  12. Increasing the Participation of Women in Scientific Research. Summary of a Conference Proceedings, October 1977, and Research Study Project Report, March 1978.

    ERIC Educational Resources Information Center

    National Science Foundation, Washington, DC.

    This publication contains highlights from a report on the participation of women in scientific research which was prepared by the Office of Opportunities in Science (OOS), American Association for the Advancement of Science (AAAS) with the support of the National Science Foundation (NSF). The report, issued March 1978, includes both the findings…

  13. The Broader Autism Phenotype in Mothers is Associated with Increased Discordance between Maternal-Reported and Clinician-Observed Instruments That Measure Child Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Rubenstein, Eric; Edmondson Pretzel, Rebecca; Windham, Gayle C.; Schieve, Laura A.; Wiggins, Lisa D.; DiGuiseppi, Carolyn; Olshan, Andrew F.; Howard, Annie G.; Pence, Brian W.; Young, Lisa; Daniels, Julie

    2017-01-01

    Autism spectrum disorder (ASD) diagnosis relies on parent-reported and clinician-observed instruments. Sometimes, results between these instruments disagree. The broader autism phenotype (BAP) in parent-reporters may be associated with discordance. Study to Explore Early Development data (N = 712) were used to address whether mothers with BAP and…

  14. DOD Major Automated Information Systems: Improvements Can Be Made in Reporting Critical Changes and Clarifying Leadership Responsibility

    DTIC Science & Technology

    2016-03-01

    The program’s estimated program development cost increased by 45 percent over the original acquisition program baseline due to program scope changes ...DOD MAJOR AUTOMATED INFORMATION SYSTEMS Improvements Can Be Made in Reporting Critical Changes and Clarifying...INFORMATION SYSTEMS Improvements Can Be Made in Reporting Critical Changes and Clarifying Leadership Responsibility Why GAO Did This Study The National

  15. CALiPER Retail Lamps Study 3

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

    none,

    2014-02-01

    This is a special CALiPER report on LED lamps available through the retail marketplace and targeted toward general consumers. It follows similar reports published in 2011 and 2012 (products purchased in 2010 and 2011), and is intended as a continuation that identifies long-term trends. For this report, products were selected to investigate specific hypotheses, rather than represent a sample of the increasingly large retail LED market.

  16. Differences in Electronic Cigarette Awareness, Use History, and Advertisement Exposure between Black and White Hospitalized Cigarette Smokers

    PubMed Central

    Baumann, Angela Warren; Kohler, Connie; Kim, Young-il; Cheong, JeeWon; Hendricks, Peter; Bailey, William C.; Harrington, Kathleen F.

    2014-01-01

    E-cigarette use has increased rapidly over the past decade. There is growing concern about e-cigarette use and advertising given limited regulation of these products. This cross-sectional study reports on data collected at baseline from hospitalized cigarette smokers (N = 944) recruited in monthly cohorts between December 2012 and September 2013. Participants were queried regarding e-cigarette awareness and use, and number and sources of e-cigarette advertisement exposures in the previous six months. Most Whites (99%) reported ever hearing of an e-cigarette compared to 96% of Blacks (p<.001). Over two-thirds (64%) of Whites reported ever using an e-cigarette compared to 30% of Blacks (p<.001). There were significant trends in increasing e-cigarette use for both racial groups with an average increase of 13% each month (p<.005) and in increasing e-cigarette advertisement exposure reported for the previous six months, with a 14% increase each month (p<.0001). Whites reported 56% greater advertisement exposure than Blacks (Mean= 25 vs. 8 in month 1 to 79 vs. 45 in month 9, respectively; p<.0001). For Blacks, advertisement exposure was significantly associated with e-cigarette use (p<.001). Whites reported more advertisement exposure from stores and the internet and Blacks reported more advertisement exposure from radio or television. Results suggest that e-cigarette marketing is beginning to breach the Black population who are, as a consequence, “catching up” with Whites with regard to e-cigarette use. Given the significant disparities for smoking-related morbidity and mortality between Blacks and Whites, these findings identify new areas for future research and policy. PMID:25503053

  17. Differences in Electronic Cigarette Awareness, Use History, and Advertisement Exposure Between Black and White Hospitalized Cigarette Smokers.

    PubMed

    Baumann, Angela Warren; Kohler, Connie; Kim, Young-il; Cheong, JeeWon; Hendricks, Peter; Bailey, William C; Harrington, Kathleen F

    2015-12-01

    E-cigarette use has increased rapidly over the past decade. There is growing concern about e-cigarette use and advertising given limited regulation of these products. This cross-sectional study reports on data collected at baseline from hospitalized cigarette smokers (N=944) recruited in monthly cohorts between December 2012 and September 2013. Participants were queried regarding e-cigarette awareness and use, and number and sources of e-cigarette advertisement exposures in the previous 6 months. Most Whites (99%) reported ever hearing of an e-cigarette compared to 96% of Blacks (p<0.001). Over two thirds (64%) of Whites reported ever using an e-cigarette compared to 30% of Blacks (p<0.001). There were significant trends in increasing e-cigarette use for both racial groups with an average increase of 13% each month (p<0.005) and in increasing e-cigarette advertisement exposure reported for the previous 6 months, with a 14% increase each month (p<0.0001). Whites reported 56% greater advertisement exposure than Blacks (mean=25 vs. 8 in month 1 to 79 vs. 45 in month 9, respectively; p<0.0001). For Blacks, advertisement exposure was significantly associated with e-cigarette use (p<0.001). Whites reported more advertisement exposure from stores and the Internet, and Blacks reported more advertisement exposure from radio or television. Results suggest that e-cigarette marketing is beginning to breach the Black population who are, as a consequence, "catching up" with Whites with regard to e-cigarette use. Given the significant disparities for smoking-related morbidity and mortality between Blacks and Whites, these findings identify new areas for future research and policy.

  18. Increasing Trend of Fatal Falls in Older Adults in the United States, 1992 to 2005: Coding Practice or Reporting Quality?

    PubMed

    Kharrazi, Rebekah J; Nash, Denis; Mielenz, Thelma J

    2015-09-01

    To investigate whether changes in death certificate coding and reporting practices explain part or all of the recent increase in the rate of fatal falls in adults aged 65 and older in the United States. Trends in coding and reporting practices of fatal falls were evaluated under mortality coding schemes for International Classification of Diseases (ICD), Ninth Revision (1992-1998) and Tenth Revision (1999-2005). United States, 1992 to 2005. Individuals aged 65 and older with falls listed as the underlying cause of death (UCD) on their death certificates. The primary outcome was annual fatal falls rates per 100,000 U.S. residents aged 65 and older. Coding practice was assessed through analysis of trends in rates of specific UCD fall ICD e-codes over time. Reporting quality was assessed by examining changes in the location on the death certificate where fall e-codes were reported, in particular, the percentage of fall e-codes recorded in the proper location on the death certificate. Fatal falls rates increased over both time periods: 1992 to 1998 and 1999 to 2005. A single falls e-code was responsible for the increasing trend of fatal falls overall from 1992 to 1998 (E888, other and unspecified fall) and from 1999 to 2005 (W18, other falls on the same level), whereas trends for other falls e-codes remained stable. Reporting quality improved steadily throughout the study period. Better reporting quality, not coding practices, contributed to the increasing rate of fatal falls in older adults in the United States from 1992 to 2005. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

  19. Childhood Trauma and Personal Mastery: Their Influence on Emotional Reactivity to Everyday Events in a Community Sample of Middle-Aged Adults

    PubMed Central

    Infurna, Frank J.; Rivers, Crystal T.; Reich, John; Zautra, Alex J.

    2015-01-01

    Childhood trauma is associated with premature declines in health in midlife and old age. Pathways that have been implicated, but less studied include social-emotional regulation, biological programming, and habitual patterns of thought and action. In this study we focused on childhood trauma’s influence via alterations in social-emotional regulation to everyday life events, a pathway that has been linked to subsequent health effects. Data from a 30-day daily diary of community residents who participated in a study of resilience in Midlife (n = 191, Mage = 54, SD = 7.50, 54% women) was used to examine whether self-reports of childhood trauma were associated with daily well-being, as well as reported and emotional reactivity to daily negative and positive events. Childhood trauma reports were associated with reporting lower overall levels of and greater variability in daily well-being. Childhood trauma was linked to greater reports of daily negative events, but not to positive events. Focusing on emotional reactivity to daily events, residents who reported higher levels of childhood trauma showed stronger decreases in well-being when experiencing negative events and also stronger increases in well-being with positive events. For those reporting childhood trauma, higher levels of mastery were associated with stronger decreases in well-being with negative events and stronger increases in well-being with positive events, suggesting that mastery increases sensitivity to daily negative and positive events. Our results suggest that childhood trauma may lead to poorer health in midlife through disturbances in the patterns of everyday life events and responses to those events. Further, our findings indicate that mastery may have a different meaning for those who experienced childhood trauma. We discuss social-emotional regulation as one pathway linking childhood trauma to health, and psychosocial resources to consider when building resilience-promoting interventions for mitigating the detrimental health effects of childhood trauma. PMID:25849572

  20. Childhood trauma and personal mastery: their influence on emotional reactivity to everyday events in a community sample of middle-aged adults.

    PubMed

    Infurna, Frank J; Rivers, Crystal T; Reich, John; Zautra, Alex J

    2015-01-01

    Childhood trauma is associated with premature declines in health in midlife and old age. Pathways that have been implicated, but less studied include social-emotional regulation, biological programming, and habitual patterns of thought and action. In this study we focused on childhood trauma's influence via alterations in social-emotional regulation to everyday life events, a pathway that has been linked to subsequent health effects. Data from a 30-day daily diary of community residents who participated in a study of resilience in Midlife (n = 191, Mage = 54, SD = 7.50, 54% women) was used to examine whether self-reports of childhood trauma were associated with daily well-being, as well as reported and emotional reactivity to daily negative and positive events. Childhood trauma reports were associated with reporting lower overall levels of and greater variability in daily well-being. Childhood trauma was linked to greater reports of daily negative events, but not to positive events. Focusing on emotional reactivity to daily events, residents who reported higher levels of childhood trauma showed stronger decreases in well-being when experiencing negative events and also stronger increases in well-being with positive events. For those reporting childhood trauma, higher levels of mastery were associated with stronger decreases in well-being with negative events and stronger increases in well-being with positive events, suggesting that mastery increases sensitivity to daily negative and positive events. Our results suggest that childhood trauma may lead to poorer health in midlife through disturbances in the patterns of everyday life events and responses to those events. Further, our findings indicate that mastery may have a different meaning for those who experienced childhood trauma. We discuss social-emotional regulation as one pathway linking childhood trauma to health, and psychosocial resources to consider when building resilience-promoting interventions for mitigating the detrimental health effects of childhood trauma.

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