Development of ethical rules for boundaries of touch in complementary medicine--outcomes of a Delphi process.

PubMed

Schiff, Elad; Ben-Arye, Eran; Shilo, Margalit; Levy, Moti; Schachter, Leora; Weitchner, Na'ama; Golan, Ofra; Stone, Julie

2010-11-01

The practice of complementary medicine (CAM) often involves touch. The unique philosophy of many CAM therapies, and the setting in which treatments are provided create a therapeutic space which may be less clearly defined than in conventional settings - a space in which the boundaries between professional touch and personal/intimate touch may become easily obscured. Thus, complementary therapists need clear definitions and firm boundaries in order to maintain therapeutic efficacy and commitment. The aim of the process described in this article, was to develop ethical guidelines for boundaries of touch that will promote the safety and protection of the public which use CAM. Through a modified Delphi process, a diverse group of CAM practitioners, physicians, ethicists, legal consultants, health policy specialists, and representatives from the public, developed Ethical Rules for Boundaries of Touch in CAM. These guidelines may be implemented in ethical codes of professional CAM organizations, and also serve as a foundation for curriculums in ethics in CAM schools. Copyright © 2010 Elsevier Ltd. All rights reserved.

Use of CAM in local African-American communities: community-partnered research.

PubMed Central

Barnett, Marina C.; Cotroneo, Margaret; Purnell, Joseph; Martin, Danielle; Mackenzie, Elizabeth; Fishman, Alfred

2003-01-01

Although previous national surveys have shown an increase in the use of complementary and alternative medicine (CAM) in the U.S. population, racial and ethnic minority populations were under-represented in these surveys. As a result, a profile of the CAM user as white, female, affluent, middle-aged and well educated has emerged. Representing the mainstream population, these previous studies did not take into account the racial and ethnic minority populations who may have their own healing traditions and who may hold different beliefs, use different terminology, and have unique patterns of CAM use. In partnership with community-based organizations and community residents, a culturally sensitive survey instrument and protocols were designed and tested to gather data on lower income, urban African-Americans' use of, attitudes toward, and understanding of CAM. The major findings of this pilot research are 1.) Community-partnered research can help researchers gain access to sensitive data and design culturally appropriate studies; 2.) CAM terminology varies by cultural group; 3.) Certain forms of CAM (folk or family practices) are commonly found in African-American populations; and 4.) Factors that affect CAM use--including age, lack of access to conventional medicine, cultural heritage, and dissatisfaction with conventional medicine. PMID:14620706

Marginal fit of indirect composite inlays using a new system for manual fabrication.

PubMed

Pott, P; Rzasa, A; Stiesch, M; Eisenburger, M

2016-09-01

This in vitro study compares a new system for manual chair side fabrication of indirect composite restorations, which uses silicone models after alginate impressions, to CAD/CAM-technology and laboratory manual production techniques. MATRIALS AND METHODS: and study design Each 10 composite inlays were fabricated using different types of production techniques: CAD/CAM- technology (A), the new inlay system (B), plaster model after alginate impression (C) or silicone impression (D). The inlays were adapted into a metal tooth and silicone replicas of the cement gaps were made and measured. Statistical analysis was performed using ANOVA and Tukey's test. Results and Statistics In group A the biggest marginal gaps (174.9μm ± 106.2μm) were found. In group B the gaps were significantly smaller (119.5 μm ± 90.6 μm) than in group A (p=0.035). Between groups C (64.6 μm ± 68.0μm) and D (58.2 μm ± 61.7 μm) no significant differences could be found (p=0.998), but the gaps were significantly smaller compared with group B. Conclusion Chairside manufacturing of composite inlays resulted in better marginal precision than CAD/CAM technology. In comparison to build restorations in a laboratory, the new system is a timesaving and inexpensive alternative. Nevertheless, production of indirect composite restorations in the dental laboratory showed the highest precision.

The Collaborative Assessment and Management of Suicidality (CAMS): an evolving evidence-based clinical approach to suicidal risk.

PubMed

Jobes, David A

2012-12-01

The Collaborative Assessment and Management of Suicidality (CAMS) is an evidence-based clinical intervention that has significantly evolved over 25 years of clinical research. CAMS is best understood as a therapeutic framework that emphasizes a unique collaborative assessment and treatment planning process between the suicidal patient and clinician. This process is designed to enhance the therapeutic alliance and increase treatment motivation in the suicidal patient. Central to the CAMS approach is the use of the Suicide Status Form (SSF), which is a multipurpose clinical assessment, treatment planning, tracking, and outcome tool. The original development of CAMS was largely rooted in SSF-based quantitative and qualitative assessment of suicidal risk. As this line of research progressed, CAMS emerged as a problem-focused clinical intervention that is designed to target and treat suicidal "drivers" and ultimately eliminate suicidal coping. To date, CAMS (and the clinical use of the SSF) has been supported by six published correlational studies and one randomized clinical trial (RCT). Currently, two well-powered RCTs are under way, and various new CAMS-related projects are also being pursued. The clinical and empirical evolution of CAMS-how it was developed and what are the next steps for this clinical approach-are described here. © 2012 The American Association of Suicidology.

The Computerized Anatomical Man (CAM) model

NASA Technical Reports Server (NTRS)

Billings, M. P.; Yucker, W. R.

1973-01-01

A computerized anatomical man (CAM) model, representing the most detailed and anatomically correct geometrical model of the human body yet prepared, has been developed for use in analyzing radiation dose distribution in man. This model of a 50-percentile standing USAF man comprises some 1100 unique geometric surfaces and some 2450 solid regions. Internal body geometry such as organs, voids, bones, and bone marrow are explicitly modeled. A computer program called CAMERA has also been developed for performing analyses with the model. Such analyses include tracing rays through the CAM geometry, placing results on magnetic tape in various forms, collapsing areal density data from ray tracing information to areal density distributions, preparing cross section views, etc. Numerous computer drawn cross sections through the CAM model are presented.

CAMS 2009 PC Co-chairs' Message

NASA Astrophysics Data System (ADS)

Hinze, Annika; Buchanan, George

In the four years since the first CAMS workshop, context awareness has become an increasingly commonplace tool for mobile developers. The limited screen displays of many mobile devices mean that content must be carefully selected to match the user's needs and expectations, and context provides one powerful means of performing such tailoring. Furthermore, increasing availability of additional hardware sensors has bolstered the use of context. GPS, Near-Field Communication, Bluetooth and WiFi have all been used to sense the general environment and to determine the devices' location. Light and tilt sensors have also been used to tune simple features such as the strength of the display lighting, through to complex uses in game control. Context-aware mobile systems are becoming ubiquitous. With this hardware comes the opportunity for "on-board" applications to use location data to provide new services - until recently such systems could only be created with complex and expensive components. Furthermore, the current "mode" of the phone (e.g., silent, meeting, outdoors), contents of the built-in calendar, etc., can all used to provide a rich context for the user's immediate environment.

A macro-ecological perspective on crassulacean acid metabolism (CAM) photosynthesis evolution in Afro-Madagascan drylands: Eulophiinae orchids as a case study.

PubMed

Bone, Ruth E; Smith, J Andrew C; Arrigo, Nils; Buerki, Sven

2015-10-01

Crassulacean acid metabolism (CAM) photosynthesis is an adaptation to water and atmospheric CO2 deficits that has been linked to diversification in dry-adapted plants. We investigated whether CAM evolution can be associated with the availability of new or alternative niches, using Eulophiinae orchids as a case study. Carbon isotope ratios, geographical and climate data, fossil records and DNA sequences were used to: assess the prevalence of CAM in Eulophiinae orchids; characterize the ecological niche of extant taxa; infer divergence times; and estimate whether CAM is associated with niche shifts. CAM evolved in four terrestrial lineages during the late Miocene/Pliocene, which have uneven diversification patterns. These lineages originated in humid habitats and colonized dry/seasonally dry environments in Africa and Madagascar. Additional key features (variegation, heterophylly) evolved in the most species-rich CAM lineages. Dry habitats were also colonized by a lineage that includes putative mycoheterotrophic taxa. These findings indicate that the switch to CAM is associated with environmental change. With its suite of adaptive traits, this group of orchids represents a unique opportunity to study the adaptations to dry environments, especially in the face of projected global aridification. © 2015 The Authors. New Phytologist © 2015 New Phytologist Trust.

Theoretical insight into the solvent effect of H2O and formamide on the cooperativity effect in HMX complex.

PubMed

Meng, Rui-Hong; Cao, Xiong; Hu, Shuang-Qi; Hu, Li-Shuang

2017-08-01

The cooperativity effects of the H-bonding interactions in HMX (1,3,5,7-tetranitro-1,3,5,7-tetrazacyclooctane)∙∙∙HMX∙∙∙FA (formamide), HMX∙∙∙HMX∙∙∙H 2 O and HMX∙∙∙HMX∙∙∙HMX complexes involving the chair and chair-chair HMX are investigated by using the ONIOM2 (CAM-B3LYP/6-31++G(d,p):PM3) and ONIOM2 (M06-2X/6-31++G(d,p):PM3) methods. The solvent effect of FA or H 2 O on the cooperativity effect in HMX∙∙∙HMX∙∙∙HMX are evaluated by the integral equation formalism polarized continuum model. The results show that the cooperativity and anti-cooperativity effects are not notable in all the systems. Although the effect of solvation on the binding energy of ternary system HMX∙∙∙HMX∙∙∙HMX is not large, that on the cooperativity of H-bonds is notable, which leads to the mutually strengthened H-bonding interaction in solution. This is perhaps the reason for the formation of different conformation of HMX in different solvent. Surface electrostatic potential and reduced density gradient are used to reveal the nature of the solvent effect on cooperativity effect in HMX∙∙∙HMX∙∙∙HMX. Graphical abstract RDG isosurface and electrostatic potential surface of HMX∙∙∙HMX∙∙∙HMX.

Acute Effects of Prostaglandin E1 and E2 on Vascular Reactivity and Blood Flow in situ in the Chick Chorioallantoic Membrane

PubMed Central

Fay, K.; Dunn, B.E.; Gruenloh, S.K.; Narayanan, J.; Jacobs, E.R.; Medhora, M.

2013-01-01

1. The chick chorioallantoic membrane (CAM) subserves gas exchange in the developing embryo and shell-less culture affords a unique opportunity for direct observations over time of individual blood vessels to pharmacologic interventions. We tested a number of lipids including prostaglandins PGE1&2 for vascular effects and signaling in the CAM. Application of PGE1&2 induced a decrease in the diameter of large blood vessels and a concentration-dependent, localized, reversible loss of blood flow through small vessels. The loss of flow was also mimicked by misoprostol, an agonist for 3 of 4 known PGE receptors, EP2-4, and by U46619, a thromboxane mimetic. Selective receptor antagonists for EP3 and thromboxane each partially blocked the response. This is a first report of the effects of prostaglandins on vasoreactivity in the CAM. Our model allows the unique ability to examine simultaneous responses of large and small vessels in real time and in vivo. PMID:22858445

The PanCam Instrument for the ExoMars Rover

NASA Astrophysics Data System (ADS)

Coates, A. J.; Jaumann, R.; Griffiths, A. D.; Leff, C. E.; Schmitz, N.; Josset, J.-L.; Paar, G.; Gunn, M.; Hauber, E.; Cousins, C. R.; Cross, R. E.; Grindrod, P.; Bridges, J. C.; Balme, M.; Gupta, S.; Crawford, I. A.; Irwin, P.; Stabbins, R.; Tirsch, D.; Vago, J. L.; Theodorou, T.; Caballo-Perucha, M.; Osinski, G. R.; PanCam Team

2017-07-01

The scientific objectives of the ExoMars rover are designed to answer several key questions in the search for life on Mars. In particular, the unique subsurface drill will address some of these, such as the possible existence and stability of subsurface organics. PanCam will establish the surface geological and morphological context for the mission, working in collaboration with other context instruments. Here, we describe the PanCam scientific objectives in geology, atmospheric science, and 3-D vision. We discuss the design of PanCam, which includes a stereo pair of Wide Angle Cameras (WACs), each of which has an 11-position filter wheel and a High Resolution Camera (HRC) for high-resolution investigations of rock texture at a distance. The cameras and electronics are housed in an optical bench that provides the mechanical interface to the rover mast and a planetary protection barrier. The electronic interface is via the PanCam Interface Unit (PIU), and power conditioning is via a DC-DC converter. PanCam also includes a calibration target mounted on the rover deck for radiometric calibration, fiducial markers for geometric calibration, and a rover inspection mirror.

Commentary: Interim leadership of academic departments at U.S. medical schools.

PubMed

Grigsby, R Kevin; Aber, Robert C; Quillen, David A

2009-10-01

Medical schools and teaching hospitals are experiencing more frequent turnover of department chairs. Loss of a department chair creates instability in the department and may have a negative effect on the organization at large. Interim leadership of academic departments is common, and interim chairs are expected to immediately demonstrate skills and leadership abilities. However, little is known about how persons are prepared to assume the interim chair role. Newer competencies for effective leadership include an understanding of the business of medicine, interpersonal and communication skills, the ability to deal with conflict and solve adaptive challenges, and the ability to build and work on teams. Medical schools and teaching hospitals need assistance to meet the unique training and support needs of persons serving as interim leaders. For example, the Association of American Medical Colleges and individual chair societies can develop programs to allow current chairs to reflect on their present positions and plan for the future. Formal leadership training, mentorship opportunities, and conscientious succession planning are good first steps in preparing to meet the needs of academic departments during transitions in leadership. Also, interim leadership experience may be useful as a means for "opening the door" to underrepresented persons, including women, and increasing the diversity of the leadership team.

The PanCam Instrument for the ExoMars Rover

PubMed Central

Coates, A.J.; Jaumann, R.; Griffiths, A.D.; Leff, C.E.; Schmitz, N.; Josset, J.-L.; Paar, G.; Gunn, M.; Hauber, E.; Cousins, C.R.; Cross, R.E.; Grindrod, P.; Bridges, J.C.; Balme, M.; Gupta, S.; Crawford, I.A.; Irwin, P.; Stabbins, R.; Tirsch, D.; Vago, J.L.; Theodorou, T.; Caballo-Perucha, M.; Osinski, G.R.

2017-01-01

Abstract The scientific objectives of the ExoMars rover are designed to answer several key questions in the search for life on Mars. In particular, the unique subsurface drill will address some of these, such as the possible existence and stability of subsurface organics. PanCam will establish the surface geological and morphological context for the mission, working in collaboration with other context instruments. Here, we describe the PanCam scientific objectives in geology, atmospheric science, and 3-D vision. We discuss the design of PanCam, which includes a stereo pair of Wide Angle Cameras (WACs), each of which has an 11-position filter wheel and a High Resolution Camera (HRC) for high-resolution investigations of rock texture at a distance. The cameras and electronics are housed in an optical bench that provides the mechanical interface to the rover mast and a planetary protection barrier. The electronic interface is via the PanCam Interface Unit (PIU), and power conditioning is via a DC-DC converter. PanCam also includes a calibration target mounted on the rover deck for radiometric calibration, fiducial markers for geometric calibration, and a rover inspection mirror. Key Words: Mars—ExoMars—Instrumentation—Geology—Atmosphere—Exobiology—Context. Astrobiology 17, 511–541.

Calmodulin regulates Cav3 T-type channels at their gating brake

PubMed Central

Taiakina, Valentina; Monteil, Arnaud; Piazza, Michael; Guan, Wendy; Stephens, Robert F.; Dieckmann, Thorsten; Guillemette, Joseph Guy; Spafford, J. David

2017-01-01

Calcium (Cav1 and Cav2) and sodium channels possess homologous CaM-binding motifs, known as IQ motifs in their C termini, which associate with calmodulin (CaM), a universal calcium sensor. Cav3 T-type channels, which serve as pacemakers of the mammalian brain and heart, lack a C-terminal IQ motif. We illustrate that T-type channels associate with CaM using co-immunoprecipitation experiments and single particle cryo-electron microscopy. We demonstrate that protostome invertebrate (LCav3) and human Cav3.1, Cav3.2, and Cav3.3 T-type channels specifically associate with CaM at helix 2 of the gating brake in the I–II linker of the channels. Isothermal titration calorimetry results revealed that the gating brake and CaM bind each other with high-nanomolar affinity. We show that the gating brake assumes a helical conformation upon binding CaM, with associated conformational changes to both CaM lobes as indicated by amide chemical shifts of the amino acids of CaM in 1H-15N HSQC NMR spectra. Intact Ca2+-binding sites on CaM and an intact gating brake sequence (first 39 amino acids of the I–II linker) were required in Cav3.2 channels to prevent the runaway gating phenotype, a hyperpolarizing shift in voltage sensitivities and faster gating kinetics. We conclude that the presence of high-nanomolar affinity binding sites for CaM at its universal gating brake and its unique form of regulation via the tuning of the voltage range of activity could influence the participation of Cav3 T-type channels in heart and brain rhythms. Our findings may have implications for arrhythmia disorders arising from mutations in the gating brake or CaM. PMID:28972185

Clarithromycin expands CD11b+Gr-1+ cells via the STAT3/Bv8 axis to ameliorate lethal endotoxic shock and post-influenza bacterial pneumonia

PubMed Central

Fujii, Hideki; Yagi, Kazuma; Suzuki, Shoji; Hegab, Ahmed E.; Tasaka, Sadatomo; Nakamoto, Nobuhiro; Iwata, Satoshi; Honda, Kenya; Kanai, Takanori; Hasegawa, Naoki; Betsuyaku, Tomoko

2018-01-01

Macrolides are used to treat various inflammatory diseases owing to their immunomodulatory properties; however, little is known about their precise mechanism of action. In this study, we investigated the functional significance of the expansion of myeloid-derived suppressor cell (MDSC)-like CD11b+Gr-1+ cells in response to the macrolide antibiotic clarithromycin (CAM) in mouse models of shock and post-influenza pneumococcal pneumonia as well as in humans. Intraperitoneal administration of CAM markedly expanded splenic and lung CD11b+Gr-1+ cell populations in naïve mice. Notably, CAM pretreatment enhanced survival in a mouse model of lipopolysaccharide (LPS)-induced shock. In addition, adoptive transfer of CAM-treated CD11b+Gr-1+ cells protected mice against LPS-induced lethality via increased IL-10 expression. CAM also improved survival in post-influenza, CAM-resistant pneumococcal pneumonia, with improved lung pathology as well as decreased interferon (IFN)-γ and increased IL-10 levels. Adoptive transfer of CAM-treated CD11b+Gr-1+ cells protected mice from post-influenza pneumococcal pneumonia. Further analysis revealed that the CAM-induced CD11b+Gr-1+ cell expansion was dependent on STAT3-mediated Bv8 production and may be facilitated by the presence of gut commensal microbiota. Lastly, an analysis of peripheral blood obtained from healthy volunteers following oral CAM administration showed a trend toward the expansion of human MDSC-like cells (Lineage−HLA-DR−CD11b+CD33+) with increased arginase 1 mRNA expression. Thus, CAM promoted the expansion of a unique population of immunosuppressive CD11b+Gr-1+ cells essential for the immunomodulatory properties of macrolides. PMID:29621339

Prospective Investigation of the Contrast Avoidance Model of Generalized Anxiety and Worry.

PubMed

Crouch, Tara A; Lewis, Jamie A; Erickson, Thane M; Newman, Michelle G

2017-07-01

The factors that maintain generalized anxiety disorder (GAD) symptoms and worry over time are not entirely clear. The Contrast Avoidance Model (CAM) postulates that individuals at risk for pathological worry and GAD symptoms uniquely fear emotional shifts from neutral or positive emotions into negative emotional states, and consequently use worry to maintain negative emotion in order to avoid shifts or blunt the effect of negative contrasts. This model has received support in laboratory experiments, but has not been investigated prospectively in the naturalistic context of daily life. The present study tested the CAM in a longitudinal experience sampling study with a subclinical sample. Participants selected to represent a broad range of symptoms (N = 92) completed baseline measures of GAD and depression symptoms, and eight weekly assessments of worry, experiences of negative emotional contrasts during their worst event of the week, and situation-specific negative emotion. Consistent with the CAM, GAD symptoms prospectively predicted higher endorsement of negative contrast experiences as worst events, independent of depression symptoms. Unsurprisingly, higher negative contrasts predicted higher negative emotion. However, both higher baseline GAD symptoms and weekly worry uniquely moderated (reduced) this relationship, providing consistent support for the idea that worry may blunt the emotional effects of contrasts. Depression symptoms did not have the same moderating effect. These findings support the CAM in an ecologically valid context. Copyright © 2016. Published by Elsevier Ltd.

Cellular distribution of calmodulin and calmodulin-binding proteins in Vicia faba L

NASA Technical Reports Server (NTRS)

Ling, V.; Assmann, S. M.

1992-01-01

The distribution of calmodulin (CaM) and CaM-binding proteins within Vicia faba was investigated. Both CaM and CaM-binding proteins were found to be differentially distributed among organs, tissues, and protoplast types. CaM levels, on a per protein basis, were found to be the highest in leaf epidermis, containing 3-fold higher levels of CaM than in total leaf. Similarly, guard cell and epidermal cell protoplasts were also found to have higher levels of CaM than mesophyll cell protoplasts. 125I-CaM blot overlay assays were performed to qualitatively examine CaM-binding proteins in these protoplast types as well as in whole tissues and organs. CaM-binding proteins with Mr 52,000, 78,000, and 115,000 were common in all metabolically active plant parts. Unique CaM-binding protein bands were detected in guard cell protoplasts (Mr 39,000, 88,000), stems (Mr 45,000, 60,000, 64,000), and roots (Mr 62,000), suggesting the presence of specialized CaM-dependent processes in these cells and organs.

Crystal structure of dimeric cardiac L-type calcium channel regulatory domains bridged by Ca[superscript 2+]·calmodulins

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

Fallon, Jennifer L.; Baker, Mariah R.; Xiong, Liangwen

2009-11-10

Voltage-dependent calcium channels (Ca(V)) open in response to changes in membrane potential, but their activity is modulated by Ca(2+) binding to calmodulin (CaM). Structural studies of this family of channels have focused on CaM bound to the IQ motif; however, the minimal differences between structures cannot adequately describe CaM's role in the regulation of these channels. We report a unique crystal structure of a 77-residue fragment of the Ca(V)1.2 alpha(1) subunit carboxyl terminus, which includes a tandem of the pre-IQ and IQ domains, in complex with Ca(2+).CaM in 2 distinct binding modes. The structure of the Ca(V)1.2 fragment is anmore » unusual dimer of 2 coiled-coiled pre-IQ regions bridged by 2 Ca(2+).CaMs interacting with the pre-IQ regions and a canonical Ca(V)1-IQ-Ca(2+).CaM complex. Native Ca(V)1.2 channels are shown to be a mixture of monomers/dimers and a point mutation in the pre-IQ region predicted to abolish the coiled-coil structure significantly reduces Ca(2+)-dependent inactivation of heterologously expressed Ca(V)1.2 channels.« less

Integrating Cloud Processes in the Community Atmosphere Model, Version 5.

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

Park, S.; Bretherton, Christopher S.; Rasch, Philip J.

2014-09-15

This paper provides a description on the parameterizations of global cloud system in CAM5. Compared to the previous versions, CAM5 cloud parameterization has the following unique characteristics: (1) a transparent cloud macrophysical structure that has horizontally non-overlapped deep cumulus, shallow cumulus and stratus in each grid layer, each of which has own cloud fraction, mass and number concentrations of cloud liquid droplets and ice crystals, (2) stratus-radiation-turbulence interaction that allows CAM5 to simulate marine stratocumulus solely from grid-mean RH without relying on the stability-based empirical empty stratus, (3) prognostic treatment of the number concentrations of stratus liquid droplets and icemore » crystals with activated aerosols and detrained in-cumulus condensates as the main sources and evaporation-sedimentation-precipitation of stratus condensate as the main sinks, and (4) radiatively active cumulus. By imposing consistency between diagnosed stratus fraction and prognosed stratus condensate, CAM5 is free from empty or highly-dense stratus at the end of stratus macrophysics. CAM5 also prognoses mass and number concentrations of various aerosol species. Thanks to the aerosol activation and the parameterizations of the radiation and stratiform precipitation production as a function of the droplet size, CAM5 simulates various aerosol indirect effects associated with stratus as well as direct effects, i.e., aerosol controls both the radiative and hydrological budgets. Detailed analysis of various simulations revealed that CAM5 is much better than CAM3/4 in the global performance as well as the physical formulation. However, several problems were also identifed, which can be attributed to inappropriate regional tuning, inconsistency between various physics parameterizations, and incomplete model physics. Continuous efforts are going on to further improve CAM5.« less

IPAD: A unique approach to government/industry cooperation for technology development and transfer

NASA Technical Reports Server (NTRS)

Fulton, Robert E.; Salley, George C.

1985-01-01

A key element to improved industry productivity is effective management of Computer Aided Design / Computer Aided Manufacturing (CAD/CAM) information. To stimulate advancement, a unique joint government/industry project designated Integrated Programs for Aerospace-Vehicle Design (IPAD) was carried out from 1971 to 1984. The goal was to raise aerospace industry productivity through advancement of computer based technology to integrate and manage information involved in the design and manufacturing process. IPAD research was guided by an Industry Technical Advisory Board (ITAB) composed of over 100 representatives from aerospace and computer companies. The project complemented traditional NASA/DOD research to develop aerospace design technology and the Air Force's Integrated Computer Aided Manufacturing (ICAM) program to advance CAM technology. IPAD had unprecedented industry support and involvement and served as a unique approach to government industry cooperation in the development and transfer of advanced technology. The IPAD project background, approach, accomplishments, industry involvement, technology transfer mechanisms and lessons learned are summarized.

Analyzing Contingency Contracting Purchases for Operation Iraqi Freedom (Unrestricted Version)

DTIC Science & Technology

2008-01-01

that could inform such strategic purchasing decisions. 14 We used the unique contract identification number to check for cross -organization...beds, mattresses, dressers , footlockers) Other (stools, rugs, seats, cabinets, tables, folding chairs, paintings) Generators Various power generators

Advances in nanopore sensing promises to transform healthcare.

PubMed

Haque, Farzin; Wang, Shaoying; Wu, Taoxiang; Guo, Peixuan

2017-08-01

International Conference on Nanopore Technology (Shenzhen), 30 March-1 April 2017, Shenzhen, China The International Conference on Nanopore Technology (Shenzhen) was held from 30 March to 1 April 2017 in Shenzhen, China. The goal of the meeting was threefold: leverage the unique properties of nanopore technology to promote transformative advances in medicine, encourage cross-disciplinary collaborations in the research community within China and abroad; and discuss critical challenges that need to be addressed to rapidly advance the field. The meeting was chaired by Peixuan Guo, Endowed chair professor and Director of The Center for RNA Nanobiotechnology & Nanomedicine at The Ohio State University, USA and co-chaired by Xian-En Zhang, distinguished professor of the Institute of Biophysics, Chinese Academy of Sciences, China. The conference was attended by more than 300 academic researchers, hospital administrators, government leaders and scientists from many disciplines across the country from both academic institutions and industry.

Endodontic Management of a Mandibular First Molar with Radix Entomolaris and Conservative Post-endodontic Restoration with CAD/CAM Onlay: A Novel Clinical Technique

PubMed Central

De Ataide, Ida De Noronha; Fernandes, Marina; Lambor, Rajan; Alreja, Dalip

2016-01-01

This case report describes a novel technique of restoring endodontically treated teeth. Hidden caries causing irreversible pulpitis in a mandibular molar with Radix Entomolaris (RE) was evident. The intact occlusal surface anatomy was duplicated before preparing an access cavity to replicate the original occlusal surface in the post endodontic restoration using (Computer-Aided Design and Computer-Aided Manufacturing) CAD/CAM technique. This report highlights uniquely designed onlay utilizing the benefits of contemporary materials and advanced technology. PMID:28050515

An antibody to the lutheran glycoprotein (Lu) recognizing the LU4 blood type variant inhibits cell adhesion to laminin α5.

PubMed

Kikkawa, Yamato; Miwa, Takahiro; Tohara, Yukiko; Hamakubo, Takayuki; Nomizu, Motoyoshi

2011-01-01

The Lutheran blood group glycoprotein (Lu), an Ig superfamily (IgSF) transmembrane receptor, is also known as basal cell adhesion molecule (B-CAM). Lu/B-CAM is a specific receptor for laminin α5, a major component of basement membranes in various tissues. Previous reports have shown that Lu/B-CAM binding to laminin α5 contributes to sickle cell vaso-occlusion. However, as there are no useful tools such as function-blocking antibodies or drugs, it is unclear how epithelial and sickled red blood cells adhere to laminin α5 via Lu/B-CAM. In this study, we discovered a function-blocking antibody that inhibits Lu binding to laminin α5 using a unique binding assay on tissue sections. To characterize the function-blocking antibody, we identified the site on Lu/B-CAM recognized by this antibody. The extracellular domain of Lu/B-CAM contains five IgSF domains, D1-D2-D3-D4-D5. The antibody epitope was localized to D2, but not to the D3 domain containing the major part of the laminin α5 binding site. Furthermore, mutagenesis studies showed that Arg(175), the LU4 blood group antigenic site, was crucial for forming the epitope and the antibody bound sufficiently close to sterically hinder the interaction with α5. Cell adhesion assay using the antibody also showed that Lu/B-CAM serves as a secondary receptor for the adhesion of carcinoma cells to laminin α5. This function-blocking antibody against Lu/B-CAM should be useful for not only investigating cell adhesion to laminin α5 but also for developing drugs to inhibit sickle cell vaso-occlusion.

The Sequence-specific Peptide-binding Activity of the Protein Sulfide Isomerase AGR2 Directs Its Stable Binding to the Oncogenic Receptor EpCAM.

PubMed

Mohtar, M Aiman; Hernychova, Lenka; O'Neill, J Robert; Lawrence, Melanie L; Murray, Euan; Vojtesek, Borek; Hupp, Ted R

2018-04-01

AGR2 is an oncogenic endoplasmic reticulum (ER)-resident protein disulfide isomerase. AGR2 protein has a relatively unique property for a chaperone in that it can bind sequence-specifically to a specific peptide motif (TTIYY). A synthetic TTIYY-containing peptide column was used to affinity-purify AGR2 from crude lysates highlighting peptide selectivity in complex mixtures. Hydrogen-deuterium exchange mass spectrometry localized the dominant region in AGR2 that interacts with the TTIYY peptide to within a structural loop from amino acids 131-135 (VDPSL). A peptide binding site consensus of Tx[IL][YF][YF] was developed for AGR2 by measuring its activity against a mutant peptide library. Screening the human proteome for proteins harboring this motif revealed an enrichment in transmembrane proteins and we focused on validating EpCAM as a potential AGR2-interacting protein. AGR2 and EpCAM proteins formed a dose-dependent protein-protein interaction in vitro Proximity ligation assays demonstrated that endogenous AGR2 and EpCAM protein associate in cells. Introducing a single alanine mutation in EpCAM at Tyr251 attenuated its binding to AGR2 in vitro and in cells. Hydrogen-deuterium exchange mass spectrometry was used to identify a stable binding site for AGR2 on EpCAM, adjacent to the TLIYY motif and surrounding EpCAM's detergent binding site. These data define a dominant site on AGR2 that mediates its specific peptide-binding function. EpCAM forms a model client protein for AGR2 to study how an ER-resident chaperone can dock specifically to a peptide motif and regulate the trafficking a protein destined for the secretory pathway. © 2018 by The American Society for Biochemistry and Molecular Biology, Inc.

Time-Efficiency Analysis Comparing Digital and Conventional Workflows for Implant Crowns: A Prospective Clinical Crossover Trial.

PubMed

Joda, Tim; Brägger, Urs

2015-01-01

To compare time-efficiency in the production of implant crowns using a digital workflow versus the conventional pathway. This prospective clinical study used a crossover design that included 20 study participants receiving single-tooth replacements in posterior sites. Each patient received a customized titanium abutment plus a computer-aided design/computer-assisted manufacture (CAD/CAM) zirconia suprastructure (for those in the test group, using digital workflow) and a standardized titanium abutment plus a porcelain-fused-to-metal crown (for those in the control group, using a conventional pathway). The start of the implant prosthetic treatment was established as the baseline. Time-efficiency analysis was defined as the primary outcome, and was measured for every single clinical and laboratory work step in minutes. Statistical analysis was calculated with the Wilcoxon rank sum test. All crowns could be provided within two clinical appointments, independent of the manufacturing process. The mean total production time, as the sum of clinical plus laboratory work steps, was significantly different. The mean ± standard deviation (SD) time was 185.4 ± 17.9 minutes for the digital workflow process and 223.0 ± 26.2 minutes for the conventional pathway (P = .0001). Therefore, digital processing for overall treatment was 16% faster. Detailed analysis for the clinical treatment revealed a significantly reduced mean ± SD chair time of 27.3 ± 3.4 minutes for the test group compared with 33.2 ± 4.9 minutes for the control group (P = .0001). Similar results were found for the mean laboratory work time, with a significant decrease of 158.1 ± 17.2 minutes for the test group vs 189.8 ± 25.3 minutes for the control group (P = .0001). Only a few studies have investigated efficiency parameters of digital workflows compared with conventional pathways in implant dental medicine. This investigation shows that the digital workflow seems to be more time-efficient than the established conventional production pathway for fixed implant-supported crowns. Both clinical chair time and laboratory manufacturing steps could be effectively shortened with the digital process of intraoral scanning plus CAD/CAM technology.

Expression of mucosal addressin cell adhesion molecule 1 on vessel endothelium of gastric mucosa in patients with nodular gastritis

PubMed Central

Ohara, Hiroshi; Isomoto, Hajime; Wen, Chun-Yang; Ejima, Chieko; Murata, Masahiro; Miyazaki, Masanobu; Takeshima, Fuminao; Mizuta, Yohei; Murata, Ikuo; Koji, Takehiko; Nagura, Hiroshi; Kohno, Shigeru

2003-01-01

AIM: The interaction of mucosal addressin cell adhesion molecule 1 (MAdCAM-1) with integrin α4β7 mediates lymphocyte recruitment into mucosa-associated lymphoid tissue (MALT). Nodular gastritis is characterized by a unique military pattern on endoscopy representing increased numbers of lymphoid follicles with germinal center, strongly associated with H pylori infection. The purpose of this study was to address the implication of the MAdCAM-1/integrin β7 pathway in NG. METHODS: We studied 17 patients with NG and H pylori infection and 19 H pylori-positive and 14 H pylori-negative controls. A biopsy sample was taken from the antrum and snap-frozen for immunohistochemical analysis of MAdCAM-1 and integrin β7. In simultaneous viewing of serial sections, the percentage of MAdCAM-1-positive to von Willebrand factor-positive vessels was calculated. We also performed immunostaining with anti-CD20, CD4, CD8 and CD68 antibodies to determine the lymphocyte subsets co-expressing integrin β7. RESULTS: Vascular endothelial MAdCAM-1 expression was more enhanced in gastric mucosa with than without H pylori infection. Of note, the percentages of MAdCAM-1-positive vessels were significantly higher in the lamina propria of NG patients than in H pylori-positive controls. Strong expression of MAdCAM-1 was identified adjacent to lymphoid follicles and dense lymphoid aggregates. Integrin β7-expressing mononuclear cells, mainly composed of CD20 and CD4 lymphocytes, were associated with vessels lined with MAdCAM-1-expressing endothelium. CONCLUSION: Our results suggest that the MAdCAM-1/ integrin α4β7 homing system may participate in gastric inflammation in response to H pylori-infection and contributes to MALT formation, typically leading to the development of NG. PMID:14669317

Gender differences in autobiographical memory for everyday events: retrieval elicited by SenseCam images versus verbal cues.

PubMed

St Jacques, Peggy L; Conway, Martin A; Cabeza, Roberto

2011-10-01

Gender differences are frequently observed in autobiographical memory (AM). However, few studies have investigated the neural basis of potential gender differences in AM. In the present functional MRI (fMRI) study we investigated gender differences in AMs elicited using dynamic visual images vs verbal cues. We used a novel technology called a SenseCam, a wearable device that automatically takes thousands of photographs. SenseCam differs considerably from other prospective methods of generating retrieval cues because it does not disrupt the ongoing experience. This allowed us to control for potential gender differences in emotional processing and elaborative rehearsal, while manipulating how the AMs were elicited. We predicted that males would retrieve more richly experienced AMs elicited by the SenseCam images vs the verbal cues, whereas females would show equal sensitivity to both cues. The behavioural results indicated that there were no gender differences in subjective ratings of reliving, importance, vividness, emotion, and uniqueness, suggesting that gender differences in brain activity were not due to differences in these measures of phenomenological experience. Consistent with our predictions, the fMRI results revealed that males showed a greater difference in functional activity associated with the rich experience of SenseCam vs verbal cues, than did females.

CREDO: a structural interactomics database for drug discovery

PubMed Central

Schreyer, Adrian M.; Blundell, Tom L.

2013-01-01

CREDO is a unique relational database storing all pairwise atomic interactions of inter- as well as intra-molecular contacts between small molecules and macromolecules found in experimentally determined structures from the Protein Data Bank. These interactions are integrated with further chemical and biological data. The database implements useful data structures and algorithms such as cheminformatics routines to create a comprehensive analysis platform for drug discovery. The database can be accessed through a web-based interface, downloads of data sets and web services at http://www-cryst.bioc.cam.ac.uk/credo. Database URL: http://www-cryst.bioc.cam.ac.uk/credo PMID:23868908

Elders' use of folk medicine and complementary and alternative therapies: an integrative review with implications for case managers.

PubMed

Sackett, Kay; Carter, Melondie; Stanton, Marietta

2014-01-01

The purpose of this study was to determine the prevalence of complementary and alternative medicine (CAM), folk medicine, and other nontraditional therapy use by the elderly population. For all case managers who coordinate health care for the elderly as they transition from one setting to another and participate in health promotion and prevention activities. A computerized database search of MEDLINE, CINAHL, ProQuest, and PsycINFO was completed before writing the integrative review. Six hundred ninety-seven abstracts were identified. Forty-five articles were further screened. Twenty-five articles met the criteria for inclusion. The integrative review is composed of 25 articles. Support for folk medicine and CAM use by older adults is located at Levels 5 and 6 of Melynk and Fine-Overholt's Hierarchy of Evidence. Folk medicine and CAM are used by the elderly for self-care purposes. A combination of both nontraditional and traditional medical interventions is used by the elderly. Although the choice to use folk medicine and CAM seems to transcend culture, the specific therapies chosen often emerge from the individual's cultural or ethnic heritage. Traditional health care providers may be unaware of elders' use of CAM or folk medicine alternatives. Case managers as coordinators of care across the health continuum are in a unique position to encourage, support, and enhance the use of folk medicine and CAM that complements traditional medical interventions for the elderly.

The quantity and quality of complementary and alternative medicine clinical practice guidelines on herbal medicines, acupuncture and spinal manipulation: systematic review and assessment using AGREE II.

PubMed

Ng, Jeremy Y; Liang, Laurel; Gagliardi, Anna R

2016-10-29

Complementary and alternative medicine (CAM) use is often not disclosed by patients, and can be unfamiliar to health care professionals. This may lead to underuse of beneficial CAM therapies, and overuse of other CAM therapies with little proven benefit or known contraindications. No prior research has thoroughly evaluated the credibility of knowledge-based resources. The purpose of this research was to assess the quantity and quality of CAM guidelines. A systematic review was conducted to identify CAM guidelines. MEDLINE, EMBASE and CINAHL were searched in January 2016 from 2003 to 2015. The National Guideline Clearinghouse, National Center for Complementary and Integrative Health web site, and two CAM journals were also searched. Eligible guidelines published in English language by non-profit agencies on herbal medicine, acupuncture, or spinal manipulation for adults with any condition were assessed with the Appraisal of Guidelines, Research and Evaluation II (AGREE II) instrument. From 3,126 unique search results, 17 guidelines (two herbal medicine, three acupuncture, four spinal manipulation, eight mixed CAM therapies) published in 2003 or later and relevant to several clinical conditions were eligible. Scaled domain percentages from highest to lowest were clarity of presentation (85.3 %), scope and purpose (83.3 %), rigour of development (61.2 %), editorial independence (60.1 %), stakeholder involvement (52.0 %) and applicability (20.7 %). Quality varied within and across guidelines. None of the 17 guidelines were recommended by both appraisers; 14 were recommended as Yes or Yes with modifications. Guidelines that scored well could be used by patients and health care professionals as the basis for discussion about the use of these CAM therapies. In future updates, guidelines that achieved variable or lower scores could be improved according to specifications in the AGREE II instrument, and with insight from a large number of resources that are available to support guideline development and implementation. Future research should identify CAM therapies other than those reviewed here for which guidelines are available. Research is also needed on the safety and effectiveness of CAM therapies.

The Preschool Confusion Assessment Method for the ICU (psCAM-ICU): Valid and Reliable Delirium Monitoring for Critically Ill Infants and Children

PubMed Central

Smith, Heidi A.B.; Gangopadhyay, Maalobeeka; Goben, Christina M.; Jacobowski, Natalie L.; Chestnut, Mary Hamilton; Savage, Shane; Rutherford, Michael T.; Denton, Danica; Thompson, Jennifer L.; Chandrasekhar, Rameela; Acton, Michelle; Newman, Jessica; Noori, Hannah P.; Terrell, Michelle K.; Williams, Stacey R.; Griffith, Katherine; Cooper, Timothy J.; Ely, E. Wesley; Fuchs, D. Catherine; Pandharipande, Pratik P.

2015-01-01

RATIONALE and OBJECTIVE Delirium assessments in critically ill infants and young children pose unique challenges due to evolution of cognitive and language skills. The objectives of this study were to determine the validity and reliability of a fundamentally objective and developmentally appropriate delirium assessment tool for critically ill infants and preschool-aged children, and to determine delirium prevalence. DESIGN and SETTING Prospective, observational cohort validation study of the PreSchool Confusion Assessment Method for the ICU (psCAM-ICU) in a tertiary medical center pediatric ICU. PATIENTS Participants aged 6 months to 5 years and admitted to the pediatric ICU regardless of admission diagnosis were enrolled. INTERVENTIONS, MEASUREMENTS and MAIN RESULTS An interdisciplinary team created the psCAM-ICU for pediatric delirium monitoring. To assess validity, patients were independently assessed for delirium daily by the research team using the psCAM-ICU and by a child psychiatrist using the Diagnostic and Statistical Manual of Mental Disorders criteria. Reliability was assessed using blinded, concurrent psCAM-ICU evaluations by research staff. A total of 530-paired delirium assessments were completed among 300 patients, with a median age of 20 months (IQR 11, 37) and 43% requiring mechanical ventilation. The psCAM-ICU demonstrated a specificity of 91% (95%CI 90, 93), sensitivity of 75% (72, 78), negative predictive value of 86% (84, 88), positive predictive value of 84% (81, 87), and a reliability kappa statistic of 0.79 (0.76, 0.83). Delirium prevalence was 44% using the psCAM-ICU and 47% by the reference-rater. The rates of delirium were 53% vs. 56% in patients < 2 years of age and 33% vs. 35% in patients ≥ 2 - 5 years of age using the psCAM-ICU and reference-rater respectively. The short-form psCAM-ICU maintained a high specificity (87%) and sensitivity (78%) in post-hoc analysis. CONCLUSIONS The psCAM-ICU is a highly valid and reliable delirium instrument for critically ill infants and preschool-aged children, in whom delirium is extremely prevalent. PMID:26565631

Competitive tuning: Competition's role in setting the frequency-dependence of Ca2+-dependent proteins

PubMed Central

Patel, Neal M.; Kinzer-Ursem, Tamara L.

2017-01-01

A number of neurological disorders arise from perturbations in biochemical signaling and protein complex formation within neurons. Normally, proteins form networks that when activated produce persistent changes in a synapse’s molecular composition. In hippocampal neurons, calcium ion (Ca2+) flux through N-methyl-D-aspartate (NMDA) receptors activates Ca2+/calmodulin signal transduction networks that either increase or decrease the strength of the neuronal synapse, phenomena known as long-term potentiation (LTP) or long-term depression (LTD), respectively. The calcium-sensor calmodulin (CaM) acts as a common activator of the networks responsible for both LTP and LTD. This is possible, in part, because CaM binding proteins are “tuned” to different Ca2+ flux signals by their unique binding and activation dynamics. Computational modeling is used to describe the binding and activation dynamics of Ca2+/CaM signal transduction and can be used to guide focused experimental studies. Although CaM binds over 100 proteins, practical limitations cause many models to include only one or two CaM-activated proteins. In this work, we view Ca2+/CaM as a limiting resource in the signal transduction pathway owing to its low abundance relative to its binding partners. With this view, we investigate the effect of competitive binding on the dynamics of CaM binding partner activation. Using an explicit model of Ca2+, CaM, and seven highly-expressed hippocampal CaM binding proteins, we find that competition for CaM binding serves as a tuning mechanism: the presence of competitors shifts and sharpens the Ca2+ frequency-dependence of CaM binding proteins. Notably, we find that simulated competition may be sufficient to recreate the in vivo frequency dependence of the CaM-dependent phosphatase calcineurin. Additionally, competition alone (without feedback mechanisms or spatial parameters) could replicate counter-intuitive experimental observations of decreased activation of Ca2+/CaM-dependent protein kinase II in knockout models of neurogranin. We conclude that competitive tuning could be an important dynamic process underlying synaptic plasticity. PMID:29107982

The Sit & Stand chair. A revolutionary advance in adaptive seating systems.

PubMed

Galumbeck, Michael H; Buschbacher, Ralph M; Wilder, Robert P; Winters, Kathryne L; Hudson, Mary Anne; Edlich, Richard F

2004-01-01

A major factor governing independence for the elderly and persons with disabilities is the ability to stand from a chair. Factors such as pain, reduced joint range of motion, stiffness, and muscle weakness frequently limit the ability to stand. Sit-to-stand position is even further reduced in patients whose hands and shoulders are afflicted with rheumatoid arthritis. When achieving a sit-to-stand position in the elderly and persons with disabilities, there is considerable risk of the individual falling and sustaining bone fracture. The purposes of this scientific report are to achieve the following goals: (1) to provide a narrative discussion of the senior author's contributions to furniture manufacturing as well as his successful patent application for the SIT & STAND chair, (2) to describe the steps involved in the development of the SIT & STAND prototype, and (3) to examine the performance of the SIT & STAND chair in assisting the elderly or persons with disabilities in achieving a sit-to-stand position. The invention of the SIT & STAND chair by the senior author, Michael Galumbeck, was a culmination of his lifelong interest in adaptive seating systems. His electrically operated chair has the unique ability to assist the occupant to achieve safely a sit-to-stand position. The rear portion of his chair remains in a fixed position to support the buttocks of the user during mechanical lift. The front portion of the seat folds down incrementally as the chair rises to allow the feet of the user to be positioned in a more posterior position firmly on the floor. Using its actuator, the height that the chair rises will vary with the length of the legs of the occupant. Using the drawing program Solid Works (Solid Works, Concord, Massachusetts), drawings of the chair were made. To visualize the operation and performance of the chair, separate drawings were made in the lateral position. The prototype of the SIT & STAND chair was manufactured with an electric actuator that allows elevation of the back portion of the seat. The design of this chair ensured that there were no pinch points that could endanger the user or assistant. Its framework ensured that it was stable and did not tip over. After the prototype chair is manufactured, it is being sent to Underwriters Laboratory Inc. (Los Angeles, California) for review and certification. The performance of the SIT & STAND chair was determined in a clinical study involving seven elderly or disabled individuals who complained of difficulty in rising from a chair from a seated position. During each performance evaluation, a mechanical chest and shoulder harness attached to an overhead sling encircled the individual to ensure that he/she would not fall. In the first part of the evaluation, these individuals were asked to achieve a standing position after being seated in the SIT & STAND chair without the use of the actuator. Three individuals were unable to achieve a standing position, while four achieved this standing position with considerable difficulty and potential instability. When these participants used the SIT & STAND chair with the use of the electrical actuator, all individuals achieved a standing position without difficulty or instability. All individuals expressed disappointment that the SIT & STAND chair was not commercially available for them to purchase and use in their homes. Because the SIT & STAND chair allows the individual to achieve a standing position without assistance, the SIT & STAND chair has other potential benefits not evaluated in this study. The beneficial effects of standing have been documented by comprehensive scientific studies. These benefits include reduction of seating pressure, decreased bone demineralization, increased bladder pressure, enhanced circulatory regulation, reduction in muscular tone, decrease in upper extremity muscle stress, and participation in activities of daily living. Another irrefutable benefit of the SIT & STAND chair is that the chair eliminates the need for physical assistance from family members or health care personnel, preventing the development of disabling back injuries in personal care assistants. In addition, the SIT & STAND chair entirely removes the risk of pain or harm to the individual, which sometimes occurs with manual assist to stand, such as dislocation or fracture of frail shoulders with the under-axilla lift. Realizing the medical benefits of the SIT & STAND chair, Aetna completed a clinical policy bulletin that states that the seat lift mechanism is a medically necessary durable medical product. On the basis of this extensive product and performance evaluation, we recommend the SIT & STAND chair for the elderly as well as persons with disability to safely achieve a sit-to-stand position.

A robot end effector exchange mechanism for space applications

NASA Technical Reports Server (NTRS)

Gorin, Barney F.

1990-01-01

Efficient robot operation requires the use of specialized end effectors or tools for tasks. In spacecraft applications, the microgravity environment precludes the use of gravitational forces to retain the tools in holding fixture. As a result of this, a retention mechanism which forms a part of the tool storage container is required. A unique approach to this problem has resulted in the development of an end effector exchange mechanism that meets the requirements for spaceflight applications while avoiding the complexity usually involved. This mechanism uses multiple latching cams both on the manipulator and in the tool storage container, combined with a system of catch rings to provide retention in both locations and the required failure tolerance. Because of the cam configuration the mechanism operates passively, requiring no electrical commands except those needed to move the manipulator into position. Similarly, it inherently provides interlocks to prevent the release of one cam before its opposite number is engaged.

Forensic characterization of camcorded movies: digital cinema vs. celluloid film prints

NASA Astrophysics Data System (ADS)

Rolland-Nevière, Xavier; Chupeau, Bertrand; Do"rr, Gwena"l.; Blondé, Laurent

2012-03-01

Digital camcording in the premises of cinema theaters is the main source of pirate copies of newly released movies. To trace such recordings, watermarking systems are exploited in order for each projection to be unique and thus identifiable. The forensic analysis to recover these marks is different for digital and legacy cinemas. To avoid running both detectors, a reliable oracle discriminating between cams originating from analog or digital projections is required. This article details a classification framework relying on three complementary features : the spatial uniformity of the screen illumination, the vertical (in)stability of the projected image, and the luminance artifacts due to the interplay between the display and acquisition devices. The system has been tuned with cams captured in a controlled environment and benchmarked against a medium-sized dataset (61 samples) composed of real-life pirate cams. Reported experimental results demonstrate that such a framework yields over 80% classification accuracy.

What Juno will see at Jupiter South Pole Simulation

NASA Image and Video Library

2011-08-03

This simulated view of the south pole of Jupiter illustrates the unique perspective of NASA Juno mission. Juno polar orbit will allow its camera, called JunoCam, to image Jupiter clouds from a vantage point never accessed by other spacecraft.

Novel HLA class I associations with HIV-1 control in a unique genetically admixed population.

PubMed

Valenzuela-Ponce, Humberto; Alva-Hernández, Selma; Garrido-Rodríguez, Daniela; Soto-Nava, Maribel; García-Téllez, Thalía; Escamilla-Gómez, Tania; García-Morales, Claudia; Quiroz-Morales, Verónica Sonia; Tapia-Trejo, Daniela; Del Arenal-Sánchez, Silvia; Prado-Galbarro, Francisco-Javier; Hernández-Juan, Ramón; Rodríguez-Aguirre, Edna; Murakami-Ogasawara, Akio; Mejía-Villatoro, Carlos; Escobar-Urias, Ingrid Y; Pinzón-Meza, Rodolfo; Pascale, Juan Miguel; Zaldivar, Yamitzel; Porras-Cortés, Guillermo; Quant-Durán, Carlos; Lorenzana, Ivette; Meza, Rita I; Palou, Elsa Y; Manzanero, Marvin; Cedillos, Rolando A; Aláez, Carmen; Brockman, Mark A; Harrigan, P Richard; Brumme, Chanson J; Brumme, Zabrina L; Ávila-Ríos, Santiago; Reyes-Terán, Gustavo

2018-04-17

Associations between HLA class I alleles and HIV progression in populations exhibiting Amerindian and Caucasian genetic admixture remain understudied. Using univariable and multivariable analyses we evaluated HLA associations with five HIV clinical parameters in 3,213 HIV clade B-infected, ART-naïve individuals from Mexico and Central America (MEX/CAM cohort). A Canadian cohort (HOMER, n = 1622) was used for comparison. As expected, HLA allele frequencies in MEX/CAM and HOMER differed markedly. In MEX/CAM, 13 HLA-A, 24 HLA-B, and 14 HLA-C alleles were significantly associated with at least one clinical parameter. These included previously described protective (e.g. B*27:05, B*57:01/02/03 and B*58:01) and risk (e.g. B*35:02) alleles, as well as novel ones (e.g. A*03:01, B*15:39 and B*39:02 identified as protective, and A*68:03/05, B*15:30, B*35:12/14, B*39:01/06, B*39:05~C*07:02, and B*40:01~C*03:04 identified as risk). Interestingly, both protective (e.g. B*39:02) and risk (e.g. B*39:01/05/06) subtypes were identified within the common and genetically diverse HLA-B*39 allele group, characteristic to Amerindian populations. While HLA-HIV associations identified in MEX and CAM separately were similar overall (Spearman's rho = 0.33, p = 0.03), region-specific associations were also noted. The identification of both canonical and novel HLA/HIV associations provides a first step towards improved understanding of HIV immune control among unique and understudied Mestizo populations.

Crystal Structure of Calmodulin Binding Domain of Orai1 in Complex with Ca2+•Calmodulin Displays a Unique Binding Mode*

PubMed Central

Liu, Yanshun; Zheng, Xunhai; Mueller, Geoffrey A.; Sobhany, Mack; DeRose, Eugene F.; Zhang, Yingpei; London, Robert E.; Birnbaumer, Lutz

2012-01-01

Orai1 is a plasma membrane protein that in its tetrameric form is responsible for calcium influx from the extracellular environment into the cytosol in response to interaction with the Ca2+-depletion sensor STIM1. This is followed by a fast Ca2+·calmodulin (CaM)-dependent inhibition, resulting from CaM binding to an Orai1 region called the calmodulin binding domain (CMBD). The interaction between Orai1 and CaM at the atomic level remains unknown. Here, we report the crystal structure of a CaM·Orai1-CMBD complex showing one CMBD bound to the C-terminal lobe of CaM, differing from other CaM-target protein complexes, in which both N- and C-terminal lobes of CaM (CaM-N and CaM-C) are involved in target binding. Orai1-CMBD binds CaM-C mainly through hydrophobic interactions, primarily involving residue Trp76 of Orai1-CMBD, which interacts with the hydrophobic pocket of CaM-C. However, NMR data, isothermal titration calorimetry data, and pulldown assays indicated that CaM-N and CaM-C both can bind Orai1-CMBD, with CaM-N having ∼4 times weaker affinity than CaM-C. Pulldown assays of a Orai1-CMBD(W76E) mutant, gel filtration chromatography data, and NOE signals indicated that CaM-N and CaM-C can each bind one Orai1-CMBD. Thus our studies support an unusual, extended 1:2 binding mode of CaM to Orai1-CMBDs, and quantify the affinity of Orai1 for CaM. We propose a two-step mechanism for CaM-dependent Orai1 inactivation initiated by binding of the C-lobe of CaM to the CMBD of one Orai1 followed by the binding of the N-lobe of CaM to the CMBD of a neighboring Orai1. PMID:23109337

SNACC Extras

NASA Astrophysics Data System (ADS)

Huber, Mark; Scolnic, D.; Riess, A. G.; Tonry, J. L.; Rodney, S. A.; Rest, A.; Stubbs, C. W.

2010-01-01

The extensive application of the SuperNovAe Cross-Correlation (SNACC) filters developed by Scolnic et al. (2009) for follow-up identification and redshift of type Ia supernovae in current and upcoming supernovae surveys will itself produce a unique imaging survey. We will present a collection of simulated and actual sources from the initial observing run using the new 4-band SNACC filters with Suprime-Cam on the Subaru telescope to explore the extra potential of this unique data set.

Science of active galactic nuclei with the GTC and CanariCam

NASA Astrophysics Data System (ADS)

Levenson, Nancy A.; Packham, Christopher C.; Alonso-Herrero, Almudena; Aretxaga, Itziar; Colina, Luis; Díaz-Santos, Tanio; Elitzur, Moshe; Mason, Rachel E.; Perlman, Eric S.; Radomski, James T.; Roche, Patrick F.; Rodríguez Espinosa, José Miguel; Young, Stuart; Telesco, Charles M.

2008-07-01

CanariCam is the facility mid-infrared (MIR) instrument for the Gran Telescopio Canarias (GTC), a 10.4m telescope at the Observatorio del Roque de los Muchachos on La Palma. One of the science drivers for CanariCam is the study of active galactic nuclei (AGN). We will exploit the instrument's high sensitivity in imaging, spectroscopy, and polarimetry modes to answer fundamental questions of AGN and their host galaxies. Dust in the nucleus of an active galaxy reprocesses the intrinsic radiation of the central engine to emerge in the MIR. Current work demonstrates that the hot dust immediately associated with the AGN, which blocks direct views of the AGN from some lines of sight, is confined to small (parsec) scales. Thus, high spatial resolution is essential to probe the "torus" of unified AGN models separate from the host galaxy. CanariCam provides a 0.08" pixel scale for Nyquist sampling the diffraction-limited point spread function at 8μm, and narrow (0.2") spectroscopy slits (with R=120-1300). New observations with the GTC/CanariCam will provide key constraints on the physical conditions in the clumpy torus, and we will sensitively determine AGN obscuration as a function of nuclear activity. We will therefore address the fueling process and its relationship to the torus, the interaction with the host galaxy, and dust chemistry. These data will be essential preparation for the next generation of telescopes that will observe the distant universe directly to explore galaxy and black hole formation and evolution, and the GTC/CanariCam system uniquely provides multiple modes to probe AGN.

Identification and period investigation of pulsation variable star UY Camelopardalis, an RR Lyrae star in binary system

NASA Astrophysics Data System (ADS)

Li, Lin-Jia; Qian, Sheng-Bang; Voloshina, Irina; Metlov, Vladimir G.; Zhu, Li-Ying; Liao, Wen-Ping

2018-06-01

We present photometric measurements of the short period variable star UY Cam, which has been classified as a δ Scuti or c-type RR Lyrae (RRc) variable in different catalogs. Based on the analyses on Fourier coefficients and (NUV - V)0, we find that UY Cam is probably an RRc star. We obtain 58 new times of light maximum for UY Cam based on several sky surveys and our observations. Combining these with the times of light maximum in literature, a total of 154 times of light maximum are used to analyze the O - C diagram of UY Cam. The results show that the O - C pattern can be described by a downward parabolic component with a rate of -6.86 ± 0.47 × 10-11 d d-1, and a cyclic variation with a period of 65.7 ± 2.4 yr. We suppose these components are caused by the stellar evolution and the light travel time effect (LiTE) of a companion in elliptical orbit, respectively. By calculation, the minimum mass of the potential companion is about 0.17 M⊙, and its mass should be less than or equal to the pulsation primary star when the inclination i > 22.5°D. Therefore, the companion should be a low-mass star, like a late-type main-sequence star or a white dwarf. Due to the unique property of UY Cam, we suggest that more observations and studies on UY Cam and other RRc stars are needed to check the nature of these stars, including the pulsations and binarities.

Development of a Student Mentored Research Program between a Complementary and Alternative Medicine University and a Traditional, Research Intensive University

PubMed Central

Sullivan, Barbara M.; Furner, Sylvia E.; Cramer, Gregory D.

2014-01-01

The global need to develop clinician-scientists capable of using research in clinical practice, translating research knowledge into practice, and carrying out research that affects the quality, efficacy, and efficiency of health care is well-documented. The complementary and alternative medicine (CAM) professions embrace the call to develop physician-researchers to carry out translational and applied research for CAM modalities. CAM universities face unique challenges when implementing research training compared to traditional, research intensive (TRI) universities and medical centers where the majority of medical research is carried out. The authors present the development and outcomes of a mentored research program (MRP) between a CAM and a TRI institution, the National University of Health Sciences and the University of Illinois at Chicago School of Public Health, between 2006 and 2012. CAM pre-doctoral students engaged in a full-immersion semester at the TRI, including didactic courses and active research with a TRI faculty research mentor. Half of the participating doctor of chiropractic (DC) students continued on to PhD programs and half established integrative medicine, primary care clinical careers. Establishing rigorous criteria for mentors and mentees, communicating expectations, developing solid relationships between the mentor, mentee, and home school advisor, responding quickly to impediments, and providing adequate support from CAM and TRI investigators were key to the MRP success. To sustain research opportunities, coordinated degree programs for the DC and master of public health (DC/MPH) and master of clinical and translational research (DC/MS CTS) were established. PMID:24988423

Complementary and alternative medicine in child and adolescent psychiatry: legal considerations.

PubMed

Cohen, Michael H; Natbony, Suzanne R; Abbott, Ryan B

2013-07-01

The rising popularity of complementary and alternative medicine (CAM) in child and adolescent psychiatry raises unique ethical and legal concerns for psychiatrists and other conventional health care providers. This article explores these concerns and provides clinical advice for promoting patient health and safety while minimizing the psychiatrist's risk. Although any departure from the conventional standard of care is a potential risk, the risk of malpractice liability for practicing integrative medicine in child and adolescent psychiatry is low. CAM is most safely recommended from a legal standpoint when there is some published evidence of safety and efficacy. Copyright © 2013 Elsevier Inc. All rights reserved.

Medical Ethnobotany in Europe: From Field Ethnography to a More Culturally Sensitive Evidence-Based CAM?

PubMed Central

Quave, Cassandra L.; Pardo-de-Santayana, Manuel; Pieroni, Andrea

2012-01-01

European folk medicine has a long and vibrant history, enriched with the various documented uses of local and imported plants and plant products that are often unique to specific cultures or environments. In this paper, we consider the medicoethnobotanical field studies conducted in Europe over the past two decades. We contend that these studies represent an important foundation for understanding local small-scale uses of CAM natural products and allow us to assess the potential for expansion of these into the global market. Moreover, we discuss how field studies of this nature can provide useful information to the allopathic medical community as they seek to reconcile existing and emerging CAM therapies with conventional biomedicine. This is of great importance not only for phytopharmacovigilance and managing risk of herb-drug interactions in mainstream patients that use CAM, but also for educating the medical community about ethnomedical systems and practices so that they can better serve growing migrant populations. Across Europe, the general status of this traditional medical knowledge is at risk due to acculturation trends and the urgency to document and conserve this knowledge is evident in the majority of the studies reviewed. PMID:22899952

An Examination of Video-Based Coaching to Support Psychological Factors of Online Dissertation Students

ERIC Educational Resources Information Center

Ames, Cathrine D.

2017-01-01

Unique challenges affecting the influx of online doctoral learners create opportunities to enhance their experience by mitigating limited contact. This quantitative causal-comparative and correlational study examined differences based on frequency and duration of video-based coaching doctoral learners received from their dissertation chairs, at a…

The Lozanov Language Class.

ERIC Educational Resources Information Center

Bancroft, W. Jane

In Sofia, Bulgaria, at the Institute of Suggestology headed by Dr. Georgi Lozanov, yoga relaxation has been combined with the Mauger oral method to produce a unique system of foreign language teaching: Suggestopedia. In a pleasant classroom, 12 students sit in specail chairs in front of a teacher individually trained in the foreign language and in…

Molecular Dissection of Neuroligin 2 and Slitrk3 Reveals an Essential Framework for GABAergic Synapse Development.

PubMed

Li, Jun; Han, Wenyan; Pelkey, Kenneth A; Duan, Jingjing; Mao, Xia; Wang, Ya-Xian; Craig, Michael T; Dong, Lijin; Petralia, Ronald S; McBain, Chris J; Lu, Wei

2017-11-15

In the brain, many types of interneurons make functionally diverse inhibitory synapses onto principal neurons. Although numerous molecules have been identified to function in inhibitory synapse development, it remains unknown whether there is a unifying mechanism for development of diverse inhibitory synapses. Here we report a general molecular mechanism underlying hippocampal inhibitory synapse development. In developing neurons, the establishment of GABAergic transmission depends on Neuroligin 2 (NL2), a synaptic cell adhesion molecule (CAM). During maturation, inhibitory synapse development requires both NL2 and Slitrk3 (ST3), another CAM. Importantly, NL2 and ST3 interact with nanomolar affinity through their extracellular domains to synergistically promote synapse development. Selective perturbation of the NL2-ST3 interaction impairs inhibitory synapse development with consequent disruptions in hippocampal network activity and increased seizure susceptibility. Our findings reveal how unique postsynaptic CAMs work in concert to control synaptogenesis and establish a general framework for GABAergic synapse development. Published by Elsevier Inc.

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

Leakey, Andrew D. B.

This project funded the C 4 and CAM (crassulacean acid metabolism) Plant Biology 2013 symposium, held at the University of Illinois at Urbana-Champaign, IL, on August 6-9, 2013. The symposium brought together a diverse group of scientists to discuss the evolution, ecology, functional biology, genomics and biotechnological engineering of C 4 and CAM plants. These two groups of plants possess evolutionary modifications to their photosynthetic machinery that improve their performance in hot and dry conditions. Maize and pineapple are classic examples of C 4 and CAM plants, respectively. The meeting discussed how lessons learned from these groups of plants canmore » be harnessed to improve crop production of biofuel feedstocks in an era of global climate change. The interdisciplinary nature of the meeting meant that the delegation members typically do not collectively attend any one scientific society meeting. As a result, the symposium was a unique opportunity for knowledge transfer, initiation of new collaborations, and recruitment and exposure of early career scientists.« less

Pull-down Assay to Characterize Ca2+/Calmodulin Binding to Plant Receptor Kinases.

PubMed

Kaufmann, Christine; Sauter, Margret

2017-01-01

Plant receptor-like kinases (RLKs) are regulated by posttranscriptional modification and by interaction with regulatory proteins. A common modification of RLKs is (auto)phosphorylation, and a common regulatory protein is the calcium sensor calmodulin (CaM). We have developed protocols to detect the interaction of an RLK with CaM. The interaction with CaM was shown by bimolecular fluorescence complementation (BiFC) (see Chapter 14) and pull-down assay (this chapter). Both methods offer unique advantages. BiFC is useful in showing interaction of soluble as well as of membrane-bound proteins in planta. Pull-down assays are restricted to soluble proteins and provide in vitro data. The pull-down assay provides the advantage that proteins can be modified prior to binding and that experimental conditions such as the concentration of Ca 2+ or other divalent cations can be controlled. This chapter provides a pull-down protocol to study RLK-CaM interaction with optional steps to investigate the impact of RLK phosphorylation or of Ca 2+ .

The Impact of Varying the Physics Grid Resolution Relative to the Dynamical Core Resolution in CAM-SE-CSLAM

NASA Astrophysics Data System (ADS)

Herrington, A. R.; Lauritzen, P. H.; Reed, K. A.

2017-12-01

The spectral element dynamical core of the Community Atmosphere Model (CAM) has recently been coupled to an approximately isotropic, finite-volume grid per implementation of the conservative semi-Lagrangian multi-tracer transport scheme (CAM-SE-CSLAM; Lauritzen et al. 2017). In this framework, the semi-Lagrangian transport of tracers are computed on the finite-volume grid, while the adiabatic dynamics are solved using the spectral element grid. The physical parameterizations are evaluated on the finite-volume grid, as opposed to the unevenly spaced Gauss-Lobatto-Legendre nodes of the spectral element grid. Computing the physics on the finite-volume grid reduces numerical artifacts such as grid imprinting, possibly because the forcing terms are no longer computed at element boundaries where the resolved dynamics are least smooth. The separation of the physics grid and the dynamics grid allows for a unique opportunity to understand the resolution sensitivity in CAM-SE-CSLAM. The observed large sensitivity of CAM to horizontal resolution is a poorly understood impediment to improved simulations of regional climate using global, variable resolution grids. Here, a series of idealized moist simulations are presented in which the finite-volume grid resolution is varied relative to the spectral element grid resolution in CAM-SE-CSLAM. The simulations are carried out at multiple spectral element grid resolutions, in part to provide a companion set of simulations, in which the spectral element grid resolution is varied relative to the finite-volume grid resolution, but more generally to understand if the sensitivity to the finite-volume grid resolution is consistent across a wider spectrum of resolved scales. Results are interpreted in the context of prior ideas regarding resolution sensitivity of global atmospheric models.

Exploring the Effects of Social Exchange Relationships on the Scholarly Productivity of New Faculty Members in Accounting

ERIC Educational Resources Information Center

Ugrin, Joseph C.; Odom, Marcus D.; Pearson, J. Michael; Bahmanziari, Tammy R.

2012-01-01

This paper explores how social relationships between new accounting faculty members and their former dissertation chairs can influence the publishing productivity of the new faculty members in their early academic careers. The focus on social relationships offers a unique approach to studying the effectiveness doctoral education. Our findings show…

Sinking or Swimming in the Deep End? Developing Professional Academic Identities as Doctoral Students Chairing Large Classes

ERIC Educational Resources Information Center

Bereznicki, Hannah; Sutherland-Smith, Wendy; Horwood, Sharon

2014-01-01

Much of the burden of undergraduate teaching in Australian higher education institutions falls to sessional staff and postgraduate students. These members of staff assume high teaching loads and administrative management responsibilities. This paper explores the perspectives of two female academics in the unique position of being the subject…

Learning and Growing CCTE

ERIC Educational Resources Information Center

Grutzik, Cynthia

2015-01-01

After being a steady member of the California Council on Teacher Education (CCTE) for 14 years as a faculty member, program director, department chair, associate dean, and even as a mother, Cynthia Grutzik was nominated to run for President-Elect of CCTE in 2010. She was in a unique situation as she came into the CCTE presidency: two women had…

Neuroglian stabilizes epithelial structure during Drosophila oogenesis.

PubMed

Wei, Jun; Hortsch, Michael; Goode, Scott

2004-08-01

The vertebrate L1 family of cell adhesion molecules (CAMs) and their fly homolog, Neuroglian, are members of the immunoglobulin (Ig) superfamily of CAMs. In general, Ig CAMs have been found to play critical roles in mediating axon guidance. One Ig CAM, NCAM, has also been implicated in maintaining epithelial integrity and suppressing metastatic dissemination of tumor cells. Other Ig CAMs, such as Nrg, are also expressed in epithelia. We thus tested the hypothesis that, like NCAM, Nrg might also be required for maintaining epithelial integrity and for inhibiting tumor invasion. We used the Drosophila follicular epithelium to determine the function of Nrg in vivo in maintaining epithelial structure, and in regulating the motility of migrating border cells and invasive tumorous follicle cells. Nrg(167) is expressed on the lateral membrane of follicle cells. Loss of Nrg(167) causes border cells to delay delamination and causes other follicle cells to delaminate inappropriately. The delaminated cells have aberrant epithelial polarity manifested as severe mislocalization of apical and basal membrane proteins, and uniform localization of lateral membrane proteins. Furthermore, loss of Nrg(167) dramatically enhances the invasive phenotype associated with loss of Discs Large, a neoplastic tumor suppressor. These results indicate that Nrg(167) stabilizes epithelial polarity by regulating junctional adhesion and function in normal and tumorous epithelia. Our data also suggest that Ig superfamily members have significant functional redundancy in maintaining epithelial polarity, with individual members playing subtle, unique roles during epithelial morphogenesis. Copyright 2004 Wiley-Liss, Inc.

Acupuncture and chiropractic care for chronic pain in an integrated health plan: a mixed methods study

PubMed Central

2011-01-01

Background Substantial recent research examines the efficacy of many types of complementary and alternative (CAM) therapies. However, outcomes associated with the "real-world" use of CAM has been largely overlooked, despite calls for CAM therapies to be studied in the manner in which they are practiced. Americans seek CAM treatments far more often for chronic musculoskeletal pain (CMP) than for any other condition. Among CAM treatments for CMP, acupuncture and chiropractic (A/C) care are among those with the highest acceptance by physician groups and the best evidence to support their use. Further, recent alarming increases in delivery of opioid treatment and surgical interventions for chronic pain--despite their high costs, potential adverse effects, and modest efficacy--suggests the need to evaluate real world outcomes associated with promising non-pharmacological/non-surgical CAM treatments for CMP, which are often well accepted by patients and increasingly used in the community. Methods/Design This multi-phase, mixed methods study will: (1) conduct a retrospective study using information from electronic medical records (EMRs) of a large HMO to identify unique clusters of patients with CMP (e.g., those with differing demographics, histories of pain condition, use of allopathic and CAM health services, and comorbidity profiles) that may be associated with different propensities for A/C utilization and/or differential outcomes associated with such care; (2) use qualitative interviews to explore allopathic providers' recommendations for A/C and patients' decisions to pursue and retain CAM care; and (3) prospectively evaluate health services/costs and broader clinical and functional outcomes associated with the receipt of A/C relative to carefully matched comparison participants receiving traditional CMP services. Sensitivity analyses will compare methods relying solely on EMR-derived data versus analyses supplementing EMR data with conventionally collected patient and clinician data. Discussion Successful completion of these aggregate aims will provide an evaluation of outcomes associated with the real-world use of A/C services. The trio of retrospective, qualitative, and prospective study will also provide a clearer understanding of the decision-making processes behind the use of A/C for CMP and a transportable methodology that can be applied to other health care settings, CAM treatments, and clinical populations. Trial registration ClinicalTrials.gov: NCT01345409 PMID:22118061

Micro-CT Evaluation of Ceramic Inlays: Comparison of the Marginal and Internal Fit of Five and Three Axis CAM Systems with a Heat Press Technique.

PubMed

Alajaji, Norah K; Bardwell, David; Finkelman, Matthew; Ali, Ala

2017-02-01

To evaluate the marginal and internal adaptation of CAD/CAM lithium-disilicate inlay restorations fabricated by two milling systems (Five and Three-axis), and a traditional heat-press technique. Fifteen premolar teeth with an MOD cavity preparation were fabricated. Lithium-disilicate inlay restorations were obtained by three fabrication techniques and fitted to their dies (n = 15/gp) as follows: Group-1, three-axis milling system, Group-2, five-axis milling system, Group-3, conventional heat-press technique. Gaps were evaluated by X-ray microtomography. Marginal gap (MG), occlusal-marginal gap (OMG), proximal-marginal gap (PMG), gingival-marginal gap (GMG), absolute marginal discrepancy (AMD), axial-internal gap (AIG), and occlusal-internal gap (OIG) were evaluated at 120 different points per inlay. Data were analyzed using repeated measures ANOVA. Pairwise comparisons were conducted for post-hoc testes and the Bonferroni correction was used to adjust for multiple comparisons (α = 0.007). The heat-press group demonstrated significantly smaller mean-values amongst all outcomes compared with CAD/CAM groups except for GMG, where there was no statistically significant difference between groups in the ANOVA (p = 0.042). Within the CAD/CAM groups, the five-axis group showed significantly lower OMG mean-value compared with the three-axis group p < 0.001, and lower AIG mean-value compared with the three-axis group p < 0.001. There was no significant difference between the five-axis and the three-axis groups' AMD, MG, PMG, and OIG locations. Different fabrication techniques affected the marginal and internal adaptation of ceramic inlay restorations. The heat-press group showed the best marginal and internal adaptation results; however, in every group, all samples were within the clinically acceptable MG limit (100 μm). The marginal fit and internal adaptation of inlay ceramic restorations fabricated by a five-axis milling system have not been tested or compared with those fabricated by three-axis machines and the conventional heat-press method. The preferred method of inlay fabrication, whether in the lab or chair side, may be influenced by the results of this study and could affect future clinical decision-making. (J Esthet Restor Dent 29:49-58, 2017). © 2016 Wiley Periodicals, Inc.

An Interview with Larry Golden: Long-Time Marriage and Family Counselor and Counselor Educator

ERIC Educational Resources Information Center

Juhnke, Gerald A.; Yu, Fangzhou

2010-01-01

Larry Golden started the marriage and family therapy program at Our Lady of the Lake University and was founding chair of the Department of Counseling at the University of Texas at San Antonio. He has contributed substantially to the literature in marriage and family counseling. This interview secured his unique perspective on developments in the…

Cox's Chair Revisited: Can Spinning Alter Mood States?

PubMed

Winter, Lotta; Wollmer, M Axel; Laurens, Jean; Straumann, Dominik; Kruger, Tillmann H C

2013-01-01

Although there is clinical and historical evidence for a vivid relation between the vestibular and emotional systems, the neuroscientific underpinnings are poorly understood. The "spin doctors" of the nineteenth century used spinning chairs (e.g., Cox's chair) to treat conditions of mania or elevated arousal. On the basis of a recent study on a hexapod motion-simulator, in this prototypic investigation we explore the impact of yaw stimulation on a spinning chair on mood states. Using a controlled experimental stimulation paradigm on a unique 3-D-turntable at the University of Zurich we included 11 healthy subjects and assessed parameters of mood states and autonomic nervous system activity. The Multidimensional Mood State Questionnaire and Visual Analog Scales (VAS) were used to assess changes of mood in response to a 100 s yaw stimulation. In addition heart rate was continuously monitored during the experiment. Subjects indicated feeling less "good," "relaxed," "comfortable," and "calm" and reported an increased alertness after vestibular stimulation. However, there were no objective adverse effects of the stimulation. Accordingly, heart rate did not significantly differ in response to the stimulation. This is the first study in a highly controlled setting using the historical approach of stimulating the vestibular system to impact mood states. It demonstrates a specific interaction between the vestibular system and mood states and thereby supports recent experimental findings with a different stimulation technique. These results may inspire future research on the clinical potential of this method.

Mechanical Design of Downhole Tractor Based on Two-Way Self-locking Mechanism

NASA Astrophysics Data System (ADS)

Fang, Delei; Shang, Jianzhong; Luo, Zirong; Wu, Guoheng; Liu, Yiying

2018-03-01

Based on the technology of horizontal well tractor, a kind of downhole tractor was developed which can realize Two-Way self-locking function. Aiming at the needs of horizontal well logging to realize the target of small size, high traction and high reliability, the tractor selects unique heart-shaped CAM as the locking mechanism. The motion principle of telescopic downhole tractor, the design of mechanical structure and locking principle of the locking mechanism are all analyzed. The mathematical expressions of traction are obtained by mechanical analysis of parallel support rod in the locking mechanism. The force analysis and contour design of the heart-shaped CAM are performed, which can lay the foundation for the development of tractor prototype.

Unique Positioning for Using Elastic Resistance Band in Providing Strengthening Exercise to the Muscles Surrounding the Ankle

PubMed Central

Bandy, William D.

2007-01-01

Ankle sprains are among the most common injuries incurred by participants in athletics. Conservative management of the patient after an ankle sprain includes a comprehensive rehabilitation program of which the resistance exercises are a part and are frequently advised by the clinician, many times as part of a home exercise program. The purpose of this Clinical Suggestion is to present a unique method of using elastic resistance band to provide strengthening activities to the inverters, ever-tors, plantarflexors, and dorsiflexors of the ankle. The method is unique, as well as convenient and efficient, as it allows the subject to perform all four exercises with a minimum of change in position, while staying seated in a chair. PMID:21522203

Agave as a model CAM crop system for a warming and drying world

PubMed Central

Stewart, J. Ryan

2015-01-01

As climate change leads to drier and warmer conditions in semi-arid regions, growing resource-intensive C3 and C4 crops will become more challenging. Such crops will be subjected to increased frequency and intensity of drought and heat stress. However, agaves, even more than pineapple (Ananas comosus) and prickly pear (Opuntia ficus-indica and related species), typify highly productive plants that will respond favorably to global warming, both in natural and cultivated settings. With nearly 200 species spread throughout the U.S., Mexico, and Central America, agaves have evolved traits, including crassulacean acid metabolism (CAM), that allow them to survive extreme heat and drought. Agaves have been used as sources of food, beverage, and fiber by societies for hundreds of years. The varied uses of Agave, combined with its unique adaptations to environmental stress, warrant its consideration as a model CAM crop. Besides the damaging cycles of surplus and shortage that have long beset the tequila industry, the relatively long maturation cycle of Agave, its monocarpic flowering habit, and unique morphology comprise the biggest barriers to its widespread use as a crop suitable for mechanized production. Despite these challenges, agaves exhibit potential as crops since they can be grown on marginal lands, but with more resource input than is widely assumed. If these constraints can be reconciled, Agave shows considerable promise as an alternative source for food, alternative sweeteners, and even bioenergy. And despite the many unknowns regarding agaves, they provide a means to resolve disparities in resource availability and needs between natural and human systems in semi-arid regions. PMID:26442005

The Arrhythmogenic Calmodulin p.Phe142Leu Mutation Impairs C-domain Ca2+ Binding but Not Calmodulin-dependent Inhibition of the Cardiac Ryanodine Receptor*

PubMed Central

Liu, Yingjie; Larsen, Kamilla Taunsig; Nani, Alma; Tian, Xixi; Holt, Christian; Wang, Ruiwu; Fill, Michael

2017-01-01

A number of point mutations in the intracellular Ca2+-sensing protein calmodulin (CaM) are arrhythmogenic, yet their underlying mechanisms are not clear. These mutations generally decrease Ca2+ binding to CaM and impair inhibition of CaM-regulated Ca2+ channels like the cardiac Ca2+ release channel (ryanodine receptor, RyR2), and it appears that attenuated CaM Ca2+ binding correlates with impaired CaM-dependent RyR2 inhibition. Here, we investigated the RyR2 inhibitory action of the CaM p.Phe142Leu mutation (F142L; numbered including the start-Met), which markedly reduces CaM Ca2+ binding. Surprisingly, CaM-F142L had little to no aberrant effect on RyR2-mediated store overload-induced Ca2+ release in HEK293 cells compared with CaM-WT. Furthermore, CaM-F142L enhanced CaM-dependent RyR2 inhibition at the single channel level compared with CaM-WT. This is in stark contrast to the actions of arrhythmogenic CaM mutations N54I, D96V, N98S, and D130G, which all diminish CaM-dependent RyR2 inhibition. Thermodynamic analysis showed that apoCaM-F142L converts an endothermal interaction between CaM and the CaM-binding domain (CaMBD) of RyR2 into an exothermal one. Moreover, NMR spectra revealed that the CaM-F142L-CaMBD interaction is structurally different from that of CaM-WT at low Ca2+. These data indicate a distinct interaction between CaM-F142L and the RyR2 CaMBD, which may explain the stronger CaM-dependent RyR2 inhibition by CaM-F142L, despite its reduced Ca2+ binding. Collectively, these results add to our understanding of CaM-dependent regulation of RyR2 as well as the mechanistic effects of arrhythmogenic CaM mutations. The unique properties of the CaM-F142L mutation may provide novel clues on how to suppress excessive RyR2 Ca2+ release by manipulating the CaM-RyR2 interaction. PMID:27927985

Use of complementary and alternative medicines is associated with delay to initiation of disease-modifying anti-rheumatic drug therapy in early inflammatory arthritis.

PubMed

Lahiri, Manjari; Santosa, Amelia; Teoh, Lay Kheng; Clayton, Jane A; Lim, Sheen Yee; Teng, Gim Gee; Cheung, Peter P M

2017-05-01

To study the predictors of complementary and alternative medicine (CAM) use in patients with early inflammatory arthritis (EIA), and its impact on delay to initiation of disease-modifying anti-rheumatic drugs (DMARD). Data were collected prospectively from EIA patients aged ≥ 21 years. Current or prior CAM use was ascertained by face-to-face interview. Predictors of CAM use and its effect on time to DMARD initiation were determined by multivariate logistic regression and Cox proportional hazards, respectively. One hundred and eighty patients (70.6% female, 58.3% Chinese), of median (interquartile range [IQR]) age 51.1 (40.9-59.8) years and symptom duration 16.6 (9.2-26.6) weeks were included: 83.9% had rheumatoid arthritis, 57% were seropositive. Median (IQR) Disease Activity Score in 28-joints (DAS28) was 4.3 (2.8-5.7), modified Health Assessment Questionnaire (mHAQ) was 0.38 (0.0-0.88) and 41.3% were CAM users. Chinese race (odds ratio [OR] 5.76 [95%CI 2.53-13.1]), being non-English speaking (OR 2.68 [95% CI 1.18-6.09]), smoking (OR 3.35 [95% CI 1.23-9.15] and high DAS28 (OR 2.73 [95% CI 1.05-7.09] were independent predictors of CAM use. CAM users initiated DMARD later (median [IQR] 21.5 [13.1-30.4] vs. 15.6 [9.4-22.7] weeks in non-users, P = 0.005). CAM use and higher DAS28 were associated with a longer delay to DMARD initiation (hazard ratio [HR] 0.69, 95% CI 0.50-0.95 and 0.63, 95% CI 0.43-0.91, respectively) while higher mHAQ was associated with a shorter delay (HR 1.59, 95% CI 1.08-2.34) and race, education level, being non-English speaking, smoking and seropositivity were not associated. Healthcare professionals should be aware of the unique challenges in treating patients with EIA in Asia. Healthcare beliefs regarding CAM may need to be addressed to reduce treatment delay. © 2017 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

JunoCam: Science and Outreach Opportunities with Juno

NASA Astrophysics Data System (ADS)

Hansen, C. J.; Orton, G. S.

2015-12-01

JunoCam is a visible imager on the Juno spacecraft en route to Jupiter. Although the primary role of the camera is for outreach, science objectives will be addressed too. JunoCam is a wide angle camera (58 deg field of view) with 4 color filters: red, green and blue (RGB) and methane at 889 nm. Juno's elliptical polar orbit will offer unique views of Jupiter's polar regions with a spatial scale of ~50 km/pixel. The polar vortex, polar cloud morphology, and winds will be investigated. RGB color mages of the aurora will be acquired. Stereo images and images taken with the methane filter will allow us to estimate cloudtop heights. Resolution exceeds that of Cassini about an hour from closest approach and at closest approach images will have a spatial scale of ~3 km/pixel. JunoCam is a push-frame imager on a rotating spacecraft. The use of time-delayed integration takes advantage of the spacecraft spin to build up signal. JunoCam will acquire limb-to-limb views of Jupiter during a spacecraft rotation, and has the possibility of acquiring images of the rings from in-between Jupiter and the inner edge of the rings. Galilean satellite views will be fairly distant but some images will be acquired. Small ring moons Metis and Adrastea will also be imaged. The theme of our outreach is "science in a fish bowl", with an invitation to the science community and the public to participate. Amateur astronomers will supply their ground-based images for planning, so that we can predict when prominent atmospheric features will be visible. With the aid of professional astronomers observing at infrared wavelengths, we'll predict when hot spots will be visible to JunoCam. Amateur image processing enthusiasts are prepared to create image products. Between the planning and products will be the decision-making on what images to take when and why. We invite our colleagues to propose science questions for JunoCam to address, and to be part of the participatory process of deciding how to use our resources and scientifically analyze the data.

Magnetic Doppler imaging of 53 Camelopardalis in all four Stokes parameters

NASA Astrophysics Data System (ADS)

Kochukhov, O.; Bagnulo, S.; Wade, G. A.; Sangalli, L.; Piskunov, N.; Landstreet, J. D.; Petit, P.; Sigut, T. A. A.

2004-02-01

We present the first investigation of the structure of the stellar surface magnetic field using line profiles in all four Stokes parameters. We extract the information about the magnetic field geometry and abundance distributions of the chemically peculiar star 53 Cam by modelling time-series of high-resolution spectropolarimetric observations with the help of a new magnetic Doppler imaging code. This combination of the unique four Stokes parameter data and state-of-the-art magnetic imaging technique makes it possible to infer the stellar magnetic field topology directly from the rotational variability of the Stokes spectra. In the magnetic imaging of 53 Cam we discard the traditional multipolar assumptions about the structure of magnetic fields in Ap stars and explore the stellar magnetic topology without introducing any global a priori constraints on the field structure. The complex magnetic model of 53 Cam derived with our magnetic Doppler imaging method achieves a good fit to the observed intensity, circular and linear polarization profiles of strong magnetically sensitive Fe II spectral lines. Such an agreement between observations and model predictions was not possible with any earlier multipolar magnetic models, based on modelling Stokes I spectra and fitting surface averaged magnetic observables (e.g., longitudinal field, magnetic field modulus, etc.). Furthermore, we demonstrate that even the direct inversion of the four Stokes parameters of 53 Cam assuming a low-order multipolar magnetic geometry is incapable of achieving an adequate fit to our spectropolarimetric observations. Thus, as a main result of our investigation, we discover that the magnetic field topology of 53 Cam is considerably more complex than any low-order multipolar expansion, raising a general question about the validity of the multipolar assumption in the studies of magnetic field structures of Ap stars. In addition to the analysis of the magnetic field of 53 Cam, we reconstruct surface abundance distributions of Si, Ca, Ti, Fe and Nd. These abundance maps confirm results of the previous studies of 53 Cam, in particular dramatic antiphase variation of Ca and Ti abundances. Based on observations obtained with the Bernard Lyot telescope of the Pic du Midi Observatory and Isaac Newton Telescope of the La Palma Observatory.

The use of art and music therapy in substance abuse treatment programs.

PubMed

Aletraris, Lydia; Paino, Maria; Edmond, Mary Bond; Roman, Paul M; Bride, Brian E

2014-01-01

Although the implementation of evidence-based practices in the treatment of substance use disorders has attracted substantial research attention, little consideration has been given to parallel implementation of complementary and alternative medical (CAM) practices. Using data from a nationally representative sample (N = 299) of U.S. substance abuse treatment programs, this study modeled organizational factors falling in the domains of patient characteristics, treatment ideologies, and structural characteristics, associated with the use of art therapy and music therapy. We found that 36.8% of treatment programs offered art therapy and 14.7% of programs offered music therapy. Programs with a greater proportion of women were more likely to use both therapies, and programs with larger proportions of adolescents were more likely to offer music therapy. In terms of other treatment ideologies, programs' use of Motivational Enhancement Therapy was positively related to offering art therapy, whereas use of contingency management was positively associated with offering music therapy. Finally, our findings showed a significant relationship between requiring 12-step meetings and the use of both art therapy and music therapy. With increasing use of CAM in a diverse range of medical settings and recent federal legislation likely to reduce barriers in accessing CAM, the inclusion of CAM in addiction treatment is growing in importance. Our findings suggest treatment programs may be utilizing art and music therapies to address unique patient needs of women and adolescents.

The California All-sky Meteor Surveillance (CAMS) System

NASA Astrophysics Data System (ADS)

Gural, P. S.

2011-01-01

A unique next generation multi-camera, multi-site video meteor system is being developed and deployed in California to provide high accuracy orbits of simultaneously captured meteors. Included herein is a description of the goals, concept of operations, hardware, and software development progress. An appendix contains a meteor camera performance trade study made for video systems circa 2010.

Chick ex ovo culture and ex ovo CAM assay: how it really works.

PubMed

Dohle, Daniel S; Pasa, Susanne D; Gustmann, Sebastian; Laub, Markus; Wissler, Josef H; Jennissen, Herbert P; Dünker, Nicole

2009-11-30

Chicken eggs in the early phase of breeding are between in vitro and in vivo systems and provide a vascular test environment not only to study angiogenesis but also to study tumorigenesis. After the chick chorioallantoic membrane (CAM) has developed, its blood vessel network can be easily accessed, manipulated and observed and therefore provides an optimal setting for angiogenesis assays. Since the lymphoid system is not fully developed until late stages of incubation, the chick embryo serves as a naturally immunodeficient host capable of sustaining grafted tissues and cells without species-specific restrictions. In addition to nurturing developing allo- and xenografts, the CAM blood vessel network provides a uniquely supportive environment for tumor cell intravasation, dissemination, and vascular arrest and a repository where arrested cells extravasate to form micro metastatic foci. For experimental purposes, in most of the recent studies the CAM was exposed by cutting a window through the egg shell and experiments were carried out in ovo, resulting in significant limitations in the accessibility of the CAM and possibilities for observation and photo documentation of effects. When shell-less cultures of the chick embryo were used(1-4), no experimental details were provided and, if published at all, the survival rates of these cultures were low. We refined the method of ex ovo culture of chick embryos significantly by introducing a rationally controlled extrusion of the egg content. These ex ovo cultures enhance the accessibility of the CAM and chick embryo, enabling easy in vivo documentation of effects and facilitating experimental manipulation of the embryo. This allows the successful application to a large number of scientific questions: (1) As an improved angiogenesis assay(5,6), (2) an experimental set up for facilitated injections in the vitreous of the chick embryo eye(7-9), (3) as a test environment for dissemination and intravasation of dispersed tumor cells from established cell lines inoculated on the CAM(10-12), (4) as an improved sustaining system for successful transplantation and culture of limb buds of chicken and mice(13) as well as (5) for grafting, propagation, and re-grafting of solid primary tumor tissue obtained from biopsies on the surface of the CAM(14). In this video article we describe the establishment of a refined chick ex ovo culture and CAM assay with survival rates over 50%. Besides we provide a step by step demonstration of the successful application of the ex ovo culture for a large number of scientific applications.

24- and 36-week outcomes for the Child/Adolescent Anxiety Multimodal Study (CAMS).

PubMed

Piacentini, John; Bennett, Shannon; Compton, Scott N; Kendall, Phillip C; Birmaher, Boris; Albano, Anne Marie; March, John; Sherrill, Joel; Sakolsky, Dara; Ginsburg, Golda; Rynn, Moira; Bergman, R Lindsey; Gosch, Elizabeth; Waslick, Bruce; Iyengar, Satish; McCracken, James; Walkup, John

2014-03-01

We report active treatment group differences on response and remission rates and changes in anxiety severity at weeks 24 and 36 for the Child/Adolescent Anxiety Multimodal Study (CAMS). CAMS youth (N = 488; 74% ≤ 12 years of age) with DSM-IV separation, generalized, or social anxiety disorder were randomized to 12 weeks of cognitive-behavioral therapy (CBT), sertraline (SRT), CBT+SRT (COMB), or medication management/pill placebo (PBO). Responders attended 6 monthly booster sessions in their assigned treatment arm; youth in COMB and SRT continued on their medication throughout this period. Efficacy of COMB, SRT, and CBT (n = 412) was assessed at 24 and 36 weeks postrandomization. Youth randomized to PBO (n = 76) were offered active CAMS treatment if nonresponsive at week 12 or over follow-up and were not included here. Independent evaluators blind to study condition assessed anxiety severity, functioning, and treatment response. Concomitant treatments were allowed but monitored over follow-up. The majority (>80%) of acute responders maintained positive response at both weeks 24 and 36. Consistent with acute outcomes, COMB maintained advantage over CBT and SRT, which did not differ, on dimensional outcomes; the 3 treatments did not differ on most categorical outcomes over follow-up. Compared to COMB and CBT, youth in SRT obtained more concomitant psychosocial treatments, whereas those in SRT and CBT obtained more concomitant combined (medication plus psychosocial) treatment. COMB maintained advantage over CBT and SRT on some measures over follow-up, whereas the 2 monotherapies remained indistinguishable. The observed convergence of COMB and monotherapy may be related to greater use of concomitant treatment during follow-up among youth receiving the monotherapies, although other explanations are possible. Although outcomes were variable, most CAMS-treated youth experienced sustained treatment benefit. Clinical trial registration information-Child and Adolescent Anxiety Disorders (CAMS); URL: http://clinicaltrials.gov. Unique identifier: NCT00052078. Copyright © 2014 American Academy of Child and Adolescent Psychiatry. All rights reserved.

Faculty development initiatives to advance research literacy and evidence-based practice at CAM academic institutions.

PubMed

Long, Cynthia R; Ackerman, Deborah L; Hammerschlag, Richard; Delagran, Louise; Peterson, David H; Berlin, Michelle; Evans, Roni L

2014-07-01

To present the varied approaches of 9 complementary and alternative medicine (CAM) institutions (all grantees of the National Center for Complementary and Alternative Medicine) used to develop faculty expertise in research literacy and evidence-based practice (EBP) in order to integrate these concepts into CAM curricula. A survey to elicit information on the faculty development initiatives was administered via e-mail to the 9 program directors. All 9 completed the survey, and 8 grantees provided narrative summaries of faculty training outcomes. The grantees found the following strategies for implementing their programs most useful: assess needs, develop and adopt research literacy and EBP competencies, target early adopters and change leaders, employ best practices in teaching and education, provide meaningful incentives, capitalize on resources provided by grant partners, provide external training opportunities, and garner support from institutional leadership. Instructional approaches varied considerably across grantees. The most common were workshops, online resources, in-person short courses, and in-depth seminar series developed by the grantees. Many also sent faculty to intensive multiday extramural training programs. Program evaluation included measuring participation rates and satisfaction and the integration of research literacy and EBP learning objectives throughout the academic curricula. Most grantees measured longitudinal changes in beliefs, attitudes, opinions, and competencies with repeated faculty surveys. A common need across all 9 CAM grantee institutions was foundational training for faculty in research literacy and EBP. Therefore, each grantee institution developed and implemented a faculty development program. In developing the framework for their programs, grantees used strategies that were viewed critical for success, including making them multifaceted and unique to their specific institutional needs. These strategies, in conjunction with the grantees' instructional approaches, can be of practical use in other CAM and non-CAM academic environments considering the introduction of research literacy and EBP competencies into their curricula.

Educating the surgeon-scientist: A qualitative study evaluating challenges and barriers toward becoming an academically successful surgeon.

PubMed

Kodadek, Lisa M; Kapadia, Muneera R; Changoor, Navin R; Dunn, Kelli Bullard; Are, Chandrakanth; Greenberg, Jacob A; Minter, Rebecca M; Pawlik, Timothy M; Haider, Adil H

2016-12-01

The advancement of surgical science relies on educating new generations of surgeon-scientists. Career development awards (K Awards) from the National Institutes of Health, often considered a marker of early academic success, are one way physician-scientists may foster skills through a mentored research experience. This study aimed to develop a conceptual framework to understand institutional support and other factors leading to a K Award. A national, qualitative study was conducted with academic surgeons. Participants included 15 K Awardees and 12 surgery department Chairs. Purposive sampling ensured a diverse range of experiences. Semistructured, in-depth telephone interviews were conducted. Interviews were audio recorded and transcribed verbatim, and 2 reviewers analyzed the transcripts using Grounded Theory methodology. Participants described individual and institutional factors contributing to success. K Awardees cited personal factors such as perseverance and team leadership skills. Chairs described the K Awardee as an institutional "investment" requiring protected time for research, financial support, and mentorship. Both K Awardees and Chairs identified a number of challenges unique to the surgeon-scientist, including financial strains and competing clinical demands. Institutional support for surgeons pursuing K Awards is a complex investment with significant initial costs to the department. Chairs act as stewards of institutional resources and support those surgeon-scientists most likely to be successful. Although the K Award pathway is one way to develop surgeon-scientists, financial burdens and challenges may limit its usefulness. These findings, however, may better prepare young surgeons to develop career plans and identify new mechanisms for academic productivity. Copyright © 2016 Elsevier Inc. All rights reserved.

Seasonal photosynthetic gas exchange and water-use efficiency in a constitutive CAM plant, the giant saguaro cactus (Carnegiea gigantea).

PubMed

Bronson, Dustin R; English, Nathan B; Dettman, David L; Williams, David G

2011-11-01

Crassulacean acid metabolism (CAM) and the capacity to store large quantities of water are thought to confer high water use efficiency (WUE) and survival of succulent plants in warm desert environments. Yet the highly variable precipitation, temperature and humidity conditions in these environments likely have unique impacts on underlying processes regulating photosynthetic gas exchange and WUE, limiting our ability to predict growth and survival responses of desert CAM plants to climate change. We monitored net CO(2) assimilation (A(net)), stomatal conductance (g(s)), and transpiration (E) rates periodically over 2 years in a natural population of the giant columnar cactus Carnegiea gigantea (saguaro) near Tucson, Arizona USA to investigate environmental and physiological controls over carbon gain and water loss in this ecologically important plant. We hypothesized that seasonal changes in daily integrated water use efficiency (WUE(day)) in this constitutive CAM species would be driven largely by stomatal regulation of nighttime transpiration and CO(2) uptake responding to shifts in nighttime air temperature and humidity. The lowest WUE(day) occurred during time periods with extreme high and low air vapor pressure deficit (D(a)). The diurnal with the highest D(a) had low WUE(day) due to minimal net carbon gain across the 24 h period. Low WUE(day) was also observed under conditions of low D(a); however, it was due to significant transpiration losses. Gas exchange measurements on potted saguaro plants exposed to experimental changes in D(a) confirmed the relationship between D(a) and g(s). Our results suggest that climatic changes involving shifts in air temperature and humidity will have large impacts on the water and carbon economy of the giant saguaro and potentially other succulent CAM plants of warm desert environments.

Boundary Layer Remote Sensing with Combined Active and Passive Techniques: GPS Radio Occultation and High-Resolution Stereo Imaging (WindCam) Small Satellite Concept

NASA Technical Reports Server (NTRS)

Mannucci, A.J.; Wu, D.L.; Teixeira, J.; Ao, C.O.; Xie, F.; Diner, D.J.; Wood, R.; Turk, Joe

2012-01-01

Objective: significant progress in understanding low-cloud boundary layer processes. This is the Single largest uncertainty in climate projections. Radio occultation has unique features suited to boundary layer remote sensing (1) Cloud penetrating (2) Very high vertical resolution (approximately 50m-100m) (3) Sensitivity to thermodynamic variables

TACOM LCMC Industrial Base Networking Summit

DTIC Science & Technology

2010-03-25

CAD/CAM CNC Programming •Quick reaction of parts - CNC , Lathes , Mills, Water Jet/Laser Cutting Design •Mechanical, Electrical, Electronics...system that can efficiently fabricate standard and unique parts at the point of need • Lathe modules deployed at 4 strategic SWA locations • Concepts...Prototype Integration Planning Machining / CNC / Metals Welding Assembly / Paint Integration •Field-Experienced Veterans •Component, Subsystems

Introducing a Chair-Side Novel Approach to Reach Evidence-based Periodontal Information in the Daily Periodontal Practice

PubMed Central

Dannan, Aous

2009-01-01

Background Evidence-based healthcare is not an easier approach to patient management, but should provide both clinicians and patients with greater confidence and trust in their mutual relationship. The intellectual embrace of evidence-based methods, coupled with clinical expertise and consideration of the patients individual uniqueness and requirements, is needed for all periodontal therapists if optimum care is the goal. One important element of evidence-based decision making in periodontology is the systematic review. Systematic reviews usually provide the periodontist with the highest level of evidence which should be taken into consideration when constructing any treatment plan in the dental clinic. However, reaching systematic reviews might be a time-consuming procedure that needs further personal skills. Methods In this paper, a chair-side novel approach to facilitate the incorporation of systematic reviews into daily periodontal practice is presented. It is based on three simple tools, namely, a list of suitable periodontics-related key words, a data bank of all up-to-date published systematic reviews in periodontology, and hand-made paper sheets to match the key words with their related systematic review statements. Results and Conclusions A primary validation of this method indicated the simplicity in learning and application. Keywords Chair-side; Evidence-based medicine; Periodontology; Systematic review PMID:22461868

Publication Productivity of Orthopaedic Surgery Chairs.

PubMed

Zelle, Boris A; Weathers, Michael A; Fajardo, Roberto J; Haghshenas, Varan; Bhandari, Mohit

2017-06-21

As academic leaders, orthopaedic chairs represent role models for scholarly activities. Despite the importance of journal publications as a measure of scholarly activity, data on the publication productivity of orthopaedic chairs remain limited. The goals of this study were to record the publication productivity of orthopaedic chairs and evaluate the extent to which they maintained their scholarly activity while serving as chairs. The chairs of all orthopaedic residency programs in the United States were identified through the Accreditation Council for Graduate Medical Education (ACGME) web site, and were confirmed by information found on the web site of each orthopaedic program that was included in the study. University and non-university chairs were defined based on affiliation of the program with a medical school. The publication records of the program chairs were retrieved through the Scopus database. During the 7 years prior to their appointment to chair, the mean number of total publications was significantly higher for university chairs (n = 58.6, range 0 to 217) than for non-university chairs (n = 29.1, range 0 to 13) (p = 0.003). The mean number of publications per year during the 7 years leading up to the chair position was 4.66 (range, 0 to 25) for the university chairs, and 2.29 (range, 0 to 10.9) for the non-university group (p = 0.02). While serving as chair, the mean number of publications per year significantly decreased among the university chairs to 3.75 (range, 0 to 32.8; p = 0.015), whereas no significant change was observed among non-university chairs. The mean percentage of first authorships was not significantly different between university and non-university chairs. Both groups showed significant declines in first authorships while serving as chair. At the time of becoming chair, the average university chair had published approximately 60 manuscripts, whereas the average non-university chair had published approximately 30 manuscripts. While serving as chair, the number of publications per year significantly decreased for university chairs. Among all chairs, the percentage of first authorships significantly decreased while serving as chair.

The Use of Art and Music Therapy in Substance Abuse Treatment Programs

PubMed Central

Aletraris, Lydia; Paino, Maria; Edmond, Mary Bond; Roman, Paul M.; Bride, Brian E.

2014-01-01

While the implementation of evidence-based practices (EBPs) in the treatment of substance use disorders (SUD) has attracted substantial research attention, little consideration has been given to parallel implementation of complementary and alternative medical (CAM) practices. Using data from a nationally representative sample (N = 299) of U.S. substance abuse treatment programs, this study modeled organizational factors falling in the domains of patient characteristics, treatment ideologies, and structural characteristics, associated with the use of art therapy and music therapy. We found that 36.8% of treatment programs offered art therapy and 14.7% of programs offered music therapy. Programs with a greater proportion of women were more likely to use both therapies, and programs with larger proportions of adolescents were more likely to offer music therapy. In terms of other treatment ideologies, programs’ use of Motivational Enhancement Therapy (MET) was positively related to offering art therapy, while use of Contingency Management (CM) was positively associated with offering music therapy. Finally, our findings showed a significant relationship between requiring 12-step meetings and the use of both art therapy and music therapy. With increasing use of CAM in a diverse range of medical settings, and recent federal legislation likely to reduce barriers in accessing CAM, the inclusion of CAM in addiction treatment is growing in importance. Our findings suggest treatment programs may be utilizing art and music therapies to address unique patient needs of women and adolescents. PMID:25514689

An alternative assay to discover potential calmodulin inhibitors using a human fluorophore-labeled CaM protein.

PubMed

González-Andrade, Martín; Figueroa, Mario; Rodríguez-Sotres, Rogelio; Mata, Rachel; Sosa-Peinado, Alejandro

2009-04-01

This article describes the development of a new fluorescent-engineered human calmodulin, hCaM M124C-mBBr, useful in the identification of potential calmodulin (CaM) inhibitors. An hCaM mutant containing a unique cysteine residue at position 124 on the protein was expressed, purified, and chemically modified with the fluorophore monobromobimane (mBBr). The fluorophore-labeled protein exhibited stability and functionality to the activation of calmodulin-sensitive cAMP phosphodiesterase (PDE1) similar to wild-type hCaM. The hCaM M124C-mBBr is highly sensitive to detecting inhibitor interaction given that it showed a quantum efficiency of 0.494, approximately 20 times more than the value for wild-type hCaM, and a large spectral change ( approximately 80% quenching) when the protein is in the presence of saturating inhibitor concentrations. Two natural products previously shown to act as CaM inhibitors, malbrancheamide (1) and tajixanthone hydrate (2), and the well-known CaM inhibitor chlorpromazine (CPZ) were found to quench the hCaM M124C-mBBr fluorescence, and the IC(50) values were comparable to those obtained for the wild-type protein. These results support the use of hCaM M124C-mBBr as a fluorescence biosensor and a powerful analytical tool in the high-throughput screening demanded by the pharmaceutical and biotechnology industries.

JunoCam's Images of Jupiter

NASA Astrophysics Data System (ADS)

Hansen, C. J.; Ravine, M. A.; Caplinger, M. A.; Orton, G. S.; Ingersoll, A. P.; Jensen, E.; Lipkaman, L.; Krysak, D.; Zimdar, R.; Bolton, S. J.

2016-12-01

JunoCam is a visible imager on the Juno spacecraft in orbit around Jupiter. It is a wide angle camera (58 deg field of view) with 4 color filters: red, green and blue (RGB) and methane at 889 nm, designed for optimal imaging of Jupiter's poles. Juno's elliptical polar orbit will offer unique views of Jupiter's polar regions with a spatial scale of 50 km/pixel. At closest approach the images will have a spatial scale of 3 km/pixel. As a push-frame imager on a rotating spacecraft, JunoCam uses time-delayed integration to take advantage of the spacecraft spin to extend integration time to increase signal. Images of Jupiter's poles reveal a largely uncharted region of Jupiter, as nearly all earlier spacecraft have orbited or flown by in the equatorial plane. Most of the images of Jupiter will be acquired in the +/-2 hours surrounding closest approach. The polar vortex, polar cloud morphology, and winds will be investigated. RGB color images of the aurora will be acquired if detectable. Stereo images and images taken with the methane filter will allow us to estimate cloud-top heights. Images of the cloud-tops will aid in understanding the data collected by other instruments on Juno that probe deeper in the atmosphere. During the two months that Jupiter is too close to the sun for ground-based observers to collect data, JunoCam will take images routinely to monitor large-scale features. Occasional, opportunistic images of the Galilean moons will be acquired.

Understanding the signature of rock coatings in laser-induced breakdown spectroscopy data

USGS Publications Warehouse

Lanza, Nina L.; Ollila, Ann M.; Cousin, Agnes; Wiens, Roger C.; Clegg, Samuel M.; Mangold, Nicolas; Bridges, Nathan; Cooper, Daniel; Schmidt, Mariek E.; Berger, Jeffrey; Arvidson, Raymond E.; Melikechi, Noureddine; Newsom, Horton E.; Tokar, Robert; Hardgrove, Craig; Mezzacappa, Alissa; Jackson, Ryan S.; Clark, Benton C.; Forni, Olivier; Maurice, Sylvestre; Nachon, Marion; Anderson, Ryan B.; Blank, Jennifer; Deans, Matthew; Delapp, Dorothea; Léveillé, Richard; McInroy, Rhonda; Martinez, Ronald; Meslin, Pierre-Yves; Pinet, Patrick

2015-01-01

Surface compositional features on rocks such as coatings and weathering rinds provide important information about past aqueous environments and water–rock interactions. The search for these features represents an important aspect of the Curiosity rover mission. With its unique ability to do fine-scale chemical depth profiling, the ChemCam laser-induced breakdown spectroscopy instrument (LIBS) onboard Curiosity can be used to both identify and analyze rock surface alteration features. In this study we analyze a terrestrial manganese-rich rock varnish coating on a basalt rock in the laboratory with the ChemCam engineering model to determine the LIBS signature of a natural rock coating. Results show that there is a systematic decrease in peak heights for elements such as Mn that are abundant in the coating but not the rock. There is significant spatial variation in the relative abundance of coating elements detected by LIBS depending on where on the rock surface sampled; this is due to the variability in thickness and spatial discontinuities in the coating. Similar trends have been identified in some martian rock targets in ChemCam data, suggesting that these rocks may have coatings or weathering rinds on their surfaces.

Life After Being a Pathology Department Chair II: Lessons Learned.

PubMed

Bailey, David N; Lipscomb, Mary F; Gorstein, Fred; Wilkinson, David; Sanfilippo, Fred

2017-01-01

The 2016 Association of Pathology Chairs annual meeting featured a discussion group of Association of Pathology Chairs senior fellows (former chairs of academic departments of pathology who have remained active in Association of Pathology Chairs) that focused on how they decided to transition from the chair, how they prepared for such transition, and what they did after the transition. At the 2017 annual meeting, the senior fellows (encompassing 481 years of chair service) discussed lessons they learned from service as chair. These lessons included preparation for the chairship, what they would have done differently as chair, critical factors for success as chair, factors associated with failures, stress reduction techniques for themselves and for their faculty and staff, mechanisms for dealing with and avoiding problems, and the satisfaction they derived from their service as chair. It is reasonable to assume that these lessons may be representative of those learned by chairs of other specialties as well as by higher-level academic administrators such as deans, vice presidents, and chief executive officers. Although the environment for serving as a department chair has been changing dramatically, many of the lessons learned by former chairs are still valuable for current chairs of any length of tenure.

Life After Being a Pathology Department Chair II

PubMed Central

Lipscomb, Mary F.; Gorstein, Fred; Wilkinson, David; Sanfilippo, Fred

2017-01-01

The 2016 Association of Pathology Chairs annual meeting featured a discussion group of Association of Pathology Chairs senior fellows (former chairs of academic departments of pathology who have remained active in Association of Pathology Chairs) that focused on how they decided to transition from the chair, how they prepared for such transition, and what they did after the transition. At the 2017 annual meeting, the senior fellows (encompassing 481 years of chair service) discussed lessons they learned from service as chair. These lessons included preparation for the chairship, what they would have done differently as chair, critical factors for success as chair, factors associated with failures, stress reduction techniques for themselves and for their faculty and staff, mechanisms for dealing with and avoiding problems, and the satisfaction they derived from their service as chair. It is reasonable to assume that these lessons may be representative of those learned by chairs of other specialties as well as by higher-level academic administrators such as deans, vice presidents, and chief executive officers. Although the environment for serving as a department chair has been changing dramatically, many of the lessons learned by former chairs are still valuable for current chairs of any length of tenure. PMID:29057316

JunoCam: Outreach and Science Opportunities

NASA Astrophysics Data System (ADS)

Hansen, Candice; Ingersoll, Andy; Caplinger, Mike; Ravine, Mike; Orton, Glenn

2014-11-01

JunoCam is a visible imager on the Juno spacecraft en route to Jupiter. Although the primary role of the camera is for outreach, science objectives will be addressed too. JunoCam is a wide angle camera (58 deg field of view) with 4 color filters: red, green and blue (RGB) and methane at 889 nm. Juno’s elliptical polar orbit will offer unique views of Jupiter’s polar regions with a spatial scale of ~50 km/pixel. The polar vortex, polar cloud morphology, and winds will be investigated. RGB color mages of the aurora will be acquired. Stereo images and images taken with the methane filter will allow us to estimate cloudtop heights. Resolution exceeds that of Cassini about an hour from closest approach and at closest approach images will have a spatial scale of ~3 km/pixel. JunoCam is a push-frame imager on a rotating spacecraft. The use of time-delayed integration takes advantage of the spacecraft spin to build up signal. JunoCam will acquire limb-to-limb views of Jupiter during a spacecraft rotation, and has the possibility of acquiring images of the rings from in-between Jupiter and the inner edge of the rings. Galilean satellite views will be fairly distant but some images will be acquired. Outer irregular satellites and small ring moons Metis and Adrastea will also be imaged. The theme of our outreach is “science in a fish bowl”, with an invitation to the science community and the public to participate. Amateur astronomers will supply their ground-based images for planning, so that we can predict when prominent atmospheric features will be visible. With the aid of professional astronomers observing at infrared wavelengths, we’ll predict when hot spots will be visible to JunoCam. Amateur image processing enthusiasts are onboard to create image products. Many of the earth flyby image products from Juno’s earth gravity assist were processed by amateurs. Between the planning and products will be the decision-making on what images to take when and why. We invite our colleagues to propose science questions for JunoCam to address, and to be part of the participatory process of deciding how to use our resources and scientifically analyze the data.

JunoCam Images of Jupiter: Science from an Outreach Experiment

NASA Astrophysics Data System (ADS)

Hansen, C. J.; Orton, G. S.; Caplinger, M. A.; Ravine, M. A.; Rogers, J.; Eichstädt, G.; Jensen, E.; Bolton, S. J.; Momary, T.; Ingersoll, A. P.

2017-12-01

The Juno mission to Jupiter carries a visible imager on its payload primarily for outreach, and also very useful for jovian atmospheric science. Lacking a formal imaging science team, members of the public have volunteered to process JunoCam images. Lightly processed and raw JunoCam data are posted on the JunoCam webpage at https://missionjuno.swri.edu/junocam/processing. Citizen scientists download these images and upload their processed contributions. JunoCam images through broadband red, green and blue filters and a narrowband methane filter centered at 889 nm mounted directly on the detector. JunoCam is a push-frame imager with a 58 deg wide field of view covering a 1600 pixel width, and builds the second dimension of the image as the spacecraft rotates. This design enables capture of the entire pole of Jupiter in a single image at low emission angle when Juno is 1 hour from perijove (closest approach). At perijove the wide field of view images are high-resolution while still capturing entire storms, e.g. the Great Red Spot. Juno's unique polar orbit yields polar perspectives unavailable to earth-based observers or most previous spacecraft. The first discovery was that the familiar belt-zone structure gives way to more chaotic storms, with cyclones grouped around both the north and south poles [1, 2]. Recent time-lapse sequences have enabled measurement of the rotation rates and wind speeds of these circumpolar cyclones [3]. Other topics are being investigated with substantial, in many cases essential, contributions from citizen scientists. These include correlating the high resolution JunoCam images to storms and disruptions of the belts and zones tracked throughout the historical record. A phase function for Jupiter is being developed empirically to allow image brightness to be flattened from the subsolar point to the terminator. We are studying high hazes and the stratigraphy of the upper atmosphere, utilizing the methane filter, structures illuminated beyond the terminator, and clouds casting shadows. Numerous high altitude clouds have been detected and we are investigating whether they are the jovian equivalent of squall lines. [1] Bolton, S. et al. (2017) Science 356:821; [2] Orton, G. et al. (2017) GRL 44:4599; [3] Adriani, A. et al. (2017) submitted to Nature.

Government Contracting Under the Javits-Wagner-O’Day Act

DTIC Science & Technology

1991-12-01

to manufacture its commodities, or provide its services. Likewise, a qualified work center for the severely disabled must employ personnel with... manufacture (CAD/CAM) systems. Additionally, it studies a unique and innovative business arrangement that serves as a model of contract efficiency and...Additional research areas include the types of commodities currently manufactured in the workshops, tha barriers to enlarging the commodity 3 base, the

Subcellular distributions of rat CaM kinase phosphatase N and other members of the CaM kinase regulatory system.

PubMed

Kitani, Takako; Okuno, Sachiko; Takeuchi, Masayuki; Fujisawa, Hitoshi

2003-07-01

Ca2+/Calmodulin-dependent protein kinase (CaM kinase) regulatory system is composed of multifunctional CaM kinases such as CaM kinases IV and I, upstream CaM kinases such as CaM kinase kinases alpha and beta, which activate multifunctional CaM kinases, and CaM kinase phosphatases such as CaM kinase phosphatase and CaM kinase phosphatase N, which deactivate the activated multifunctional CaM kinases. To understand the combinations of CaM kinases I and IV, CaM kinase kinases alpha and beta, and CaM kinase phosphatases, the locations of the enzymes in the cell were examined by immunocytochemical studies of cultured cells. The results indicate that CaM kinase I, CaM kinase kinase beta, and CaM kinase phosphatase occur in the cytoplasm and that CaM kinase IV, CaM kinase kinase alpha (and CaM kinase kinase beta in some cell types and tissues), and CaM kinase phosphatase N occur inside the cellular nucleus, suggesting that there are at least two different sets of CaM kinase regulatory systems, one consisting of CaM kinase I, CaM kinase kinase beta, and CaM kinase phosphatase in the cytoplasm and the other consisting of CaM kinase IV, CaM kinase kinase alpha (and CaM kinase kinase beta in some cell types and tissues), and CaM kinase phosphatase N in the nucleus.

A pilot investigation into the effects of different office chairs on spinal angles.

PubMed

Annetts, S; Coales, P; Colville, R; Mistry, D; Moles, K; Thomas, B; van Deursen, R

2012-05-01

To investigate the effects of four office chairs on the postural angles of the lumbopelvic and cervical regions. Which chair(s) produce an "ideal" spinal posture? An experimental same subject design was used involving healthy subjects (n = 14) who conducted a typing task whilst sitting on four different office chairs; two "dynamic" chairs (Vari-Kneeler and Swopper), and two static chairs (Saddle and Standard Office with back removed). Data collection was via digital photogrammetry, measuring pelvic and lumbar angles, neck angle and head tilt which were then analysed within MatLab. A repeated measures ANOVA with Bonferroni corrections for multiple comparisons was conducted. Statistically significant differences were identified for posterior pelvic tilt and lumbar lordosis between the Vari-Kneeler and Swopper chairs (p = 0.006, p = 0.001) and the Vari-Kneeler and Standard Office chairs (p = 0.000, 0.000); and also for neck angle and head tilt between the Vari-Kneeler and Swopper chairs (p = 0.000, p = 0.000), the Vari-Kneeler and Saddle chairs (p = 0.002, p = 0.001), the Standard Office and Swopper chairs (p = 0.000, p = 0.000), and the Standard Office and Saddle chairs (p = 0.005, p = 0.001). This study confirms a within region association between posterior pelvic tilt and lumbar lordosis, and between neck angle and head tilt. It was noted that an ideal lumbopelvic position does not always result in a corresponding ideal cervical position resulting in a spinal alignment mismatch. In this study, the most appropriate posture for the lumbopelvic region was produced by the Saddle chair and for the cervical region by both the Saddle and Swopper chairs. No chair consistently produced an ideal posture across all regions, although the Saddle chair created the best posture of those chairs studied. Chair selection should be based on individual need.

4 CFR 27.2 - The Chair, Vice Chair.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 4 Accounts 1 2010-01-01 2010-01-01 false The Chair, Vice Chair. 27.2 Section 27.2 Accounts GOVERNMENT ACCOUNTABILITY OFFICE GENERAL PROCEDURES GOVERNMENT ACCOUNTABILITY OFFICE PERSONNEL APPEALS BOARD; ORGANIZATION § 27.2 The Chair, Vice Chair. The members of the Board shall select from among its membership a...

Physical health, mental health, and utilization of complementary and alternative medicine services among Gulf War veterans.

PubMed

Holliday, Stephanie Brooks; Hull, Amanda; Lockwood, Courtney; Eickhoff, Christine; Sullivan, Patrick; Reinhard, Matthew

2014-12-01

Gulf War veterans represent a unique subset of the veteran population. It has been challenging to identify interventions that result in improvements in physical and mental health for this population. Recently, there has been recognition of a potential role for complementary and alternative medicine (CAM) interventions. This paper examines the characteristics of Gulf War and non-Gulf War veterans referred to a CAM clinic, and explores the utilization of services by this population. Participants included 226 veterans enrolled in a CAM clinic at a Veterans Affairs medical center, 42 of whom were Gulf War veterans. Self-report measures of physical/mental health were administered, and service utilization was obtained from participants' medical records for a 6-month period. Gulf War veterans enrolled in the program reported more severe physical and mental health symptoms than non-Gulf War veterans. However, examining only veterans who participated in services in the 6 months following enrollment, the 2 groups reported similar symptom severity. Both groups were similar in their attendance of individual acupuncture and iRest yoga nidra, although Gulf War veterans attended fewer sessions of group acupuncture. Although Gulf War veterans who enroll in a CAM program may have more severe symptoms than non-Gulf War veterans, those who actually participate in services are similar to non-Gulf War veterans on these measures. These groups also differ in their pattern of service utilization. Future research should explore the reasons for these differences, and to identify ways to promote treatment engagement with this population.

Almost Psychiatry: The Impact of Teaching Child and Adolescent Mental Health Studies to Undergraduate College Students.

PubMed

Diamond, Ursula; Di Bartolo, Christina A; Badin, Emily; Shatkin, Jess P

2017-10-01

The Child and Adolescent Mental Health Studies (CAMS) program is housed in a Liberal Arts undergraduate college of a large research university. Psychiatrists, clinical psychologists, and social workers at the university's medical center teach the courses. The purpose of this study is to evaluate the extent to which CAMS encourages graduates of the program to pursue a career in child and adolescent mental health (CAMH). In 2015-2016, graduates of the CAMS program were invited to participate in a mixed methods study. In addition to statistical analyses, qualitative thematic analyses were performed to interpret free-text responses. Forty-five percent (314/702) of invited graduates completed the online survey. Interviews were conducted with 11% (34/314) of participants by study staff over the phone. Quantitative results suggested that 81% (149/185) of participants enrolled in educational programs after graduation due to an interest in CAMH. A significantly higher proportion of the total sample (t = 3.661, p < .001) reported that they changed their career goals while undergraduate students compared to those who did so after graduation. Results of qualitative interviews with 34 participants uncovered five key themes unique to CAMS that may explain the program's influence on graduates' career choices and career development: practitioners-as-instructors, instructor mentorship, novel course content, experiential learning opportunities, and career training and skills. Quantitative and qualitative results indicated that teaching college undergraduate students about CAMH encourages them to set career goals within the field. These findings suggest the utility of implementing similar programs at other undergraduate colleges.

A comparison of four office chairs using biomechanical measures.

PubMed

Bush, Tamara Reid; Hubbard, Robert P

2008-08-01

The authors sought to use biomechanical measures, including motion and pressure, to compare four office chairs. The fit of a person to a chair is related to the geometric and kinematic compatibility between the two. This geometric compatibility influences the motions that are allowed or prohibited and the support pressures at the body-chair interface. Thus, during evaluation, it is necessary to treat the chair and user as a system. Four dynamic test conditions were evaluated with 14 participants of varying anthropometries. Test conditions were selected to compare the ability to accommodate primary and secondary motions (recline and spinal articulation) of seated occupants. The ability of a chair to allow recline, yet maintain head and hand positions, was compared across chairs. Also, the ability of each chair to allow and support spinal articulation was evaluated. Motion data for the chair, head, thorax, pelvis, and extremities were collected along with chair back pressures. Upon completion of testing, subjective assessments were also conducted. Statistically significant differences were found between chairs relative to head and hand motions. Also, significant differences were noted for the chairs' ability to move with the body during spinal articulation and the ability to provide support. Subjective assessments also yielded differences. Biomechanical analyses using motions and pressures can be conducted on office chairs with significant differences detected in their performance. Biomechanical assessments can be used to compare and contrast office chairs in terms that are relatable to fatigue reduction as well as operator performance.

An approach to biomimetics: the natural CAD/CAM restoration: a clinical report.

PubMed

Schlichting, Luís Henrique; Schlichting, Kathryn Klemz; Stanley, Kyle; Magne, Michel; Magne, Pascal

2014-02-01

Those in the dental field have always pursued the perfect dental material for the treatment of compromised teeth. Gold, amalgam, composite resin, glass ionomer, and porcelain have been used. Tooth-like restorative materials (composite resin and porcelain) combined with an effective hard tissue bond have met the growing demand for esthetic or metal-free restorations in the past 15 to 20 years. However, none of those materials can fully mimic the unique properties of dentin (compliance and crack-stopping behavior) and enamel (wear resistance, function). The aim of this article is to report the restoration of an extensively damaged tooth with a natural restoration obtained by milling an extracted third molar tooth with a computer-aided design and computer-aided manufacturing (CAD/CAM) system. The main benefit of this novel technique is the replacement of lost tissues by actual enamel and dentin, with the potential to recover mechanical, esthetic, and biologic properties. The indication for extracting third molars and premolars because of impaction or for orthodontic reasons makes these posterior teeth readily available. The innovation of the method presented here is the optimal use of the extracted tooth substrate thanks to its positioning technique in the CAD/CAM milling chamber. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.

Characterization of exosomes derived from ovarian cancer cells and normal ovarian epithelial cells by nanoparticle tracking analysis.

PubMed

Zhang, Wei; Peng, Peng; Kuang, Yun; Yang, Jiaxin; Cao, Dongyan; You, Yan; Shen, Keng

2016-03-01

Cellular exosomes are involved in many disease processes and have the potential to be used for diagnosis and treatment. In this study, we compared the characteristics of exosomes derived from human ovarian epithelial cells (HOSEPiC) and three epithelial ovarian cancer cell lines (OVCAR3, IGROV1, and ES-2) to investigate the differences between exosomes originating from normal and malignant cells. Two established colloid-chemical methodologies, electron microscopy (EM) and dynamic light scattering (DLS), and a relatively new method, nanoparticle tracking analysis (NTA), were used to measure the size and size distribution of exosomes. The concentration and epithelial cellular adhesion molecule (EpCAM) expression of exosomes were measured by NTA. Quantum dots were conjugated with anti-EpCAM to label exosomes, and the labeled exosomes were detected by NTA in fluorescent mode. The normal-cell-derived exosomes were significantly larger than those derived from malignant cells, and exosomes were successfully labeled using anti-EpCAM-conjugated quantum dots. Exosomes from different cell lines may vary in size, and exosomes might be considered as potential diagnosis biomarkers. NTA can be considered a useful, efficient, and objective method for the study of different exosomes and their unique properties in ovarian cancer.

75 FR 25210 - Procurement List Proposed Additions and Deletions

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-07

...-9276--Multi Cam NSN: 8415-01-579-9272--Multi Cam NSN: 8415-01-579-9267--Multi Cam NSN: 8415-01-579-9260--Multi Cam NSN: 8415-01-579-9219--Multi Cam NSN: 8415-01-579-9210--Multi Cam NSN: 8415-01-579-9197--Multi Cam NSN: 8415-01-579-9189--Multi Cam NSN: 8415-01-579-9182--Multi Cam NSN: 8415-01-579-9175--Multi Cam...

The usage of a hand-made chair at home for children with moderate to severe cerebral palsy: preliminary study.

PubMed

Siritaratiwat, Wantana; Inthachom, Rumrada; Warnset, Somporn

2012-02-01

Specially designed chairs are expensive. A hand-made chair easily constructed from recycled material can be an alternative option. However data on the feasibility of hand-made chair use at home is limited. The present study aimed to explore the usage of a hand-made chair at home in children with moderate to severe motor disabilities. Seventeen children with cerebral palsy were recruited. Main caregivers were interviewed regarding the possibility of using the chair at home. Home visits and observations were also performed to explain how the chair had been used at home. Nine children (52.9%) used the chair everyday. Seven of these nine children were seated at least 30 minutes each time and two to three times per day. The total time that children spent on the hand-made chair each day ranged from 10 to 90 minutes. The severity of disability and main caregivers' workload may explain an inadequate usage of the hand-made chair. A few modifications may help to improve the applicability of the hand-made chair.

Seating in aged care: Physical fit, independence and comfort

PubMed Central

Brophy, Claire; O’Reilly, Maria

2018-01-01

Objectives: This research was intended to provide a greater understanding of the context and needs of aged care seating, specifically: To conduct an audit of typical chairs used in aged care facilities; To collect data about resident and staff experiences and behaviour around chairs in order to gain a deeper understanding of the exact issues that residents and staff have with the chairs they use at aged care facilities; To identify positive and negative issues influencing use of chairs in aged care facilities; To deliver evidence-based recommendations for the design of chairs for aged care facilities. Methods: Methods included a chair dimension audit, interviews with residents, experts and carers and observations of aged care residents getting into chairs, sitting in them and getting out. Results: Results showed that residents, experts and carers all prefer chairs which are above the recommended height for older people so that they will be able to get out of them more easily. Armrests were essential for ease of entry and egress. However, many residents struggled with chairs which were also too deep in the seat pan so that they could not easily touch the floor or sit comfortably and were forced to slump. Most residents used cushions and pillows to relieve discomfort where possible. Conclusion: The implications of these issues for chair design and selection are discussed. Variable height chairs, a range of chairs of different heights in each space and footrests could all address the height problem. Chair designers need to address the seat depth problem by reducing depth in most aged care specific chairs, even when they are higher. Armrests must be provided but could be made easier to grip. Addressing these issues would increase access to comfortable yet easy-to-use chairs for a wider range of the aged care population. PMID:29326817

Effect of Furniture Weight on Carrying, Lifting, and Turning of Chairs and Desks among Elementary School Children.

PubMed

Purwaningrum, Lu'lu'; Funatsu, Kyotaro; Xiong, Jinghong; Rosyidi, Cucuk Nur; Muraki, Satoshi

2015-01-01

Rearranging furniture in elementary school classrooms encourages classroom activities. In elementary schools in Indonesia and some other developing countries, usually only one style of furniture is used for all children, and the furniture is heavy and oversized for younger children. This affects their ability to carry it. The objective of this study is to investigate the effects of elementary school furniture weight and children's age on performance of three carrying tasks (carrying a chair, lifting and turning a chair on a desk, and carrying both a chair and a desk together), from the ergonomics point of view. A total of 42 schoolchildren (ages 6-9; 17 Indonesian, 25 Japanese) participated in this study. Two types of Japanese chairs (Chair A and B, weight: 3.2 kg and 3.9 kg), one type of Indonesian chair (Chair C, weight: 5.0 kg), and two types of desks (height: 58 cm and 68 cm) were used. Indonesian chairs took significantly longer time to carry than the two Japanese chairs, and there was a significant negative relationship between age and task time for Chairs B and C, but not Chair A. Success rates for lifting and turning the chair declined as age decreased and chair weight increased, but were not significantly influenced by desk height. Success rates for carrying a chair and desk together significantly decreased with heavier furniture. Children aged six showed an extremely low success rate in almost all conditions. In conclusion, children's ability to carry furniture is affected by their age and furniture characteristics, especially weight. In order to encourage classroom activities in elementary school, school furniture should be of appropriate weight. Supervision for younger children is required during classroom furniture arrangement.

Effect of Furniture Weight on Carrying, Lifting, and Turning of Chairs and Desks among Elementary School Children

PubMed Central

Funatsu, Kyotaro; Xiong, Jinghong; Rosyidi, Cucuk Nur

2015-01-01

Rearranging furniture in elementary school classrooms encourages classroom activities. In elementary schools in Indonesia and some other developing countries, usually only one style of furniture is used for all children, and the furniture is heavy and oversized for younger children. This affects their ability to carry it. The objective of this study is to investigate the effects of elementary school furniture weight and children’s age on performance of three carrying tasks (carrying a chair, lifting and turning a chair on a desk, and carrying both a chair and a desk together), from the ergonomics point of view. A total of 42 schoolchildren (ages 6–9; 17 Indonesian, 25 Japanese) participated in this study. Two types of Japanese chairs (Chair A and B, weight: 3.2 kg and 3.9 kg), one type of Indonesian chair (Chair C, weight: 5.0 kg), and two types of desks (height: 58 cm and 68 cm) were used. Indonesian chairs took significantly longer time to carry than the two Japanese chairs, and there was a significant negative relationship between age and task time for Chairs B and C, but not Chair A. Success rates for lifting and turning the chair declined as age decreased and chair weight increased, but were not significantly influenced by desk height. Success rates for carrying a chair and desk together significantly decreased with heavier furniture. Children aged six showed an extremely low success rate in almost all conditions. In conclusion, children’s ability to carry furniture is affected by their age and furniture characteristics, especially weight. In order to encourage classroom activities in elementary school, school furniture should be of appropriate weight. Supervision for younger children is required during classroom furniture arrangement. PMID:26053154

Journal of Special Operations Medicine. Volume 10, Edition 3, Summer 2010

DTIC Science & Technology

2010-01-01

team from Bagram to help. This spe- cial team of healthcare providers was utilized by him and the SF medics in other parts of Afghanistan, as well...Give the local doc a set of basic dental tools, not an $8,000 state-of-the-art chair that is not sustainable.” LTC Harrington said he utilized a unique...produced. Furthermore, the SF teams utilize DoD CERP (Commander’s Emergency Response Program) funding for the local purchases, but this tends to take

Geometric Modeling for Computer Vision

DTIC Science & Technology

1974-10-01

within a distance R of a locus X ,Y,Z; spatial uniqueness refers to the property that physical solids can not occupy the same space simultaneously. A...density functions W«p( X ,Y,Z). Unfortunately such density functions can no» be writtrn out for objects such as a typing chair or a plastic horse...be approximated by a surface function 2 = F( X ,Y). For example landscape may be represented by geodetic maps in such a 2-D fashion. By definition, a

Hillary Clinton's visit to Ottawa hospital an exercise in military precision

PubMed Central

Gray, Charlotte

1995-01-01

The Children's Hospital of Eastern Ontario learned that hosting the wife of the US president is more like a military manoeuvre than a typical VIP visit, but Hillary Rodham Clinton brought a unique perspective on universal health care to the Ottawa hospital. CMAJ Contributing Editor Charlotte Gray, who is also vice-chair of the hospital's board of trustees, recounts the experience of listening to “the sharpest, most intense professor of health care management you've ever met.” Imagesp1299-a

An event-related potential study of semantic style-match judgments of artistic furniture.

PubMed

Lin, Ming-Huang; Wang, Ching-yi; Cheng, Shih-kuen; Cheng, Shih-hung

2011-11-01

This study investigates how semantic networks represent different artistic furniture. Event-related potentials (ERPs) were recorded while participants made style-match judgments for table and chair sets. All of the tables were in the Normal style, whereas the chairs were in the Normal, Minimal, ReadyMade, or Deconstruction styles. The Normal and Minimal chairs had the same rates of "match" responses, which were both higher than the rates for the ReadyMade and Deconstruction chairs. Compared with Normal chairs, the ERPs elicited by both ReadyMade chairs and Deconstruction chairs exhibited reliable N400 effects, which suggests that these two design styles were unlike the Normal design style. However, Minimal chairs evoked ERPs that were similar to the ERPs of Normal chairs. Furthermore, the N400 effects elicited by ReadyMade and Deconstruction chairs showed different scalp distributions. These findings reveal that semantic networks represent different design styles for items of the same category. Copyright © 2011 Elsevier B.V. All rights reserved.

Eye-witness interviews on the Chelyabinsk airburst

NASA Astrophysics Data System (ADS)

Kartashova, Anna; Popova, Olga; Jenniskens, Peter; Emel'yanenko, Vaycheslav; Korotkiy, Stanislav; Khaibrakhmanov, Sergey; Dudorov, Alexandr; Biryukov, Evgeny; Glazachev, Dmitry; Trubetskaya, Irina; Serdyuk, Ilya

2014-01-01

Eye-witness accounts of the Chelyabinsk airburst have provided unique information that is not recorded in the many security and dash-cam videos of the event. Accounts were collected from in-person interviews during a field study from March 9 to 25, 2013, and from phone and internet surveys. In total, about 2000 accounts were collected, which provide information about sensations of heat, smells, sounds, the occurrence of sunburn, and the nature of injuries.

Extending the data dictionary for data/knowledge management

NASA Technical Reports Server (NTRS)

Hydrick, Cecile L.; Graves, Sara J.

1988-01-01

Current relational database technology provides the means for efficiently storing and retrieving large amounts of data. By combining techniques learned from the field of artificial intelligence with this technology, it is possible to expand the capabilities of such systems. This paper suggests using the expanded domain concept, an object-oriented organization, and the storing of knowledge rules within the relational database as a solution to the unique problems associated with CAD/CAM and engineering data.

Use of complementary and alternative medicine by lymphoma survivors in South Korea.

PubMed

Kim, Kisook; Kim, Soo Hyun; Ok, Oh Nam; Kim, Im-Ryung; Lee, Suyeon; Kim, So Hee; Kim, Won Seog; Ryu, Min-Hee; Lee, Moon Hee

2018-04-01

We aimed to examine the experience of complementary and alternative medicine (CAM) use and its association with health-related quality of life (HRQOL) in lymphoma survivors in South Korea. The participants were 869 lymphoma survivors from three hospitals in South Korea, all diagnosed with lymphoma at least 24 months prior to participation. Self-reported questionnaires were used to assess CAM use. The questionnaire addressed types of CAM used, sources of information about CAM, reason for CAM use, satisfaction with CAM use, discussion of CAM use with doctors, experience of side effects, costs of CAM use, and intentions to continue using CAM. HRQOL was measured with the EORTC QLQ-C30. Of the 869 participants, 42.2% had experience using CAM, and there were statistically significant differences among CAM users and non-users in terms of sex, religion, and time since diagnosis. A special diet (e.g., ginseng, chitosan, mixed cereals) was the most commonly used type of CAM, and most CAM users (82.1%) were satisfied with their CAM use. Most CAM users (77.5%) did not discuss the use of CAM with their doctors, and only 9.2% reported any side effects from CAM. CAM users showed significantly lower HRQOL scores than did non-users. A significant number of lymphoma survivors in Korea have used CAM, and most CAM users are satisfied with their CAM use. Oncology nurses should be aware of the range of CAM use among patients and reflect their responses in their treatment and/or follow-up care. Copyright © 2018 Elsevier Ltd. All rights reserved.

Women chairs in psychiatry: a collective reflection.

PubMed

Atre Vaidya, Nutan

2006-01-01

This article describes the experiences of women chairs in psychiatry. All women chairs in psychiatry were contacted by the author to share their personal experiences as chair. Seven out of 10 chairs accepted the invitation. A similar invitation was extended to a few female and male academics. Women in chair positions come from smaller schools and departments, have clinical and educational backgrounds, have fewer grants than their male counterparts, and are more likely to be recruited from within. Most of the women did not aspire to be chair, but after an initial adjustment period, they felt their job to be less stressful. Mentors played a role in the careers of some, but not all women chairs. Copyright (C) 2006 Academic Psychiatry.

Cryogenic expansion machine

DOEpatents

Pallaver, Carl B.; Morgan, Michael W.

1978-01-01

A cryogenic expansion engine includes intake and exhaust poppet valves each controlled by a cam having adjustable dwell, the valve seats for the valves being threaded inserts in the valve block. Each cam includes a cam base and a ring-shaped cam insert disposed at an exterior corner of the cam base, the cam base and cam insert being generally circular but including an enlarged cam dwell, the circumferential configuration of the cam base and cam dwell being identical, the cam insert being rotatable with respect to the cam base. GI CONTRACTUAL ORIGIN OF THE INVENTION The invention described herein was made in the course of, or under, a contract with the UNITED STATES ENERGY RESEARCH AND DEVELOPMENT ADMINISTRATION.

Comparison of four specific dynamic office chairs with a conventional office chair: impact upon muscle activation, physical activity and posture.

PubMed

Ellegast, Rolf P; Kraft, Kathrin; Groenesteijn, Liesbeth; Krause, Frank; Berger, Helmut; Vink, Peter

2012-03-01

Prolonged and static sitting postures provoke physical inactivity at VDU workplaces and are therefore discussed as risk factors for the musculoskeletal system. Manufacturers have designed specific dynamic office chairs featuring structural elements which promote dynamic sitting and therefore physical activity. The aim of the present study was to evaluate the effects of four specific dynamic chairs on erector spinae and trapezius EMG, postures/joint angles and physical activity intensity (PAI) compared to those of a conventional standard office chair. All chairs were fitted with sensors for measurement of the chair parameters (backrest inclination, forward and sideward seat pan inclination), and tested in the laboratory by 10 subjects performing 7 standardized office tasks and by another 12 subjects in the field during their normal office work. Muscle activation revealed no significant differences between the specific dynamic chairs and the reference chair. Analysis of postures/joint angles and PAI revealed only a few differences between the chairs, whereas the tasks performed strongly affected the measured muscle activation, postures and kinematics. The characteristic dynamic elements of each specific chair yielded significant differences in the measured chair parameters, but these characteristics did not appear to affect the sitting dynamics of the subjects performing their office tasks. Copyright © 2011 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Tenure of academic chairs in obstetrics and gynecology: a 25-year perspective.

PubMed

Rayburn, William F; Schrader, Ronald M; Cain, Joanna M; Artal, Raul; Anderson, Garland D; Merkatz, Irwin R

2006-11-01

To assist in predicting future leadership needs, this longitudinal study examines turnover and net retention rates among chairs at university obstetrics and gynecology departments between 1981 and 2005. A database of appointment dates and tenure of chairs at each of 125 Association of American Medical Colleges-approved United States medical schools was collated using membership listings from the Association of Professors of Gynecology and Obstetrics and from the Council of University Chairs in Obstetrics and Gynecology. Complete data from 118 departments were confirmed by selective correspondence at individual departments and further review by the investigators. A total of 260 individuals (232 men, 28 women) became new chairs between 1981 and 2005. The annual turnover rate increased gradually from 6.0% to 12.7%. Five-year net retention rates remained steady between 1982 and 1997 but dropped after 1997 (85.6% compared with 63.2%; P=.03). A chair's tenure ranged widely (1 to 23 years; median 8 years), regardless of gender or school type, size, or location. Approximately one half of interim chairs became permanent chairs, usually at their own institution. The number of new women chairs increased from none in 1981 to 17 (15.2% of total chairs) in 2005. Academic chair positions in obstetrics and gynecology experienced a doubling in annual turnover rates, while retention rates declined. The proportion of chairs occupied by women increased progressively. II-2.

Life After Being a Pathology Department Chair

PubMed Central

Lipscomb, Mary F.; Gorstein, Fred; Wilkinson, David; Sanfilippo, Fred

2016-01-01

Although there is a considerable literature on transition of faculty members to the position of department chair, there is a dearth of publications about transitioning from the chair to other activities including retirement. The Association of Pathology Chairs senior fellows (all of whom are former chairs of academic departments of pathology) made this topic a focus of discussion at the Association of Pathology Chairs 2016 Annual Meeting. Of the 33 senior fellows engaged in this discussion, following their time as chairs, a small majority (18) transitioned to other administrative posts within or outside the university, while the others either returned to the active faculty (7) or retired (8). The motivating factors and influences for transitioning from the chair were probed along with the processes used in executing the transition, such as the development of transition plans. The reasons for selecting the specific type of postchair activity were also investigated. There was extraordinary diversity in the type of post-chair activities pursued. To our knowledge, no other medical specialty has examined these issues, which may be potentially relevant for the career planning of active chairs. PMID:28725780

Pediatric dental chair vs. traditional dental chair: a pediatric dentist's poll.

PubMed

Barjatya, Khushboo; Vatsal, Ankur; Kambalimath, Halaswamy V; Kulkarni, Vinay Kumar; Reddy, Naveen Banda

2015-01-01

Proper positioning of the child patient, can not only have positive ramifications for the operator's posture, comfort, and career longevity - it can also lead to better treatment and increased productivity. The aim of the survey questionnaire was to assess the utilization, need, and attitude concerning dental chairs among pediatric dentist while working on and managing the child patient. The questions were structured using adobe forms central online software, regarding the user-friendliness of pediatric dental chair vs. traditional adult dental chair available in the market. Our result shows that out of 337 respondents, 79% worked on pediatric dental chair, whereas 21% had no experience of it. Of these 79% pediatric dentist, 48% preferred pediatric dental chair. But pediatric dental problem still has certain disadvantages like higher cost, leg space problem, lower availability, etc. During the research it was found that ergonomics and usability issues were the main problems. Thus, pediatric dental chair is not so popular in the current scenario. This study allowed for general ideas for the improvement of dental chairs and thus improved dental chair would fill the gap in the current scenario.

Hospital-based chiropractic integration within a large private hospital system in Minnesota: a 10-year example.

PubMed

Branson, Richard A

2009-01-01

The purpose of this article is to describe a model of chiropractic integration developed over a 10-year period within a private hospital system in Minnesota. Needs were assessed by surveying attitudes and behaviors related to chiropractic and complementary and alternative medicine (CAM) of physicians associated with the hospital. Analyzing referral and utilization patterns assessed chiropractic integration into the hospital system. One hundred five surveys were returned after 2 mailings for a response rate of 74%. Seventy-four percent of respondents supported integration of CAM into the hospital system, although 45% supported the primary care physician as the gatekeeper for CAM use. From 2006 to 2008, there were 8294 unique new patients in the chiropractic program. Primary care providers (medical doctors and physician assistants) were the most common referral source, followed by self-referred patients, sports medicine physicians, and orthopedic physicians. Overall examination of the program identified that facilitators of chiropractic integration were (1) growth in interest in CAM, (2) establishing relationships with key administrators and providers, (3) use of evidence-based practice, (4) adequate physical space, and (5) creation of an integrated spine care program. Barriers were (1) lack of understanding of chiropractic professional identity by certain providers and (2) certain financial aspects of third-party payment for chiropractic. This article describes the process of integrating chiropractic into one of the largest private hospital systems in Minnesota from a business and professional perspective and the results achieved once chiropractic was integrated into the system. This study identified key factors that facilitated integration of services and demonstrates that chiropractic care can be successfully integrated within a hospital system.

Adaptive sports technology and biomechanics: wheelchairs.

PubMed

Cooper, Rory A; De Luigi, Arthur Jason

2014-08-01

Wheelchair sports are an important tool in the rehabilitation of people with severe chronic disabilities and have been a driving force for innovation in technology and practice. In this paper, we will present an overview of the adaptive technology used in Paralympic sports with a special focus on wheeled technology and the impact of design on performance (defined as achieving the greatest level of athletic ability and minimizing the risk of injury). Many advances in manual wheelchairs trace their origins to wheelchair sports. Features of wheelchairs that were used for racing and basketball 25 or more years ago have become integral to the manual wheelchairs that people now use every day; moreover, the current components used on ultralight wheelchairs also have benefitted from technological advances developed for sports wheelchairs. For example, the wheels now used on chairs for daily mobility incorporate many of the components first developed for sports chairs. Also, advances in manufacturing and the availability of aerospace materials have driven current wheelchair design and manufacture. Basic principles of sports wheelchair design are universal across sports and include fit; minimizing weight while maintaining high stiffness; minimizing rolling resistance; and optimizing the sports-specific design of the chair. However, a well-designed and fitted wheelchair is not sufficient for optimal sports performance: the athlete must be well trained, skilled, and use effective biomechanics because wheelchair athletes face some unique biomechanical challenges. Copyright © 2014 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Beliefs, decision-making, and dialogue about complementary and alternative medicine (CAM) within families using CAM: a qualitative study.

PubMed

Nichol, James; Thompson, Elizabeth A; Shaw, Alison

2011-02-01

The rise in complementary and alternative medicine (CAM) use is well documented. Surveys provide varying estimates of the prevalence of CAM use. Qualitative research has explored individuals' decision-making regarding CAM. This study aimed to examine the family as a context for beliefs, decision-making, and dialogue about CAM. Families were recruited via the Avon Longitudinal Study of Parents and Children. A subsample of CAM users was targeted using purposeful sampling. Focus groups and interviews were conducted with 15 families and the data were analyzed thematically. Family understandings and beliefs about CAM: CAM was understood as treatments provided outside mainstream care, offering a more "natural" and "holistic" approach, tailored to individual needs and overlapping with wider healthy lifestyle practices. Hierarchies of acceptability of CAM: Physical and "mainstream" therapies were widely supported, with "fringe" therapies producing the most polarized views. There was a belief particularly among fathers and young people that certain therapies rely on "placebo" effects and their value was contested. Types of CAM users within families: Family members were predominantly "pragmatic" CAM users, with "committed" users (all mothers) characterized by deeper philosophical commitment to CAM and skepticism toward conventional medicine. Family dynamics of CAM decision-making: Mothers tended to "champion" CAM within families, while not determining family CAM use. Fathers largely positioned themselves as lacking expertise or skeptical of CAM. Young people were beginning to articulate independent and more critical views of CAM, some directly challenging their mother's perspective. However, all families shared openness to CAM as part of broader beliefs in proactive healthy lifestyles. Family focus groups and interviews allow a window on beliefs, decision-making, and dialogue about CAM within families, illuminating the CAM "champion" role held by mothers, and young people's developing autonomy regarding health beliefs and decision-making.

Does a dynamic chair increase office workers' movements? - Results from a combined laboratory and field study.

PubMed

Grooten, Wilhelmus J A; Äng, Björn O; Hagströmer, Maria; Conradsson, David; Nero, Håkan; Franzén, Erika

2017-04-01

Dynamic chairs have the potential to facilitate movements that could counteract health problems associated with sedentary office work. This study aimed to evaluate whether a dynamic chair can increase movements during desk-based office work. Fifteen healthy subjects performed desk-based office work using a dynamic office chair and compared to three other conditions in a movement laboratory. In a field study, the dynamic office chair was studied during three working days using accelerometry. Equivocal results showed that the dynamic chair increased upper body and chair movements as compared to the conventional chair, but lesser movements were found compared to standing. No differences were found between the conditions in the field study. A dynamic chair may facilitate movements in static desk-based office tasks, but the results were not consistent for all outcome measures. Validation of measuring protocols for assessing movements during desk-based office work is warranted. Copyright © 2016 Elsevier Ltd. All rights reserved.

Utilizing Chair Massage to Address One Woman’s Health in Rural Ghana West Africa: a Case Report

PubMed Central

Meryanos, Cathy J.

2016-01-01

Background and Objectives There is limited access to health care in rural Ghana and virtually no rehabilitative services available. This situation presents a unique opportunity to utilize chair massage in addressing women’s health in rural Ghana, particularly when it comes to muscle pain and fatigue from heavy labor. The objective of this case report is to determine the results of chair massage as a strategy to reduce neck, shoulder, and back pain, while increasing range of motion. Case Presentation The patient is a 63-year-old Ghanaian female, who was struck by a public transport van while carrying a 30–50 pound load on her head, two years prior. The accident resulted in a broken right humerus and soft tissue pain. A traditional medicine practitioner set the bone, however there was no post-accident rehabilitation available. At the time of referral, she presented complaints of shoulder, elbow, and wrist pain. In addition, she was unable to raise her right hand to her mouth for food intake. Results The results of this case report include an increase in range of motion, as well as elimination of pain in the right shoulder, elbow, and hand. Visual assessments showed an approximate increase of ROM within the ranges of 45–65 degrees in the right arm, as well as 10–15 degrees in 4th and 5th fingers. There was also a decrease in muscle hypertonicity in the thoracic and cervical areas, and a profound increase in quality of life for the patient. Discussion This case report illustrates how therapeutic chair massage was utilized to address a common health concern for one woman in rural Ghana. It also demonstrates that pre-existing musculoskeletal disorders and pain may be eliminated with massage intervention. Massage therapy may be important to ameliorating certain types of health problems in remote rural villages in low income countries. PMID:27974948

Utilizing Chair Massage to Address One Woman's Health in Rural Ghana West Africa: a Case Report.

PubMed

Meryanos, Cathy J

2016-12-01

There is limited access to health care in rural Ghana and virtually no rehabilitative services available. This situation presents a unique opportunity to utilize chair massage in addressing women's health in rural Ghana, particularly when it comes to muscle pain and fatigue from heavy labor. The objective of this case report is to determine the results of chair massage as a strategy to reduce neck, shoulder, and back pain, while increasing range of motion. The patient is a 63-year-old Ghanaian female, who was struck by a public transport van while carrying a 30-50 pound load on her head, two years prior. The accident resulted in a broken right humerus and soft tissue pain. A traditional medicine practitioner set the bone, however there was no post-accident rehabilitation available. At the time of referral, she presented complaints of shoulder, elbow, and wrist pain. In addition, she was unable to raise her right hand to her mouth for food intake. The results of this case report include an increase in range of motion, as well as elimination of pain in the right shoulder, elbow, and hand. Visual assessments showed an approximate increase of ROM within the ranges of 45-65 degrees in the right arm, as well as 10-15 degrees in 4th and 5th fingers. There was also a decrease in muscle hypertonicity in the thoracic and cervical areas, and a profound increase in quality of life for the patient. This case report illustrates how therapeutic chair massage was utilized to address a common health concern for one woman in rural Ghana. It also demonstrates that pre-existing musculoskeletal disorders and pain may be eliminated with massage intervention. Massage therapy may be important to ameliorating certain types of health problems in remote rural villages in low income countries.

Leadership trends in academic pediatric departments.

PubMed

Stapleton, F Bruder; Jones, Douglas; Fiser, Debra H

2005-08-01

To examine recent turnover trends among chairs of academic pediatric departments. Membership data for the 150 institutions represented by the Association of Medical School Pediatric Department Chairs in the United States, Canada, and Puerto Rico were reviewed for the time period of 1993-2003. From 1993 to 2003, 278 individuals (250 men and 28 women) held the position of chair. The mean time of service was 5.58 +/- 3.2 years (median: 5 years). Twenty-nine individuals served continuously as chairs during the 11-year period. Seventy-two individuals served as interim chairs. Twenty-eight women were appointed either chairs or interim chairs during the 11 years. The number of female chairs decreased from 13 in 1993 to 11 in 2003. Female chairs were in office 3.42 +/- 2.72 years. A total of 123 departments had a change in leadership, with a mean annual turnover rate of 17% (range: 4.6-24%). Three departments had 5 different leaders as either interim chair or chair and 6 departments had 4 different leaders during this time period. Neonatology was the most common subspecialty represented by recent pediatric chairs, although nephrology was the subspecialty with the greatest proportional representation. Departments of pediatrics have high turnover of leadership. Women, in particular, serve for relatively short periods and appear to be under-represented within the leadership of pediatrics. Efforts should be made to ascertain personal qualities that allow sustained leadership and to attract more women into leadership positions.

Complementary and alternative medicine (CAM) among hospitalised patients: reported use of CAM and reasons for use, CAM preferred during hospitalisation, and the socio-demographic determinants of CAM users.

PubMed

Shorofi, Seyed Afshin

2011-11-01

This paper reports a study to examine hospitalised patients' frequency and patterns of CAM use, their reasons for CAM use, their preferences of CAMs during hospitalisation, and the association between patients' socio-demographic variables and use of each individual CAM/CAM domain. A convenience sample of 353 patients hospitalised in 19 surgical wards at four metropolitan hospitals completed a questionnaire on CAM use and socio-demographic variables. The response rate was 73.5%, and over 90% of the sample acknowledged using CAMs. Non-herbal supplements (60.3%) and massage therapy (45%) were the most frequently used CAMs, with biologically based therapies (68.8%) as well as mind-body interventions (65.4%) being the most often used CAM domains. About 1 in 10 patients (9.6%) used CAMs from all five domains. With the exception of herbal-botanical therapies, self-prayer for health reasons/spiritual healing and music therapy, all CAMs were mainly used on an 'only when needed' basis. The most common reason nominated for using CAMs was that '[it] fits into my way of life/philosophy' (26%). The majority of patients declared interest in and support for the hospital providing CAMs. Patients were most inclined to choose therapies categorised as manipulative and body-based methods (65.4%) for use in hospital. Massage therapy (53.5%) and non-herbal supplements (43.1%) were the top two CAMs favoured for use in hospital. CAM use was also dependent of socio-demographic data (age, gender, marital status, place of residence, education level, religion, and income in hospitalised patients). The use of CAMs is pervasive amongst surgical in-patients, making it feasible to initially assess these patients for CAM use and provide them with clinically approved CAMs where possible. Notwithstanding that CAM use is fairly predictable by socio-demographic variables, further studies should be directed to know the variables useful for predicting the use of each CAM approach. Copyright © 2011 Elsevier Ltd. All rights reserved.

Patients' choice of portable folding chairs to reduce symptoms of orthostatic hypotension

NASA Technical Reports Server (NTRS)

Smit, A. A.; Wieling, W.; Opfer-Gehrking, T. L.; van Emmerik-Levelt, H. M.; Low, P. A.

1999-01-01

Patients with neurogenic orthostatic hypotension may use portable folding chairs to prevent or reduce symptoms of low blood pressure. However, a concomitant movement disorder may limit the use of these chairs in daily living. In this prospective study, 13 patients with orthostatic hypotension, balance disturbance associated with motor disability, or both examined three commercially available portable folding chairs. A questionnaire was used to document the characteristics in chair design that were relevant for satisfactory use to these patients. Armrests, seat width, and an adjustable sitting height were found to be important features of a portable folding chair. One chair was selected by 11 of 13 patients to fit most needs.

Discrepant Views of Oncologists and Cancer Patients on Complementary and Alternative Medicine in a Chinese General Hospital.

PubMed

Yang, Geliang; Zhang, Huiqing; Gan, Zheng; Fan, Yifu; Gu, Wei; Ling, Changquan

2018-06-01

Complementary and alternative medicine (CAM) has been widely used by cancer patients but rarely discussed by oncologists. This study was designed to evaluate the communication gap between China's oncologists and cancer patients on CAM. Two parallel cross-sectional studies assessed 83 oncologists and 402 cancer patients on CAM communication between patients and oncologists, and attitudes toward CAM use and clinical decisions about CAM. A majority (75.1%) of the cancer patients (302/402) were identified as CAM users within the most recent three months while 77.6% of the cancer patients (312/402) were identified as CAM users since diagnosis of cancer. Oncologists and patients responded differently ( P < .001) on CAM communications. Both oncologists and patients expected that CAM could improve the immune system. They both agreed that oncologists usually discouraged their patients from using CAM. Regarding the effectiveness of CAM, cancer patients were more likely to believe that CAM was effective while oncologists had more concerns about adverse effects of CAM use. CAM use by patients was predicted by disease duration (≥9 months) in the multivariable logistic regression model. China's oncologists and cancer patients may hold discrepant views on CAM. China's oncologists are encouraged to improve their knowledge on CAM and to initiate more discussions with their patients regarding effective and the safe use of CAM.

Job satisfaction among chairs of surgery from Europe and North America.

PubMed

Tschuor, Christoph; Raptis, Dimitri Aristotle; Morf, Manuela Christina; Staffelbach, Bruno; Manser, Tanja; Clavien, Pierre-Alain

2014-11-01

Strong evidence exists associating job satisfaction and risk of burnout with productivity, efficiency, and creativity in many organizations. However no data are available assessing chairs of surgery. This study assessed job satisfaction and risk for burnout of surgical chairs from Europe and North America and identified contributing factors. A survey among 650 chairs in surgery from 23 European and 2 North American countries was conducted in 2012. Satisfaction at work was analyzed using the validated Global Job Satisfaction (GJS) instrument and the abbreviated Maslach Burnout Inventory. Additional items targeting personal and environmental factors were included. The rate of chairs reached successfully was 86%, the overall response rate was 29% (188/650), with 1% female. Median age was 58 years. 11% of chairs were dissatisfied with work. Younger age and being fewer years in practice as a chair was associated with higher job satisfaction (P = .054 and P = .003). Surgical specialty with the greatest median GJS score was hepatopancreatobiliary, whereas vascular surgery scored lowest. Chairs desire to devote 20% more of their time on research. Clerical support as well as the ability to be innovative was suggested by 51% and 45%, respectively, to improve job satisfaction. Compared with Europeans, North American chairs were overall more satisfied and would recommend their job to their children. North American chairs seem to be more satisfied at work and at less risk for burnout than European chairs. The overall job satisfaction was greater among chairs compared with previously published reports of young, board-certified surgeons or residents (89% vs 87% and 66%, respectively). The superior satisfaction in chairs is strongest related to career achievements, innovation, and lifestyle. Copyright © 2014 Elsevier Inc. All rights reserved.

77 FR 18242 - Environmental Management Site-Specific Advisory Board Chairs

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-27

..., 2012 [cir] EM Program Update [cir] Recognition of Departing Chairs [cir] EM SSAB Chairs' Round Robin... [cir] EM SSAB Chairs' Round Robin: Cross-Complex Issues Thursday, April 19, 2012 [cir] DOE Headquarters...

Comparison of improved range of motion between cam-type femoroacetabular impingement and borderline developmental dysplasia of the hip -evaluation by virtual osteochondroplasty using computer simulation.

PubMed

Kubota, So; Inaba, Yutaka; Kobayashi, Naomi; Choe, Hyonmin; Tezuka, Taro; Saito, Tomoyuki

2017-10-16

While cam resection is essential to achieve a good clinical result with respect to femoroacetabular impingement (FAI), it is unclear whether it should also be performed in cases of borderline developmental dysplasia of the hip (DDH) with a cam deformity. The aim of this study was to evaluate improvements in range of motion (ROM) in cases of cam-type FAI and borderline DDH after virtual osteochondroplasty using a computer impingement simulation. Thirty-eight symptomatic hips in 31 patients (11male and 20 female) diagnosed with cam-type FAI or borderline DDH were analyzed. There were divided into a cam-type FAI group (cam-FAI group: 15 hips), borderline DDH without cam group (DDH W/O cam group: 12 hips), and borderline DDH with cam group (DDH W/ cam group: 11 hips). The bony impingement point on the femoral head-neck junction at 90° flexion and maximum internal rotation of the hip joint was identified using ZedHip® software. Virtual osteochondroplasty of the impingement point was then performed in all cases. The maximum flexion angle and maximum internal rotation angle at 90° flexion were measured before and after virtual osteochondroplasty at two resection ranges (i.e., slight and sufficient). The mean improvement in the internal rotation angle in the DDH W/ cam group after slight resection was significantly greater than that in the DDH W/O cam group (P = 0.046). Furthermore, the mean improvement in the internal rotation angle in the DDH W/ cam and cam-FAI groups after sufficient resection was significantly greater than that in the DDH W/O cam group (DDH W/ cam vs DDH W/O cam: P = 0.002, cam-FAI vs DDH W/O cam: P = 0.043). Virtual osteochondroplasty resulted in a significant improvement in internal rotation angle in DDH W/ cam group but not in DDH W/O cam group. Thus, borderline DDH cases with cam deformity may be better to consider performing osteochondroplasty.

AACP Strategy for Addressing the Professional Development Needs of Department Chairs

PubMed Central

Rodriguez, Tobias E.; Weinstein, George; Sorofman, Bernard A.; Bosso, John A.; Kerr, Robert A.; Haden, N. Karl

2012-01-01

Objectives. Characterize the skills and abilities required for department chairs, identify development needs, and then create AACP professional development programs for chairs. Methods. A 30-question electronic survey was sent to AACP member department chairs related to aspects of chairing an academic department. Results. The survey identified development needs in the leadership, management, and personal abilities required for effective performance as department chair. The information was used to prioritize topics for subsequent AACP development programs. Subsequent programs conducted at AACP Interim and Annual Meetings were well attended and generally received favorable reviews from participants. A list of development resources was placed on the AACP website. Conclusions. This ongoing initiative is part of an AACP strategy to identify and address the professional development needs of department chairs. Survey results may also inform faculty members and other academic leaders about the roles and responsibilities of department chairs. PMID:22919099

Teaching Evidence-Based Medicine at Complementary and Alternative Medicine Institutions: Strategies, Competencies, and Evaluation

PubMed Central

Schiffke, Heather; Fleishman, Susan; Haas, Mitch; Cruser, des Anges; LeFebvre, Ron; Sullivan, Barbara; Taylor, Barry; Gaster, Barak

2014-01-01

Abstract Background: As evidence-based medicine (EBM) becomes a standard in health care, it is essential that practitioners of complementary and alternative medicine (CAM) become experts in searching and evaluating the research literature. In support of this goal, the National Institutes of Health (NIH) National Center for Complementary and Alternative Medicine (NCCAM) provided R25 funding to nine CAM colleges to develop individual programs focused on teaching EBM. An overarching goal of these research education grants has been to provide CAM faculty and students with the skills they need to apply a rigorous evidence-based perspective to their training and practice. Methods/Results: This paper reviews the competencies and teaching strategies developed and implemented to enhance research literacy at all nine R25-funded institutions. While each institution designed approaches suitable for its research culture, the guiding principles were similar: to develop evidence-informed skills and knowledge, thereby helping students and faculty to critically appraise evidence and then use that evidence to guide their clinical practice. Curriculum development and assessment included faculty-driven learning activities and longitudinal curricular initiatives to encourage skill reinforcement and evaluate progress. Conclusion: As the field of integrative medicine matures, the NIH-NCCAM research education grants provide essential training for future clinicians and clinician-researchers. Building this workforce will facilitate multidisciplinary collaborations that address the unique needs for research that informs integrative clinical practice. PMID:25380144

Axiology, the Subject and the Chair

NASA Astrophysics Data System (ADS)

Melville, Wayne; Campbell, Todd; Jones, Doug

2017-08-01

This article addresses two gaps in the literature related to science department chairs: the axiological relationship between the chair and science, the subject, and the perceptions of the chair with respect to teaching and learning within their departments. In this work, axiology is used to understand how the chair's values toward the subject influenced his own perceived capacity to lead learning within his department in a reformed discourse. A narrative inquiry methodology was used to consider the chair's experiences in the development of his identify over his life span in the form of two stories: (1) the relationship between the chair and science, the subject, and (2) the perceptions of the chair with regards to teacher learning within the department. The findings revealed that the work and career of the chair in this study were authored by strong elements of personal continuity and points of stability around the valuing of science, the subject, even as this valuing evolved from being more focused on epistemic values early in his career, to being more concerned with universal values connected to his legacy and his department later in his career.

Use of complementary and alternative medicine among patients: classification criteria determine level of use.

PubMed

Kristoffersen, Agnete Egilsdatter; Fønnebø, Vinjar; Norheim, Arne Johan

2008-10-01

Self-reported use of complementary and alternative medicine (CAM) among patients varies widely between studies, possibly because the definition of a CAM user is not comparable. This makes it difficult to compare studies. The aim of this study is to present a six-level model for classifying patients' reported exposure to CAM. Prayer, physical exercise, special diets, over-the-counter products/CAM techniques, and personal visits to a CAM practitioner are successively removed from the model in a reductive fashion. By applying the model to responses given by Norwegian patients with cancer, we found that 72% use CAM if the user was defined to include all types of CAM. This proportion was reduced successively to only 11% in the same patient group when a CAM user was defined as a user visiting a CAM practitioner four or more times. When considering a sample of 10 recently published studies of CAM use among patients with breast cancer, we found 98% use when the CAM user was defined to include all sorts of CAM. This proportion was reduced successively to only 20% when a CAM user was defined as a user of a CAM practitioner. We recommend future surveys of CAM use to report at more than one level and to clarify which intensity level of CAM use the report is based on.

Facultative crassulacean acid metabolism (CAM) plants: powerful tools for unravelling the functional elements of CAM photosynthesis.

PubMed

Winter, Klaus; Holtum, Joseph A M

2014-07-01

Facultative crassulacean acid metabolism (CAM) describes the optional use of CAM photosynthesis, typically under conditions of drought stress, in plants that otherwise employ C3 or C4 photosynthesis. In its cleanest form, the upregulation of CAM is fully reversible upon removal of stress. Reversibility distinguishes facultative CAM from ontogenetically programmed unidirectional C3-to-CAM shifts inherent in constitutive CAM plants. Using mainly measurements of 24h CO2 exchange, defining features of facultative CAM are highlighted in five terrestrial species, Clusia pratensis, Calandrinia polyandra, Mesembryanthemum crystallinum, Portulaca oleracea and Talinum triangulare. For these, we provide detailed chronologies of the shifts between photosynthetic modes and comment on their usefulness as experimental systems. Photosynthetic flexibility is also reviewed in an aquatic CAM plant, Isoetes howellii. Through comparisons of C3 and CAM states in facultative CAM species, many fundamental biochemical principles of the CAM pathway have been uncovered. Facultative CAM species will be of even greater relevance now that new sequencing technologies facilitate the mapping of genomes and tracking of the expression patterns of multiple genes. These technologies and facultative CAM systems, when joined, are expected to contribute in a major way towards our goal of understanding the essence of CAM. © The Author 2014. Published by Oxford University Press on behalf of the Society for Experimental Biology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

A systematic review of the traits and cognitions associated with use of and belief in complementary and alternative medicine (CAM).

PubMed

Galbraith, Niall; Moss, Tim; Galbraith, Victoria; Purewal, Satvinder

2018-08-01

Complementary and alternative medicine (CAM) use is widespread despite the controversy over its effectiveness. Although previous reviews have examined the demographics and attitudes of CAM users, there is no existing review on the traits or cognitions which characterise either CAM users or those who believe in CAM effectiveness. The current systematic review set out to address these gaps in the literature by applying a narrative synthesis. A bibliographic search and manual searches were undertaken and key authors were contacted. Twenty-three papers were selected. The trait openness to experience was positively associated with CAM use but not CAM belief. Absorption and various types of coping were also positively associated with CAM use and belief. No other trait was reliably associated with CAM use or belief. Intuitive thinking and ontological confusions were positively associated with belief in CAM effectiveness; intuitive thinking was also positively associated with CAM use. Studies researching cognitions in CAM use/belief were mostly on non-clinical samples, whilst studies on traits and CAM use/belief were mostly on patients. The quality of studies varied but unrepresentative samples, untested outcome measures and simplistic statistical analyses were the most common flaws. Traits and cognition might be important correlates of CAM use and also of faith in CAM.

2D FT-ICR MS of Calmodulin: A Top-Down and Bottom-Up Approach.

PubMed

Floris, Federico; van Agthoven, Maria; Chiron, Lionel; Soulby, Andrew J; Wootton, Christopher A; Lam, Yuko P Y; Barrow, Mark P; Delsuc, Marc-André; O'Connor, Peter B

2016-09-01

Two-dimensional Fourier transform ion cyclotron resonance mass spectrometry (2D FT-ICR MS) allows data-independent fragmentation of all ions in a sample and correlation of fragment ions to their precursors through the modulation of precursor ion cyclotron radii prior to fragmentation. Previous results show that implementation of 2D FT-ICR MS with infrared multi-photon dissociation (IRMPD) and electron capture dissociation (ECD) has turned this method into a useful analytical tool. In this work, IRMPD tandem mass spectrometry of calmodulin (CaM) has been performed both in one-dimensional and two-dimensional FT-ICR MS using a top-down and bottom-up approach. 2D IRMPD FT-ICR MS is used to achieve extensive inter-residue bond cleavage and assignment for CaM, using its unique features for fragment identification in a less time- and sample-consuming experiment than doing the same thing using sequential MS/MS experiments. Graphical Abstract ᅟ.

Calcium-dependent stoichiometries of the KCa2.2 (SK) intracellular domain/calmodulin complex in solution

PubMed Central

Halling, D. Brent; Kenrick, Sophia A.; Riggs, Austen F.

2014-01-01

Ca2+ activates SK Ca2+-activated K+ channels through the protein Ca2+ sensor, calmodulin (CaM). To understand how SK channels operate, it is necessary to determine how Ca2+ regulates CaM binding to its target on SK. Tagless, recombinant SK peptide (SKp), was purified for binding studies with CaM at low and high Ca2+ concentrations. Composition gradient multi-angle light scattering accurately measures the molar mass, stoichiometry, and affinity of protein complexes. In 2 mM Ca2+, SKp and CaM bind with three different stoichiometries that depend on the molar ratio of SKp:CaM in solution. These complexes include 28 kD 1SKp/1CaM, 39 kD 2SKp/1CaM, and 44 kD 1SKp/2CaM. A 2SKp/2CaM complex, observed in prior crystallographic studies, is absent. At <5 nM Ca2+, 1SKp/1CaM and 2SKp/1CaM were observed; however, 1SKp/2CaM was absent. Analytical ultracentrifugation was used to characterize the physical properties of the three SKp/CaM stoichiometries. In high Ca2+, the sedimentation coefficient is smaller for a 1SKp:1CaM solution than it is for either 2SKp:1CaM or 1SKp:2CaM. At low Ca2+ and at >100 µM protein concentrations, a molar excess of SKp over CaM causes aggregation. Aggregation is not observed in Ca2+ or with CaM in molar excess. In low Ca2+ both 1SKp:1CaM and 1SKp:2CaM solutions have similar sedimentation coefficients, which is consistent with the absence of a 1SKp/2CaM complex in low Ca2+. These results suggest that complexes with stoichiometries other than 2SKp/2CaM are important in gating. PMID:24420768

Calcium-dependent stoichiometries of the KCa2.2 (SK) intracellular domain/calmodulin complex in solution.

PubMed

Halling, D Brent; Kenrick, Sophia A; Riggs, Austen F; Aldrich, Richard W

2014-02-01

Ca(2+) activates SK Ca(2+)-activated K(+) channels through the protein Ca(2+) sensor, calmodulin (CaM). To understand how SK channels operate, it is necessary to determine how Ca(2+) regulates CaM binding to its target on SK. Tagless, recombinant SK peptide (SKp), was purified for binding studies with CaM at low and high Ca(2+) concentrations. Composition gradient multi-angle light scattering accurately measures the molar mass, stoichiometry, and affinity of protein complexes. In 2 mM Ca(2+), SKp and CaM bind with three different stoichiometries that depend on the molar ratio of SKp:CaM in solution. These complexes include 28 kD 1SKp/1CaM, 39 kD 2SKp/1CaM, and 44 kD 1SKp/2CaM. A 2SKp/2CaM complex, observed in prior crystallographic studies, is absent. At <5 nM Ca(2+), 1SKp/1CaM and 2SKp/1CaM were observed; however, 1SKp/2CaM was absent. Analytical ultracentrifugation was used to characterize the physical properties of the three SKp/CaM stoichiometries. In high Ca(2+), the sedimentation coefficient is smaller for a 1SKp:1CaM solution than it is for either 2SKp:1CaM or 1SKp:2CaM. At low Ca(2+) and at >100 µM protein concentrations, a molar excess of SKp over CaM causes aggregation. Aggregation is not observed in Ca(2+) or with CaM in molar excess. In low Ca(2+) both 1SKp:1CaM and 1SKp:2CaM solutions have similar sedimentation coefficients, which is consistent with the absence of a 1SKp/2CaM complex in low Ca(2+). These results suggest that complexes with stoichiometries other than 2SKp/2CaM are important in gating.

Complementary and alternative medicine (CAM) among Australian hospital-based nurses: knowledge, attitude, personal and professional use, reasons for use, CAM referrals, and socio-demographic predictors of CAM users.

PubMed

Shorofi, Seyed Afshin; Arbon, Paul

2017-05-01

This study was intended to examine CAM among Australian hospital-based nurses, identifying their knowledge, attitude, personal and professional use, reasons for use, CAM referrals, and socio-demographic predictors of CAM users. Nurses holding a qualification in nursing and working in surgical wards were included using a convenience sampling technique. A self-complete questionnaire was developed to achieve the aims of the study. Descriptive and non-parametric statistics were calculated to describe and analyse data. Overall, 95.7% and 49.7% of nurses reported personal and professional use of CAM, respectively. The most popular CAM/CAM domain personally and professionally used by nurses was massage therapy and mind-body therapies. The primary reason for personal use of CAM was "[it] fits into my way of life/philosophy". Furthermore, massage therapists were the most commonly recommended CAM practitioners to patients. Only 15.8% of nurses would always ask patients about use of herbal medicines as part of nursing history taking. Over one-fifth (22.4%) of nurses rated their attitude as having a very positive, and 60.3% rated themselves as having very little or no knowledge of CAM. A positive correlation was also found between knowledge and attitude about CAM. Positive attitude and higher knowledge about CAM were positively correlated to CAM referrals. Several socio-demographic factors predicted personal and professional use of CAM. This study revealed that nurses generally believe not to have sufficient knowledge of CAM but are open to use CAM with patients. Nurses' positive attitude toward and personal use of CAM could be an indication that they are poised for further integration of evidence-based CAM into nursing practice to treat whole person. Copyright © 2017 Elsevier Ltd. All rights reserved.

An integrative review of complementary and alternative medicine use for back pain: a focus on prevalence, reasons for use, influential factors, self-perceived effectiveness, and communication.

PubMed

Murthy, Vijayendra; Sibbritt, David W; Adams, Jon

2015-08-01

Back pain is the most prevalent of musculoskeletal conditions, and back pain sufferers have been identified as high users of complementary and alternative medicine (CAM). Despite lacking evidence, CAM treatments (e.g., acupuncture, chiropractic, and massage) and CAM products (eg, vitamins, supplements, and aromatherapy oils) for back pain care have become widely available internationally, and CAM use by back pain sufferers has become a significant health service issue. However, to date, there has been no integrative review on CAM use for back pain. This study aims to conduct an integrative review on CAM use for back pain focusing on prevalence of use, commonly used CAM, characteristics of users, factors influencing decision making, self-perceived effectiveness, and communication with health-care providers. The study is based on an integrative literature review. A comprehensive search of international literature from 2000 to 2014 in MEDLINE, CINHAL, AMED, DARE, EMBASE, ExceptaMedica, psycINFO, and SCOPUS databases was conducted. The search was limited to peer-reviewed articles published in English language and reporting empirical research findings on CAM use for back pain. The review reveals a considerable variation in prevalences of CAM use for back pain internationally. Acupuncture, chiropractic, osteopathy, and massage therapy are the commonly used CAM treatments besides a range of self-prescribed CAM, and back pain sufferers use CAM alongside conventional medical treatments. Female gender, chronicity of back pain, and previous exposure to CAM are key predictors of CAM use for back pain as highlighted from the reviewed literature. Family, friends, and recommendation by doctors appear to influence decision making on CAM use for back pain. The review reveals that users of CAM for back pain tend to report CAM as beneficial, but there is little knowledge on communication between CAM users with back pain and health-care providers about such use. Existing literature is largely based on the research investigating CAM use for back pain among a range of other health conditions. Further rigorous research is needed to investigate the use of a wider range of CAM treatments, particularly self-prescribed CAM for back pain. The review findings provide insights for health-care providers and policy makers on the range of CAM treatments used by back pain sufferers. Conventional medical and CAM practitioners should be aware of back pain sufferers' decision making regarding a range of CAM treatments and be prepared to communicate with patients on safe and effective CAM treatments for back pain. Copyright © 2015 Elsevier Inc. All rights reserved.

Voices from the Field: Perspectives of U.S. Kinesiology Chairs on Opportunities, Challenges, and the Role of Mentoring in the Chair Position

ERIC Educational Resources Information Center

Ransdell, Lynda B.; Nguyen, Nhu; Hums, Mary A.; Clark, Megan; Williams, Sarah B.

2018-01-01

This study examined perspectives of U.S. collegiate kinesiology department chairs (n = 54/144; 37.5% response rate) relative to: (a) opportunities and most enjoyable aspects of being a department chair, (b) challenges and least enjoyable aspects of being a department chair, and (c) perspectives on mentoring. The majority of participants enjoyed…

Cryogenic Cam Butterfly Valve

NASA Technical Reports Server (NTRS)

McCormack, Kenneth J. (Inventor)

2016-01-01

A cryogenic cam butterfly valve has a body that includes an axially extending fluid conduit formed there through. A disc lug is connected to a back side of a valve disc and has a circular bore that receives and is larger than a cam of a cam shaft. The valve disc is rotatable for a quarter turn within the body about a lug axis that is offset from the shaft axis. Actuating the cam shaft in the closing rotational direction first causes the camming side of the cam of the cam shaft to rotate the disc lug and the valve disc a quarter turn from the open position to the closed position. Further actuating causes the camming side of the cam shaft to translate the valve disc into sealed contact with the valve seat. Opening rotational direction of the cam shaft reverses these motions.

Complementary and Alternative Medicine: A Clinical Study in 1,016 Hematology/Oncology Patients.

PubMed

Hierl, Marina; Pfirstinger, Jochen; Andreesen, Reinhard; Holler, Ernst; Mayer, Stephanie; Wolff, Daniel; Vogelhuber, Martin

2017-01-01

Surveys state a widespread use of complementary and alternative medicine (CAM) in patients with malignant diseases. CAM methods might potentially interfere with the metabolization of tumor-specific therapy. However, there is little communication about CAM use in hematology/oncology patients between patients, CAM providers, and oncologists. A self-administered questionnaire was handed out to all patients attending to the hematology/oncology outpatient clinic of Regensburg University Hospital. Subsequently, a chart review of all CAM users was performed. Questionnaires of 1,016 patients were analyzed. Of these patients, 30% used CAM, preferably vitamins and micronutrients. Main information sources for CAM methods were physicians/nonmedical practitioners and friends/relatives. CAM therapies were provided mainly by licensed physicians (29%), followed by nonmedical practitioners (14%) and the patients themselves (13%). Although 62% of the CAM users agreed that the oncologist may know about their CAM therapy, a chart entry about CAM use was found only in 41%. CAM is frequently used by hematology/oncology patients. Systematic communication about CAM is essential to avoid possible drug interactions. © 2017 S. Karger AG, Basel.

Incorporating Yoga Therapy into Primary Care: The Casey Health Institute.

PubMed

Ross, Alyson; Williams, Laurie; Pappas-Sandonas, Mary; Touchton-Leonard, Katharine; Fogel, David

2015-01-01

Individuals seek complementary and alternative medicine (CAM) for a variety of health conditions, and yoga is a popular CAM modality. Over the past few decades, yoga has become incorporated into hundreds of healthcare facilities, most commonly in large university medical centers. While research has shown yoga to be effective in reducing symptoms and improving outcomes in chronic health conditions, most patients seek yoga therapy on their own, as few primary care practitioners have incorporated yoga therapy into their practices. The purpose of this article is to describe the efforts of the Casey Health Institute to incorporate yoga therapy into their primary care integrative medicine center. At Casey Health, a full-time Clinical Yoga Specialist works alongside the physicians, nurses, and CAM providers in delivering care to a wide variety of patients. The majority of referrals to yoga therapy have been for pain-related musculoskeletal conditions, as well as hypertension, headaches, anxiety, depression, and sleep disturbances. Most patients attend weekly 60-minute individual sessions, and the Clinical Yoga Specialist stays in touch with the patient between appointments via telephone and email. T h e Clinical Yoga Specialist has become an integral part of Casey Health, participating in collaborative medical appointments in which two CAM practitioners provide simultaneous treatments to a patient. She also participates in the clinic's ongoing weight loss program. The Clinical Yoga Specialist spends one morning each week "floating" in the clinic, when she is on-call to the practitioners to assist in treatment and/or to introduce a yoga therapy experience to the patients. These brief interventions introduce the patients to the therapeutic benefits of yoga, while simultaneously demonstrating yoga's effectiveness to the healthcare providers. Casey Health has developed a unique teacher training program whose faculty includes senior Iyengar yoga teachers as well as physicians and CAM practitioners. Casey Health is incorporating clinical outcomes into their electronic medical record that can be used internally to assess comparable effectiveness and cost effectiveness of the different treatment modalities such as yoga therapy, providing evidence that eventually may lead to yoga therapy becoming an accepted treatment that is eligible for insurance reimbursement.

CAM practitioners in the Australian health workforce: an underutilized resource

PubMed Central

2012-01-01

Background CAM practitioners are a valuable but underutilizes resource in Australian health care. Despite increasing public support for complementary and alternative medicine (CAM) little is known about the CAM workforce. Apart from the registered professions of chiropractic, osteopathy and Chinese medicine, accurate information about the number of CAM practitioners in the workforce has been difficult to obtain. It appears that many non-registered CAM practitioners, although highly qualified, are not working to their full capacity. Discussion Increasing public endorsement of CAM stands in contrast to the negative attitude toward the CAM workforce by some members of the medical and other health professions and by government policy makers. The marginalisation of the CAM workforce is evident in prejudicial attitudes held by some members of the medical and other health professions and its exclusion from government policy making. Inconsistent educational standards has meant that non-registered CAM practitioners, including highly qualified and competent ones, are frequently overlooked. Legitimising their contribution to the health workforce could alleviate workforce shortages and provide opportunities for redesigned job roles and new multidisciplinary teams. Priorities for better utilisation of the CAM workforce include establishing a guaranteed minimum education standard for more CAM occupation groups through national registration, providing interprofessional education that includes CAM practitioners, developing courses to upgrade CAM practitioners' professional skills in areas of indentified need, and increasing support for CAM research. Summary Marginalisation of the CAM workforce has disadvantaged those qualified and competent CAM practitioners who practise evidence-informed medicine on the basis of many years of university training. Legitimising and expanding the important contribution of CAM practitioners could alleviate projected health workforce shortages, particularly for the prevention and management of chronic health conditions and for health promotion. PMID:23116374

CAM practitioners in the Australian health workforce: an underutilized resource.

PubMed

Grace, Sandra

2012-11-02

CAM practitioners are a valuable but underutilizes resource in Australian health care. Despite increasing public support for complementary and alternative medicine (CAM) little is known about the CAM workforce. Apart from the registered professions of chiropractic, osteopathy and Chinese medicine, accurate information about the number of CAM practitioners in the workforce has been difficult to obtain. It appears that many non-registered CAM practitioners, although highly qualified, are not working to their full capacity. Increasing public endorsement of CAM stands in contrast to the negative attitude toward the CAM workforce by some members of the medical and other health professions and by government policy makers. The marginalisation of the CAM workforce is evident in prejudicial attitudes held by some members of the medical and other health professions and its exclusion from government policy making. Inconsistent educational standards has meant that non-registered CAM practitioners, including highly qualified and competent ones, are frequently overlooked. Legitimising their contribution to the health workforce could alleviate workforce shortages and provide opportunities for redesigned job roles and new multidisciplinary teams. Priorities for better utilisation of the CAM workforce include establishing a guaranteed minimum education standard for more CAM occupation groups through national registration, providing interprofessional education that includes CAM practitioners, developing courses to upgrade CAM practitioners' professional skills in areas of indentified need, and increasing support for CAM research. Marginalisation of the CAM workforce has disadvantaged those qualified and competent CAM practitioners who practise evidence-informed medicine on the basis of many years of university training. Legitimising and expanding the important contribution of CAM practitioners could alleviate projected health workforce shortages, particularly for the prevention and management of chronic health conditions and for health promotion.

Principal Components Analysis of Reflectance Spectra from the Mars Exploration Rover Opportunity

NASA Technical Reports Server (NTRS)

Mercer, C. M.; Cohen, B. A.

2010-01-01

In the summer of 2007 a global dust storm on Mars effectively disabled Opportunity's Miniature Thermal Emission Spectrometer (Mini-TES), the primary instrument used by the Athena Science Team to identify locally unique rocks on the Martian surface. The science team needs another way to distinguish interesting rocks from their surroundings on a tactical timescale. This study was designed to develop the ability to identify locally unique rocks on the Martian surface remotely using the Mars Exploration Rovers' Panoramica Camera (PanCam) instrument. Meridiani bedrock observed by Opportunity is largely characterized by sulfate-rich sandstones and hematite spherules. Additionally, loose fragments of bedrock and "cobbles" of foreign origin collet on the surface, some of which are interpreted as meteorites.

The utilisation of Complementary and Alternative Medicine (CAM) among ethnic minorities in South Korea

PubMed Central

2014-01-01

Background Race has been reported to affect the use of complementary and alternative medicine (CAM), but there is very little research on the use of CAM by ethnicity in Korea. This study explores the prevalence of CAM use among ethnic minorities in South Korea. Methods The design is a descriptive and cross-sectional study. A convenience sample of ethnic minorities was recruited from two public healthcare centres in Gyeonggi province. The survey instrument included 37 questions regarding CAM use, factors influencing use of CAM, self-health management, and the socio-demographic profile of study participants. Results Sixty-two percent of study participants reported the use of CAM. Multivitamins (53.3%), acupuncture (48.9%), and traditional Korean herbal medicine (38.9%) were popular CAM modalities in our sample. Other notable CAM modalities included herbal plants, therapeutic massage, and moxibustion therapy. The majority of CAM users (52.2%) received CAM services to treat diseases or as a secondary treatment while receiving conventional care. Having positive perceptions toward the effectiveness of CAM was a major determining factor in CAM use. Conclusions Physicians need to be aware of the fact that many ethnic minorities use CAM therapies. Many CAM users reported that they want doctors to know about their CAM use and have a basic understanding of traditional medicine in their home country. Overcoming language and cultural barriers will help reduce unwanted medical complications. High prevalence of CAM use among ethnic minorities in our study warrants further studies using larger sample population. PMID:24641983

Backbone resonance assignments of complexes of human voltage-dependent sodium channel NaV1.2 IQ motif peptide bound to apo calmodulin and to the C-domain fragment of apo calmodulin.

PubMed

Mahling, Ryan; Kilpatrick, Adina M; Shea, Madeline A

2017-10-01

Human voltage-gated sodium channel Na V 1.2 has a single pore-forming α-subunit and two transmembrane β-subunits. Expressed primarily in the brain, Na V 1.2 is critical for initiation and propagation of action potentials. Milliseconds after the pore opens, sodium influx is terminated by inactivation processes mediated by regulatory proteins including calmodulin (CaM). Both calcium-free (apo) CaM and calcium-saturated CaM bind tightly to an IQ motif in the C-terminal tail of the α-subunit. Our thermodynamic studies and solution structure (2KXW) of a C-domain fragment of apo 13 C, 15 N- CaM (CaM C ) bound to an unlabeled peptide with the sequence of rat Na V 1.2 IQ motif showed that apo CaM C (a) was necessary and sufficient for binding, and (b) bound more favorably than calcium-saturated CaM C . However, we could not monitor the Na V 1.2 residues directly, and no structure of full-length CaM (including the N-domain of CaM (CaM N )) was determined. To distinguish contributions of CaM N and CaM C , we used solution NMR spectroscopy to assign the backbone resonances of a complex containing a 13 C, 15 N-labeled peptide with the sequence of human Na V 1.2 IQ motif (Na V 1.2 IQp ) bound to apo 13 C, 15 N-CaM or apo 13 C, 15 N-CaM C . Comparing the assignments of apo CaM in complex with Na V 1.2 IQp to those of free apo CaM showed that residues within CaM C were significantly perturbed, while residues within CaM N were essentially unchanged. The chemical shifts of residues in Na V 1.2 IQp and in the C-domain of CaM were nearly identical regardless of whether CaM N was covalently linked to CaM C . This suggests that CaM N does not influence apo CaM binding to Na V 1.2 IQp .

European Glaucoma Society Terminology and Guidelines for Glaucoma, 4th Edition - Part 1Supported by the EGS Foundation

PubMed Central

2017-01-01

Foreword It gives me pleasure to introduce the 4th edition of the EGS Guidelines. The Third edition proved to be extremely successful, being translated into 7 languages with over 70000 copies being distributed across Europe; it has been downloadable, free, as a pdf file for the past 4 years. As one of the main objectives of the European Glaucoma Society has been to both educate and standardize glaucoma practice within the EU, these guidelines were structured so as to play their part. Glaucoma is a living specialty, with new ideas on causation, mechanisms and treatments constantly appearing. As a number of years have passed since the publication of the last edition, changes in some if not all of these ideas would be expected. For this new edition of the guidelines a number of editorial teams were created, each with responsibility for an area within the specialty; updating where necessary, introducing new diagrams and Flowcharts and ensuring that references were up to date. Each team had writers previously involved with the last edition as well as newer and younger members being co-opted. As soon as specific sections were completed they had further editorial comment to ensure cross referencing and style continuity with other sections. Overall guidance was the responsibility of Anders Heijl and Carlo Traverso. Tribute must be made to the Task Force whose efforts made the timely publication of the new edition possible. Roger Hitchings Chairman of the EGS Foundation www.eugs.org The Guidelines Writers and Contributors  Augusto Azuara Blanco Luca Bagnasco Alessandro Bagnis Keith Barton Christoph Baudouin Boel Bengtsson Alain Bron Francesca Cordeiro Barbara Cvenkel Philippe Denis Christoph Faschinger Panayiota Founti Stefano Gandolfi David Garway Heath Francisco Goni Franz Grehn Anders Heijl Roger Hitchings Gabor Hollo Tony Hommer Michele Iester Jost Jonas Yves Lachkar Giorgio Marchini Frances Meier Gibbons Stefano Miglior Marta Misiuk-Hojo Maria Musolino Jean Philippe Nordmann Norbert Pfeiffer Luis Abegao Pinto Luca Rossetti John Salmon Leo Schmetterer Riccardo Scotto Tarek Shaarawy Ingeborg Stalmans Gordana Sunaric Megevand Ernst Tamm John Thygesen Fotis Topouzis Carlo Enrico Traverso Anja Tuulonen Ananth Viswanathan Thierry Zeyen The Guidelines Task Force  Luca Bagnasco Anders Heijl Carlo Enrico Traverso Augusto Azuara Blanco Alessandro Bagnis David Garway Heath Michele Iester Yves Lachkar Ingeborg Stalmans Gordana Sunaric Mégevand Fotis Topouzis Anja Tuulonen Ananth Viswanathan The EGS Executive Committee  Carlo Enrico Traverso (President) Anja Tuulonen (Vice President) Roger Hitchings (Past President) Anton Hommer (Treasurer) Barbara Cvenkel Julian Garcia Feijoo David Garway Heath Norbert Pfeiffer Ingeborg Stalmans The Board of the European Glaucoma Society Foundation  Roger Hitchings (Chair) Carlo E. Traverso (Vice Chair) Franz Grehn Anders Heijl John Thygesen Fotis Topouzis Thierry Zeyen The EGS Committees  CME and Certification  Gordana Sunaric Mégevand (Chair) Carlo Enrico Traverso (Co-chair) Delivery of Care  Anton Hommer (Chair) EU Action  Thierry Zeyen (Chair) Carlo E. Traverso (Co-chair) Education  John Thygesen (Chair) Fotis Topouzis (Co-chair) Glaucogene  Ananth Viswanathan (Chair) Fotis Topouzis (Co-chair) Industry Liaison  Roger Hitchings (Chair) Information Technology  Ingeborg Stalmans (Chair) Carlo E. Traverso (Co-chair) National Society Liaison  Anders Heijl (Chair) Program Planning  Fotis Topouzis (Chair) Ingeborg Stalmans (Co-chair) Quality and Outcomes  Anja Tuulonen (Chair) Augusto Azuara Blanco (Co-chair) Scientific  Franz Grehn (Chair) David Garway Heath (Co-chair) PMID:27378485

A qualitative study of faculty members' views of women chairs.

PubMed

Isaac, Carol; Griffin, Lindsay; Carnes, Molly

2010-03-01

Concurrent with the evolving role of the department chair in academic medicine is the entry of women physicians into chair positions. Because implicit biases that stereotypically masculine behaviors are required for effective leadership remain strong, examining faculty members' perceptions of their chair's leadership in medical school departments with women chairs can provide insight into the views of women leaders in academic medicine and the complex ways in which gender may impact these chairs' leadership style and actions. We conducted semistructured interviews with 13 male and 15 female faculty members representing all faculty tracks in three clinical departments chaired by women. Inductive, qualitative analysis of the subsequent text allowed themes to emerge across interviews. Four themes emerged regarding departmental leadership. One dealt with the leadership of the previous chair. The other three described the current chair's characteristics (tough, direct, and transparent), her use of communal actions to help support and mentor her faculty, and her ability to build power through consensus. Because all three chairs were early in their tenure, a wait and see attitude was frequently expressed. Faculty generally viewed having a woman chair as an indication of positive change, with potential individual and institutional advantages. This exploratory study suggests that the culture of academic medicine has moved beyond questioning women physicians' competence to lead once they are in top organizational leadership positions. The findings are also consonant with experimental research indicating that women leaders are most successful when they pair stereotypic male (agentic) behaviors with stereotypic female (communal) behaviors. All three chairs exhibited features of a transformational leadership style and characteristics deemed essential for effective leadership in academic medicine.

A Qualitative Study of Faculty Members' Views of Women Chairs

PubMed Central

Isaac, Carol; Griffin, Lindsay

2010-01-01

Abstract Background Concurrent with the evolving role of the department chair in academic medicine is the entry of women physicians into chair positions. Because implicit biases that stereotypically masculine behaviors are required for effective leadership remain strong, examining faculty members' perceptions of their chair's leadership in medical school departments with women chairs can provide insight into the views of women leaders in academic medicine and the complex ways in which gender may impact these chairs' leadership style and actions. Methods We conducted semistructured interviews with 13 male and 15 female faculty members representing all faculty tracks in three clinical departments chaired by women. Inductive, qualitative analysis of the subsequent text allowed themes to emerge across interviews. Results Four themes emerged regarding departmental leadership. One dealt with the leadership of the previous chair. The other three described the current chair's characteristics (tough, direct, and transparent), her use of communal actions to help support and mentor her faculty, and her ability to build power through consensus. Because all three chairs were early in their tenure, a wait and see attitude was frequently expressed. Faculty generally viewed having a woman chair as an indication of positive change, with potential individual and institutional advantages. Conclusions This exploratory study suggests that the culture of academic medicine has moved beyond questioning women physicians' competence to lead once they are in top organizational leadership positions. The findings are also consonant with experimental research indicating that women leaders are most successful when they pair stereotypic male (agentic) behaviors with stereotypic female (communal) behaviors. All three chairs exhibited features of a transformational leadership style and characteristics deemed essential for effective leadership in academic medicine. PMID:20156081

Does chair type influence outcome in the timed "Up and Go" test in older persons?

PubMed

Kalula, S Z; Swingler, G H; Sayer, A A; Badri, M; Ferreira, M

2010-04-01

To test the effects of the use of a collapsible, portable chair (chair B), as opposed to a 'standard' chair (chair A), on the outcome of the timed "Up and Go" (TUG) test. Cross-sectional. Multipurpose senior centres. Mobile older persons (N=118, mean age 77 years (range 62-99 years)). Time to complete the timed "Up and Go" test using chair A and chair B, and inter-rater agreement in the time scores. Time taken to complete the TUG test did not differ by chair type [median (interquartile range, IQR) = 12.3 (9.53-15.9) and 12.6 (9.7-16.6)] seconds for Chair A and B respectively, p-value=0.87. In multiple regression analyses, factors that impacted on time difference in test performance for the two chairs were use of a walking aid during the test [Odds ratio (OR) = 3.7 95%CI 1.1-11.9, p=0.031], observed difficulty with mobility (OR= 27.7 95%CI 2.6-290, p=0.006), and a history of arthritis in the knees (OR= 2.9 95%CI 1.0-8.7, P=0.05). In an inter-rater agreement analysis, no significant difference was found between time scores recorded by the two raters; median (IQR) = 12.4 (10.9-15.9) and 12.3 (7.2-59.1) seconds for the occupation therapist and for the research assistant, respectively (Wilcoxon matched pairs test, p=0.124, Spearman correlation coefficient = 0.99, p < 0.001). The use of a portable canvas chair with standardised specifications offers an acceptable alternative to the use of a 'standard' chair in assessments of fall risk using the TUG test in field settings where field workers are reliant on public transport.

Composite casting/bonding construction of an air-cooled, high temperature radial turbine wheel

NASA Technical Reports Server (NTRS)

Hammer, A. N.; Aigret, G.; Rodgers, C.; Metcalfe, A. G.

1983-01-01

A composite casting/bonding technique has been developed for the fabrication of a unique air-cooled, high temperature radial inflow turbine wheel design applicable to auxilliary power units with small rotor diameters and blade entry heights. The 'split blade' manufacturing procedure employed is an alternative to complex internal ceramic coring. Attention is given to both aerothermodynamic and structural design, of which the latter made advantageous use of the exploration of alternative cooling passage configurations through CAD/CAM system software modification.

Allosteric Effects of the Anti-Psychotic Drug Trifluoperazine on the Energetics of Calcium Binding by Calmodulin

PubMed Central

Feldkamp, Michael D.; O'Donnell, Susan E.; Yu, Liping; Shea, Madeline A.

2010-01-01

Trifluoperazine (TFP; Stelazine™) is an antagonist of calmodulin (CaM), an essential regulator of calcium-dependent signal transduction. Reports differ regarding whether, or where, TFP binds to apo CaM. Three crystallographic structures (1CTR, 1A29, 1LIN) show TFP bound to (Ca2+)4-CaM in ratios of 1, 2 or 4 TFP per CaM. In all of these, CaM domains adopt the “open” conformation seen in CaM-kinase complexes having increased calcium affinity. Most reports suggest TFP also increases calcium affinity of CaM. To compare TFP binding to apo CaM and (Ca2+)4-CaM, and explore differential effects on the N- and C-domains of CaM, stoichiometric TFP titrations of CaM were monitored by 15N-HSQC NMR. Two TFP bound to apo CaM, while four bound to (Ca2+)4-CaM. In both cases, the preferred site was in the C-domain. During the titrations, biphasic responses for some resonances suggested inter-site interactions. TFP-binding sites in apo CaM appeared distinct from those in (Ca2+)4-CaM. In equilibrium calcium titrations at defined ratios of TFP:CaM, TFP reduced calcium affinity at most levels tested; this is similar to the effect of many IQ-motifs on CaM. However, at the highest level tested, TFP raised the calcium affinity of the N-domain of CaM. A model of conformational switching is proposed to explain how TFP can exert opposing allosteric effects on calcium affinity by binding to different sites in the “closed”, “semi-open” and “open” domains of CaM. In physiological processes, apo CaM, as well as (Ca2+)4-CaM, needs to be considered a potential target of drug action. PMID:20544963

Kutscher Elected Future Chair of American Solar Energy Society

Science.gov Websites

serve as vice-chair/chair-elect for two years and then serve a two-year term as chair beginning January and served on the board of directors for two. The Center for Buildings and Thermal Systems evaluates

The prevalence, patterns of usage and people's attitude towards complementary and alternative medicine (CAM) among the Indian community in Chatsworth, South Africa.

PubMed

Singh, Vimal; Raidoo, Deshandra M; Harries, Catherine S

2004-02-04

The purpose of this study was to determine, among the Indian community of Chatsworth, South Africa, the prevalence and utilisation patterns of complementary and alternative medicine (CAM), attitudes associated with CAM use and communication patterns of CAM users with their primary care doctors. Face-to-face structured interviews were conducted in Chatsworth, a suburb of Durban in which South Africans of Indian origin predominantly reside. Participants were 200 randomly selected adult English-speaking Indian residents. The prevalence of CAM usage for period 2000/2001 was 38.5% (95% confidence interval 31.7% to 45.6%). Spiritual healing and herbal/natural medicines, including vitamins were the most common types of CAM used, accounting for 42.8% and 48.1% respectively of overall CAM usage. People used CAM to treat conditions including diabetes mellitus, headaches, arthritis and joint pains, stress, skin disorders, backaches, hypertension and nasal disorders. Half of the CAM users used allopathic medicines concurrently. The cost of CAM utilization over this 1-year period, incurred by 80.5% of users for the duration of therapy for their most troublesome condition was below R500 (approximately US50 dollars). Age, sex, marital status, religion, level of education and income were shown not to influence the use of CAM. Greater than half (51.9%) of CAM users did so either upon the advice of someone they knew, or after noticing a CAM advertisement in the local press. Seventy-nine percent of CAM users indicated that they had positive outcomes with their treatments. Fifty four percent of CAM users (excluding those using spiritual healing only) failed to inform their doctors that they used CAM. The main reason given by half of this group was that informing their doctors did not seem necessary. The prevalence of CAM in Chatsworth is similar to findings in other parts of the world. Although CAM was used to treat many different ailments, this practice could not be attributed to any particular demographic profile. The majority of CAM users were satisfied with the effects of CAM. Findings support a need for greater integration of allopathic medicine and CAM, as well as improved communication between patients and caregivers regarding CAM usage.

The prevalence, patterns of usage and people's attitude towards complementary and alternative medicine (CAM) among the Indian community in Chatsworth, South Africa

PubMed Central

Singh, Vimal; Raidoo, Deshandra M; Harries, Catherine S

2004-01-01

Background The purpose of this study was to determine, among the Indian community of Chatsworth, South Africa, the prevalence and utilisation patterns of complementary and alternative medicine (CAM), attitudes associated with CAM use and communication patterns of CAM users with their primary care doctors. Methods Face-to-face structured interviews were conducted in Chatsworth, a suburb of Durban in which South Africans of Indian origin predominantly reside. Participants were 200 randomly selected adult English-speaking Indian residents. Results The prevalence of CAM usage for period 2000/2001 was 38.5% (95% confidence interval 31.7% to 45.6%). Spiritual healing and herbal/natural medicines, including vitamins were the most common types of CAM used, accounting for 42.8% and 48.1% respectively of overall CAM usage. People used CAM to treat conditions including diabetes mellitus, headaches, arthritis and joint pains, stress, skin disorders, backaches, hypertension and nasal disorders. Half of the CAM users used allopathic medicines concurrently. The cost of CAM utilization over this 1-year period, incurred by 80.5% of users for the duration of therapy for their most troublesome condition was below R500 (approximately US$50). Age, sex, marital status, religion, level of education and income were shown not to influence the use of CAM. Greater than half (51.9%) of CAM users did so either upon the advice of someone they knew, or after noticing a CAM advertisement in the local press. Seventy-nine percent of CAM users indicated that they had positive outcomes with their treatments. Fifty four percent of CAM users (excluding those using spiritual healing only) failed to inform their doctors that they used CAM. The main reason given by half of this group was that informing their doctors did not seem necessary. Conclusion The prevalence of CAM in Chatsworth is similar to findings in other parts of the world. Although CAM was used to treat many different ailments, this practice could not be attributed to any particular demographic profile. The majority of CAM users were satisfied with the effects of CAM. Findings support a need for greater integration of allopathic medicine and CAM, as well as improved communication between patients and caregivers regarding CAM usage. PMID:15018622

Survey of practices and policies relating to the use of complementary and alternative medicines and therapies in New South Wales cancer services.

PubMed

Raszeja, V M; Jordens, C F C; Kerridge, I H

2013-01-01

To examine policies and practices relating to the provision, prescription and monitoring of complementary and alternative medicine and therapies (CAM) in conventional cancer services in NSW. Self-administered questionnaire sent to directors of all 65 eligible cancer services in NSW in 2009. Forty-three services responded to the survey (response rate 66%). Only six (14%) services reported having formal policies about CAM. Most (n = 33, 77%) expected that patients would be asked about CAM use during their initial assessment. Eight services (19%) provided and/or prescribed CAM for patients, and most of these (n = 7) recorded details of CAM use in patients' records. Only four (9%) services permitted CAM practitioners from the community to attend inpatients, whereas 24 (56%) permitted inpatients to bring in their own CAM. Most of these services (n = 17) required medical approval for the use of CAM. Of the latter, most (n = 13) recorded the use of approved CAM, but only seven recorded use of unapproved CAM and only three refused permission to continue use of unapproved CAM. Most cancer services in NSW recognise potential CAM use by patients and expect medical staff to ask patients about their use of CAM. While few cancer services provided or prescribed CAM, over half permitted inpatients to bring their own CAM into hospital. There was little control over the use of CAM, however, and monitoring was lax. Given the wide usage of CAM by patients with cancer, this lack of control may compromise clinical outcomes, with potentially dangerous consequences. © 2013 The Authors; Internal Medicine Journal © 2013 Royal Australasian College of Physicians.

Disclosure of complementary and alternative medicine use to health care providers among HIV-infected women.

PubMed

Liu, Chenglong; Yang, Yang; Gange, Stephen J; Weber, Kathleen; Sharp, Gerald B; Wilson, Tracey E; Levine, Alexandra; Robison, Esther; Goparaju, Lakshmi; Gandhi, Monica; Ganhdi, Monica; Merenstein, Dan

2009-11-01

To determine prevalence and predictors of complementary and alternative medicine (CAM) use disclosure to health care providers and whether CAM use disclosure is associated with highly active antiretroviral therapy (HAART) adherence among HIV-infected women, we analyzed longitudinal data collected between October 1994 and March 2002 from HIV-infected CAM-using women enrolled in the Women's Interagency HIV Study. Repeated measures Poisson regression models were constructed to evaluate associations of selected predictors with CAM use disclosure and association between CAM use disclosure and HAART adherence. A total of 1,377 HIV-infected women reported CAM use during study follow-up and contributed a total of 4,689 CAM-using person visits. The overall prevalence of CAM use disclosure to health care providers was 36% across study visits. Women over 45 years old, with a college education, or with health insurance coverage were more likely to disclose their CAM use to health care providers, whereas women identified as non-Hispanic Black or other ethnicities were less likely to communicate their CAM usage. More health care provider visits, more CAM domains used, and higher health care satisfaction scores had significant relationships with increased levels of CAM use disclosure. Restricting analysis to use of herbal or nonherbal medications only, similar results were obtained. Compared to other CAM domains, mind-body practice had the lowest prevalence of CAM use disclosure. Additionally, CAM use disclosure was significantly associated with higher HAART adherence. From this study, we showed that a high percentage of HIV-infected women did not discuss their CAM use with health care providers. Interventions targeted towards both physicians and patients may enhance communication of CAM use, avoid potential adverse events and drug interactions, and enhance HAART adherence.

Disclosure of Complementary and Alternative Medicine Use to Health Care Providers among HIV-Infected Women

PubMed Central

Yang, Yang; Gange, Stephen J.; Weber, Kathleen; Sharp, Gerald B.; Wilson, Tracey E.; Levine, Alexandra; Robison, Esther; Goparaju, Lakshmi; Gandhi, Monica; Merenstein, Dan

2009-01-01

Abstract To determine prevalence and predictors of complementary and alternative medicine (CAM) use disclosure to health care providers and whether CAM use disclosure is associated with highly active antiretroviral therapy (HAART) adherence among HIV-infected women, we analyzed longitudinal data collected between October 1994 and March 2002 from HIV-infected CAM-using women enrolled in the Women's Interagency HIV Study. Repeated measures Poisson regression models were constructed to evaluate associations of selected predictors with CAM use disclosure and association between CAM use disclosure and HAART adherence. A total of 1377 HIV-infected women reported CAM use during study follow-up and contributed a total of 4689 CAM-using person visits. The overall prevalence of CAM use disclosure to health care providers was 36% across study visits. Women over 45 years old, with a college education, or with health insurance coverage were more likely to disclose their CAM use to health care providers, whereas women identified as non-Hispanic Black or other ethnicities were less likely to communicate their CAM usage. More health care provider visits, more CAM domains used, and higher health care satisfaction scores had significant relationships with increased levels of CAM use disclosure. Restricting analysis to use of herbal or nonherbal medications only, similar results were obtained. Compared to other CAM domains, mind–body practice had the lowest prevalence of CAM use disclosure. Additionally, CAM use disclosure was significantly associated with higher HAART adherence. From this study, we showed that a high percentage of HIV-infected women did not discuss their CAM use with health care providers. Interventions targeted towards both physicians and patients may enhance communication of CAM use, avoid potential adverse events and drug interactions, and enhance HAART adherence. PMID:19821723

Complementary and alternative medicine use among paediatric emergency department patients.

PubMed

Taylor, David McDonald; Dhir, Reetika; Craig, Simon S; Lammers, Thalia; Gardiner, Kaya; Hunter, Kirrily; Joffe, Paul; Krieser, David; Babl, Franz E

2015-09-01

To determine the period prevalence and nature of complementary and alternative medicine (CAM) use among paediatric emergency department (ED) patients and the perceptions of CAM among the CAM administrators. A survey was undertaken in four Victorian EDs (January to September 2013). A convenience sample of parents/carers accompanying paediatric patients completed a self-administered questionnaire. The main outcome measures were CAM use and perceptions of CAM. The parents/carers of 883 patients participated. Three hundred eighty-eight (43.9%, 95% confidence interval (CI) 40.6-47.3) and 53 (6.0%, 95% CI 4.6-7.8) patients had taken a CAM within the previous 12 months and on the day of presentation, respectively. There were no gender differences between CAM users and non-users (P = 0.83). The use of CAM was significantly more common among older patients (P < 0.001), those with European ethnicity (P = 0.046) and among those with chronic disease (P < 0.01). Fish oil, garlic, chamomile and acidophilus were the most commonly used CAM. Only 4.4% of CAM use was reported to the ED doctor. There were reports of potentially dangerous CAM use (St John's wort, ginseng). Parents/carers who had administered CAM were more likely to report that CAMs are safe, drug free and could prevent illness (P < 0.01). In addition, a number of this group reported that CAMs are more effective than prescription medicines and safe when taken with prescription medicines. CAM use is common among paediatric ED patients although rarely reported to the ED doctor. Parents/carers who administer CAM have differing perceptions of CAM safety from those who do not. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Classification of CAM use and its correlates in patients with early-stage breast cancer.

PubMed

Saquib, Juliann; Madlensky, Lisa; Kealey, Sheila; Saquib, Nazmus; Natarajan, Loki; Newman, Vicky A; Patterson, Ruth E; Pierce, John P

2011-06-01

Self-reported use of complementary and alternative medicine (CAM) has been shown to increase following a cancer diagnosis, and breast cancer survivors are the heaviest users among cancer survivors. The aim of this study was to determine whether the prevalence estimate of CAM use varied according to classification of CAM. The authors used a comprehensive system to classify CAM users and test differences in demographic, lifestyle, quality of life, and cancer characteristics among them. Participants were 2562 breast cancer survivors participating in the Women's Healthy Eating and Living (WHEL) Study, aged 28 to 74 years. A structured telephone interview assessed CAM use, questioning about specific CAM practices, and whether use was related to cancer. This study examined CAM use in relation to demographics, health behaviors, and quality of life. Approximately 80% of the women used CAM for general purposes but only 50% reported CAM use for cancer purposes. Visual imagery, spiritual healing, and meditation were the most frequently used practices for cancer purposes. CAM use, defined as consulting a CAM practitioner and regular use, was significantly related to younger age, higher education, increased fruit and vegetable intake, and lower body mass index (P < .05). CAM users who had seen a practitioner were also more likely to report poor physical and mental health than non-CAM users (P < .05). CAM use was not associated with changes in physical and mental health between study baseline and 1-year follow-up. This study addressed important differences in the classification of CAM use among breast cancer survivors. Future studies need to further test the potential benefits and risks associated with CAM use.

EpCAM and the biology of hepatic stem/progenitor cells

PubMed Central

Theise, Neil D.; Schmelzer, Eva; Boulter, Luke; Gires, Olivier; van Grunsven, Leo A.

2014-01-01

Epithelial cell adhesion molecule (EpCAM) is a transmembrane glycoprotein, which is frequently and highly expressed on carcinomas, tumor-initiating cells, selected tissue progenitors, and embryonic and adult stem cells. During liver development, EpCAM demonstrates a dynamic expression, since it can be detected in fetal liver, including cells of the parenchyma, whereas mature hepatocytes are devoid of EpCAM. Liver regeneration is associated with a population of EpCAM-positive cells within ductular reactions, which gradually lose the expression of EpCAM along with maturation into hepatocytes. EpCAM can be switched on and off through a wide panel of strategies to fine-tune EpCAM-dependent functional and differentiative traits. EpCAM-associated functions relate to cell–cell adhesion, proliferation, maintenance of a pluripotent state, regulation of differentiation, migration, and invasion. These functions can be conferred by the full-length protein and/or EpCAM-derived fragments, which are generated upon regulated intramembrane proteolysis. Control by EpCAM therefore not only depends on the presence of full-length EpCAM at cellular membranes but also on varying rates of the formation of EpCAM-derived fragments that have their own regulatory properties and on changes in the association of EpCAM with interaction partners. Thus spatiotemporal localization of EpCAM in immature liver progenitors, transit-amplifying cells, and mature liver cells will decisively impact the regulation of EpCAM functions and might be one of the triggers that contributes to the adaptive processes in stem/progenitor cell lineages. This review will summarize EpCAM-related molecular events and how they relate to hepatobiliary differentiation and regeneration. PMID:25477371

Chair Talk: Resources to Maximize Administrative Efforts

NASA Astrophysics Data System (ADS)

MacDonald, H.; Chan, M. A.; Bierly, E. W.; Manduca, C. A.; Ormand, C. J.

2009-12-01

Earth science department chairs are generally scientists who have little/no formal administrative training. The common rotation of faculty members in three-six year cycles distributes the heavy leadership responsibilities but involves little preparation beforehand to deal with budgets, fundraising, personnel issues, confrontations, and crises. The amount of information exchange and support upon exit and handoff to the next chair is variable. Resources for chairs include workshops, meetings (ranging from annual meetings of geoscience chairs to monthly meetings of small groups of chairs from various disciplines on a campus), discussions, and online resources. These resources, some of which we designed in the past several years, provide information and support for chairs, help them share best practices, and reduce time spent “reinventing the wheel”. Most of these resources involve groups of chairs in our discipline who meet together. The AGU Board of Heads and Chairs of Earth and Space Science Departments offers annual one-day workshops at the Fall AGU meeting. The specific topics vary from year to year; they have included goals and roles of heads and chairs, fundraising and Advisory Boards, student recruitment, interdisciplinarity, dual-career couples, and undergraduate research. The workshop provides ample opportunities for open discussion. Annual one-two day meetings of groups of geoscience department chairs (e.g., research universities in a particular region) provide an opportunity for chairs to share specific data about their departments (e.g., salaries, graduate student stipends, information about facilities) and discuss strategies. At the College of William and Mary, a small group of chairs meets monthly throughout the year; each session includes time for open discussion as well as a more structured discussion on a particular topic (e.g., merit review, development and fundraising, mentoring early career faculty and the tenure process, leadership styles, dealing with difficult situations, working with alumni). Through the Association for Women Geoscientists, we have offered annual one-hour lunch discussions at AGU and GSA meetings on issues facing women chairs and deans. Focusing on a different topic each year, these discussions include sharing good solutions, problem solving on various case scenarios, and so forth. In addition, the Building Strong Geoscience Departments program has offered workshops on different aspects of building strong geoscience departments, distributed reports, and made a variety of materials that would be useful to geoscience chairs available on their website. These programs and resources should continue and build to provide more continuity within departments and to increase a broader experience base of faculty. One of the greatest resources for chairs is to have personal connections with other chairs (via these programs), who can be called upon for advice, ideas, or general support. The sense of collective community could act in a powerful way to inspire and encourage more innovations and creative solutions to promote stronger departments.

Use of complementary and alternative medicine before and after organ removal due to urologic cancer

PubMed Central

Mani, Jens; Juengel, Eva; Arslan, Ilhan; Bartsch, Georg; Filmann, Natalie; Ackermann, Hanns; Nelson, Karen; Haferkamp, Axel; Engl, Tobias; Blaheta, Roman A

2015-01-01

Objective Many patients use complementary and alternative medicine (CAM) as primary treatment or symptom relief for a variety of illnesses. This study was designed to investigate the influence of surgical removal of a tumor-bearing urogenital organ on CAM use. Methods From 2007 to 2011, 350 patients underwent major urological surgery for kidney, prostate, or bladder cancer at the Goethe-University Hospital, Frankfurt, Germany. Data from 172 patients (49%), who returned a questionnaire, were retrospectively evaluated using the hospital information system along with the questionnaire to objectify CAM use 2 years before and after surgery. Results From the 172 patients returning questionnaires, 56 (33%) used CAM before and/or after surgery and 116 (67%) never used CAM. Of the 56 CAM users, 30 (54%) used CAM presurgery and 53 (95%) used CAM postsurgery, indicating a significant change of mind about CAM use. Patients of German nationality used CAM significantly more than patients of other nationalities. Higher educational status (high-school diploma or higher) was a significant factor in favor of CAM use. The most common type of CAM used before/after surgery was an alternative medical system (63/49%), a manipulative and body-based method (50/19%), and a biological-based therapy (37/32%). Information about CAM, either provided by medical professionals or by other sources, was the main reason determining whether patients used CAM or not. Conclusion The number of patients using CAM almost doubled after surgical removal of a cancer-bearing organ. Better awareness and understanding of CAM use by medical professionals could improve patient counseling. PMID:26491269

The welcoming attitude of dermatologists towards complementary and alternative medicine despite their lack of knowledge and training.

PubMed

AlGhamdi, Khalid M; Khurrum, Huma; Asiri, Yousif

2017-09-01

Background / aim: Although complementary and alternative medicine (CAM) use is highly prevalent, there is very limited information on dermatologists' attitudes and knowledge about CAM. In this survey, we aimed to study the knowledge and attitude of dermatologists in Saudi Arabia towards CAM. Furthermore, we assessed dermatologists' intention to receive CAM education and training. Methods and design: We collected data through an online cross-sectional survey sent to email addresses of dermatologists in Saudi Arabia. Questions included socio-demographic data, knowledge and attitudes towards CAM practice. Results: A total of 93 questionnaires were returned from dermatologists in various regions of Saudi Arabia. The mean age was 41.7 ± 10.3 (range, 25-63) years. A total of 67% of dermatologists had welcoming attitudes towards CAM. We did not find any significant relationship between age, gender, experience or any other factor and positive attitudes towards CAM. More than 70% of participants reported an interest in learning about CAM. However, only 9 (9.7%) dermatologists had attended CAM courses. Sixty-one participants (65.6%) were eager to receive CAM-specific education, and 66% of dermatologists acknowledged having previously discussed CAM with their patients. The most important reason that dermatologists did not discuss CAM with their patients was a lack of studies supporting CAM (66.7%) and the belief that doctors' knowledge on CAM is insufficient (58.1%). Conclusion: A greater number of dermatologists have an affirmative attitude towards CAM. The willingness to improve knowledge and training indicates that the CAM field could potentially grow in dermatology.

Pattern and predictors of complementary and alternative medicine (CAM) use among pediatric patients with epilepsy.

PubMed

Doering, Jan H; Reuner, Gitta; Kadish, Navah E; Pietz, Joachim; Schubert-Bast, Susanne

2013-10-01

Parents of pediatric patients with chronic conditions such as epilepsy increasingly opt for complementary and alternative medicine (CAM). However, data on the pattern and reasons of CAM use in childhood epilepsy are scarce. The objectives of this study were as follows: first, to characterize CAM use among pediatric patients with epilepsy by assessing its spectrum, prevalence, costs, and frequency of use; second, to evaluate the influence of CAM use on compliance and satisfaction with conventional care as well as to explore parent-child neurologist communication concerning CAM; and third, to investigate predictors of CAM use. A postal survey was administered to all parents of pediatric outpatients with epilepsy aged 6 to 12, who have received treatment at the neuropediatric outpatient clinic of the University Children's Hospital Heidelberg between 2007 and 2009. One hundred thirty-two of the 297 distributed questionnaires were suitable for inclusion in statistical analysis (44.7%). Forty-nine participants indicated that their children used CAM during the previous year (37.1%). Thirty different types of CAM were used, with homeopathy (55.1%), osteopathy (24.5%), and kinesiology (16.3%) being the most commonly named. A mean of 86€ (0€-500€) and 3h (1 h-30 h) per month was committed to CAM treatment. Only 53% of the users informed their child neurologist of the additional CAM treatment, while 85.6% of all parents wished to discuss CAM options with their child neurologist. Seventy-five percent of users considered the CAM treatment effective. Among the participants most likely to seek CAM treatment are parents whose children show a long duration of epileptic symptoms, parents who make use of CAM treatment themselves, and parents who value a holistic and natural treatment approach. A substantial portion of pediatric patients with epilepsy receive CAM treatment. The high prevalence of use and significant level of financial and time resources spent on CAM indicate the high importance of these treatment options for parents. On the other hand, communication concerning CAM with the child neurologist is largely insufficient despite the wish to speak about CAM. Complementary and alternative medicine users' high compliance with conventional treatment and high perceived effectiveness of CAM support an integrative approach to CAM for pediatric patients with epilepsy. Our study implies that in addition to open parent-child neurologist communication, active inquiry on CAM treatments is necessary to enable informed decision making by parents and to establish the suitability of CAM treatment for the patient. Reliable predictors for CAM use, which allow for improved identification of patients with a high likelihood to receive CAM treatment, are the duration of the illness, use of CAM by the parents themselves, and the desire of the parents to receive a holistic and natural treatment for their child. © 2013.

Does Using a Chair Backrest or Reducing Seated Hip Flexion Influence Trunk Muscle Activity and Discomfort? A Systematic Review.

PubMed

Curran, Máire; O'Sullivan, Leonard; O'Sullivan, Peter; Dankaerts, Wim; O'Sullivan, Kieran

2015-11-01

This paper systematically reviews the effect of chair backrests and reducing seated hip flexion on low back discomfort (LBD) and trunk muscle activation. Prolonged sitting commonly exacerbates low back pain (LBP). Several modifications to seated posture and chair design have been recommended, including using chairs with backrests and chairs that reduce hip flexion. Electronic databases were searched by two independent assessors. Part 1 of this review includes 26 studies comparing the effect of sitting with at least two different hip angles. In Part 2, seven studies that compared the effect of sitting with and without a backrest were eligible. Study quality was assessed using the PEDro scale. Significant confounding variables and a relatively small number of randomized controlled trials (RCTs) involving people with LBP complicates analysis of the results. There was moderate evidence that chair backrests reduce paraspinal muscle activation, and limited evidence that chair backrests reduce LBD. There was no evidence that chairs involving less hip flexion reduce LBP or LBD, or consistently alter trunk muscle activation. However, participants in several studies subjectively preferred the modified chairs involving less hip flexion. The limited evidence to support the use of chairs involving less seated hip flexion, or the effect of a backrest, is consistent with the limited evidence that other isolated chair design features can reduce LBP. LBP management is likely to require consideration of several factors in addition to sitting position. Larger RCTs involving people with LBP are required. © 2015, Human Factors and Ergonomics Society.

Geneva mechanism. [including star wheel and driver

NASA Technical Reports Server (NTRS)

Summers, R. H.; Kenney, R. L. (Inventor)

1974-01-01

An improved Geneva mechanism is characterized by a driven star-wheel having a segmented cam-follower surface. Star-wheel driver includes a restraining cam having a segmented cam surface for engaging the cam-follower surface of the star-wheel and antifriction rollers pinned to the restraining cam for engaging the cam-follower surface.

Crassulacean acid metabolism and fitness under water deficit stress: if not for carbon gain, what is facultative CAM good for?

PubMed Central

Herrera, Ana

2009-01-01

Background In obligate Crassulacean acid metabolism (CAM), up to 99 % of CO2 assimilation occurs during the night, therefore supporting the hypothesis that CAM is adaptive because it allows CO2 fixation during the part of the day with lower evaporative demand, making life in water-limited environments possible. By comparison, in facultative CAM (inducible CAM, C3-CAM) and CAM-cycling plants drought-induced dark CO2 fixation may only be, with few exceptions, a small proportion of C3 CO2 assimilation in watered plants and occur during a few days. From the viewpoint of survival the adaptive advantages, i.e. increased fitness, of facultative CAM and CAM-cycling are not obvious. Therefore, it is hypothesized that, if it is to increase fitness, CAM must aid in reproduction. Scope An examination of published reports of 23 facultative CAM and CAM-cycling species finds that, in 19 species, drought-induced dark CO2 fixation represents on average 11 % of C3 CO2 assimilation of watered plants. Evidence is discussed on the impact of the operation of CAM in facultative and CAM-cycling plants on their survival – carbon balance, water conservation, water absorption, photo-protection of the photosynthetic apparatus – and reproductive effort. It is concluded that in some species, but not all, facultative and cycling CAM contribute, rather than to increase carbon balance, to increase water-use efficiency, water absorption, prevention of photoinhibition and reproductive output. PMID:18708641

Crassulacean acid metabolism and fitness under water deficit stress: if not for carbon gain, what is facultative CAM good for?

PubMed

Herrera, Ana

2009-02-01

In obligate Crassulacean acid metabolism (CAM), up to 99 % of CO(2) assimilation occurs during the night, therefore supporting the hypothesis that CAM is adaptive because it allows CO(2) fixation during the part of the day with lower evaporative demand, making life in water-limited environments possible. By comparison, in facultative CAM (inducible CAM, C(3)-CAM) and CAM-cycling plants drought-induced dark CO(2) fixation may only be, with few exceptions, a small proportion of C(3) CO(2) assimilation in watered plants and occur during a few days. From the viewpoint of survival the adaptive advantages, i.e. increased fitness, of facultative CAM and CAM-cycling are not obvious. Therefore, it is hypothesized that, if it is to increase fitness, CAM must aid in reproduction. Scope An examination of published reports of 23 facultative CAM and CAM-cycling species finds that, in 19 species, drought-induced dark CO(2) fixation represents on average 11 % of C(3) CO(2) assimilation of watered plants. Evidence is discussed on the impact of the operation of CAM in facultative and CAM-cycling plants on their survival--carbon balance, water conservation, water absorption, photo-protection of the photosynthetic apparatus--and reproductive effort. It is concluded that in some species, but not all, facultative and cycling CAM contribute, rather than to increase carbon balance, to increase water-use efficiency, water absorption, prevention of photoinhibition and reproductive output.

7 CFR 1900.6 - Chair, Loan Resolution Task Force.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 12 2010-01-01 2010-01-01 false Chair, Loan Resolution Task Force. 1900.6 Section... AGRICULTURE PROGRAM REGULATIONS GENERAL Delegations of Authority § 1900.6 Chair, Loan Resolution Task Force. The Chair, Loan Resolution Task Force is delegated the following authorities, to be exercised until...

Department Chair Advice on Teaching and Research at U.S. Research Universities

ERIC Educational Resources Information Center

Taggart, Gabel

2015-01-01

Using data from a 2010 survey of academic chairs, this study reports on academic department chairs' recommended time allocations to new assistant professors. I contend that personal values about research and teaching influence the department chair's recommendations along with organizational characteristics. Multi-level modeling indicates that…

Science Instructional Leadership: The Role of the Department Chair

ERIC Educational Resources Information Center

Peacock, Jeremy S.

2014-01-01

With science teachers facing comprehensive curriculum reform that will shape science education for decades to come, high school department chairs represent a critical resource for instructional leadership and teacher support. While the historical literature on the department chair indicates that chairs are in prime positions to provide…

21 CFR 886.1140 - Ophthalmic chair.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ophthalmic chair. 886.1140 Section 886.1140 Food... DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1140 Ophthalmic chair. (a) Identification. An ophthalmic chair is an AC-powered or manual device with adjustable positioning in which a patient is to sit...

A Prospective, Multicenter Study of Complementary/Alternative Medicine (CAM) Utilization During Definitive Radiation for Breast Cancer

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

Moran, Meena S., E-mail: meena.moran@yale.edu; Department of Radiation Therapy, William W. Backus Hospital, Norwich, Connecticut; Ma Shuangge

Purpose: Although complementary and alternative medicine (CAM) utilization in breast cancer patients is reported to be high, there are few data on CAM practices in breast patients specifically during radiation. This prospective, multi-institutional study was conducted to define CAM utilization in breast cancer during definitive radiation. Materials/Methods: A validated CAM instrument with a self-skin assessment was administered to 360 Stage 0-III breast cancer patients from 5 centers during the last week of radiation. All data were analyzed to detect significant differences between users/nonusers. Results: CAM usage was reported in 54% of the study cohort (n=194/360). Of CAM users, 71% reportedmore » activity-based CAM (eg, Reiki, meditation), 26% topical CAM, and 45% oral CAM. Only 16% received advice/counseling from naturopathic/homeopathic/medical professionals before initiating CAM. CAM use significantly correlated with higher education level (P<.001), inversely correlated with concomitant hormone/radiation therapy use (P=.010), with a trend toward greater use in younger patients (P=.066). On multivariate analysis, level of education (OR: 6.821, 95% CI: 2.307-20.168, P<.001) and hormones/radiation therapy (OR: 0.573, 95% CI: 0.347-0.949, P=.031) independently predicted for CAM use. Significantly lower skin toxicity scores were reported in CAM users vs nonusers, respectively (mild: 34% vs 25%, severe: 17% vs 29%, P=.017). Conclusion: This is the first prospective study to assess CAM practices in breast patients during radiation, with definition of these practices as the first step for future investigation of CAM/radiation interactions. These results should alert radiation oncologists that a large percentage of breast cancer patients use CAM during radiation without disclosure or consideration for potential interactions, and should encourage increased awareness, communication, and documentation of CAM practices in patients undergoing radiation treatment for breast cancer.« less

Quality of Life in CAM and Non-CAM Users among Breast Cancer Patients during Chemotherapy in Malaysia

PubMed Central

Chui, Ping Lei; Abdullah, Khatijah Lim; Wong, Li Ping; Taib, Nur Aishah

2015-01-01

Background Complementary and alternative medicine (CAM) use has become increasingly popular among patients with cancer. The purposes of this study were to compare the QOL in CAM users and non-CAM users and to determine whether CAM use influences QOL among breast cancer patients during chemotherapy. Methodology A cross-sectional survey was conducted at two outpatient chemotherapy centers. A total of 546 patients completed the questionnaires on CAM use. QOL was evaluated based on the European Organization for Research and Treatment of Cancer (EORTC) core quality of life (QLQ-C30) and breast cancer-specific quality of life (QLQ-BR23) questionnaires. Results A total of 70.7% of patients were identified as CAM users. There was no significant difference in global health status scores and in all five subscales of the QLQ C30 functional scales between CAM users and non-CAM users. On the QLQ-C30 symptom scales, CAM users (44.96±3.89) had significantly (p = 0.01) higher mean scores for financial difficulties than non-CAM users (36.29±4.81). On the QLQ-BR23 functional scales, CAM users reported significantly higher mean scores for sexual enjoyment (6.01±12.84 vs. 4.64±12.76, p = 0.04) than non-CAM users. On the QLQ-BR23 symptom scales, CAM users reported higher systemic therapy side effects (41.34±2.01 vs. 37.22±2.48, p = 0.04) and breast symptoms (15.76±2.13 vs. 11.08±2.62, p = 0.02) than non-CAM users. Multivariate logistic regression analysis indicated that the use of CAM modality was not significantly associated with higher global health status scores (p = 0.71). Conclusion While the findings indicated that there was no significant difference between users and non-users of CAM in terms of QOL, CAM may be used by health professionals as a surrogate to monitor patients with higher systemic therapy side effects and breast symptoms. Furthermore, given that CAM users reported higher financial burdens (which may have contributed to increased distress), patients should be encouraged to discuss the potential benefits and/or disadvantages of using CAM with their healthcare providers. PMID:26451732

Prayer-for-health and complementary alternative medicine use among Malaysian breast cancer patients during chemotherapy.

PubMed

Chui, Ping Lei; Abdullah, Khatijah Lim; Wong, Li Ping; Taib, Nur Aishah

2014-10-30

The inclusion of prayer-for-health (PFH) in the definition of complementary alternative medicine (CAM) has resulted in higher levels of CAM use. The objective of this study was to assess PFH and CAM use among breast cancer patients undergoing chemotherapy. A cross-sectional study was performed at two chemotherapy providers. Patients were questioned about use of three categories of CAM, mind-body practices (MBPs), natural products (NPs) and traditional medicine (TM). PFH was also examined separately from CAM to better characterise the patterns of CAM and PFH used during chemotherapy. A total of 546 eligible patients participated in the study; 70.7% (n = 386) reported using some form of CAM, and 29.3% (n = 160) were non-CAM users. When PFH was excluded as a CAM, fewer patients reported the use of CAM (66.1%; n = 361). The total number of patients who used MBPs decreased from 342 to 183. The most common CAM use category was NPs (82.8%), followed by MBPs (50.7%), and TM (35.7%). CAM users were more likely to have a tertiary education (OR 2.11, 95% CI 1.15-3.89 vs. primary/lower), have household incomes > RM 3,000 (≈944 USD) per month (OR 2.32, 95% CI 1.40-3.84 vs. ≤RM 3,000 (≈944 USD)), and have advanced cancer (OR 1.75, 95% CI 1.18-2.59 vs. early stage cancer), compared with non-CAM users. The CAM users were less likely to have their chemotherapy on schedule (OR 0.24, 95% CI 0.10-0.58 vs. chemotherapy postponed) than non-CAM users. Most MBPs were perceived to be more helpful by their users, compared with the users of NPs and TM. CAM use was prevalent among breast cancer patients. Excluding PFH from the definition of CAM reduced the prevalence of overall CAM use. Overall, CAM use was associated with higher education levels and household incomes, advanced cancer and lower chemotherapy schedule compliance. Many patients perceived MBP to be beneficial for improving overall well-being during chemotherapy. These findings, while preliminary, clearly indicate the differences in CAM use when PFH is included in, and excluded from, the definition of CAM.

Collecting Information About a CAM Practitioner’s Practice: A Preliminary Report of a Self-Interview Methodology

PubMed Central

Elder, William G.; Purdy, Hunter; Bentley, Andrew

2009-01-01

To prepare allopathic providers to advise patients about complementary and alternative medicine (CAM) therapies, the University of Kentucky CAM curriculum integration project has identified and trained CAM practitioners to coteach, precept, and demonstrate their respective practices. This project is interested in integrating CAM practitioners as teachers into this university and has formed a multidisciplinary committee for advice. The committee has recognized the importance of increased understanding of CAM practices to enhance communication within itself and to decide to which CAM practices students should receive exposure. This article reports our attempt to create a CAM practice description, based on questions general to CAM practice and specific to a particular approach. Because there is limited existing systematic research on CAM practice characteristics, these questions may interest researchers conducting qualitative studies, especially those seeking an example of questions to ask CAM practitioners. We also believe this practice description will be of general interest. PMID:19890441

Association of complementary and alternative medicine use with highly active antiretroviral therapy initiation.

PubMed

Merenstein, Daniel; Yang, Yang; Schneider, Michael F; Goparaju, Lakshmi; Weber, Kathleen; Sharma, Anjali; Levine, Alexandra M; Sharp, Gerald B; Gandhi, Monica; Liu, Chenglong

2008-01-01

To assess whether complementary and alternative medicine (CAM) use is associated with the timing of highly active antiretroviral therapy (HAART) initiation among human immunodeficiency virus (HIV)-infected participants of the Women's Interagency HIV Study. Prospective cohort study between January 1996 and March 2002. Differences in the cumulative incidence of HAART initiation were compared between CAM users and non-CAM users using a logrank test. Cox regression model was used to assess associations of CAM exposures with time to HAART initiation. MAIN OUTCOME AND EXPOSURES: Study outcome was time from January 1996 to initiation of HAART. Primary exposure was use of any CAM modality before January 1996, and secondary exposures included the number and type of CAM modalities used (ingestible CAM medication, body practice, or spiritual healing) during the same period. One thousand thirty-four HIV-infected women contributed a total of 4987 person-visits during follow-up. At any time point, the cumulative incidence of HAART initiation among CAM users was higher than that among non-CAM users. After adjustment for potential confounders, those reporting CAM use were 1.34 times (95% confidence interval: 1.09, 1.64) more likely to initiate HAART than non-CAM users. Female CAM users initiated HAART regimens earlier than non-CAM users. Initiation of HAART is an important clinical marker, but more research is needed to elucidate the role specific CAM modalities play in HIV disease progression.

Disclosure of Complementary and Alternative Medicine to Conventional Medical Providers: Variation by Race/Ethnicity and Type of CAM

PubMed Central

Chao, Maria T.; Wade, Christine; Kronenberg, Fredi

2009-01-01

Background Complementary and alternative medicine (CAM) is often used alongside conventional medical care, yet fewer than half of patients disclose CAM use to medical doctors. CAM disclosure is particularly low among racial/ethnic minorities, but reasons for differences, such as type of CAM used or quality of conventional healthcare, have not been explored. Objective We tested the hypotheses that disclosure of CAM use to medical doctors is higher for provider-based CAM and among non-Hispanic whites, and that access to and quality of conventional medical care account for racial/ethnic differences in CAM disclosure. Methods Bivariate and multiple variable analyses of the 2002 National Health Interview Survey and 2001 Health Care Quality Survey were performed. Results Disclosure of CAM use to medical providers was higher for provider-based than self-care CAM. Disclosure of any CAM was associated with access to and quality of conventional care and higher among non-Latino whites relative to minorities. Having a regular doctor and quality patient–provider relationship mitigated racial/ethnic differences in CAM disclosure. Conclusion Insufficient disclosure of CAM use to conventional providers, particularly for self-care practices and among minority populations, represents a serious challenge in medical encounter communications. Efforts to improve disclosure of CAM use should be aimed at improving consistency of care and patient–physician communication across racial/ethnic groups. PMID:19024232

Consequences of systematic model drift in DYNAMO MJO hindcasts with SP-CAM and CAM5

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

Hannah, Walter M.; Maloney, Eric D.; Pritchard, Michael S.

Hindcast simulations of MJO events during the dynamics of the MJO (DYNAMO) field campaign are conducted with two models, one with conventional parameterization (CAM5) and a comparable model that utilizes superparameterization (SP–CAM). SP–CAM is shown to produce a qualitatively better reproduction of the fluctuations of precipitation and low–level zonal wind associated with the first two DYNAMO MJO events compared to CAM5. Interestingly, skill metrics using the real–time multivariate MJO index (RMM) suggest the opposite conclusion that CAM5 has more skill than SP–CAM. This inconsistency can be explained by a systematic increase of RMM amplitude with lead time, which results frommore » a drift of the large–scale wind field in SP–CAM that projects strongly onto the RMM index. CAM5 hindcasts exhibit a contraction of the moisture distribution, in which extreme wet and dry conditions become less frequent with lead time. SP–CAM hindcasts better reproduce the observed moisture distribution, but also have stronger drift patterns of moisture budget terms, such as an increase in drying by meridional advection in SP–CAM. This advection tendency in SP–CAM appears to be associated with enhanced off–equatorial synoptic eddy activity with lead time. In conclusion, systematic drift moisture tendencies in SP–CAM are of similar magnitude to intraseasonal moisture tendencies, and therefore are important for understanding MJO prediction skill.« less

Complementary and conventional medicine: a concept map

PubMed Central

Baldwin, Carol M; Kroesen, Kendall; Trochim, William M; Bell, Iris R

2004-01-01

Background Despite the substantive literature from survey research that has accumulated on complementary and alternative medicine (CAM) in the United States and elsewhere, very little research has been done to assess conceptual domains that CAM and conventional providers would emphasize in CAM survey studies. The objective of this study is to describe and interpret the results of concept mapping with conventional and CAM practitioners from a variety of backgrounds on the topic of CAM. Methods Concept mapping, including free sorts, ratings, and multidimensional scaling was used to organize conceptual domains relevant to CAM into a visual "cluster map." The panel consisted of CAM providers, conventional providers, and university faculty, and was convened to help formulate conceptual domains to guide the development of a CAM survey for use with United States military veterans. Results Eight conceptual clusters were identified: 1) Self-assessment, Self-care, and Quality of Life; 2) Health Status, Health Behaviors; 3) Self-assessment of Health; 4) Practical/Economic/ Environmental Concerns; 5) Needs Assessment; 6) CAM vs. Conventional Medicine; 7) Knowledge of CAM; and 8) Experience with CAM. The clusters suggest panelists saw interactions between CAM and conventional medicine as a critical component of the current medical landscape. Conclusions Concept mapping provided insight into how CAM and conventional providers view the domain of health care, and was shown to be a useful tool in the formulation of CAM-related conceptual domains. PMID:15018623

Complementary alternative medicine for children with autism: a physician survey.

PubMed

Golnik, Allison E; Ireland, Marjorie

2009-07-01

Previous studies suggest over half of children with autism are using complementary alternative medicine (CAM). In this study, physicians responded (n = 539, 19% response rate) to a survey regarding CAM use in children with autism. Physicians encouraged multi-vitamins (49%), essential fatty acids (25%), melatonin (25%) and probiotics (19%) and discouraged withholding immunizations (76%), chelation (61%), anti-infectives (57%), delaying immunizations (55%) and secretin (43%). Physicians encouraging CAM were more likely to desire CAM training, inquire about CAM use, be female, be younger, and report greater autism visits, autism education and CAM knowledge. Physicians were more likely to desire CAM training, inquire about CAM and view CAM as a challenge for children with autism compared to children with other neurodevelopmental and chronic/complex conditions.

Abnormal placental development and early embryonic lethality in EpCAM-null mice.

PubMed

Nagao, Keisuke; Zhu, Jianjian; Heneghan, Mallorie B; Hanson, Jeffrey C; Morasso, Maria I; Tessarollo, Lino; Mackem, Susan; Udey, Mark C

2009-12-31

EpCAM (CD326) is encoded by the tacstd1 gene and expressed by a variety of normal and malignant epithelial cells and some leukocytes. Results of previous in vitro experiments suggested that EpCAM is an intercellular adhesion molecule. EpCAM has been extensively studied as a potential tumor marker and immunotherapy target, and more recent studies suggest that EpCAM expression may be characteristic of cancer stem cells. To gain insights into EpCAM function in vivo, we generated EpCAM -/- mice utilizing an embryonic stem cell line with a tacstd1 allele that had been disrupted. Gene trapping resulted in a protein comprised of the N-terminus of EpCAM encoded by 2 exons of the tacstd1 gene fused in frame to betageo. EpCAM +/- mice were viable and fertile and exhibited no obvious abnormalities. Examination of EpCAM +/- embryos revealed that betageo was expressed in several epithelial structures including developing ears (otocysts), eyes, branchial arches, gut, apical ectodermal ridges, lungs, pancreas, hair follicles and others. All EpCAM -/- mice died in utero by E12.5, and were small, developmentally delayed, and displayed prominent placental abnormalities. In developing placentas, EpCAM was expressed throughout the labyrinthine layer and by spongiotrophoblasts as well. Placentas of EpCAM -/- embryos were compact, with thin labyrinthine layers lacking prominent vascularity. Parietal trophoblast giant cells were also dramatically reduced in EpCAM -/- placentas. EpCAM was required for differentiation or survival of parietal trophoblast giant cells, normal development of the placental labyrinth and establishment of a competent maternal-fetal circulation. The findings in EpCAM-reporter mice suggest involvement of this molecule in development of vital organs including the gut, kidneys, pancreas, lungs, eyes, and limbs.

Use of complementary and alternative medicine (CAM) in autism spectrum disorder (ASD): comparison of Chinese and western culture (Part A).

PubMed

Wong, V C N

2009-03-01

A cross-sectional survey of the use of CAM by children was undertaken in the Duchess of Kent Children's Hospital in Hong Kong (March-December 2006). A questionnaire survey concerning the use of CAM was administered to chief caretakers (only the mothers) who accompanied children with neurodevelopmental disabilities followed up in our Neurodevelopmental paediatrics clinics. Four hundred and thirty agreed for interview of which 98 (22.8%) had Autism Spectrum Disorder (ASD). CAM was used in 40.8% for ASD and 21.4% of non-ASD (p < 0.001). We describe the profile of use of CAM in ASD in this part A paper. The three most common type of CAM use was Acupuncture (47.5%), Sensory Integration (42.5%), and Chinese Medicine (30%). About 76.9% of interviewees expected CAM to augment conventional treatment. Although 47.5% used both conventional western medicine and CAM, only 22.4% disclosed the use of CAM to Doctors. The following factors were significantly related to CAM use: father's job and mother's religion. Our frequency of CAM used in children with ASD was lower in Canada (52%) and USA (74%, 92%). The main CAM use in western culture was biological-based therapy whereas acupuncture was the most common CAM used in our locality.

Integrating CAM into nursing curricula: CAM camp as an educational intervention.

PubMed

Cornman, B Jane; Carr, Catherine A; Heitkemper, Margaret M

2006-05-01

In 2002, the University of Washington School of Nursing (SON) partnered with Bastyr University on a five-year plan to offer a four-week intensive "CAM Camp" (CAMp) for SON faculty members and medical students from across the country. The four-week educational program introduced attendees to various complementary and alternative medicine (CAM) modalities through didactic and experiential learning. To enhance complementary and alternative medicine content in a SON curriculum and to increase SON faculty knowledge and understanding about (1) the range of CAM therapies, (2) the theoretic and cultural backgrounds of these therapies, and (3) their potential contributions to the health of diverse populations. A descriptive pretest, posttest design was used to compare pre-CAMp CAM knowledge and CAM course content with post-CAMp knowledge levels of faculty and course CAM content. On post-CAMp surveys, familiarity with CAM modalities was rated with mixed results as compared with positive reports on the qualitative interviews. Interview results were more positive about CAM in general and were less specific about individual CAM topics. Statistically significant increases in competences were evident in each of 13 competencies rated with four competencies at P < .01. The number of required and elective courses containing CAM content increased as did the CAM content in continuing education conferences offered by the SON.

Valve actuator for internal combustion engine

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

Uchida, T.

1987-06-16

A valve actuating mechanism is described for an overhead valve and overhead cam type internal combustion engine in which the camshaft is positioned above and between the valve and a cam follower seat member in a cylinder head of the engine. The cam follower seat member is threadedly mounted in the cylinder head and has a semi-spherical recess facing upwardly. A cam follower has an adjustable bolt threadedly received in one end of the cam follower. The adjustable bolt has a spherical fulcrum engaging the semispherical recess of the seat member. The cam follower also has a downwardly facing meansmore » on the other end for engaging the valve and an upwardly facing slipper face for sliding engagement with a cam on the camshaft. The cam is adapted to rotate across the slipper face in the direction of the valve. The slipper face has a surface shape for engaging the cam at the start of valve-lifting movement of the cam follower at a point through which a line tangent to the slipper face is substantially parallel to a line through contact points between the cam follower. The seat member and valve for minimizing the lateral forces are imposed on the cam follower by the cam at the start of the valve-lifting movement.« less

Evaluation of complementary-alternative medicine (CAM) questionnaire development for Indonesian clinical psychologists: A pilot study.

PubMed

Liem, Andrian; Newcombe, Peter A; Pohlman, Annie

2017-08-01

This study aimed to evaluate questionnaire development to measure the knowledge of Complementary-Alternative Medicine (CAM), attitudes towards CAM, CAM experiences, and CAM educational needs of clinical psychologists in Indonesia. A 26-item questionnaire was developed through an extensive literature search. Data was obtained from provisional psychologists from the Master of Professional Clinical Psychology programs at two established public universities in urban areas of Indonesia. To validate the questionnaire, panel reviews by executive members of the Indonesian Clinical Psychology Association (ICPA), experts in health psychology, and experts in public health and CAM provided their professional judgements. The self-reporting questionnaire consisted of four scales including: knowledge of CAM (6 items), attitudes towards CAM (10 items), CAM experiences (4 items), and CAM educational needs (6 items). All scales, except CAM Experiences, were assessed on a 7-point Likert scale. Sixty provisional psychologists were eligible to complete the questionnaire with a response rate of 73% (N=44). The results showed that the CAM questionnaire was reliable (Cronbach's coefficient alpha range=0.62-0.96; item-total correlation range=0.14-0.92) and demonstrated content validity. Following further psychometric evaluation, the CAM questionnaire may provide the evidence-based information to inform the education and practice of Indonesian clinical psychologists. Copyright © 2017 Elsevier Ltd. All rights reserved.

Attitudes towards complementary and alternative medicine among medical and psychology students.

PubMed

Ditte, Darja; Schulz, Wolfgang; Ernst, Gundula; Schmid-Ott, Gerhard

2011-03-01

The use of complementary and alternative medicine (CAM) is increasing in Europe as well as in the USA, but CAM courses are infrequently integrated into medical curricula. In Europe, but also especially in the USA and in Canada, the attitudes of medical students and health science professionals in various disciplines towards CAM have been the subject of investigation. Most studies report positive attitudes. The main aim of this study was to compare the attitudes towards CAM of medical and psychology students in Germany. An additional set of questions concerned how CAM utilisation and emotional and physical condition affect CAM-related attitudes. Two hundred thirty-three medical students and 55 psychology students were questioned concerning their attitudes towards CAM using the Questionnaire on Attitudes Towards Complementary Medical Treatment (QACAM). Both medical students and psychology students were sceptical about the diagnostic and the therapeutic proficiency of doctors and practitioners of CAM. Students' attitudes towards CAM correlated neither with their experiences as CAM patients nor with their emotional and physical condition. It can be assumed that German medical and psychology students will be reluctant to use or recommend CAM in their professional careers. Further studies should examine more closely the correlation between attitudes towards CAM and the students' worldview as well as their existing knowledge of the effectiveness of CAM.

Fusion and Compatibility of Camphor and Octane Plasmids in Pseudomonas

PubMed Central

Chou, George I. N.; Katz, Dvorah; Gunsalus, I. C.

1974-01-01

The octane (OCT) plasmid in Pseudomonas putida derived from the ω-hydroxylase-carrying strain of Coon and coworkers is transferable to the camphor (CAM) plasmid-bearing strain by conjugation or by transduction. While the majority of the Cam +Oct+ exconjugants segregate Cam+ or Oct+ cells, exconjugants with stable Cam +Oct+ phenotype (CAM-OCT) can be detected at a low frequency. The transductants are all of the CAM-OCT phenotype. In the stable Cam +Oct+ strains, the OCT plasmid resembles the CAM plasmid with respect to curing by mitomycin C, transfer in conjugation, and reaction to ts (temperature-sensitive) mutation specifically affecting CAM plasmid replication. Therefore, it is suggested that certain regions of homology exist between the CAM and OCT plasmids that enable them to recombine to form a single plasmid, and to overcome the incompatibility barrier that prevents their coexisting. PMID:4527812

Concentration of clarithromycin and 14-R-hydroxy-clarithromycin in plasma of patients with Mycobacterium avium complex infection, before and after the addition of rifampicin.

PubMed

Yamamoto, F; Harada, S; Mitsuyama, T; Harada, Y; Kitahara, Y; Yoshida, M; Nakanishi, Y

2004-02-01

Clarithromycin (CAM) and rifampicin (RFP) have both been recognized to be effective antibiotic agents against Mycobacterium avium complex (MAC) infection. Rifamycin derivatives including RFP and rifabutin modulate the CAM metabolism by inducing the hepatic cytochrome p-450 3A4. To clarify the effect of RFP on the CAM metabolism, we measured the plasma concentration of CAM and 14-R-hydroxyclarithromycin (M-5), the major metabolite of CAM, in 9 patients suffering from MAC infection before and after the addition of RFP. After the addition of RFP, the mean plasma concentration of CAM significantly decreased, while that of M-5 did not. In addition, the amount of CAM + M-5 concentration also significantly decreased. As M-5 is less effective against MAC infection than CAM, more attention should thus be paid to the plasma CAM concentration in patients administered CAM and RFP concomitantly.

[Understanding chair-side digital technology for stomatology from an engineering viewpoint].

PubMed

Zhao, Y J; Wang, Y

2018-04-09

In recent years with the rapid development of digital technology for stomatology, the application field, application model, technical features and technical connotation of the chair-side digital technology has got development and change. The open modular system has gradually replaced the traditional closed system, and the application field of digital technology is no longer limited to chair-side dental restoration, it also has been extend to various kinds of chair-side digital treatment-assisted technology. In this paper, from the engineering point of view, the up to date general connotation of chair-side digital technology was explained, the characteristics and the development of each unit in chair-side digital technology were analyzed, and the application pattern and the localization status were also discussed in this paper. The aim of this paper was to introduce the trend of chair-side digital technological to readers and to better guide clinical application.

21 CFR 872.6250 - Dental chair and accessories.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Dental chair and accessories. 872.6250 Section 872...) MEDICAL DEVICES DENTAL DEVICES Miscellaneous Devices § 872.6250 Dental chair and accessories. (a) Identification. A dental chair and accessories is a device, usually AC-powered, in which a patient sits. The...

21 CFR 872.6250 - Dental chair and accessories.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Dental chair and accessories. 872.6250 Section 872...) MEDICAL DEVICES DENTAL DEVICES Miscellaneous Devices § 872.6250 Dental chair and accessories. (a) Identification. A dental chair and accessories is a device, usually AC-powered, in which a patient sits. The...

21 CFR 872.6250 - Dental chair and accessories.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Dental chair and accessories. 872.6250 Section 872...) MEDICAL DEVICES DENTAL DEVICES Miscellaneous Devices § 872.6250 Dental chair and accessories. (a) Identification. A dental chair and accessories is a device, usually AC-powered, in which a patient sits. The...

21 CFR 872.6250 - Dental chair and accessories.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Dental chair and accessories. 872.6250 Section 872...) MEDICAL DEVICES DENTAL DEVICES Miscellaneous Devices § 872.6250 Dental chair and accessories. (a) Identification. A dental chair and accessories is a device, usually AC-powered, in which a patient sits. The...

21 CFR 872.6250 - Dental chair and accessories.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Dental chair and accessories. 872.6250 Section 872...) MEDICAL DEVICES DENTAL DEVICES Miscellaneous Devices § 872.6250 Dental chair and accessories. (a) Identification. A dental chair and accessories is a device, usually AC-powered, in which a patient sits. The...

21 CFR 880.6140 - Medical chair and table.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Medical chair and table. 880.6140 Section 880.6140...) MEDICAL DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital and Personal Use Miscellaneous Devices § 880.6140 Medical chair and table. (a) Identification. A medical chair or table is a device...

The state of the art in evaluating the performance of department chairs and division heads.

PubMed

Dunning, David G; Durham, Timothy M; Aksu, Mert N; Lange, Brian M

2007-04-01

This study explores the little understood process of evaluating the performance of department chairs/division heads in dental schools. Specifically, this research aimed to elucidate the methods, processes, and outcomes related to the job performance of department chairs/division heads. Forty-three deans and 306 chairs completed surveys with both close-ended and open-ended questions. In addition, ten deans and ten chairs were interviewed. Results indicate that 80 to 90 percent of department chairs are formally evaluated, although as many as 50 percent may lack job descriptions. Recommended best practices for performance appraisal--such as having at least yearly appraisals, holding face-to-face meetings, and setting specific, personal performance objectives/benchmarks for chairs--are being used in most schools. Still, there is much room to improve appraisals by incorporating other recommended practices. Overall high levels of satisfaction were reported by both chairs and deans for the process and outcomes of appraisals. Qualitative data showed some convergence of opinions about appraisals with the notable exception of informal feedback. We explore some implications of these results, especially as they relate to improving performance appraisals.

The use of complementary and alternative medicine among people living with diabetes in Sydney.

PubMed

Manya, Kiran; Champion, Bernard; Dunning, Trisha

2012-01-12

Complementary and alternative medicine (CAM) is common in patients with chronic disease such as diabetes mellitus. The primary objective of the study was to determine the overall prevalence and type of CAM use in individuals with diabetes mellitus (DM) in Western Sydney and to compare the prevalence and factors associated with CAM use with the literature. A multicenter cross-sectional study was undertaken using a self-completed questionnaire distributed to patients with DM attending a public hospital and specialist endocrinology clinics in the region. The type of DM and pattern of CAM utilisation were analyzed. Sixty nine people responded to the questionnaire: age range of 18-75 years during a twelve week collection period. Overall, 32 respondents with diabetes were using some form of CAM, resulting in a utilisation rate of 46.3%. Twenty of the 32 CAM users used CAM specifically to treat their diabetes accounting for 28.9% of the respondent sample population. Multivitamins (40%), cinnamon, Co-enzyme q10 and prayer were the most frequently used CAM modalities. There was no significant difference between males and females, age range, income or diabetes complications between CAM and non-CAM users. (p values each > 0.05) The factor most significantly associated with CAM usage was being born overseas (p = 0.044). Almost half the respondents (46.3%) used CAM: 28% used CAM specifically to treat their diabetes. Individuals born overseas were significantly more likely to use CAM than those born in Australia. Other factors such as age, gender, wealth and duration of living with diabetes were not associated with higher rate of CAM usage.

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

Ge Jin; Fishman, Jessica; Annenberg School for Communication at University of Pennsylvania, University of Pennsylvania Health System, Philadelphia, Pennsylvania

Purpose: Despite the extensive use of complementary and alternative medicine (CAM) among cancer patients, patient-physician communication regarding CAM therapies remains limited. This study quantified the extent of patient-physician communication about CAM and identified factors associated with its discussion in radiation therapy (RT) settings. Methods and Materials: We conducted a cross-sectional survey of 305 RT patients at an urban academic cancer center. Patients with different cancer types were recruited in their last week of RT. Participants self-reported their demographic characteristics, health status, CAM use, patient-physician communication regarding CAM, and rationale for/against discussing CAM therapies with physicians. Multivariate logistic regression was usedmore » to identify relationships between demographic/clinical variables and patients' discussion of CAM with radiation oncologists. Results: Among the 305 participants, 133 (43.6%) reported using CAM, and only 37 (12.1%) reported discussing CAM therapies with their radiation oncologists. In multivariate analyses, female patients (adjusted odds ratio [AOR] 0.45, 95% confidence interval [CI] 0.21-0.98) and patients with full-time employment (AOR 0.32, 95% CI 0.12-0.81) were less likely to discuss CAM with their radiation oncologists. CAM users (AOR 4.28, 95% CI 1.93-9.53) were more likely to discuss CAM with their radiation oncologists than were non-CAM users. Conclusions: Despite the common use of CAM among oncology patients, discussions regarding these treatments occur rarely in the RT setting, particularly among female and full-time employed patients. Clinicians and patients should incorporate discussions of CAM to guide its appropriate use and to maximize possible benefit while minimizing potential harm.« less

Complementary and alternative medicine use in radiotherapy: what are patients using?

PubMed

Gillett, John; Ientile, Clare; Hiscock, Joanne; Plank, Ashley; Martin, Jarad M

2012-11-01

Complementary and alternative medicine (CAM) use by patients could interact in unpredictable ways with conventional therapies. This trial was designed to study the prevalence, types, and clinical implications of CAM use in patients with cancer who are receiving radiotherapy. A validated questionnaire was given to consenting outpatients in this ethics-approved study. Questions specified types of CAM used, clinician knowledge, reason for use, perceived effectiveness, safety, and cost. Of the 101 assessable questionnaires, 38 patients (38%) of the total patient group used CAM, with vitamins (53%), antioxidants (29%), spiritual/meditation practices (29%), and herbs (18%) being the most commonly used. The intention of CAM use was to improve quality of life in 69% of patients and for either hope of cure or to assist other forms of treatment in 26%. The majority of patients (58%) were using CAM prior to their diagnosis of cancer, with 40% starting at diagnosis or during conventional treatment. Patients spent up to $300/month on CAM use. Patients using CAM were significantly more likely to also receive chemotherapy versus non-CAM users (45% versus 24%, p=0.045). Significantly fewer CAM users expected cure from conventional therapy, compared to non-CAM users (50% versus 75%, p=0.016). More CAM users expected conventional therapy to prolong life (58% versus 32%, p<0.001). Only 40% discussed CAM use with their oncologists. CAM is commonly used by patients with cancer. CAMs, particularly antioxidants, are being taken which could negate the underlying free-radical tumorcidal effects of radiotherapy. Oncologists need to have greater awareness of this use and of its potential adverse consequences.

JunoCam's Imaging of Jupiter

NASA Astrophysics Data System (ADS)

Orton, Glenn; Hansen, Candice; Momary, Thomas; Caplinger, Michael; Ravine, Michael; Atreya, Sushil; Ingersoll, Andrew; Bolton, Scott; Rogers, John; Eichstaedt, Gerald

2017-04-01

Juno's visible imager, JunoCam, is a wide-angle camera (58° field of view) with 4 color filters: red, green and blue (RGB) and methane at 889 nm, designed for optimal imaging of Jupiter's poles. Juno's elliptical polar orbit offers unique views of Jupiter's polar regions with spatial scales as good as 50 km/pixel. At closest approach ("perijove") the images have spatial scale down to ˜3 km/pixel. As a push-frame imager on a rotating spacecraft, JunoCam uses time-delayed integration to take advantage of the spacecraft spin to extend integration time to increase signal. Images of Jupiter's poles reveal a largely uncharted region of Jupiter, as nearly all earlier spacecraft except Pioneer 11 have orbited or flown by close to the equatorial plane. Poleward of 64-68° planetocentric latitude, Jupiter's familiar east-west banded structure breaks down. Several types of discrete features appear on a darker, bluish-cast background. Clusters of circular cyclonic spirals are found immediately around the north and south poles. Oval-shaped features are also present, ranging in size down to JunoCam's resolution limits. The largest and brightest features usually have chaotic shapes; animations over ˜1 hour can reveal cyclonic motion in them. Narrow linear features traverse tens of degrees of longitude and are not confined in latitude. JunoCam also detected optically thin clouds or hazes that are illuminated beyond the nightside ˜1-bar terminator; one of these detected at Perijove lay some 3 scale heights above the main cloud deck. Tests have been made to detect the aurora and lightning. Most close-up images of Jupiter have been acquired at lower latitudes within 2 hours of closest approach. These images aid in understanding the data collected by other instruments on Juno that probe deeper in the atmosphere. When Jupiter was too close to the sun for ground-based observers to collect data between perijoves 1 and 2, JunoCam took a sequence of routine images to monitor large-scale features, which fortuitously yielded the earliest images of a very energetic outbreak on the rapid jet at 24°N. Images taken around perijove 3 (PJ3) allow a closer inspection of the outbreak features in a later state of evolution. Methane band images covering both polar regions within about four hours, around PJ3, show the shape and extent of the polar-haze features from favorable vantage points. Occasional, opportunistic images of the Galilean moons and the ring system were also acquired.

Radiographic Prevalence of Dysplasia, Cam, and Pincer Deformities in Elite Ballet.

PubMed

Harris, Joshua D; Gerrie, Brayden J; Varner, Kevin E; Lintner, David M; McCulloch, Patrick C

2016-01-01

The demands of hip strength and motion in ballet are high. Hip disorders, such as cam and pincer deformities or dysplasia, may affect dance performance. However, the prevalence of these radiographic findings is unknown. To determine the prevalence of radiographic cam and pincer deformities, borderline dysplasia, and dysplasia in a professional ballet company. Cross-sectional study; Level of evidence, 3. An institutional review board-approved cross-sectional investigation of a professional ballet company was undertaken. Male and female adult dancers were eligible for inclusion. Four plain radiographs were obtained (standing anteroposterior pelvis, bilateral false profile, and supine Dunn 45°) and verified for adequacy. Cam and pincer deformities, dysplasia, borderline dysplasia, and osteoarthritis were defined. All plain radiographic parameters were measured and analyzed on available radiographs. Student t test, chi-square test (and Fisher exact test), and Spearman correlation analyses were performed to compare sexes, groups, and the effect of select radiographic criteria. A total of 47 dancers were analyzed (21 males, 26 females; mean age (±SD), 23.8 ± 5.4 years). Cam deformity was identified in 25.5% (24/94) of hips and 31.9% (15/47) of subjects, with a significantly greater prevalence in male dancers than females (48% hips and 57% subjects vs 8% hips and 12% subjects; P < .001 and P = .001, respectively). Seventy-four percent of subjects had at least 2 of 6 radiographic signs of pincer deformity. Male dancers had a significantly greater prevalence of both prominent ischial spine and posterior wall signs (P = .001 and P < .001, respectively), while female dancers had a significantly greater prevalence of coxa profunda (85% female hips vs 26% male hips; P < .001). Eighty-nine percent of subjects had dysplasia or borderline dysplasia in at least 1 hip (37% dysplastic), with a significantly greater prevalence of dysplasia or borderline dysplasia in female versus male dancers (92% female hips vs 74% male hips; P < .022). Further, in those with dysplasia or borderline dysplasia, 92% of female and 82% of male dancers had bilateral findings. In this professional ballet company, a high prevalence of radiographic abnormalities was found, including cam and pincer deformity and dysplasia. The results also revealed several sex-related differences of these abnormalities in this unique population. The long-term implications of these findings in this group of elite athletes remain unknown, and this issue warrants future investigation. © 2015 The Author(s).

Specific flexion-related low back pain and sitting: comparison of seated discomfort on two different chairs.

PubMed

O'Keeffe, Mary; Dankaerts, Wim; O'Sullivan, Peter; O'Sullivan, Leonard; O'Sullivan, Kieran

2013-01-01

No study has examined the effectiveness of prescribing seating modifications according to the individual clinical presentation of people with low back pain (LBP). A dynamic, forward-inclined chair ('Back App') can reduce seated paraspinal muscle activation among pain-free participants. This study examined 21 participants whose LBP was specifically aggravated by prolonged sitting and was eased by standing. Low back discomfort (LBD) and overall body discomfort (OBD) were assessed every 15 min while participants sat for 1 h on both the dynamic, forward-inclined chair and a standard office chair. LBD increased significantly more (p = 0.005) on the standard office chair, with no significant difference (p = 0.178) in OBD between the chairs. The results demonstrate that, in a specific flexion-related subgroup of people with LBP, increased LBD during sitting can be minimised through modifying chair design. Mechanisms that minimise seated discomfort may be of relevance in LBP management, as part of a biopsychosocial management plan. This study examined low back discomfort (LBD) during a typing task among people with low back pain (LBP). Sitting on a dynamic, forward-inclined chair resulted in less seated LBD than sitting on a standard office chair. Further research is required to examine the long-term effectiveness of ergonomics interventions in LBP.

Lumbar posture and trunk muscle activation during a typing task when sitting on a novel dynamic ergonomic chair.

PubMed

O'Sullivan, Kieran; McCarthy, Raymond; White, Alison; O'Sullivan, Leonard; Dankaerts, Wim

2012-01-01

Low back pain (LBP) is a common musculoskeletal disorder and prolonged sitting often aggravates LBP. A novel dynamic ergonomic chair ('Back App'), which facilitates less hip flexion while sitting on an unstable base has been developed. This study compared lumbar posture and trunk muscle activation on this novel chair with a standard backless office chair. Twelve painfree participants completed a typing task on both chairs. Lumbar posture and trunk muscle activation were collected simultaneously and were analysed using paired t-tests. Sitting on the novel dynamic chair significantly (p < 0.05) reduced both lumbar flexion and the activation of one back muscle (Iliocostalis Lumborum pars Thoracis). The discomfort experienced was mild and was similar (p > 0.05) between chairs. Maintaining lordosis with less muscle activation during prolonged sitting could reduce the fatigue associated with upright sitting postures. Studies with longer sitting durations, and in people with LBP, are required. Sitting on a novel dynamic chair resulted in less lumbar flexion and less back muscle activation than sitting on a standard backless office chair during a typing task among pain-free participants. Facilitating lordotic sitting with less muscle activation may reduce the fatigue and discomfort often associated with lordotic sitting postures.

Can we reduce the effort of maintaining a neutral sitting posture? A pilot study.

PubMed

O'Sullivan, Kieran; McCarthy, Raymond; White, Alison; O'Sullivan, Leonard; Dankaerts, Wim

2012-12-01

Neutral sitting postures encouraging lumbar lordosis have been recommended in the management of sitting-related low back pain (LBP). However, prolonged lordotic sitting postures can be associated with increased fatigue and discomfort. This pilot study investigated whether changing the type of chair used in sitting can reduce the effort of maintaining a neutral sitting posture. The muscle activation of six trunk muscles was recorded using surface electromyography in 12 painfree participants. Participants were facilitated into a neutral sitting posture for 1 min on both a standard backless office chair and a dynamic, forward-inclined chair (Back App). Lumbar multifidus activity was significantly lower on the Back App chair (p=0.013). None of the other five trunk muscles measured demonstrated a significant difference in activity between the chairs. There was no significant difference (p=0.108) in the perceived effort of maintaining the neutral sitting posture on the two chairs. This study suggests that the lumbar multifidus activation required to maintain a neutral sitting posture can be reduced by considering the type of chair used. The mechanism through which the Back App chair reduces lumbar multifidus activation is unclear, but the greatest difference between chairs is the degree of hip flexion. The ability to maintain a neutral lumbar posture with less lumbar multifidus activation is potentially advantageous during prolonged sitting. Further investigations of the effects of chair design on longer duration sitting, and among LBP subjects, are warranted. Copyright © 2012 Elsevier Ltd. All rights reserved.

Executive onboarding: ensuring the success of the newly hired department chair.

PubMed

Ross, Warren E; Huang, Karen H C; Jones, Greg H

2014-05-01

The success of newly recruited medical school department chairs has become increasingly important for achievement of organizational goals. An effective onboarding program for these chairs can greatly facilitate early success, as well as satisfaction of the new hire with the position and the school. Onboarding programs can include traditional orientation items such as payroll signup and parking details, but should focus heavily on sharing organizational structure, culture, and how things get done. The goals of onboarding will be well served by implementation of three roles in the process. An Orientation Navigator can assist the new chair in the orientation phase, completing new employee documents and navigating the day-to-day challenges of working at the location. A Peer Mentor, generally a sitting chair, serves as both "buddy" and mentor, providing moral support as well as ensuring that the new chair gains an understanding of the people and processes important for getting things done. A Transition Mentor serves over a longer term as a sounding board and coach outside the peer group, assisting in a variety of ways to promote the chair's growth, development, and success as a leader. Finally, any onboarding process is significantly compromised without the active participation of the dean, meeting regularly with the chair to clarify expectations, promote assimilation, and solve problems. Successful onboarding begins with a mindfulness of the needs of the newly hired chair, and a well-designed and well-implemented plan will have wide-ranging benefits for the chair and the organization.

Demographic and Personal Characteristics of Male and Female Chairs in Academic Psychiatry.

PubMed

Doyle, Marley; Pederson, Aderonke; Meltzer-Brody, Samantha

2016-06-01

Despite the strong representation of female psychiatrists in residency and early-career positions, the number of female faculty sharply decreases in tenured or executive leadership positions. Why there exists a marked change in representation at the level of senior leadership within academic psychiatry is unclear. The authors investigated the causative factors contributing to this observation and gathered information about the personal characteristics of women in executive leadership roles. The authors surveyed psychiatry chairs at academic institutions. They identified all female chairs and randomly selected a group of male chairs to serve as a control group. The survey assessed perceived barriers, strengths, and weaknesses and differences in demographics and leadership styles between female and male chairs. Ten percent of psychiatry chairs were female. Male chairs were more likely than female chairs to head large departments (p = 0.02, confidence interval (CI) -17.1-69.1) and had a higher H-index (p = 0.001, CI 6.6-37.2). Female chairs were more likely than male chairs to perceive barriers in their career development (p = 0.01, CI 0.7-2.2), citing little or no mentorship (p = 0.04), gender discrimination (p = 0.0001), and family obligations (p = 0.001) more often. Academic institutions must incorporate programs to decrease barriers and work to achieve equitable representation of women in upper-level leadership positions. Moreover, academic medicine must evolve to cultivate a family-friendly environment that successfully supports both genders.

Calcium-Dependent Energetics of Calmodulin Domain Interactions with Regulatory Regions of the Ryanodine Receptor Type 1 (RyR1)

PubMed Central

Newman, Rhonda A.; Sorensen, Brenda R.; Kilpatrick, Adina M.; Shea, Madeline A.

2014-01-01

Calmodulin (CaM) plays a vital role in calcium homeostasis by allosterically modulating intracellular calcium channels including the homo-tetrameric human Ryanodine Receptor Type 1 (hRyR1). Apo (calcium-free) CaM activates hRyR1 while calcium-saturated CaM inhibits it. Two CaM-binding regions (residues 1975–1999 and 3614–3643) identified in each RyR1 monomer were proposed to allow CaM to bridge adjacent RyR1 subunits. We explored the distinct roles of CaM domains by using fluorescence anisotropy to determine the affinity of CaM1–148 (full-length), CaM1–80 (N-domain) and CaM76–148 (C-domain) for peptides encompassing hRyR1 residues 1975–1999 or 3614–3643. Both CaM1–148 and CaM76–148 associated in a calcium-independent manner with similar affinities for hRyR1(3614–3643)p while CaM1–80 required calcium and bound ~250-fold more weakly. Association of CaM1–148, CaM1–80 and CaM76–148 with hRyR1(1975–1999)p was much less favorable than with hRyR1(3614–3643)p; differences between the two CaM domains were smaller. Equilibrium calcium titrations monitored by steady-state fluorescence demonstrated that both hRyR1 peptides increased the calcium-binding affinity of both CaM domains. These thermodynamic properties support a prior model in which the CaM C-domain associates with RyR1(3614–3643) at low levels of calcium, positioning CaM to rapidly respond to calcium efflux. However, the affinity of the N-domain of CaM for hRyR1(1975–1999)p is insufficient to explain a model in which CaM bridges adjacent RyR1 subunits within the tetramer. This indicates that other protein factors or properties of the tertiary or quaternary structure of hRyR1 contribute to the energetics of CaM-mediated regulation. PMID:25145833

Use of Complementary and Alternative Medicine Among Dermatology Outpatients: Results From a National Survey.

PubMed

AlGhamdi, Khalid M; Khurrum, Huma; Al-Natour, Sahar H; Alghamdi, Waleed; Mubki, Thamer; Alzolibani, Abdulatif; Hafez, Dhafer Mohammed Y; AlDraibi, Mohammed

2015-01-01

Little is known about the prevalence and practice of complementary and alternative medicine (CAM) among dermatology patients in the Arab world. The aim of this study was to determine knowledge and attitudes about CAM, prevalence of its use, reasons for its use, and types of CAM used in dermatology patients in Saudi Arabia. This was a national survey of various regions of Saudi Arabia. In this cross-sectional study, dermatology outpatients were interviewed using a questionnaire. Sociodemographic characteristics, acceptability, utilization pattern, and reasons for CAM use were elicited. Dermatology life quality index (DLQI) was obtained. Overall, 1901 patients returned complete questionnaires out of 2500 distributed (76% response rate). Of these, 808 (40%) were CAM users, and the majority were woman (55.1%), with a mean age of 31.6±12 years. Most were literate (71.2%) and just over half were married (51.9%). Patients with acute skin diseases were found to be more likely to use CAM (P=.027). The mean DLQI score was higher (worse quality of life) among CAM users than among nonusers (P=.002). The results showed that 315 of 801 (40%) and 250 of 601 (30%) CAM users agreed that CAM methods are safer and more effective than modern medicine, respectively, and 83% will continue to use CAM in future. The most commonly used CAM modalities were vitamins, prayers, natural products, and herbs. Responses indicated that 379 of 803 (47.2%) CAM users did not consult their doctor before using CAM, and 219 of 743 (30%) did not obtain sufficient answers regarding CAM use from their dermatologists. There is a significant use of CAM among dermatology outpatients in Saudi Arabia. In view of the common belief that CAM has fewer side effects than conventional medicine, dermatologists need to increase their awareness of CAM. © The Author(s) 2015.

The Synaptic Cell Adhesion Molecule, SynCAM1, Mediates Astrocyte-to-Astrocyte and Astrocyte-to-GnRH Neuron Adhesiveness in the Mouse Hypothalamus

PubMed Central

Sandau, Ursula S.; Mungenast, Alison E.; McCarthy, Jack; Biederer, Thomas; Corfas, Gabriel

2011-01-01

We previously identified synaptic cell adhesion molecule 1 (SynCAM1) as a component of a genetic network involved in the hypothalamic control of female puberty. Although it is well established that SynCAM1 is a synaptic adhesion molecule, its contribution to hypothalamic function is unknown. Here we show that, in addition to the expected neuronal localization illustrated by its presence in GnRH neurons, SynCAM1 is expressed in hypothalamic astrocytes. Cell adhesion assays indicated that SynCAM is recognized by both GnRH neurons and astrocytes as an adhesive partner and promotes cell-cell adhesiveness via homophilic, extracellular domain-mediated interactions. Alternative splicing of the SynCAM1 primary mRNA transcript yields four mRNAs encoding membrane-spanning SynCAM1 isoforms. Variants 1 and 4 are predicted to be both N and O glycosylated. Hypothalamic astrocytes and GnRH-producing GT1-7 cells express mainly isoform 4 mRNA, and sequential N- and O-deglycosylation of proteins extracted from these cells yields progressively smaller SynCAM1 species, indicating that isoform 4 is the predominant SynCAM1 variant expressed in astrocytes and GT1-7 cells. Neither cell type expresses the products of two other SynCAM genes (SynCAM2 and SynCAM3), suggesting that SynCAM-mediated astrocyte-astrocyte and astrocyte-GnRH neuron adhesiveness is mostly mediated by SynCAM1 homophilic interactions. When erbB4 receptor function is disrupted in astrocytes, via transgenic expression of a dominant-negative erbB4 receptor form, SynCAM1-mediated adhesiveness is severely compromised. Conversely, SynCAM1 adhesive behavior is rapidly, but transiently, enhanced in astrocytes by ligand-dependent activation of erbB4 receptors, suggesting that erbB4-mediated events affecting SynCAM1 function contribute to regulate astrocyte adhesive communication. PMID:21486931

Features of complementary and alternative medicine use by patients with coronary artery disease in Beijing: a cross-sectional study

PubMed Central

2013-01-01

Background Complementary and alternative medicine (CAM) is commonly used in China for the management of coronary artery disease (CAD). However, few studies have been conducted to investigate the prevalence, perceived effectiveness, types, and reasons of CAM use in patients diagnosed with CAD. Methods A cross-sectional study design was adopted. Questionnaires were distributed at the outpatient cardiac clinics of four tertiary-level teaching general hospitals in Beijing. Quantitative data were analyzed using Student’s t-test. Categorical data were analyzed using chi-square test. Logistic regression was employed to explore factors associated with the use of CAM as well as CAM use features in Chinese medicine (CM) hospitals when significant differences were found upon comparisons. Results From May to July, 2009, a total of 600 questionnaires were distributed, and 546 patients with a diagnosis of CAD responded with valid values and were included in the present study. CAM was used by 69.1% of the patients with CAD; the majority (75.9%) of these CAM users believes that CAM is effective. “Few side effects” (49.6%) was the main reason of CAM use; whereas “doubt of effect” (61.5%) was the main reason for non-use. Patent herbal medicine (90.7%) was the most commonly used CAM type. Compared with non-CAM users, CAM users tended to be older (p < 0.01), have a longer disease duration (p = 0.02) and better current health status. In addition, CAM users had significant lower odds for emergency admission and hospitalization within the past one year. Patients with CAD from CM and WM hospitals differ in CAM use frequency, types, perceived effectiveness, as well as reasons for CAM use or non-CAM use. Conclusion The present study suggested a group of significant factors which could influence the use of CAM in patients with CAD. CAM use patterns differ in patients from CM and WM hospitals. PMID:24160843

The role of complementary and alternative medicine (CAM) in Germany - a focus group study of GPs.

PubMed

Joos, Stefanie; Musselmann, Berthold; Miksch, Antje; Rosemann, Thomas; Szecsenyi, Joachim

2008-06-12

There has been a marked increase in the use of complementary and alternative medicine (CAM) in recent years worldwide. In Germany, apart from 'Heilpraktiker' (= state-licensed, non-medical CAM practitioners), some general practitioners (GPs) provide CAM in their practices. This paper aims to explore the attitudes of GPs about the role of CAM in Germany, in relation to the healthcare system, quality of care, medical education and research. Furthermore, experiences of GPs integrating CAM in their daily practice were explored. Using a qualitative methodological approach 3 focus groups with a convenience sample of 17 GPs were conducted. The discussions were transcribed verbatim and analysed using qualitative content analysis. The majority of the participating GPs had integrated one or more CAM therapies into their every-day practice. Four key themes were identified based on the topics covered in the focus groups: the role of CAM within the German healthcare system, quality of care, education and research. Within the theme 'role of CAM within the healthcare system' there were five categories: integration of CAM, CAM in the Statutory Health Insurance, modernisation of the Statutory Health Insurance Act, individual healthcare services and 'Heilpraktiker'. Regarding quality of care there were two broad groups of GPs: those who thought patients would benefit from standardizing CAM and those who feared that quality control would interfere with the individual approach of CAM. The main issues identified relating to research and education were the need for the development of alternative research strategies and the low quality of existing CAM education respectively. The majority of the participating GPs considered CAM as a reasonable complementary approach within primary care. The study increased our understanding of GPs attitudes about the role of CAM within the German healthcare system and the use of 'Heilpraktiker' as a competing CAM-provider. It seems to be a need for increased funding for research, better education and remuneration by the Statutory Health Insurance in order to improve access to 'Integrative medicine' in Germany.

Inflammatory bowel disease professionals’ attitudes to and experiences of complementary and alternative medicine

PubMed Central

2013-01-01

Background Complementary and alternative medicine (CAM) use in patients with IBD is on the increase. Patients report they use CAM when their condition is unresponsive to conventional medication or when they suffer from side-effects, negative stress and disease-related concerns. CAM use may improve patients’ well-being but it can also lead to side-effects and interactions with conventional medications. Research on attitudes to and experiences of CAM among healthcare professionals working with IBD patients is not well studied. Studies in this area could lead to enhanced awareness of and improved communication about CAM between care staff and IBD patients. The aim of this study was to explore IBD professionals’ attitudes to and experience of CAM. Methods Sixteen physicians and nurses, 26–70 years old, who had worked with IBD patients for 1–42 years, were recruited. Semi-structured qualitative interviews were conducted. Qualitative content analysis was performed. Results Participants stated patients used CAM to improve their well-being generally and there conditions specifically. Participants had a positive attitude towards CAM and respected their patients’ decision to use it, but reported a lack of CAM knowledge. They required education about CAM to be able to meet patients’ needs and provide adequate information. The result of this study indicates that there is a need for CAM education to be implemented in nursing and medical school. Conclusions All participants had experience of IBD patients who had used CAM in an attempt to achieve improvement and well-being. Attitudes to CAM were mainly positive, although a problematic aspect was lack of knowledge and evidence in relation to CAM. Implementing CAM education in nursing and medical school will allow healthcare professionals to gain an understanding of therapies widely used by patients with IBD. In clinical practice, using a standard questionnaire regarding CAM use allow healthcare professionals to better understand their patients’ wishes and current CAM use. PMID:24325595

High prevalence of prior contact sports play and concussion among orthopedic and neurosurgical department chairs.

PubMed

Sone, Je Yeong; Courtney-Kay Lamb, S; Techar, Kristina; Dammavalam, Vikalpa; Uppal, Mohit; Williams, Cedric; Bergman, Thomas; Tupper, David; Ort, Paul; Samadani, Uzma

2018-04-27

OBJECTIVE Increased understanding of the consequences of traumatic brain injury has heightened concerns about youth participation in contact sports. This study investigated the prevalence of high school and collegiate contact sports play and concussion history among surgical department chairs. METHODS A cross-sectional survey was administered to 107 orthopedic and 74 neurosurgery chairs. Responses were compared to published historical population norms for contact sports (high school 27.74%, collegiate 1.44%), football (high school 10.91%, collegiate 0.76%), and concussion prevalence (12%). One-proportion Z-tests, chi-square tests, and binary logistic regression were used to analyze differences. RESULTS High school contact sports participation was 2.35-fold higher (65.3%, p < 0.001) for orthopedic chairs and 1.73-fold higher (47.9%, p = 0.0018) for neurosurgery chairs than for their high school peers. Collegiate contact sports play was 31.0-fold higher (44.7%, p < 0.001) for orthopedic chairs and 15.1-fold higher (21.7%, p < 0.001) for neurosurgery chairs than for their college peers. Orthopedic chairs had a 4.30-fold higher rate of high school football participation (46.9%, p < 0.001) while neurosurgery chairs reported a 3.05-fold higher rate (33.3%, p < 0.001) than their high school peers. Orthopedic chairs reported a 28.1-fold higher rate of collegiate football participation (21.3%, p < 0.001) and neurosurgery chairs reported an 8.58-fold higher rate (6.5%, p < 0.001) compared to their college peers. The rate at which orthopedic (42.6%, p < 0.001) and neurosurgical (42.4%, p < 0.001) chairs reported having at least 1 concussion in their lifetime was significantly higher than the reported prevalence in the general population. After correction for worst possible ascertainment bias, all results except high school contact sports participation remained significant. CONCLUSIONS The high prevalence of youth contact sports play and concussion among surgical specialty chairs affirms that individuals in careers requiring high motor and cognitive function frequently played contact sports. The association highlights the need to further examine the relationships between contact sports and potential long-term benefits as well as risks of sport-related injury.

Taiwanese adult cancer patients' reports of using complementary therapies.

PubMed

Lu, Jui-Hua; Tsay, Shiow-Luan; Sung, Su-Ching

2010-01-01

More information is needed by cancer clinicians regarding cancer patients' use of complementary and alternative medicine (CAM). In this qualitative study, in-depth interviews were used to obtain the reports of adult cancer patients regarding their use of CAM. Seven cancer patients (4 women, 3 men) who reported using CAM were recruited by snowball sampling. Content analysis was used to examine the interview transcriptions. Five themes and multiple categories were identified related to CAM use: (1) facing the challenges of cancer (I can't be defeated, need to cooperate with conventional medical treatment, rebuilding my confidence), (2) handling the physical and psychological distress of CAM use (extra loading due to the therapy, uncertainty and fear about the efficacy of CAM, being understood and supported, feeling guilty about being sick, (3) lifestyle disruption (altering social life, changing family living style), (4) having reasons for seeking other therapies (finding a way to cure the disease, boosting my immunity, improving my overall health status, and prolonging life and searching for peace of mind), and (5) unresolved practical concerns about CAM (finding an easy and effective way to practice CAM, needing CAM to be integrated into mainstream health care, and where to get the related information). Adult Taiwanese cancer patients who use CAM do experience burdens secondary to CAM use and prefer that oncology specialists be more informed about CAM. Oncology specialists who know where adult cancer patients could obtain helpful information about CAM would help to decrease the burdens that patients who use CAM experience.

ASSOCIATION OF COMPLEMENTARY AND ALTERNATIVE MEDICINE USE WITH HIGHLY ACTIVE ANTIRETROVIRAL THERAPY INITIATION

PubMed Central

Merenstein, Daniel; Yang, Yang; Schneider, Michael F.; Goparaju, Lakshmi; Weber, Kathleen; Sharma, Anjali; Levine, Alexandra M.; Sharp, Gerald B.; Gandhi, Monica; Liu, Chenglong

2009-01-01

Objective To assess whether complementary and alternative medicine (CAM) use is associated with the timing of highly active antiretroviral therapy (HAART) initiation among human immunodeficiency virus (HIV)–infected participants of the Women’s Interagency HIV Study. Study Methods Prospective cohort study between January 1996 and March 2002. Differences in the cumulative incidence of HAART initiation were compared between CAM users and non–CAM users using a logrank test. Cox regression model was used to assess associations of CAM exposures with time to HAART initiation. Main Outcome and Exposures Study outcome was time from January 1996 to initiation of HAART. Primary exposure was use of any CAM modality before January 1996, and secondary exposures included the number and type of CAM modalities used (ingestible CAM medication, body practice, or spiritual healing) during the same period. Results One thousand thirty-four HIV-infected women contributed a total of 4987 person-visits during follow-up. At any time point, the cumulative incidence of HAART initiation among CAM users was higher than that among non–CAM users. After adjustment for potential confounders, those reporting CAM use were 1.34 times (95% confidence interval: 1.09, 1.64) more likely to initiate HAART than non–CAM users. Conclusion Female CAM users initiated HAART regimens earlier than non–CAM users. Initiation of HAART is an important clinical marker, but more research is needed to elucidate the role specific CAM modalities play in HIV disease progression. PMID:18780580

Optical Aptamer Probes of Fluorescent Imaging to Rapid Monitoring of Circulating Tumor Cell

PubMed Central

Hwang, Ji Yeon; Kim, Sang Tae; Han, Ho-Seong; Kim, Kyunggon; Han, Jin Soo

2016-01-01

Fluorescence detecting of exogenous EpCAM (epithelial cell adhesion molecule) or muc1 (mucin1) expression correlated to cancer metastasis using nanoparticles provides pivotal information on CTC (circulating tumor cell) occurrence in a noninvasive tool. In this study, we study a new skill to detect extracellular EpCAM/muc1 using quantum dot-based aptamer beacon (QD-EpCAM/muc1 ALB (aptamer linker beacon). The QD-EpCAM/muc1 ALB was designed using QDs (quantum dots) and probe. The EpCAM/muc1-targeting aptamer contains a Ep-CAM/muc1 binding sequence and BHQ1 (black hole quencher 1) or BHQ2 (black hole quencher2). In the absence of target EpCAM/muc1, the QD-EpCAM/muc1 ALB forms a partial duplex loop-like aptamer beacon and remained in quenched state because the BHQ1/2 quenches the fluorescence signal-on of the QD-EpCAM/muc1 ALB. The binding of EpCAM/muc1 of CTC to the EpCAM/muc1 binding aptamer sequence of the EpCAM/muc1-targeting oligonucleotide triggered the dissociation of the BHQ1/2 quencher and subsequent signal-on of a green/red fluorescence signal. Furthermore, acute inflammation was stimulated by trigger such as caerulein in vivo, which resulted in increased fluorescent signal of the cy5.5-EpCAM/muc1 ALB during cancer metastasis due to exogenous expression of EpCAM/muc1 in Panc02-implanted mouse model. PMID:27886058

Comparison of the NCI open database with seven large chemical structural databases.

PubMed

Voigt, J H; Bienfait, B; Wang, S; Nicklaus, M C

2001-01-01

Eight large chemical databases have been analyzed and compared to each other. Central to this comparison is the open National Cancer Institute (NCI) database, consisting of approximately 250 000 structures. The other databases analyzed are the Available Chemicals Directory ("ACD," from MDL, release 1.99, 3D-version); the ChemACX ("ACX," from CamSoft, Version 4.5); the Maybridge Catalog and the Asinex database (both as distributed by CamSoft as part of ChemInfo 4.5); the Sigma-Aldrich Catalog (CD-ROM, 1999 Version); the World Drug Index ("WDI," Derwent, version 1999.03); and the organic part of the Cambridge Crystallographic Database ("CSD," from Cambridge Crystallographic Data Center, 1999 Version 5.18). The database properties analyzed are internal duplication rates; compounds unique to each database; cumulative occurrence of compounds in an increasing number of databases; overlap of identical compounds between two databases; similarity overlap; diversity; and others. The crystallographic database CSD and the WDI show somewhat less overlap with the other databases than those with each other. In particular the collections of commercial compounds and compilations of vendor catalogs have a substantial degree of overlap among each other. Still, no database is completely a subset of any other, and each appears to have its own niche and thus "raison d'être". The NCI database has by far the highest number of compounds that are unique to it. Approximately 200 000 of the NCI structures were not found in any of the other analyzed databases.

What should students learn about complementary and alternative medicine?

PubMed

Gaster, Barak; Unterborn, John N; Scott, Richard B; Schneeweiss, Ronald

2007-10-01

With thousands of complementary and alternative medicine (CAM) treatments currently being used in the United States today, it is challenging to design a concise body of CAM content which will fit into already overly full curricula for health care students. The purpose of this article is to outline key principles which 15 National Center for Complementary and Alternative Medicine-funded education programs found useful when developing CAM course-work and selecting CAM content. Three key guiding principles are discussed: teach foundational CAM competencies to give students a framework for learning about CAM; choose specific content on the basis of evidence, demographics and condition (what conditions are most appropriate for CAM therapies?); and finally, provide students with skills for future learning, including where to find reliable information about CAM and how to search the scientific literature and assess the results of CAM research. Most of the programs developed evidence-based guides to help students find reliable CAM resources. The cumulative experiences of the 15 programs have been compiled, and an annotated table outlining the most highly recommended resources about CAM is presented.

Complementary and alternative health care in Israel

PubMed Central

2012-01-01

The paper explores the patterns of coexistence of alternative/complementary health care (CAM) and conventional medicine in Israel in the cultural, political, and social contexts of the society. The data are drawn from over ten years of sociological research on CAM in Israel, which included observation, survey research, and over one hundred in-depth interviews with a variety of CAM practitioners - many with bio-medical credentials - and with policy makers in the major medical institutions. The analysis considers the reasons for CAM use, number of practitioners, the frequency of CAM use and some of its correlates, and how CAM is regulated. The structure of the relationship between the conventional health care system and CAM is discussed in the public sector, which provides two-thirds of CAM services, and in the private sector, which provides about one-third. The history of the development of these structures and some of the dilemmas of their operation are discussed. A number of policy issues are considered against this background: regulation and licensing, CAM in primary care, reimbursement for CAM treatment, and the inclusion of CAM in education and training for the health professions. PMID:22913721

Is prayer CAM?

PubMed

Tippens, Kim; Marsman, Kevin; Zwickey, Heather

2009-04-01

Alternative medicine researchers and policy makers have classified prayer as a mind-body intervention, and thus, a modality of complementary and alternative medicine (CAM). As such, numerous epidemiological surveys of CAM utilization-which have included prayer-depict increasing CAM use, particularly in specific racial and ethnic groups. This paper discusses the implications of conflating prayer and CAM, especially regarding the definitions of both concepts and the resulting statistics of CAM utilization.

Prevalence and determinants of complementary and alternative medicine use among infertile patients in Lebanon: a cross sectional study

PubMed Central

2012-01-01

Background Complementary and alternative medicine (CAM) is widely used for the treatment of infertility. While the Middle East and North Africa region has been shown to house one of the fastest growing markets of CAM products in the world, research describing the use of CAM therapies among Middle-Eastern infertile patients is minimal. The aim of this study is to examine the prevalence, characteristics and determinants of CAM use among infertile patients in Lebanon. Methods A cross sectional survey design was used to carry out face-to-face interviews with 213 consecutive patients attending the Assisted Reproductive Unit at a major academic medical center in Beirut. The questionnaire comprised three sections: socio-demographic and lifestyle characteristics, infertility-related aspects and information on CAM use. The main outcome measure was the use of CAM modalities for infertility treatment. Determinants of CAM use were assessed through the logistic regression method. Results Overall, 41% of interviewed patients reported using a CAM modality at least once for their infertility. There was a differential by gender in the most commonly used CAM therapies; where males mostly used functional foods (e.g. honey & nuts) (82.9%) while females mostly relied on spiritual healing/prayer (56.5%). Factors associated with CAM use were higher household income (OR: 0.305, 95% CI: 0.132–0.703) and sex, with females using less CAM than males (OR: 0.12, 95% CI: 0.051–0.278). The older patients were diagnosed with infertility, the lower the odds of CAM use (p for trend <0.05). Almost half of the participants (48%) were advised on CAM use by their friends, and only 13% reported CAM use to their physician. Conclusions The considerably high use of CAM modalities among Lebanese infertile patients, added to a poor CAM use disclosure to physicians, underscore the need to integrate CAM into the education and training of health professionals, as well as enhance infertile patients' awareness on safe use of CAM products. PMID:22901284

Complementary and alternative medicine use by visitors to rural Japanese family medicine clinics: results from the international complementary and alternative medicine survey.

PubMed

Shumer, Gregory; Warber, Sara; Motohara, Satoko; Yajima, Ayaka; Plegue, Melissa; Bialko, Matthew; Iida, Tomoko; Sano, Kiyoshi; Amenomori, Masaki; Tsuda, Tsukasa; Fetters, Michael D

2014-09-25

There is growing interest in the use of complementary and alternative medicine (CAM) throughout the world, however previous research done in Japan has focused primarily on CAM use in major cities. The purpose of this study was to develop and distribute a Japanese version of the International Complementary and Alternative Medicine Questionnaire (I-CAM-Q) to assess the use of CAM among people who visit rural Japanese family medicine clinics. Using a Japanese version of the International Complementary and Alternative Medicine Questionnaire (I-CAM-Q), a cross-sectional survey was conducted in three rural family medicine clinics. All patients and those accompanying patients who met inclusion criteria were eligible to participate. Data were entered into SPSS Statistics and analyzed for use by age, gender, and location. Of the 519 respondents who participated in the project, 415 participants reported CAM use in the past 12 months (80.0%). When prayer is excluded, the prevalence of CAM use drops to 77.3% in the past year, or 403 respondents. The most common forms of CAM used by respondents were pain relief pads (n = 170, 32.8%), herbal medicines/supplements (n = 167, 32.2%), and massage by self or family (n = 166, 32.0%). Female respondents, individuals with higher levels of education, and those with poorer overall health status were more likely to use CAM than respondents without these characteristics. Only 22.8% of CAM therapies used were reported to physicians by survey participants. These data indicate that CAM use in rural Japan is common. The results are consistent with previous studies that show that Japanese individuals are more interested in forms of CAM such as pain relief pads and massage, than in mind-body forms of CAM like relaxation and meditation. Due to the high utilization of certain CAM practices, and given that most CAM users do not disclose their CAM use to their doctors, we conclude that physicians in rural Japan would benefit by asking about CAM use during patient interviews, and by familiarizing themselves with the potential benefits and risks of commonly used CAM modalities.

Opening a Conversation between Department Chairs: Possibilities for the U.S. and Australia.

ERIC Educational Resources Information Center

Wolverton, Mimi; And Others

This study identified and compared the environmental pressures and work-related stresses that impact the chairs of academic departments at universities in Australia and the United States. Surveys were mailed to every department chair at all 40 Australian universities (1680 chairs) with a 51 percent response rate. Surveys were also mailed to a…

Mapping the Past, Present, and Future of Teaching Leadership Chairs in Canada: A Report

ERIC Educational Resources Information Center

Andrews, David M.; Bornais, Judy A. K.; Cramer, Ken M.

2016-01-01

We explore the advent and initiatives of teaching leadership chairs--modeled after the Canada Research Chair framework--to instill individuals or small groups of teaching leaders at various centres across the country to stimulate educational change. In its past, present, and future, we explore the grassroots of teaching leadership chairs and their…

Democratic Leadership and Faculty Empowerment at the Community College: A Theoretical Model for the Department Chair.

ERIC Educational Resources Information Center

McArthur, Ronald C.

2002-01-01

Argues that community college organization at the department level presents challenging leadership issues for the newly appointed department chair. Asserts that existing culture, which looks upon the chair with some mistrust, demands chairs who behave as peers rather than military commanders. Concludes that democratic leadership is the most…

Decision-Making Styles of Department Chairs at Public Jordanian Universities: A High-Expectancy Workforce

ERIC Educational Resources Information Center

Khasawneh, Samer; Alomari, Aiman; Abu-tineh, Abdullah

2011-01-01

The primary purpose of this study was to determine the decision-making styles of department chairs employed by three public institutions in Jordan. A total of 95 department chairs participated in the study by completing the General Decision-Making Styles survey. The results indicated that department chairs under study have the rational…

A roadmap for research on crassulacean acid metabolism (CAM) to enhance sustainable food and bioenergy production in a hotter, drier world.

PubMed

Yang, Xiaohan; Cushman, John C; Borland, Anne M; Edwards, Erika J; Wullschleger, Stan D; Tuskan, Gerald A; Owen, Nick A; Griffiths, Howard; Smith, J Andrew C; De Paoli, Henrique C; Weston, David J; Cottingham, Robert; Hartwell, James; Davis, Sarah C; Silvera, Katia; Ming, Ray; Schlauch, Karen; Abraham, Paul; Stewart, J Ryan; Guo, Hao-Bo; Albion, Rebecca; Ha, Jungmin; Lim, Sung Don; Wone, Bernard W M; Yim, Won Cheol; Garcia, Travis; Mayer, Jesse A; Petereit, Juli; Nair, Sujithkumar S; Casey, Erin; Hettich, Robert L; Ceusters, Johan; Ranjan, Priya; Palla, Kaitlin J; Yin, Hengfu; Reyes-García, Casandra; Andrade, José Luis; Freschi, Luciano; Beltrán, Juan D; Dever, Louisa V; Boxall, Susanna F; Waller, Jade; Davies, Jack; Bupphada, Phaitun; Kadu, Nirja; Winter, Klaus; Sage, Rowan F; Aguilar, Cristobal N; Schmutz, Jeremy; Jenkins, Jerry; Holtum, Joseph A M

2015-08-01

Crassulacean acid metabolism (CAM) is a specialized mode of photosynthesis that features nocturnal CO2 uptake, facilitates increased water-use efficiency (WUE), and enables CAM plants to inhabit water-limited environments such as semi-arid deserts or seasonally dry forests. Human population growth and global climate change now present challenges for agricultural production systems to increase food, feed, forage, fiber, and fuel production. One approach to meet these challenges is to increase reliance on CAM crops, such as Agave and Opuntia, for biomass production on semi-arid, abandoned, marginal, or degraded agricultural lands. Major research efforts are now underway to assess the productivity of CAM crop species and to harness the WUE of CAM by engineering this pathway into existing food, feed, and bioenergy crops. An improved understanding of CAM has potential for high returns on research investment. To exploit the potential of CAM crops and CAM bioengineering, it will be necessary to elucidate the evolution, genomic features, and regulatory mechanisms of CAM. Field trials and predictive models will be required to assess the productivity of CAM crops, while new synthetic biology approaches need to be developed for CAM engineering. Infrastructure will be needed for CAM model systems, field trials, mutant collections, and data management. © 2015 ORNL/UT-Battelle New Phytologist © 2015 New Phytologist Trust.

Socioeconomic Factors and Women's Use of Complementary and Alternative Medicine in Four Racial/Ethnic Groups

PubMed Central

Chao, Maria T.; Wade, Christine M.

2014-01-01

Objective Higher socioeconomic status (SES) is associated with using complementary and alternative medicine (CAM) in national surveys. Less is known about how socioeconomic factors affect CAM use in US subpopulations. We examined whether the relationship between SES and CAM use differs by racial/ethnic groups. Methods Using national survey data, we assessed education and income effects on women's CAM use in four racial/ethnic groups (Whites, Blacks, Mexican Americans, and Chinese Americans), controlling for age, health status, and geographic region. CAM use was defined as using any of 11 domains in the prior year. Results Adjusted effects of SES on CAM use were similar among Mexican American and non-Hispanic White women—education had a distinct gradient effect, with each increasing level of education significantly more likely to use CAM; household income ≥$60,000 was associated with CAM use compared to income <$20,000. For Chinese American women, socioeconomic factors were not associated with CAM use when controlling for confounders. Although income was not associated with CAM use among African American women, college graduates were three times more likely to use CAM than those with less than a high school education, adjusting for confounders. Conclusion SES effects on CAM use are not uniform across racial/ethnic populations. Other factors, such as culture and social networks, may interact with SES to influence CAM use in minority populations. PMID:18447102

Oncologists' experiences of discussing complementary and alternative treatment options with their cancer patients. A qualitative analysis.

PubMed

Corina, Güthlin; Christine, Holmberg; Klein, Gudrun

2016-09-01

The rising use of complementary and alternative medicine (CAM) means oncologists are increasingly asked by patients to discuss CAM treatment options. However, no formal training or established standards are available on the subject. The aim of this paper was to investigate real-world discussions of CAM treatments. In particular, we wanted to learn about the values, norms and defining features that characterise oncologist-patient discussions on CAM. Semi-standardised interviews with 17 oncologists were analysed using interpretation pattern analysis combined with thematic analysis. Advice on CAM is seen by oncologists as an important service they provide to their patients, even though their knowledge of the subject is often limited. Many interviewees mentioned an apparent lack of scientific proof, especially when their aim was to warn patients against the use of CAM. Discussions on CAM tend to reflect the idea that CAM belongs 'to another world', and judging by the interviews with oncologists, this notion appears to be shared by patients and oncologists alike. Oncologists require reliable information on CAM and would profit from training in the communication of CAM treatment options to patients. Knowing scientific data on CAM would also lower barriers stemming from the view that CAM belongs 'to another world'. Under- and postgraduate education programmes should include training on how to respond to requests addressing possible CAM options.

The impact of EpCAM expression on response to chemotherapy and clinical outcomes in patients with epithelial ovarian cancer.

PubMed

Tayama, Shingo; Motohara, Takeshi; Narantuya, Dashdemberel; Li, Chenyan; Fujimoto, Koichi; Sakaguchi, Isao; Tashiro, Hironori; Saya, Hideyuki; Nagano, Osamu; Katabuchi, Hidetaka

2017-07-04

Epithelial ovarian cancer is a highly lethal malignancy; moreover, overcoming chemoresistance is the major challenging in treating ovarian cancer patients. The cancer stem cell (CSC) hypothesis considers CSCs to be the main culprits in driving tumor initiation, metastasis, and resistance to conventional therapy. Although growing evidence suggest that CSCs are responsible for chemoresistance, the contribution of CSC marker EpCAM to resistance to chemotherapy remains unresolved.Here we have demonstrated that ovarian cancers containing high levels of EpCAM have a significantly much lower probability of achieving overall responsive rates after first-line chemotherapy. In addition, multivariate analysis revealed that EpCAM expression is an independent risk factor for chemoresistance, indicating that EpCAM expression is a predictive biomarker of chemotherapeutic response. Consistent with these clinical observations, in vitro assays, we found that the subpopulation of EpCAM-positive ovarian cancer cells shows a significantly higher viability compared with EpCAM-negative cells in response to cisplatin treatment by preventing chemotherapy-induced apoptosis, which is regulated by EpCAM-Bcl-2 axis. Furthermore, in an in vivo mouse model, platinum agents preferentially eliminated EpCAM-negative cells in comparison with EpCAM-positive cells, suggesting that the remaining subpopulation of EpCAM-positive cells contributes to tumor recurrence after chemotherapy. Finally, we also found that an increased expression of EpCAM is associated with poor prognosis in ovarian cancer patients.Our findings highlight the clinical significance of EpCAM in the resistance to chemotherapy and provide a rationale for EpCAM-targeted therapy to improve chemoresistance. Targeting EpCAM should be a promising approach to effectively extirpate the CSCs as the putative root of ovarian cancer.

Different CAD/CAM-processing routes for zirconia restorations: influence on fitting accuracy.

PubMed

Kohorst, Philipp; Junghanns, Janet; Dittmer, Marc P; Borchers, Lothar; Stiesch, Meike

2011-08-01

The aim of the present in vitro study was to evaluate the influence of different processing routes on the fitting accuracy of four-unit zirconia fixed dental prostheses (FDPs) fabricated by computer-aided design/computer-aided manufacturing (CAD/CAM). Three groups of zirconia frameworks with ten specimens each were fabricated. Frameworks of one group (CerconCAM) were produced by means of a laboratory CAM-only system. The other frameworks were made with different CAD/CAM systems; on the one hand by in-laboratory production (CerconCAD/CAM) and on the other hand by centralized production in a milling center (Compartis) after forwarding geometrical data. Frameworks were then veneered with the recommended ceramics, and marginal accuracy was determined using a replica technique. Horizontal marginal discrepancy, vertical marginal discrepancy, absolute marginal discrepancy, and marginal gap were evaluated. Statistical analyses were performed by one-way analysis of variance (ANOVA), with the level of significance chosen at 0.05. Mean horizontal discrepancies ranged between 22 μm (CerconCAM) and 58 μm (Compartis), vertical discrepancies ranged between 63 μm (CerconCAD/CAM) and 162 μm (CerconCAM), and absolute marginal discrepancies ranged between 94 μm (CerconCAD/CAM) and 181 μm (CerconCAM). The marginal gap varied between 72 μm (CerconCAD/CAM) and 112 μm (CerconCAM, Compartis). Statistical analysis revealed that, with all measurements, the marginal accuracy of the zirconia FDPs was significantly influenced by the processing route used (p < 0.05). Within the limitations of this study, all restorations showed a clinically acceptable marginal accuracy; however, the results suggest that the CAD/CAM systems are more precise than the CAM-only system for the manufacture of four-unit FDPs.

Attitudes, Knowledge, Use, and Recommendation of Complementary and Alternative Medicine by Health Professionals in Western Mexico.

PubMed

Brambila-Tapia, Aniel Jessica Leticia; Rios-Gonzalez, Blanca Estela; Lopez-Barragan, Liliana; Saldaña-Cruz, Ana Miriam; Rodriguez-Vazquez, Katya

2016-01-01

The use of complementary and alternative medicine (CAM) has increased in many countries, and this has altered the knowledge, attitudes, and treatment recommendations of health professionals in regard to CAM. Considering Mexican health professionals׳ lack of knowledge of CAM, in this report we surveyed 100 biomedical researchers and Ph.D. students and 107 specialized physicians and residents of a medical specialty in Guadalajara, México (Western Mexico) with a questionnaire to address their attitudes, knowledge, use, and recommendation of CAM. We observed that significantly more researchers had ever used CAM than physicians (83% vs. 69.2%, P = .023) and that only 36.4% of physicians had ever recommended CAM. Female researchers tended to have ever used CAM more than male researchers, but CAM use did not differ between genders in the physician group or by age in either group. Homeopathy, herbal medicine, and massage therapy were the most commonly used CAMs in both the groups. Physicians more frequently recommended homeopathy, massage therapy, and yoga to their patients than other forms of CAM, and physicians had the highest perception of safety and had taken the most courses in homeopathy. All CAMs were perceived to have high efficacy (>60%) in both the groups. The attitude questionnaire reported favorable attitudes toward CAM in both the groups. We observed a high rate of Mexican health professionals that had ever used CAM, and they had mainly used homeopathy, massage therapy, and herbal medicine. However, the recommendation rate of CAM by Mexican physicians was significantly lower than that in other countries, which is probably due to the lack of CAM training in most Mexican medical schools. Copyright © 2016 Elsevier Inc. All rights reserved.

EpCAM expression in primary tumour tissues and metastases: an immunohistochemical analysis.

PubMed

Spizzo, Gilbert; Fong, Dominic; Wurm, Martin; Ensinger, Christian; Obrist, Peter; Hofer, Carina; Mazzoleni, Guido; Gastl, Guenther; Went, Philip

2011-05-01

Epithelial cell adhesion molecule (EpCAM) is a cell surface protein with oncogenic features that is expressed on healthy human epithelia and corresponding malignant tumours. EpCAM expression frequently correlates with more aggressive tumour behaviour and new EpCAM-specific therapeutic agents have recently been approved for clinical use in patients with cancer. However, no consensus exists on how and when to evaluate EpCAM expression in patients with cancer. EpCAM expression was assessed by a well-established immunohistochemical staining protocol in 2291 primary tumour tissues and in 108 metastases using the EpCAM-specific antibody clone VU1D9. A total immunostaining score was calculated as the product of a proportion score and an intensity score. Four expression subgroups (no, weak, moderate and intense) were defined. As described previously, the term 'EpCAM overexpression' was reserved for tissues showing a total immunostaining score >4. EpCAM was highly expressed in most tumours of gastrointestinal origin and in some carcinomas of the genitourinary tract. However, hepatocellular carcinomas, clear cell renal cell cancer, urothelial cancer and squamous cell cancers were frequently EpCAM negative. EpCAM expression in breast cancer depended on the histological subtype; lobular histology usually showed no or weak expression. Most metastases were EpCAM positive and they frequently reflected the expression phenotype of the primary tumour. EpCAM expression was detected on adenocarcinomas of various primary sites. If EpCAM-specific antibodies are intended to be used in patients with cancer, we recommend prior immunohistochemical evaluation of EpCAM expression, particularly in patients with renal cell cancer, hepatocellular carcinoma, urothelial carcinoma, breast cancer and squamous cell carcinomas.

The use of complementary and alternative medicine among people living with diabetes in Sydney

PubMed Central

2012-01-01

Background Complementary and alternative medicine (CAM) is common in patients with chronic disease such as diabetes mellitus. The primary objective of the study was to determine the overall prevalence and type of CAM use in individuals with diabetes mellitus (DM) in Western Sydney and to compare the prevalence and factors associated with CAM use with the literature. Methods A multicenter cross-sectional study was undertaken using a self-completed questionnaire distributed to patients with DM attending a public hospital and specialist endocrinology clinics in the region. The type of DM and pattern of CAM utilisation were analyzed. Results Sixty nine people responded to the questionnaire: age range of 18-75 years during a twelve week collection period. Overall, 32 respondents with diabetes were using some form of CAM, resulting in a utilisation rate of 46.3%. Twenty of the 32 CAM users used CAM specifically to treat their diabetes accounting for 28.9% of the respondent sample population. Multivitamins (40%), cinnamon, Co-enzyme q10 and prayer were the most frequently used CAM modalities. There was no significant difference between males and females, age range, income or diabetes complications between CAM and non-CAM users. (p values each > 0.05) The factor most significantly associated with CAM usage was being born overseas (p = 0.044). Conclusions Almost half the respondents (46.3%) used CAM: 28% used CAM specifically to treat their diabetes. Individuals born overseas were significantly more likely to use CAM than those born in Australia. Other factors such as age, gender, wealth and duration of living with diabetes were not associated with higher rate of CAM usage. PMID:22240113

Novel CAD/CAM rapid prototyping of next-generation biomedical devices

NASA Astrophysics Data System (ADS)

Doraiswamy, Anand

An aging population with growing healthcare needs demands multifaceted tools for diagnosis and treatment of health conditions. In the near-future, drug-administration devices, implantable devices/sensors, enhanced prosthesis, artificial and unique functional tissue constructs will become increasingly significant. Conventional technologies for mass-produced implants do not adequately take individual patient anatomy into consideration. Development of novel CAD/CAM rapid prototyping techniques may significantly accelerate progress of these devices for next-generation patient-care. In this dissertation, several novel rapid prototyping techniques have been introduced for next-generation biomedical applications. Two-photon polymerization was developed to microfabricate scaffolds for tissue engineering, microneedles for drug-delivery and ossicular replacement prostheses. Various photoplymers were evaluated for feasibility, mechanical properties, cytotoxicity, and surface properties. Laser direct write using MDW was utilized for developing microstructures of bioceramics such as hydroxyapatite, and viable mammalian osteosarcoma cells. CAD/CAM laser micromachining (CLM) was developed to engineer biointerfaces as surface recognition regions for differential adherence of cells and growth into tissue-like networks. CLM was also developed for engineering multi-cellular vascular networks. Cytotoxic evaluations and growth studies demonstrated VEGF-induced proliferation of HAAE-1 human aortic endothelial cells with inhibition of HA-VSMC human aortic smooth muscle cells. Finally, piiezoelectric inkjet printing was developed for controlled administration of natural and synthetic adhesives to overcome several problems associated with conventional tissue bonding materials, and greatly improve wound-repair in next generation eye repair, fracture fixation, organ fixation, wound closure, tissue engineering, and drug delivery devices.

Kinetic consequences of introducing a proximal selenocysteine ligand into cytochrome P450cam.

PubMed

Vandemeulebroucke, An; Aldag, Caroline; Stiebritz, Martin T; Reiher, Markus; Hilvert, Donald

2015-11-10

The structural, electronic, and catalytic properties of cytochrome P450cam are subtly altered when the cysteine that coordinates to the heme iron is replaced with a selenocysteine. To map the effects of the sulfur-to-selenium substitution on the individual steps of the catalytic cycle, we conducted a comparative kinetic analysis of the selenoenzyme and its cysteine counterpart. Our results show that the more electron-donating selenolate ligand has only negligible effects on substrate, product, and oxygen binding, electron transfer, catalytic turnover, and coupling efficiency. Off-pathway reduction of oxygen to give superoxide is the only step significantly affected by the mutation. Incorporation of selenium accelerates this uncoupling reaction approximately 50-fold compared to sulfur, but because the second electron transfer step is much faster, the impact on overall catalytic turnover is minimal. Density functional theory calculations with pure and hybrid functionals suggest that superoxide formation is governed by a delicate interplay of spin distribution, spin state, and structural effects. In light of the remarkably similar electronic structures and energies calculated for the sulfur- and selenium-containing enzymes, the ability of the heavier atom to enhance the rate of spin crossover may account for the experimental observations. Because the selenoenzyme closely mimics wild-type P450cam, even at the level of individual steps in the reaction cycle, selenium represents a unique mechanistic probe for analyzing the role of the proximal ligand and spin crossovers in P450 chemistry.

College Access Marketing

ERIC Educational Resources Information Center

Tremblay, Christopher W.

2011-01-01

College Access Marketing (CAM) is a relatively new phenomenon that seeks to positively influence the college-going rate. This report defines CAM, describes CAM examples, and discusses how CAM seeks to counter barriers to college. It explores four main elements of CAM: information, marketing, advocacy, and social mobilization. Further, it…

Complementary and alternative medicine in pulmonology.

PubMed

Mark, John D; Chung, Youngran

2015-06-01

To provide a comprehensive review of complementary and alternative medicine (CAM) therapies for the treatment of pulmonary disorders in children. The use of complementary medicine (CAM) is commonly used by both children and adults with breathing problems, and especially in chronic pulmonary disorders such as asthma and cystic fibrosis. Many clinics and hospitals now offer CAM, even though most of the conventionally trained health practitioners have little knowledge or education regarding CAM therapies. Research in CAM that demonstrates overall benefit is lacking, especially in children. Often parents do not report CAM use to their child's healthcare provider and this could compromise their overall quality of care. Although many research studies evaluating CAM therapies have methodological flaws, data exist to support CAM therapies in treating children with pulmonary disorders. This review examines the latest evidence of CAM use and effectiveness in children with pulmonary disorders. Physicians should be aware of the many CAM therapy options and the research surrounding them in order to provide their patients with the most current and accurate information available.

Pattern and frequency of use of complementary and alternative medicine among patients with epilepsy in the midwestern United States.

PubMed

Liow, Kore; Ablah, Elizabeth; Nguyen, John C; Sadler, Toni; Wolfe, Deborah; Tran, Ky-Dieu; Guo, Lisa; Hoang, Tina

2007-06-01

Complementary and alternative medicine (CAM) is recognized to be commonly used by patients, yet there have been few studies regarding the scope of CAM use by patients with epilepsy. This study assessed usage and perceptions of CAM by patients with epilepsy in the midwest of the United States. A 25-item survey was administered to adult patients with epilepsy, and data were collected from 228 patients. The survey collected demographics, specific CAM usage, adverse effects of CAM therapy, and perceptions of the effectiveness of CAM. Thirty-nine percent reported using CAM; 25% reported using CAM specifically for their epilepsy. Prayer/spirituality was the most commonly used form of CAM (46%), followed by "mega" vitamins (25%), chiropractic care (24%), and stress management (16%). CAM use is common among midwestern patients with epilepsy, although the pattern of use may be slightly different than in other regions of the United States and elsewhere.

Is Prayer CAM?

PubMed Central

Marsman, Kevin; Zwickey, Heather

2009-01-01

Abstract Background Alternative medicine researchers and policy makers have classified prayer as a mind–body intervention, and thus, a modality of complementary and alternative medicine (CAM). As such, numerous epidemiological surveys of CAM utilization—which have included prayer—depict increasing CAM use, particularly in specific racial and ethnic groups. Objectives This paper discusses the implications of conflating prayer and CAM, especially regarding the definitions of both concepts and the resulting statistics of CAM utilization. PMID:19388867

L1-CAM in cancerous tissues.

PubMed

Gavert, Nancy; Ben-Shmuel, Amir; Raveh, Shani; Ben-Ze'ev, Avri

2008-11-01

L1-cell adhesion molecule (L1-CAM) is a cell adhesion receptor of the immunoglobulin superfamily, known for its roles in nerve cell function. While originally believed to be present only in brain cells, in recent years L1-CAM has been detected in other tissues, and in a variety of cancer cells, including some common types of human cancer. We review the prevalence of L1-CAM in human cancer, the possible mechanisms involved in L1-CAM-mediated tumorigenesis, and cancer therapies based upon L1-CAM antibody treatment. In colon cancer cells, the L1-CAM gene was identified as a target of the Wnt/beta-catenin-TCF signaling pathway, and L1-CAM was exclusively detected at the invasive front of colon and ovarian cancer tissue. The expression of L1-CAM in normal and cancer cells enhanced tumorigenesis and conferred metastasis in colon cancer cells. Antibodies against the L1-CAM ectodomain severely inhibited the proliferation of a variety of cancer cells in culture and reduced tumor burden when injected into mice harboring cancer cells expressing L1-CAM. These results, in addition to the presence of L1-CAM on the cell surface and its restricted distribution in normal tissues, make it an ideal target for tumor therapy.

Perception, attitude and usage of complementary and alternative medicine among doctors and patients in a tertiary care hospital in India.

PubMed

Roy, Vandana; Gupta, Monica; Ghosh, Raktim Kumar

2015-01-01

Complementary and alternative medicine (CAM) has been practiced in India for thousands of years. The aim of this study was to determine the extent of use, perception and attitude of doctors and patients utilizing the same healthcare facility. This study was conducted among 200 doctors working at a tertiary care teaching Hospital, India and 403 patients attending the same, to determine the extent of usage, attitude and perception toward CAM. The use of CAM was more among doctors (58%) when compared with the patients (28%). Among doctors, those who had utilized CAM themselves, recommended CAM as a therapy to their patients (52%) and enquired about its use from patients (37%) to a greater extent. CAM was used concomitantly with allopathic medicine by 60% patients. Very few patients (7%) were asked by their doctors about CAM use, and only 19% patients voluntarily informed their doctors about the CAM they were using. Most patients who used CAM felt it to be more effective, safer, less costly and easily available in comparison to allopathic medicines. CAM is used commonly by both doctors and patients. There is a lack of communication between doctors and patients regarding CAM, which may be improved by sensitization of doctors and inclusion of CAM in the medical curriculum.

Molecular cloning and expression of the calmodulin gene from guinea pig hearts.

PubMed

Feng, Rui; Liu, Yan; Sun, Xuefei; Wang, Yan; Hu, Huiyuan; Guo, Feng; Zhao, Jinsheng; Hao, Liying

2015-06-01

The aim of the present study was to isolate and characterize a complementary DNA (cDNA) clone encoding the calmodulin (CaM; GenBank accession no. FJ012165) gene from guinea pig hearts. The CaM gene was amplified from cDNA collected from guinea pig hearts and inserted into a pGEM®-T Easy vector. Subsequently, CaM nucleotide and protein sequence similarity analysis was conducted between guinea pigs and other species. In addition, reverse transcription-polymerase chain reaction (RT-PCR) was performed to investigate the CaM 3 expression patterns in different guinea pig tissues. Sequence analysis revealed that the CaM gene isolated from the guinea pig heart had ∼90% sequence identity with the CaM 3 genes in humans, mice and rats. Furthermore, the deduced peptide sequences of CaM 3 in the guinea pig showed 100% homology to the CaM proteins from other species. In addition, the RT-PCR results indicated that CaM 3 was widely and differentially expressed in guinea pigs. In conclusion, the current study provided valuable information with regard to the cloning and expression of CaM 3 in guinea pig hearts. These findings may be helpful for understanding the function of CaM3 and the possible role of CaM3 in cardiovascular diseases.

Trick or treat? Australian newspaper portrayal of complementary and alternative medicine for the treatment of cancer.

PubMed

Mercurio, Reegan; Eliott, Jaklin Ardath

2011-01-01

Many cancer patients within developed nations cite the media as informing their decisions to use complementary and alternative medicine (CAM). The present study describes (1) Australian newspaper coverage of CAM use for cancer between 1998 and 2007; (2) trends in reporting frequency and characteristics; and (3) how the Australian press framed stories on CAM use for cancer. This study is a content analysis featuring quantitative and qualitative techniques, the latter guided by 'media framing', of targeted newspaper articles. One hundred nineteen articles focused on CAM use for the treatment of cancer were identified. Quantitative analysis found that biologically based CAMs were most frequently described and breast cancer most mentioned. Two thirds of all articles described CAM use in the context of a cure, with approximately half of these opposing this reason for use. Potential benefits of CAM were discussed more frequently than potential risks, and information on costs and how to access CAM were uncommon. Recommendations included advice to use complementary, not alternative therapies, yet advice to discuss CAM with a medical doctor was rare. Qualitative analysis found six CAM cancer-related frames, four in support of CAM use for cancer treatment. The dominant frame constructed CAM as legitimate tools to assist biomedicine (even to cure), with others depicting CAM as normal and necessary or as addressing limitations of biomedicine. Negative frames depicted CAM as questionable and risky practices and the industry/practitioners as possessing malevolent intent. These findings have implications for biomedical practitioners attempting to determine, respect and assist patient choices about their treatment.

The shed ectodomain of Nr-CAM stimulates cell proliferation and motility, and confers cell transformation.

PubMed

Conacci-Sorrell, Maralice; Kaplan, Anna; Raveh, Shani; Gavert, Nancy; Sakurai, Takeshi; Ben-Ze'ev, Avri

2005-12-15

Nr-CAM, a cell-cell adhesion molecule of the immunoglobulin-like cell adhesion molecule family, known for its function in neuronal outgrowth and guidance, was recently identified as a target gene of beta-catenin signaling in human melanoma and colon carcinoma cells and tissue. Retrovirally mediated transduction of Nr-CAM into fibroblasts induces cell motility and tumorigenesis. We investigated the mechanisms by which Nr-CAM can confer properties related to tumor cell behavior and found that Nr-CAM expression in NIH3T3 cells protects cells from apoptosis in the absence of serum by constitutively activating the extracellular signal-regulated kinase and AKT signaling pathways. We detected a metalloprotease-mediated shedding of Nr-CAM into the culture medium of cells transfected with Nr-CAM, and of endogenous Nr-CAM in B16 melanoma cells. Conditioned medium and purified Nr-CAM-Fc fusion protein both enhanced cell motility, proliferation, and extracellular signal-regulated kinase and AKT activation. Moreover, Nr-CAM was found in complex with alpha4beta1 integrins in melanoma cells, indicating that it can mediate, in addition to homophilic cell-cell adhesion, heterophilic adhesion with extracellular matrix receptors. Suppression of Nr-CAM levels by small interfering RNA in B16 melanoma inhibited the adhesive and tumorigenic capacities of these cells. Stable expression of the Nr-CAM ectodomain in NIH3T3 cells conferred cell transformation and tumorigenesis in mice, suggesting that the metalloprotease-mediated shedding of Nr-CAM is a principal route for promoting oncogenesis by Nr-CAM.

The use of complementary and alternative medicines by patients with peripheral neuropathy.

PubMed

Brunelli, Brian; Gorson, Kenneth C

2004-03-15

Complementary and alternative medicine (CAM) therapies have become increasingly popular and are used regularly by patients with chronic neurological disorders. The prevalence and characteristics of CAM use by patients with peripheral neuropathy is unknown. We performed a prospective, questionnaire-based study to determine the prevalence and patterns of use of CAM therapies in 180 consecutive outpatients with peripheral neuropathy. The use of CAM was reported by 77 patients (43%) with neuropathy. The most frequent were megavitamins (35%), magnets (30%), acupuncture (30%), herbal remedies (22%), and chiropractic manipulation (21%); 37 (48%) tried more than one form of alternative treatment. Seventeen respondents (27%) thought their neuropathy symptoms improved with these approaches. Those who used CAM were slightly younger (mean age 62 vs. 65 years, p = 0.05) and more often college educated (39% vs. 24%, p = 0.03) compared to CAM nonusers. They also more often reported burning neuropathic pain (62% vs. 44%, p = 0.01). Patients with diabetic neuropathy used CAM more frequently than others (p = 0.03). The most common reason for using CAM was inadequate pain control (32%). Almost half of patients did not consult a physician before starting CAM. We conclude that there is a high prevalence of CAM use in our patients with neuropathy, and one-quarter reported that their symptoms improved. CAM users were better educated than nonusers, but most did not discuss CAM treatments with their physician. Neuropathic pain was substantially more common in CAM users, and lack of pain control was the most common reason for CAM use.

The role of complementary and alternative medicine (CAM) routines and rituals in men with cancer and their significant others (SOs): a qualitative investigation.

PubMed

Klafke, Nadja; Eliott, Jaklin A; Olver, Ian N; Wittert, Gary A

2014-05-01

Complementary and alternative medicine (CAM) is frequently used in cancer patients, often with contribution of the significant others (SOs), but without consultation of healthcare professionals. This research explored how cancer patients integrate and maintain CAM use in their everyday life, and how SOs are involved in it. In this qualitative study, male participants were selected from a preceding Australian survey on CAM use in men with cancer (94 % response rate and 86 % consent rate for follow-up interview). Semistructured interviews were conducted with 26 men and 24 SOs until data saturation was reached. Interview transcripts were coded and analyzed thematically, thereby paying close attention to participants' language in use. A major theme associated with high CAM use was "CAM routines and rituals," as it was identified that men with cancer practiced CAM as (1) functional routines, (2) meaningful rituals, and (3) mental/spiritual routines or/and rituals. Regular CAM use was associated with intrapersonal and interpersonal benefits: CAM routines provided men with certainty and control, and CAM rituals functioned for cancer patients and their SOs as a means to create meaning, thereby working to counter fear and uncertainty consequent upon a diagnosis of cancer. SOs contributed most to men's uptake and maintenance of dietary-based CAM in ritualistic form resulting in interpersonal bonding and enhanced closeness. CAM routines and rituals constitute key elements in cancer patients' regular and satisfied CAM use, and they promote familial strengthening. Clinicians and physicians can convey these benefits to patient consultations, further promoting the safe and effective use of CAM.

Modeled hydraulic redistribution in tree-grass, CAM-grass, and tree-CAM associations: the implications of crassulacean acid metabolism (CAM).

PubMed

Yu, Kailiang; Foster, Adrianna

2016-04-01

Past studies have largely focused on hydraulic redistribution (HR) in trees, shrubs, and grasses, and recognized its role in interspecies interactions. HR in plants that conduct crassulacean acid metabolism (CAM), however, remains poorly investigated, as does the effect of HR on transpiration in different vegetation associations (i.e., tree-grass, CAM-grass, and tree-CAM associations). We have developed a mechanistic model to investigate the net direction and magnitude of HR at the patch scale for tree-grass, CAM-grass, and tree-CAM associations at the growing season to yearly timescale. The modeling results show that deep-rooted CAM plants in CAM-grass associations could perform hydraulic lift at a higher rate than trees in tree-grass associations in a relatively wet environment, as explained by a significant increase in grass transpiration rate in the shallow soil layer, balancing a lower transpiration rate by CAM plants. By comparison, trees in tree-CAM associations may perform hydraulic descent at a higher rate than those in tree-grass associations in a dry environment. Model simulations also show that hydraulic lift increases the transpiration of shallow-rooted plants, while hydraulic descent increases that of deep-rooted plants. CAM plants transpire during the night and thus perform HR during the day. Based on these model simulations, we suggest that the ability of CAM plants to perform HR at a higher rate may have different effects on the surrounding plant community than those of plants with C3 or C4 photosynthetic pathways (i.e., diurnal transpiration).

Older adults' use of complementary and alternative medicine for mental health: findings from the 2002 National Health Interview Survey.

PubMed

Grzywacz, Joseph G; Suerken, Cynthia K; Quandt, Sara A; Bell, Ronny A; Lang, Wei; Arcury, Thomas A

2006-06-01

To compare complementary and alternative medicine (CAM) use among adults 65 and older with and without self-reported anxiety or depression, and to investigate the prevalence and predictors of CAM use for treatment by persons with anxiety or depression. Cross-sectional survey. Computer-assisted interviews conducted in participants' homes. Subjects included 5827 adults aged 65 and older who participated in the 2002 National Health Interview Survey including the Alternative Health Supplement. None. Overall use of CAM, use of four categories of CAM, and use of 20 CAM modalities. CAM use for treatment of any health condition, and CAM use to treat mental health. Eighty-one and seven tenths percent (81.7%) of older adults with self-reported anxiety or depression who used CAM in the past year, whereas 64.6% of older adults without these conditions used CAM. Differences in CAM use were driven by elevated use of spiritual practices, relaxation techniques, and use of nonvitamin, nonmineral natural products by patients with symptoms of mental conditions. Fewer than 20% of CAM users with self-reported anxiety or depression used CAM for their mental health. Few personal and health-related factors predicted CAM use for treatment among older adults with self-reported anxiety or depression. Older adults with self-reported anxiety or depression were more likely to use spiritual practices, relaxation techniques, and nonvitamin, nonmineral natural products than elders in good mental health. However, for the majority of older adults with self-reported anxiety or depression, CAM was used for purposes other than treating mental health.

Women chairs in academic medicine: engendering strategic intuition.

PubMed

Isaac, Carol; Griffin, Lindsay

2015-01-01

Because stereotypically masculine behaviors are required for effective leadership, examining female chairs' leadership in academic medicine can provide insight into the complex ways in which gender impacts on their leadership practices. The paper aims to discuss this issue. The author interviewed three female clinical chairs and compared the findings to interviews with 28 of their faculty. Grounded theory analysis of the subsequent text gathered comprehensive, systematic, and in-depth information about this case of interest at a US top-tier academic medical center. Four of five themes from the faculty were consistent with the chair's narrative with modifications: Prior Environment (Motivated by Excellence), Tough, Direct, Transparent (Developing Trust), Communal Actions (Creating Diversity of Opinion), and Building Power through Consensus (an "Artful Exercise") with an additional theme, the Significance (and Insignificance) of a Female Chair. While faculty members were acutely aware of the chair's gender, the chairs paradoxically vacillated between gender being a "non-issue" and noting that male chairs "don't do laundry." All three female chairs in this study independently and explicitly stated that gender was not a barrier, yet intuitively used successful strategies derived from the research literature. This study suggests that while their gender was highlighted by faculty, these women dismissed gender as a "non-issue." The duality of gender for these three female leaders was both minimized and subtly affirmed.

77 FR 71168 - Folding Metal Tables and Chairs From the People's Republic of China: Final Results of Sunset...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-29

... Chairs From the People's Republic of China: Final Results of Sunset Review and Revocation of Order AGENCY... duty order on folding metal tables and chairs from the People's Republic of China (``PRC''). Because...: Folding Metal Tables and Chairs From the People's Republic of China, 67 FR 43277 (June 27, 2002). \\2\\ See...

An evidence-based review of commonly used dietary supplements.

PubMed

Laird, John

2015-07-01

Use of complementary and alternative medicine (CAM) is increasing in the United States. Physician assistants need to know about the efficacy of CAM therapies if they practice integrative medicine (which combines CAM and traditional therapies), recommend a CAM therapy occasionally as part of their treatment plan, refer patients to CAM providers, or have patients who self-select CAM therapies. This article describes integrative medicine and reviews the most commonly used dietary supplements.

Integrating Complementary and Alternative Medicine Education Into the Pharmacy Curriculum

PubMed Central

Wallis, Marianne

2008-01-01

Objectives To evaluate the effectiveness of an integrated approach to the teaching of evidence-based complementary and alternative medicine (CAM) in a pharmacy curriculum. Design Evidence-based CAM education was integrated throughout the third, fourth, and fifth years of the pharmacy curriculum. Specifically, an introductory module focusing on CAM familiarization was added in the third year and integrated, evidence-based teaching related to CAM was incorporated into clinical topics through lectures and clinical case studies in the fourth and fifth years. Assessment Students' self-assessed and actual CAM knowledge increased, as did their use of evidence-based CAM resources. However, only 30% of the fourth-year students felt they had learned enough about CAM. Students preferred having CAM teaching integrated into the curriculum beginning in the first year rather than waiting until later in their education. Conclusion CAM education integrated over several years of study increases students' knowledge and application. PMID:19002274

Complementary and Alternative Medicine (CAM) use by Malaysian oncology patients.

PubMed

Farooqui, Maryam; Hassali, Mohamed Azmi; Abdul Shatar, Aishah Knight; Shafie, Asrul Akmal; Seang, Tan Boon; Farooqui, Muhammad Aslam

2012-05-01

The current study sought to evaluate Malaysian oncology patients' decision making about the use of Complementary and Alternative Medicine (CAM) for the management of their care. Patients were interviewed across three major Malaysian ethnic groups, Malay, Chinese and Indian. Thematic content analysis identified four central themes: Conceptualizing CAM, the decision making process; rationale given for selecting or rejecting CAM and barriers to CAM use. Participants generally used the term 'traditional medicine', referred to locally as 'ubat kampung', meaning medicine derived from 'local traditions'. Mixed reactions were shown concerning the effectiveness of CAM to cure cancer and the slow progression of CAM results and treatment costs were cited as major barriers to CAM use. Concerns regarding safety and efficacy of CAM in ameliorating cancer as well as potential interactions with conventional therapies highlighted the importance of patients' knowledge about cancer treatments. Copyright © 2011 Elsevier Ltd. All rights reserved.

L1-CAM and N-CAM: From Adhesion Proteins to Pharmacological Targets.

PubMed

Colombo, Federico; Meldolesi, Jacopo

2015-11-01

L1 cell adhesion molecule (L1-CAM) and neural cell adhesion molecule (N-CAM), key members of the immunoglobulin-like CAM (Ig-CAM) family, were first recognized to play critical roles in surface interactions of neurons, by binding with each other and with extracellular matrix (ECM) proteins. Subsequently, adhesion was recognized to include signaling due to both activation of β-integrin, with the generation of intracellular cascades, and integration with the surface cytoskeleton. The importance of the two Ig-CAMs was revealed by their activation of the tyrosine kinase receptors of fibroblast growth factor (FGF), epidermal growth factor (EGF), and nerve growth factor (NGF). Based on these complex signaling properties, L1-CAM and N-CAM have become of great potential pharmacological interest in neurons and cancers. Treatment of neurodegenerative disorders and cognitive deficits of neurons is aimed to increase the cell Ig-CAM tone, possibly provided by synthetic/mimetic peptides. In cancer cells, where Ig-CAMs are often overexpressed, the proteins are employed for prognosis. The approaches to therapy are based on protein downregulation, antibodies, and adoptive immunotherapy. Copyright © 2015 Elsevier Ltd. All rights reserved.

The Arrhythmogenic Calmodulin Mutation D129G Dysregulates Cell Growth, Calmodulin-dependent Kinase II Activity, and Cardiac Function in Zebrafish*

PubMed Central

Zacharias, Triantafyllos; Kulej, Katarzyna; Wang, Kevin; Torggler, Raffaela; la Cour, Jonas M.

2016-01-01

Calmodulin (CaM) is a Ca2+ binding protein modulating multiple targets, several of which are associated with cardiac pathophysiology. Recently, CaM mutations were linked to heart arrhythmia. CaM is crucial for cell growth and viability, yet the effect of the arrhythmogenic CaM mutations on cell viability, as well as heart rhythm, remains unknown, and only a few targets with relevance for heart physiology have been analyzed for their response to mutant CaM. We show that the arrhythmia-associated CaM mutants support growth and viability of DT40 cells in the absence of WT CaM except for the long QT syndrome mutant CaM D129G. Of the six CaM mutants tested (N53I, F89L, D95V, N97S, D129G, and F141L), three showed a decreased activation of Ca2+/CaM-dependent kinase II, most prominently the D129G CaM mutation, which was incapable of stimulating Thr286 autophosphorylation. Furthermore, the CaM D129G mutation led to bradycardia in zebrafish and an arrhythmic phenotype in a subset of the analyzed zebrafish. PMID:27815504

[Complementary and alternative medicine in primary care in Switzerland].

PubMed

Déglon-Fischer, Agnès; Barth, Jürgen; Ausfeld-Hafter, Brigitte

2009-08-01

This study investigated the current supply of complementary and alternative medicine (CAM) in Swiss primary care. Information was collected on physicians' qualifications in CAM, frequency of patients' demand for CAM, physicians' supply and temporal resources for CAM as well as physicians' referrals to CAM. 750 (500 German-speaking and 250 French-speaking) randomly selected Swiss female and male primary care physicians were asked to complete a questionnaire (response rate 50.4%). Sociodemographic data on professional training, place of residence, and sex were used to calculate a weighting factor to correct the responders' data in the analysis accordingly. 14.2% of the physicians were qualified in at least one CAM discipline. Around 30% (95% confidence interval 25.4-34.6%) of the physicians were asked for CAM by their patients more than once a week. Homeopathy and phytotherapy were the most frequently offered therapies, followed by traditional Chinese medicine (TCM)/acupuncture. 62.5% (57.6-67.4%) of the physicians refer their patients to CAM. Most patients were referred to TCM/acupuncture. Of the 37.2% (32.6-42.4%) of the physicians who do not refer their patients to CAM, around 40% (35.1-44.9%) offer it themselves. About three quarters of the physicians offer CAM themselves or refer their patients to CAM treatments. CAM is very important in primary medical care in Switzerland. Clear regulations for CAM are required in order to ensure a high quality in care. Copyright 2009 S. Karger AG, Basel.

Complementary and alternative medicine use in patients with hematological cancers in Malaysia.

PubMed

Gan, G G; Leong, Y C; Bee, P C; Chin, E; Teh, A K H

2015-08-01

Complementary and alternative medicine (CAM) is often used by cancer patients, but not many studies had been published on the prevalence of CAM use in patients with hematological cancers. This study aims to determine the prevalence of CAM and type of CAM used in this group of patients in a multiracial and multicultural country. This is a cross-sectional survey carried out in two hospitals in Malaysia. Patients with underlying hematological cancers were asked to complete the questionnaires on CAM and the Hospital Anxiety and Depression Scale. A total of 245 patients participated. The prevalence of CAM use was 70.2 %. The most common types of CAM used are biological-based therapies (90.2 %) and mind-body interventions (42 %). Vitamin and diet supplements (68.6 %) and folk/herb remedies (58 %) are the most common biological-based therapies used. There is no significant association of CAM use with age, gender, education level, and household income. Female patients are more likely to use more than one CAM therapies. The most common reason reported for CAM use was to boost immunity (57 %) and cure (24 %). Majority of patients (65 %) felt CAM was effective, and 60 % did not inform their physicians regarding CAM usage. In view of the high prevalence of CAM use in patients with hematological cancers, it is important that the physicians play an active role in seeking information from patients and to monitor possible drug-vitamin-herbal interactions.

Use of Complementary and Alternative Medicine (CAM) as Part of the Oncological Treatment: Survey about Patients' Attitude towards CAM in a University-Based Oncology Center in Germany.

PubMed

Kessel, Kerstin A; Lettner, Sabrina; Kessel, Carmen; Bier, Henning; Biedermann, Tilo; Friess, Helmut; Herrschbach, Peter; Gschwend, Jürgen E; Meyer, Bernhard; Peschel, Christian; Schmid, Roland; Schwaiger, Markus; Wolff, Klaus-Dietrich; Combs, Stephanie E

2016-01-01

To understand if and which patients would be open-minded to Complementary and Alternative Medicine (CAM) use parallel to their oncological treatment. Moreover, we sought to determine which methods are most accepted and which are the primary motivators to use CAM. We developed and anonymously conducted a questionnaire for patients in the oncology center (TU Munich). Questions focus on different CAM methods, previous experiences, and willingness to apply or use CAM when offered in a university-based setting. A total of 171 of 376 patients (37.4% women, 62.0% men, 0.6% unknown) participated. This corresponds to a return rate of 45%. Median age was 64 years (17-87 years). Of all participants, 15.2% used CAM during their oncological therapy; 32.7% have used it in the past. The majority (81.9%) was not using CAM during therapy; 55.5% have not used CAM in the past respectively. The analysis revealed a significant correlation between education and CAM use during therapy (r = 0.18; p = 0.02), and CAM use in the past (r = 0.17; p = 0.04). Of all patients using CAM during therapy, favored methods were food supplements (42.3%), vitamins/minerals (42.3%), massage (34.6%). Motivations are especially the reduction of side effect and stress, the positive effect of certain CAM-treatments on the immune system and tumor therapy. Results showed no difference between women and men. Most patients not having had any experience with CAM complain about the deficiency of information by their treating oncologist (31.4%) as well as missing treatment possibilities (54.3%). Since many patients believe in study results demonstrating the efficacy of CAM, it stresses our task to develop innovative study protocols to investigate the outcomes of certain CAM on symptom reduction or other endpoints. Thus, prospective trials and innovative evidence-based treatment concepts to include CAM into high-end oncology is what patients demand and what a modern oncology center should offer.

Leadership experiences and characteristics of chairs of academic departments of psychiatry.

PubMed

Keith, Samuel J; Buckley, Peter F

2011-01-01

Effective leadership in academic medicine requires a broad constellation of skills, experiences, and core values. The authors sought to describe and define these. The authors conducted a web-based survey among 132 Chairs of North American departments of psychiatry. Eighty-five Chairs (64%) responded to the survey, the majority of whom were first-time Chairs. Identified leadership attributes included strategic/visionary acumen, interpersonal communication skills, core administrative and academic/technical skills, motivational capacity, personal integrity, and altruism/tenacity. The identified values are consistent with the leadership attributes that are described as necessary for success in the business community. Developing the required skill-set among faculty who aspire to become a departmental Chair is an important commitment for Deans and extant psychiatry Chairs. Copyright © 2011 Academic Psychiatry

Clinical academic careers: embracing the art and science of nursing.

PubMed

Masterson, Abigail; Robb, Liz

2016-11-23

Clinical academics make a unique contribution to health research and scholarship by undertaking practice-focused research that offers direct benefits to patient care. The Florence Nightingale Foundation supports the development of research skills in nursing and midwifery through its scholarships and by establishing a network of chairs in clinical nursing practice research. The Florence Nightingale Foundation also provides leadership scholarships to deans and aspiring deans of university faculties of health. It is from these perspectives that the case is made for investment in clinical academic roles and the development of career pathways that embrace the art and science of nursing.

Highlights from the Faraday Discussion on New Directions in Porous Crystalline Materials, Edinburgh, UK, June 2017.

PubMed

Addicoat, Matthew A; Bennett, Thomas D; Stassen, Ivo

2017-09-28

A lively discussion on new directions in porous crystalline materials took place in June 2017, with the beautiful city of Edinburgh as a backdrop, in the context of the unique Faraday Discussions format. Here, 5 minute presentations were given on papers which had been submitted in advance of the conference, with copious time allocated for in-depth discussion of the work presented. Prof. Mircea Dincă (MIT), chair of the scientific committee, opened the conference by welcoming the many different nationalities attending, and outlining the format of discussions.

The Ideal Chair: Appropriate and Inappropriate Roles.

ERIC Educational Resources Information Center

Taylor, Anita

1985-01-01

Reviews tasks and duties of department chairs, stressing the importance of establishing priorities and delegating appropriately. Includes an Appropriate Chair Role analysis for the Communication Department, George Mason University. (PD)

The path to CAM6: coupled simulations with CAM5.4 and CAM5.5

NASA Astrophysics Data System (ADS)

Bogenschutz, Peter A.; Gettelman, Andrew; Hannay, Cecile; Larson, Vincent E.; Neale, Richard B.; Craig, Cheryl; Chen, Chih-Chieh

2018-01-01

This paper documents coupled simulations of two developmental versions of the Community Atmosphere Model (CAM) towards CAM6. The configuration called CAM5.4 introduces new microphysics, aerosol, and ice nucleation changes, among others to CAM. The CAM5.5 configuration represents a more radical departure, as it uses an assumed probability density function (PDF)-based unified cloud parameterization to replace the turbulence, shallow convection, and warm cloud macrophysics in CAM. This assumed PDF method has been widely used in the last decade in atmosphere-only climate simulations but has never been documented in coupled mode. Here, we compare the simulated coupled climates of CAM5.4 and CAM5.5 and compare them to the control coupled simulation produced by CAM5.3. We find that CAM5.5 has lower cloud forcing biases when compared to the control simulations. Improvements are also seen in the simulated amplitude of the Niño-3.4 index, an improved representation of the diurnal cycle of precipitation, subtropical surface wind stresses, and double Intertropical Convergence Zone biases. Degradations are seen in Amazon precipitation as well as slightly colder sea surface temperatures and thinner Arctic sea ice. Simulation of the 20th century results in a credible simulation that ends slightly colder than the control coupled simulation. The authors find this is due to aerosol indirect effects that are slightly stronger in the new version of the model and propose a solution to ameliorate this. Overall, in these early coupled simulations, CAM5.5 produces a credible climate that is appropriate for science applications and is ready for integration into the National Center for Atmospheric Research's (NCAR's) next-generation climate model.

Complementary and Alternative Medicine Use and Symptom Burden in Women Undergoing Chemotherapy for Breast Cancer in Malaysia.

PubMed

Chui, Ping Lei; Abdullah, Khatijah Lim; Wong, Li Ping; Taib, Nur Aishah

Complementary and alternative medicine (CAM) is commonly used for cancer- and chemotherapy-related symptoms. Nurses are likely to encounter many CAM users in their practice. The aims of this study were to assess CAM use and examine the symptom burden of CAM and non-CAM users among patients with breast cancer who are undergoing chemotherapy. A CAM use questionnaire and the Side-Effect Burden Scale were administered to 546 patients. Complementary and alternative medicine use was categorized as mind-body practices (MBPs), natural products (NPs), or traditional medicine (TM). We identified 386 CAM users (70.7%) in this study. The CAM users reported a higher marginal mean total symptom burden score (40.39 ± 2.6) than non-CAM users (36.93 ± 3.21), although this difference was not statistically significant (P = .09). Triple-modality (MBP-NP-TM) CAM users had a significantly higher marginal mean total symptom burden score (47.44 ± 4.12) than single-modality (MBP) users (34.09 ± 4.43). The risk of having a high total symptom burden score was 12.9-fold higher among the MBP-NP-TM users than among the MBP users. Complementary and alternative medicine use is common among Malaysian patients who are undergoing chemotherapy for breast cancer. However, CAM and non-CAM users reported similar symptom burdens, although single-modality use of MBP is likely associated with a lower symptom burden. Nurses should keep abreast of current developments and trends in CAM use. Understanding CAM use and the related symptom burden will allow nurses to initiate open discussion and guide their patients in seeking additional information or referrals for a particular therapy.

Medical student attitudes towards complementary and alternative medicine (CAM) in medical education: a critical review.

PubMed

Joyce, Paul; Wardle, Jon; Zaslawski, Chris

2016-12-01

Background This paper aims to remedy a gap in the knowledge by presenting the first critical review of the literature on major themes relating to medical students perceptions and attitudes towards the exponentially growing field of complementary and alternative medicine (CAM). MethodsAfter a comprehensive database search of the literature, 21 papers were chosen as suitable for the review. The results from these papers were tabled and discussed. ResultsThe results indicated that medical students lacked knowledge of CAM and are generally positive towards CAM education (especially in the preclinical years, if it provided evidence of efficacy and post-placement). Medical students thought that CAM should generally be incorporated into the medical curriculum mainly so they can confidently undertake referral to CAM practitioners. Being able to communicate with future patients about their CAM use was a major motivation for medical students to learn about CAM and a factor for medical student support of further incorporation of CAM content in the medical curricula. Educational exposure to CAM in many forms and in many papers was shown to significantly affect medical student attitudes to CAM. This may be reflective of the fact that, outside direct CAM training, there may be limited accessible opportunities for medical students and if integration is to occur, educational exposure is most important. ConclusionsThe rise of CAM as a social and clinical phenomenon necessitates consideration of further inclusion of these topics in the medical curriculum, if future physicians are to be able to fully discharge their role as care providers in an increasingly medically pluralistic world. However, the inclusion of CAM needs to be done in an objective and critical manner, which is relevant to the learner.

Complementary and alternative medicine in breast cancer patients.

PubMed

Nahleh, Zeina; Tabbara, Imad A

2003-09-01

Complementary and Alternative Medicine (CAM) is becoming increasingly popular among cancer patients, in particular those with breast cancer. It represents one of the fastest growing treatment modalities in the United States. Therefore, knowledge of CAM therapies is becoming necessary for physicians and other health care providers. CAM encompasses a wide range of modalities including special diet and nutrition, mind-body approaches, and traditional Chinese medicine. We reviewed the biomedical literature on CAM use in breast cancer patients, using Medline search from 1975 until 2002. In addition, consensus reports and books on CAM and breast cancer were included in the review. We evaluated the prevalence of CAM use in breast cancer patients, the reasons cited for its use, the different available modalities, and the reported outcomes. Use of CAM in breast cancer patients ranges between 48% and 70% in the United States. The most commonly used CAM modalities include dietary supplements, mind-body approaches, and acupuncture. The reasons cited for using CAM were to boost the immune system, improve the quality of life, prevent recurrence of cancer, provide control over life, and treat breast cancer and the side effects of treatment. Several studies reported favorable results including improved survival, better pain control, reduced anxiety, improvement in coping strategies and significant efficacy in treating nausea and vomiting. Other less well-organized trials have reported either no benefit or negative effect of CAM and potential toxicity of some commercial products. CAM is a growing field in health care and particularly among breast cancer patients. Knowledge of CAM by physicians, especially oncologists, is necessary. Oncologists should be willing to discuss the role of CAM with their patients and encourage patients to participate in well-organized research about CAM.

Nitric Oxide Mediates the Hormonal Control of Crassulacean Acid Metabolism Expression in Young Pineapple Plants1[W][OA

PubMed Central

Freschi, Luciano; Rodrigues, Maria Aurineide; Domingues, Douglas Silva; Purgatto, Eduardo; Van Sluys, Marie-Anne; Magalhaes, Jose Ronaldo; Kaiser, Werner M.; Mercier, Helenice

2010-01-01

Genotypic, developmental, and environmental factors converge to determine the degree of Crassulacean acid metabolism (CAM) expression. To characterize the signaling events controlling CAM expression in young pineapple (Ananas comosus) plants, this photosynthetic pathway was modulated through manipulations in water availability. Rapid, intense, and completely reversible up-regulation in CAM expression was triggered by water deficit, as indicated by the rise in nocturnal malate accumulation and in the expression and activity of important CAM enzymes. During both up- and down-regulation of CAM, the degree of CAM expression was positively and negatively correlated with the endogenous levels of abscisic acid (ABA) and cytokinins, respectively. When exogenously applied, ABA stimulated and cytokinins repressed the expression of CAM. However, inhibition of water deficit-induced ABA accumulation did not block the up-regulation of CAM, suggesting that a parallel, non-ABA-dependent signaling route was also operating. Moreover, strong evidence revealed that nitric oxide (NO) may fulfill an important role during CAM signaling. Up-regulation of CAM was clearly observed in NO-treated plants, and a conspicuous temporal and spatial correlation was also evident between NO production and CAM expression. Removal of NO from the tissues either by adding NO scavenger or by inhibiting NO production significantly impaired ABA-induced up-regulation of CAM, indicating that NO likely acts as a key downstream component in the ABA-dependent signaling pathway. Finally, tungstate or glutamine inhibition of the NO-generating enzyme nitrate reductase completely blocked NO production during ABA-induced up-regulation of CAM, characterizing this enzyme as responsible for NO synthesis during CAM signaling in pineapple plants. PMID:20147491

Calcium triggers reversal of calmodulin on nested anti-parallel sites in the IQ motif of the neuronal voltage-dependent sodium channel NaV1.2.

PubMed

Hovey, Liam; Fowler, C Andrew; Mahling, Ryan; Lin, Zesen; Miller, Mark Stephen; Marx, Dagan C; Yoder, Jesse B; Kim, Elaine H; Tefft, Kristin M; Waite, Brett C; Feldkamp, Michael D; Yu, Liping; Shea, Madeline A

2017-05-01

Several members of the voltage-gated sodium channel family are regulated by calmodulin (CaM) and ionic calcium. The neuronal voltage-gated sodium channel Na V 1.2 contains binding sites for both apo (calcium-depleted) and calcium-saturated CaM. We have determined equilibrium dissociation constants for rat Na V 1.2 IQ motif [IQRAYRRYLLK] binding to apo CaM (~3nM) and (Ca 2+ ) 4 -CaM (~85nM), showing that apo CaM binding is favored by 30-fold. For both apo and (Ca 2+ ) 4 -CaM, NMR demonstrated that Na V 1.2 IQ motif peptide (Na V 1.2 IQp ) exclusively made contacts with C-domain residues of CaM (CaM C ). To understand how calcium triggers conformational change at the CaM-IQ interface, we determined a solution structure (2M5E.pdb) of (Ca 2+ ) 2 -CaM C bound to Na V 1.2 IQp . The polarity of (Ca 2+ ) 2 -CaM C relative to the IQ motif was opposite to that seen in apo CaM C -Na v 1.2 IQp (2KXW), revealing that CaM C recognizes nested, anti-parallel sites in Na v 1.2 IQp . Reversal of CaM may require transient release from the IQ motif during calcium binding, and facilitate a re-orientation of CaM N allowing interactions with non-IQ Na V 1.2 residues or auxiliary regulatory proteins interacting in the vicinity of the IQ motif. Copyright © 2017 Elsevier B.V. All rights reserved.

Integrative medicine or infiltrative pseudoscience?

PubMed

Li, Ben; Forbes, Thomas L; Byrne, John

2018-01-02

Evidence-based medicine, first described in 1992, offers a clear, systematic, and scientific approach to the practice of medicine. Recently, the non-evidence-based practice of complementary and alternative medicine (CAM) has been increasing in the United States and around the world, particularly at medical institutions known for providing rigorous evidence-based care. The use of CAM may cause harm to patients through interactions with evidence-based medications or if patients choose to forego evidence-based care. CAM may also put financial strain on patients as most CAM expenditures are paid out-of-pocket. Despite these drawbacks, patients continue to use CAM due to media promotion of CAM therapies, dissatisfaction with conventional healthcare, and a desire for more holistic care. Given the increasing demand for CAM, many medical institutions now offer CAM services. Recently, there has been controversy surrounding the leaders of several CAM centres based at a highly respected academic medical institution, as they publicly expressed anti-vaccination views. These controversies demonstrate the non-evidence-based philosophies that run deep within CAM that are contrary to the evidence-based care that academic medical institutions should provide. Although there are financial incentives for institutions to provide CAM, it is important to recognize that this legitimizes CAM and may cause harm to patients. The poor regulation of CAM allows for the continued distribution of products and services that have not been rigorously tested for safety and efficacy. Governments in Australia and England have successfully improved regulation of CAM and can serve as a model to other countries. Copyright © 2017 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

Occurrence and co-occurrence of types of complementary and alternative medicine use by age, gender, ethnicity, and education among adults in the United States: the 2002 National Health Interview Survey (NHIS).

PubMed

Neiberg, Rebecca H; Aickin, Mikel; Grzywacz, Joseph G; Lang, Wei; Quandt, Sara A; Bell, Ronny A; Arcury, Thomas A

2011-04-01

There are widespread assumptions that a large proportion of American adults use a variety of complementary and alternative medicine (CAM) therapies. The goal of this study is to explore the clustering or linkages among CAM categories in the general population. Linkset analysis and data from the 2002 National Health Interview Survey (NHIS) were used to address two specific aims. First, the dominant linkages of CAM categories used by the same individual were delineated, and population estimates were generated of the percentage of American adults using different linksets of CAM categories. Second, it was determined whether dominant linkages of CAM modalities differ by age, gender, ethnicity, and education. Linkset analysis, a method of estimating co-occurrence beyond chance, was used on data from the 2002 NHIS (N = 29,862) to identify possible sets of CAM use. Most adults use CAM therapies from a single category. Approximately 20% of adults combined two CAM categories, with the combination of mind-body therapies and biologically based therapies estimated to be most common. Only 5% of adults use therapies representing three or more CAM categories. Combining therapies across multiple CAM categories was more common among those 46-64, women, whites, and those with a college education. The results of this study allow researchers to refine descriptions of CAM use in the adult population. Most adults do not use a wide assortment of CAM; most use therapies within a single CAM category. Sets of CAM use were found to differ by age, gender, ethnicity, and education in ways consistent with previous research.

Women's reasons for complementary and alternative medicine use: racial/ethnic differences.

PubMed

Chao, Maria T; Wade, Christine; Kronenberg, Fredi; Kalmuss, Debra; Cushman, Linda F

2006-10-01

Although racial/ethnic differences in the prevalence of complementary and alternative medicine (CAM) utilization have been documented, differences in the reasons for using CAM have not been empirically assessed. In an increasingly diverse society, understanding differences in rates of and reasons for CAM use could elucidate cultural and social factors of health behaviors and inform health care improvements. The current study examines reasons for CAM use among women in four racial/ethnic groups. A national telephone survey of 3172 women aged 18 years and older was conducted in four languages. Respondents were asked about their use of remedies or treatments not typically prescribed by a medical doctor. This study focuses on those women who used CAM in the previous year and their reasons for using CAM. Non-Hispanic white women were most likely to cite personal beliefs for CAM use. Cost of conventional medicine was most prevalent among Mexican-American women CAM users. Physician referral, family and friends, and media sources were all equally likely to lead to CAM use in non-Hispanic white women. In contrast, informal networks of family and friends were the most important social influences of CAM use among African-, Mexican-, and Chinese-American women. Racial/ethnic differences in reasons for CAM use highlight cultural and social factors that are important to consider in public evaluation of the risks and benefits of CAM remedies and treatments.

Prevalence and Correlates of Complementary and Alternative Medicine Use among Patients with Lung Cancer: A Cross-Sectional Study in Beirut, Lebanon

PubMed Central

Anouti, Bilal; Haibe, Yolla

2017-01-01

Patients with lung cancer are increasingly seeking complementary and alternative medicine (CAM) to improve their physiological and psychological well-being. This study aimed to assess CAM use among lung cancer patients in Lebanon. Using a cross-sectional design, 150 lung cancer patients attending the Basile Cancer Institute at the American University of Beirut Medical Center were interviewed. Participants completed a questionnaire addressing sociodemographic characteristics, lung cancer condition, and use of CAM. The main outcome of interest was “use of any CAM therapy since diagnosis.” Prevalence of CAM use was 41%. The most commonly used CAM modality among study participants was “dietary supplements/special foods.” Results of the multiple logistic regression analyses showed that CAM use was positively associated with Lebanese nationality and paying for treatment out of pocket and was negatively associated with unemployment and having other chronic diseases. About 10% of patients used CAM on an alternative base, 58% did not disclose CAM use to their physician, and only 2% cited health professionals as influencing their choice of CAM. This study revealed a prevalent CAM use among lung cancer patients in Lebanon, with a marginal role for physicians in guiding this use. Promoting an open-communication and a patient-centered approach regarding CAM use is warranted. PMID:28912824

Complementary and alternative medicine in the undergraduate medical curriculum: a survey of Korean medical schools.

PubMed

Kim, Do Yeun; Park, Wan Beom; Kang, Hee Cheol; Kim, Mi Jung; Park, Kyu-Hyun; Min, Byung-Il; Suh, Duk-Joon; Lee, Hye Won; Jung, Seung Pil; Chun, Mison; Lee, Soon Nam

2012-09-01

The current status of complementary and alternative medicine (CAM) education in Korean medical schools is still largely unknown, despite a growing need for a CAM component in medical education. The prevalence, scope, and diversity of CAM courses in Korean medical school education were evaluated. Participants included academic or curriculum deans and faculty at each of the 41 Korean medical schools. A mail survey was conducted from 2007 to 2010. Replies were received from all 41 schools. CAM was officially taught at 35 schools (85.4%), and 32 schools (91.4%) provided academic credit for CAM courses. The most common courses were introduction to CAM or integrative medicine (88.6%), traditional Korean medicine (57.1%), homeopathy and naturopathy (31.4%), and acupuncture (28.6%). Educational formats included lectures by professors and lectures and/or demonstrations by practitioners. The value order of core competencies was attitude (40/41), knowledge (32/41), and skill (6/41). Reasons for not initiating a CAM curriculum were a non-evidence-based approach in assessing the efficacy of CAM, insufficiently reliable reference resources, and insufficient time to educate students in CAM. This survey reveals heterogeneity in the content, format, and requirements among CAM courses at Korean medical schools. Korean medical school students should be instructed in CAM with a more consistent educational approach to help patients who participate in or demand CAM.

Expression of L1-CAM and ADAM10 in human colon cancer cells induces metastasis.

PubMed

Gavert, Nancy; Sheffer, Michal; Raveh, Shani; Spaderna, Simone; Shtutman, Michael; Brabletz, Thomas; Barany, Francis; Paty, Phillip; Notterman, Daniel; Domany, Eytan; Ben-Ze'ev, Avri

2007-08-15

L1-CAM, a neuronal cell adhesion receptor, is also expressed in a variety of cancer cells. Recent studies identified L1-CAM as a target gene of beta-catenin-T-cell factor (TCF) signaling expressed at the invasive front of human colon cancer tissue. We found that L1-CAM expression in colon cancer cells lacking L1-CAM confers metastatic capacity, and mice injected in their spleen with such cells form liver metastases. We identified ADAM10, a metalloproteinase that cleaves the L1-CAM extracellular domain, as a novel target gene of beta-catenin-TCF signaling. ADAM10 overexpression in colon cancer cells displaying endogenous L1-CAM enhanced L1-CAM cleavage and induced liver metastasis, and ADAM10 also enhanced metastasis in colon cancer cells stably transfected with L1-CAM. DNA microarray analysis of genes induced by L1-CAM in colon cancer cells identified a cluster of genes also elevated in a large set of human colon carcinoma tissue samples. Expression of these genes in normal colon epithelium was low. These results indicate that there is a gene program induced by L1-CAM in colon cancer cells that is also present in colorectal cancer tissue and suggest that L1-CAM can serve as target for colon cancer therapy.

Women's Reasons for Complementary and Alternative Medicine Use: Racial/Ethnic Differences

PubMed Central

CHAO, MARIA T.; WADE, CHRISTINE; KRONENBERG, FREDI; KALMUSS, DEBRA; CUSHMAN, LINDA F.

2009-01-01

Objectives Although racial/ethnic differences in the prevalence of complementary and alternative medicine (CAM) utilization have been documented, differences in the reasons for using CAM have not been empirically assessed. In an increasingly diverse society, understanding differences in rates of and reasons for CAM use could elucidate cultural and social factors of health behaviors and inform health care improvements. The current study examines reasons for CAM use among women in four racial/ethnic groups. Design A national telephone survey of 3172 women aged 18 years and older was conducted in four languages. Respondents were asked about their use of remedies or treatments not typically prescribed by a medical doctor. This study focuses on those women who used CAM in the previous year and their reasons for using CAM. Results Non-Hispanic white women were most likely to cite personal beliefs for CAM use. Cost of conventional medicine was most prevalent among Mexican-American women CAM users. Physician referral, family and friends, and media sources were all equally likely to lead to CAM use in non-Hispanic white women. In contrast, informal networks of family and friends were the most important social influences of CAM use among African-, Mexican-, and Chinese-American women. Conclusions Racial/ethnic differences in reasons for CAM use highlight cultural and social factors that are important to consider in public evaluation of the risks and benefits of CAM remedies and treatments. PMID:17034277

Complementary and alternative medicine use by Canadian university students.

PubMed

Teper, Amy M; Tsai, Ellen

2008-01-01

Studies investigating Complementary and Alternative Medicine (CAM) prevalence are outdated and are generalized across different demographic groups due to their national scope. Determining trends among specific populations is necessary to gain insight into the growing popularity of CAM. To determine the prevalence and factors associated with CAM use among Canadian university undergraduate students and to determine student views regarding CAM research, education and policy-making decisions. Two arbitrarily selected undergraduate student classes at Queen's University were surveyed for this cross-sectional descriptive study. Information was provided by 128 respondents via questionnaire (75% response rate) on key demographics, CAM use and satisfaction with mainstream Canadian healthcare. Upon completion of the survey, voluntary participation was requested for the interview portion resulting in 7 semi-structured qualitative interviews. Of the 128 participants, 90 (70%) claimed to be users of at least one CAM modality. Female gender was strongly associated with CAM use (p<0.001). Other characteristics that may be correlated include being enrolled in a health-related academic program, being dissatisfied with certain aspects of the healthcare system and having parents who use CAM. The majority of respondents desired more research and education on CAM and more collaboration between the two healthcare streams. Canadian university undergraduate students are active CAM users and interest in CAM is high among this population. Further investigation is required to ensure that students are using CAM safely and appropriately.

Calcium Signaling Is Required for Erythroid Enucleation

PubMed Central

Russell, Sarah M.; Humbert, Patrick O.

2016-01-01

Although erythroid enucleation, the property of erythroblasts to expel their nucleus, has been known for 7ore than a century, surprisingly little is known regarding the molecular mechanisms governing this unique developmental process. Here we show that similar to cytokinesis, nuclear extrusion requires intracellular calcium signaling and signal transduction through the calmodulin (CaM) pathway. However, in contrast to cytokinesis we found that orthochromatic erythroblasts require uptake of extracellular calcium to enucleate. Together these functional studies highlight a critical role for calcium signaling in the regulation of erythroid enucleation. PMID:26731108

Fabrication of Zirconia-Reinforced Lithium Silicate Ceramic Restorations Using a Complete Digital Workflow

PubMed Central

Rödiger, Matthias; Ziebolz, Dirk; Schmidt, Anne-Kathrin

2015-01-01

This case report describes the fabrication of monolithic all-ceramic restorations using zirconia-reinforced lithium silicate (ZLS) ceramics. The use of powder-free intraoral scanner, generative fabrication technology of the working model, and CAD/CAM of the restorations in the dental laboratory allows a completely digitized workflow. The newly introduced ZLS ceramics offer a unique combination of fracture strength (>420 MPa), excellent optical properties, and optimum polishing characteristics, thus making them an interesting material option for monolithic restorations in the digital workflow. PMID:26509088

Self-latching eccentric cam for dual stroke compressor or pump

DOEpatents

Sisk, Francis J.

1985-01-01

For a dual capacity refrigerant compressor of the type which has an eccentric cam rotatable on a crankpin between two opposite positions which changes the total eccentricity of the crankpin and cam so as to obtain two different stroke lengths, the rotation of the cam on the crankpin being effected by a reversal of motor operation, the cam moves through an angle of about 270.degree. around the crankpin so that a centrifugal force torque tending to hold the cam in place is available at least in the reduced stroke length position of the cam, and by providing lightening cavities and eccentric weightings, the center of mass 74 of the cam can be shifted to obtain the centrifugal torque in the proper direction at both the maximum and reduced stroke positions.

Self-latching eccentric cam for dual stroke compressor or pump

DOEpatents

Sisk, F.J.

1985-01-22

For a dual capacity refrigerant compressor of the type which has an eccentric cam rotatable on a crankpin between two opposite positions which changes the total eccentricity of the crankpin and cam so as to obtain two different stroke lengths, the rotation of the cam on the crankpin being effected by a reversal of motor operation, the cam moves through an angle of about 270[degree] around the crankpin so that a centrifugal force torque tending to hold the cam in place is available at least in the reduced stroke length position of the cam, and by providing lightening cavities and eccentric weightings, the center of mass of the cam can be shifted to obtain the centrifugal torque in the proper direction at both the maximum and reduced stroke positions. 7 figs.

Burnout in United States Academic Chairs of Radiation Oncology Programs

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

Kusano, Aaron S.; Thomas, Charles R., E-mail: thomasch@ohsu.edu; Bonner, James A.

Purpose: The aims of this study were to determine the self-reported prevalence of burnout in chairs of academic radiation oncology departments, to identify factors contributing to burnout, and to compare the prevalence of burnout with that seen in other academic chair groups. Methods and Materials: An anonymous online survey was administered to the membership of the Society of Chairs of Academic Radiation Oncology Programs (SCAROP). Burnout was measured with the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). Results: Questionnaires were returned from 66 of 87 chairs (76% response rate). Seventy-nine percent of respondents reported satisfaction with their current positions. Common majormore » stressors were budget deficits and human resource issues. One-quarter of chairs reported that it was at least moderately likely that they would step down in the next 1 to 2 years; these individuals demonstrated significantly higher emotional exhaustion. Twenty-five percent of respondents met the MBI-HSS criteria for low burnout, 75% for moderate burnout, and none for high burnout. Group MBI-HSS subscale scores demonstrated a pattern of moderate emotional exhaustion, low depersonalization, and moderate personal accomplishment, comparing favorably with other specialties. Conclusions: This is the first study of burnout in radiation oncology chairs with a high response rate and using a validated psychometric tool. Radiation oncology chairs share similar major stressors to other chair groups, but they demonstrate relatively high job satisfaction and lower burnout. Emotional exhaustion may contribute to the anticipated turnover in coming years. Further efforts addressing individual and institutional factors associated with burnout may improve the relationship with work of chairs and other department members.« less

Impact of Surface Type, Wheelchair Weight, and Axle Position on Wheelchair Propulsion by Novice Older Adults

PubMed Central

Cowan, Rachel E.; Nash, Mark S.; Collinger, Jennifer L.; Koontz, Alicia M.; Boninger, Michael L.

2009-01-01

Objective To examine the impact of surface type, wheelchair weight, and rear axle position on older adult propulsion biomechanics. Design Crossover trial. Setting Biomechanics laboratory. Participants Convenience sample of 53 ambulatory older adults with minimal wheelchair experience (65−87y); men = 20, women = 33. Intervention Participants propelled 4 different wheelchair configurations over 4 surfaces; tile, low carpet, high carpet, and an 8% grade ramp (surface, chair order randomized). Chair configurations included: (1) unweighted chair with an anterior axle position, (2) 9.05kg weighted chair with an anterior axle position, (3) unweighted chair with a posterior axle position (Δ0.08m), and (4) 9.05kg weighted chair with a posterior axle position (Δ0.08m). Weight was added to a titanium folding chair, simulating the weight difference between very light and depot wheelchairs. Instrumented wheels measured propulsion kinetics. Main Outcome Measures Average self-selected velocity, push-frequency, stroke length, peak resultant and tangential force. Results Velocity decreased as surface rolling resistance or chair weight increased. Peak resultant and tangential forces increased as chair weight increased, surface resistance increased, and with a posterior axle position. The effect of a posterior axle position was greater on high carpet and the ramp. The effect of weight was constant, but more easily observed on high carpet and ramp. The effects of axle position and weight were independent of one another. Conclusion Increased surface resistance decreases self-selected velocity and increases peak forces. Increased weight decreases self-selected velocity and increases forces. Anterior axle positions decrease forces, more so on high carpet. Effects of weight and axle position are independent. Greatest reductions in peak forces occur in lighter chairs with anterior axle positions. PMID:19577019

High prevalence but limited evidence in complementary and alternative medicine: guidelines for future research

PubMed Central

2014-01-01

The use of complementary and alternative Medicine (CAM) has increased over the past two decades in Europe. Nonetheless, research investigating the evidence to support its use remains limited. The CAMbrella project funded by the European Commission aimed to develop a strategic research agenda starting by systematically evaluating the state of CAM in the EU. CAMbrella involved 9 work packages covering issues such as the definition of CAM; its legal status, provision and use in the EU; and a synthesis of international research perspectives. Based on the work package reports, we developed a strategic and methodologically robust research roadmap based on expert workshops, a systematic Delphi-based process and a final consensus conference. The CAMbrella project suggests six core areas for research to examine the potential contribution of CAM to the health care challenges faced by the EU. These areas include evaluating the prevalence of CAM use in Europe; the EU cititzens’ needs and attitudes regarding CAM; the safety of CAM; the comparative effectiveness of CAM; the effects of meaning and context on CAM outcomes; and different models for integrating CAM into existing health care systems. CAM research should use methods generally accepted in the evaluation of health services, including comparative effectiveness studies and mixed-methods designs. A research strategy is urgently needed, ideally led by a European CAM coordinating research office dedicated to fostering systematic communication between EU governments, the public, charitable and industry funders, researchers and other stakeholders. A European Centre for CAM should also be established to monitor and further a coordinated research strategy with sufficient funds to commission and promote high quality, independent research focusing on the public’s health needs and pan-European collaboration. There is a disparity between highly prevalent use of CAM in Europe and solid knowledge about it. A strategic approach on CAM research should be established to investigate the identified gaps of knowledge and to address upcoming health care challenges. PMID:24499316

Use of complementary and alternative medicine (CAM) by parents in their children and adolescents with epilepsy - Prevelance, predictors and parents' assessment.

PubMed

Hartmann, Nicole; Neininger, Martina P; Bernhard, Matthias K; Syrbe, Steffen; Nickel, Petra; Merkenschlager, Andreas; Kiess, Wieland; Bertsche, Thilo; Bertsche, Astrid

2016-01-01

The use of complementary and alternative medicine (CAM) is popular. Parents of children suffering from epilepsy may also consider administering CAM to their children. Systematic data about frequency of and motivations for CAM use, however, are scarce. In a university hospital's neuropaediatric department parents of patients aged 0-18 years suffering from epilepsy were consecutively invited to take part in a structured interview during 4 months in 2014. Of the invited parents, 164/165 (99%) agreed to participate. From those, 21/164 (13%) stated that they used CAM in their child. The highest independent predictive value of CAM use was the occurrence of adverse drug events (ADE) of anticonvulsants as judged by parents. Patients affected by ADE had a 5.6 higher chance of receiving CAM compared to patients without ADE. Most commonly used were homeopathy (14/21, 67%) and osteopathy (12/21, 57%). The internet was the most frequently used source of information (14/21, 67%). Of the parents, 10/21 (48%) described positive effects of CAM on seizure frequency, 12/21 (57%) on general condition of their child, and 20/21 (95%) wished to continue CAM for epilepsy therapy. From the non-users of CAM, 91/143 (66%) expressed the desire to learn more about CAM for epilepsy therapy. Our study was performed in a university hospital in a large urban city in Eastern Germany. CAM user rates can differ in other parts of Germany and Europe, in other institutions and for chronic diseases other than epilepsy. The main reason for CAM use was the occurrence of ADE of anticonvulsants. More than half of the parents saw a benefit of CAM for their children. Almost all parents wished to continue CAM use, even those who did not see concrete positive effects. Copyright © 2015 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Jupiter Fractal Art

NASA Image and Video Library

2017-08-10

See Jupiter's Great Red Spot as you've never seen it before in this new Jovian work of art. Artist Mik Petter created this unique, digital artwork using data from the JunoCam imager on NASA's Juno spacecraft. The art form, known as fractals, uses mathematical formulas to create art with an infinite variety of form, detail, color and light. The tumultuous atmospheric zones in and around the Great Red Spot are highlighted by the author's use of colorful fractals. Vibrant colors of various tints and hues, combined with the almost organic-seeming shapes, make this image seem to be a colorized and crowded petri dish of microorganisms, or a close-up view of microscopic and wildly-painted seashells. The original JunoCam image was taken on July 10, 2017 at 7:10 p.m. PDT (10:10 p.m. EDT), as the Juno spacecraft performed its seventh close flyby of Jupiter. The spacecraft captured the image from about 8,648 miles (13,917 kilometers) above the tops of the clouds of the planet at a latitude of -32.6 degrees. https://photojournal.jpl.nasa.gov/catalog/PIA21777

Evaluation of Biogenic and Fire Emissions in a Global Chemistry Model with NOMADSS, DC3 and SEAC4RS observations

NASA Astrophysics Data System (ADS)

Emmons, L. K.; Wiedinmyer, C.; Park, M.; Kaser, L.; Apel, E. C.; Guenther, A. B.

2014-12-01

Numerous measurements of compounds produced by biogenic and fire emissions were made during several recent field campaigns in the southeast United States, providing a unique data set for emissions and chemical model evaluation. The NCAR Community Atmosphere Model with Chemistry (CAM-chem) is coupled to the Community Land Model (CLM), which includes the biogenic emissions model MEGAN-v2.1, allowing for online calculation of emissions from vegetation for 150 compounds. Simulations of CAM-chem for summers 2012 and 2013 are evaluated with the aircraft and ground-based observations from DC3, NOMADSS and SEAC4RS. Comparison of directly emitted biogenic species, such as isoprene, terpenes, methanol and acetone, are used to evaluate the MEGAN emissions. Evaluation of oxidation products, including methyl vinyl ketone (MVK), methacrolein, formaldehyde, and other oxygenated VOCs are used to test the model chemistry mechanism. In addition, several biomass burning inventories are used in the model, including FINN, QFED, and FLAMBE, and are compared for their impact on atmospheric composition and ozone production, and evaluated with the aircraft observations.

Talaromyces neofusisporus and T. qii, two new species of section Talaromyces isolated from plant leaves in Tibet, China.

PubMed

Wang, Qi-Ming; Zhang, Yong-Hong; Wang, Bo; Wang, Long

2016-01-04

Two new species isolated from plant leaves belonging to Talaromyces section Talaromyces are reported, namely T. neofusisporus (ex-type AS3.15415 (T) = CBS 139516 (T)) and T. qii (ex-type AS3.15414 (T) = CBS 139515 (T)). Morphologically, T. neofusisporus is featured by forming synnemata on CYA and YES, bearing appressed biverticillate penicilli and smooth-walled fusiform conidia about 3.5-4.5 × 2-2.5 μm; and T. qii is characterized by velutinous colony texture, yellowish green conidia, yellow mycelium and ovoid to subglobose echinulate conidia measuring 3-3.5 μm. Phylogenetically, T. neofusisporus is such a unique species that no close relatives are found according to CaM, BenA and ITS1-5.8S-ITS2 as well as the combined three-gene sequences; and T. qii is related to T. thailandensis according to CaM, BenA and the combined sequence matrices, whereas ITS1-5.8S-ITS2 sequences do not support the close relationship between T. qii and T. thailandensis.

Perspectives of Oncology Nurses on Complementary and Alternative Medicine in Turkey: A Cross-Sectional Survey.

PubMed

Gok Metin, Zehra; Izgu, Nur; Karadas, Canan; Arikan Donmez, Ayse

In Turkey, between 22.1% and 84.1% of patients with cancer use complementary and alternative medicine (CAM). However, few CAM-related studies have focused on the perspective of oncology nurses. This study aimed to determine the knowledge, attitudes, and practices of Turkish oncology nurses regarding CAM. A descriptive cross-sectional survey of 127 participants was conducted in Ankara, Turkey. A semistructured questionnaire including characteristics, knowledge, attitudes, and practices of oncology nurses toward CAM was administered to participants. We found that more than half of nurses (54.0%) surveyed had no information on CAM modalities. Most oncology nurses (81.1%) used audiovisual media sources to obtain CAM information. Many nurses (81.3%) reported not using any CAM in cancer care, and only 26.8% recommended CAM to patients. Most nurses used CAM to accelerate wound healing (19.7%) and to manage symptoms, including constipation and diarrhea (8.8%) and anxiety (7.9%). Music (52.8%), massage (49.6%), and exercise (48.8%) were stated to be beneficial. Important barriers to use CAM for patients with cancer involved a lack of knowledge (60.6%); needing physician approval to apply any CAM methods to patients (52.1%); legal and institutional issues (47.2%); and limited educational, training, or certificate programs (44.1%). There is a need for increased knowledge about CAM by oncology nurses, considering their vital role in symptom management of patients with cancer. This can be achieved through solving legal and institutional problems, structured and comprehensive education/training programs, and the integration of CAM therapy into cancer care guidelines.

Preventive Screening of Women Who Use Complementary and Alternative Medicine Providers

PubMed Central

Tyree, Patrick T.; Lafferty, William E.

2009-01-01

Abstract Background Many women use complementary and alternative medicine (CAM). Although CAM use has been associated with reductions in conventionally recommended pediatric preventive care (e.g., vaccination), little is known about associations between CAM use and receipt of recommended preventive screening in women. Methods Using Washington State insurance data from 2000 to 2003, the authors generated clustered logistic regression models, examining associations between provider-based CAM use and receipt of screening tests for Chlamydia trachomatis, breast cancer, and cervical cancer: (1) contrasting women who used CAM providers only (alternative use) and women who used both conventional and CAM providers (complementary use) with women who used conventional care only and (2) testing associations between screening and use of four specific CAM provider types—naturopathic physicians, chiropractors, massage therapists, and acupuncturists. Results Both alternative and complementary use was associated with reduced Chlamydia screening. Cancer screening increased with complementary use but decreased with alternative use of CAM. Use of naturopathy was associated with decreased mammography, whereas all four CAM therapies were positively associated with Papanicolaou testing. Conclusions When used in conjunction with conventional care, use of provider-based CAM may signal high interest in various types of health-promoting behavior, including cancer screening. Negative associations between CAM and Chlamydia screening and between naturopathy and mammography require additional study. Interventions with CAM providers and their patients, aimed at improving rates of conventionally recommended screening, might encourage greater focus on preventive care, an important task when CAM providers serve as women's only contact with the healthcare system. PMID:19630554

Perception of cancer patients of their disease, self-efficacy and locus of control and usage of complementary and alternative medicine.

PubMed

Ebel, Marie-Desirée; Rudolph, Ivonne; Keinki, Christian; Hoppe, Andrea; Muecke, Ralph; Micke, Oliver; Muenstedt, Karsten; Huebner, Jutta

2015-08-01

A high percentage of cancer patients use complementary and alternative medicine (CAM). The aim of our study was to learn more about the association of CAM usage, information needs, perceived impact of disease, locus of control and self-efficacy of cancer patients. We asked patients attending a series of lectures on CAM using a standardized questionnaire which integrated questions on information needs, CAM and validated short questionnaires on self-efficacy, perception of the disease and locus of control of reinforcement. One hundred and eighty-five patients answered the questionnaire, from whom 45 % used CAM. Sixty percentage disclosed using CAM to the general practitioner and 57 % to the oncologist. Physicians and nurses, print media and the Internet are the most important source of information on CAM (used by 20-25 % each). Impact on neither daily life, perceived personal control nor coherence was associated with CAM usage, disclosure to physicians or sources of information. There also was no association between CAM usage and self-efficacy. In contrast, there was a significant association between CAM user rate and a high external locus of control. While CAM usage is agreed upon by many physicians due to the idea that it helps patients to become active and feel more in control of the disease, our data are in favor of the contrary. A strong perception of external locus of control seems to be a driver of CAM usage. Physicians should be aware of this association when counseling on CAM.

Belief in complementary and alternative medicine is related to age and paranormal beliefs in adults.

PubMed

Van den Bulck, Jan; Custers, Kathleen

2010-04-01

The use of complementary and alternative medicine (CAM) is widespread, even among people who use conventional medicine. Positive beliefs about CAM are common among physicians and medical students. Little is known about the beliefs regarding CAM among the general public. Among science students, belief in CAM was predicted by belief in the paranormal. In a cross-sectional study, 712 randomly selected adults (>18 years old) responded to the CAM Health Belief Questionnaire (CHBQ) and a paranormal beliefs scale. CAM beliefs were very prevalent in this sample of adult Flemish men and women. Zero-order correlations indicated that belief in CAM was associated with age (r = 0.173 P < 0.001) level of education (r = -0.079 P = 0.039) social desirability (r = -0.119 P = 0.002) and paranormal belief (r = 0.365 P < 0.001). In a multivariate model, two variables predicted CAM beliefs. Support for CAM increased with age (regression coefficient: 0.01; 95% confidence interval (CI): 0.006 to 0.014), but the strongest relationship existed between support for CAM and beliefs in the paranormal. Paranormal beliefs accounted for 14% of the variance of the CAM beliefs (regression coefficient: 0.376; 95%: CI 0.30-0.44). The level of education (regression coefficient: 0.06; 95% CI: -0.014-0.129) and social desirability (regression coefficient: -0.023; 95% CI: -0.048-0.026) did not make a significant contribution to the explained variance (<0.1%, P = 0.867). Support of CAM was very prevalent in this Flemish adult population. CAM beliefs were strongly associated with paranormal beliefs.

The Strategic Value of Succession Planning for Department Chairs.

PubMed

Rayburn, William; Grigsby, Kevin; Brubaker, Linda

2016-04-01

Most faculty who aspire to be department chairs are unaware of succession processes at their institution. This Commentary highlights the importance of succession planning, emphasizing the general need for transparency. Succession planning provides institutional leaders the opportunity to optimize, renew, and revitalize their organization by ensuring successful leadership transitions. In contrast to leadership pathways in the military, corporate business, and hospital administration, planned succession of medical school department chairs has received little attention. Different approaches to succession planning are essential for emergency and planned transitions. Emergency succession plans should be in place at all times, regularly revisited, and modified as needed. Department chairs should begin considering their planned succession between one and five years after their initial appointment. The succession discussion between a chair and medical school dean requires cautious, thoughtful, and open discussions. Intradepartmental annual faculty performance evaluations permit the chair to mentor potential successors in acquiring future-oriented, institution-based leadership qualities necessary to be considered for a future department chair position. If health and time permit, the successful chair should remain in his or her current position until a successor is named or, preferably, is in place. Appointment of an interim chair as part of succession planning can be useful for on-the-job training of an internal candidate, yet awkwardness might ensue if there is more than one internal candidate.Succession development offers the great advantage of maintaining smooth organizational performance while optimizing talent management and exploring opportunities for transitioning individuals into leadership roles.

Determination of methyl mercury in dental-unit wastewater.

PubMed

Stone, Mark E; Cohen, Mark E; Liang, Lian; Pang, Patrick

2003-11-01

The objective of this investigation was to establish whether monomethyl mercury (MMHg) is present in dental-unit wastewater and if present, to determine the concentration relative to total mercury. Wastewater samples were collected over an 18-month period from three locations: at the dental chair; at a 30-chair clinic, and at a 107-chair clinic. Total mercury determinations were completed using United States Environmental Protection Agency's (USEPA) method 1631. MMHg was measured utilizing modified USEPA method 1630. The total mercury levels were found to be: 45182.11 microg/l (n=13, SD=68562.42) for the chair-side samples, 5350.74 microg/l (n=12, SD=2672.94) for samples at the 30-chair clinic, and 13439.13 microg/l (n=13, SD=9898.91) for samples at the107-chair clinic. Monomethyl Hg levels averaged 0.90 microg/l (n=13, SD=0.87) for chair side samples, 8.26 (n=12, SD=7.74) for the 30-chair facility, and 26.77 microg/l (n=13, SD=34.50) for 107-chair facility. By way of comparison, the MMHg levels for the open ocean, lakes and rain are orders of magnitude lower than methyl mercury levels seen in dental wastewater (part per billion levels for dental wastewater samples compared to part per trillion levels for samples from the environment). Environmentally important levels of MMHg were found to be present in dental-unit wastewater at concentrations orders of magnitude higher than seen in natural settings.

The Use of Complementary and Alternative Medicine among Lebanese Adults: Results from a National Survey

PubMed Central

Naja, F.; Alameddine, M.; Itani, L.; Shoaib, H.; Hariri, D.; Talhouk, S.

2015-01-01

Objective. To examine the prevalence and correlates of Complementary and Alternative Medicine (CAM) use in Lebanon. Methods. A cross-sectional survey was conducted through face to face interviews on a nationally representative sample of 1,475 Lebanese adults. The survey questionnaire explored the sociodemographic and health related characteristics as well as the types and modes of CAM use. The main outcome in this study was the use of CAM during the last 12 months. Results. Prevalence of CAM use was 29.87% with “folk herbs” being the most commonly used (75%). Two out of five CAM users indicated using it as alternative to conventional therapies and only 28.4% of users disclosed the use of CAM to their physician. CAM use was significantly associated with higher income, presence of a chronic disease, and lack of access to needed health care. Lower odds of CAM use were observed among older adults and those with a higher education level. Conclusions. This study revealed a high prevalence of CAM use in Lebanon. Health policy and decision makers need to facilitate proper regulation and integration of CAM into mainstream medicine and educate health care providers and the public alike on the safe and effective use of CAM therapies. PMID:26106436

Negotiating complementary and alternative medicine use in primary care visits with older patients

PubMed Central

Koenig, Christopher J.; Ho, Evelyn Y.; Yadegar, Vivien; Tarn, Derjung M.

2013-01-01

Objective To empirically investigate the ways in which patients and providers discuss Complementary and Alternative Medicine (CAM) treatment in primary care visits. Methods Audio recordings from visits between 256 adult patients aged 50 years and older and 28 primary care physicians were transcribed and analyzed using discourse analysis, an empirical sociolinguistic methodology focusing on how language is used to negotiate meaning. Results Discussion about CAM occurred 128 times in 82 of 256 visits (32.0%). The most frequently discussed CAM modalities were non-vitamin, non-mineral supplements and massage. Three physician–patient interactions were analyzed turn-by-turn to demonstrate negotiations about CAM use. Patients raised CAM discussions to seek physician expertise about treatments, and physicians adopted a range of responses along a continuum that included encouragement, neutrality, and discouragement. Despite differential knowledge about CAM treatments, physicians helped patients assess the risks and benefits of CAM treatments and made recommendations based on patient preferences for treatment. Conclusion Regardless of a physician's stance or knowledge about CAM, she or he can help patients negotiate CAM treatment decisions. Practice implications Providers do not have to possess extensive knowledge about specific CAM treatments to have meaningful discussions with patients and to give patients a framework for evaluating CAM treatment use. PMID:22483672

Complementary and alternative medicine use among adults in Enugu, Nigeria.

PubMed

Onyiapat, Jane-Lovena E; Okoronkwo, Ijeoma L; Ogbonnaya, Ngozi P

2011-03-04

Attention and interest in the use of Complementary and Alternative Medicine (CAM) has been reawakened globally. Evidence from studies carried out in different parts of the world has established that CAM use is very common and varies among populations. This study investigated the use of CAM among adults in Enugu urban, irrespective of their health status. It provided information on the prevalence of CAM use, forms of CAM remedies used and reasons for utilizing them The study areas were three local government areas in Enugu urban of Enugu State. Cross-sectional survey using questionnaires were administered to randomly selected households. All consenting participants were used for the study 732 participants (37.2% males and 62.8% females) were used for the study. Ages ranged from 18 - 65 years. 620 (84.7%) of the adult population have used CAM ranging from one single type to twenty different types while 112 (15.3%) have not used any form of CAM. The most commonly used CAM product was the biological products, followed by prayer/faith healing. Major reasons for using CAM include their natural state and also for health promotion and maintenance. There is need for adequate policy formulation and regulation to ensure safety and efficacy of CAM products. Measures to ensure rational use of CAM should be instituted.

Temporal and spatial transcriptomic and microRNA dynamics of CAM photosynthesis in pineapple.

PubMed

Wai, Ching M; VanBuren, Robert; Zhang, Jisen; Huang, Lixian; Miao, Wenjing; Edger, Patrick P; Yim, Won C; Priest, Henry D; Meyers, Blake C; Mockler, Todd; Smith, J Andrew C; Cushman, John C; Ming, Ray

2017-10-01

The altered carbon assimilation pathway of crassulacean acid metabolism (CAM) photosynthesis results in an up to 80% higher water-use efficiency than C 3 photosynthesis in plants making it a potentially useful pathway for engineering crop plants with improved drought tolerance. Here we surveyed detailed temporal (diel time course) and spatial (across a leaf gradient) gene and microRNA (miRNA) expression patterns in the obligate CAM plant pineapple [Ananas comosus (L.) Merr.]. The high-resolution transcriptome atlas allowed us to distinguish between CAM-related and non-CAM gene copies. A differential gene co-expression network across green and white leaf diel datasets identified genes with circadian oscillation, CAM-related functions, and source-sink relations. Gene co-expression clusters containing CAM pathway genes are enriched with clock-associated cis-elements, suggesting circadian regulation of CAM. About 20% of pineapple microRNAs have diel expression patterns, with several that target key CAM-related genes. Expression and physiology data provide a model for CAM-specific carbohydrate flux and long-distance hexose transport. Together these resources provide a list of candidate genes for targeted engineering of CAM into C 3 photosynthesis crop species. © 2017 The Authors The Plant Journal © 2017 John Wiley & Sons Ltd.

Negotiating complementary and alternative medicine use in primary care visits with older patients.

PubMed

Koenig, Christopher J; Ho, Evelyn Y; Yadegar, Vivien; Tarn, Derjung M

2012-12-01

To empirically investigate the ways in which patients and providers discuss Complementary and Alternative Medicine (CAM) treatment in primary care visits. Audio recordings from visits between 256 adult patients aged 50 years and older and 28 primary care physicians were transcribed and analyzed using discourse analysis, an empirical sociolinguistic methodology focusing on how language is used to negotiate meaning. Discussion about CAM occurred 128 times in 82 of 256 visits (32.0%). The most frequently discussed CAM modalities were non-vitamin, non-mineral supplements and massage. Three physician-patient interactions were analyzed turn-by-turn to demonstrate negotiations about CAM use. Patients raised CAM discussions to seek physician expertise about treatments, and physicians adopted a range of responses along a continuum that included encouragement, neutrality, and discouragement. Despite differential knowledge about CAM treatments, physicians helped patients assess the risks and benefits of CAM treatments and made recommendations based on patient preferences for treatment. Regardless of a physician's stance or knowledge about CAM, she or he can help patients negotiate CAM treatment decisions. Providers do not have to possess extensive knowledge about specific CAM treatments to have meaningful discussions with patients and to give patients a framework for evaluating CAM treatment use. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Complementary and alternative medicine (CAM) use in an Italian cohort of pediatric headache patients: the tip of the iceberg.

PubMed

Dalla Libera, D; Colombo, B; Pavan, G; Comi, G

2014-05-01

The use of complementary alternative medicine (CAM) in paediatric populations is considerably increased, especially for pain and chronic conditions, as demonstrated by epidemiological surveys both in Europe and in the USA. In our study, CAM was used in 76 % patients of a cohort of 124 children affected by headache (age 4-16 years; 67 % female; 70 % migraine without aura, 12 % migraine with aura, 18 % tensive headache according to IHS criteria) consecutively recruited at a Pediatric Headache University Center. CAM was used as preventive treatment in 80 % cases. The main reasons for seeking CAM were: the wish of avoiding chronic use of drugs with their related side effects, the desire of an integrated approach, the reported inefficacy of conventional medicine, and a more suitable children disposition to CAM than to pharmacological compound. Female gender, younger age, migraine without aura, parents' higher educational status, maternal use of CAM and other associated chronic conditions, correlated with CAM use (p < 0.05). 73 % patients chose CAM also to treat other diseases (i.e. allergies, colitis, asthma, insomnia, muscle-scheletric disorders and dysmenorrhoea). The most assumed CAM were: herbal remedies (64 %) such as Valeriana, Ginkgo biloba, Boswellia serrata, Vitex agnus-castus, passion flower, Linden tree; vitamins/minerals supplements (40 %) with magnesium, 5-Hydroxytryptophan, vitamin B6 or B12, Multivitamin compounds; Homeopathy (47 %) with Silicea, Ignatia Amara, Pulsatilla, Aconitum, Nux Vomica, Calcarea phosphorica; physical treatment (45 %) such as Ayurvedic massage, shiatsu, osteopathy; yoga (33 %); acupuncture (11 %). CAM-often integrated with conventional care-was auto-prescribed in 30 % of the cases, suggested by non-physician in 22 %, by the General Practitioner in 24 % and by paediatrician in 24 %. Both general practitioners and neurologists were mostly unaware of their patients' CAM use. In conclusion, neurologists should inquire for CAM use and be prepared to learn about CAM therapies or to directly interact with CAM trained experts, in order to coordinate an integrative approach to health, as especially required in paediatric headache patients and their parents. Further studies are required to investigate safety and efficacy of CAM in pediatric headache, as a possible side-medicine to conventional pharmacological approach.

The use of complementary and alternative medicine by patients with cancer: a cross-sectional survey in Saudi Arabia.

PubMed

Abuelgasim, Khadega A; Alsharhan, Yousef; Alenzi, Tariq; Alhazzani, Abdulaziz; Ali, Yosra Z; Jazieh, Abdul Rahman

2018-03-12

A significant proportion of cancer patients use complementary and alternative medicine (CAM) along with conventional therapies (CT), whereas a smaller proportion delay or defer CT in favor of CAM. Previous studies exploring CAM use among cancer patients in the Middle East region have shown discrepant results. This study investigates the prevalence and pattern of CAM use by Saudi cancer patients. It also discusses the possible benefits and harm related to CAM use by cancer patients, and it explores the beliefs patients hold and their transparency with health care providers regarding their CAM use. A cross-sectional study was conducted in oncology wards and outpatient clinics by using face-to-face interviews with the participants. A total of 156 patients with a median age of 50 years (18-84) participated in the study. The prevalence of CAM use was 69.9%; the most prominent types of CAM were those of a religious nature, such as supplication (95.4%), Quran recitation (88.1%), consuming Zamzam water (84.4%), and water upon which the Quran has been read (63.3%). Drinking camel milk was reported by 24.1% of CAM users, whereas camel urine was consumed by 15.7%. A variety of reasons were given for CAM use: 75% reported that they were using CAM to treat cancer, enhance mood (18.3%),control pain (11.9%), enhance the immune system (11%),increase physical fitness (6.4%), and improve appetite (4.6%). Thirty percent of CAM users had discussed the issue with their doctors; only 7.7% had done so with their nurses. The use of CAM, including camel products, is highly prevalent among cancer patients in the Middle East, but these patients do not necessarily divulge their CAM use to their treating physicians and nurses. Although CAM use can be beneficial, some can be very harmful, especially for cancer patients. Association is known between camel products and brucellosis and Middle East respiratory syndrome coronavirus (MERS-CoV). Both can lead to tremendous morbidity in immune-compromised patients. Doctor-patient communication regarding CAM use is of paramount importance in cancer care.

Complementary and alternative medicine use amongst Malaysian orthopaedic oncology patients.

PubMed

Dhanoa, Amreeta; Yong, Tze Lek; Yeap, Stephanie Jin Leng; Lee, Isaac Shi Zhung; Singh, Vivek Ajit

2014-10-17

Although studies have shown that a large proportion of cancer patients use CAM, no study on CAM use amongst orthopaedic oncology patients has been published. Therefore, this study aims to determine the prevalence, characteristics and factors associated with CAM use amongst orthopaedic oncology patients. All consecutive consenting patients/parents who presented at the Orthopaedic Oncology Clinic, University Malaya Medical Centre (1st January to 31st December 2013) were interviewed using a structured questionnaire. Overall, one hundred sixty-eight of the 274 patients recruited (61.3%) had used CAM at some time during their current illness. The prevalence of CAM used was 68% (123/181) for patients with malignant tumours and 48.4% (45/93) for patients with benign tumours. The most popular CAMs were biological-based therapies (90.5%), followed by mind-body techniques (40.5%). The most frequently used biological therapies were mega/multivitamins (31%), snakehead (Chana striatus) (28%) and sea cucumber (Stichopus horrens) (18%); whereas prayers (31%) and holy water (13%) dominated the mind-body category. Common reasons for CAM use were to improve physical well-being (60.1%), try out everything that would help (59.5%) and to enhance wound-healing (39.3%). Independent predictors for CAM use in multivariate analysis were paediatric patients [OR 2.46; 95% CI 0.99-6.06; p = 0.05], malignant tumours [OR 1.90; 95% CI 1.12-3.25; p = 0.018] and patients who underwent surgery [OR 2.06; 95% CI 1.15-3.69; p = 0.015]. Majority patients started taking CAMs following suggestions from family members (53%) and friends (49%). Sixty-six percent of patients felt they actually benefitted from CAM and 83.3% were satisfied/very satisfied. Only 5 patients reported side-effects. Majority of CAM users planned to continue CAM use or recommend it to others. However, only 31.5% of patients disclosed their CAM usage to their doctors. This survey revealed a high prevalence of CAM usage amongst orthopaedic oncology patients, with majority patients expressing satisfaction towards CAM. Oncologists should proactively ask patients about CAM to prevent potential adverse effects, as most patients do not share this information with them.

Individualised medicine from the perspectives of patients using complementary therapies: a meta-ethnography approach.

PubMed

Franzel, Brigitte; Schwiegershausen, Martina; Heusser, Peter; Berger, Bettina

2013-06-03

Personalised (or individualised) medicine in the days of genetic research refers to molecular biologic specifications in individuals and not to a response to individual patient needs in the sense of person-centred medicine. Studies suggest that patients often wish for authentically person-centred care and personal physician-patient interactions, and that they therefore choose Complementary and Alternative medicine (CAM) as a possibility to complement standard care and ensure a patient-centred approach. Therefore, to build on the findings documented in these qualitative studies, we investigated the various concepts of individualised medicine inherent in patients' reasons for using CAM. We used the technique of meta-ethnography, following a three-stage approach: (1) A comprehensive systematic literature search of 67 electronic databases and appraisal of eligible qualitative studies related to patients' reasons for seeking CAM was carried out. Eligibility for inclusion was determined using defined criteria. (2) A meta-ethnographic study was conducted according to Noblit and Hare's method for translating key themes in patients' reasons for using CAM. (3) A line-of-argument approach was used to synthesize and interpret key concepts associated with patients' reasoning regarding individualized medicine. (1) Of a total of 9,578 citations screened, 38 studies were appraised with a quality assessment checklist and a total of 30 publications were included in the study. (2) Reasons for CAM use evolved following a reciprocal translation. (3) The line-of-argument interpretations of patients' concepts of individualised medicine that emerged based on the findings of our multidisciplinary research team were "personal growth", "holism", "alliance", "integrative care", "self-activation" and "wellbeing". The results of this meta-ethnographic study demonstrate that patients' notions of individualised medicine differ from the current idea of personalised genetic medicine. Our study shows that the "personal" patients' needs are not identified with a specific high-risk group or with a unique genetic profile in the sense of genome-based "personalised" or "individualised" medicine. Thus, the concept of individualised medicine should include the humanistic approach of individualisation as expressed in concepts such as "personal growth", "holistic" or "integrative care", doctor-patient "alliance", "self-activation" and "wellbeing" needs. This should also be considered in research projects and the allocation of healthcare resources.

Individualised medicine from the perspectives of patients using complementary therapies: a meta-ethnography approach

PubMed Central

2013-01-01

Background Personalised (or individualised) medicine in the days of genetic research refers to molecular biologic specifications in individuals and not to a response to individual patient needs in the sense of person-centred medicine. Studies suggest that patients often wish for authentically person-centred care and personal physician-patient interactions, and that they therefore choose Complementary and Alternative medicine (CAM) as a possibility to complement standard care and ensure a patient-centred approach. Therefore, to build on the findings documented in these qualitative studies, we investigated the various concepts of individualised medicine inherent in patients’ reasons for using CAM. Methods We used the technique of meta-ethnography, following a three-stage approach: (1) A comprehensive systematic literature search of 67 electronic databases and appraisal of eligible qualitative studies related to patients’ reasons for seeking CAM was carried out. Eligibility for inclusion was determined using defined criteria. (2) A meta-ethnographic study was conducted according to Noblit and Hare's method for translating key themes in patients’ reasons for using CAM. (3) A line-of-argument approach was used to synthesize and interpret key concepts associated with patients’ reasoning regarding individualized medicine. Results (1) Of a total of 9,578 citations screened, 38 studies were appraised with a quality assessment checklist and a total of 30 publications were included in the study. (2) Reasons for CAM use evolved following a reciprocal translation. (3) The line-of-argument interpretations of patients’ concepts of individualised medicine that emerged based on the findings of our multidisciplinary research team were “personal growth”, “holism”, “alliance”, “integrative care”, “self-activation” and “wellbeing”. Conclusions The results of this meta-ethnographic study demonstrate that patients’ notions of individualised medicine differ from the current idea of personalised genetic medicine. Our study shows that the “personal” patients’ needs are not identified with a specific high-risk group or with a unique genetic profile in the sense of genome-based “personalised” or “individualised” medicine. Thus, the concept of individualised medicine should include the humanistic approach of individualisation as expressed in concepts such as “personal growth”, “holistic” or “integrative care”, doctor-patient “alliance”, “self-activation” and “wellbeing” needs. This should also be considered in research projects and the allocation of healthcare resources. PMID:23731970

What do patients know? Education from the European Lung Foundation perspective.

PubMed

Powell, Pippa; Smyth, Dan; Saraiva, Isabel; Lisspers, Karin; Hardavella, Georgia; Fuertes, Juan; Hill, Kate

2018-03-01

The European Lung Foundation (ELF) is an organisation whose mission is to bring together the public and patients with respiratory professionals to improve lung health. A core part of all its activities focus on education: the education of patients on their condition, including how to prevent, treat and manage it; the education of healthcare professionals on how to improve work with patients and awareness about the issues that are important to patients; and education of the public and policy makers of the importance of lung health at a European level. ELF was founded and works in a unique partnership with the European Respiratory Society (ERS). This article has been written by the recent past Chairs and the new Chairs of three ELF committees (Council (D. Smyth and I. Saraiva), Professional Advisory Committee (K. Lisspers and G. Hardavella) and Patient Advisory Committee (J. Fuertes and K. Hill)) in order to reflect on ELF's journey in this regard over recent years. In particular, it seems a good moment to assess the success and impact of the first patient Chair of ELF, Dan Smyth, and reflect on what this has meant for ELF's educational activities, and what the future now looks like. To understand the importance of educated patients (patients that are knowledgeable on their condition and how healthcare processes work).To understand the importance of guiding patients to quality reliable sources of information and education.To establish ways to ensure that healthcare professionals are prepared to work with educated patients.To outline the initiatives that ELF has driven forward in the field of education.To see the value in patients advocating at the European level for raising standards of education for patients and physicians.

Experimental investigation of chair type, row spacing, occupants, and carpet on theatre chair absorption.

PubMed

Choi, Young-Ji; Bradley, John S; Jeong, Dae-Up

2015-01-01

This paper examines how the individual variations of chair type, row spacing, as well as the presence of occupants and carpet, combine to influence the absorption characteristics of theater chairs as a function of sample perimeter-to-area (P/A) ratios. Scale models were used to measure the interactive effects of the four test variables on the chair absorption characteristics, avoiding the practical difficulties of full scale measurements. All of the test variables led to effects that could lead to important changes to auditorium acoustics conditions. At mid and higher frequencies, the various effects can usually be explained as due to, more or less, porous absorbing material. In the 125 and 250 Hz octave bands, the major changes were attributed to resonant absorbing mechanisms. The results indicate that for accurate predictions of the effective absorption of the chairs in an auditorium, one should use the P/A method and reverberation chamber tests of the chair absorption coefficients to predict the absorption coefficients of each block of chairs and use these results as input in a room acoustics computer model of the auditorium. The application of these results to auditorium acoustics design is described, more approximate approaches are considered, and relations to existing methods are discussed.

Development and classification of an operational definition of complementary and alternative medicine for the Cochrane Collaboration

PubMed Central

Wieland, L. Susan; Manheimer, Eric; Berman, Brian M.

2011-01-01

Over the past decade the Cochrane Collaboration has been an increasingly important source of information on complementary and alternative medicine (CAM) therapies. From 2007 to 2008 the Cochrane CAM Field developed a topics list that allowed us to categorize all 396 Cochrane reviews related to CAM (as of The Cochrane Library, Issue 4, 2009). This topics list is an advance in making Cochrane reviews on CAM topics accessible to the public. In this paper, we discuss challenges in developing the topics list, including developing an operational definition of CAM, deciding which reviews should be included within the CAM Field’s scope, developing the structured list of CAM Field-specific topics, and determining where in the topics list the reviews should be placed. Although aspects of our operational definition of CAM are open to revision, a standardized definition provides us with an objective, reproducible and systematic method for defining and classifying CAM therapies. PMID:21717826

Use and interest in complementary and alternative medicine among college students seeking healthcare at a university campus student health center.

PubMed

Nguyen, Jannett; Liu, Michael A; Patel, Rohini J; Tahara, Keli; Nguyen, Annie L

2016-08-01

There is growing data on complementary and alternative medicine (CAM) preferences among college students. While several studies have focused on undergraduate students, there is limited data on graduate students. Cross sectional analysis of undergraduate and graduate students seeking medical care at the University of California Irvine's Student Health Center (SHC). The survey assessed previous CAM use and preferences for future CAM use and education. The majority (67.0%) had used CAM within the last year, 27.0% would use CAM for their current health condition, and 51.9% would consider CAM for their current health condition if they were more knowledgeable. Most respondents desired more CAM education and indicated that they would try CAM modalities if covered under insurance. Most college students requested more knowledge to assist in their decisions to use CAM. These findings provide insight for health centers on the preferences of college student patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

Cam-Operated Pitch-Change Apparatus

NASA Technical Reports Server (NTRS)

Barnes, P. E. (Inventor)

1978-01-01

A pitch-change apparatus for a ducted thrust fan having a plurality of variable pitch blades employs a camming ring mounted coaxially at the hub at an axially fixed station along the hub axis for rotation about the hub axis both with the blades and relative to the blades. The ring has a generally spherical outer periphery and a plurality of helical camming grooves extending in a generally spherical plane on the periphery. Each of the variable pitch blades is connected to a pitch-change horn having a cam follower mounted on its outer end, and the camming ring and the horns are so arranged about the hub axis that the plurality of followers on the horns engage respectively the plurality of helical camming grooves. Rotary drive means rotates the camming ring relative to the blades to cause blade pitch to be changed through the cooperative operation of the camming grooves on the ring and the cam followers on the pitch-change horns.

Attitudes, Patterns of Recommendation, and Communication of Pediatric Providers About Complementary and Alternative Medicine in a Large Metropolitan Children’s Hospital

PubMed Central

Kundu, Anjana; Tassone, Rosalie F.; Jimenez, Nathalia; Seidel, Kristy; Valentine, Jessica K.; Pagel, Paul S.

2014-01-01

The authors conducted an Email survey of their medical staff to explore the attitudes, patterns of recommendation, and communication of pediatric providers about complementary and alternative medicine (CAM) in a large metropolitan children’s hospital. Two thirds of the respondents reported awareness about their patients’ CAM therapy use (65%) and recommended CAM therapy to their patients (67%). Providers who reported personal use of CAM (71%) were more likely to recommend CAM to their patients compared with those who do not (76% vs 45%; P < .05). One half of pediatric providers reported occasional consultation with their patient’s CAM provider, but bidirectional communication was rare (4%). Specific changes in care based on a CAM provider’s recommendations were also unusual (4%). Despite the positive attitudes about and willingness to recommend CAM by pediatric providers, communication between these clinicians and CAM providers may be less than ideal. PMID:21127080

Complementary and Alternative Medicine Use in Infertility: Cultural and Religious Influences in a Multicultural Canadian Setting

PubMed Central

Read, Suzanne C.; Carrier, Marie-Eve; Whitley, Rob; Gold, Ian; Tulandi, Togas

2014-01-01

Abstract Objectives: To explore the use of complementary and alternative medicine (CAM) for infertility in a multicultural healthcare setting and to compare Western and non-Western infertility patients' reasons for using CAM and the meanings they attribute to CAM use. Design: Qualitative semi-structured interviews using thematic analysis. Settings/location: Two infertility clinics in Montreal, Quebec, Canada. Participants: An ethnoculturally varied sample of 32 heterosexual infertile couples. Results: CAM used included lifestyle changes (e.g., changing diet, exercise), alternative medicine (e.g., acupuncture, herbal medicines), and religious methods (e.g., prayers, religious talismans). Patients expressed three attitudes toward CAM: desperate hope, casual optimism, and amused skepticism. Participants' CAM use was consistent with cultural traditions of health and fertility: Westerners relied primarily on biomedicine and used CAM mainly for relaxation, whereas non-Westerners' CAM use was often influenced by culture-specific knowledge of health, illness and fertility. Conclusions: Understanding patients' CAM use may help clinicians provide culturally sensitive, patient-centered care. PMID:25127071

Effect of gel formation on the dissolution behavior of clarithromycin tablets.

PubMed

Inukai, Koki; Takiyama, Kei; Noguchi, Shuji; Iwao, Yasunori; Itai, Shigeru

2017-04-15

Clarithromycin (CAM) is a macrolide antibiotic that is widely used at clinical sites. We found that release of CAM is suppressed when tablets of CAM were exposed to an external solvent containing carboxylate buffers such as citrate. The suppressed release of CAM can be attributed to the formation of gels on the tablet surfaces, which inhibits penetration of the solvent into the tablet and thus disintegration of the tablets. Delayed disintegration of the tablets was also observed for commercial tablets. This suggests that taking CAM and carboxylates at the same time might be avoided. The crystal structure of CAM citrate reveals that molecular chains of CAM are cross-linked by hydrogen bond between citrate groups in the crystal. The crystal structure indicates that cross-linked CAM chains of the three-dimensional mesh structure might also be formed in high concentration CAM solutions in the presence of carboxylates, resulting in gel formation. Copyright © 2017 Elsevier B.V. All rights reserved.

Folding chair

DOEpatents

Cornell, Howell N.

1985-08-20

A foldable chair of the lawn chair type has ground-engaging front and rear legs, attached to and carrying a back frame and seat frame, the back frame and seat frame being pivotally attached to a spreader rod which extends beyond the back and seat frames to bear against one of the leg members when the chair is unfolded. A contact pad mounted on the extending portion of the spreader rod is formed as an externally-contoured bushing fit over the spreader rod and adapted to engage the leg member to restrict side-to-side movement of the spreader rod, with respect to the leg member, when the chair is unfolded.

Prevalence and correlates of complementary and alternative medicine use among diabetic patients in Beirut, Lebanon: a cross-sectional study

PubMed Central

2014-01-01

Background Patients with Type 2 Diabetes Mellitus (T2DM) are increasingly using complementary and alternative medicine (CAM) therapies due to difficulty in adhering to the therapeutic regimens and lifestyle changes necessary for disease management. Little is known about the prevalence and mode of CAM use among patients with T2DM in Lebanon. Objective To assess the prevalence and modes of CAM use among patients with T2DM residing in Beirut, Lebanon. Methods A cross-sectional survey of T2DM patients was conducted on patients recruited from two major referral centers in Beirut- a public hospital and a private academic medical center. In a face-to-face interview, participants completed a questionnaire comprised of three sections: socio-demographic, diabetes characteristics and types and modes of CAM use. Descriptive statistics, univariate and multivariate logistic regression analyses were utilized to assess the prevalence and correlates of CAM use, as well as whether the use was complementary or alternative to mainstream medicine. The main outcome in this study, CAM use, was defined as using CAM at least once since diagnosis with T2DM. Results A total of 333 T2DM patients completed the survey (response rate: 94.6%). Prevalence of CAM use since diagnosis with the disease was 38%. After adjustment, CAM use was significantly associated with a “married” status, a longer duration of T2DM, the presence of disease complications, and a positive family history of the disease. Folk foods and herbs were the most commonly used CAM followed by natural health products. One in five patients used CAM as alternative to conventional treatment. Only 7% of CAM users disclosed the CAM use to their treating physician. Health care practitioners were the least cited (7%) as influencing the choice of CAM among users. Conclusion The use of CAM therapies among T2DM patients in Lebanon is prevalent. Decision makers and care providers must fully understand the potential risks and benefits of CAM therapies to appropriately advise their patients. Attention must be dedicated to educating T2DM patients on the importance of disclosing CAM use to their physicians especially patients with a family history of diabetes, and those who have had the disease for a long time. PMID:24906634

Prevalence, patterns, and perceived value of complementary and alternative medicine among cancer patients: a cross-sectional, descriptive study.

PubMed

Bahall, Mandreker

2017-06-30

Sophisticated conventional medicine (CM) has brought significant advances to cancer prevention, detection, and treatment. However, many cancer patients still turn to complementary and alternative medicine (CAM) treatment. This study explored the prevalence, patterns, and perceived value of CAM among cancer patients. This quantitative descriptive study was conducted between March 1, 2015, and July 31, 2015, among a cross-sectional, convenience sample of patients from the Oncology Department of San Fernando General Hospital in Trinidad and Tobago. Face-to-face interviews were conducted at the oncology clinic and treatment suite after obtaining informed consent. Data analysis included descriptive analysis, chi-square tests, and binary logistic regression analysis. The prevalence of CAM use among a sample of 350 cancer patients was 39.1% (39.6% for breast cancer, 44.4% for prostate cancer, 37% for ovarian cancer, and 38.7% for colon cancer patients). Herbs were the most common type of CAM used (93.4%), followed by spiritual therapy (73.7%). CAM use was more prevalent among females (68.6%), Indo-Trinidadians (63.5%), and patients aged 41-50 years (37.2%). The majority (70%-80%) rated CAM efficacy on perceived value. CAM was used mainly because of a desire to try anything that might help (67.6%), followed by it being congruent with the patients' beliefs (59.1%). Patients knew about CAM mainly through friends (69.3%) and family (69.3%). Most patients were generally satisfied (93.6%) and considered CAM helpful (89.8%), but the majority never informed their health care provider of CAM use (78.8%). Patients reported the simultaneous use of more than one type of CAM, without considering or knowing of possible side-effects. The perceived value of CAM included empowerment, control, cure, and improved quality of life. CAM use was associated with age, but no predictors of CAM use could be identified. Medicinal herbs and spiritual therapy are commonly used among cancer patients because of perceived benefits and satisfaction. CAM use is more prevalent among females, Indo-Trinidadians, and patients aged 41-50 years old. There are no useful predictors of CAM use. More than one type of CAM is commonly used simultaneously without disclosure to health care providers.

Knowledge of, Attitudes Toward, and Experience of Complementary and Alternative Medicine in Western Medicine– and Oriental Medicine–Trained Physicians in Korea

PubMed Central

Lee, Sang-Il; Khang, Young-Ho; Lee, Moo-Song; Kang, Weechang

2002-01-01

Objectives. We compared knowledge of, attitudes toward, and experience with complementary and alternative medicine (CAM) among Western medicine–trained doctors (WMDs) and Oriental medicine–trained doctors (OMDs). Methods. In Korea, 502 WMDs and 500 OMDs were interviewed with a structured questionnaire. Results. OMDs held more favorable attitudes toward CAM than did WMDs. OMDs possessed a deeper understanding of and greater experience with CAM. OMDs more readily endorsed health beliefs congruent with CAM. Conclusions. In the future, CAM can be more readily used by OMDs than by WMDs. Because evidence for the effectiveness of CAM remains sparse, more research is needed for the prudent use of CAM in Korea. An education and training system for potential CAM providers remains to be developed. PMID:12453822

Perspectives of complementary and alternative medicine (CAM) practitioners in the support and treatment of infertility.

PubMed

O'Reilly, Erin; Sevigny, Marika; Sabarre, Kelley-Anne; Phillips, Karen P

2014-10-14

Infertility patients are increasingly using complementary and alternative medicine (CAM) to supplement or replace conventional fertility treatments. The objective of this study was to determine the roles of CAM practitioners in the support and treatment of infertility. Ten semi-structured interviews were conducted in Ottawa, Canada in 2011 with CAM practitioners who specialized in naturopathy, acupuncture, traditional Chinese medicine, hypnotherapy and integrated medicine. CAM practitioners played an active role in both treatment and support of infertility, using a holistic, interdisciplinary and individualized approach. CAM practitioners recognized biological but also environmental and psychosomatic determinants of infertility. Participants were receptive to working with physicians, however little collaboration was described. Integrated infertility patient care through both collaboration with CAM practitioners and incorporation of CAM's holistic, individualized and interdisciplinary approaches would greatly benefit infertility patients.

Complementary and Alternative Medicine Use and Adherence to Asthma Medications among Latino and Non-Latino White Families

PubMed Central

McQuaid, Elizabeth L.; Fedele, David A.; Adams, Sue K.; Koinis-Mitchell, Daphne; Mitchell, Jessica; Kopel, Sheryl J.; Seifer, Ronald; Jandasek, Barbara; Fritz, Gregory K.; Canino, Glorisa

2013-01-01

Objective The current study sought to evaluate patterns of complementary and alternative medicine (CAM) use in a sample of Latino and Non-Latino white (NLW) children with asthma, to determine whether parental beliefs about conventional medications and barriers to obtaining these medications were related to CAM use, and to assess whether CAM use was associated with decreased adherence to controller medications. Methods Participants included 574 families of children with asthma from Non-Latino White, Puerto Rican, and Dominican backgrounds from RI and from Island Puerto Rico. All parents completed a brief checklist of barriers to medication use and an assessment of CAM approaches. A subsample of 259 families had controller medication use monitored objectively for approximately one month by MDILog (fluticasone propionate), TrackCap (montelukast), or dosage counter (fluticasone/salmeterol combination). Results Prevalence of CAM use was high among Latino families. Perceived barriers to obtaining medication were related to increased CAM use in Puerto Rican families from RI. Elevated medication concerns were positively associated with CAM use among NLW and Island PR families. CAM use was positively related to objective adherence within NLW families, and unrelated in other groups. Conclusions CAM use is common among Latino families with asthma. Among some families, CAM use may be initiated as a way to cope with barriers to obtaining medication or when parents have concerns about conventional medications. Families who report CAM use do not appear to be substituting CAM for conventional asthma medication. PMID:24602583

Family Medicine Residency Program Directors Attitudes and Knowledge of Family Medicine CAM Competencies

PubMed Central

Gardiner, Paula; Filippelli, Amanda C.; Lebensohn, Patricia; Bonakdar, Robert

2013-01-01

Context Little is known about the incorporation of integrative medicine (IM) and complementary and alternative medicine (CAM) into family medicine residency programs. Objective The Society for Teachers of Family Medicine (STFM) approved a set of CAM/IM competencies for family medicine residencies. We hope to evaluate with an online survey tool, whether residency programs are implementing such competencies into their curriculum. We also hope to assess the knowledge and attitudes of Residency Directors (RDs) on the CAM/IM competencies. Design A survey was distributed by the CAFM (Council of Academic Family Medicine) Educational Research Alliance to RDs via email. The survey was distributed to 431 RDs. Of those who received it, 212 responded for a response rate of 49.1%. Questions assessed the knowledge and attitudes of CAM/IM competencies and incorporation of CAM/IM into residency curriculum. Results Forty-five percent of RDs were aware of the competencies. In term of RD attitudes, 58% reported that CAM/IM is an important component of residents' curriculum yet, 60% report not having specific learning objectives for CAM/IM in their residency curriculum. Among all programs, barriers to CAM/IM implementation included: time in residents' schedules (77%); faculty training (75%); access to CAM experts (43%); lack of reimbursement (43%), and financial resources (29%). Conclusions While many RDs are aware of the STFM CAM/IM competencies and acknowledge their role in residence education, there are many barriers preventing residencies to implementing the STFM CAM/IM competencies. PMID:24021471

Family medicine residency program directors attitudes and knowledge of family medicine CAM competencies.

PubMed

Gardiner, Paula; Filippelli, Amanda C; Lebensohn, Patricia; Bonakdar, Robert

2013-01-01

Little is known about the incorporation of integrative medicine (IM) and complementary and alternative medicine (CAM) into family medicine residency programs. The Society for Teachers of Family Medicine (STFM) approved a set of CAM/IM competencies for family medicine residencies. We hope to evaluate whether residency programs are implementing such competencies into their curriculum using an online survey tool. We also hope to assess the knowledge and attitudes of Residency Directors (RDs) on the CAM/IM competencies. A survey was distributed by the Council of Academic Family Medicine (CAFM) Educational Research Alliance to RDs via e-mail. The survey was distributed to 431 RDs. Of those who received it, 212 responded, giving a response rate of 49.1%. Questions assessed the knowledge and attitudes of CAM/IM competencies and incorporation of CAM/IM into the residency curriculum. Forty-five percent of RDs were aware of the competencies. In terms of RD attitudes, 58% reported that CAM/IM is an important component of residents' curriculum; yet, 60% report not having specific learning objectives for CAM/IM in their residency curriculum. Among all programs, barriers to CAM/IM implementation included time in residents' schedules (77%); faculty training (75%); access to CAM experts (43%); lack of reimbursement (43%); and financial resources (29%). While many RDs are aware of the STFM CAM/IM competencies and acknowledge their role in residence education, there are many barriers that prevent residencies from implementing the STFM CAM/IM competencies. © 2013 Elsevier Inc. All rights reserved.

Comparative study of RetCamRetCam II vs. binocular ophthalmoscopy in a screening program for retinopathy of prematurity.

PubMed

Tejada-Palacios, P; Zarratea, L; Moral, M; de la Cruz-Bértolo, J

2015-08-01

To determine the performance of RetCam vs. binocular ophthalmoscopy (BIO) in a screening program for retinopathy of prematurity (ROP). Observational comparative study with prospective data collection. Examinations with RetCam (n=169) were performed on 83 infants included in a screening program for ROP and stored for analysis at a later stage. An experienced ophthalmologist examined the ocular fundus with binocular indirect ophthalmoscopy (BIO). The RetCam images were assessed for the presence of ROP, zone, grade, and presence of plus disease. RetCam and BIO data were compared by visually to estimate sensitivity, specificity, positive (VPP) and negative (VPN) predictive values. ROP disease was detected in 108 eyes with BIO, and in 74 with RetCam. Out of 306 eyes examined with RetCam, false negative results were found in 34 eyes, with no false positives. Sensitivity of RetCam exam vs. BIO was 0.68, and specificity was 0.99. Positive predictive value was 0.93 and negative predictive value was 0.85. All 34 ROP cases not detected with RetCam were in zone III or outer zone II. They were all mild and regressed spontaneously. No threshold ROP was missed with RetCam. Binocular indirect ophthalmoscopy is the reference method for the diagnosis of ROP. RetCam may be used as an alternative for ROP screening. Copyright © 2010 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

Attitudes of members of the German Society for Palliative Medicine toward complementary and alternative medicine for cancer patients.

PubMed

Conrad, A C; Muenstedt, K; Micke, O; Prott, F J; Muecke, R; Huebner, J

2014-07-01

A high proportion of cancer patients use complementary and alternative medicine (CAM). In oncology, risks of CAM are side effects and interactions. Our aim was to conduct a survey on professionals in palliative care regarding attitudes toward CAM. An internet-based survey with a standardized questionnaire was sent to all members of the German Society for Palliative Care. The questionnaire collected data on attitude toward CAM and experiences. Six hundred and ninety questionnaires (19 %) were returned (49 % physicians, 35 % nurses, 3 % psychologists). Acceptance of CAM is high (92 % for complementary and 54 % for alternative medicine). Most participants had already been asked on CAM by patients (95 %) and relatives (89 %). Forty-four percent already had used complementary methods and 5 % alternative methods. Only 21 % think themselves adequately informed. Seventy-four percent would use complementary methods in a patient with advanced tumor, and 62 % would use alternative therapy in patients if there was no other therapy. Even from those who are skeptical 45 % would treat a patient with alternative methods. In order to inform patients on CAM and to further patients' autonomy, evidence on benefits and harms of CAM must be provided. As awareness of risks from CAM is low and critical appraisal especially of alternative medicine missing, but interest on information on CAM is high, experts should provide evidence-based recommendations for CAM in palliative care to members of different professions. This could be done by a curriculum focusing on the most often used CAM methods.

Laser Transformation Hardening of Firing Zone Cutout Cams.

DTIC Science & Technology

1981-06-01

bath nitriding to case harden firing zone cutout cams for the Mk 10 Guided Missile Launcher System (GMLS). These cams, machined of 4340 steel ...salt bath nitriding to case harden firing zone cutout cams for the Mk 10 Guided Missile Launcher System (GMLS). These cams, machined of 4340 steel ...Patterns ........ ................ 8 9 Laser Beam Step Pattern ...... .................. .. 10 10 Hardness Profile, 4340 Steel

Physician and patient attitudes towards complementary and alternative medicine in obstetrics and gynecology

PubMed Central

Furlow, Mandi L; Patel, Divya A; Sen, Ananda; Liu, J Rebecca

2008-01-01

Background In the U.S., complementary and alternative medicine (CAM) use is most prevalent among reproductive age, educated women. We sought to determine general attitudes and approaches to CAM among obstetric and gynecology patients and physicians. Methods Obstetrician-gynecologist members of the American Medical Association in the state of Michigan and obstetric-gynecology patients at the University of Michigan were surveyed. Physician and patient attitudes and practices regarding CAM were characterized. Results Surveys were obtained from 401 physicians and 483 patients. Physicians appeared to have a more positive attitude towards CAM as compared to patients, and most reported routinely endorsing, providing or referring patients for at least one CAM modality. The most commonly used CAM interventions by patients were divergent from those rated highest among physicians, and most patients did not consult with a health care provider prior to starting CAM. Conclusion Although obstetrics/gynecology physicians and patients have a positive attitude towards CAM, physician and patients' view of the most effective CAM therapies were incongruent. Obstetrician/gynecologists should routinely ask their patients about their use of CAM with the goal of providing responsible, evidence-based advice to optimize patient care. PMID:18582380

AUTONOMOUS AND NONAUTONOMOUS REGULATION OF WNT-MEDIATED NEURONAL POLARITY BY THE C. ELEGANS ROR KINASE CAM-1

PubMed Central

Chien, Shih-Chieh Jason; Gurling, Mark; Kim, Changsung; Craft, Teresa; Forrester, Wayne; Garriga, Gian

2015-01-01

Wnts are a conserved family of secreted glycoproteins that regulate various developmental processes in metazoans. Three of the five C. elegans Wnts, CWN-1, CWN-2 and EGL-20, and the sole Wnt receptor of the Ror kinase family, CAM-1, are known to regulate the anterior polarization of the mechanosensory neuron ALM. Here we show that CAM-1 and the Frizzled receptor MOM-5 act in parallel pathways to control ALM polarity. We also show that CAM-1 has two functions in this process: an autonomous signaling function that promotes anterior polarization and a nonautonomous Wnt-antagonistic function that inhibits anterior polarization. These antagonistic activities can account for the weak ALM phenotypes displayed by cam-1 mutants. Our observations suggest that CAM-1 could function as a Wnt receptor in many developmental processes, but the analysis of cam-1 mutants may fail to reveal CAM-1’s role as a receptor in these processes because of its Wnt-antagonistic activity. In this model, loss of CAM-1 results in increased levels of Wnts that act through other Wnt receptors, masking CAM-1’s autonomous role as a Wnt receptor. PMID:25917219

Integration of complementary and alternative medicine information and advice in chronic disease management guidelines.

PubMed

Team, Victoria; Canaway, Rachel; Manderson, Lenore

2011-01-01

The growing evidence on the benefits and risks of complementary and alternative medicine (CAM) and its high rate of use (69% of Australians) - particularly for chronic or recurrent conditions - means increasing attention on CAM. However, few people disclose CAM use to their GP, and health professionals tend to inadequately discuss CAM-related issues with their patients, partly due to insufficient knowledge. As clinical and non-clinical chronic condition management guidelines are a means to educate primary health care practitioners, we undertook a content analysis of guidelines relevant to two common chronic conditions - cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM) - to assess their provision of CAM-related information. Ten current Australian guidelines were reviewed, revealing scant CAM content. When available, the CAM-relevant information was brief, in some cases unclear, inconclusive and lacking in direction to the GP or health care provider. Although we focus on CVD and T2DM, we argue the value of all chronic condition management guidelines integrating relevant evidence-informed information and advice on CAM risks, benefits and referrals, to increase GP awareness and knowledge of appropriate CAM therapies, and potentially to facilitate doctor-client discussion about CAM.

Prevalence and parental perceptions of complementary and alternative medicine use by children with cancer in a multi-ethnic Southeast Asian population.

PubMed

Hamidah, Alias; Rustam, Zainudin A; Tamil, Azmi M; Zarina, Latiff A; Zulkifli, Zakaria S; Jamal, Rahman

2009-01-01

The purpose of the current study was to determine the prevalence of use of complementary and alternative medicine (CAM) by children with cancer and to compare the characteristics of CAM users and CAM nonusers. A cross-sectional study was performed at a pediatric oncology center in Kuala Lumpur, Malaysia. The parents of 97 children with cancer were interviewed using a structured questionnaire. Overall, 84.5% of the respondents had used CAM, and most of them believed that CAM provided a boost to the immune system, and used CAM with the intention to complement conventional treatment. The most frequently used CAM was water therapy (78%), followed by spirulina (33%), vitamin C (27%), multivitamin (23%), visit to traditional healers (22%), sea cucumber (Stichopus horrens) (15%), and Chinese traditional medicine (12%). The Malay (n = 67) were using more often (93%) CAM than non-Malay (n = 30, use 67%, P = 0.001). CAM use is common among Malaysian children with cancer. Understanding the sociocultural dimension of patients' health beliefs is important to a successful treatment, and pediatric oncologists should ask for the use of CAM.

Differential expression and functional analysis of three calmodulin isoforms in germinating pea (Pisum sativum L.) seeds.

PubMed

Duval, Frédéric D; Renard, Michelle; Jaquinod, Michel; Biou, Valérie; Montrichard, Françoise; Macherel, David

2002-11-01

Implication of the ubiquitous, highly conserved, Ca2+ sensor calmodulin (CaM) in pea seed germination has been investigated. Mass spectrometry analysis of purified CaM revealed the coexistence in seeds of three protein isoforms, diverging from each other by single amino acid substitution in the N-terminal alpha-helix. CaM was shown to be encoded by a small multigenic family, and full-length cDNAs of the three isoforms (PsCaM1, 2 and 3) were isolated to allow the design of specific primers in more divergent 5' and 3' untranslated regions. Expression studies, performed by semiquantitative RT-PCR, demonstrated differential expression patterns of the three transcripts during germination. PsCaM1 and 2 were detected at different levels in dry axes and cotyledons, and they accumulated during imbibition and prior to radicle protrusion. In contrast, PsCaM3 appeared only upon radicle protrusion, then gradually increased in both tissues. To characterise the biochemical properties of the CaM isoforms, functional analyses were conducted in vitro using recombinant Strep-tagged proteins (CaM1-ST, CaM2-ST and CaM3-ST) expressed in Escherichia coli. Gel mobility shift assays revealed that CaM1-ST exhibited a stoichiometric binding of a synthetic amphiphilic CaM kinase II peptide while CaM2-ST and CaM3-ST affinities for the same peptide were reduced. Affinity differences were also observed for CaM isoform binding to Trp-3, an idealised helical CaM-binding peptide. However, the three proteins activated in the same way the CaM-dependent pea NAD kinase. Finally, the significance of the single substitutions upon CaM interaction with its targets is discussed in a structural context.

The use of complementary and alternative medicines during breastfeeding: results from the Herbal supplements in Breastfeeding InvesTigation (HaBIT).

PubMed

Bettiol, Alessandra; Lombardi, Niccolò; Marconi, Ettore; Crescioli, Giada; Bonaiuti, Roberto; Maggini, Valentina; Gallo, Eugenia; Mugelli, Alessandro; Firenzuoli, Fabio; Ravaldi, Claudia; Vannacci, Alfredo

2018-05-16

Use of complementary and alternative medicines (CAMs) during breastfeeding is commonly increasing, mainly due to their presumed higher safety compared to conventional medications. Indeed, CAMs can cause serious adverse effects, and high-quality evidence supporting their use during lactation is limited. In Italy, specific investigations on the attitude of lactating women towards CAMs are lacking. The Herbal supplements in Breastfeeding InvesTigation (HaBIT) aimed to explore the attitudes and knowledge on CAMs among lactating women. A web-based survey was conducted over a six-year period among lactating women resident in Tuscany (Italy). Data on lactating behavior, CAMs use during pregnancy or breastfeeding, and women knowledge about CAMs' efficacy and safety were collected. 388 lactating women answered the questionnaire; the majority of them were primiparae with high education level. Two-hundred and four women declared to have been CAMs users during breastfeeding. Moreover, the 61 and 48% of subjects reported CAMs use also before and during pregnancy. A significant proportion of subjects were unable to correctly identify the type of CAMs they were using. The 73% of women were convinced that CAMs had higher or comparable safety than conventional medications; nevertheless, 65% of women admitted to have no scientific information about the potential risks of CAMs, and 14 CAMs users reported to have experienced side effects. These results claim the necessity that healthcare providers amplify their role to increase nursing women' awareness about CAMs. Further research is needed to support the evidence base of non-pharmaceutical approaches for symptom control during breastfeeding. This article is protected by copyright. All rights reserved.

Insights into molecular interactions between CaM and its inhibitors from molecular dynamics simulations and experimental data.

PubMed

González-Andrade, Martin; Rodríguez-Sotres, Rogelio; Madariaga-Mazón, Abraham; Rivera-Chávez, José; Mata, Rachel; Sosa-Peinado, Alejandro; Del Pozo-Yauner, Luis; Arias-Olguín, Imilla I

2016-01-01

In order to contribute to the structural basis for rational design of calmodulin (CaM) inhibitors, we analyzed the interaction of CaM with 14 classic antagonists and two compounds that do not affect CaM, using docking and molecular dynamics (MD) simulations, and the data were compared to available experimental data. The Ca(2+)-CaM-Ligands complexes were simulated 20 ns, with CaM starting in the "open" and "closed" conformations. The analysis of the MD simulations provided insight into the conformational changes undergone by CaM during its interaction with these ligands. These simulations were used to predict the binding free energies (ΔG) from contributions ΔH and ΔS, giving useful information about CaM ligand binding thermodynamics. The ΔG predicted for the CaM's inhibitors correlated well with available experimental data as the r(2) obtained was 0.76 and 0.82 for the group of xanthones. Additionally, valuable information is presented here: I) CaM has two preferred ligand binding sites in the open conformation known as site 1 and 4, II) CaM can bind ligands of diverse structural nature, III) the flexibility of CaM is reduced by the union of its ligands, leading to a reduction in the Ca(2+)-CaM entropy, IV) enthalpy dominates the molecular recognition process in the system Ca(2+)-CaM-Ligand, and V) the ligands making more extensive contact with the protein have higher affinity for Ca(2+)-CaM. Despite their limitations, docking and MD simulations in combination with experimental data continue to be excellent tools for research in pharmacology, toward a rational design of new drugs.

Gender Differences in the Use of Complementary and Alternative Medicine and Their Association With Moderate Mental Distress in U.S. Adults With Migraines/Severe Headaches.

PubMed

Rhee, Taeho Greg; Harris, Ila M

2017-01-01

We examined whether the prevalence of complementary and alternative medicine (CAM) use varies by gender, and assessed the interaction of gender and CAM use on moderate mental distress (MMD) in U.S. adults with migraines/severe headaches. We used data from the 2012 National Health Interview Survey, which represents non-institutionalized U.S. adults with migraines/severe headaches (n = 4645 unweighted). Using a cross-sectional design with survey sampling techniques, we conducted descriptive analyses for prevalence of CAM use by gender. Multivariate logistic regression analyses were run to investigate potential roles of migraines/severe headaches and CAM use on MMD by gender. The overall prevalence of past year CAM use was 44.4%. Women consistently used CAM more frequently than men (P = .004). The most commonly used CAM types included herbal supplements (22.2%), massage (14.2%), and chiropractic/osteopathic (13.9%). After controlling for covariates, the odds of MDD were increased by the presence of migraines/severe headaches (P < .001) and the use of any CAM (P < .001). The interaction effect of migraines/severe headaches and CAM use decreased the odds of MMD by 27% in women (P < .05), but not in men. Women used CAM more frequently than men among adults with migraines/severe headaches in the United States. In addition, the interaction of gender and CAM use exists; the CAM use was associated with decreased odds of MMD among women only, suggesting that women with migraines/severe headaches may have benefited from CAM for their mental distress. Future research is needed to explore why such patterns vary by gender. © 2016 American Headache Society.

Calmodulin in complex with the first IQ motif of myosin-5a functions as an intact calcium sensor

PubMed Central

Shen, Mei; Zhang, Ning; Zheng, Sanduo; Zhang, Wen-Bo; Zhang, Hai-Man; Lu, Zekuan; Su, Qian Peter; Sun, Yujie; Li, Xiang-dong

2016-01-01

The motor function of vertebrate myosin-5a is inhibited by its tail in a Ca2+-dependent manner. We previously demonstrated that the calmodulin (CaM) bound to the first isoleucine-glutamine (IQ) motif (IQ1) of myosin-5a is responsible for the Ca2+-dependent regulation of myosin-5a. We have solved the crystal structure of a truncated myosin-5a containing the motor domain and IQ1 (MD-IQ1) complexed with Ca2+-bound CaM (Ca2+-CaM) at 2.5-Å resolution. Compared with the structure of the MD-IQ1 complexed with essential light chain (an equivalent of apo-CaM), MD-IQ1/Ca2+-CaM displays large conformational differences in IQ1/CaM and little difference in the motor domain. In the MD-IQ1/Ca2+-CaM structure, the N-lobe and the C-lobe of Ca2+-CaM adopt an open conformation and grip the C-terminal and the N-terminal portions of the IQ1, respectively. Remarkably, the interlobe linker of CaM in IQ1/Ca2+-CaM is in a position opposite that in IQ1/apo-CaM, suggesting that CaM flip-flops relative to the IQ1 during the Ca2+ transition. We demonstrated that CaM continuously associates with the IQ1 during the Ca2+ transition and that the binding of CaM to IQ1 increases Ca2+ affinity and substantially changes the kinetics of the Ca2+ transition, suggesting that the IQ1/CaM complex functions as an intact Ca2+ sensor responding to distinct calcium signals. PMID:27647889

Solution Structure of Calmodulin Bound to the Binding Domain of the HIV-1 Matrix Protein*

PubMed Central

Vlach, Jiri; Samal, Alexandra B.; Saad, Jamil S.

2014-01-01

Subcellular distribution of calmodulin (CaM) in human immunodeficiency virus type-1 (HIV-1)-infected cells is distinct from that observed in uninfected cells. CaM co-localizes and interacts with the HIV-1 Gag protein in the cytosol of infected cells. Although it has been shown that binding of Gag to CaM is mediated by the matrix (MA) domain, the structural details of this interaction are not known. We have recently shown that binding of CaM to MA induces a conformational change that triggers myristate exposure, and that the CaM-binding domain of MA is confined to a region spanning residues 8–43 (MA-(8–43)). Here, we present the NMR structure of CaM bound to MA-(8–43). Our data revealed that MA-(8–43), which contains a novel CaM-binding motif, binds to CaM in an antiparallel mode with the N-terminal helix (α1) anchored to the CaM C-terminal lobe, and the C-terminal helix (α2) of MA-(8–43) bound to the N-terminal lobe of CaM. The CaM protein preserves a semiextended conformation. Binding of MA-(8–43) to CaM is mediated by numerous hydrophobic interactions and stabilized by favorable electrostatic contacts. Our structural data are consistent with the findings that CaM induces unfolding of the MA protein to have access to helices α1 and α2. It is noteworthy that several MA residues involved in CaM binding have been previously implicated in membrane binding, envelope incorporation, and particle production. The present findings may ultimately help in identification of the functional role of CaM in HIV-1 replication. PMID:24500712

USE OF COMPLEMENTARY AND ALTERNATIVE MEDICINE IN GEORGIA.

PubMed

Nadareishvili, I; Lunze, K; Tabagari, N; Beraia, A; Pkhakadze, G

2017-11-01

In Georgia, like in most countries globally, people commonly resort to complementary and alternative medicine (CAM). However, not much is known about CAM practices there. The aim of the study was to document common practices of CAM in Georgia and related patient attitudes. We collected data from peoples who commonly use CAM at 20 service provision centers in Georgia using cluster sampling from 300 patients. We admininstered a cross-sectional survey and conducted descriptive statistical analyses. People in Georgia use CAM either for prevention to improve general health (33%) or to treat chronic conditions (36%), spending about 25 Euros per month out of pocket. Most (77%) get their knowledge about CAM from family or friends , less than half (44%) from books or media, and 11% from medical providers. A close person's advice or experience was the most common rationale given for CAM use (54%). In our sample, 17% either don't trust or are unsatisfied with conventional medicine, 29% found CAM treatment "very effective" and 61% "quite/partially" effective; only 5% not effective. Conventional treatment was stopped in half of the cases. 35% of respondents informed their physicians of their CAM use, while about half did not. Public mistrust towards conventional medicine, CAM user high satisfaction, relatively low cost of such services in Georgia - are the factors letting us to suggest that CAM use will further increase. Frequent self taking decisions made by patients to stop physician prescribed treatment, not informing physicians on CAM use, as well as other factors put patients health at risk. Further research and capacity building in practice, education and other related aspects are needed to establish evidence-based regulation and standards for CAM in Georgia that ensure informed decision making and patient safety.

Medical students' knowledge and attitude towards complementary and alternative medicine - A survey in Ghana.

PubMed

Ameade, Evans Paul Kwame; Amalba, Anthony; Helegbe, Gideon Kofi; Mohammed, Baba Sulemana

2016-07-01

Interest, use of and research into Complementary and Alternative Medicine (CAM; bǔ chōng yǔ tì dài yī xué) is on the increase in recent times even in developed countries. It may therefore be appropriate if medical students who would become future physicians possess adequate knowledge and better attitude towards CAMS. This study assessed medical students' knowledge of, attitude towards, and usage of CAM as well as their opinion about integrating CAMs into the medical curriculum. In a cross-sectional study, 203 medical students in 2nd, 3rd and 4th year classes completed a questionnaire. Data was analyzed using SPSS 18 and GraphPad 5.01. Association between different variables was tested. The overall mean knowledge score was 19.6%. Students in higher years of study were significantly more knowledgeable in CAMs (p = 0.0006). The best known CAM was herbal medicine (63.6%), with relatives and friends being their main source of information. Students' attitude towards CAM was good (75.1%) with majority (71.5%) favouring introduction of CAM into the medical curriculum; preferably at the preclinical level (67.5%). Year of study, gender and locality where student grew up did not significantly affect attitude towards CAM use. Up to 117 (59.0%) of the students had ever used CAM especially herbal medicine. Although students in this study were deficient in knowledge on CAMs, their attitude and usage was good. Herbal medicine was the best known and used CAM. Majority of the students believed knowledge on CAM would be beneficial to their practice hence, desirous of its introduction into their medical curriculum.

Overexpression of HepaCAM inhibits cell viability and motility through suppressing nucleus translocation of androgen receptor and ERK signaling in prostate cancer.

PubMed

Song, Xuedong; Wang, Yin; Du, Hongfei; Fan, Yanru; Yang, Xue; Wang, Xiaorong; Wu, Xiaohou; Luo, Chunli

2014-07-01

HepaCAM is suppressed in a variety of human cancers, and involved in cell adhesion, growth, migration, invasion, and survival. However, the expression and function of HepaCAM in prostate cancer are still unknown. HepaCAM expression has been detected by RT-PCR, Western blotting and immunohistochemistry staining in prostate cell lines RWPE-1, LNCap, DU145, PC3, and in 75 human prostate tissue specimens, respectively. Meanwhile, the cell proliferation ability was detected by WST-8 assay. The role of HepaCAM in prostate cancer cell migration and invasion was examined by wound healing and transwell assay. And flow cytometry was used to observe the apoptosis of prostate cancer cells. Then we detected changes of Androgen Receptor translocation and ERK signaling using immunofluorescence staining and western blot after overexpression of HepaCAM. The HepaCAM expression was significantly down-regulated in prostate cancer tissues and undetected in prostate cancer cells. However, the low HepaCAM expression was not statistically associated with clinicopathological characteristics of prostate cancer. Overexpression of HepaCAM in prostate cancer cells decreased the cell proliferation, migration and invasion, and induced the cell apoptosis. Meanwhile, HepaCAM prevented the androgen receptor translocation from the cytoplasm to the nucleus and down-regulated the MAPK/ERK signaling. Our results suggested that HepaCAM acted as a tumor suppressor in prostate cancer. HepaCAM inhibited cell viability and motility which might be through suppressing the nuclear translocation of Androgen Receptor and down-regulating the ERK signaling. Therefore, it was indicated that HepaCAM may be a potential therapeutic target for prostate cancer. © 2014 Wiley Periodicals, Inc.

Complementary alternative medicine use among patients with dengue fever in the hospital setting: a cross-sectional study in Malaysia.

PubMed

Ching, SiewMooi; Ramachandran, Vasudevan; Gew, Lai Teck; Lim, Sazlyna Mohd Sazlly; Sulaiman, Wan Aliaa Wan; Foo, Yoke Loong; Zakaria, Zainul Amiruddin; Samsudin, Nurul Huda; Lau, Paul Chih Ming Chih; Veettil, Sajesh K; Hoo, Fankee

2016-01-29

In Malaysia, the number of reported cases of dengue fever demonstrates an increasing trend. Since dengue fever has no vaccine or antiviral treatment available, it has become a burden. Complementary and alternative medicine (CAM) has become one of the good alternatives to treat the patients with dengue fever. There is limited study on the use of CAM among patients with dengue fever, particularly in hospital settings. This study aims to determine the prevalence, types, reasons, expenditure, and resource of information on CAM use among patients with dengue fever. This is a descriptive, cross-sectional study of 306 patients with dengue fever, which was carried out at the dengue clinic of three hospitals. Data were analysed using IBM SPSS Statistics version 21.0 and logistic regression analysis was used to determine the factors associated with CAM use. The prevalence of CAM use was 85.3% among patients with dengue fever. The most popular CAMs were isotonic drinks (85.8%), crab soup (46.7%) and papaya leaf extract (22.2%). The most common reason for CAM use was a good impression of CAM from other CAM users (33.3%). The main resource of information on CAM use among patients with dengue fever was family (54.8%). In multiple logistic regression analysis, dengue fever patients with a tertiary level are more likely to use CAM 5.8 (95% confidence interval (CI 1.62-20.45) and 3.8 (95% CI 1.12-12.93) times than secondary level and primary and below respectively. CAM was commonly used by patients with dengue fever. The predictor of CAM use was a higher level of education.

Perception and use of complementary and alternative medicine for low back pain.

PubMed

Tsang, Vivian Hiu Man; Lo, Phoebe Hiu Wai; Lam, Fong Tao; Chung, Lulu Suet Wing; Tang, Tin Yan; Lui, Hoi Man; Lau, Jordan Tsz Gwan; Yee, Ho Fung; Lun, Yiu Kun; Chan, Hei Tung; Cheung, Jason Pui Yin

2017-01-01

To determine the prevalence of complementary and alternative medicine (CAM) use in patients with low back pain (LBP) and to identify its correlation with demographic factors, clinical condition and psychosocial factors. A cross-sectional study was conducted with 278 LBP patients. Use of CAM, demographic parameters and disease duration were determined. Self-reported health status and self-rated scales assessed the effect of disease on quality of life and emotional well-being, respectively. Satisfaction with orthopaedic care and belief partiality towards CAM were assessed. In all, 72.3% patients sought CAM treatment. The most common choice of CAM was traditional Chinese medicine (TCM; n = 166), followed by massage therapy ( n = 114) and chiropractic treatment ( n = 45). Within TCM, acupuncture was the most popular treatment for LBP ( n = 127). Only 32.5% patients informed their doctors of their CAM use. In univariate analyses, factors positively associated with CAM use included duration of LBP (odds ratio (OR) = 1.45, 95% confidence interval (CI): 1.06-1.97), use of CAM in close social circles (OR = 1.98, 95% CI: 1.15-3.43) and summary score for belief partiality towards CAM (OR = 1.18, 95% CI: 1.13-1.23). Variables negatively and significantly associated with status of CAM use include age (OR = 0.97, 95% CI: 0.95-0.99) and summary score for satisfaction with orthopaedic care (OR = 0.93, 95% CI: 0.88-0.99). CAM use in patients with LBP is prevalent and largely unknown to their doctors. Personal beliefs and their satisfaction with conventional medical treatment both play a part in their decisions to use CAM. Future studies may aim at understanding the effect of CAM on patient adherence to conventional medical treatment and patients' perception of well-being and pain.

Calmodulin in complex with the first IQ motif of myosin-5a functions as an intact calcium sensor.

PubMed

Shen, Mei; Zhang, Ning; Zheng, Sanduo; Zhang, Wen-Bo; Zhang, Hai-Man; Lu, Zekuan; Su, Qian Peter; Sun, Yujie; Ye, Keqiong; Li, Xiang-Dong

2016-10-04

The motor function of vertebrate myosin-5a is inhibited by its tail in a Ca 2+ -dependent manner. We previously demonstrated that the calmodulin (CaM) bound to the first isoleucine-glutamine (IQ) motif (IQ1) of myosin-5a is responsible for the Ca 2+ -dependent regulation of myosin-5a. We have solved the crystal structure of a truncated myosin-5a containing the motor domain and IQ1 (MD-IQ1) complexed with Ca 2+ -bound CaM (Ca 2+ -CaM) at 2.5-Å resolution. Compared with the structure of the MD-IQ1 complexed with essential light chain (an equivalent of apo-CaM), MD-IQ1/Ca 2+ -CaM displays large conformational differences in IQ1/CaM and little difference in the motor domain. In the MD-IQ1/Ca 2+ -CaM structure, the N-lobe and the C-lobe of Ca 2+ -CaM adopt an open conformation and grip the C-terminal and the N-terminal portions of the IQ1, respectively. Remarkably, the interlobe linker of CaM in IQ1/Ca 2+ -CaM is in a position opposite that in IQ1/apo-CaM, suggesting that CaM flip-flops relative to the IQ1 during the Ca 2+ transition. We demonstrated that CaM continuously associates with the IQ1 during the Ca 2+ transition and that the binding of CaM to IQ1 increases Ca 2+ affinity and substantially changes the kinetics of the Ca 2+ transition, suggesting that the IQ1/CaM complex functions as an intact Ca 2+ sensor responding to distinct calcium signals.

The use of complementary and alternative medicine in adults with depressive disorders. A critical integrative review.

PubMed

Solomon, Daniela; Adams, Jon

2015-07-01

Depression has been identified as one of the most frequent indications for CAM use and is a strong predictor of CAM use. The present article provides a critical review of CAM use for depressive disorders including bipolar depression by addressing prevalence of CAM use and CAM users׳ characteristics, motivation, decision-making and communication with healthcare providers. A comprehensive search of 2003-2014 international literature in the Medline, CINAHL, AMED, and SCOPUS databases was conducted. The search was confined to peer-reviewed articles published in English with abstracts and reporting new empirical research findings regarding CAM use and depressive disorders. A considerable level of CAM use was observed among both general and clinical populations of people suffering from depressive disorders, many of whom use CAM concurrently with their conventional medicine. In particular, high rates of CAM use were found among those with bipolar disorder, an illness known to cause substantial impairments in health-related quality of life. Concomitant prescription medication use ranged from 0.52% to as high as 100%. Study design such as the inclusion of bipolar and depression in the same diagnostic category hamper the differentiation and attribution of CAM usage for symptoms. Findings of our review show that enduring impairments in function and persistence of symptoms (as reflected by increased CAM use proportional to severity of illness and comorbidity) are the impetus for sufferers of depressive illness to seek out CAM. The psychosocial factors associated with CAM use in depressive illnesses and severe mental illness are yet to be established. Subsequent research amongst those with depressive disorders would be informative in clarifying the range of motivations associated with mental illness. Copyright © 2015 Elsevier B.V. All rights reserved.

A Comparison of the Comfort of Seats for Sonarmen

DTIC Science & Technology

1987-07-07

Barkla , 1964; Mandal, 1982; Life and Pheasant, 1984; Grandjean, et al, 1984; Branton, 1984; Corlett and Eklund, 1984). The interest in chair design has...the chair at the end of the day. Such ratings are often obtained after a much shorter exposure. Barkla (1964) claimed that subjects reported...chair developed in Denmark. Appl. Ergon. 7, 185-186. Barkla , D. M. (1964). Chair angles, duration of sitting, and comfort ratings. Ergonomics 7, 297

Informed Consent and Genomic Incidental Findings: IRB Chair Perspectives

PubMed Central

Simon, Christian M.; Williams, Janet K.; Shinkunas, Laura; Brandt, Debra; Daack-Hirsch, Sandra; Driessnack, Martha

2013-01-01

It is unclear how genomic incidental finding (GIF) prospects should be addressed in informed consent processes. An exploratory study on this topic was conducted with 34 purposively sampled Chairs of institutional review boards (IRBs) at centers conducting genome-wide association studies. Most Chairs (96%) reported no knowledge of local IRB requirements regarding GIFs and informed consent. Chairs suggested consent processes should address the prospect of, and study disclosure policy on, GIFs; GIF management and follow-up; potential clinical significance of GIFs; potential risks of GIF disclosure; an opportunity for participants to opt out of GIF disclosure; and duration of the researcher's duty to disclose GIFs. Chairs were concerned about participant disclosure preferences changing over time; inherent limitations in determining the scope and accuracy of claims about GIFs; and making consent processes longer and more complex. IRB Chair and other stakeholder perspectives can help advance informed consent efforts to accommodate GIF prospects. PMID:22228060

Informed consent and genomic incidental findings: IRB chair perspectives.

PubMed

Simon, Christian M; Williams, Janet K; Shinkunas, Laura; Brandt, Debra; Daack-Hirsch, Sandra; Driessnack, Martha

2011-12-01

It is unclear how genomic incidental finding (GIF) prospects should be addressed in informed consent processes. An exploratory study on this topic was conducted with 34 purposively sampled Chairs of institutional review boards (IRBs) at centers conducting genome-wide association studies. Most Chairs (96%) reported no knowledge of local IRB requirements regarding GIFs and informed consent. Chairs suggested consent processes should address the prospect of, and study disclosure policy on, GIFs; GIF management and follow-up; potential clinical significance of GIFs; potential risks of GIF disclosure; an opportunity for participants to opt out of GIF disclosure; and duration of the researcher's duty to disclose GIFs. Chairs were concerned about participant disclosure preferences changing over time; inherent limitations in determining the scope and accuracy of claims about GIFs; and making consent processes longer and more complex. IRB Chair and other stakeholder perspectives can help advance informed consent efforts to accommodate GIF prospects.

A randomized controlled trial of chair interventions on back and hip pain among sewing machine operators: the los angeles garment study.

PubMed

Wang, Pin-Chieh; Ritz, Beate R; Janowitz, Ira; Harrison, Robert J; Yu, Fei; Chan, Jacqueline; Rempel, David M

2008-03-01

Determine whether an adjustable chair with a curved or a flat seat pan improved monthly back and hip pain scores in sewing machine operators. This 4-month intervention study randomized 293 sewing machine operators with back and hip pain. The participants in the control group received a placebo intervention, and participants in the intervention groups received the placebo intervention and one of the two intervention chairs. Compared with the control group, mean pain improvement for the flat chair intervention was 0.43 points (95% CI = 0.34, 0.51) per month, and mean pain improvement for the curved chair intervention was 0.25 points (95% CI = 0.16, 0.34) per month. A height-adjustable task chair with a swivel function can reduce back and hip pain in sewing machine operators. The findings may be relevant to workers who perform visual- and hand-intensive manufacturing jobs.

Phytonanotherapy for management of diabetes using green synthesis nanoparticles.

PubMed

Anand, K; Tiloke, C; Naidoo, Pragalathan; Chuturgoon, A A

2017-08-01

The world has a rich diversity of indigenous medicinal plants. The World Health Organization (WHO) gives high priority to eco-friendly, non-hazardous and cost effective healthcare such as the use of medicinal plants to treat various illnesses, including Human immunodeficiency virus (HIV) infection and Acquired immune deficiency syndrome (AIDS), tuberculosis (TB), diabetes mellitus (DM), malaria, and cancer. In developing countries, a high proportion of the population tends to use complementary and alternative medicines (CAM) together with conventional prescription drugs. Globally, CAM has been used in both developed and developing countries. In China, 30-50% of medicinal use is based on traditional alternative medicine. In Africa, it is estimated that 80% of primary health care is CAM, whilst in the USA, about 158 million people us CAM. This increase is due to three main influences: improve their eminence of life, relieve symptoms and preclude long-term complications. Despite the advances and advantages of conventional pharmaceutical medication, these are associated with long-term side effects and pose risks of inefficacy for treatment of chronic diseases such as cancer and DM. The biosynthesis of metal nanoparticles (NPs) using medicinal plants has received considerable attention as a proper alternative to using hazardous chemical and physical synthetic techniques. Plants are being exploited for their unique metal tolerance and effective production of gold metal NPs. A single medicinal plant contains an orchestra of chemical elements (e.g. proteins, vitamins, enzymes, amino acids, polysaccharides and organic compounds) that are "environmentally benign, yet chemically complex" and therefore serve as ideal tools for enhanced medicinal applications. It is reported that phytocompounds such as terpenoids, polysaccharides, polyols and flavones take part in the bio-reduction, stabilization and bio-capping mechanisms to form stable gold and silver NPs. Also the inhibitory potential of plant compounds against diabetic targets followed by a study of enzyme inhibitor kinetics, ligand binding dynamics supported by in silico docking studies that reveal the mode of bioactive compounds and their inhibitory activities. The present review focuses on the potential anticancer, antidiabetic and antimicrobial activity of phyto-synthesized gold and silver NPs. In phytonanotherapy, synergistic features of plant and metal NPs are unique as they offer healing properties that may be the clinical bioequivalent to many synthetic drugs, with minimal side effects. This could provide alternative treatment for chronic diseases that is efficient to overcome the disadvantages of synthetic monotherapy and allows medicinal plant therapy to co-exist with current synthetic treatments. This creates a much needed paradigm shift for further clinical studies in non-communicable and communicable diseases. Copyright © 2017 Elsevier B.V. All rights reserved.

Use of complementary and alternative medicine during pregnancy and the postpartum period: an analysis of the National Health Interview Survey.

PubMed

Birdee, Gurjeet S; Kemper, Kathi J; Rothman, Russell; Gardiner, Paula

2014-10-01

Complementary and alternative medicine (CAM) is commonly used among women, but few national data exist regarding CAM use during pregnancy or the postnatal period. Data from the 2007 National Health Interview Survey were analyzed for women ages between the ages of 18 and 49 years who were pregnant or had children less than 1 year old. CAM use was identified based on standard definitions of CAM from the National Institutes of Health's National Center for Complementary and Alternative Medicine. CAM use among women who were pregnant or with a child less than 1 year was compared with the other similarly aged female responders. CAM use was examined among these women stratified by sociodemographics, health conditions, and conventional medicine use through bivariable and multivariable logistic regression models. Among pregnant and postpartum women from the ages of 19 to 49 years in the United States, 37% of pregnant women and 28% of postpartum women reported using CAM in the last 12 months compared with 40% of nonpregnant/non-postpartum women. Mind-body practices were the most common CAM modality reported, with one out of four women reporting use. Biological therapies, excluding vitamins and minerals, during the postpartum period were used by only 8% of women. Using multivariable regression modeling, we report no significant difference in CAM use among pregnant compared with non-pregnant women (adjusted odds ratio [AOR], 0.88; [95% confidence interval 0.65-1.20]), but lower CAM use among postpartum women compared with non-pregnant women (AOR 0.67; [0.52-0.88]), while adjusting for sociodemographics. CAM use among pregnancy similar to women who are not pregnant, while postpartum CAM use decreases. Further evaluation of CAM therapies among pregnant and postpartum women is necessary to determine the costs and benefits of integrative CAM therapies in conventional care.

Use of complementary and alternative medicine for children: a parents' perspective.

PubMed

Gad, Ashry; Al-Faris, Eiad; Al-Rowais, Noura; Al-Rukban, Mohamed

2013-10-01

The present study aims to detect the frequency and types of complementary and alternative medicine (CAM) therapies used for children and to explore parental motivating factors for using CAM for their children in Riyadh, Saudi Arabia. This is a cross-sectional study that involved 462 families selected through a multistage cluster-sampling technique covering Riyadh region, Saudi Arabia. The sample was selected from 40 clusters, distributed proportionally according to the size of the population in the catchment area of primary health care centres (PHCCs). A structured questionnaire that contains items fulfilling the research objectives was used to collect data by research assistants. The study included 926 parents, comprising 351 fathers and 575 mothers; 37.3% of them reported the use of CAM for their children including reciting the Quran, honey and Ferula asafoetida (26.1%, 21.5% and 18.8%, respectively). CAM was used six times higher for children of parents using CAM for themselves than children of parents who did not use CAM themselves (odds ratio (OR)=6.03, 3.9-9.37). Multivariate logistic regression showed that parental use of CAM (OR=3.0, 2.2-4.0), keeping CAM remedies at home (OR=2.3, 1.8-3.1), perceived success of CAM in practice (OR=1.8, 1.3-2.4) and preference of use of natural materials (OR=1.7, 1.2-2.5) were independent predictors of use of CAM for children. In this study, around one-third of the parents used CAM for their children. Quran (Muslims' holy book) was the most common CAM type used for children. Parents' use of CAM for themselves is the most important predictor of its use for children. An in-depth study to investigate CAM use for specific diseases in children is recommended. Copyright © 2013 Elsevier Ltd. All rights reserved.

3D-CAM: Derivation and Validation of a 3-Minute Diagnostic Interview for CAM-defined Delirium

PubMed Central

Marcantonio, Edward R.; Ngo, Long H.; O’Connor, Margaret; Jones, Richard N.; Crane, Paul K.; Metzger, Eran D.; Inouye, Sharon K.

2015-01-01

Background Delirium is common, morbid, and costly, yet remains often unrecognized in most clinical settings. The Confusion Assessment Method (CAM) is the most widely used diagnostic algorithm, and operationalizing its features would represent a substantial advance for clinical care. Objective To derive the 3D-CAM, a new 3-minute diagnostic assessment for CAM-defined delirium, and to validate it against a clinical reference standard. Design Diagnostic test study Setting 4 general medicine units in an academic medical center Participants 201 inpatients aged ≥ 75 years old Measurements We identified 20 items that best operationalized the 4 CAM diagnostic features to create the 3D-CAM. For prospective validation, 3D-CAM assessments were administered by trained research assistants. Independently, clinicians performed an extensive assessment that included patient interviews, family interviews, and review of the medical record. These data were considered by an expert panel to determine the presence or absence of delirium and dementia (reference standard). We compared the 3D-CAM delirium determination to the reference standard in all patients and in subgroups with and without dementia. Results The 201 participants in the prospective validation study had mean age (SD) of 84 (5.5) years, and 27% had dementia. The expert panel identified delirium in 21%. Median administration time for 3D-CAM was 3 minutes (inter-quartile range: 2–5 minutes). The sensitivity [95% CI] of 3D-CAM was 95% [84%, 99%] and the specificity was 94% [90%, 97%]. The 3D-CAM performed well in patients both with dementia (sensitivity=96% [82%, 100%], specificity=86% [67%, 96%]) and without dementia (sensitivity=93% [66%, 100%], specificity=96% [91%,99%]). Limitations Limited to single center, cross-sectional, and medicine patients only Conclusion The 3D-CAM operationalizes the CAM algorithm using a 3-minute structured assessment with high sensitivity and specificity relative to a reference standard and could be an important tool for improving recognition of delirium. PMID:25329203

Complementary and alternative medicines use among pediatric patients with epilepsy in a multiethnic community.

PubMed

Chen, Chunliang; Chong, Ying Jie; Hie, Szu Liang; Sultana, Rehena; Lee, Sze Huay Dorothy; Chan, Wei Shih Derrick; Chan, Sui Yung; Cheong, Han Hui

2016-07-01

Prior studies highlighted that patients on chronic medications who used complementary and alternative medicines (CAMs) did not share this information with their healthcare providers. Furthermore, there might be potential adverse interactions between CAMs and antiepileptic drug (AED) therapy. However, there are no studies that investigate the effect of religion or race on CAM use in a multiethnic community. Therefore, we aimed to investigate CAM usage among pediatric patients with epilepsy (PPE) and identify predictors of CAM usage in our multiethnic setting. This was a cross-sectional study where caregivers of recruited at an outpatient epilepsy clinic between September 2013 and July 2014 completed a self-administered survey. Those who declined participation, lacked understanding of English or Mandarin, or missed the clinic appointments were excluded. Those caring for more than one patient participated only once. Of the 195 surveys collected, 178 were used for analysis. The PPE used an average of 1.50 AEDs (range: 0-4). Forty-nine (27.5%) caregivers reported giving CAMs to their PPE. Commonly used CAMs were multivitamins (44.4%), traditional herbs (42.2%), and acupuncture (17.4%). Multivitamins were mostly given by Christian/Catholic caregivers while Buddhist caregivers mostly gave traditional herbs or acupuncture. The majority of the CAM users were Chinese. Univariate analysis showed that caregivers with secondary school (high school) education were 3.52 times more likely to use CAMs compared to those with primary school (elementary school) education. While some caregivers gave CAMs to their PPE, they had various misconceptions and did not discuss the usage with their healthcare providers. We propose that the predictors identified in this study can help to identify potential CAM users. Healthcare providers should routinely probe about the usage of CAMs by PPE, and thereafter, the suitability of CAM use could be evaluated. The caregivers will benefit from open discussion with healthcare professionals on the safe use of AEDs with or without CAMs. Copyright © 2016 Elsevier Inc. All rights reserved.

The CUPCIG (CAM-Use in Primary Care in Germany) Study:Part I-Pain. Study Protocol of a Pilot-trial to Assess Feasibility, Acceptability and Perceived Effectiveness of CAM in Pain Disorders in Primary Care.

PubMed

Schencking, Martin; Sönnichsen, Andreas; Bassüner, Susanne; Redaelli, Marcus

2015-01-01

There is limited valid data available on CAM procedures for chronic joint and neuropathic pain in primary care in Germany. Indiviual CAM qualifications of the general practitioners (GPs) and the potential of cost reduction through CAM treatment are almost unknown. The aim of this pilot trial preceding the main study is to examine the survey mode, to estimate the response rate by GPs with or without an additional qualification for CAM, and to identify the status quo in therapeutic approaches for chronic pain disorders in primary care. This is a cross-sectional study with an ex post facto design among German GPs consisting of 2 parts: In a first step, a pilot trial precedes the main study targeting 200 GPs with and 200 GPs without additional qualification in CAM in a selected region. The results of the CUPCIG study comprise the distribution of pain types treated in primary care practices, the GPs' attitude toward complementary pain therapy, pharmacological or CAM treatment, the estimate of cost reduction through CAM treatment of pain, the application of diverse CAM procedures, and biographical data. The CUPCIG study serves to compile pain therapy approaches in primary care in Germany with respect to the individual CAM expertise of the GPs. © 2015 S. Karger GmbH, Freiburg.

Complementary and alternative medicine use by pediatric specialty outpatients.

PubMed

Adams, Denise; Dagenais, Simon; Clifford, Tammy; Baydala, Lola; King, W James; Hervas-Malo, Marilou; Moher, David; Vohra, Sunita

2013-02-01

Complementary and alternative medicine (CAM) use is high among children and youth with chronic illnesses. The objective of this study was to assess the prevalence and patterns of CAM use in 10 subspecialty clinics in Canada and to compare CAM use between 2 geographically diverse locations. This survey was carried out at 1 Children's Hospital in western Canada (Edmonton) and 1 Children's Hospital in central Canada (Ottawa). Questionnaires were completed by parents in either French or English. Although demographic characteristics of the 2 populations were similar, CAM use at the western hospital was 71% (n = 704) compared with 42% (n = 222) at the central hospital (P < .0001). Most respondents agreed or strongly agreed that they feel comfortable discussing CAM in their clinic. The most common CAM products currently used were multivitamins/minerals, herbal products, and homeopathic remedies. The most common CAM practices currently used were massage, chiropractic, relaxation, and aromatherapy. Eighty adverse effects were reported, and 55 (68.8%) of these were self-assessed as minor. Results of this study indicate that CAM use is high among pediatric specialty clinic outpatients and is much greater in the western than in the central hospital. Most respondents felt that their CAM use was helpful with few or no harms associated. Many patients, using CAM alongside their conventional medicines, are still not discussing their CAM use with their physicians and are increasing the likelihood for potential interactions and preventable harms.

National survey of China's oncologists' knowledge, attitudes, and clinical practice patterns on complementary and alternative medicine.

PubMed

Yang, Geliang; Lee, Richard; Zhang, Huiqing; Gu, Wei; Yang, Peiying; Ling, Changquan

2017-02-21

It is common for cancer patients to use complementary and alternative medicine (CAM). This study was designed to explore China's oncologists' knowledge, attitudes and clinical practices regarding CAM use by their patients. An online survey was conducted of China's oncologists. Among 11,270 participants who completed the online survey, 6,007 (53.3%) were identified as oncologists. Most were men (75.2%), with a mean age of 33.4 (standard deviation: 6.5) years. The 6,007 oncologists discussed with 36.5% of their patients about CAM. Most of them (75.6%) did not want to initiate discussions due to lack of knowledge on CAM. Oncologists estimated that 40.0% of their patients used CAM treatments. Oncologists reported that 28.7% of their patients underwent anticancer therapy with the concurrent use of CAM. Four out of five of the responding oncologists self-reported inadequate knowledge and only 22.0% reported receiving professional education on CAM. Nearly half (44.9%) of the oncologists believed CAM treatment was effective for symptoms and treatment of cancer. Physician factors associated with initiating discussions with patients about CAM use included sex, age (≥ 33 years), medical license for traditional Chinese medicine, enough knowledge and professional education experience. China's oncologists infrequently discussed with their patients about CAM due to lack of knowledge. Most of the oncologists did not encourage CAM use.

Use of complementary and alternative medicine among midlife Arab women living in Qatar.

PubMed

Gerber, L M; Mamtani, R; Chiu, Y-L; Bener, A; Murphy, M; Cheema, S; Verjee, M

2014-10-12

The prevalence of use of complementary and alternative medicine (CAM) is widespread and is growing worldwide. This cross-sectional study in Qatar examined the use of CAM and its correlates among Arab women in their midlife years. Women aged 40-60 years (n = 814) were recruited at primary care centres in Qatar and completed a specially designed, pre-tested questionnaire. Overall, 38.2% of midlife women in Qatar had used CAM in the previous 12 months. Nutritional remedies and herbal remedies were the most commonly used CAM therapies, followed by physical methods. Qatari nationality and higher level of education were independently associated with CAM use. Menopause transition status was not independently associated with use of CAM. The prevalence of CAM use by women in Qatar was high, consistent with other reports worldwide. It is essential to educate and inform patients and health-care providers about the benefits and limitations associated with CAM.

Complementary and alternative medicine - representations in popular magazines.

PubMed

Dunne, Alexandra; Phillips, Christine

2010-09-01

More than half the patients who use complementary and alternative medicine (CAM) in Australia do not discuss it with their doctors. Many consumers use popular media, especially women's magazines, to learn about CAM. To explore representations of CAM in popular Australian women's magazines. Content analysis of three Australian magazines: Australian Women's Weekly, Dolly and New Idea published from January to June 2008. Of 220 references to CAM (4-17 references per issue), most were to biologically based practices, particularly 'functional foods', which enhance health. Most representations of CAM were positive (81.3% positive, 16.4% neutral, 2.3% negative). Explanations of modes of action of CAM tended to be biological but relatively superficial. Australian magazines cast CAM as safe therapy which enhances patient engagement in healthcare, and works in ways analogous to orthodox medical treatments. General practitioners can use discussions with their patients about CAM to encourage health promoting practices.

Advancing Women's Health and Women's Leadership With Endowed Chairs in Women's Health.

PubMed

Carnes, Molly; Johnson, Paula; Klein, Wendy; Jenkins, Marjorie; Bairey Merz, C Noel

2017-02-01

Gender-based bias and conflation of gender and status are root causes of disparities in women's health care and the slow advancement of women to leadership in academic medicine. More than a quarter of women physicians train in internal medicine and its subspecialties, and women physicians almost exclusively constitute the women's health focus within internal medicine. Thus, internal medicine has considerable opportunity to develop women leaders in academic medicine and promote women's health equity.To probe whether holding an endowed chair-which confers status-in women's health may be an effective way to advance women leaders in academic medicine and women's health, the authors explored the current status of endowed chairs in women's health in internal medicine. They found that the number of these endowed chairs in North America increased from 7 in 2013 to 19 in 2015, and all were held by women. The perceptions of incumbents and other women's health leaders supported the premise that an endowed chair in women's health would increase women's leadership, the institutional stature of women's health, and activities in women's health research, education, and clinical care.Going forward, it will be important to explore why not all recipients perceived that the endowed chair enhanced their own academic leadership, whether providing women's health leaders with fundraising expertise fosters future success in increasing the number of women's health endowed chairs, and how the conflation of gender and status play out (e.g., salary differences between endowed chairs) as the number of endowed chairs in women's health increases.

Subspecialty and gender of obstetrics and gynecology faculty in department-based leadership roles.

PubMed

Hofler, Lisa; Hacker, Michele R; Dodge, Laura E; Ricciotti, Hope A

2015-02-01

To characterize the cohort who may become senior leaders in obstetrics and gynecology by examining the gender and subspecialty of faculty in academic department administrative and educational leadership roles. This is an observational study conducted through web sites of U.S. obstetrics and gynecology residency programs accredited in 2012-2013. In obstetrics and gynecology departmental administrative leadership roles, women comprised 20.4% of chairs, 36.1% of vice chairs, and 29.6% of division directors. Among educational leaders, women comprised 31.9% of fellowship directors, 47.3% of residency directors, and 66.1% of medical student clerkship directors. Chairs were most likely to be maternal-fetal medicine faculty (38.2%) followed by specialists in general obstetrics and gynecology (21.8%), reproductive endocrinologists (15.6%), and gynecologic oncologists (14.7%). Among chairs, 32.9% are male maternal-fetal medicine specialists. Family planning had the highest representation of women (80.0%) among division directors, whereas reproductive endocrinology and infertility had the lowest (15.8%). The largest proportion of women chairs, vice chairs, residency program directors, and medical student clerkship directors were specialists in general obstetrics and gynecology. Women remained underrepresented in the departmental leadership roles of chair, vice chair, division director, and fellowship director. Representation of women was closer to parity among residency program directors, in which women held just under half of positions. Nearly one in three department chairs was a male maternal-fetal medicine specialist. Compared with subspecialist leaders, specialist leaders in general obstetrics and gynecology were more likely to be women.

[A research roadmap for complementary and alternative medicine - what we need to know by 2020].

PubMed

Fischer, Felix; Lewith, George; Witt, Claudia M; Linde, Klaus; von Ammon, Klaus; Cardini, Francesco; Falkenberg, Torkel; Fønnebø, Vinjar; Johannessen, Helle; Reiter, Bettina; Uehleke, Bernhard; Weidenhammer, Wolfgang; Brinkhaus, Benno

2014-01-01

The CAMbrella coordination action was funded within the Framework Programme 7. Its aim is to provide a research roadmap for clinical and epidemiological research for complementary and alternative medicine (CAM) that is appropriate for the health needs of European citizens and acceptable to their national research institutes and healthcare providers in both public and private sectors. One major issue in the European research agenda is the demographic change and its impact on health care. Our vision for 2020 is that there is an evidence base that enables European citizens to make informed decisions about CAM, both positive and negative. This roadmap proposes a strategic research agenda for the field of CAM designed to address future European health care challenges. This roadmap is based on the results of CAMbrella’s several work packages, literature reviews and expert discussions including a consensus meeting. We first conducted a systematic literature review on key issues in clinical and epidemiological research in CAM to identify the general concepts, methods and the strengths and weaknesses of current CAM research. These findings were discussed in a workshop (Castellaro, Italy, September 7–9th 2011) with international CAM experts and strategic and methodological recommendations were defined in order to improve the rigor and relevance of CAM research. These recommendations provide the basis for the research roadmap, which was subsequently discussed in a consensus conference (Järna, Sweden, May 9–11th 2012) with all CAMbrella members and the CAMbrella advisory board. The roadmap was revised after this discussion in CAMbrella Work Package (WP) 7 and finally approved by CAMbrella’s scientific steering committee on September 26th 2012. Our main findings show that CAM is very heterogenous in terms of definitions and legal regulations between the European countries. In addition, citizens’ needs and attitudes towards CAM as well as the use and provision of CAM differ significantly between countries. In terms of research methodology, there was consensus that CAM researchers should make use of all the commonly accepted scientific research methods and employ those with utmost diligence combined in a mixed methods framework. We propose 6 core areas of research that should be investigated to achieve a robust knowledge base and to allow stakeholders to make informed decisions. These are: Research into the prevalence of CAM in Europe: Reviews show that we do not know enough about the circumstances in which CAM is used by Europeans. To enable a common European strategic approach, a clear picture of current use is of the utmost importance. Research into differences regarding citizens’ attitudes and needs towards CAM: Citizens are the driver for CAM utilization. Their needs and views on CAM are a key priority, and their interests must be investigated and addressed in future CAM research. Research into safety of CAM: Safety is a key issue for European citizens. CAM is considered safe, but reliable data is scarce although urgently needed in order to assess the risk and cost-benefit ratio of CAM. Research into the comparative effectiveness of CAM: Everybody needs to know in what situation CAM is a reasonable choice. Therefore, we recommend a clear emphasis on concurrent evaluation of the overall effectiveness of CAM as an additional or alternative treatment strategy in real-world settings. Research into effects of context and meaning: The impact of effects of context and meaning on the outcome of CAM treatments must be investigated; it is likely that they are significant. Research into different models of CAM health care integration: There are different models of CAM being integrated into conventional medicine throughout Europe, each with their respective strengths and limitations. These models should be described and concurrently evaluated; innovative models of CAM provision in health care systems should be one focus for CAM research. We also propose a methodological framework for CAM research. We consider that a framework of mixed methodological approaches is likely to yield the most useful information. In this model, all available research strategies including comparative effectiveness research utilising quantitative and qualitative methods should be considered to enable us to secure the greatest density of knowledge possible. Stakeholders, such as citizens, patients and providers, should be involved in every stage of developing the specific and relevant research questions, study design and the assurance of real-world relevance for the research. Furthermore, structural and sufficient financial support for research into CAM is needed to strengthen CAM research capacity if we wish to understand why it remains so popular within the EU. In order to consider employing CAM as part of the solution to the health care, health creation and self-care challenges we face by 2020, it is vital to obtain a robust picture of CAM use and reliable information about its cost, safety and effectiveness in real-world settings. We need to consider the availability, accessibility and affordability of CAM. We need to engage in research excellence and utilise comparative effectiveness approaches and mixed methods to obtain this data. Our recommendations are both strategic and methodological. They are presented for the consideration of researchers and funders while being designed to answer the important and implicit questions posed by EU citizens currently using CAM in apparently increasing numbers. We propose that the EU actively supports an EU-wide strategic approach that facilitates the development of CAM research. This could be achieved in the first instance through funding a European CAM coordinating research office dedicated to foster systematic communication between EU governments, public, charitable and industry funders as well as researchers, citizens and other stakeholders. The aim of this office would be to coordinate research strategy developments and research funding opportunities, as well as to document and disseminate international research activities in this field. With the aim to develop sustainability as second step, a European Centre for CAM should be established that takes over the monitoring and further development of a coordinated research strategy for CAM, as well as it should have funds that can be awarded to foster high quality and robust independent research with a focus on citizens health needs and pan-European collaboration. We wish to establish a solid funding for CAM research to adequately inform health care and health creation decision-making throughout the EU. This centre would ensure that our vision of a common, strategic and scientifically rigorous approach to CAM research becomes our legacy and Europe’s reality. We are confident that our recommendations will serve these essential goals for EU citizens.

C-reactive protein as a predictor of chorioamnionitis.

PubMed

Smith, Erik J; Muller, Corinna L; Sartorius, Jennifer A; White, David R; Maslow, Arthur S

2012-10-01

Chorioamnionitis (CAM) affects many pregnancies complicated by preterm premature rupture of membranes (PPROM). Finding a serum factor that could accurately predict the presence of CAM could potentially lead to more efficient management of PPROM and improved neonatal outcomes. To determine if C-reactive protein (CRP) is an effective early marker of CAM in patients with PPROM. A retrospective evaluation of pregnant women with PPROM at Geisinger Medical Center in Danville, Pennsylvania, between January 2005 and January 2009. Nonparametric statistical tests (ie, Wilcoxon rank sum and Spearman rank correlation) were used to compare distributions that were skewed. Characteristics of the study population were compared using 2-sample t tests for continuous variables and Fisher exact tests for discrete variables. Logistic regression analysis was used to generate receiver operating characteristic curves and obtain area under the curve estimates in stepwise fashion for predicting histologic CAM. A secondary analysis compared the characteristics among patients with clinical CAM, histologic CAM, or non-CAM. The total population of 73 women was subdivided into patients with histologic CAM (n=26) and patients without histologic CAM (ie, no evidence of CAM on placental pathology; n=47). There was no difference between groups in CRP levels, days of pregnancy latency, white blood cell count, smoking status, antibiotic administration, or steroid benefit. The group with histologic CAM delivered at earlier gestational ages: mean (standard deviation) age was 29.5 (4.4) weeks vs 31.9 (3.5) weeks (P=.02). For our primary analysis, we found no difference in CRP levels (P=.32). Receiver operating characteristic curve plots of CRP levels, temperature at delivery, and white blood cell count resulted in an area under the curve estimate of 0.696, which was 70% predictive of histologic CAM. In the secondary analysis, after adjusting for gestational age, the estimated hazard ratio for CRP change was 1.05 (95% confidence interval, 1.02-1.08; P=.001). Therefore, increasing CRP levels from PPROM was statistically significant in predicting clinical CAM development over time. C-reactive protein levels were not effective independent predictors of clinical or histologic CAM, nor was sequential CRP testing statistically significant for the identification of clinical or histologic CAM in patients with PPROM.

Marginal adaptation and CAD-CAM technology: A systematic review of restorative material and fabrication techniques.

PubMed

Papadiochou, Sofia; Pissiotis, Argirios L

2018-04-01

The comparative assessment of computer-aided design and computer-aided manufacturing (CAD-CAM) technology and other fabrication techniques pertaining to marginal adaptation should be documented. Limited evidence exists on the effect of restorative material on the performance of a CAD-CAM system relative to marginal adaptation. The purpose of this systematic review was to investigate whether the marginal adaptation of CAD-CAM single crowns, fixed dental prostheses, and implant-retained fixed dental prostheses or their infrastructures differs from that obtained by other fabrication techniques using a similar restorative material and whether it depends on the type of restorative material. An electronic search of English-language literature published between January 1, 2000, and June 30, 2016, was conducted of the Medline/PubMed database. Of the 55 included comparative studies, 28 compared CAD-CAM technology with conventional fabrication techniques, 12 contrasted CAD-CAM technology and copy milling, 4 compared CAD-CAM milling with direct metal laser sintering (DMLS), and 22 investigated the performance of a CAD-CAM system regarding marginal adaptation in restorations/infrastructures produced with different restorative materials. Most of the CAD-CAM restorations/infrastructures were within the clinically acceptable marginal discrepancy (MD) range. The performance of a CAD-CAM system relative to marginal adaptation is influenced by the restorative material. Compared with CAD-CAM, most of the heat-pressed lithium disilicate crowns displayed equal or smaller MD values. Slip-casting crowns exhibited similar or better marginal accuracy than those fabricated with CAD-CAM. Cobalt-chromium and titanium implant infrastructures produced using a CAD-CAM system elicited smaller MD values than zirconia. The majority of cobalt-chromium restorations/infrastructures produced by DMLS displayed better marginal accuracy than those fabricated with the casting technique. Compared with copy milling, the majority of zirconia restorations/infrastructures produced by CAD-CAM milling exhibited better marginal adaptation. No clear conclusions can be drawn about the superiority of CAD-CAM milling over the casting technique and DMLS regarding marginal adaptation. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Attitudes and perceptions of Australian pharmacy students towards Complementary and Alternative Medicine – a pilot study

PubMed Central

Tiralongo, Evelin; Wallis, Marianne

2008-01-01

Background With the increased usage of CAM worldwide comes the demand for its integration into health professional education. However, the incorporation of CAM into health professional curricula is handled quite differently by different institutions and countries. Furthermore, the evaluation of CAM curricula is complicated because students' ability to learn about CAM may be influenced by factors such as student's prior knowledge and motivation, together with the perceptions and attitudes of clinical preceptors. The study aimed to describe the attitudes, perceptions and beliefs of second, third and fourth year pharmacy students towards complementary and alternative medicine (CAM) and to explore factors that might affect attitudes such as learning, preceptors and placements. Methods Pharmacy students from a University in South East Queensland, Australia participated in the study. The study consisted of a cross-sectional survey (n = 110) and semi-structured interviews (n = 9). Results The overall response rate for the survey was 75%, namely 50% (36/72) for second year, 77.3% (34/44) for third year and 97.6% (40/41) for fourth year students. Overall, 95.5% of pharmacy students believe that pharmacists should be able to advise patients about CAM and most (93.7%) have used CAM prior to course enrolment. Students' attitudes to CAM are influenced by the use of CAM by family, friends and self, CAM training, lecturers and to a lesser degree by preceptors. The majority of pharmacy students (89.2%) perceive education about CAM as a core and integral part of their professional degree and favour it over an additional postgraduate degree. However, they see a greater need for education in complementary medicines (such as herbal medicines, vitamins and minerals) than for education in complementary therapies (such as acupuncture, meditation and bio-magnetism). Knowledge and educational input rationalised rather than marginalised students' attitudes towards CAM. Conclusion Pharmacy students perceive education about CAM as a core and integral part of their professional degree. Students' attitudes towards CAM can be influenced by learning, lecturers, preceptors and practice experience. The content and focus of CAM education has to be further investigated and tailored to meet the professional needs of our future health professionals. PMID:18221569

Use of Complementary and Alternative Medicine among People with Multiple Sclerosis in the Nordic Countries

PubMed Central

Skovgaard, L.; Nicolajsen, P. H.; Pedersen, E.; Kant, M.; Fredrikson, S.; Verhoef, M.; Meyrowitsch, D. W.

2012-01-01

Aims. The aim of the study was to describe and compare (1) the types and prevalence of complementary and alternative medicine (CAM) treatments used among individuals with multiple sclerosis (MS) in the Nordic countries; (2) the types of conventional treatments besides disease-modifying medicine for MS that were used in combination with CAM treatments; (3) the types of symptoms/health issues addressed by use of CAM treatments. Methods. An internet-based questionnaire was used to collect data from 6455 members of the five Nordic MS societies. The response rates varied from 50.9% in Norway to 61.5% in Iceland. Results. A large range of CAM treatments were reported to be in use in all five Nordic countries. Supplements of vitamins and minerals, supplements of oils, special diet, acupuncture, and herbal medicine were among the CAM treatment modalities most commonly used. The prevalence of the overall use of CAM treatments within the last twelve months varied from 46.0% in Sweden to 58.9% in Iceland. CAM treatments were most often used in combination with conventional treatments. The conventional treatments that were most often combined with CAM treatment were prescription medication, physical therapy, and over-the-counter (OTC) medications. The proportion of CAM users who reported exclusive use of CAM (defined as use of no conventional treatments besides disease-modifying medicine for MS) varied from 9.5% in Finland to 18.4% in Norway. In all five Nordic countries, CAM treatments were most commonly used for nonspecific/preventative purposes such as strengthening the body in general, improving the body's muscle strength, and improving well-being. CAM treatments were less often used for the purpose of improving specific symptoms such as body pain, problems with balance, and fatigue/lack of energy. Conclusions. A large range of CAM treatments were used by individuals with MS in all Nordic countries. The most commonly reported rationale for CAM treatment use focused on improving the general state of health. The overall pattern of CAM treatment use was similar across the five countries. PMID:23304461

Attitudes of Arab and Jewish patients toward integration of complementary medicine in primary care clinics in Israel: a cross-cultural study.

PubMed

Ben-Arye, Eran; Karkabi, Khaled; Karkabi, Sonia; Keshet, Yael; Haddad, Maria; Frenkel, Moshe

2009-01-01

The purpose of this cross-cultural study was to evaluate patient perspectives on complementary and alternative medicine (CAM) integration within primary care clinics. It is one of the first multiethnic studies to explore patients' perspectives on the best model for integrating CAM into the conventional care setting. We developed a 13-item questionnaire that addresses issues of CAM use, expectations from the primary care physicians concerning CAM, and attitudes toward CAM integration within a patient's primary care clinic. We constructed the questionnaire with cross-cultural sensitivity concerning the core concepts of CAM and traditional medicine in both the Arab and Jewish communities in northern Israel. Data for statistical analysis were obtained from 3840 patients attending seven primary care clinics. Of the 3713 respondents who were willing to identify their religion, 2184 defined themselves as Muslims, Christians, or Druze and 1529 as Jews. Respondents in the two groups were equally distributed by sex but differed significantly by age, education, self-rated religiosity, and self-reported chronic diseases in their medical background. Respondents in the two groups reported comparable overall CAM use during the previous year, but the Arab respondents reported more use of herbs and traditional medicine. Respondents in both groups stated that their primary expectation from a family physician concerning CAM was to refer them appropriately and safely to a CAM practitioner. Respondents in both groups greatly supported a theoretical scenario of CAM integration into primary medical care. However, Arab respondents were more supportive of the option that non-physician CAM practitioners would provide CAM rather than physicians.

Complementary and Alternative Medicine Use in Pediatric Hematology/Oncology Patients at the University of Mississippi Medical Center.

PubMed

Sanchez, Hanny C; Karlson, Cynthia W; Hsu, Johann H; Ostrenga, Andrew; Gordon, Catherine

2015-11-01

To examine the prevalence and modalities of complementary and alternative medicine (CAM) use in children with cancer and sickle cell disease; the reasons for use of CAM; and the use of CAM before, during, and after treatment in children with cancer. This single-center, observational study administered caregivers a written questionnaire regarding the use of CAM therapies. A total of 101 caregivers completed questionnaires. Including prayer, total CAM use in oncology and sickle cell disease was 64% and 63%, respectively. Non-prayer CAM use was 30% in oncology and 23% in sickle cell disease. Of respondents who reported using any CAM, the three most commonly used types were prayer (62.3% oncology; 60.0% sickle cell disease), vitamins/minerals (14.8% oncology; 10.0% sickle cell disease), and massage (9.8% oncology; 7.5% sickle cell disease). The primary reasons for using CAM were to provide hope, to improve quality of life, and to lessen adverse effects. In oncology patients, CAM use tended to increase during treatment compared with before and after treatment. The reported prevalence of non-prayer CAM use was lower (23%-30%) in this sample than has been reported in national samples or other geographic regions of the United States. Nonetheless, participants reported many positive reasons for using CAM, including to gain hope, improve quality of life, and control pain. Thus, CAM use appears to be an important aspect of medical care for many pediatric hematology/oncology families and should be a consideration when providers are discussing treatment and quality of care with families.

Patterns of utilization of complementary and alternative medicine in 2 pediatric gastroenterology clinics.

PubMed

Adams, Denise; Schiffgen, Miriam; Kundu, Anjana; Dagenais, Simon; Clifford, Tammy; Baydala, Lola; King, W James; Vohra, Sunita

2014-09-01

The aim of the present study was to assess the prevalence and patterns of complementary and alternative medicine (CAM) use among pediatric patients with gastrointestinal (GI) disorders at academic clinics in Canada. The survey was carried out at 2 hospital-based gastroenterology clinics: the Stollery Children's Hospital in Edmonton and the Children's Hospital of Eastern Ontario (CHEO) in Ottawa. CAM use at the Stollery was 83% compared with 36% at CHEO (P < 0.001). The most common reason for not using CAM was lack of knowledge about it. Most respondents felt comfortable discussing CAM in their clinic and wanted more information on CAM. The most common CAM products being taken were multivitamins (91%), calcium (35%), vitamin C (32%), probiotics (14%), and fish oil/omega-3 fatty acids (13%). The most common CAM practices being used were massage (43%), chiropractic (27%), faith healing (25%), and relaxation (18%). Most respondents believed that CAM was helpful, and most of the 23 reported adverse effects were minor. Seven were reported as moderate, and 3 were reported as severe. Many (42%) patients used CAM at the same time as prescription medicines, and of these patients, concurrent use was discussed with their physician (76%) or pharmacist (52%). CAM use is high among pediatric patients with GI disorders and is much greater among those in Edmonton than in Ottawa. Most respondents reported their CAM use as helpful, with little or no associated harm. Many patients fail to disclose their concurrent use of CAM and conventional medicines to their doctors, increasing the likelihood of interactions.

Complementary and alternative medicine use and adherence to asthma medications among Latino and non-Latino white families.

PubMed

McQuaid, Elizabeth L; Fedele, David A; Adams, Sue K; Koinis-Mitchell, Daphne; Mitchell, Jessica; Kopel, Sheryl J; Seifer, Ronald; Jandasek, Barbara; Fritz, Gregory K; Canino, Glorisa

2014-01-01

The current study sought to evaluate patterns of complementary and alternative medicine (CAM) use in a sample of Latino and non-Latino white (NLW) children with asthma to determine whether parental beliefs about conventional medications and barriers to obtaining these medications were related to CAM use and to assess whether CAM use was associated with decreased adherence to controller medications. Participants included 574 families of children with asthma from NLW, Puerto Rican (PR), and Dominican backgrounds from Rhode Island (RI) and from Island PR. All parents completed a brief checklist of barriers to medication use and an assessment of CAM approaches. A subsample of 259 families had controller medication use monitored objectively for approximately 1 month by MDILog (fluticasone propionate), TrackCap (montelukast), or dosage counter (fluticasone/salmeterol combination). Prevalence of CAM use was high among Latino families. Perceived barriers to obtaining medication were related to increased CAM use in PR families from RI. Elevated medication concerns were positively associated with CAM use among NLW and Island PR families. CAM use was positively related to objective adherence within NLW families, and unrelated in other groups. CAM use is common among Latino families with asthma. Among some families, CAM use may be initiated as a way to cope with barriers to obtaining medication or when parents have concerns about conventional medications. Families who report CAM use do not appear to be substituting CAM for conventional asthma medication. Copyright © 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Doctor communication quality and Friends' attitudes influence complementary medicine use in inflammatory bowel disease.

PubMed

Mountifield, Réme; Andrews, Jane M; Mikocka-Walus, Antonina; Bampton, Peter

2015-03-28

To examine the frequency of regular complementary and alternative therapy (CAM) use in three Australian cohorts of contrasting care setting and geography, and identify independent attitudinal and psychological predictors of CAM use across all cohorts. A cross sectional questionnaire was administered to inflammatory bowel disease (IBD) patients in 3 separate cohorts which differed by geographical region and care setting. Demographics and frequency of regular CAM use were assessed, along with attitudes towards IBD medication and psychological parameters such as anxiety, depression, personality traits and quality of life (QOL), and compared across cohorts. Independent attitudinal and psychological predictors of CAM use were determined using binary logistic regression analysis. In 473 respondents (mean age 50.3 years, 60.2% female) regular CAM use was reported by 45.4%, and did not vary between cohorts. Only 54.1% of users disclosed CAM use to their doctor. Independent predictors of CAM use which confirm those reported previously were: covert conventional medication dose reduction (P < 0.001), seeking psychological treatment (P < 0.001), adverse effects of conventional medication (P = 0.043), and higher QOL (P < 0.001). Newly identified predictors were CAM use by family or friends (P < 0.001), dissatisfaction with patient-doctor communication (P < 0.001), and lower depression scores (P < 0.001). In addition to previously identified predictors of CAM use, these data show that physician attention to communication and the patient-doctor relationship is important as these factors influence CAM use. Patient reluctance to discuss CAM with physicians may promote greater reliance on social contacts to influence CAM decisions.

Assessment of Perception, Experience, and Information-seeking Behavior of the Public of Ras Al-Khaimah, United Arab Emirates, Toward Usage and Safety of Complementary and Alternative Medicine.

PubMed

Sridhar, Sathvik Belagodu; Shariff, Atiqulla; Al Halabi, Nour; Sarmini, Rand; Harb, Lubab Arkan

2017-01-01

This study was conducted to identify the different types of complementary and alternative medicine (CAM) used, reasons for the use of CAM, and the perceptions, experience, and information seeking-behavior toward usage and safety of CAM by the general public of Ras Al-Khaimah, UAE. This was a prospective cross-sectional study. A validated, self-administered, or interviewer-assisted survey questionnaire was used to collect the data. Data from 403 respondents satisfying inclusion criteria were collected and were analyzed using the Statistical Package for the Social Sciences version 24.0. A majority of the respondents (218 [54.1%]) were females. The most commonly (210 [52.1%]) used CAM among the study respondents was herbal medicine. A total of 91 (22.6%) of the survey respondents mentioned that they receive conventional medications along with their CAM. Majority (213 [52.9%]) of the survey respondents opted for CAM to prevent illness. Good number (208 [51.6%]) of the survey respondents mentioned that CAM usage was beneficial in improving their health condition, and they (216 [53.6%]) do believe it as safe and effective. However, a small group (26 [6%]) of respondents reported side effects or complications with the use of CAM. Widespread use of CAM for different medical problems was evident in our study. Although majority of the CAM users believe it as safe and effective, CAM usage should be discussed with the health-care providers to understand the safety issues involved in the use of majority of CAM.

Complementary and alternative healthcare use by participants in the PACE trial of treatments for chronic fatigue syndrome.

PubMed

Lewith, G; Stuart, B; Chalder, T; McDermott, C; White, P D

2016-08-01

Chronic Fatigue Syndrome (CFS) is characterised by persistent fatigue, disability and a range of other symptoms. The PACE trial was randomised to compare four non-pharmacological treatments for patients with CFS in secondary care clinics. The aims of this sub study were to describe the use of complementary and alternative medicine (CAM) in the trial sample and to test whether CAM use correlated with an improved outcome. CAM use was recorded at baseline and 52weeks. Logistic and multiple regression models explored relationships between CAM use and both patient characteristics and trial outcomes. At baseline, 450/640 (70%) of participants used any sort of CAM; 199/640 (31%) participants were seeing a CAM practitioner and 410/640 (64%) were taking a CAM medication. At 52weeks, those using any CAM fell to 379/589 (64%). Independent predictors of CAM use at baseline were female gender, local ME group membership, prior duration of CFS and treatment preference. At 52weeks, the associated variables were being female, local ME group membership, and not being randomised to the preferred trial arm. There were no significant associations between any CAM use and fatigue at either baseline or 52weeks. CAM use at baseline was associated with a mean (CI) difference of 4.10 (1.28, 6.91; p=0.024) increased SF36 physical function score at 52weeks, which did not reach the threshold for a clinically important difference. CAM use is common in patients with CFS. It was not associated with any clinically important trial outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

Integration of Complementary and Alternative Medicine into Family Practices in Germany: Results of a National Survey

PubMed Central

Joos, Stefanie; Musselmann, Berthold; Szecsenyi, Joachim

2011-01-01

More than two-thirds of patients in Germany use complementary and alternative medicine (CAM) provided either by physicians or non-medical practitioners (“Heilpraktiker”). There is little information about the number of family physicians (FPs) providing CAM. Given the widespread public interest in the use of CAM, this study aimed to ascertain the use of and attitude toward CAM among FPs in Germany. A postal questionnaire developed based on qualitatively derived data was sent to 3000 randomly selected FPs in Germany. A reminder letter including a postcard (containing a single question about CAM use in practice and reasons for non-particpation in the survey) was sent to all FPs who had not returned the questionnaire. Of the 3000 FPs, 1027 (34%) returned the questionnaire and 444 (15%) returned the postcard. Altogether, 886 of the 1471 responding FPs (60%) reported using CAM in their practice. A positive attitude toward CAM was indicated by 503 FPs (55%), a rather negative attitude by 127 FPs (14%). Chirotherapy, relaxation and neural therapy were rated as most beneficial CAM therapies by FPs, whereas neural therapy, phytotherapy and acupuncture were the most commonly used therapies in German family practices. This survey clearly demonstrates that CAM is highly valued by many FPs and is already making a substantial contribution to first-contact primary care in Germany. Therefore, education and research about CAM should be increased. Furthermore, with the provision of CAM by FPs, the role of non-medical CAM practitioners within the German healthcare system is to be questioned. PMID:19293252

Discrepant Views of Korean Medical Oncologists and Cancer Patients on Complementary and Alternative Medicine

PubMed Central

Kim, Bong-Seog; Lee, Kyung Hee; Lee, Myung Ah; Hong, Young Seon; Shin, Sang Won; Lee, Soon Nam

2008-01-01

Purpose This study was designed to evaluate the communication gap between Korean medical oncologists and cancer patients on complementary and alternative medicine (CAM). Materials and Methods Cross sectional studies utilized the responses of 59 medical oncologists and 211 patients. To understand the communication gap, perceived reasons and nondisclosure of CAM use, reactions of physicians to disclosure, and expectations for CAM were analyzed. Data were compared with use of the chi-squared test. Results Both medical oncologists and patients were in accord that CAM use would privde the patients with a feeling of hope. The medical oncologists believed more often than patients to attribute CAM use for control over medical care decisions, for the treatment of an incurable disease or as a nontoxic approach (p<0.05). Regarding reasons for nondisclosure, medical oncologists were more likely to think that physicians would not understand the use of CAM, discontinue treatment or disapprove of the use of CAM (p<0.0001). Patients attributed nondisclosure mainly to the lack of questioning about CAM. Medical oncologists were more likely to warn of the risks with CAM use and less likely to encourage the use of CAM than perceived by patients (p=0.01). Patients expected that CAM could cure disease, extend survival, relieve symptoms and improve the immune system or quality of life more often than medical oncologists (p<0.05). Conclusion Given the discrepant views of medical oncologists and patients on the use of CAM, medical oncologists should be aware of the discrepancies and attempt to resolve any differences. PMID:19688054

Use of complementary and alternative medicine in Europe: Health-related and sociodemographic determinants.

PubMed

Kemppainen, Laura M; Kemppainen, Teemu T; Reippainen, Jutta A; Salmenniemi, Suvi T; Vuolanto, Pia H

2018-06-01

The aim of this research was to study health-related and sociodemographic determinants of the use of different complementary and alternative medicine (CAM) treatments in Europe and differences in CAM use in various European countries. The study was based on a design-based logistic regression analysis of the European Social Survey (ESS), Round 7. We distinguished four CAM modalities: manual therapies, alternative medicinal systems, traditional Asian medical systems and mind-body therapies. In total, 25.9% of the general population had used CAM during the last 12 months. Typically, only one CAM treatment had been used, and it was used more often as complementary rather than alternative treatment. The use of CAM varied greatly by country, from 10% in Hungary to almost 40% in Germany. Compared to those in good health, the use of CAM was two to fourfold greater among those with health problems. The health profiles of users of different CAM modalities varied. For example, back or neck pain was associated with all types of CAM, whereas depression was associated only with the use of mind-body therapies. Individuals with difficult to diagnose health conditions were more inclined to utilize CAM, and CAM use was more common among women and those with a higher education. Lower income was associated with the use of mind-body therapies, whereas the other three CAM modalities were associated with higher income. Help-seeking differed according to the health problem, something that should be acknowledged by clinical professionals to ensure safe care. The findings also point towards possible socioeconomic inequalities in health service use.

Doctor communication quality and Friends' attitudes influence complementary medicine use in inflammatory bowel disease

PubMed Central

Mountifield, Réme; Andrews, Jane M; Mikocka-Walus, Antonina; Bampton, Peter

2015-01-01

AIM: To examine the frequency of regular complementary and alternative therapy (CAM) use in three Australian cohorts of contrasting care setting and geography, and identify independent attitudinal and psychological predictors of CAM use across all cohorts. METHODS: A cross sectional questionnaire was administered to inflammatory bowel disease (IBD) patients in 3 separate cohorts which differed by geographical region and care setting. Demographics and frequency of regular CAM use were assessed, along with attitudes towards IBD medication and psychological parameters such as anxiety, depression, personality traits and quality of life (QOL), and compared across cohorts. Independent attitudinal and psychological predictors of CAM use were determined using binary logistic regression analysis. RESULTS: In 473 respondents (mean age 50.3 years, 60.2% female) regular CAM use was reported by 45.4%, and did not vary between cohorts. Only 54.1% of users disclosed CAM use to their doctor. Independent predictors of CAM use which confirm those reported previously were: covert conventional medication dose reduction (P < 0.001), seeking psychological treatment (P < 0.001), adverse effects of conventional medication (P = 0.043), and higher QOL (P < 0.001). Newly identified predictors were CAM use by family or friends (P < 0.001), dissatisfaction with patient-doctor communication (P < 0.001), and lower depression scores (P < 0.001). CONCLUSION: In addition to previously identified predictors of CAM use, these data show that physician attention to communication and the patient-doctor relationship is important as these factors influence CAM use. Patient reluctance to discuss CAM with physicians may promote greater reliance on social contacts to influence CAM decisions. PMID:25834335

Realization of Comfortable Massage by Using Iterative Learning Control Based on EEG

NASA Astrophysics Data System (ADS)

Teramae, Tatsuya; Kushida, Daisuke; Takemori, Fumiaki; Kitamura, Akira

Recently the massage chair is used by a lot of people because they are able to use it easily at home. However a present massage chair only realizes the massage motion. Moreover the massage chair can not consider the user’s condition and massage force. On the other hand, the professional masseur is according to presume the mental condition by patient’s reaction. Then this paper proposes the method of applying masseur’s procedure for the massage chair using iterative learning control based on EEG. And massage force is estimated by acceleration sensor. The realizability of the proposed method is verified by the experimental works using the massage chair.

Cycling chair: a novel vehicle for the lower limbs disabled

NASA Astrophysics Data System (ADS)

Takahashi, Takayuki; Nishiyyama, Yuuki; Ozawa, Yukiko; Nakano, Eiji; Handa, Yasunobu

2005-12-01

The goal of our research is to develop a practical vehicle for lower limbs disabled to improve their mobility and health. The most significant mechanical character of the proposed vehicle is that it is driven by the lower limbs of the disabled themselves. We call it as Cycling Chair. Disuse of the lower limbs leads many subsidiary issues on health, deteriorating the whole-body circulation, it is the most serious problem, cases so-called the disuse syndrome. The proposed Cycling Chair solves those problems by using the leg-driven mechanism. In this paper, the mechanism of the Cycling Chair and the way to drive the chair by paraplegics are discussed. Some experimental results are also presented.

Therapeutic uses of the WebCam in child psychiatry.

PubMed

Chlebowski, Susan; Fremont, Wanda

2011-01-01

The authors provide examples for the use of the WebCam as a therapeutic tool in child psychiatry, discussing cases to demonstrate the application of the WebCam, which is most often used in psychiatry training programs during resident supervision and for case presentations. Six cases illustrate the use of the WebCam in individual and family therapy. The WebCam, used during individual sessions, can facilitate the development of prosocial skills. Comparing individual WebCam video sessions can help to evaluate the effectiveness of medication and progress in therapy. The WebCam has proven to be useful in psycho-education, facilitating communication, and treating children and families. The applications of this technology may include cognitive-behavioral therapy, dialectical-behavioral, and group therapy.

Regulation of Vascular Growth in the Chorioallantoic Membrane of Japanese Quail Eggs

NASA Technical Reports Server (NTRS)

Montague, Idoreyin P.

2004-01-01

The Microgravity Research Program is part of NASA's Office of Biological and Physical Research (OBPR). The mission of the Microgravity Fluid Physics research program is to facilitate and conduct the best possible fluid physics research using the space environment and make this knowledge available to the scientific community and the public at large. During the summer of 2004, I worked in this division with Dr. Patricia Parsons-Wingerter. Dr. Parsons was working on several projects that used the chorioallantoic membrane (CAM) of Japanese quail eggs. The CAM develops in the eggs of birds and reptiles and is a very vascular fetal membrane composed of the fused chorion and adjacent wall of the allantois. The CAM is formed on day 4 of incubation and its primary job is to mediate gas exchanges with the extra embryonic environment. The CAM of our Japanese quail eggs is easily identifiable to us because it is transparent and it sits on top of the yolk with the embryo in the center. The CAM is of interest because of its many applications in the field of medicine as it relates to vascular remodeling and angiogenesis. Angiogenesis is simply the growth or formation of new blood vessels and anti-angiogenesis is the inhibition of said vessels. Angiogenesis occurs naturally in a healthy body for healing wounds and for restoring blood flow to tissues after injury and in females during the monthly reproductive cycle. In many serious diseases, like several types of cancer and those that affect the heart and cardiovascular system, the body loses control over angiogenesis. These diseases, which are dependent on angiogenesis, result when new blood vessels either grow excessively or insufficiently. The chorioallantoic membrane of our Japanese quail eggs gives a good model of angiogenesis. We used angiogenic regulators to inhibit or stimulate vascular growth in the CAM in a healthy manner and they induced distinct vascular patterns in vivo. Certain dominant regulators can be recognized by their unique vascular patterns and from these patterns; we can deduce specific alterations in vascular remodeling and angiogenesis. This will aid us in early-stage diagnosis and customized therapies for patients with angiogenic-dependent diseases. This particular research is important to NASA because cardiovascular health issues are the second highest of ten categories that have been defined as risk factors in human space exploration. Also, cardiovascular-related diseases have been the leading cause of death in America since 1981. Therefore, this kind of research in the field of cardiovascular health is of great importance to humans on earth and in space. This particular research is important to NASA because cardiovascular health is of great importance to humans on earth and in space.

Three essays on the economics of science policy: The impact of funding, collaboration and research chairs

NASA Astrophysics Data System (ADS)

Mirnezami, Seyed Reza

This thesis studies the determinants that influence the number of citations, the effect of having a research collaboration with top-funded scientists on scientific productivity, and the effect of holding a research chair on scientific productivity. Based on a review study by Bornmann and Daniel (2008), one can argue that non-scientific factors determining the decision to cite do not significantly alter the role of citation as a measure of research impact. Assuming that the number of citations is a good measure for research impact and, in turn, for a certain kind of quality, we showed that the number of articles and the visibility of a researcher, the impact factor of the journal, the size of the research team, and the institutional setting of the university are the important determinants of citation counts. However, we have found that there is no significant effect of public funding and gender in most of the domains examined. The point that funding amount is not a significant determinant of citation counts does not necessarily contradict the positive effect of funding on scientific productivity. We also developed a theoretical model and proposed some hypotheses about the effect of collaboration with top-funded scientists on scientific productivity. We then validated the hypotheses with empirical analysis and showed that such collaboration has a positive effect on scientific productivity. This significant effect may exist through different channels: transfer of tacit knowledge, more scientific publications, economy of scale in knowledge production because of better research equipment, and expanded research network. The results also verified the positive effect of funding, the positive effect of networking (measured by number of co-authors), the inverted U-shaped effect of age, and the fewer number of publications by women compared to men. Finally, we made a distinction between different attributes of research chairs and their effect on scientific productivity. One of the important questions is to find out whether a research chair still has better scientific productivity (compared to non-chair holders) after controlling for the research funds available to the researchers. To investigate that question, we employed a matching technique to identify pairs of scientists (chair and non-chair holders) of the same gender, funding and research field. After such matching, we found that the effect of the Canada research chair program on scientific productivity remains significant and positive, while the effect of industrial chairs and the chairs appointed by the Canadian federal granting councils (NSERC and CIHR) become non-significant. This finding highlights the effectiveness of our matching technique methodology; because before matching, holding any type of chair had a positive and significant effect on scientific productivity. This finding highlights the special attributes of the Canada research chair program, which are not replicated in other chairs. Those specific attributes may significantly push scientific productivity. For example, Canada research chairs are generally associated with some degree of prestige or higher visibility to recruit talented students or to have research collaboration with top scientists in the field. In addition, the Canada research chair program has a firm and efficient method of allocation (which is explained in the thesis). This approach institutionally synchronizes different chairs in universities and research fields. The fact that other types of research chairs, once matched with equivalent scientists, do not have an impact on scientific output in terms of quantity does not imply that these chair holders are lesser scientists, but that they are devoting part of their time to other endeavours of a more practical nature. Hence universities are maintaining a balance between the pursuit of pure scientific knowledge and its application to socioeconomic benefits. By solely studying scientific articles, we are missing a great deal of the university professors' activities. Although not trivial, future research should aim to cast a wider net on outputs, outcomes and impacts of university research.

PreCam Survey Work at ANL

Science.gov Websites

- Astrophysics - DES - PreCam PreCam Work at ANL The Argonne/HEP Dark Energy Survey (DES) group, working on the Dark Energy Camera (DECam), built a mini-DECam camera called PreCam. This camera has provided valuable

Complementary and Alternative Medicine Use for HIV Management in the State of Florida: Medical Monitoring Project

PubMed Central

Okafor, Chukwuemeka N.; Harman, Jeffrey S.; Canidate, Shantrel S.; Cook, Christa L.; Cook, Robert L.

2016-01-01

Abstract Objective: The aims of this study were to describe complementary and alternative medicine (CAM) use and to assess the relationships between CAM use and antiretroviral therapy (ART) adherence and human immunodeficiency virus (HIV) RNA viral load suppression among a sample of persons living with HIV (PLWH) engaged in care in the state of Florida. Design: The Florida Medical Monitoring Project (n = 803) collected repeated cross-sectional data for surveillance of clinical outcomes among PLWH from 2009 to 2010. Past-year CAM use specifically for the management of HIV was measured via self-report. Logistic regression models were conducted to assess the effect of CAM use on ART adherence and viral load suppression, controlling for demographic and clinical factors using backwards stepwise deletion of factors with a p-value of >0.25. Results: CAM use was reported in 53.3% (n = 428). In bivariate analysis, CAM use was the highest among those 40–49 years of age (61%; p < 0.05), males (56%; p < 0.01), whites (61%; p = 0.001), and those educated beyond high school (59%; p < 0.05). Among those using CAM, 63% and 37% reported one and two or more CAM modalities, respectively. CAM modalities included biologically based therapies (89%), mind–body medicine/manipulative body-based therapies (30%), spiritual healing (23%), energy therapies (6%), and whole medical systems (6%). In multivariable analyses, any CAM use and number of CAM methods used were not associated with ART adherence. Any CAM use was not associated with detectable viral load (adjusted odds ratio [aOR] 0.81; 95% confidence interval [CI] 0.58–1.12; p = 0.20). Those using two or more methods had significantly decreased risk for detectable viral load (aOR 0.60; 95% CI 0.39–0.92; p < 0.02). Conclusions: CAM use was not associated with negative effects on ART adherence. CAM users were less likely to have detectable viral load compared with non-users. Future research should focus on CAM use among PLWH not engaged in HIV care and the longitudinal patterns of CAM use and possible effects of long-term health outcomes. PMID:27631385

Adult vaccination coverage levels among users of complementary/alternative medicine - results from the 2002 National Health Interview Survey (NHIS).

PubMed

Stokley, Shannon; Cullen, Karen A; Kennedy, Allison; Bardenheier, Barbara H

2008-02-22

While many Complementary/Alternative Medicine (CAM) practitioners do not object to immunization, some discourage or even actively oppose vaccination among their patients. However, previous studies in this area have focused on childhood immunizations, and it is unknown whether and to what extent CAM practitioners may influence the vaccination behavior of their adult patients. The purpose of this study was to describe vaccination coverage levels of adults aged > or = 18 years according to their CAM use status and determine if there is an association between CAM use and adult vaccination coverage. Data from the 2002 National Health Interview Survey, limited to 30,617 adults that provided at least one valid answer to the CAM supplement, were analyzed. Receipt of influenza vaccine during the past 12 months, pneumococcal vaccine (ever), and > or = 1 dose of hepatitis B vaccine was self-reported. Coverage levels for each vaccine by CAM use status were determined for adults who were considered high priority for vaccination because of the presence of a high risk condition and for non-priority adults. Multivariable analyses were conducted to evaluate the association between CAM users and vaccination status, adjusting for demographic and healthcare utilization characteristics. Overall, 36% were recent CAM users. Among priority adults, adjusted vaccination coverage levels were significantly different between recent and non-CAM users for influenza (44% vs 38%; p-value < 0.001) and pneumococcal (40% vs 33%; p-value < 0.001) vaccines but were not significantly different for hepatitis B (60% vs 56%; p-value = 0.36). Among non-priority adults, recent CAM users had significantly higher unadjusted and adjusted vaccination coverage levels compared to non-CAM users for all three vaccines (p-values < 0.001). Vaccination coverage levels among recent CAM users were found to be higher than non-CAM users. Because CAM use has been increasing over time in the U.S., it is important to continue monitoring CAM use and its possible influence on receipt of immunizations among adults. Since adult vaccination coverage levels remain below Healthy People 2010 goals, it may be beneficial to work with CAM practitioners to promote adult vaccines as preventive services in keeping with their commitment to maintaining good health.

Report of the 10(th) Asia-Pacific Federation of Societies for Surgery of the Hand Congress (Organising Chair and Scientific Chair).

PubMed

A, Roohi Sharifah; Abdullah, Shalimar

2016-10-01

A report on the 10(th) Asia-Pacific Federation of Societies for the Surgery of the Hand and 6(th) Asia-Pacific Federation of Societies for Hand Therapists is submitted detailing the numbers of attendees participating, papers presented and support received as well the some of the challenges faced and how best to overcome them from the local conference chair and scientific chair point of view.

What a medical school chair wants from the dean

PubMed Central

Hromas, Robert; Leverence, Robert; Mramba, Lazarus K; Jameson, J Larry; Lerman, Caryn; Schwenk, Thomas L; Zimmermann, Ellen M; Good, Michael L

2018-01-01

Economic pressure has led the evolution of the role of the medical school dean from a clinician educator to a health care system executive. In addition, other dynamic requirements also have likely led to changes in their leadership characteristics. The most important relationship a dean has is with the chairs, yet in the context of the dean’s changing role, little attention has been paid to this relationship. To frame this discussion, we asked medical school chairs what characteristics of a dean’s leadership were most beneficial. We distributed a 26-question survey to 885 clinical and basic science chairs at 41 medical schools. These chairs were confidentially surveyed on their views of six leadership areas: evaluation, barriers to productivity, communication, accountability, crisis management, and organizational values. Of the 491 chairs who responded (response rate =55%), 88% thought that their dean was effective at leading the organization, and 89% enjoyed working with their dean. Chairs indicated that the most important area of expertise of a dean is to define a strategic vision, and the most important value for a dean is integrity between words and deeds. Explaining the reasons behind decisions, providing good feedback, admitting errors, open discussion of complex or awkward topics, and skill in improving relations with the teaching hospital were judged as desirable attributes of a dean. Interestingly, only 23% of chairs want to be a dean in the future. Financial acumen was the least important skill a chair thought a dean should hold, which is in contrast to the skill set for which many deans are hired and evaluated. After reviewing the literature and analyzing these responses, we assert that medical school chairs want their dean to maintain more traditional leadership than that needed by a health care system executive, such as articulating a vision for the future and keeping their promises. Thus, there appears to be a mismatch between what medical school chairs perceive they need from their dean and how the success of a dean is evaluated. PMID:29872359

76 FR 17118 - Environmental Management Site-Specific Advisory Board Chairs

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-28

... DEPARTMENT OF ENERGY Environmental Management Site-Specific Advisory Board Chairs AGENCY... Environmental Management Site-Specific Advisory Board (EM SSAB) Chairs. The Federal Advisory Committee Act (Pub... areas of environmental restoration, waste management, and related activities. Tentative Agenda Topics...

76 FR 62054 - Environmental Management Site-Specific Advisory Board Chairs

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-06

... environmental restoration, waste management, and related activities. Tentative Agenda Topics [cir] EM Program... DEPARTMENT OF ENERGY Environmental Management Site-Specific Advisory Board Chairs AGENCY... of the Environmental Management Site-Specific Advisory Board (EM SSAB) Chairs. The Federal Advisory...

77 FR 55813 - Environmental Management Site-Specific Advisory Board Chairs

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-11

... DEPARTMENT OF ENERGY Environmental Management Site-Specific Advisory Board Chairs AGENCY... Environmental Management Site-Specific Advisory Board (EM SSAB) Chairs. The Federal Advisory Committee Act (Pub... environmental restoration, waste management, and related activities. Tentative Agenda Topics Tuesday, October 2...

78 FR 59012 - Environmental Management Site-Specific Advisory Board Chairs

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-25

... DEPARTMENT OF ENERGY Environmental Management Site-Specific Advisory Board Chairs AGENCY... Environmental Management Site-Specific Advisory Board (EM SSAB) Chairs. The Federal Advisory Committee Act (Pub... and site management in the areas of environmental restoration, waste management, and related...

Content-addressable memory based enforcement of configurable policies

DOEpatents

Berg, Michael J

2014-05-06

A monitoring device for monitoring transactions on a bus includes content-addressable memory ("CAM") and a response policy unit. The CAM includes an input coupled to receive a bus transaction tag based on bus traffic on the bus. The CAM stores data tags associated with rules of a security policy to compare the bus transaction tag to the data tags. The CAM generates an output signal indicating whether one or more matches occurred. The response policy unit is coupled to the CAM to receive the output signal from the CAM and to execute a policy action in response to the output signal.

Complementary and alternative medicine (CAM) use by african american (AA) and caucasian american (CA) older adults in a rural setting: a descriptive, comparative study

PubMed Central

Cuellar, Norma; Aycock, Teresa; Cahill, Bridgett; Ford, Julie

2003-01-01

Background The use of CAM is at an all time high. There is very little research that compares the use of CAM in elders by ethnicity in rural settings. The purpose of the study was to determine if there was a difference between African American and Caucasian American rural elders on use of CAM and self-reported satisfaction with CAM. Methods The design was a descriptive, comparative study of 183 elders who reported the number of CAM used and satisfaction with CAM. A convenience sample was recruited through community service organizations in the state of Mississippi. The availability of elders through the support groups, sampling bias, subject effect, and self-report were limitations of the study. Results The commonest examples of CAM used by rural elders were prayer, vitamins, exercise, meditation, herbs, chiropractic medicine, glucosamine, and music therapy. Significant findings on SES and marital status were calculated. Differences on ethnicity and demographic variables were significant for age, education, and the use of glucosamine. Conclusions Health care providers must be aware that elders are using CAM and are satisfied with their use. Identifying different uses of CAM by ethnicity is important for health care practitioners, impacting how health care is provided. PMID:14622445

Complementary and alternative medicine (CAM) use by African American (AA) and Caucasian American (CA) older adults in a rural setting: a descriptive, comparative study.

PubMed

Cuellar, Norma; Aycock, Teresa; Cahill, Bridgett; Ford, Julie

2003-11-18

The use of CAM is at an all time high. There is very little research that compares the use of CAM in elders by ethnicity in rural settings. The purpose of the study was to determine if there was a difference between African American and Caucasian American rural elders on use of CAM and self-reported satisfaction with CAM. The design was a descriptive, comparative study of 183 elders who reported the number of CAM used and satisfaction with CAM. A convenience sample was recruited through community service organizations in the state of Mississippi. The availability of elders through the support groups, sampling bias, subject effect, and self-report were limitations of the study. The commonest examples of CAM used by rural elders were prayer, vitamins, exercise, meditation, herbs, chiropractic medicine, glucosamine, and music therapy. Significant findings on SES and marital status were calculated. Differences on ethnicity and demographic variables were significant for age, education, and the use of glucosamine. Health care providers must be aware that elders are using CAM and are satisfied with their use. Identifying different uses of CAM by ethnicity is important for health care practitioners, impacting how health care is provided.

A web-based course on complementary medicine for medical students and residents improves knowledge and changes attitudes.

PubMed

Cook, David A; Gelula, Mark H; Lee, Mark C; Bauer, Brent A; Dupras, Denise M; Schwartz, Alan

2007-01-01

There is a growing need to educate physicians about complementary and alternative medicine (CAM). Few introductory courses in CAM have been described. To develop and evaluate an introductory course in CAM for medical students and residents. We conducted a controlled study evaluating a case-based, Web-based course in CAM, making comparison to no intervention. Participants were 123 internal medicine residents, family medicine residents, and 3rd- and 4th-year medical students at academic residency programs in internal medicine and family medicine and two U.S. medical schools. Outcomes included knowledge of CAM, attitudes toward CAM, and course evaluation information. Eighty-nine learners completed the course. Test scores among a subset of these (n = 57) were higher (M +/- SD = 78.7 +/- 10.1) than scores (50.9 +/- 8.5, p < .001) among a no-intervention control group (n = 34), and remained higher (64.9 +/- 11.4) 3 months later. After the course participants felt more comfortable discussing CAM with patients, recognized a greater role for CAM, and knew better where to find information on CAM (ps < .001 compared to baseline). Course ratings were high, although 26% of learners desired greater feedback. This brief course in CAM improved knowledge, changed attitudes, and was well received.

Use of complementary and alternative medicines among women with gestational trophoblastic diseases: a survey at the Philippine General Hospital.

PubMed

Cagayan, M Stephanie Fay S; Oras, Celestrell May W

2010-01-01

To determine the prevalence of complementary and alternative medicine (CAM) use among women with gestational trophoblastic disease (GTD) at the University of the Philippines-Philippine General Hospital (UP-PGH). A survey on the use of CAM among women (N = 52) with GTD managed at the UP-PGH Gestational Trophoblastic Disease Center from June to August 2009 was done. The mean age of the participants was 32.3 years, and there were no significant differences in the proportion of CAM users as to educational attainment, diagnosis and treatment type received. Among the participants 96% used CAM, most commonly mental healing/prayer, fruit juices/vegetable diet, banaba/taheebo tea and multivitamins. Reasons for CAM use included safety, improvement of immune system, stress reduction and hope for their condition. Benefits included enhanced quality of life, stress reduction, immune system improvement and a healthier lifestyle. No untoward effect of CAM use was reported. Thirty-six percent of the participants disclosed CAM use to their physician. About 56% percent of the physicians were in favor of the CAM used. The main sources of information on CAM were relatives and friends. To better address patients' needs, physicians should routinely ask patients about their use of CAM and be able to discuss these therapies with them.

Vct system having closed loop control employing spool valve actuated by a stepper motor

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

Quin, S.B. Jr.; Siemon, E.C.

1993-06-15

An internal combustion engine is described comprising: a crankshaft, the crankshaft being rotable about an axis; a cam shaft, the cam shaft being rotatable about a second axis, the second axis being parallel to the axis, the cam shaft being subject to torque reversals during the rotation thereof; a vane, the vane having at least one lobe, the vane being attached to the cam shaft, being rotatable with the cam shaft and being non-oscillatable with respect to the cam shaft; a housing, the housing being rotatable with the cam shaft and being oscillatable with respect to the cam shaft, themore » housing having at least one recess, the recess receiving the lobe, the lobe being oscillatable within the recess; rotary movement transmitting means for transmitting rotary movement from the crankshaft to the housing; actuating means for varying the position of the housing relative to the cam shaft in reaction to torque reversals in the cam shaft, the actuating means comprising a stepper motor, a lead screw and a proportional spool valve, the position of the spool valve being controlled by the position of the lead screw driven by the stepper motor, the actuating means also delivering hydraulic fluid to the vane; and processing means for controlling the position of the actuating means.« less

Range of Hip Joint Motion Is Correlated With MRI-Verified Cam Deformity in Adolescent Elite Skiers

PubMed Central

Agnvall, Cecilia; Swärd Aminoff, Anna; Todd, Carl; Jonasson, Pall; Thoreson, Olof; Swärd, Leif; Karlsson, Jon; Baranto, Adad

2017-01-01

Background: Radiologically verified cam-type femoroacetabular impingement (FAI) has been shown to correlate with reduced internal rotation, reduced passive hip flexion, and a positive anterior impingement test. Purpose: To validate how a clinical examination of the hip joint correlates with magnetic resonance imaging (MRI)–verified cam deformity in adolescents. Study Design: Cross-sectional study; Level of evidence, 3. Methods: The sample group consisted of 102 adolescents with the mean age 17.7 ± 1.4 years. The hip joints were examined using MRI for measurements of the presence of cam (α-angle ≥55°) and clinically for range of motion (ROM) in both supine and sitting positions. The participants were divided into a cam and a noncam group based on the results of the MRI examination. Passive hip flexion, internal rotation, anterior impingement, and the FABER (flexion, abduction, and external rotation) test were used to test both hips in the supine position. With the participant sitting, the internal/external rotation of the hip joint was measured in 3 different positions of the pelvis (neutral, maximum anteversion, and retroversion) and lumbar spine (neutral, maximum extension, and flexion). Results: Differences were found between the cam and noncam groups in terms of the anterior impingement test (right, P = .010; left, P = .006), passive supine hip flexion (right: mean, 5°; cam, 117°; noncam, 122° [P = .05]; and left: mean, 8.5°; cam, 116°; noncam, 124.5° [P = .001]), supine internal rotation (right: mean, 4.9°; cam, 24°; noncam, 29° [P = .022]; and left: mean, 4.8°; cam, 26°; noncam, 31° [P = .028]), sitting internal rotation with the pelvis and lumbar spine in neutral (right: mean, 7.95°; cam, 29°; noncam, 37° [P = .001]; and left: mean, 6.5°; cam, 31.5°; noncam, 38° [P = .006]), maximum anteversion of the pelvis and extension of the lumbar spine (right: mean, 5.2°; cam, 20°; noncam, 25° [P = .004]; and left: mean, 5.85°; cam, 20.5; noncam, 26.4° [P = .004]), and maximum retroversion of the pelvis and flexion of the spine (right: mean, 8.4°; cam, 32.5°; noncam, 41° [P = .001]; and left: mean, 6.2°; cam, 36°; noncam, 42.3° [P = .012]). The cam group had reduced ROM compared with the noncam group in all clinical ROM measures. Conclusion: The presence of cam deformity on MRI correlates with reduced internal rotation in the supine and sitting positions, passive supine hip flexion, and the impingement test in adolescents. PMID:28695136

An Evaluation of Marine Boundary Layer Cloud Property Simulations in the Community Atmosphere Model Using Satellite Observations: Conventional Subgrid Parameterization versus CLUBB

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

Song, Hua; Zhang, Zhibo; Ma, Po-Lun

This paper presents a two-step evaluation of the marine boundary layer (MBL) cloud properties from two Community Atmospheric Model (version 5.3, CAM5) simulations, one based on the CAM5 standard parameterization schemes (CAM5-Base), and the other on the Cloud Layers Unified By Binormals (CLUBB) scheme (CAM5-CLUBB). In the first step, we compare the cloud properties directly from model outputs between the two simulations. We find that the CAM5-CLUBB run produces more MBL clouds in the tropical and subtropical large-scale descending regions. Moreover, the stratocumulus (Sc) to cumulus (Cu) cloud regime transition is much smoother in CAM5-CLUBB than in CAM5-Base. In addition,more » in CAM5-Base we find some grid cells with very small low cloud fraction (<20%) to have very high in-cloud water content (mixing ratio up to 400mg/kg). We find no such grid cells in the CAM5-CLUBB run. However, we also note that both simulations, especially CAM5-CLUBB, produce a significant amount of “empty” low cloud cells with significant cloud fraction (up to 70%) and near-zero in-cloud water content. In the second step, we use satellite observations from CERES, MODIS and CloudSat to evaluate the simulated MBL cloud properties by employing the COSP satellite simulators. We note that a feature of the COSP-MODIS simulator to mimic the minimum detection threshold of MODIS cloud masking removes much more low clouds from CAM5-CLUBB than it does from CAM5-Base. This leads to a surprising result — in the large-scale descending regions CAM5-CLUBB has a smaller COSP-MODIS cloud fraction and weaker shortwave cloud radiative forcing than CAM5-Base. A sensitivity study suggests that this is because CAM5-CLUBB suffers more from the above-mentioned “empty” clouds issue than CAM5-Base. The COSP-MODIS cloud droplet effective radius in CAM5-CLUBB shows a spatial increase from coastal St toward Cu, which is in qualitative agreement with MODIS observations. In contrast, COSP-MODIS cloud droplet effective radius in CAM5-Base almost remains a constant. In comparison with CloudSat observations, the histogram of the radar reflectivity from modeled MBL clouds is too narrow without a distinct separation between cloud and drizzle modes. Moreover, the probability of drizzle in both simulations is almost twice as high as the observation. Future studies are needed to understand the causes of these differences and their potential connection with the “empty” cloud issues in the model.« less

SU-C-19A-05: Treatment Chairs for Modern Radiation Therapy Treatments

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

Court, L; Fullen, D; Tharp, K

2014-06-15

Purpose: Treating patients in a seated position has potential advantages including improved comfort, increased lung volume, and reduced respiratory motion. We compared chair designs for head and neck, thoracic and breast patients for use with either IGRT linacs or a proposed low-cost fixed horizontal beam-line machine. Methods: Three treatment chairs were designed and constructed. Two of the chairs are based on a massage-chair, with the patient angled slightly forwards and knee rests used to minimize intra-fraction slouch. The third chair design is more conventional; the patient is angled backwards, with indexed positioning devices and the ability to attach thermoplastic masks.more » Patient geometries, including PTV location and patient sizes, were extracted from 137 CTs of past patients were used to model the probability of collision between the patient and the linac for various seated positions. All chairs were designed around the weight limits for couches on our linacs. At the time of writing we have just received IRB approval for imaging studies to evaluate comfort, and intra- and interfraction reproducibility. Results: The geometric analysis showed that head and neck patients and thoracic patients could be treated without collision. However, there is very limited space between the patient and the treatment/imaging devices, so careful design of the chair is essential. The position of the treatment target and extended arm positioning means that this is a particular concern for thoracic and breast patients. This was demonstrated for one of the prototype chairs designed for breast treatment where the arm holders would collide with the kV detector. The extra clearance of a dedicated fixed-beam linac would overcome these difficulties. Intra- and inter-fraction reproducibility results will be presented at the meeting. Conclusion: To take advantage of the clinical advantages of seated treatments, appropriate treatment chairs are needed. A dedicate fixed-beam linac may enable more options. This work was partially funded by Varian Medical Systems.« less

Does agreement on institutional values and leadership issues between deans and surgery chairs predict their institutions' performance?

PubMed

Souba, Wiley W; Mauger, David; Day, David V

2007-03-01

To gain a better understanding of the values that medical school deans and surgery chairs consider most essential for effective leadership, to assess their perceptions of the values and leadership climate in their institutions, and to test the premise that agreement on leadership values and climate predict greater organizational effectiveness and performance. From June 2005 through March 2006, questionnaires designed to assess leadership core values and organizational leadership climate were mailed to medical school deans and surgery chairs of the 125 U.S. academic health centers. Institutional performance measures used were the National Institutes of Health (NIH) standing and U.S. News and World Report ranking of each institution. Sixty-eight surgery chairs (54%) and 60 deans (48%) returned surveys. Q-sort results on 38 positive leadership values indicated that integrity, trust, and vision were considered the most important core values for effective leadership by both chairs and deans. Both groups ranked business acumen, authority, and institutional reputation as least important. Deans consistently ranked the leadership climate as being healthier (more positive) than did their surgery chairs on multiple scale items: leadership is widely shared (P = .005), information is widely shared (P = .002), missions are aligned (P = .003), open communication is the norm (P = .009), good performance is rewarded (P = .01), teamwork is widely practiced (P = .01), and leaders are held accountable (P = 002). Tighter alignment between chairs and deans on core values and on the leadership climate scale correlated with higher school and department NIH standing and higher U.S. News and World Report medical school and hospital ranking (P < .05). Although surgery chairs and deans espouse similar core leadership values, deans believe that a healthier leadership climate exists in their institutions than their surgery chairs do. The study findings suggest that tighter leadership alignment between deans and surgery chairs may predict a higher level of institutional performance in the clinical and academic arenas.

Complementary and Alternative Medicine Use Among US Adults With Headache or Migraine: Results from the 2012 National Health Interview Survey.

PubMed

Zhang, Yan; Dennis, Jeff A; Leach, Matthew J; Bishop, Felicity L; Cramer, Holger; Chung, Vincent C H; Moore, Craig; Lauche, Romy; Cook, Ron; Sibbritt, David; Adams, Jon

2017-09-01

Given the safety concerns regarding pharmacological agents, and the considerable impact of headache and migraine on the sufferer's quality of life, many people seek other treatment options beyond conventional medication and care to address their symptoms; this includes complementary and alternative medicine (CAM). Some CAM interventions have shown promising results in clinical trials of headache and migraine management. Nonetheless, there has been little research exploring the reasons for using CAM, and the types of CAM used, among this population. The study aimed to answer the following questions: (1) Which CAM modalities are used most frequently among migraine/headache sufferers? and (2) What are the self-reported reasons for CAM use among migraine/headache sufferers? This secondary analysis of data from the 2012 U.S. NHIS (a national cross-sectional survey) examined the use of CAM among migraine/headache sufferers, including the main reasons related to CAM use. Data were weighted and analyzed using STATA 14.0. The sample of 34,525 adults included 6558 (18.7%) headache/migraine sufferers. Of the headache/migraine sufferers, a substantial proportion (37.6%, n = 2427) used CAM for various conditions; however, CAM use specifically for headache/migraine was much less prevalent (3.3%, n = 216). Of those who used CAM for headache/migraine, about half used CAM in conjunction with prescription (47.8%, n = 100) or over-the-counter medication (55.1%, n = 113). As severity of headache/migraine increased so did the likelihood of using CAM (severe migraine odds ratio [OR] = 2.32; 95% confidence interval [CI]: 1.41, 3.82; both recurring headache/severe migraine OR = 3.36; 95% CI: 2.08, 5.43; when compared to those with recurring headache only). The most frequently used CAM modality among all headache/migraine sufferers (N = 6558) was manipulative therapy (22.0%, n = 1317), herbal supplementation (21.7%, n = 1389) and mind-body therapy (17.9%, n = 1100). The top 3 reasons for using CAM for headache were general wellness (28.7%, n = 60/209), improving overall health (26.8%, n = 56/209), and reducing stress (16.7%, n = 35/209). Although CAM is used by many sufferers of headache/migraine, the use of CAM specifically for the treatment of headache/migraine is relatively low in the United States. The study also assesses the key differences of CAM use among headache/migraine sufferers in NHIS 2012 compared with those in NHIS 2007, and identifies shortfalls in the evidence-base of several CAM modalities used by U.S. adults for headache/migraine. This information may assist health providers and consumers in making informed decisions about the safest and most appropriate approach to managing headache/migraine. © 2017 American Headache Society.

CAM Photosynthesis in Submerged Aquatic Plants

USGS Publications Warehouse

Keeley, J.E.

1998-01-01

Crassulacean acid metabolism (CAM) is a CO2-concentrating mechanism selected in response to aridity in terrestrial habitats, and, in aquatic environments, to ambient limitations of carbon. Evidence is reviewed for its presence in five genera of aquatic vascular plants, including Isoe??tes, Sagittaria, Vallisneria, Crassula, and Littorella. Initially, aquatic CAM was considered by some to be an oxymoron, but some aquatic species have been studied in sufficient detail to say definitively that they possess CAM photosynthesis. CO2-concentrating mechanisms in photosynthetic organs require a barrier to leakage; e.g., terrestrial C4 plants have suberized bundle sheath cells and terrestrial CAM plants high stomatal resistance. In aquatic CAM plants the primary barrier to CO2 leakage is the extremely high diffusional resistance of water. This, coupled with the sink provided by extensive intercellular gas space, generates daytime CO2(Pi) comparable to terrestrial CAM plants. CAM contributes to the carbon budget by both net carbon gain and carbon recycling, and the magnitude of each is environmentally influenced. Aquatic CAM plants inhabit sites where photosynthesis is potentially limited by carbon. Many occupy moderately fertile shallow temporary pools that experience extreme diel fluctuations in carbon availability. CAM plants are able to take advantage of elevated nighttime CO2 levels in these habitats. This gives them a competitive advantage over non-CAM species that are carbon starved during the day and an advantage over species that expend energy in membrane transport of bicarbonate. Some aquatic CAM plants are distributed in highly infertile lakes, where extreme carbon limitation and light are important selective factors. Compilation of reports on diel changes in titratable acidity and malate show 69 out of 180 species have significant overnight accumulation, although evidence is presented discounting CAM in some. It is concluded that similar proportions of the aquatic and terrestrial floras have evolved CAM photosynthesis. Aquatic Isoe??tes (Lycophyta) represent the oldest lineage of CAM plants and cladistic analysis supports an origin for CAM in seasonal wetlands, from which it has radiated into oligotrophic lakes and into terrestrial habitats. Temperate Zone terrestrial species share many characteristics with amphibious ancestors, which in their temporary terrestrial stage, produce functional stomata and switch from CAM to C3. Many lacustrine Isoe??tes have retained the phenotypic plasticity of amphibious species and can adapt to an aerial environment by development of stomata and switching to C3. However, in some neotropical alpine species, adaptations to the lacustrine environment are genetically fixed and these constitutive species fail to produce stomata or loose CAM when artificially maintained in an aerial environment. It is hypothesized that neotropical lacustrine species may be more ancient in origin and have given rise to terrestrial species, which have retained most of the characteristics of their aquatic ancestry, including astomatous leaves, CAM and sediment-based carbon nutrition.

Validation of a Manually Oscillating Chair for In-The-Field Assessment of Dynamic Visual Acuity on Crewmembers Within Hours of Returning from Long-Duration Spaceflight

NASA Technical Reports Server (NTRS)

Kreutzberg, G. A.; Rosenberg, M. J. F.; Peters, B. T.; Reschke, M. F.

2017-01-01

Due to the deconditioned state of crewmembers in the initial hours after landing, it is safer and more practical to perform a vision test while seated in a chair versus walking on a treadmill. The purpose of this study was to validate the ability of a manually operated oscillating chair to produce the oscillatory frequency and displacement equivalent of walking on a treadmill at a 4 mph pace. A fast Fourier transform (FFT)was performed on the vertical trunk acceleration to compare the peak and spread of the distribution of oscillation frequencies for each oscillating condition. Peak oscillation frequencies achieved with the manual chair were lower and more variable than those of treadmill walking and the automatic chair. This can mostly be attributed to operator fatigue. However, DVA scores across conditions were not significantly different, indicating that the manual chair can provide adequate vertical oscillation frequency and displacement with the added advantage of being portable enough for testing outside a laboratory. Furthermore the automatic chair very closely matches the oscillation frequency of treadmill walking, making it an ideal method for testing DVA in a laboratory setting.

Enrichment, Isolation and Molecular Characterization of EpCAM-Negative Circulating Tumor Cells.

PubMed

Lampignano, Rita; Schneck, Helen; Neumann, Martin; Fehm, Tanja; Neubauer, Hans

2017-01-01

The presence of EpCAM-positive circulating tumor cells (CTCs) in the peripheral blood is associated with poor clinical outcomes in breast, colorectal and prostate cancer, as well as the prognosis of other tumor types. In addition, recent studies have suggested that the presence of CTCs undergoing epithelial-to-mesenchymal transition and, as such, may exhibit reduced or no expression of epithelial proteins e.g. EpCAM, might be related to disease progression in metastatic breast cancer (MBC) patients. Analyzing the neoplastic nature of this EpCAM-low/negative (EpCAM-neg) subpopulation remains an open issue as the current standard detection methods for CTCs are not efficient at identifying this subpopulation of cells. The possible association of EpCAM-neg CTCs with EpCAM-positive (EpCAM-pos) CTCs and role in the clinicopathological features and prognosis of MBC patients has still to be demonstrated. Several technologies have been developed and are currently being tested for the identification and the downstream analyses of EpCAM-pos CTCs. These technologies can be adapted and implemented into workflows to isolate and investigate EpCAM-neg cells to understand their biology and clinical relevance. This chapter will endeavour to explain the rationale behind the identification and analyses of all CTC subgroups, as well as to review the current strategies employed to enrich, isolate and characterize EpCAM-negative CTCs. Finally, the latest findings in the field will briefly be discussed with regard to their clinical relevance.

Ethnic Differences in Complementary and Alternative Medicine Use among Patients with Diabetes

PubMed Central

Villa-Caballero, Leonel; Morello, Candis M; Chynoweth, Megan E; Prieto-Rosinol, Ariadna; Polonsky, William H; Palinkas, Lawrence A; Edelman, Steven V

2010-01-01

Objective To evaluate the effect of ethnicity as a predictor of the use of complementary and alternative medicine (CAM) among patients with diabetes. Design and Settings A 16-item questionnaire investigating CAM use was distributed among patients attending the Taking Control of Your Diabetes (TCOYD) educational conferences during 2004-2006. Six TCOYD were held across the United States. Information of diabetes status and sociodemographic data was collected. CAM use was identified as pharmacological (herbs and vitamins) and nonpharmacological CAM. (e.g., prayer, yoga, and acupuncture). Results The prevalence of pharmacological and non-pharmacological CAM among 806 participants with diabetes patients was 81.9% and 80.3%, respectively. Overall, CAM prevalence was similar for Caucasians (94.2%), African Americans (95.5%), Hispanics (95.6%) and Native Americans (95.2%) and lower in Pacific Islanders/Other (83.9%) and Asians (87.8%). Pharmacologic CAM prevalence was positively associated with education (p = 0.001). The presence of diabetes was a powerful predictor of CAM use. Several significant ethnic differences were observed in specific forms of CAM use. Hispanics reported using frequently prickly pear (nopal) to complement their diabetes treatment while Caucasians more commonly used multivitamins. Conclusions Treatment with CAM widely used in persons with diabetes. Ethnic group differences determine a variety of practices, reflecting groups' cultural preferences. Future research is needed to clarify the perceived reasons for CAM use among patients with diabetes in clinical practice and the health belief system associated with diabetes by ethnic group. PMID:21130360

Ethnic differences in complementary and alternative medicine use among patients with diabetes.

PubMed

Villa-Caballero, Leonel; Morello, Candis M; Chynoweth, Megan E; Prieto-Rosinol, Ariadna; Polonsky, William H; Palinkas, Lawrence A; Edelman, Steven V

2010-12-01

To evaluate the effect of ethnicity as a predictor of the use of complementary and alternative medicine (CAM) among patients with diabetes. A 16-item questionnaire investigating CAM use was distributed among patients attending the Taking Control of Your Diabetes (TCOYD) educational conferences during 2004-2006. Six TCOYD were held across the United States. Information of diabetes status and sociodemographic data was collected. CAM use was identified as pharmacologic (herbs and vitamins) and nonpharmacologic CAMs (e.g., prayer, yoga, and acupuncture). The prevalence of pharmacologic and non-pharmacologic CAMs among 806 participants with diabetes patients was 81.9% and 80.3%, respectively. Overall, CAM prevalence was similar for Caucasians (94.2%), African Americans (95.5%), Hispanics (95.6%) and Native Americans (95.2%) and lower in Pacific Islanders/others (83.9%) and Asians (87.8%). Pharmacologic CAM prevalence was positively associated with education (p=0.001). The presence of diabetes was a powerful predictor of CAM use. Several significant ethnic differences were observed in specific forms of CAM use. Hispanics reported using frequently prickly pear (nopal) to complement their diabetes treatment while Caucasians more commonly used multivitamins. Treatment with CAM widely used in persons with diabetes. Ethnic group differences determine a variety of practices, reflecting groups' cultural preferences. Future research is needed to clarify the perceived reasons for CAM use among patients with diabetes in clinical practice and the health belief system associated with diabetes by ethnic group. Published by Elsevier Ltd.

A dynamic alpha-beta inter-subunit agonist signaling complex is a novel feedback mechanism for regulating L-type Ca2+ channel opening.

PubMed

Zhang, Rong; Dzhura, Igor; Grueter, Chad E; Thiel, William; Colbran, Roger J; Anderson, Mark E

2005-09-01

L-type Ca2+ channels are macromolecular protein complexes in neurons and myocytes that open in response to cell membrane depolarization to supply Ca2+ for regulating gene transcription and vesicle secretion and triggering cell contraction. L-type Ca2+ channels include a pore-forming alpha and an auxiliary beta subunit, and alpha subunit openings are regulated by cellular Ca2+ through a mechanism involving the Ca2+-sensing protein calmodulin (CaM) and CaM binding motifs in the alpha subunit cytoplasmic C terminus. Here we show that these CaM binding motifs are "auto-agonists" that increase alpha subunit openings by binding the beta subunit. The CaM binding domains are necessary and sufficient for the alpha subunit C terminus to bind the beta subunit in vitro, and excess CaM blocks this interaction. Addition of CaM binding domains to native cardiac L-type Ca2+ channels in excised cell membrane patches increases openings, and this agonist effect is prevented by excess CaM. Recombinant LTCC openings are also increased by exogenous CaM binding domains by a mechanism requiring the beta subunit, and excess CaM blocks this effect. Thus, the bifunctional ability of the alpha subunit CaM binding motifs to competitively associate with the beta subunit or CaM provides a novel paradigm for feedback control of cellular Ca2+ entry.

Prevalence, predictors, and perceived effectiveness of complementary, alternative and integrative medicine in adult-onset primary dystonia

PubMed Central

Fleming, Brandy M.; Schwab, Emiko L.; Nouer, Simonne S.; Wan, Jim Y.; LeDoux, Mark S.

2012-01-01

Background Complementary and Alternative Medicine (CAM) use is on the rise in both the US and Europe, despite questions about its safety, effectiveness and lack of national standards. We aimed to determine the prevalence and predictors of CAM and integrative medicine use (CAM-I) and perceived effectiveness compared to the standard treatment of botulinum toxin injections in patients with adult-onset primary dystonia. Methods This was a retrospective questionnaire study of 389 dystonia patients examining the effects age, gender, education level and number of anatomical regions affected on botulinum toxin and CAM-I use and their perceived effectiveness. Results 53% (208) of patients reported CAM-I use, while 90% (349) used the standard treatment (botulinum toxin), and 48% used both. Education was the only significant predictor of CAM-I use – individuals with bachelor’ s degrees were more likely to try CAM-I whereas those with high school diplomas were less likely. The mean effectiveness rate for botulinum toxin injections (59%) significantly exceeded that for and CAM-I (28%, p<0.0001). Conclusions Our work highlights the need for scientifically sound studies to determine the safety, effectiveness and expense of CAM-I treatments for dystonia and other neurological disorders given that CAM-I use is steadily increasing, there is great variability in what is classified as CAM-I, and the effectiveness of some modalities may be significantly less than conventional medical treatments. PMID:22633698

Prevalence, predictors, and perceived effectiveness of complementary, alternative and integrative medicine in adult-onset primary dystonia.

PubMed

Fleming, Brandy M; Schwab, Emiko L; Nouer, Simonne S; Wan, Jim Y; LeDoux, Mark S

2012-09-01

Complementary and Alternative Medicine (CAM) use is on the rise in both the US and Europe, despite questions about its safety and effectiveness, and lack of national standards. We aimed to determine the prevalence and predictors of CAM and integrative medicine use (CAM-I) and perceived effectiveness compared to the standard treatment of botulinum toxin injections in patients with adult-onset primary dystonia. This was a retrospective questionnaire study of 389 dystonia patients examining the effects age, gender, education level and number of affected anatomical regions on botulinum toxin and CAM-I use and their perceived effectiveness. 53% (208) of patients reported CAM-I use, while 90% (349) used the standard treatment (botulinum toxin), and 48% used both. Education was the only significant predictor of CAM-I use - individuals with bachelor's degrees were more likely to try CAM-I whereas those with high school diplomas were less likely. The mean effectiveness rate for botulinum toxin injections (59%) significantly exceeded that for CAM-I (28%, p < 0.0001). Our work highlights the need for scientifically sound studies to determine the safety, effectiveness and expense of CAM-I treatments for dystonia and other neurological disorders given that CAM-I use is steadily increasing, there is great variability in what is classified as CAM-I, and the effectiveness of some modalities may be significantly less than conventional medical treatments. Copyright © 2012 Elsevier Ltd. All rights reserved.

Expected and perceived efficacy of complementary and alternative medicine: A comparison views of patients with cancer and oncologists.

PubMed

Kim, Sang Hyuck; Shin, Dong Wook; Nam, You-Seon; Kim, So Young; Yang, Hyung-Kook; Cho, Be Long; Park, Keeho; Jo, Heui-Sug; Yim, Chang-Yeol; Kam, Sin; Park, Jong-Hyock

2016-10-01

This study sought to identify discrepancies between the expectations of patients with cancer and oncologists regarding the efficacy of complementary and alternative medicines (CAMs), and to determine how patients evaluate CAM efficacy after its use. Data from the Cancer Patient Experience Study, a nationwide survey, were used. Seven subdivided efficacy domains were included in the survey. An oncologist-patient matching analysis was done to assess the concordance of CAM efficacies between oncologists and patients with cancer. In addition, the patients' expectations of CAM efficacies were compared before and after use. Out of 719 participants, 201 patients with cancer (28.0%) reported using CAMs. The patients with cancer generally tended to be more positive about CAM efficacies than the oncologists. The largest discrepancy in efficacy perception was found in the efficacy domain of survival benefit, which included complete disease remission and prolonged survival. Many patients reported that they did not experience the positive efficacy they had anticipated before use. However, a substantial proportion of patients indicated that CAMs were as effective as they had expected, even though there is little evidence supporting the CAM efficacies. There was a marked discrepancy and a lack of concordance in expectations of CAM efficacy between patients with cancer and oncologists. Better communication between the patients and oncologists regarding CAM efficacy would be needed to make the patients to have shared expectations, and to reduce unnecessary CAM use. Copyright © 2016. Published by Elsevier Ltd.

N-glycosylation at the SynCAM (synaptic cell adhesion molecule) immunoglobulin interface modulates synaptic adhesion.

PubMed

Fogel, Adam I; Li, Yue; Giza, Joanna; Wang, Qing; Lam, Tukiet T; Modis, Yorgo; Biederer, Thomas

2010-11-05

Select adhesion molecules connect pre- and postsynaptic membranes and organize developing synapses. The regulation of these trans-synaptic interactions is an important neurobiological question. We have previously shown that the synaptic cell adhesion molecules (SynCAMs) 1 and 2 engage in homo- and heterophilic interactions and bridge the synaptic cleft to induce presynaptic terminals. Here, we demonstrate that site-specific N-glycosylation impacts the structure and function of adhesive SynCAM interactions. Through crystallographic analysis of SynCAM 2, we identified within the adhesive interface of its Ig1 domain an N-glycan on residue Asn(60). Structural modeling of the corresponding SynCAM 1 Ig1 domain indicates that its glycosylation sites Asn(70)/Asn(104) flank the binding interface of this domain. Mass spectrometric and mutational studies confirm and characterize the modification of these three sites. These site-specific N-glycans affect SynCAM adhesion yet act in a differential manner. Although glycosylation of SynCAM 2 at Asn(60) reduces adhesion, N-glycans at Asn(70)/Asn(104) of SynCAM 1 increase its interactions. The modification of SynCAM 1 with sialic acids contributes to the glycan-dependent strengthening of its binding. Functionally, N-glycosylation promotes the trans-synaptic interactions of SynCAM 1 and is required for synapse induction. These results demonstrate that N-glycosylation of SynCAM proteins differentially affects their binding interface and implicate post-translational modification as a mechanism to regulate trans-synaptic adhesion.

Collaborating with medicine? Perceptions of Australian naturopaths on integrating within the conventional medical system.

PubMed

Wardle, J; Steel, A; Lauche, R; Adams, J

2017-11-01

Complementary and alternative medicine (CAM) is an increasingly prevalent part of contemporary health care. Whilst there have been some attempts to understand the dynamics of CAM integration in the health care system from the perspective of conventional care providers and patients, little research has examined the view of CAM practitioners. This study aims to identify the experiences of integration within a conventional healthcare system as perceived by naturopaths. Qualitative semi-structured interviews were conducted using a purposeful sample of 20 practising naturopaths in South East Queensland, Australia to discuss their experiences and perceptions of integrating with conventional medical providers. Analysis of the interviews revealed five broad challenges for the integration of CAM according to naturopaths: competing paradigms between CAM and conventional medicine; co-option of CAM by conventional medical practitioners; the preservation of separate CAM and conventional medical worlds by patients and providers due to lack of formalised relations; negative feedback and biases created through selective or limited experience or information with CAM; and indifferent, reactive and one-sided interaction between CAM and conventional medical providers. Naturopaths support the integration of health services and attempt to provide safe and appropriate care to their patients through collaborative approaches to practice. The challenges identified by naturopaths associated with integration of CAM with conventional providers may impact the quality of care of patients who choose to integrate CAM and conventional approaches to health. Given the significant role of naturopaths in contemporary health-care systems, these challenges require further research and policy attention.

Impact of age, sex, socioeconomic status, and physical activity on associated movements and motor speed in preschool children.

PubMed

Kakebeeke, Tanja H; Zysset, Annina E; Messerli-Bürgy, Nadine; Chaouch, Aziz; Stülb, Kerstin; Leeger-Aschmann, Claudia S; Schmutz, Einat A; Arhab, Amar; Rousson, Valentin; Kriemler, Susi; Munsch, Simone; Puder, Jardena J; Jenni, Oskar G

2018-02-01

Young children generally show contralateral associated movements (CAMs) when they are making an effort to perform a unimanual task. CAM and motor speed are two relevant aspects of motor proficiency in young children. These CAMs decrease over age, while motor speed increases. As both CAM and motor speed are associated with age, we were interested in whether these two parameters are also linked with each other. In this study, three manual dexterity tasks with the dominant and nondominant hands (pegboard, repetitive hand, and repetitive finger tasks) were used to investigate the effect of covariates (age, sex, socioeconomic status, total physical activity) on both motor speed and CAMs in preschool children. There was a significant age effect for both motor speed and CAMs in all tasks when the dominant hand was used. When the nondominant hand was used, the decrease in the intensity of CAMs over age was not consistently significant. The influence of physical activity and socioeconomic status on motor proficiency was small. Furthermore, the correlation between motor speed and CAMs, although significant, was low. Motor speed improved with age over three fine motor tasks in preschool children. Decrease in CAMs was observed but it was not always significant when the nondominant hand was working. Motor speed and CAMs were only weakly associated. We conclude that the excitatory pathways responsible for motor speed and inhibitory pathways responsible for reducing CAMs occupy two different domains in the brain and therefore mostly behave independently of each other.

Complementary and alternative medicine among veterans and military personnel: a synthesis of population surveys.

PubMed

Davis, Margot T; Mulvaney-Day, Norah; Larson, Mary Jo; Hoover, Ronald; Mauch, Danna

2014-12-01

Recent reports reinforce the widespread interest in complementary and alternative medicine (CAM), not only among military personnel with combat-related disorders, but also among providers who are pressed to respond to patient demand for these therapies. However, an understanding of utilization of CAM therapies in this population is lacking. The goals of this study are to synthesize the content of self-report population surveys with information on use of CAM in military and veteran populations, assess gaps in knowledge, and suggest ways to address current limitations. The research team conducted a literature review of population surveys to identify CAM definitions, whether military status was queried, the medical and psychological conditions queried, and each specific CAM question. Utilization estimates specific to military/veterans were summarized and limitations to knowledge was classified. Seven surveys of CAM utilization were conducted with military/veteran groups. In addition, 7 household surveys queried military status, although there was no military/veteran subgroup analysis. Definition of CAM varied widely limiting cross-survey analysis. Among active duty and Reserve military, CAM use ranged between 37% and 46%. Survey estimates do not specify CAM use that is associated with a medical or behavioral health condition. Comparisons between surveys are hampered due to variation in methodologies. Too little is known about reasons for using CAM and conditions for which it is used. Additional information could be drawn from current surveys with additional subgroup analysis, and future surveys of CAM should include military status variable.

L1CAM expression in endometrial carcinomas: an ENITEC collaboration study.

PubMed

van der Putten, Louis Jm; Visser, Nicole Cm; van de Vijver, Koen; Santacana, Maria; Bronsert, Peter; Bulten, Johan; Hirschfeld, Marc; Colas, Eva; Gil-Moreno, Antonio; Garcia, Angel; Mancebo, Gemma; Alameda, Fransesc; Trovik, Jone; Kopperud, Reidun K; Huvila, Jutta; Schrauwen, Stefanie; Koskas, Martin; Walker, Francine; Weinberger, Vit; Minar, Lubos; Jandakova, Eva; Snijders, Marc Plm; van den Berg-van Erp, Saskia; Matias-Guiu, Xavier; Salvesen, Helga B; Amant, Frederic; Massuger, Leon Fag; Pijnenborg, Johanna Ma

2016-09-06

Identification of aggressive endometrioid endometrial carcinomas (EECs) and non-endometrioid carcinomas (NEECs) is essential to improve outcome. L1 cell adhesion molecule (L1CAM) expression is a strong prognostic marker in stage I EECs, but less is known about L1CAM expression in advanced-stage EECs and NEECs. This study analyses L1CAM expression in a clinically representative cohort of endometrial carcinomas. The expression of L1CAM was immunohistochemically determined in 1199 endometrial carcinomas, treated at one of the European Network for Individualized Treatment of Endometrial Cancer (ENITEC) centres. Staining was considered positive when >10% of the tumour cells expressed L1CAM. The association between L1CAM expression and several clincopathological characteristics and disease outcome was calculated. In all, L1CAM was expressed in 10% of the 935 stage I EECs, 18% of the 160 advanced stage EECs, and 75% of the 104 NEECs. The expression of L1CAM was associated with advanced stage, nodal involvement, high tumour grade, non-endometrioid histology, lymphovascular space invasion, and distant recurrences in all cases, and with reduced survival in the EECs, but not in the NEECs. The expression of L1CAM is a strong predictor of poor outcome in EECs, but not NEECs. It is strongly associated with non-endometrioid histology and distant spread, and could improve the postoperative selection of high-risk endometrial carcinomas. The value of L1CAM expression in the preoperative selection of high-risk endometrial carcinomas should be studied.

'Thinking outside the box': complementary and alternative therapies use in paediatric oncology patients.

PubMed

Molassiotis, Alexander; Cubbin, Denise

2004-03-01

The aim of this study was to determine the prevalence of complementary and alternative medicine (CAM) use among children with cancer who had received or were receiving treatment at a large hospital in the UK, including the identification of the most commonly used therapies and parental motives for doing so. Using a cross-sectional survey design, questionnaires were sent to parents of paediatric patients diagnosed with cancer. Of the 49 respondents, 32.7% reported using some type of CAM. The most commonly used therapies included multivitamins, aromatherapy massage, diets and music as therapy. Most children had used more than one therapy. Many of the factors that motivated parents to use CAM were related to helping or supporting their child's medical treatment. The main benefits identified from using CAM included increased confidence, pain relief and relaxation. The longer the time since diagnosis the more children tended to use CAM. The reasons for parents not using CAM included the child doing well and therefore not seeing the need for CAM use; not being aware of CAM; CAM not being offered and lack of information available. Parents identified a need for more information to be available both at ward level and for information about CAM to be discussed by medical staff, particularly at the start of treatment. The results indicate that CAM is frequently used by children and young people with cancer and that their use plays a substantial role in helping children through their conventional cancer treatment.

N-Glycosylation at the SynCAM (Synaptic Cell Adhesion Molecule) Immunoglobulin Interface Modulates Synaptic Adhesion*

PubMed Central

Fogel, Adam I.; Li, Yue; Giza, Joanna; Wang, Qing; Lam, TuKiet T.; Modis, Yorgo; Biederer, Thomas

2010-01-01

Select adhesion molecules connect pre- and postsynaptic membranes and organize developing synapses. The regulation of these trans-synaptic interactions is an important neurobiological question. We have previously shown that the synaptic cell adhesion molecules (SynCAMs) 1 and 2 engage in homo- and heterophilic interactions and bridge the synaptic cleft to induce presynaptic terminals. Here, we demonstrate that site-specific N-glycosylation impacts the structure and function of adhesive SynCAM interactions. Through crystallographic analysis of SynCAM 2, we identified within the adhesive interface of its Ig1 domain an N-glycan on residue Asn60. Structural modeling of the corresponding SynCAM 1 Ig1 domain indicates that its glycosylation sites Asn70/Asn104 flank the binding interface of this domain. Mass spectrometric and mutational studies confirm and characterize the modification of these three sites. These site-specific N-glycans affect SynCAM adhesion yet act in a differential manner. Although glycosylation of SynCAM 2 at Asn60 reduces adhesion, N-glycans at Asn70/Asn104 of SynCAM 1 increase its interactions. The modification of SynCAM 1 with sialic acids contributes to the glycan-dependent strengthening of its binding. Functionally, N-glycosylation promotes the trans-synaptic interactions of SynCAM 1 and is required for synapse induction. These results demonstrate that N-glycosylation of SynCAM proteins differentially affects their binding interface and implicate post-translational modification as a mechanism to regulate trans-synaptic adhesion. PMID:20739279

Marginal and internal fits of fixed dental prostheses zirconia retainers.

PubMed

Beuer, Florian; Aggstaller, Hans; Edelhoff, Daniel; Gernet, Wolfgang; Sorensen, John

2009-01-01

CAM (computer-aided manufacturing) and CAD (computer-aided design)/CAM systems facilitate the use of zirconia substructure materials for all-ceramic fixed partial dentures. This in vitro study compared the precision of fit of frameworks milled from semi-sintered zirconia blocks that were designed and machined with two CAD/CAM and one CAM system. Three-unit posterior fixed dental prostheses (FDP) (n=10) were fabricated for standardized dies by: a milling center CAD/CAM system (Etkon), a laboratory CAD/CAM system (Cerec InLab), and a laboratory CAM system (Cercon). After adaptation by a dental technician, the FDP were cemented on definitive dies, embedded and sectioned. The marginal and internal fits were measured under an optical microscope at 50x magnification. A one-way analysis of variance (ANOVA) was used to compare data (alpha=0.05). The mean (S.D.) for the marginal fit and internal fit adaptation were: 29.1 microm (14.0) and 62.7 microm (18.9) for the milling center system, 56.6 microm (19.6) and 73.5 microm (20.6) for the laboratory CAD/CAM system, and 81.4 microm (20.3) and 119.2 microm (37.5) for the laboratory CAM system. One-way ANOVA showed significant differences between systems for marginal fit (P<0.001) and internal fit (P<0.001). All systems showed marginal gaps below 120 microm and were therefore considered clinically acceptable. The CAD/CAM systems were more precise than the CAM system.

SuperCam_MastUnit

NASA Astrophysics Data System (ADS)

Deleuze, M. D.; Bernardi, P. B.; Caïs, Ph. C.; Perez, R. P.; Rees, J. M. R.; Pares, L. P.; Dubois, B. D.; Parot, Y. P.; Quertier, B. Q.; Maurice, S. M.; Maccabe, K. M.; Wiens, R. W.; Rull, F. R.

2016-10-01

This paper will describe and give a development status of SuperCam's mast unit. SuperCam will be carried on the Mars 2020 rover, and consists in an enhanced version of the ChemCam LIBS which is still performing at the surface of Mars, on Curiosity.

Buying CAM.

ERIC Educational Resources Information Center

Meloy, Jim; And Others

1990-01-01

The relationship between computer-aided design (CAD), computer-aided manufacturing (CAM), and computer numerical control (CNC) computer applications is described. Tips for helping educate the CAM buyer on what to look for and what to avoid when searching for the most appropriate instructional CAM package are provided. (KR)

21 CFR 892.1820 - Pneumoencephalographic chair.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Pneumoencephalographic chair. 892.1820 Section 892.1820 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1820 Pneumoencephalographic chair. (a...

Preface

NASA Astrophysics Data System (ADS)

Qiu, Roger; Paskova, Tania

2016-10-01

This special issue of Journal of Crystal Growth contains papers presented at the 20th American Conference on Crystal Growth and Epitaxy (ACCGE-20), the 17th Biennial Workshop on Organometallic Vapor Phase Epitaxy (OMVPE-17) and the Second 2D Electronic Materials Symposium, which were jointly held in Big Sky, Montana from August 2-7, 2015. The conference was co-chaired by Joan Redwing (Penn State, ACCGE chair), Luke Mawst (University of Wisconsin, Madison, OMVPE chair), and D. Kurt Gaskill (U.S. Naval Research Laboratory, 2D chair).

Emerging model systems for functional genomics analysis of Crassulacean acid metabolism

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

Hartwell, James; Dever, Louisa V.; Boxall, Susanna F.

Crassulacean acid metabolism (CAM) is one of three main pathways of photosynthetic carbon dioxide fixation found in higher plants. It stands out for its ability to underpin dramatic improvements in plant water use efficiency, which in turn has led to a recent renaissance in CAM research. The current ease with which candidate CAM-associated genes and proteins can be identified through high-throughput sequencing has opened up a new horizon for the development of diverse model CAM species that are amenable to genetic manipulations. The adoption of these model CAM species is underpinning rapid advances in our understanding of the complete genemore » set for CAM. Here, we highlight recent breakthroughs in the functional characterisation of CAM genes that have been achieved through transgenic approaches.« less

Emerging model systems for functional genomics analysis of Crassulacean acid metabolism

DOE PAGES

Hartwell, James; Dever, Louisa V.; Boxall, Susanna F.

2016-04-12

Crassulacean acid metabolism (CAM) is one of three main pathways of photosynthetic carbon dioxide fixation found in higher plants. It stands out for its ability to underpin dramatic improvements in plant water use efficiency, which in turn has led to a recent renaissance in CAM research. The current ease with which candidate CAM-associated genes and proteins can be identified through high-throughput sequencing has opened up a new horizon for the development of diverse model CAM species that are amenable to genetic manipulations. The adoption of these model CAM species is underpinning rapid advances in our understanding of the complete genemore » set for CAM. Here, we highlight recent breakthroughs in the functional characterisation of CAM genes that have been achieved through transgenic approaches.« less

“We make choices we think are going to save us”: Debate and stance identification for online breast cancer CAM discussions

PubMed Central

Zhang, Shaodian; Qiu, Lin; Chen, Frank; Zhang, Weinan; Yu, Yong; Elhadad, Noémie

2017-01-01

Patients discuss complementary and alternative medicine (CAM) in online health communities. Sometimes, patients’ conflicting opinions toward CAM-related issues trigger debates in the community. The objectives of this paper are to identify such debates, identify controversial CAM therapies in a popular online breast cancer community, as well as patients’ stances towards them. To scale our analysis, we trained a set of classifiers. We first constructed a supervised classifier based on a long short-term memory neural network (LSTM) stacked over a convolutional neural network (CNN) to detect automatically CAM-related debates from a popular breast cancer forum. Members’ stances in these debates were also identified by a CNN-based classifier. Finally, posts automatically flagged as debates by the classifier were analyzed to explore which specific CAM therapies trigger debates more often than others. Our methods are able to detect CAM debates with F score of 77%, and identify stances with F score of 70%. The debate classifier identified about 1/6 of all CAM-related posts as debate. About 60% of CAM-related debate posts represent the supportive stance toward CAM usage. Qualitative analysis shows that some specific therapies, such as Gerson therapy and usage of laetrile, trigger debates frequently among members of the breast cancer community. This study demonstrates that neural networks can effectively locate debates on usage and effectiveness of controversial CAM therapies, and can help make sense of patients’ opinions on such issues under dispute. As to CAM for breast cancer, perceptions of their effectiveness vary among patients. Many of the specific therapies trigger debates frequently and are worth more exploration in future work. PMID:28967000

Complementary and alternative medicine use by osteoporotic patients in Australia (CAMEO-A): a prospective study.

PubMed

Mak, Jenson C S; Faux, Steven

2010-05-01

Complementary and alternative medicine (CAM) therapies have become increasingly popular and are used regularly by patients with osteoporosis in Australasia and worldwide. This study was done to determine the prevalence and patterns of use of CAM in an Australian osteoporosis clinic. This was a prospective, cross-sectional questionnaire-based study of 202 patients attending an academic osteoporosis clinic in Sydney, Australia. Subject had a mean age of 68.5 +/- 10.9 years, 79.7% were female, and 55.9% were born overseas. CAM use was reported by 104 patients (51.5%) using the standard and 62 patients (30.7%) using the stringent definition of CAM. The most frequent CAM were multivitamins (24.0%), acupuncture (19.2%), t'ai chi (14.4%), and yoga (12.5%). Seventy-three percent (73%) did not consult a physician before starting CAM and 23.1% stated that their treating specialists were unaware of CAM use. The most common reasons for using CAM were having a holistic approach (53.0%) and inadequate pain control (29.0%). CAM users were associated with Asian country of birth (23.1% versus 12.2%, p = 0.03), more frequent clinic visits over a 12-month period (1.8 versus 1.5 times, p = 0.03), and a trend for a worse lumbar spine T-score (-2.35 versus -2.20 SD, p = 0.05) and higher rates of university education (26.0% versus 14.3%, p = 0.05). It is estimated that $696 million is spent annually on CAM by patients with osteoporosis. Patients attending osteoporosis clinics frequently use CAM. Physicians may need to routinely inquire about a history of CAM use to ensure better screening for possible adverse clinical interactions.

"We make choices we think are going to save us": Debate and stance identification for online breast cancer CAM discussions.

PubMed

Zhang, Shaodian; Qiu, Lin; Chen, Frank; Zhang, Weinan; Yu, Yong; Elhadad, Noémie

2017-04-01

Patients discuss complementary and alternative medicine (CAM) in online health communities. Sometimes, patients' conflicting opinions toward CAM-related issues trigger debates in the community. The objectives of this paper are to identify such debates, identify controversial CAM therapies in a popular online breast cancer community, as well as patients' stances towards them. To scale our analysis, we trained a set of classifiers. We first constructed a supervised classifier based on a long short-term memory neural network (LSTM) stacked over a convolutional neural network (CNN) to detect automatically CAM-related debates from a popular breast cancer forum. Members' stances in these debates were also identified by a CNN-based classifier. Finally, posts automatically flagged as debates by the classifier were analyzed to explore which specific CAM therapies trigger debates more often than others. Our methods are able to detect CAM debates with F score of 77%, and identify stances with F score of 70%. The debate classifier identified about 1/6 of all CAM-related posts as debate. About 60% of CAM-related debate posts represent the supportive stance toward CAM usage. Qualitative analysis shows that some specific therapies, such as Gerson therapy and usage of laetrile, trigger debates frequently among members of the breast cancer community. This study demonstrates that neural networks can effectively locate debates on usage and effectiveness of controversial CAM therapies, and can help make sense of patients' opinions on such issues under dispute. As to CAM for breast cancer, perceptions of their effectiveness vary among patients. Many of the specific therapies trigger debates frequently and are worth more exploration in future work.

Ecophysiology of Crassulacean Acid Metabolism (CAM).

PubMed

Lüttge, Ulrich

2004-06-01

Crassulacean Acid Metabolism (CAM) as an ecophysiological modification of photosynthetic carbon acquisition has been reviewed extensively before. Cell biology, enzymology and the flow of carbon along various pathways and through various cellular compartments have been well documented and discussed. The present attempt at reviewing CAM once again tries to use a different approach, considering a wide range of inputs, receivers and outputs. Input is given by a network of environmental parameters. Six major ones, CO(2), H(2)O, light, temperature, nutrients and salinity, are considered in detail, which allows discussion of the effects of these factors, and combinations thereof, at the individual plant level ('physiological aut-ecology'). Receivers of the environmental cues are the plant types genotypes and phenotypes, the latter including morphotypes and physiotypes. CAM genotypes largely remain 'black boxes', and research endeavours of genomics, producing mutants and following molecular phylogeny, are just beginning. There is no special development of CAM morphotypes except for a strong tendency for leaf or stem succulence with large cells with big vacuoles and often, but not always, special water storage tissues. Various CAM physiotypes with differing degrees of CAM expression are well characterized. Output is the shaping of habitats, ecosystems and communities by CAM. A number of systems are briefly surveyed, namely aquatic systems, deserts, salinas, savannas, restingas, various types of forests, inselbergs and paramós. While quantitative census data for CAM diversity and biomass are largely missing, intuition suggests that the larger CAM domains are those systems which are governed by a network of interacting stress factors requiring versatile responses and not systems where a single stress factor strongly prevails. CAM is noted to be a strategy for variable, flexible and plastic niche occupation rather than lush productivity. 'Physiological syn-ecology' reveals that phenotypic plasticity constitutes the ecophysiological advantage of CAM.

Complementary and alternative medicine: Do physicians believe they can meet the requirements of the Collège des médecins du Québec?

PubMed

Gaboury, Isabelle; Johnson, Noémie; Robin, Christine; Luc, Mireille; O'Connor, Daniel; Patenaude, Johane; Pélissier-Simard, Luce; Xhignesse, Marianne

2016-12-01

To determine whether medical training prepares FPs to meet the requirements of the Collège des médecins du Québec for their role in advising patients on the use of complementary and alternative medicine (CAM). Secondary analysis of survey results. Quebec. Family physicians and GPs in active practice. Perceptions of the role of the physician as an advisor on CAM; level of comfort responding to questions and advising patients on CAM; frequency with which patients ask their physicians about CAM; personal position on CAM; and desire for training on CAM. The response rate was 19.5% (195 respondents of 1000) and the sample appears to be representative of the target population. Most respondents (85.8%) reported being asked about CAM several times a month. A similar proportion (86.7%) believed it was their role to advise patients on CAM. However, of this group, only 33.1% reported being able to do so. There is an association between an urban practice and knowledge of the advisory role of physicians. More than three-quarters of respondents expressed interest in receiving additional training on CAM. There is a gap between the training that Quebec physicians receive on CAM and their need to meet legal and ethical obligations designed to protect the public where CAM products and therapies are concerned. One solution might be more thorough training on CAM to help physicians meet the Collège des médecins du Québec requirements. Copyright© the College of Family Physicians of Canada.

WADeG Cell Phone

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

2009-09-01

The on cell phone software captures the images from the CMOS camera periodically, stores the pictures, and periodically transmits those images over the cellular network to the server. The cell phone software consists of several modules: CamTest.cpp, CamStarter.cpp, StreamIOHandler .cpp, and covertSmartDevice.cpp. The camera application on the SmartPhone is CamStarter, which is "the" user interface for the camera system. The CamStarter user interface allows a user to start/stop the camera application and transfer files to the server. The CamStarter application interfaces to the CamTest application through registry settings. Both the CamStarter and CamTest applications must be separately deployed on themore » smartphone to run the camera system application. When a user selects the Start button in CamStarter, CamTest is created as a process. The smartphone begins taking small pictures (CAPTURE mode), analyzing those pictures for certain conditions, and saving those pictures on the smartphone. This process will terminate when the user selects the Stop button. The camtest code spins off an asynchronous thread, StreamIOHandler, to check for pictures taken by the camera. The received image is then tested by StreamIOHandler to see if it meets certain conditions. If those conditions are met, the CamTest program is notified through the setting of a registry key value and the image is saved in a designated directory in a custom BMP file which includes a header and the image data. When the user selects the Transfer button in the CamStarter user interface, the covertsmartdevice code is created as a process. Covertsmartdevice gets all of the files in a designated directory, opens a socket connection to the server, sends each file, and then terminates.« less

Cecropin A-melittin mutant with improved proteolytic stability and enhanced antimicrobial activity against bacteria and fungi associated with gastroenteritis in vitro.

PubMed

Ji, Shengyue; Li, Weili; Zhang, Lei; Zhang, Yue; Cao, Binyun

2014-09-05

Cecropin A-melittin (CAM), a chimeric antimicrobial peptide with potent antimicrobial activity, is threatened by some special extracellular proteases when used to deal with certain drug-resistant pathogenic microbes in the gastrointestinal tract. Thus, a four-tryptophan-substitution mutant (CAM-W) from CAM was developed via the replacement of special amino acid residues to enhance the antimicrobial potency and to improve the proteolytic stability of this agent. The pharmaceutical index of CAM-W was investigated, with a focus on biological potency, cytotoxicity, and proteolytic stability, as well as pH and thermal resistance. CAM-W exhibited potent antimicrobial activity and was approximately 3-12 times higher than that of CAM. CAM-W also exhibited a strong antifungal activity against a series of common pathogenic fungi, in a lower IC50 range between 2.1mg/L and 3.3mg/L than that of its reference CAM ranging from 9.8mg/L to 14.2mg/L. Besides, CAM-W showed moderate cytotoxicity (IC50>300mg/L) in erythrocyte lysis test. In addition, CAM-W overcame challenges under various conditions, including specific temperatures (20, 30, 40, 50, 60, 70, 80, and 90°C), pH values (2.0, 3.0, 4.0, 5.0, 6.0, 7.0, 8.0, and 9.0), and proteases (trypsin, pepsin, human neutrophil elastase, Pseudomonas aeruginosa elastase, and Staphylococcus aureus V8 protease) that are commonly present in human gastrointestinal tract. These results suggest that the four-tryptophan-substitution can confer CAM-W with a high pharmaceutical index, which is important for CAM-W to become a potential alternative to conventional antibiotics against bacteria and fungi associated with gastroenteritis. Copyright © 2014 Elsevier Inc. All rights reserved.

Use of electronic personal health records (PHRs) for complementary and alternative medicine (CAM) disclosure: Implications for integrative health care.

PubMed

Yeo, Younsook; Park, Jisung; Roh, Soonhee; Levkoff, Sue

2016-06-01

To test a hypothesis that patients' use of Internet-based personal health records (PHRs) will be positively related to their disclosure of their CAM use to medical doctors, controlling for covariates' effects (e.g., health, human capital, and demographics), and to examine the factors influencing patients' CAM use disclosures. Cross-sectional survey. We analyzed data in a subsample of CAM users who used both the internet and healthcare services (n=1457) from the Health Information National Trends Survey, a nationally representative study of U.S. adults (≥18), by using a multivariate logistic analysis. Among the subsample, 52.7% disclosed their use of CAM to their doctors and 19.3% used PHRs. Both the bivariate (64.1% vs. 35.9%, p<0.01) and multivariate (β=0.558, SE=0.220, OR=1.75, p<0.05) analyses revealed a positive relationship between PHR use and CAM use disclosure. Other significant factors for CAM use disclosure included being older, being a female, having insurance, and having regular source of care. Particularly, foreign-born adults had significantly lower odds of disclosing their CAM use than U.S.-born adults. We found that patients' PHR use facilitated their disclosure of CAM use to medical doctors. To ensure integrative healthcare and integrative medicine in the healthcare sector and optimum care for patients, education for CAM users regarding PHR adoption is encouraged. Next-generation PHR designs should consider incorporating domains for CAM data that allow patients to store CAM data and also incorporating 'intelligent' PHRs, whose contents can be converted into the patient's first language. Copyright © 2016 Elsevier Ltd. All rights reserved.

Complementary and alternative medicine use: Results from a descriptive study of pregnant women in Udi local Government area of Enugu state, Nigeria.

PubMed

Onyiapat, Jane-Lovena; Okafor, Chinyelu; Okoronkwo, Ijeoma; Anarado, Agnes; Chukwukelu, Ekene; Nwaneri, Ada; Okpala, Pat

2017-04-04

The use of CAM by pregnant women is very popular in developed countries. The trend is increasing globally and lack of evidence of safety particularly when used during pregnancy may lead to complications. Pregnancy is a vulnerable period especially during the first trimester. There is scarcity of empirical evidence on CAM use particularly among women in Udi LGA of Enugu State and South East Nigeria. Moreover, studies carried out in Nigeria have been limited to herbal medicine use, which is one aspect of CAM. This study was designed to obtain information on the use of Complementary and Alternative Medicine among pregnant women. The study was a cross sectional descriptive survey of 396 pregnant women systematically drawn from twenty political wards in Udi Local Government Area (LGA) of Enugu State. Interviewer administered questionnaire developed by the researchers was used for data collection. Data were analyzed using descriptive statistics. Majority (82.1%) of the pregnant women in Udi LGA used CAM during pregnancy out of which 53.8% had used CAM in previous pregnancies. CAM used ranges from one single type to sixteen different types with biological products eg, herbal tea, herbal mixture being the most commonly used CAM. Whereas most (89.5%) of the CAM used by pregnant women was consumed orally, approximately half of the pregnant women used CAM together with conventional medicine. The use of CAM by women during pregnancy was high in Udi LGA. Therefore, maternity care providers especially midwives need to elicit CAM commonly used by women during pregnancy and counsel them appropriately for best care and safety. Researchers should focus on establishing the efficacy of CAM products.

Clinical indications and perceived effectiveness of complementary and alternative medicine in departments of obstetrics in Germany: a questionnaire study.

PubMed

Münstedt, Karsten; Brenken, Anja; Kalder, Matthias

2009-09-01

Our earlier study on complementary and alternative medicine (CAM) methods showed that acupuncture, homeopathy, and aromatherapy are available in most obstetrics departments in Germany but it did not evaluate the clinical indications for using CAM. The present study aimed to explore further the effectiveness of CAM use in obstetrics. We sent all departments of obstetrics in North Rhine-Westphalia a questionnaire designed to delineate their use of acupuncture, homeopathy, and aromatherapy during childbirth. It sought details on who provided the CAM therapy (midwife or physician). We asked respondents to indicate on a five-point scale how reasonable or otherwise they would consider the provision of CAM in each of six common problem situations and to estimate for each the proportion of patients given the CAM treatment. Respondents were also asked about the rationale for offering CAM, quality assurance and side effects. Spearman's bivariate correlation, cross-tabulation and Pearson's chi(2) test were used for statistical analysis. About 73.4% (138/187) of the departments responded. Acupuncture and homoeopathy were most widely used. Although obstetricians are responsible for patient care, decisions to provide CAM were largely taken by midwives, and the midwives' belief in the methods' effectiveness and patient demand were the principle motivating factors. Rates of CAM use in the six problem scenarios evaluated were directly related to practitioners' perceptions of the methods' therapeutic effectiveness. CAM methods were widely offered despite the lack of evidence of effectiveness or information on adverse consequences. In Germany, including CAM in the mandatory national quality assurance measures and perinatal surveys would provide valuable information; CAM use elsewhere merits further study.

Use of complementary and alternative medicine in children with recurrent acute otitis media in Italy.

PubMed

Marchisio, P; Bianchini, S; Galeone, C; Baggi, E; Rossi, E; Albertario, G; Torretta, S; Pignataro, L; Esposito, S; Principi, N

2011-01-01

Controlling environmental factors, chemoprophylaxis, immunoprophylaxis and surgery are considered possible means of preventing recurrent acute otitis media (RAOM), but there are no available data concerning the paediatric use of complementary and alternative medicine (CAM). We evaluated the uses of CAM (homeopathy and/or herbal medicine) as means of preventing AOM in children with a history of RAOM. Eight hundred and forty Italian children with RAOM (≥3 episodes in six months) aged 1-7 years were surveyed in 2009 using a face-to-face questionnaire, filled by parents or caregivers, that explored the prevalence, determinants, reasons, cost, and perceived safety and efficacy of CAM. About one-half (46%) of the children used CAM, significantly more than the number who used immunoprophylaxis (influenza vaccine 15%; p<0.05), PCV-7 34%; p<0.05) or chemoprophylaxis (2%; p<0.001). Use of CAM in the family was the only important factor positively associated with the use of CAM in children (adjusted OR 7.94; 95% CI: 5.26-11.99). The main reasons for using CAM were a fear of the adverse effects of conventional medicine (40%) and to increase host defences (20%). CAM was widely seen as safe (95%) and highly effective (68%). CAM prescribers were paediatricians in 50.7% of cases; self-initiation was reported by 23% of respondents. CAM expenditure was between Euro 25 and Euro 50/month in 27.6% of cases and ≥ Euro 50/month in 16%. Children with RAOM should be considered among the categories of subjects likely to be using CAM. Together with the fact that paediatricians are the main prescribers, this is worrying because of the current lack of evidence regarding the efficacy, safety and cost-effectiveness of CAM in the prevention of RAOM.

How to locate and appraise qualitative research in complementary and alternative medicine

PubMed Central

2013-01-01

Background The aim of this publication is to present a case study of how to locate and appraise qualitative studies for the conduct of a meta-ethnography in the field of complementary and alternative medicine (CAM). CAM is commonly associated with individualized medicine. However, one established scientific approach to the individual, qualitative research, thus far has been explicitly used very rarely. This article demonstrates a case example of how qualitative research in the field of CAM studies was identified and critically appraised. Methods Several search terms and techniques were tested for the identification and appraisal of qualitative CAM research in the conduct of a meta-ethnography. Sixty-seven electronic databases were searched for the identification of qualitative CAM trials, including CAM databases, nursing, nutrition, psychological, social, medical databases, the Cochrane Library and DIMDI. Results 9578 citations were screened, 223 articles met the pre-specified inclusion criteria, 63 full text publications were reviewed, 38 articles were appraised qualitatively and 30 articles were included. The search began with PubMed, yielding 87% of the included publications of all databases with few additional relevant findings in the specific databases. CINHAL and DIMDI also revealed a high number of precise hits. Although CAMbase and CAM-QUEST® focus on CAM research only, almost no hits of qualitative trials were found there. Searching with broad text terms was the most effective search strategy in all databases. Conclusions This publication presents a case study on how to locate and appraise qualitative studies in the field of CAM. The example shows that the literature search for qualitative studies in the field of CAM is most effective when the search is begun in PubMed followed by CINHAL or DIMDI using broad text terms. Exclusive CAM databases delivered no additional findings to locate qualitative CAM studies. PMID:23731997

How to locate and appraise qualitative research in complementary and alternative medicine.

PubMed

Franzel, Brigitte; Schwiegershausen, Martina; Heusser, Peter; Berger, Bettina

2013-06-03

The aim of this publication is to present a case study of how to locate and appraise qualitative studies for the conduct of a meta-ethnography in the field of complementary and alternative medicine (CAM). CAM is commonly associated with individualized medicine. However, one established scientific approach to the individual, qualitative research, thus far has been explicitly used very rarely. This article demonstrates a case example of how qualitative research in the field of CAM studies was identified and critically appraised. Several search terms and techniques were tested for the identification and appraisal of qualitative CAM research in the conduct of a meta-ethnography. Sixty-seven electronic databases were searched for the identification of qualitative CAM trials, including CAM databases, nursing, nutrition, psychological, social, medical databases, the Cochrane Library and DIMDI. 9578 citations were screened, 223 articles met the pre-specified inclusion criteria, 63 full text publications were reviewed, 38 articles were appraised qualitatively and 30 articles were included. The search began with PubMed, yielding 87% of the included publications of all databases with few additional relevant findings in the specific databases. CINHAL and DIMDI also revealed a high number of precise hits. Although CAMbase and CAM-QUEST® focus on CAM research only, almost no hits of qualitative trials were found there. Searching with broad text terms was the most effective search strategy in all databases. This publication presents a case study on how to locate and appraise qualitative studies in the field of CAM. The example shows that the literature search for qualitative studies in the field of CAM is most effective when the search is begun in PubMed followed by CINHAL or DIMDI using broad text terms. Exclusive CAM databases delivered no additional findings to locate qualitative CAM studies.

Assessment of Perception, Experience, and Information-seeking Behavior of the Public of Ras Al-Khaimah, United Arab Emirates, Toward Usage and Safety of Complementary and Alternative Medicine

PubMed Central

Sridhar, Sathvik Belagodu; Shariff, Atiqulla; Al Halabi, Nour; Sarmini, Rand; Harb, Lubab Arkan

2017-01-01

Aims and Objectives: This study was conducted to identify the different types of complementary and alternative medicine (CAM) used, reasons for the use of CAM, and the perceptions, experience, and information seeking-behavior toward usage and safety of CAM by the general public of Ras Al-Khaimah, UAE. Materials and Methods: This was a prospective cross-sectional study. A validated, self-administered, or interviewer-assisted survey questionnaire was used to collect the data. Data from 403 respondents satisfying inclusion criteria were collected and were analyzed using the Statistical Package for the Social Sciences version 24.0. Results: A majority of the respondents (218 [54.1%]) were females. The most commonly (210 [52.1%]) used CAM among the study respondents was herbal medicine. A total of 91 (22.6%) of the survey respondents mentioned that they receive conventional medications along with their CAM. Majority (213 [52.9%]) of the survey respondents opted for CAM to prevent illness. Good number (208 [51.6%]) of the survey respondents mentioned that CAM usage was beneficial in improving their health condition, and they (216 [53.6%]) do believe it as safe and effective. However, a small group (26 [6%]) of respondents reported side effects or complications with the use of CAM. Conclusion: Widespread use of CAM for different medical problems was evident in our study. Although majority of the CAM users believe it as safe and effective, CAM usage should be discussed with the health-care providers to understand the safety issues involved in the use of majority of CAM. PMID:28584493

Calmodulin and calcium differentially regulate the neuronal Nav1.1 voltage-dependent sodium channel

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

Gaudioso, Christelle; Carlier, Edmond; Youssouf, Fahamoe

2011-07-29

Highlights: {yields} Both Ca{sup ++}-Calmodulin (CaM) and Ca{sup ++}-free CaM bind to the C-terminal region of Nav1.1. {yields} Ca{sup ++} and CaM have both opposite and convergent effects on I{sub Nav1.1}. {yields} Ca{sup ++}-CaM modulates I{sub Nav1.1} amplitude. {yields} CaM hyperpolarizes the voltage-dependence of activation, and increases the inactivation rate. {yields} Ca{sup ++} alone antagonizes CaM for both effects, and depolarizes the voltage-dependence of inactivation. -- Abstract: Mutations in the neuronal Nav1.1 voltage-gated sodium channel are responsible for mild to severe epileptic syndromes. The ubiquitous calcium sensor calmodulin (CaM) bound to rat brain Nav1.1 and to the human Nav1.1 channelmore » expressed by a stably transfected HEK-293 cell line. The C-terminal region of the channel, as a fusion protein or in the yeast two-hybrid system, interacted with CaM via a consensus C-terminal motif, the IQ domain. Patch clamp experiments on HEK1.1 cells showed that CaM overexpression increased peak current in a calcium-dependent way. CaM had no effect on the voltage-dependence of fast inactivation, and accelerated the inactivation kinetics. Elevating Ca{sup ++} depolarized the voltage-dependence of fast inactivation and slowed down the fast inactivation kinetics, and for high concentrations this effect competed with the acceleration induced by CaM alone. Similarly, the depolarizing action of calcium antagonized the hyperpolarizing shift of the voltage-dependence of activation due to CaM overexpression. Fluorescence spectroscopy measurements suggested that Ca{sup ++} could bind the Nav1.1 C-terminal region with micromolar affinity.« less

Complementary and alternative medicine use and cost in functional bowel disorders: a six month prospective study in a large HMO.

PubMed

van Tilburg, Miranda A L; Palsson, Olafur S; Levy, Rona L; Feld, Andrew D; Turner, Marsha J; Drossman, Douglas A; Whitehead, William E

2008-07-24

Functional Bowel Disorders (FBD) are chronic disorders that are difficult to treat and manage. Many patients and doctors are dissatisfied with the level of improvement in symptoms that can be achieved with standard medical care which may lead them to seek alternatives for care. There are currently no data on the types of Complementary and Alternative Medicine (CAM) used for FBDs other than Irritable Bowel Syndrome (IBS), or on the economic costs of CAM treatments. The aim of this study is to determine prevalence, types and costs of CAM in IBS, functional diarrhea, functional constipation, and functional abdominal pain. 1012 Patients with FBD were recruited through a health care maintenance organization and followed for 6 months. Questionnaires were used to ascertain: Utilization and expenditures on CAM, symptom severity (IBS-SS), quality of life (IBS-QoL), psychological distress (BSI) and perceived treatment effectiveness. Costs for conventional medical care were extracted from administrative claims. CAM was used by 35% of patients, at a median yearly cost of $200. The most common CAM types were ginger, massage therapy and yoga. CAM use was associated with female gender, higher education, and anxiety. Satisfaction with physician care and perceived effectiveness of prescription medication were not associated with CAM use. Physician referral to a CAM provider was uncommon but the majority of patients receiving this recommendation followed their physician's advice. CAM is used by one-third of FBD patients. CAM use does not seem to be driven by dissatisfaction with conventional care. Physicians should discuss CAM use and effectiveness with their patients and refer patients if appropriate.

Complementary and alternative medicine use and cost in functional bowel disorders: A six month prospective study in a large HMO

PubMed Central

van Tilburg, Miranda AL; Palsson, Olafur S; Levy, Rona L; Feld, Andrew D; Turner, Marsha J; Drossman, Douglas A; Whitehead, William E

2008-01-01

Background Functional Bowel Disorders (FBD) are chronic disorders that are difficult to treat and manage. Many patients and doctors are dissatisfied with the level of improvement in symptoms that can be achieved with standard medical care which may lead them to seek alternatives for care. There are currently no data on the types of Complementary and Alternative Medicine (CAM) used for FBDs other than Irritable Bowel Syndrome (IBS), or on the economic costs of CAM treatments. The aim of this study is to determine prevalence, types and costs of CAM in IBS, functional diarrhea, functional constipation, and functional abdominal pain. Methods 1012 Patients with FBD were recruited through a health care maintenance organization and followed for 6 months. Questionnaires were used to ascertain: Utilization and expenditures on CAM, symptom severity (IBS-SS), quality of life (IBS-QoL), psychological distress (BSI) and perceived treatment effectiveness. Costs for conventional medical care were extracted from administrative claims. Results CAM was used by 35% of patients, at a median yearly cost of $200. The most common CAM types were ginger, massage therapy and yoga. CAM use was associated with female gender, higher education, and anxiety. Satisfaction with physician care and perceived effectiveness of prescription medication were not associated with CAM use. Physician referral to a CAM provider was uncommon but the majority of patients receiving this recommendation followed their physician's advice. Conclusion CAM is used by one-third of FBD patients. CAM use does not seem to be driven by dissatisfaction with conventional care. Physicians should discuss CAM use and effectiveness with their patients and refer patients if appropriate. PMID:18652682

[Definition and validation of a comfort index calculation method for office seats].

PubMed

Taboga, P; Marcolin, F; Bordignon, M; Antonutto, G

2012-01-01

Among its other required features, a highly comfortable chair should adapt its contact surfaces, namely the seat and the back rest, to the shape of the body of the person sitting on it. However, "comfort" is not usually perceived as an absolute value, but is derived from a subjective comparison between two or more chairs. The purpose of this research was the definition of an objective comfort index (IC), i.e., derived from instrumental measurements, and which would also represent an absolute comfort value. Analytical evaluation of the distribution of body weight, by means of a barometric matrix, shows that a comfortable chair tends to minimize peak and average values of pressure at the level of the contact areas located between the body and the seat and the back of the chair. To define a comparison parameter for determining an absolute comfort value, a reference chair (SDR) was developed. The seat and the back of this chair are rigid, with poor compliance. A comfort value of zero was, by definition, assigned to this chair. Therefore, the Comfort index (IC) was obtained by the mathematical calculation of the ratios of averages, peaks and gradients of pressure, appropriately weighted, and the corresponding values measured on the tested chair and on the SDR. It is shown that the anthropometric characteristics of each subject are irrelevant to the assessment of the IC, which depends only on the compliance characteristics of the seat and back surfaces of the tested chair IC can be improved through analysis of a larger number of seats, which would thus constitute the basis for the use of an objective evaluation of seating comfort.

Cox's chair: 'a moral and a medical mean in the treatment of maniacs'.

PubMed

Wade, Nicholas J; Norrsell, U; Presly, A

2005-03-01

Two hundred years ago Joseph Cox published his book on the treatment of insanity. His novel technique was rotating the body in a specially designed chair. Initially modest and later extravagant claims were made for the therapeutic benefit of 'Cox's chair'. It was widely adopted in Europe in the first decades of the nineteenth century, but lost favour thereafter. Its benefits have proved to be scientific rather than medical because it was adopted by students of the senses to investigate vertigo; a century later it re-emerged as the Bárány chair for the clinical assessment of vestibular function. The legacy of Cox's chair, and its related treatment of swinging, are to be found in funfairs throughout the world.

EpCAM overexpression prolongs proliferative capacity of primary human breast epithelial cells and supports hyperplastic growth

PubMed Central

2013-01-01

Introduction The Epithelial Cell Adhesion Molecule (EpCAM) has been shown to be strongly expressed in human breast cancer and cancer stem cells and its overexpression has been supposed to support tumor progression and metastasis. However, effects of EpCAM overexpression on normal breast epithelial cells have never been studied before. Therefore, we analyzed effects of transient adenoviral overexpression of EpCAM on proliferation, migration and differentiation of primary human mammary epithelial cells (HMECs). Methods HMECs were transfected by an adenoviral system for transient overexpression of EpCAM. Thereafter, changes in cell proliferation and migration were studied using a real time measurement system. Target gene expression was evaluated by transcriptome analysis in proliferating and polarized HMEC cultures. A Chicken Chorioallantoic Membrane (CAM) xenograft model was used to study effects on in vivo growth of HMECs. Results EpCAM overexpression in HMECs did not significantly alter gene expression profile of proliferating or growth arrested cells. Proliferating HMECs displayed predominantly glycosylated EpCAM isoforms and were inhibited in cell proliferation and migration by upregulation of p27KIP1 and p53. HMECs with overexpression of EpCAM showed a down regulation of E-cadherin. Moreover, cells were more resistant to TGF-β1 induced growth arrest and maintained longer capacities to proliferate in vitro. EpCAM overexpressing HMECs xenografts in chicken embryos showed hyperplastic growth, lack of lumen formation and increased infiltrates of the chicken leukocytes. Conclusions EpCAM revealed oncogenic features in normal human breast cells by inducing resistance to TGF-β1-mediated growth arrest and supporting a cell phenotype with longer proliferative capacities in vitro. EpCAM overexpression resulted in hyperplastic growth in vivo. Thus, we suggest that EpCAM acts as a prosurvival factor counteracting terminal differentiation processes in normal mammary glands. PMID:23758908

Medical students' knowledge, perceptions, and interest in complementary and alternative medicine.

PubMed

Loh, Kah Poh; Ghorab, Hatem; Clarke, Eric; Conroy, Ronan; Barlow, James

2013-04-01

Complementary and alternative medicine (CAM) is a growing industry in the health care system. In Ireland, to date there has not been a study that evaluates the knowledge of, interest in, and attitude of Irish medical students toward CAM. This research can serve as a pilot study to inform Irish medical schools on the need to introduce CAM into the medical curriculum. The survey instrument was a modified design based on previously published studies carried out in other geographical areas. All medical students within the undergraduate and graduate entry programs (GEP) at the Royal College of Surgeons in Ireland were invited to participate in the study. SPSS software was used to analyze the results of the questionnaires. The survey completion rate was 20.1%. A majority of students (78.4%) thought that CAM knowledge is important for their future career as physicians. Approximately 65% of students reported that they have not acquired sufficient knowledge about CAM from medical school, and 50.2% of students believe CAM should be incorporated into the medical curriculum. Preclinical years (49.4%) were suggested as the most appropriate time to learn about CAM. Knowledge of CAM modalities was generally rated as minimal or none by students. Among the 15 CAM modalities incorporated in the survey, massage, acupuncture, and meditation received the highest interest from students. Students who believe in a religion had a higher interest in CAM (p<0.05). In terms of their personal view, massage, spirituality, and acupuncture received the highest positive responses. Attitudes toward CAM were positive from students. Lower willingness to use CAM was seen in clinical students (p<0.05). It is important for the faculty of Irish medical schools to consider the possibility of integrating CAM education into the conventional medical curriculum in a systematic manner to better prepare students in their future career.

Perceived treatment effectiveness, medication compliance, and complementary and alternative medicine use among veterans with bipolar disorder.

PubMed

Jarman, Christopher N; Perron, Brian E; Kilbourne, Amy M; Teh, Carrie Farmer

2010-03-01

Recent research shows a high rate of complementary and alternative medicine (CAM) use among persons with mental disorders, although correlates and patterns of CAM use are relatively unknown. This study tested whether CAM use is associated with perceived effectiveness of conventional treatment (i.e., psychotropic medication and psychotherapy) and medication compliance among persons with bipolar disorder. Patients with bipolar disorder (n = 435) were included as part of a naturalistic cohort study. Measures of CAM utilization, medication compliance, and perceptions of the effectiveness of psychotropic medications and psychotherapy were based on previously established questionnaires. Associations were tested using bivariate and multivariate analyses. Bivariate analyses showed that patients who did not perceive psychotherapy as effective at improving social, family, or job functioning reported greater CAM use. However, medication compliance was not significantly associated with use of CAM. Patients who used oral (e.g., herbal therapies) or cognitive (e.g., meditation) CAM were more likely to report that their medications were not effective at relieving manic or depressive symptoms. Users of cognitive CAM were more likely to report that their medications did not help with social, job, or family functioning, and that they did not prevent recurrences of manic or depressive episodes. None of the bivariate associations remained significant in multivariate analyses. Prior research has suggested that persons who are dissatisfied with treatment for medical conditions are more likely to use CAM therapies. However, the results of this study do not show CAM therapies to be associated with perceived effectiveness of treatments for mental health problems among this sample of persons with serious mental illnesses. This suggests that motivations for CAM use may vary by population and condition. Because few correlates of CAM use among persons with serious mental illnesses are known, providers should conduct routine assessments of CAM use.

Parental perspectives on use, benefits, and physician knowledge of complementary and alternative medicine in children with autistic disorder and attention-deficit/hyperactivity disorder.

PubMed

Huang, Angela; Seshadri, Kapila; Matthews, Tara Anne; Ostfeld, Barbara M

2013-09-01

Complementary and alternative medicine (CAM) use appears to be increasing in children with developmental disorders. However, it is not clear whether parents perceive their healthcare providers as resources who are knowledgeable about CAM therapies and are interested in further developing their knowledge. (1) To establish and compare use of, and perceived satisfaction with, traditional medicine and CAM in children with attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorders (ASDs) and (2) to assess parental perceptions of physician knowledge of CAM and physician interest in continuing education about CAM for the two groups of parents. Families of children with a diagnosis of ADHD or ASD were surveyed regarding the frequency of use of traditional treatment and CAM, parental perceptions of the helpfulness of each therapy, parental perceptions regarding physicians' knowledge level about CAM, and physician interest in continuing education. Thirty-six percent (n=135) of 378 surveys were returned: 41 contained a diagnosis of ADHD and 22 of ASD. Traditional therapies were used by 98% of children with ADHD and 100% of those with ASD. Perceived helpfulness of medication was 92% for children with ADHD and 60% for children with ASD (p<0.05). CAM was used for 19.5% of children with ADHD and 82% of children with ASD. Perceived satisfaction for any form of CAM in the children with ADHD was at an individual patient level. Satisfaction for two of the most commonly used CAM treatments in children with ASD ranged from 50% to 78%. In children with ASD (the diagnostic group with the highest use of and satisfaction with CAM), physician's perceived knowledge of CAM was lower (14% versus 38%; p<0.05), as was perceptions of the physician's interest in learning more (p<0.05). CAM use is significant, especially in children with ASD. Physicians are not perceived as a knowledgeable resource.

Anti-TIF1-γ antibody and cancer-associated myositis: A clinicohistopathologic study.

PubMed

Hida, Ayumi; Yamashita, Takenari; Hosono, Yuji; Inoue, Manami; Kaida, Kenichi; Kadoya, Masato; Miwa, Yusuke; Yajima, Nobuyuki; Maezawa, Reika; Arai, Satoko; Kurasawa, Kazuhiro; Ito, Kazuhiro; Shimada, Hiroyuki; Iwanami, Tomoko; Sonoo, Masahiro; Hatanaka, Yuki; Murayama, Shigeo; Uchibori, Ayumi; Chiba, Atsuro; Aizawa, Hitoshi; Momoo, Takayuki; Nakae, Yoshiharu; Sakurai, Yasuhisa; Shiio, Yasushi; Hashida, Hideji; Yoshizawa, Toshihiro; Sakiyama, Yoshio; Oda, Aya; Inoue, Kiyoharu; Takeuchi, Sousuke; Iwata, Nobue K; Date, Hidetoshi; Masuda, Naoki; Mikata, Takashi; Motoyoshi, Yasufumi; Uesaka, Yoshikazu; Maeda, Meiko Hashimoto; Nakashima, Ran; Tsuji, Shoji; Kwak, Shin; Mimori, Tsuneyo; Shimizu, Jun

2016-07-19

We aimed to analyze the clinical and histopathologic features of cancer-associated myositis (CAM) in relation to anti-transcriptional intermediary factor 1 γ antibody (anti-TIF1-γ-Ab), a marker of cancer association. We retrospectively studied 349 patients with idiopathic inflammatory myopathies (IIMs), including 284 patients with pretreatment biopsy samples available. For the classification of IIMs, the European Neuromuscular Center criteria were applied. Patients with CAM with (anti-TIF1-γ-Ab[+] CAM) and without anti-TIF1-γ-Ab (anti-TIF1-γ-Ab[-] CAM) were compared with patients with IIM without cancers within and beyond 3 years of myositis diagnosis. Cancer was detected in 75 patients, of whom 36 (48%) were positive for anti-TIF1-γ-Ab. In anti-TIF1-γ-Ab(+) patients with CAM, cancers were detected within 1 year of myositis diagnosis in 35 (97%) and before 1 year of myositis diagnosis in 1. All the anti-TIF1-γ-Ab(+) patients with CAM satisfied the dermatomyositis (DM) criteria, including 2 possible DM sine dermatitis cases, and were characterized histologically by the presence of perifascicular atrophy, vacuolated fibers (VFs), and dense C5b-9 deposits on capillaries (dC5b-9). In contrast, 39 anti-TIF1-γ-Ab(-) patients with CAM were classified into various subgroups, and characterized by a higher frequency of necrotizing autoimmune myopathy (NAM). Notably, all 7 patients with CAM classified into the NAM subgroup were anti-TIF1-γ-Ab(-) and exhibited no dC5b-9 or VFs. CAM includes clinicohistopathologically heterogeneous disease entities. Among CAM entities, anti-TIF1-γ-Ab(+) CAM has characteristically shown a close temporal association with cancer detection and the histopathologic findings of dC5b-9 and VFs, and CAM with NAM is a subset of anti-TIF1-γ-Ab(-) CAM. © 2016 American Academy of Neurology.

Complementary and alternative medicines use in children with epilepsy in Ibadan, Nigeria.

PubMed

Lagunju, I A

2013-03-01

There is documented evidence that the use of complementary and alternative medicines (CAM) has been on the increase worldwide. A standardized questionnaire was administered to caregivers of children with epilepsy to evaluate the prevalence and pattern of CAM use. One hundred and seventy five caregivers of 175 children with epilepsy were studied. Ninety nine (56.6%) of the caregivers gave a history of CAM use. The forms of CAM used were herbal preparations (39.4%), spiritual/prayer healing (34.3%), scarifications (17.1%) and special vitamins (6.1%). Seventy (40%) of the 175 children had received CAM ever before seeking Western Medicine for the treatment of epilepsy. Of the 99 children with history of CAM use, 33 (33.3%) continued to use CAM in combination with the prescribed anti-epileptic drug (AED). Adverse effects were reported in 17 (17.1%) cases. There was no statistically significant relationship between the type of epilepsy and the use of CAM (p= 0.229, OR 1.655, 95% CI 0.608-4.508). There was a statistically significant inverse relationship between social class of the family (p = 0.043, OR 0.354, 95% CI 1.087-2.489) and mother's level of education (p = 0.013, OR 2.618, 95% CI 1.173-5.844) and the use of CAM. Only 30 (30.3%) of the 99 caregivers had spontaneously volunteered the history of the use of CAM to the attending physician and the leading reason for not giving the history was that the attending physician did not ask for the information. Children with epilepsy frequently use CAM and attending physicians often fail to ask about use of CAM in the routine evaluation of patients. There is a need to routinely ask caregivers and patients about the use of CAM in management of their disease.

Complementary and alternative medicine usage among cardiac patients: a descriptive study.

PubMed

Bahall, Mandreker

2015-03-31

The use of complementary and alternative medicine (CAM) persists, despite the availability of conventional medicine (CM), modernisation, globalisation, technological advancement, and limited scientific evidence supporting CAM. People with cardiovascular diseases often use CAM, despite possible major adverse effects and lack of evidence supporting CAM claims. This study explored CAM use among cardiac patients, the types of CAM used, reasons and factors that influence its use, and the association between patient demographics and CAM use. This cross-sectional quantitative study was conducted using quota sampling to survey 329 public clinic adult cardiac patients within the South-West Regional Health Authority (SWRHA) of Trinidad and Tobago. From 1 July 2012 to 31August 2012, each participant completed questionnaires, after consenting to participate. Data analysis included χ(2) tests and binary logistic regression. One hundred eighty-five (56.2%; standard error [SE] = 2.74%) patients used CAM. Herbal medicine was the most common CAM (85.9%; SE = 2.56%), followed by spiritual therapy/mind-body systems (61.6%; SE = 3.58%), physical therapy/body manipulation (13.5%; SE = 2.51%), alternative systems (8.1%; SE = 2.01%), and other methods (3.8%; SE = 1. 41%). The patients believed that CAM promotes health and wellness (79.5%; SE = 2.97%), assists in fighting illness (78.9%; SE = 3.00%), addresses the limitations of CM (69.2%; SE = 3.56%), alleviates symptoms (21.6%; SE = 6.51%), costs less than CM (21.6 %, SE = 3.03), and has fewer adverse/damaging effects than CM (29.7, SE =3.36), or they were disappointed with CM (12.4%, SE = 2.42). Ethnicity and religion were associated with CAM usage, but only ethnicity was a useful predictor of CAM use. Complementary and alternative medicine use was high among cardiac patients (56.2%, SE = 2.74%), and associated with ethnicity and religion. Friends, family, and perceived mode of action influenced a patient's use of CAM.

Use of complementary and alternative medicines in haemodialysis patients: a cross-sectional study from Palestine.

PubMed

Zyoud, Sa'ed H; Al-Jabi, Samah W; Sweileh, Waleed M; Tabeeb, Ghada H; Ayaseh, Nora A; Sawafta, Mayas N; Khdeir, Razan L; Mezyed, Diana O; Daraghmeh, Dala N; Awang, Rahmat

2016-07-11

Complementary and alternative medicine (CAM), and herbal therapies, are accepted worldwide, and have been important from medical, sociological and economic perspectives, among haemodialysis (HD) patients. The primary aim of this study was to evaluate the use of CAM among patients with end-stage renal disease (ESRD) who are undergoing HD. Face-to-face interviews of patients with ESRD undergoing HD from ten outpatient renal departments at a national level in Palestine were conducted from June 2014 to January 2015. A survey questionnaire, which included questions on socio-demographic and clinical characteristics, and on the CAM therapies that were used, was administered. Out of 267 patients interviewed, 172 patients used at least one type of CAM in the last month prior to the interview, and thus the utilisation rate was 64.4 %. Forty one (15.4 %) patients reported using one type of CAMs, while 18.7 % used two different CAMs and 30.3 % used more than two types of CAMs for their health status. Of the patients who used CAM, herbal therapies were used most often (43.5 %), followed by honey (35.6 %), diet (22.8 %), and exorcism in Islam (16.9 %). The herbal therapies mentioned most often were Nigella sativa L. (18.7 %), followed by Salvia officinalis L. (16.9 %), and Pimpinella anisum L. (10.5 %). In conclusion, the prevalence of CAM is relatively high in the selected population. Most patients used biological therapies such as herbal remedies, thus highlighting a greater need for patient education regarding CAM therapies and possible herb-drug interactions. Health care providers must be aware of the potential benefits and risks related to CAM use. There is a need for more clinical research pertaining to CAM to reach stronger evidence regarding potential benefits and risks related to CAM use.

Use of complementary and alternative medicine among midlife Arab women living in Qatar

PubMed Central

Gerber, L.M.; Mamtani, R.; Chiu, Y-L.; Bener, A.; Murphy, M.; Cheema, S.; Verjee, M.

2015-01-01

The prevalence of use of complementary and alternative medicine (CAM) is widespread and is growing worldwide. This cross-sectional study in Qatar examined the use of CAM and its correlates among Arab women in their midlife years. Women aged 40–60 years (n = 814) were recruited at primary health-care centres in Qatar and completed a specially designed, pre-tested questionnaire. Overall, 38.2% of midlife women in Qatar had used CAM in the previous 12 months. Nutritional remedies and herbal remedies were the most commonly used CAM therapies, followed by physical methods. Qatari nationality and higher level of education were independently associated with CAM use. Menopause transition status was not independently associated with use of CAM. The prevalence of CAM use by women in Qatar was high, consistent with other reports worldwide. It is essential to educate and inform patients and health-care providers about the benefits and limitations associated with CAM. PMID:25343468

An active learning complementary and alternative medicine session in a self-care therapeutics class.

PubMed

Mattison, Melissa J; Nemec, Eric C

2014-09-15

To provide an interactive, non-supplement based complementary and alternative medicine (CAM) session in a self-care therapeutics class and to evaluate the effect of the session on pharmacy students' perceptions and knowledge of CAM. Second professional year pharmacy students enrolled in a required 3-credit course titled Self-Care Therapeutics participated in an active learning session on CAM. Students physically engaged in 5 separate active learning CAM sessions including massage therapy, Tai Chi, yoga, progressive muscle relaxation, and Reiki. Students were assessed on both knowledge and perception of CAM. Concept mastery was assessed using a written examination and individual readiness assurance tests (iRAT) and team readiness assurance tests (tRAT). Perception of CAM was measured using both a presession and a postsession survey. Participating in an intensive, active learning CAM session provided an opportunity to increase students' knowledge of CAM and an effective strategy for providing the learner with the experience to better envision incorporation into patient therapies.

Clinical Oncology Society of Australia position statement on the use of complementary and alternative medicine by cancer patients.

PubMed

Braun, Lesley; Harris, Jessica; Katris, Paul; Cain, Michael; Dhillon, Haryana; Koczwara, Bogda; Olver, Ian; Robotin, Monica

2014-12-01

Health professionals involved in the clinical management of cancer are becoming increasingly aware that their patients use complementary and alternative medicine (CAM). As cancer incidence and survival rates increase, use of CAM is also likely to increase. This paper outlines the position of the Clinical Oncology Society of Australia (COSA) on the use of CAM by cancer patients and provides guidance for health professionals involved with the treatment of cancer patients who are using or wish to use CAM. Key definitions and common communication scenarios are presented along with evidence-based recommended steps for health professionals when discussing CAM use. COSA encourages health professionals to focus on open discussion with their patients regarding CAM, to become familiar with reputable resources for CAM information, to discuss with patients the concept of evidence-based medicine, to recognize limitations to their knowledge of CAM and seek further advice when necessary, and to be respectful of the patients' right to autonomy. © 2014 Wiley Publishing Asia Pty Ltd.

The Use of Complementary and Alternative Medicine in Scandinavia.

PubMed

Nilsson, Jonas; Källman, Mikael; Östlund, Ulrika; Holgersson, Georg; Bergqvist, Michael; Bergström, Stefan

2016-07-01

Complementary alternative medicine (CAM) is widely used among patients with cancer. This usage may have potentially harmful effects, especially when combined with anticancer drugs. However, some complementary methods may benefit patients. This review investigated the prevalence of CAM use among patients with cancer in Scandinavia and secondly studied the educational levels of CAM users compared to non-users. A systematic search of the PubMed library was carried out to locate articles published between January 2000 and October 2015 that investigated prevalence of CAM use among Scandinavian patients with cancer. Twenty-two articles were found, of which nine were included in the review. The prevalence of CAM use was 7.9% to 53%, with an average of 36.0% across all studies. Use of CAM is widespread among patients with cancer. Knowledge about CAM should be disseminated to both patients and staff in order to optimise discussions about CAM in clinical practice. Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

21 CFR 882.4125 - Neurosurgical chair.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Neurosurgical chair. 882.4125 Section 882.4125 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4125 Neurosurgical chair. (a...

21 CFR 882.4125 - Neurosurgical chair.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Neurosurgical chair. 882.4125 Section 882.4125 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4125 Neurosurgical chair. (a...

Leadership Skills for Department Chairs.

ERIC Educational Resources Information Center

Gmelch, Walter H.; Miskin, Val D.

This guide to leadership for college department chairs addresses three major challenges: (1) developing understanding and clarity about the motives and role of a department chair; (2) understanding the strategic planning process for creating a productive department; and (3) developing key leadership skills required for effectiveness. The first…

Handbook for Theatre Department Chairs.

ERIC Educational Resources Information Center

Whitmore, Jon, Ed.

Based on a workshop for theatre department chairs, guidance on administrative and departmental responsibilities are provided in the following chapters: (1) "Chairs and Deans: Working Together" (J. Robert Wills); (2) "Faculty Evaluation" (Patti P. Gillespie); (3) "Evaluation for Promotion and Tenure" (James M. Symons); (4) "Production Program…

78 FR 20311 - Environmental Management Site-Specific Advisory Board Chairs

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-04

... DEPARTMENT OF ENERGY Environmental Management Site-Specific Advisory Board Chairs AGENCY... Environmental Management Site-Specific Advisory Board (EM SSAB) Chairs. The Federal Advisory Committee Act (Pub... Board is to make recommendations to DOE-EM and site management in the areas of environmental restoration...

Secondary School Science Department Chairs Leading Change

ERIC Educational Resources Information Center

Gaubatz, Julie A.

2012-01-01

Secondary school department chairs are content area specialists in their schools and are responsible for providing students with the most appropriate curricula. However, most secondary school department chairs have limited authority to institute change unilaterally (Gmelch, 1993; Hannay & Erb, 1999). To explore how these educational leaders…

Department Chairs' Perceptions of the Importance of Business Communication Skills.

ERIC Educational Resources Information Center

Wardrope, William J.

2002-01-01

Determines business department chairs' ratings of topics typically covered in the business communication course. Indicates that department chairs perceive writing skills to be more important to business communication courses than other communication skills, such as speaking, technology-mediated communication, interpersonal communication,…

77 FR 27185 - Availability of Seats for the Hawaiian Islands Humpback Whale National Marine Sanctuary Advisory...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-09

... National Marine Sanctuary Advisory Council (council): Native Hawaiian, Fishing, Education, Research... and professional affiliations; philosophy regarding the protection and management of marine resources... Council Chair, a Research Committee chaired by the Research Representative, an Education Committee chaired...

Prevalence and reasons for intentional use of complementary and alternative medicine as an adjunct to future visits to a medical doctor for chronic disease.

PubMed

Kristoffersen, Agnete E; Stub, Trine; Musial, Frauke; Fønnebø, Vinjar; Lillenes, Ola; Norheim, Arne Johan

2018-03-27

Intentional use of complementary and alternative medicine (CAM) has previously only been researched in small, possibly biased, samples. There seems to be a lack of scientific information regarding healthy individual's attitudes and presumed use of CAM. The aim of this study is to describe prevalence and characteristics of participants who intend to see a CAM provider compared to participants who intend to see a medical doctor (MD) only when suffering from a chronic, non- life-threatening disease and in the need of treatment. Further to describe differences between the groups regarding expected reasons for CAM use and expected skills of CAM providers. The survey was conducted in January 2016 as part of the "TNS Gallup Health policy Barometer". In total, 1728 individuals aged 16-92 years participated in the study, constituting an overall response rate of 47%. The survey included questions regarding opinions and attitudes towards health, health services and health politics in Norway. The majority of the participants (90.2%) would see a MD only if they were suffering from a chronic, non- life-threatening disease and were in the need of treatment. Men over the age of 60 with a university education tended to see a MD only. Only 9.8% of all respondents would in addition visit a CAM provider. Being an intentional user of a MD + CAM provider was associated with being a woman under the age of 60. The respondents believed that CAM providers have professional competence based on formal training in CAM. They also believed that individuals seeing a CAM provider have poor health and are driven by the hope of being cured. Further, that they have heard that others have good experience with such treatment. Intentional use of CAM is associated with positive attitudes, trustworthiness, and presumed positive experiences in the CAM-patient-setting. Intentional CAM users also have the impression that CAM providers have professional competence based on formal training in alternative therapies.

Stakeholders' perspectives on the regulation and integration of complementary and alternative medicine products in Lebanon: a qualitative study

PubMed Central

2011-01-01

Background The regulation of the markets for Complementary and Alternative Medicine (CAM) products presents a global challenge. There is a dearth of studies that have examined or evaluated the regulatory policies of CAM products in the Eastern Mediterranean Region (EMR). We investigate the regulatory frameworks and the barriers for the proper regulation and integration of CAM products in Lebanon, as an example of an EMR country with a weak public infrastructure. Methods We utilized a qualitative study design involving a series of semi-structured interviews with stakeholders of the CAM market in Lebanon. Snowball sampling was used to identify interviewees; interviews continued until the "saturation" point was reached. A total of 16 interviews were carried out with decision makers, representatives of professional associations, academic researchers, CAM product importers, policy makers and a media representative. Interviews were transcribed and thematic analysis of scripts was carried out. Results There was a consensus among all stakeholders that the regulation of the market for CAM products in Lebanon needs to be strengthened. Thematic analysis identified a number of impediments jeopardizing the safety of public consumption and hindering the integration of CAM therapies into mainstream medicine; including: weak infrastructure, poor regulation, ineffective policies and politics, weak CAM awareness and sub-optimal coordination and cooperation among stakeholders. With respect to policy instruments, voluntary instruments (self regulation) were deemed ineffective by stakeholders due to poor awareness of both users and providers on safe use of CAM products. Stakeholders' rather recommended the adoption of a combination of mixed (enhancing public awareness and integration of CAM into medical and nursing curricula) and compulsory (stricter governmental regulation) policy instruments for the regulation of the market for CAM products. Conclusions The current status quo with respect to the regulation of CAM products in Lebanon is not conducive to public safety, nor does it support the integration of CAM products into the healthcare system. The Ministry of Health indeed plays a dominant role in the regulation of these products through a combination of mixed and compulsory policy instruments. Yet, the proper implementation of these regulations requires political resolve coupled with the cooperation of all CAM stakeholders. PMID:21871124

Equity in surgical leadership for women: more work to do.

PubMed

Weiss, Anna; Lee, Katherine C; Tapia, Viridiana; Chang, David; Freischlag, Julie; Blair, Sarah L; Ramamoorthy, Sonia

2014-09-01

Sex disparity in the Program Director role has not been studied. The goal of this study is to evaluate the percentage of women in Chair and Program Director positions. We hypothesize that there is a higher percentage of women in the Program Director role than Chair role. An Internet search identified Chairs, Program Directors, Associate Program Directors, and Division Chiefs. Statistical analysis compared percentages of women in these roles at all institutions, academic/community programs, and regions. There is higher female representation in the Program Director position than Chair position (P = .002) in General Surgery, Otolaryngology, and Orthopedics. More women are Associate Program Directors than Division Chiefs (23.6% vs 9.8%, P ≤ .001). Academic and community programs are no different. In the West, a greater percentage of women are Chairs as compared with the other regions (P ≤ .002). There are higher rates of women in Program Director position than Department Chair position. This discrepancy warrants further investigation. Published by Elsevier Inc.

Spontaneous vaginal delivery in the birth-chair versus in the conventional dorsal position: a matched controlled comparison.

PubMed

Scholz, H S; Benedicic, C; Arikan, M G; Haas, J; Petru, E

2001-09-17

The aim of the study was to assess the effect of a birth-chair on obstetric outcome. We reviewed the hospital records of 220 consecutive pregnant women who gave birth on a birth-chair at our institution. The control group consisted of 440 pregnant women who preceded and followed the index cases and who had spontaneous vaginal deliveries in the conventional dorsal supine position. The controls were matched for parity and for the attending mid-wife. Patients who delivered in the birth-chair had significantly lower rates of episiotomy and manual separation of the placenta. The umbilical blood cord pH was significantly higher in neonates of the birth-chair group. The duration of labour, rate of perineal and vaginal injury, Apgar scores and rate of admission to a neonatal intermediate care unit were not influenced by the mode of delivery. Our data support previous studies that a birth-chair delivery may be a safe alternative to conventional delivery in the supine position.

New inner boundaries of the habitable zones around M dwarfs

NASA Astrophysics Data System (ADS)

Bin, Jiayu; Tian, Feng; Liu, Lei

2018-06-01

Two general circulation models CAM4 and CAM5 are used to study the climate of ocean planets around M dwarfs with different effective temperatures. The atmospheres in CAM5 simulations are warmer and contain more water vapor than those in CAM4 under identical model settings, a result likely caused by improved treatments of radiation and possibly clouds in CAM5. The inner boundary of the habitable zones of M dwarfs based on CAM5 simulations, expressed as a second order polynomial function, are farther away from the stars than what are suggested by previous works and the corresponding atmospheres are in the moist greenhouse state.

Overview of integrative medicine in child and adolescent psychiatry.

PubMed

Simkin, Deborah R; Popper, Charles W

2013-07-01

Complementary and alternative medicine (CAM) defies simple definition, because the distinction between CAM and conventional medicine is largely arbitrary and fluid. Despite inconclusive data on the efficacy and safety of many CAM treatments in child and adolescent psychiatry, there are enough data on certain treatments to provide guidance to clinicians and researchers. CAM treatments, as adjunctive therapy or monotherapy, can be clinically beneficial and sensible. The low stigma and cost-competitiveness of many CAM psychiatric treatments are highly attractive to children and parents. Physicians need to be knowledgeable about CAM treatments to provide clinically valid informed consent for some conventional treatments. Copyright © 2013 Elsevier Inc. All rights reserved.

Effects of antibacterial agents, levofloxacin and clarithromycin, on aquatic organisms.

PubMed

Yamashita, N; Yasojima, M; Nakada, N; Miyajima, K; Komori, K; Suzuki, Y; Tanaka, H

2006-01-01

Contamination of surface waters by pharmaceutical chemicals is an emerging environmental problem. This study evaluated the toxic effects of the antibacterial agents levofloxacin (LVFX) and clarithromycin (CAM), which are widely used in Japan, on aquatic organisms. Ecotoxicity tests using a bacterium, alga and crustacean were conducted. Microtox test using a marine fluorescent bacterium showed that LVFX and CAM have no acute toxicity to the bacterium. From the results of the Daphnia immobilisation test, LVFX and CAM did not show acute toxicity to the crustacean. Meanwhile, an algal growth inhibition test revealed that LVFX and CAM have high toxicity to the microalga. The phytotoxicity of CAM was about 100-fold higher than that of LVFX from a comparison of EC50 (median effective concentration) value. From the Daphnia reproduction test, LVFX and CAM also showed chronic toxicity to the crustacean. Concentrations of LVFX and CAM in the aquatic environment were compared with PNEC (predicted no effect concentration) to evaluate the ecological risk. As a result, the ecological risk of LVFX is considered to be low, but that of CAM is higher, suggesting that CAM discharged into an aquatic environment after therapeutic use may affect organisms in the aquatic environment.

L1CAM in the Early Enteric and Urogenital System

PubMed Central

Pechriggl, Elisabeth Judith; Concin, Nicole; Blumer, Michael J.; Bitsche, Mario; Zwierzina, Marit; Dudas, Jozsef; Koziel, Katarzyna; Altevogt, Peter; Zeimet, Alain-Gustave; Fritsch, Helga

2016-01-01

L1 cell adhesion molecule (L1CAM) is a transmembrane molecule belonging to the L1 protein family. It has shown to be a key player in axonal guidance in the course of neuronal development. Furthermore, L1CAM is also crucial for the establishment of the enteric and urogenital organs and is aberrantly expressed in cancer originating in these organs. Carcinogenesis and embryogenesis follow a lot of similar molecular pathways, but unfortunately, comprehensive data on L1CAM expression and localization in human developing organs are lacking so far. In the present study we, therefore, examined the spatiotemporal distribution of L1CAM in the early human fetal period (weeks 8–12 of gestation) by means of immunohistochemistry and in situ hybridization (ISH). In the epithelia of the gastrointestinal organs, L1CAM localization cannot be observed in the examined stages most likely due to their advanced polarization and differentiation. Despite these results, our ISH data indicate weak L1CAM expression, but only in few epithelial cells. The genital tracts, however, are distinctly L1CAM positive throughout the entire fetal period. We, therefore, conclude that in embryogenesis L1CAM is crucial for further differentiation of epithelia. PMID:28026654

Comparative fracture strength analysis of Lava and Digident CAD/CAM zirconia ceramic crowns.

PubMed

Kwon, Taek-Ka; Pak, Hyun-Soon; Yang, Jae-Ho; Han, Jung-Suk; Lee, Jai-Bong; Kim, Sung-Hun; Yeo, In-Sung

2013-05-01

All-ceramic crowns are subject to fracture during function. To minimize this common clinical complication, zirconium oxide has been used as the framework for all-ceramic crowns. The aim of this study was to compare the fracture strengths of two computer-aided design/computer-aided manufacturing (CAD/CAM) zirconia crown systems: Lava and Digident. Twenty Lava CAD/CAM zirconia crowns and twenty Digident CAD/CAM zirconia crowns were fabricated. A metal die was also duplicated from the original prepared tooth for fracture testing. A universal testing machine was used to determine the fracture strength of the crowns. THE MEAN FRACTURE STRENGTHS WERE AS FOLLOWS: 54.9 ± 15.6 N for the Lava CAD/CAM zirconia crowns and 87.0 ± 16.0 N for the Digident CAD/CAM zirconia crowns. The difference between the mean fracture strengths of the Lava and Digident crowns was statistically significant (P<.001). Lava CAD/CAM zirconia crowns showed a complete fracture of both the veneering porcelain and the core whereas the Digident CAD/CAM zirconia crowns showed fracture only of the veneering porcelain. The fracture strengths of CAD/CAM zirconia crowns differ depending on the compatibility of the core material and the veneering porcelain.

Distributed Energy Resources Customer Adoption Model Plus (DER-CAM+), Version 1.0.0

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

Stadler, Michael; Cardorso, Goncalo; Mashayekh, Salman

DER-CAM+ v1.0.0 is internally referred to as DER-CAM v5.0.0. Due to fundamental changes from previous versions, a new name (DER-CAM+) will be used for DER-CAM version 5.0.0 and above. DER-CAM+ is a Decision Support Tool for Decentralized Energy Systems that has been tailored for microgrid applications, and now explicitly considers electrical and thermal networks within a microgrid, ancillary services, and operating reserve. DER-CAM was initially created as an exclusively economic energy model, able to find the cost minimizing combination and operation profile of a set of DER technologies that meet energy loads of a building or microgrid for a typicalmore » test year. The previous versions of DER-CAM were formulated without modeling the electrical/thermal networks within the microgrid, and hence, used aggregate single-node approaches. Furthermore, they were not able to consider operating reserve constraints, and microgrid revenue streams from participating in ancillary services markets. This new version DER-CAM+ considers these issues by including electrical power flow and thermal flow equations and constraints in the microgrid, revenues from various ancillary services markets, and operating reserve constraints.« less

Awareness, use, attitude and perceived need for Complementary and Alternative Medicine (CAM) education among undergraduate pharmacy students in Sierra Leone: a descriptive cross-sectional survey.

PubMed

James, Peter B; Bah, Abdulai J

2014-11-08

The widespread use of CAM around the world requires health professionals including pharmacists to have the required knowledge to better advise their patients. This has lead to an increased need for the inclusion of CAM instruction into the mainstream undergraduate Pharmacy education. This study was designed to describe pharmacy students awareness, use, attitude and perceived need for CAM education at COMAHS-USL and at the same time, determine how these descriptive outcomes are influenced by the socio-demographic variables considered in this study. A descriptive cross-sectional survey was conducted among undergraduate pharmacy students (n = 90) at the College of Medicine and Allied Health Sciences, University of Sierra Leone using a structured questionnaire. Chi square, fisher exact test, and general linear model univariate analysis were used to compare data between independent cohorts. All 90 (100%) of the students were aware and have used (except Ayurveda) at least one of the listed CAM modalities. Herbal/Botanical/Supplements followed by Spirituality/Prayer were the most commonly known and used CAM modalities. Almost two thirds of students considered the CAM modalities they have used to be effective and not harmful. Overall, pharmacy students had a positive attitude towards CAM (Mean attitudinal score = 34.9 ± 4. 5 (range 19-43)) with fourth and fifth year students showing a significantly less positive attitude as compared to the first, second and third year (B = -3.203 p = 0.001, 95% confidence interval -5.093 to -1.314). The media [53 (58.9%)] was the most frequent source of information about CAM. Nearly all students [89 (98.9%)] agreed that CAM knowledge is important to them as future pharmacist and that CAM should be included into the Pharmacy curriculum at COMAHS-USL [81 (90.0%)]. Pharmacy students in Sierra Leone are aware of and have used at least one of the CAM modalities and do show a positive attitude towards CAM. This was demonstrated by their overwhelming endorsement for CAM course to be part of the undergraduate pharmacy training at COMAHS-USL. This study among others will inform and guide the development and implementation of CAM instruction at COMAHS-USL.

Does physical exposure throughout working life influence chair-rise performance in midlife? A retrospective cohort study of associations between work and physical function in Denmark

PubMed Central

Møller, Anne; Reventlow, Susanne; Hansen, Åse Marie; Andersen, Lars L; Siersma, Volkert; Lund, Rikke; Avlund, Kirsten; Andersen, Johan Hviid; Mortensen, Ole Steen

2015-01-01

Objectives Our aim was to study associations between physical exposures throughout working life and physical function measured as chair-rise performance in midlife. Methods The Copenhagen Aging and Midlife Biobank (CAMB) provided data about employment and measures of physical function. Individual job histories were assigned exposures from a job exposure matrix. Exposures were standardised to ton-years (lifting 1000 kg each day in 1 year), stand-years (standing/walking for 6 h each day in 1 year) and kneel-years (kneeling for 1 h each day in 1 year). The associations between exposure-years and chair-rise performance (number of chair-rises in 30 s) were analysed in multivariate linear and non-linear regression models adjusted for covariates. Results Mean age among the 5095 participants was 59 years in both genders, and, on average, men achieved 21.58 (SD=5.60) and women 20.38 (SD=5.33) chair-rises in 30 s. Physical exposures were associated with poorer chair-rise performance in both men and women, however, only associations between lifting and standing/walking and chair-rise remained statistically significant among men in the final model. Spline regression analyses showed non-linear associations and confirmed the findings. Conclusions Higher physical exposure throughout working life is associated with slightly poorer chair-rise performance. The associations between exposure and outcome were non-linear. PMID:26537502

High prevalence of complementary and alternative medicine use among patients with sickle cell disease in a tertiary hospital in Lagos, South West, Nigeria.

PubMed

Busari, A A; Mufutau, M A

2017-06-07

Attention and interest in the use of complementary and alternative medicine (CAM) has been reignited globally, most especially in patients with chronic diseases. Sickle cell disease (SCD) is one of such chronic diseases associated with devastating clinical and psychosocial consequences, thus leading those affected to seek alternative treatment apart from orthodox medicine. Hence, this study aimed to determine the prevalence, pattern and tolerability of the use of CAM in patients with SCD in the Lagos University Teaching Hospital (LUTH). This was a cross-sectional survey of 200 respondents with SCD attending the hematology clinics of the Lagos University Teaching Hospital over a period of 3 months. Data on socio-demographic characteristic, clinical profile, the types and sources of CAM used were collected using a well structured pretested questionnaire. The data obtained were analyzed using Statistical Package for Social Sciences (SPSS®) version 17. Of the 200 patients who participated in the study, 113; 56.5% were males and 87; 43.5% were females. Majority of the SCD patients were 1-10 years old and their mean age was 18.8 ± 14.39 years. CAM was reportedly used by 88.5% of the respondents. Biological (herbal) products 156; 62.9% were the most commonly used CAM, followed by alternative medical systems 52; 20.9% and mind-body interventions 30; 12.1%. Relations, friends and neighbors influenced 85.2% of CAM users by recommending CAM to them. Tolerability of CAM was perceived to be excellent as only 33 (18.6%) of the respondents abandoned the use of CAM. Comparing CAM users and CAM non-users, there was no statistical significant difference in the proportion of those >18 years (45.76% vs 52.17%; p = 0.658), those who experienced two or more crises (51.41% vs 34.78%; p = 0.183), and those with stable haemoglobin concentration of >7 g/dL (15.81% vs 8.69%; p = 0.539) More patients among CAM non-users (91.30%) significantly spend over 3000 Naira (USD 15) per month on medicine than CAM users (4.51%) (p < 0.001). CAM use is highly prevalent among adults with sickle cell diseases in Nigeria. CAM is well tolerated and relatively affordable by these patients. Clinician awareness and understanding of the factors influencing the use of CAM and the potential herbal-orthodox medicine interaction are crucial during hospital treatment of these patients.

Rutger's CAM2000 chip architecture

NASA Technical Reports Server (NTRS)

Smith, Donald E.; Hall, J. Storrs; Miyake, Keith

1993-01-01

This report describes the architecture and instruction set of the Rutgers CAM2000 memory chip. The CAM2000 combines features of Associative Processing (AP), Content Addressable Memory (CAM), and Dynamic Random Access Memory (DRAM) in a single chip package that is not only DRAM compatible but capable of applying simple massively parallel operations to memory. This document reflects the current status of the CAM2000 architecture and is continually updated to reflect the current state of the architecture and instruction set.

A roadmap for research on crassulacean acid metabolism (CAM) to enhance sustainable food and bioenergy production in a hotter, drier world

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

Yang, Xiaohan; Cushman, John C.; Borland, Anne M.

Crassulacean acid metabolism (CAM) is a specialized mode of photosynthesis that features nocturnal CO₂ uptake, facilitates increased water-use efficiency (WUE), and enables CAM plants to inhabit water-limited environments such as semi-arid deserts or seasonally dry forests. Human population growth and global climate change now present challenges for agricultural production systems to increase food, feed, forage, fiber, and fuel production. One approach to meet these challenges is to increase reliance on CAM crops, such as Agave and Opuntia, for biomass production on semi-arid, abandoned, marginal, or degraded agricultural lands. Major research efforts are now underway to assess the productivity of CAMmore » crop species and to harness the WUE of CAM by engineering this pathway into existing food and bioenergy crops. An improved understanding of CAM gained through intensive and expanded research efforts has potential for high returns on research investment in the foreseeable future. To help realize the potential of sustainable dryland agricultural systems, it is necessary to address scientific questions related to the genomic features, regulatory mechanisms, and evolution of CAM; CAM-into-C3 engineering; and the production of CAM crops. Answering these questions requires collaborative efforts to build infrastructure for CAM model systems, field trials, mutant collections, and data management.« less

Impact of physical parameterizations on idealized tropical cyclones in the Community Atmosphere Model

NASA Astrophysics Data System (ADS)

Reed, K. A.; Jablonowski, C.

2011-02-01

This paper explores the impact of the physical parameterization suite on the evolution of an idealized tropical cyclone within the National Center for Atmospheric Research's (NCAR) Community Atmosphere Model (CAM). The CAM versions 3.1 and 4 are used to study the development of an initially weak vortex in an idealized environment over a 10-day simulation period within an aqua-planet setup. The main distinction between CAM 3.1 and CAM 4 lies within the physical parameterization of deep convection. CAM 4 now includes a dilute plume Convective Available Potential Energy (CAPE) calculation and Convective Momentum Transport (CMT). The finite-volume dynamical core with 26 vertical levels in aqua-planet mode is used at horizontal grid spacings of 1.0°, 0.5° and 0.25°. It is revealed that CAM 4 produces stronger and larger tropical cyclones by day 10 at all resolutions, with a much earlier onset of intensification when compared to CAM 3.1. At the highest resolution CAM 4 also accounts for changes in the storm's vertical structure, such as an increased outward slope of the wind contours with height, when compared to CAM 3.1. An investigation concludes that the new dilute CAPE calculation in CAM 4 is largely responsible for the changes observed in the development, strength and structure of the tropical cyclone.

A roadmap for research on crassulacean acid metabolism (CAM) to enhance sustainable food and bioenergy production in a hotter, drier world

DOE PAGES

Yang, Xiaohan; Cushman, John C.; Borland, Anne M.; ...

2015-07-07

Crassulacean acid metabolism (CAM) is a specialized mode of photosynthesis that features nocturnal CO₂ uptake, facilitates increased water-use efficiency (WUE), and enables CAM plants to inhabit water-limited environments such as semi-arid deserts or seasonally dry forests. Human population growth and global climate change now present challenges for agricultural production systems to increase food, feed, forage, fiber, and fuel production. One approach to meet these challenges is to increase reliance on CAM crops, such as Agave and Opuntia, for biomass production on semi-arid, abandoned, marginal, or degraded agricultural lands. Major research efforts are now underway to assess the productivity of CAMmore » crop species and to harness the WUE of CAM by engineering this pathway into existing food and bioenergy crops. An improved understanding of CAM gained through intensive and expanded research efforts has potential for high returns on research investment in the foreseeable future. To help realize the potential of sustainable dryland agricultural systems, it is necessary to address scientific questions related to the genomic features, regulatory mechanisms, and evolution of CAM; CAM-into-C3 engineering; and the production of CAM crops. Answering these questions requires collaborative efforts to build infrastructure for CAM model systems, field trials, mutant collections, and data management.« less

Model of human recurrent respiratory papilloma on chicken embryo chorioallantoic membrane for tumor angiogenesis research.

PubMed

Uloza, Virgilijus; Kuzminienė, Alina; Palubinskienė, Jolita; Balnytė, Ingrida; Ulozienė, Ingrida; Valančiūtė, Angelija

2017-07-01

We aimed to develop a chick embryo chorioallantoic membrane (CAM) model of recurrent respiratory papilloma (RPP) and to evaluate its morphological and morphometric characteristics, together with angiogenic features. Fresh RRP tissue samples obtained from 13 patients were implanted in 174 chick embryo CAMs. Morphological, morphometric, and angiogenic changes in the CAM and chorionic epithelium were evaluated up until 7 days after the implantation. Immunohistochemical analysis (34βE12, Ki-67, MMP-9, PCNA, and Sambucus nigra staining) was performed to detect cytokeratins and endothelial cells and to evaluate proliferative capacity of the RRP before and after implantation on the CAM. The implanted RRP tissue samples survived on CAM in 73% of cases while retaining their essential morphologic characteristics and proliferative capacity of the original tumor. Implants induced thickening of both the CAM (241-560%, p=0.001) and the chorionic epithelium (107-151%, p=0.001), while the number of blood vessels (37-85%, p=0.001) in the CAM increased. The results of the present study confirmed that chick embryo CAM is a relevant host for serving as a medium for RRP fresh tissue implantation. The CAM assay demonstrated the specific RRP tumor growth pattern after implantation and provided the first morphological and morphometric characterization of the RRP CAM model that opens new horizons in studying this disease.

Pivoting between calmodulin lobes triggered by calcium in the Kv7.2/calmodulin complex.

PubMed

Alaimo, Alessandro; Alberdi, Araitz; Gomis-Perez, Carolina; Fernández-Orth, Juncal; Bernardo-Seisdedos, Ganeko; Malo, Covadonga; Millet, Oscar; Areso, Pilar; Villarroel, Alvaro

2014-01-01

Kv7.2 (KCNQ2) is the principal molecular component of the slow voltage gated M-channel, which strongly influences neuronal excitability. Calmodulin (CaM) binds to two intracellular C-terminal segments of Kv7.2 channels, helices A and B, and it is required for exit from the endoplasmic reticulum. However, the molecular mechanisms by which CaM controls channel trafficking are currently unknown. Here we used two complementary approaches to explore the molecular events underlying the association between CaM and Kv7.2 and their regulation by Ca(2+). First, we performed a fluorometric assay using dansylated calmodulin (D-CaM) to characterize the interaction of its individual lobes to the Kv7.2 CaM binding site (Q2AB). Second, we explored the association of Q2AB with CaM by NMR spectroscopy, using (15)N-labeled CaM as a reporter. The combined data highlight the interdependency of the N- and C-lobes of CaM in the interaction with Q2AB, suggesting that when CaM binds Ca(2+) the binding interface pivots between the N-lobe whose interactions are dominated by helix B and the C-lobe where the predominant interaction is with helix A. In addition, Ca(2+) makes CaM binding to Q2AB more difficult and, reciprocally, the channel weakens the association of CaM with Ca(2+).

Mind the gap! Lay and medical perceptions of risks associated with the use of alternative treatment and conventional medicine.

PubMed

Salamonsen, Anita

2015-01-01

Studies on the widespread use of complementary and alternative medicine (CAM) demonstrate that CAM users base their treatment decisions on both subjective, experience-based knowledge and medical knowledge. The aim of this study was to explore lay and medical risk perceptions associated with CAM and conventional medicine. In this explorative qualitative study, we conducted in-depth interviews with 25 Norwegian CAM users with cancer or multiple sclerosis and 12 doctors. The interviews revealed fundamental differences in risk perceptions influencing treatment decisions and risk communication in a clinical setting. While CAM users considered conventional medicine as potentially risky and related this to experiences of severe adverse effects, CAM was perceived as natural and safe. Doctors' risk perceptions were quite the contrary, mainly because of lack of scientific evidence for CAM as a safe and beneficial treatment option. For the safety of CAM users, such divergent risk perceptions may have far-reaching consequences. CAM users should be taken seriously with their self-perception as decision-makers considering their approaches to experiences, knowledge, and science. An awareness of differing lay and medical risk perceptions associated with CAM and conventional medicine in research, doctor-patient communication, and education of patients and doctors is thus important to optimize patient safety in complex health care systems. © 2015 S. Karger GmbH, Freiburg.

Expression of calmodulin mRNA in rat olfactory neuroepithelium.

PubMed

Biffo, S; Goren, T; Khew-Goodall, Y S; Miara, J; Margolis, F L

1991-04-01

A calmodulin (CaM) cDNA was isolated by differential hybridization screening of a lambda gt10 library prepared from rat olfactory mucosa. This cDNA fragment, containing most of the open reading frame of the rat CaMI gene, was subcloned and used to characterize steady-state expression of CaM mRNA in rat olfactory neuroepithelium and bulb. Within the bulb mitral cells are the primary neuronal population expressing CaM mRNA. The major CaM mRNA expressed in the olfactory mucosa is 1.7 kb with smaller contributions from mRNAs of 4.0 and 1.4 kb. CaM mRNA was primarily associated with the olfactory neurons and, despite the cellular complexity of the tissue and the known involvement of CaM in diverse cellular processes, was only minimally evident in sustentacular cells, gland cells or respiratory epithelium. Following bulbectomy CaM mRNA declines in the olfactory neuroepithelium as does olfactory marker protein (OMP) mRNA. In contrast to the latter, CaM mRNA makes a partial recovery by one month after surgery. These results, coupled with those from in situ hybridization, indicate that CaM mRNA is expressed in both mature and immature olfactory neurons. The program regulating CaM gene expression in olfactory neurons is distinct from those controlling expression of B50/GAP43 in immature, or OMP in mature, neurons respectively.