An Introduction to Medical Malpractice in the United States

PubMed Central

2008-01-01

Medical malpractice law in the United States is derived from English common law, and was developed by rulings in various state courts. Medical malpractice lawsuits are a relatively common occurrence in the United States. The legal system is designed to encourage extensive discovery and negotiations between adversarial parties with the goal of resolving the dispute without going to jury trial. The injured patient must show that the physician acted negligently in rendering care, and that such negligence resulted in injury. To do so, four legal elements must be proven: (1) a professional duty owed to the patient; (2) breach of such duty; (3) injury caused by the breach; and (4) resulting damages. Money damages, if awarded, typically take into account both actual economic loss and noneconomic loss, such as pain and suffering. PMID:19034593

An introduction to medical malpractice in the United States.

PubMed

Bal, B Sonny

2009-02-01

Medical malpractice law in the United States is derived from English common law, and was developed by rulings in various state courts. Medical malpractice lawsuits are a relatively common occurrence in the United States. The legal system is designed to encourage extensive discovery and negotiations between adversarial parties with the goal of resolving the dispute without going to jury trial. The injured patient must show that the physician acted negligently in rendering care, and that such negligence resulted in injury. To do so, four legal elements must be proven: (1) a professional duty owed to the patient; (2) breach of such duty; (3) injury caused by the breach; and (4) resulting damages. Money damages, if awarded, typically take into account both actual economic loss and noneconomic loss, such as pain and suffering.

A Century of Misunderstanding: The History of the Development of Post Traumatic Stress Disorder Understanding in the United States Military

DTIC Science & Technology

2015-06-12

development of treatment for servicemen and women suffering from PTSD, and the treatment methods unique to WWII, Korea, Vietnam, and the GWOT eras...the development of treatment for servicemen and women suffering from PTSD, and the treatment methods unique to WWII, Korea, Vietnam, and the GWOT...Army began to acknowledge the effects that PTSD has on the force, and implemented programs and procedures, medicinal and psychological, in order to

Solving the Mystery of Insanity Law: Zealous Representation of Mentally Ill Servicemembers

DTIC Science & Technology

2005-04-01

57 M.J. 127 (2002). 29 Id. 30 Amnesia is defined as a "disturbance in the memory of information stored in long-term memory , in contrast to short...erroneous.27 More recently, the CAAF addressed whether an accused suffering from amnesia is capable of assisting in his own defense.28 In United...States v. Barreto,29 a sanity board diagnosed the accused as suffering from anterograde and retrograde amnesia ,30 a condition that resulted in his

77 FR 52293 - Endangered and Threatened Wildlife and Plants; 90-Day Finding on a Petition To List Mimulus...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-29

... review. Climate Change Information Provided in the Petition The petitioner states that the western United States will likely suffer a decrease in water resources due to climate change, which will affect montane... conclusions from the Intergovernmental Panel on Climate Change (IPCC) (2007, p. 52) and RMNP (2007a, p. 6...

Adventitious shoot regeneration and rooting of Fraxinus americana

Treesearch

Kaitlin J. Palla; Paula M. Pijut

2010-01-01

White ash (Fraxinus americana) trees provide both ecological and economic benefits. Loss of this North American endemic would disturb the environment. The urban ash tree industry in the United States would also suffer, as would manufacturers of baseball bats, furniture, and cabinets.

Loathing the sinner, medicalizing the sin: why sexually violent predator statutes are unjust.

PubMed

Douard, John

2007-01-01

In seventeen states, persons convicted of one or more sexually violent offenses may be involuntarily civilly committed at the end of their criminal terms if they suffer from a mental disorder that renders them likely to reoffend sexually. These statutes place the burden on states to show that the sex offender meets the United States Constitutional standard of dangerousness. The key to proving dangerousness is proof of a mental disorder. However, the United States Supreme Court recently found that the offender need not be mentally ill. He need only "suffer" from "mental abnormality" or "personality disorder" that affects his cognitive, emotional or volitional capacities such that he is highly likely to sexually reoffend. These statutes are expressions of disgust: a fear of contamination by persons who engage in sexual conduct that forces us to confront our dark impulses. We do not merely hate the sin; we hate the sinner, and we want the sinner to be removed from our presence. Moreover, the emotions these statutes express are the source of widespread moral panic not warranted by data about recidivism risk. Laws that express disgust are likely to result in the unjust treatment of sex offenders.

Using the GRAPES OF WRATH in the History Classroom.

ERIC Educational Resources Information Center

Mills, Randy

1987-01-01

Maintains that literary fiction may be used to enhance students' understanding of an historical period. Demonstrates how Steinbeck's GRAPES OF WRATH may be used to convey the human side of problems, sufferings, and triumphs that the United States experienced during the Great Depression. (JDH)

31 CFR 560.210 - Exempt transactions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... not apply to donations by United States persons of articles, such as food, clothing, and medicine, intended to be used to relieve human suffering. (c) Information and informational materials. (1) The importation from any country and the exportation to any country of information and informational materials as...

31 CFR 560.210 - Exempt transactions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... not apply to donations by United States persons of articles, such as food, clothing, and medicine, intended to be used to relieve human suffering. (c) Information and informational materials. (1) The importation from any country and the exportation to any country of information and informational materials as...

31 CFR 560.210 - Exempt transactions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... not apply to donations by United States persons of articles, such as food, clothing, and medicine, intended to be used to relieve human suffering. (c) Information and informational materials. (1) The importation from any country and the exportation to any country of information and informational materials as...

Incentives for organ donation in the United States: feasible alternative or forthcoming apocalypse?

PubMed

Hippen, Benjamin; Matas, Arthur

2009-04-01

Several factors have generated interest in proposals to offer incentives in exchange for kidneys from living donors, including the growing shortage of available organs, the apparent asymptote of traditional means of organ procurement, and the intimate link between the inadequacies of organ procurement policies in developed countries with the flourishing of underground organ trafficking in developing countries. Herein, we review the scope and dimensions of the growing shortage of organs in the United States, with attention to how each of the proposed solutions to same has proven insufficient. With special attention to the concerns leveled by Gabriel Danovitch in his 'Open Letter,' we conclude that each of his concerns are unfounded, and offer a prospectus on how a trial of such systems might be pursued in the United States. The failure of current approaches to organ procurement in the United States and other developed countries has led to unnecessary suffering and death, with morally unacceptable consequences for developing countries. For these reasons, a structured trial of incentives for organ procurement in the United States is a moral imperative.

Living Outside the Gender Box in Mexico: Testimony of Transgender Mexican Asylum Seekers.

PubMed

Cheney, Marshall K; Gowin, Mary J; Taylor, E Laurette; Frey, Melissa; Dunnington, Jamie; Alshuwaiyer, Ghadah; Huber, J Kathleen; Garcia, Mary Camero; Wray, Grady C

2017-10-01

To explore preimmigration experiences of violence and postimmigration health status in male-to-female transgender individuals (n = 45) from Mexico applying for asylum in the United States. We used a document review process to examine asylum declarations and psychological evaluations of transgender Mexican asylum seekers in the United States from 2012. We coded documents in 2013 and 2014 using NVivo, a multidisciplinary team reviewed them, and then we analyzed them for themes. Mexican transgender asylum applicants experienced pervasive verbal, physical, and sexual abuse from multiple sources, including family, school, community, and police. Applicants also experienced discrimination in school and in the workplace. Applicants immigrated to the United States to escape persistent assaults and threats to their life. Applicants suffered health and psychological effects from their experiences in Mexico that affected opportunities in the United States for employment, education, and social inclusion. Additional social protections for transgender individuals and antidiscrimination measures in Mexican schools and workplaces are warranted as are increased mental health assessment and treatment, job training, and education services for asylum seekers in the United States.

Why the United States lags in auto safety and lessons it can import.

PubMed

Kelley, Benjamin

2010-09-01

The United States has slipped in recent decades from its role of leadership in combating road crash injuries. The early promise of the country's approach to vehicle safety regulation, adopted by law in 1966, has suffered because of decades of regulatory inertia caused by antiregulatory government policies, industry obstructionism, and failure to set meaningful goals. Meanwhile, other industrial nations have vastly outpaced the United States in reducing crash deaths and injuries. The Obama administration is thus challenged to learn from other nations' successes while reestablishing the US presence as a vigorous proponent of effective crash injury reduction strategies. It can best accomplish this by crafting approaches and objectives that reduce motor vehicle use, reduce harmful disparities within the US vehicle population, and reduce motor vehicle travel speeds.

31 CFR 560.210 - Exempt transactions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 560.206 do not apply to donations by United States persons of articles, such as food, clothing, and medicine, intended to be used to relieve human suffering. (c) Information or informational materials. (1... exportation to any country of information or informational materials, as defined in § 560.315, whether...

31 CFR 538.212 - Exempt transactions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... donations by United States persons of articles, such as food, clothing, and medicine, intended to be used to relieve human suffering. (c) Information and informational materials. (1) The importation from any country and the exportation to any country of information or informational materials as defined in § 538.306...

31 CFR 560.210 - Exempt transactions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 560.206 do not apply to donations by United States persons of articles, such as food, clothing, and medicine, intended to be used to relieve human suffering. (c) Information or informational materials. (1... exportation to any country of information or informational materials, as defined in § 560.315, whether...

31 CFR 538.212 - Exempt transactions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... donations by United States persons of articles, such as food, clothing, and medicine, intended to be used to relieve human suffering. (c) Information and informational materials. (1) The importation from any country and the exportation to any country of information or informational materials as defined in § 538.306...

31 CFR 538.212 - Exempt transactions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... donations by United States persons of articles, such as food, clothing, and medicine, intended to be used to relieve human suffering. (c) Information and informational materials. (1) The importation from any country and the exportation to any country of information or informational materials as defined in § 538.306...

31 CFR 538.212 - Exempt transactions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... donations by United States persons of articles, such as food, clothing, and medicine, intended to be used to relieve human suffering. (c) Information and informational materials. (1) The importation from any country and the exportation to any country of information or informational materials as defined in § 538.306...

31 CFR 538.212 - Exempt transactions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... donations by United States persons of articles, such as food, clothing, and medicine, intended to be used to relieve human suffering. (c) Information and informational materials. (1) The importation from any country and the exportation to any country of information or informational materials as defined in § 538.306...

Indochina Refugees: Families in Turmoil.

ERIC Educational Resources Information Center

Okura, K. Patrick

Many Indochinese refugees in the United States suffer from serious social adjustment problems. These adjustment problems appear to reflect the stress of adapting to American life rather than chronic dysfunction. Particular groups of Indochinese who appear to experience social adjustment problems that are more severe in terms of intensity,…

ADD and Physicians.

ERIC Educational Resources Information Center

Hewick, Walter; And Others

In the United States today Attention Deficit Disorder (ADD) is recognized by professionals as a distinct disorder, a neurobiological disability marked by inattentiveness, impulsivity, and hyperactivity. About 2-10% of school-age children suffer from ADD, making it an issue of rising concern to families and school leaders. It is necessary that…

Impact on the world poultry industry of the global shift to biofuels.

PubMed

Aho, P

2007-11-01

The shift to biofuels is a worldwide phenomenon, but the most notable recent development has been the rapid increase in the production of ethanol in the United States. Ethanol production in the United States enjoys a substantial subsidy, tariff protection, and mandated use. The consequence of increasing biofuels production is to raise the cost of feed and food worldwide. Those that suffer from this policy include all consumers of food, most notably the urban poor of developing countries. Those that benefit from the policy are farmers everywhere, including farmers in developing countries.

Cambodians in Western Massachusetts and Bronx, New York.

ERIC Educational Resources Information Center

Melnick, Leah

1990-01-01

Cambodian refugees in the United States, in addition to suffering loss of homeland, culture, and families, are survivors of a holocaust that has affected every Khmer family. Summarizes the history of Cambodian conflict and genocide, and describes its lingering effects on refugees attempting to rebuild their lives in this country. (AF)

Assessing gully widening and its control in the Debri-Mawi Watershed, northern Ethiopia

USDA-ARS?s Scientific Manuscript database

The highlands of northern Ethiopia suffer from severe land degradation manifested by widespread gully and channel erosion and network development. Research on the geomorphic adjustment of similar landscapes in the midcontinental United States has resulted in the development of the computer models BS...

Pathology of Central American Refugees.

ERIC Educational Resources Information Center

Molesky, Jean

1986-01-01

The rapidly increasing numbers of Central American refugees in the United States include many whose sufferings have led to severe psychological problems. The article attempts to lay a foundation for assisting them by discussing the following: (1) origins of disorders; (2) culture shock and stress; (3) prevalence of symptoms; and (4) suggestions…

78 FR 72531 - Thanksgiving Day, 2013

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-02

... Thanksgiving Day, 2013 By the President of the United States of America A Proclamation Thanksgiving offers each... aside a day of prayer. And when we join with friends and neighbors to alleviate suffering and make our... volunteers who dedicate this day to those less fortunate. This Thanksgiving Day, let us forge deeper...

Implications of the Physical Educator's Broadened Wellness Role

ERIC Educational Resources Information Center

Melville, Scott

2009-01-01

The United States is experiencing a health crisis because of poor dietary habits and insufficient physical activity. Unless something changes, more of the population will become overweight or obese and suffer from debilitating and life-threatening diseases. The federal government has responded by charging schools with the establishment of…

Cambodian Refugees.

ERIC Educational Resources Information Center

Boright, Lucinda L.

The Khmer are the predominant ethnic group of Cambodia, yet they have suffered genocide in their own homeland. The English language is the primary social barrier confronted by Cambodian refugees to the United States, since there are no similarities between English and Khmer alphabets and tenses. Refugees who arrrived in 1975 tended to be educated,…

Mississippi Communities for Healthy Living: Results of a 6-month nutrition education comparative effectiveness trial

USDA-ARS?s Scientific Manuscript database

The United States Lower Mississippi Delta (LMD) region suffers from high prevalence of chronic health conditions with nutritional etiologies, including obesity, high cholesterol, hypertension, and diabetes. Responding to the need for effective nutrition interventions in the LMD, a 2-arm, 6-month, n...

Elementary School Students' Perceptions of Overweight Peers

ERIC Educational Resources Information Center

Tillman, Tracey; Kehle, Thomas J.; Bray, Melissa A.; Chafouleas, Sandra M.; Grigerick, Sarah

2007-01-01

Obesity is a growing epidemic in the United States. Children who are overweight tend to participate in fewer activities, to withdraw from social situations, and to be less physically active than their normal-weight peers. Additionally, they have lower self-image and often suffer from depression. Research on children's perceptions of overweight…

Iraqi Refugee High School Students' Academic Adjustment

ERIC Educational Resources Information Center

Bang, Hyeyoung

2017-01-01

Many Iraqi refugee students in the United States suffer from posttraumatic stress disorder (PTSD) as well as acculturation stresses. These stresses often create challenges for their integration into U.S. schools. The project explored risk factors such as the length of educational gaps in transit, PTSD, and separation and marginalization…

Re-Seeing Our Professional Face(s).

ERIC Educational Resources Information Center

Okawa, Gail Y.

1998-01-01

Argues that English teaching in the United States suffers from a monocultural teaching force, even as student bodies become increasingly diverse. Tells how one teacher of color came to literacy and later to teaching, often against challenging odds. Argues that English teachers should examine their assumptions about "potential" and about what…

Saudi Arabia-United States Collaboration in Health Research: A Formula for Success

DTIC Science & Technology

2005-04-01

serologic evidence that Gulf War veterans are suffering postwar morbidity from Mycoplasma fermentans infection. Am J Trop Med Hyg 1999;60:752-7. 17...sclerosis, or fibromyalgia associated with Persian Gulf War service? Examination of Department of Defense hospital- ization data. Am J Epidemiol

Variation in bird-window collision mortality and scavenging rates within an urban landscape

EPA Science Inventory

Annual avian mortality from collisions with windows and buildings is estimated to range from a million to a billion birds in the United States alone. However, estimates of mortality based on carcass counts suffer from bias due to imperfect detection and carcass scavenging. We stu...

Academic Improvement through Regular Assessment

ERIC Educational Resources Information Center

Wolf, Patrick J.

2007-01-01

Media reports are rife with claims that students in the United States are overtested and that they and their education are suffering as result. Here I argue the opposite--that students would benefit in numerous ways from more frequent assessment, especially of diagnostic testing. The regular assessment of students serves critical educational and…

Listeria contamination in food products and potential interventions

USDA-ARS?s Scientific Manuscript database

Every year, 1 out of 6 peoples in the United States suffer from foodborne illness, more than a hundred thousand are hospitalized and thousands die. Listeria monocytogenes is one of the leading foodborne pathogen responsible for 1600 illnesses and 260 deaths in the U.S. every year. L. monocytogenes i...

The Ecological Effects in Acculturation of Puerto Rican Migrants.

ERIC Educational Resources Information Center

Lopez-Ramirez, Norma Iris

Various studies discuss the influences on and effects of the process of adjustment to a new environment among Puerto Rican migrants to the United States mainland. In confronting cultural differences, Puerto Ricans may experience culture shock and identity problems and suffer disassociation leading to schizophrenia and hysteria, stress,…

PFOS and PFOSA in Bottlenose Dolphins: An Investigation into Two High Mortality Epizootics (NRMMSTSN2009)

EPA Science Inventory

Along the Atlantic coast of the United States during 1987 and 1988, bottlenose dolphins (Tursiops truncatus) suffered one of this country's largest marine mammal mass mortality events. An estimated 50% of all near-shore bottlenose died during this short period. Two years later a ...

PFOS and PFOSA in Bottlenose Dolphins: An Investigation into Two Unusually High Mortality Epizootics

EPA Science Inventory

Along the Atlantic coast of the United States during 1987 and 1988, bottlenose dolphins (Tursiops truncatus) suffered one of this country's largest marine mammal mass mortality events. An estimated 50% of all near-shore bottlenose died during this short period. Two years later a ...

PFOS and PFOSA in Bottlenose Dolphins: An Investigation into Two Unusual Mortality Epizootics (WDA)

EPA Science Inventory

Along the Atlantic coast of the United States during 1987 and 1988, bottlenose dolphins (Tursiops truncatus) suffered one of this country's largest marine mammal mass mortality events. An estimated 50% of all near-shore bottlenose died during this short period. Two years later a ...

PFOS and PFOSA in Bottlenose Dolphins: An Investigation into Two Unusually High Mortality Events

EPA Science Inventory

Along the Atlantic coast of the United States during 1987 and 1988, bottlenose dolphins (Tursiops truncatus) suffered one of this country's largest marine mammal mass mortality events. An estimated 50% of all near-shore bottlenose died during this short period. Two years later a ...

Schools in the Great Depression. Studies in the History of Education Volume 2. Garland Reference Library of Social Science Volume 1037.

ERIC Educational Resources Information Center

Moreo, Dominic W.

This book examines the state of schools and the thinking of educators during the years from 1929 until the entry of the United States into World War II. These years were marked by social dislocation and suffering, yet research shows neither public school bureaucracies nor the leading educators of the day advocated any new advances in education…

Predicting Persistence in Practical Nursing and Success on the NCLEX-PN: Examining Demographic, Non-Academic, and Academic Variables

ERIC Educational Resources Information Center

Davis, Alicia Debra

2015-01-01

The United States is now in the midst of a major nursing shortage that is predicted to get worse over the next ten years (Kurzen, 2005). The Health Resources and Services Administration reports that all 50 states will suffer from a nursing shortage by 2020 (U.S. Department of Health and Human Services, 2004). This means that there will be a…

Health Issues Facing Black Women.

ERIC Educational Resources Information Center

Reid, Inez Smith

Black women in the United States experience a high incidence of serious health problems and, as a group, receive insufficient and inadequate medical care. The death rate for black women suffering from breast cancer has increased substantially since 1950. Also of great concern is the high incidence of cervical cancer in low income black women…

Theory in Chronic Disease Prevention and Health Promotion

ERIC Educational Resources Information Center

Hall, Michael; Elise, Eifert

2016-01-01

Morbidity and mortality related to chronic diseases are a primary concern of health professionals, including Health Educators. According to the Centers for Disease Control and Prevention, over one half of the adult population in the United States suffer from one or more chronic conditions. Understanding the health risk behaviors that contribute to…

An analysis of the link between strokes and soils in the South Carolina coastal plains

USDA-ARS?s Scientific Manuscript database

The Stroke Belt is a geographical region of the southeastern United States where resident individuals suffer a disproportionately higher rate of strokes than the rest of the population. While the “buckle” of this Stroke Belt coincides with the southeastern Coastal Plain region of North and South Car...

Still No 40 Acres, Still No Mule

ERIC Educational Resources Information Center

Keels, Crystal L.

2005-01-01

The simple mention of reparations for African-Americans in the United States can be counted on to generate a firestorm. When it comes to the issue of recompense for injustices Black Americans have suffered throughout U.S. history--slavery, Jim Crow segregation, and other political and social mechanisms designed to maintain racial inequality--the…

African American Males. A Critical Link in the African American Family.

ERIC Educational Resources Information Center

Jones, Dionne J., Ed.

African Americans are experiencing extreme stress in the United States, and African-American males appear to suffer the most. The chapters in this volume examine some of the issues confronting African-American men today. They include: (1) "Introduction" (Dionne J. Jones); (2) "Reaffirming Young African American Males: Mentoring and…

National Strategy for Suicide Prevention: Goals and Objectives for Action.

ERIC Educational Resources Information Center

Silverman, Morton M., Ed.

This guide is designed to be a catalyst for social change, and to transform attitudes, policies, and services concerned with suicide prevention to reflect current knowledge. It involves a comprehensive and integrated approach to reducing the loss and suffering from suicide and suicidal behaviors in the United States. Representing the combined work…

Differences between Angus and Holstein cattle in the Lupinus leucophyllus induced inhibition of fetal activity

USDA-ARS?s Scientific Manuscript database

In the United States, calves with congenital defects born to cows that have grazed teratogenic Lupinus spp. during pregnancy can suffer from what is colloquially termed crooked calf syndrome. Crooked calf defects include cleft palate, spinal column defects and angular limb malformations which are fo...

Education Models for Teaching Adults about Modifying Dietary Carbohydrate and Controlling Weight

ERIC Educational Resources Information Center

Cleamons, Vincient M.

2018-01-01

The prevalence of diabetes and other pathophysiological conditions has been correlated with the incidence of obesity. A large portion of an adult community in the northwestern United States suffers from excessive weight that has been linked to premature mortality rates and certain forms of diabetes. Excess calories from carbohydrate have been…

School Enrollment Changes and Student Achievement Growth: A Case Study in Educational Disruption and Continuity

ERIC Educational Resources Information Center

Grigg, Jeffrey

2012-01-01

Students in the United States change schools often, and frequent changes are associated with poor outcomes along numerous dimensions. These moves occur for many reasons, including both promotional transitions between educational levels and nonpromotional moves. Promotional student mobility is less likely than nonpromotional mobility to suffer from…

Management of western dwarf mistletoe in ponderosa and Jeffrey pines in forest recreation areas

Treesearch

Robert F. Scharpf; Richard S. Smith; Detlev Vogler

1988-01-01

Pines on many high value recreational sites in the Western United States suffer damage and death from western dwarf mistletoe (Arceuthobium campylopodum Engelm.). Dwarf mistletoe alone, however, is not solely responsible. Other pests and environmental conditions interact with dwarf mistletoe to damage and kill trees. An integrated pest management...

Treating Childhood Anxiety in Schools: Service Delivery in a Response to Intervention Paradigm

ERIC Educational Resources Information Center

Sulkowski, Michael L.; Joyce, Diana K.; Storch, Eric A.

2012-01-01

Millions of youth who attend schools in the United States suffer from clinically significant anxiety. Left untreated, these students often experience significant disruptions in their academic, social, and family functioning. Fortunately, promising treatments exist for childhood anxiety that are amenable for delivery in school settings. However,…

Evidence for porcine parvovirus type 4 (PPV4) in Brazilian swine herds

USDA-ARS?s Scientific Manuscript database

Introduction Porcine bocaviruses were recently identified among swine co-infected with PCV2 (2,3) and suffering an acute-onset disease of high mortality in the United States, in pigs with PMWS in Sweden (1), and in pigs with reproductive and neurological disease in China (4). Parvoviruses are smal...

Perceptions of Care: Self Reflections of Women Teachers of African Descent Who Teach in Urban Settings

ERIC Educational Resources Information Center

Abioro, Elizabeth

2010-01-01

Discussions and debates about the educational system in the United States continue to center on curriculum and school reform. However, many children in America's public schools suffer from existing "life hazards" including social isolation, poverty, neglect, drug abuse, violence, school failure, and the breakdown of traditional family…

Mitigating Anthropocene influences in forests in the United States

Treesearch

Chadwick Dearing Oliver

2014-01-01

Anthropogenic and other climate changes, land use changes, forest structure changes, and introduced organisms are difficult to isolate with respect to their cumulative consequences. Similar changes have occurred before with undesirable effects and the currently high human population could suffer greatly if they happen again. Active forest management can help avoid...

Minority Youth, Physical Activity, and Fitness Levels: Targeted Interventions Needed

ERIC Educational Resources Information Center

Fahlman, Mariane; Hall, Heather L.; Gutuskey, Lila

2015-01-01

Background: There is a clear disparity in health in the United States such that African Americans and Hispanics are more likely to suffer from morbidity and mortality related to chronic disease than their Caucasian counterparts. Purpose: We will determine whether fourth- and fifth-grade students' measures of health-related fitness and physical…

Poverty, Violence, and Health: The Impact of Domestic Violence during Pregnancy on Newborn Health

ERIC Educational Resources Information Center

Aizer, Anna

2011-01-01

Two percent of women in the United States suffer from intimate partner violence annually, with poor and minority women disproportionately affected. I provide evidence of an important negative externality associated with domestic violence by estimating a negative and causal relationship between violence during pregnancy and newborn health,…

77 FR 73889 - National Pearl Harbor Remembrance Day, 2012

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-11

... pay solemn tribute to America's sons and daughters who made the ultimate sacrifice at Oahu. As we do... United States of America A Proclamation On December 7, 1941, our Nation suffered one of the most... our Nation through some of the 20th century's darkest moments. In his address to the Congress...

Discovery Camp Excites Students about Engineering and Technology Careers

ERIC Educational Resources Information Center

Massiha, G. H.

2011-01-01

In the United States and elsewhere, there is a dramatic shortage of engineers and technologists. And, unfortunately, these professions often suffer from a lack of awareness among K-12 students. Clearly, educators need to show students the very exciting and lucrative aspects of these fields. Engineering and technology are consistently listed by…

Compassionate, Spiritual, and Creative Listening in Teaching and Learning

ERIC Educational Resources Information Center

Garrison, Jim

2010-01-01

Background/Context: Listening is largely overlooked in cultures constituted on the basis of the freedom of speech, such as we find in the United States and elsewhere. Purpose/Objective/Research Question/Focus of Study: The article explores compassionate listening as a creative spiritual activity. Such listening recognizes the suffering of others…

The Original Americans: U.S. Indians. Third Edition.

ERIC Educational Resources Information Center

Wilson, James

About 1.5 million people in the United States identify themselves as Indians. Despite great cultural diversity, all Native groups have a common feature: they suffer poverty and related problems stemming from their relationship to White America. For four generations, the Bureau of Indian Affairs (BIA) has exercised an incredible degree of economic…

Lifelong Battle

ERIC Educational Resources Information Center

Hurst, Marianne D.

2004-01-01

It is estimated that nearly 19 million adults in the United States suffer from depression. While research on the number of school-age children with depression varies, most experts agree that between 5 percent and 11 percent of 6- to 17-year-olds are living with the problem every day. Depression is characterized by a number of symptoms, including…

The responsibility to protect: a new notion of state sovereignty.

PubMed

Ashford, Mary-Wynne

2003-01-01

The recent policies of the United States Administration threaten the entire structure of international law. Widespread concern in the US and elsewhere has been expressed in a different cluster of principles, in particular in the report of the Canadian-based Commission on Intervention and State Sovereignty. Its report states that the primary responsibility of a state is to protect its citizens; such protection includes prevention, reaction and rebuilding. The implications of this for military intervention are discussed; this must be a last resort after all non-military options have failed in response to the actual or probable large-scale loss of life and the objective to prevent further suffering. The action must be authorized by the United Nations Security Council or, if this fails to respond, the General Assembly. A further commission should examine how the international community should respond to states that refuse to comply with international law regarding weapons of mass destruction.

Structural Vulnerability and Health: Latino Migrant Laborers in the United States

PubMed Central

Quesada, James; Hart, Laurie K.; Bourgois, Philippe

2011-01-01

Latino immigrants in the United States constitute a paradigmatic case of a population group subject to structural violence. Their subordinated location in the global economy and their culturally depreciated status in the United States are exacerbated by legal persecution. Medical Anthropology Volume 30, issues 4 and 5, include a series of ethnographic analyses of the processes that render undocumented Latino immigrants structurally vulnerable to ill-health. We hope to extend the social science concept of ‘structural vulnerability’ to make it a useful tool for health care. Defined as a positionality that imposes physical/emotional suffering on specific population groups and individuals in patterned ways, structural vulnerability is a product of two complementary forces: (1) class-based economic exploitation and cultural, gender/sexual, and racialized discrimination; and (2) processes of symbolic violence and subjectivity formation that have increasingly legitimized punitive neoliberal discourses of individual unworthiness. PMID:21777121

United States Navy - Canadian forces solid state flight data recorder/crash position locator experiment on the B-720 controlled impact demonstration

NASA Technical Reports Server (NTRS)

Watters, D. M.

1986-01-01

The operation of a radio beacon position locator during and after the remotely controlled transport aircraft is discussed. The radio beacon transmission was actuated and was picked up by the Navy P-3A chase aircraft for a short time, after which reception was lost. The pilot reported that he received a signal on both 121.5 MHz and 243 MHz for a period of approximately 5 seconds. Five minutes after the crash a portable direction finding unit located on the roof of the NASA Dryden Flight Research Facility, 4 miles distant from the crash, was unable to pick up the beacon transmission. The fire crews started fighting the fires approximately 90 seconds after the time of impact. Navy personnel access to the crash site was allowed on the morning of December 2, 1984. Radio beacon locator was found resting top side up, 15 feet forward and 13 feet perpendicular from the tray location the starboard side of the aircraft. An immediate inspection indicated the airfoil suffered moderate fire damage with paint peeling but not intumescing. The visual marker strobe lamp housings were intact but extensively burned such that it was impossible to see if the lamps had survived. The airfoil suffered minor structural damage, with assorted dents, etc. The extended plunger on the ARU-21 release unit indicated that the pyrotechnic deployment system operated. The radio beacon base (tray) suffered some heat and fire damage, and was charred and blackened by smoke. The frangible switch in the nose survived and the switch in the belly was recovered and found to have actuated. It is assumed that this switch fired the ARU-21 squib. There were no other release switches installed in the normally open system in the aircraft.

Reflections of Adults on Their School Experiences Growing up with a Severely Mentally Ill Parent

ERIC Educational Resources Information Center

Leahy, Marie A.

2013-01-01

More than five million children in the United States have a parent suffering from a severe mental illness and these children have specific experiences and needs, particularly in school. Children of mentally ill parents are at greater risk of being neglected and of developing psychological, social, emotional, and behavioral problems. They often…

Members of Faculty with Hearing Impairments in Academia: What Are Their Needs?

ERIC Educational Resources Information Center

Roufs, Kathleen S.

2011-01-01

Seventeen percent of adults in the United States suffer from some degree of hearing loss, and this impairment can pose considerable personal, professional, social, and psychological challenges, often, to people reluctant to seek help (Hearing Loss Association, 2011). Post-secondary faculty members with hearing loss are among us, and most of them…

Everything New Is Old Again: The American Catholic Bishops' Politics of Conscience

ERIC Educational Resources Information Center

O'Keefe, Meaghan

2012-01-01

Over the last ten years, American Catholic bishops have suffered a catastrophic loss of authority in the wake of sexual abuse scandals. In the midst of these scandals, the United States Conference of Catholic Bishops [USCCB] has issued voting guides for presidential elections. In this dissertation, I investigate the American Catholic church's…

The Movie "The Secret Life of Words:" Implications for Counselors

ERIC Educational Resources Information Center

Cook, Katrina

2008-01-01

Torture still occurs at an alarming rate in the world today. Because many torture victims suffer silently in isolation instead of seeking help for their symptoms of posttraumatic stress, it is impossible to know how many lives have been impacted. However, as more and more torture victims seek asylum in countries such as the United States,…

Research into the Current Plight of Farmworkers in the United States.

ERIC Educational Resources Information Center

Thedinger, Bob

Farmworkers suffer from the same economic and social problems as other poor people but to a greater degree. Among classes of the disadvantaged designated for special Federal attention, only farmworkers are an occupational group. Their plight is unique because it is their working conditions which give rise to most of the other problems endemic to…

Hospital-School Collaboration to Serve the Needs of Children with Traumatic Brain Injury

ERIC Educational Resources Information Center

Chesire, David J.; Canto, Angela I.; Buckley, Valerie A.

2011-01-01

Traumatic brain injuries are the leading cause of death and disability for children and adolescents each year in the United States. Children who survive these injuries often suffer from a range of impairments including intellectual, academic, behavioral, affective, and social problems, but they often become mired in a slow-moving process while…

Involvement of African-American Girls in Science, Technology, Engineering, and Mathematics (STEM) Education

ERIC Educational Resources Information Center

Nkere, Nsidi

2016-01-01

A qualitative case study was conducted by examining the perceptions of fifth-grade African American girls about their experiences with science, technology, engineering and mathematics (STEM) education and potential for STEM as a future career. As the United States suffers from waning participation across all demographics in STEM and a high level…

Who Suffers during Recessions? NBER Working Paper No. 17951

ERIC Educational Resources Information Center

Hoynes, Hilary W.; Miller, Douglas L.; Schaller, Jessamyn

2012-01-01

In this paper we examine how business cycles affect labor market outcomes in the United States. We conduct a detailed analysis of how cycles affect outcomes differentially across persons of differing age, education, race, and gender, and we compare the cyclical sensitivity during the Great Recession to that in the early 1980s recession. We present…

Assessment of Hurricane Katrina Damage to New Orleans Public School Facilities

ERIC Educational Resources Information Center

Council of the Great City Schools, 2005

2005-01-01

Hurricane Katrina hit the Gulf Coast of the United States on August 29, 2005, and triggered one of the most devastating natural disasters in the history of the nation. New Orleans, in particular, and the schools that served the community's children, suffered severe storm damage and massive flooding. Central to the city's strategy of getting back…

Learning to Do Diversity Work: A Model for Continued Education of Program Organizers

ERIC Educational Resources Information Center

Dounas-Frazer, Dimitri R.; Hyater-Adams, Simone A.; Reinholz, Daniel L.

2017-01-01

Physics and physics education in the United States suffer from severe (and, in some cases, worsening) underrepresentation of Black, Latinx, and Native American people of all genders and women of all races and ethnicities. In this paper, we describe an approach to facilitating physics students' collective and continued education about such…

Neonatal euthanasia.

PubMed

Kon, Alexander A

2009-12-01

Despite advances in the care of infants, there remain many newborns whose medical conditions are incompatible with sustained life. At times, healthcare providers and parents may agree that prolonging life is not an appropriate goal of care, and they may redirect treatment to alleviate suffering. While pediatric palliative treatment protocols are gaining greater acceptance, there remain some children whose suffering is unrelenting despite maximal efforts. Due to the realization that some infants suffer unbearably (ie, the burdens of suffering outweigh the benefits of life), the Dutch have developed a protocol for euthanizing these newborns. In this review, I examine the ethical aspects of 6 forms of end of life care, explain the ethical arguments in support of euthanasia, review the history and verbiage of the United States regulations governing limiting and withdrawing life-prolonging interventions in infants, describe the 3 categories of neonates for whom the Dutch provide euthanasia, review the published analyses of the Dutch protocol, and finally present some practical considerations should some form of euthanasia ever be deemed appropriate.

The Holocaust after 70 years: Holocaust survivors in the United States(.).

PubMed

Prince, Robert M

2015-09-01

Over 70 years, there have been different narratives of the Holocaust survivors coming to the United States. Survivors' stories begin with an event of major historical significance. Difficulties in conceptualizing historical trauma, along with common distortions and myths about Holocaust survivors and their children are examined. This article proposes that it is impossible to discuss the consequences of extreme suffering without consideration of historical meaning and social context with which they are entwined. The evolution of the social representation of the Holocaust and the contradictions in clinical attributions to survivors and their children with consideration of the future is described. Attributions to survivors and their children with consideration of the future is described.

Concerns of Women around the World: The Responsibilities of the Adult Education Movement.

ERIC Educational Resources Information Center

Cassara, Beverly B.

Around the world, women suffer oppression to various degrees. In the United States, they have a difficult time rising in corporations or having their ideas taken seriously. In some other countries, they are abused and overworked. Some women in Norway are concerned that their country's entrance into the European Community will mean an end to the…

Preparing Ideologically Clear Bilingual Teachers: Honoring Working-Class Non-Standard Language Use in the Bilingual Education Classroom

ERIC Educational Resources Information Center

Alfaro, Cristina; Bartolomé, Lilia

2017-01-01

Mexicanos/Chicanos in the United States have historically suffered derision and mistreatment by the mainstream culture because of their use of nonstandard Spanish and English, as well as codeswitching (alternating between two or more languages or language varieties). In the field of education, codeswitching and the use of nonstandard English and…

North American montane red foxes: expansion, fragmentation, and the origin of the Sacramento Valley red fox

Treesearch

Benjamin N. Sacks; Mark J. Statham; John D. Perrine; Samantha M. Wisely; Keith B. Aubry

2010-01-01

Most native red foxes (Vulpes vulpes) in the western contiguous United States appear to be climatically restricted to colder regions in the major mountain ranges and, in some areas, have suffered precipitous declines in abundance that may be linked to warming trends. However, another population of unknown origin has occurred in arid habitats in the...

Leaks in the Chicana and Chicano Educational Pipeline. Latino Policy & Issues Brief. Number 13

ERIC Educational Resources Information Center

Yosso, Tara J.; Solorzano, Daniel G.

2006-01-01

Academic institutions facilitate the flow of knowledge, skills, and students through the educational pipeline. Yet, no matter how one measures educational outcomes, Chicana/os suffer the lowest educational attainment of any major racial or ethnic group in the United States. This brief calls for the repair of the serious and persistent leaks in the…

A Quantitative Evaluation of an Ability-Grouped Literacy Program in the Elementary Grades

ERIC Educational Resources Information Center

Portales Blair, Lidiana

2017-01-01

National assessments have shown that the majority of students in the United States cannot read at grade level by fourth grade. These results are alarming because students who are not proficient readers by third grade suffer long-term consequences and are more likely to drop out of high school. Feeling pressure to improve reading outcomes, schools…

Effectiveness of Universal School-Based Mental Health Awareness Programs among Youth in the United States: A Systematic Review

ERIC Educational Resources Information Center

Salerno, John P.

2016-01-01

Background: Stigmatizing attitudes toward mental illness and low mental health literacy have been identified as links to social adversity, and barriers to seeking and adhering to treatment among adolescents suffering from mental illness. Prior research has found that it is possible to improve these outcomes using school-based mental health…

Re-introducing fire at the urban/wild-land interface: planning for success

Treesearch

Steven R. Miller; Dale Wade

2003-01-01

The application of fire in the southern United States continues to increase in complexity due to urban sprawl, air quality issues and regulatory constraints. Many sites suffer from unnaturally high fuel accumulations due to decades of fire exclusion. The loss of habitat to urbanization and successional changes resulting from the absence of fire increases the importance...

3 CFR 8914 - Proclamation 8914 of December 6, 2012. National Pearl Harbor Remembrance Day, 2012

Code of Federal Regulations, 2013 CFR

2013-01-01

... solemn tribute to America's sons and daughters who made the ultimate sacrifice at Oahu. As we do, let us... the United States of America A Proclamation On December 7, 1941, our Nation suffered one of the most... our Nation through some of the 20th century's darkest moments. In his address to the Congress...

Financial Crisis Management in Higher Education: Responses by 20 Private Colleges and Universities to the 2007-2009 Financial Crisis

ERIC Educational Resources Information Center

Dorantes, Andrew R.; Low, Justin R.

2016-01-01

As a result of the Great Recession, higher education in the United States suffered from the most significant financial crisis since the Great Depression (Breneman 2008; Zumeta 2010). This crisis affected all institutions of higher education since it challenged three major revenue sources: net tuition income, endowment income, and gift income…

An Economic Evaluation Comparing Stroke Telemedicine to Conventional Stroke Medicine

ERIC Educational Resources Information Center

Budhram, Stanley Chandra

2011-01-01

Stroke is not only a serious medical problem, but it also poses an enormous economic burden on society. Stroke ranks the third as the leading cause of death in the United States behind heart disease and cancer. The survivors of stroke suffer from various degrees of long-term disability which create a severe financial burden on society. University…

Mental health symptoms in Iraqi refugees: posttraumatic stress disorder, anxiety, and depression.

PubMed

Jamil, Hikmet; Farrag, Mohamed; Hakim-Larson, Julie; Kafaji, Talib; Abdulkhaleq, Husam; Hammad, Adnan

2007-01-01

Refugees suffer from a higher rate of mental health symptoms than the general population since they have experienced extreme suffering and the accumulated effects of trauma. Because of the diversity of regions from which refugees originate, there is a need to understand some of the unique experiences that are specific to each sub-groups of immigrants. The purpose of the present study was to explore mental health symptoms in Iraqi refugee clients who immigrated to the United States after the Gulf War of the early 1990's. As part of a larger study, 116 adult Iraqi immigrants to the United States (46 male, 70 females) who were seeking mental health services completed measures of anxiety, depression, and posttraumatic stress disorder. As expected, the majority of refugees reported intense anxiety and depression, and many met the DSM IV criteria for posttraumatic stress disorder. Like refugees from other countries-of-origin, Iraqi refugees are in need of culturally sensitive assessment and mental health treatment. The results are discussed in light of the treatment needs of Iraqi refugee clients, their resilience and motivation for a better life, and the ways that health professionals can assist in optimizing their adjustment.

The absence of cruelty is not the presence of humanness: physicians and the death penalty in the United States.

PubMed

Zivot, Joel B

2012-12-03

The death penalty by lethal injection is a legal punishment in the United States. Sodium Thiopental, once used in the death penalty cocktail, is no longer available for use in the United States as a consequence of this association. Anesthesiologists possess knowledge of Sodium Thiopental and possible chemical alternatives. Further, lethal injection has the look and feel of a medical act thereby encouraging physician participation and comment. Concern has been raised that the death penalty by lethal injection, is cruel. Physicians are ethically directed to prevent cruelty within the doctor-patient relationship and ethically prohibited from participation in any component of the death penalty. The US Supreme Court ruled that the death penalty is not cruel per se and is not in conflict with the 8th amendment of the US constitution. If the death penalty is not cruel, it requires no further refinement. If, on the other hand, the death penalty is in fact cruel, physicians have no mandate outside of the doctor patient relationship to reduce cruelty. Any intervention in the name of cruelty reduction, in the setting of lethal injection, does not lead to a more humane form of punishment. If physicians contend that the death penalty can be botched, they wrongly direct that it can be improved. The death penalty cocktail, as a method to reduce suffering during execution, is an unverifiable claim. At best, anesthetics produce an outward appearance of calmness only and do not address suffering as a consequence of the anticipation of death on the part of the condemned.

The absence of cruelty is not the presence of humanness: physicians and the death penalty in the United States

PubMed Central

2012-01-01

The death penalty by lethal injection is a legal punishment in the United States. Sodium Thiopental, once used in the death penalty cocktail, is no longer available for use in the United States as a consequence of this association. Anesthesiologists possess knowledge of Sodium Thiopental and possible chemical alternatives. Further, lethal injection has the look and feel of a medical act thereby encouraging physician participation and comment. Concern has been raised that the death penalty by lethal injection, is cruel. Physicians are ethically directed to prevent cruelty within the doctor-patient relationship and ethically prohibited from participation in any component of the death penalty. The US Supreme Court ruled that the death penalty is not cruel per se and is not in conflict with the 8th amendment of the US constitution. If the death penalty is not cruel, it requires no further refinement. If, on the other hand, the death penalty is in fact cruel, physicians have no mandate outside of the doctor patient relationship to reduce cruelty. Any intervention in the name of cruelty reduction, in the setting of lethal injection, does not lead to a more humane form of punishment. If physicians contend that the death penalty can be botched, they wrongly direct that it can be improved. The death penalty cocktail, as a method to reduce suffering during execution, is an unverifiable claim. At best, anesthetics produce an outward appearance of calmness only and do not address suffering as a consequence of the anticipation of death on the part of the condemned. PMID:23199336

Ideologies of self, suffering, and gender nonconformity at work in a US gender identity clinic.

PubMed

van Eijk, Marieke

2014-01-01

Health care institutions are often severely criticized for regulating the lives of individuals who deviate from socially sanctioned norms. In teaching people where they fit in the conventional scheme of things, institutions often reproduce socially dominant ideologies of normality, health, and self. Drawing on ethnographic fieldwork conducted at a university-based gender identity clinic in the United States, I demonstrate that while some institutions adopt dominant cultural frameworks, others critically assess these. To understand the intricacies of the clinic's psychotherapeutic practices, I analyze the clinicians' constructions of health and suffering. Instead of viewing transgenderism as a psychiatric condition, these clinicians approach it as a normal human condition that is marginalized by society's heteronormative values. The analysis, attentive to the interaction among social context, institutional work, and psychotherapeutic ideologies, shows that while some institutions reproduce hegemonic cultural frameworks, others, in their attempts to alleviate people's suffering, do challenge dominant social norms.

Evaluation and Management of Diabetes Mellitus

PubMed Central

Nguyen, Quang; Nguyen, Loida; Felicetta, James

2008-01-01

Diabetes mellitus is a major public health problem with tremendous medical and economic burdens. It is the seventh leading cause of death and the number one cause of end-stage renal disease, adult blindness, impotence, and nontraumatic lower-limb amputation in the United States. People with diabetes are 2 to 4 times more likely to suffer from stroke or from cardiovascular disease, and are twice as likely to die compared with age-matched individuals without diabetes. Diabetes cost the United States around $174 billion in 2007, $58 billion of which was related to disability, work loss, and early mortality. Although there is currently no known cure for diabetes, much progress has been made over the past 2 decades to improve the diagnosis and management of diabetes. Evidence has shown that applying aggressive interventions early can prevent or delay progression to microvascular complications that increase the mortality rate in diabetes. The authors review the guidelines for optimal evaluation of diabetes mellitus and discuss the current and emerging therapeutic options available in the United States. PMID:25126259

The Therapeutic use of Radon: A Biomedical Treatment in Europe; An “Alternative” Remedy in the United States

PubMed Central

Erickson, Barbra E.

2007-01-01

There is a growing recognition in the United States and Europe that health care is driven to a significant extent by an emphasis on consumer choice and demand. As consumers, people regularly choose their own solutions for health promotion and maintenance, solutions which may or may not be sanctioned by mainstream medicine. Radioactive radon therapy exemplifies a non-sanctioned treatment eagerly sought by certain patients, but scorned or dismissed by many physicians. This is certainly the case in the United States, where well-publicized Environmental Protection Agency (EPA) warnings portray radon as a potential carcinogen. Between 1997 and 2001, I worked with a population of arthritis sufferers who expose themselves to radon gas in Montana radon health mines in order to alleviate their symptoms. In this paper I discuss the decision-making process involved in using radon, and compare the Montana radon health mine facilities with selected radon mines and spas in Europe. PMID:18648554

Health issues of Afghan refugees in California.

PubMed Central

Lipson, J G; Omidian, P A

1992-01-01

Since the 1979 Soviet invasion of Afghanistan, more than 6 million Afghan refugees have become the world's largest refugee population. Although refugees in Pakistan and Iran are now beginning to repatriate, continuing political turmoil in Afghanistan and children's acculturation and educational opportunities will keep many Afghans in the United States permanently. Although there are no accurate statistics, local resettlement agencies and Afghan community leaders estimate that there are 10,000 to 35,000 Afghans in northern California. They suffer from a variety of problems common to refugees: language, economic and occupational problems, and substantial challenges in psychological, family, social, and cultural adjustment to the United States. Although many Afghans are doing well, many others have depression, psychosomatic symptoms, and posttraumatic stress disorder. PMID:1413768

[Impact of rural or urban areas on disability after a stroke].

PubMed

Ortega-Barrio, M Ángeles; Herce-Martínez, M Begoña; Valiñas-Sieiro, Florita; Mariscal-Pérez, Natividad; López-Cunquero, M Ángeles; Cubo-Delgado, Esther

2013-01-01

To assess the residual disability in a sample of patients after suffering a first episode of a stroke and to compare the disability of those patients who live in rural areas with those living in urban areas. An observational, longitudinal study of a cohort of 89 patients from a Neurology Unit, affected by cerebrovascular accident. The following factors were assessed: sociodemographic and environmental factors, co-morbidity, functional status, disability, depression and anxiety, and quality of life. The different clinical and demographic variables were compared after admission to the unit, at hospital discharge, and 3 months afterwards. Regression analyses were also carried out in order to study the association between the clinical and sociodemographic factors, and post-stroke disability. Compared to their previous clinical state, after suffering a stroke patients showed a higher rate of co-morbidity (P<.0001), disability (P<.0001), depression (P=.002), and a poorer quality of life (P=.013). The difference between patients coming from rural and urban areas was not statistically significant in terms of disability, quality of life, anxiety, depression, or co-morbidity. The level of disability, depression and co-morbidity that patients showed after suffering a stroke was similar to the results obtained in other studies. As a novel feature, there were no differences between patients living in rural areas after suffering a stroke and those living in urban areas, as regards disability, depression, or co-morbidity. Copyright © 2013 Elsevier España, S.L. All rights reserved.

Korean Unification and United States Security Alternatives in Northeast Asia

DTIC Science & Technology

1993-06-01

subterfuge or the failure of the respective government to deal effectively with political, social, or economic crises as they develop . Such a collapse would...revolutionary power will suffer a fundamental defeat, and the American invaders will run more rampant, and have negative effects for the entire Far East.46 In...100 C. KOREA AND NORTHEAST ASIA IN THE GLOBAL CONTEXT ......... 102 VII. CONCLUSION

Early Rockets

NASA Image and Video Library

1957-10-04

The Army Ballistic Missile Agency incorporated the von Braun team in key positions with Dr. von Braun as a head of the Development Operations Division. On October 4, 1957, the Nation was shocked when the Russians launched Sputnik, the world's first artificial satellite. Two months later, the United States suffered disappointment when a Navy Vanguard rocket, with its satellite payload, failed to develop sufficient thrust and toppled over on the launch pad.

Relationship among Perceived Parental Trauma, Parental Attachment, and Sense of Coherence in Southeast Asian American College Students

ERIC Educational Resources Information Center

Han, Meekyung

2005-01-01

There are nearly 2 million Southeast Asians (SEAs) currently living in the United States. The overwhelming majority are refugees from the Southeast Asian wars and political turmoil in the latter half of the 20th century. While an abundance of literature has documented the significant war-related traumas that SEA refugees have suffered, very little…

Conservation of lynx in the United States: A systematic approach to closing critical knowledge gaps [Chapter 17

Treesearch

Keith B. Aubry; Leonard F. Ruggiero; John R. Squires; Kevin S. McKelvey; Gary M. Koehler; Steven W. Buskirk; Charles J. Krebs

2000-01-01

Large-scale ecological studies and assessments are often implemented only after the focus of study generates substantial social, political, or legal pressure to take action (e.g., Thomas et al. 1990; Ruggiero et al. 1991; FEMAT 1993). In such a funding environment, the coordinated planning of research may suffer as the pressure to produce results escalates. To avoid...

Employment of an Informal Educational Mathematical Facility to Lower Math Anxiety and Improve Teacher and Student Attitudes Towards Understanding Mathematics

ERIC Educational Resources Information Center

Adams, Vicki

2012-01-01

Students do not pursue careers in science, technology, engineering, or mathematics (STEM) because of a lack of ability, but rather a lack of positive experiences with mathematics. Research has concluded that attitudes in math directly influence success in mathematics. As many as 75% of high school graduates in the United States suffer from mild to…

United States Air Force Academy, Department of Chemistry Research: AY 1982-83.

DTIC Science & Technology

1984-03-01

9 𔃼 0 Several reactions have been run using grignard reagents but initial results have not been examined in enough detail to make com- ments at this...potential in aromatic nucleophilic substitution and are useful reagents for the preparation of unsymmetrically substituted biaryls and benzoic acids...aromatic monofluorinated compounds suffers several disadvantages. First, several of the conventional fluori- nating reagents are ineffective in

The President and the Chancellor: German-American Relations, The 2002-2003 Iraq Crisis, and the Role of Personality in Statecraft

DTIC Science & Technology

2008-06-01

no longer the country of Oktoberfest and steel, but the Berlin Love Parade and software. With more than 4 million unemployed and investment...Schröder’s assessment at that time was “that the United States responded in the only rational way to the psychic shock which they suffered from the wound of

Sputnik

NASA Technical Reports Server (NTRS)

1957-01-01

The Army Ballistic Missile Agency incorporated the von Braun team in key positions with Dr. von Braun as a head of the Development Operations Division. On October 4, 1957, the Nation was shocked when the Russians launched Sputnik, the world's first artificial satellite. Two months later, the United States suffered disappointment when a Navy Vanguard rocket, with its satellite payload, failed to develop sufficient thrust and toppled over on the launch pad.

Is There a Student "Disconnect?" First-Year Hybrid Class Teachers' Observations and Recommendations for Improving Student Engagement in Information Systems Classes

ERIC Educational Resources Information Center

Parris, Joan B.; Beaver, Jana P.; Nickels, David W.; Crabtree, John D.

2011-01-01

Research shows that during times of economic downturn in the United States, education funding suffers. One method that higher education administrators are choosing to ease the economic crunch is to offer hybrid classes that blend one regular face-to-face class meeting with online and outside class components. The challenge of managing large…

War and Sacrifice in the Post-9/11 Era. The Military-Civilian Gap

ERIC Educational Resources Information Center

Taylor, Paul; Morin, Rich; Parker, Kim; Cohn, D'Vera; Funk, Cary; Mokrzycki, Mike

2011-01-01

As the United States marks the 10th anniversary of the longest period of sustained warfare in its history, the overwhelming majority of veterans of the post-9/11 era are proud of their military service. At the same time, many report that they have had difficulties readjusting to civilian life, and have suffered from post-traumatic stress. While…

United States Military Posture for FY 1983.

DTIC Science & Technology

1983-01-01

ious - but perhaps manageable - problems in a world economy suffers from the excessive demands of de- without potential for major power confrontation...provide no net and lasting advantage, store confidence and consensus among its allies and 3 friends. Increased attention and resources are now gions...fense arrangements, and - paradoxically - problems past two decades, they have reason to doubt whether of alliance management that may divert

Population densities of northern Saw-whet Owls (Aegolius acadicus) in degraded boreal forests of the southern Appalachians

Treesearch

Timothy C. Milling; Matthew P. Rowe; Bennie L. Cockerel; Timothy A. Dellinger; Johnny B. Gailes; Christopher E. Hill

1997-01-01

A disjunct population of the Northern Saw-whet Owl (Aegolius acadicus) breeds in the montane spruce-fir forests of the southern Appalachian Mountains. These forests are listed as the second most endangered ecosystem in the United States, having suffered from logging and massive fir die-off from the exotic balsam woolly adelgid. We used audio...

Neonatal euthanasia is unsupportable: the Groningen protocol should be abandoned.

PubMed

Kon, Alexander A

2007-01-01

The growing support for voluntary active euthanasia (VAE) is evident in the recently approved Dutch Law on Termination of Life on Request. Indeed, the debate over legalized VAE has increased in European countries, the United States, and many other nations over the last several years. The proponents of VAE argue that when a patient judges that the burdens of living outweigh the benefits, euthanasia can be justified. If some adults suffer to such an extent that VAE is justified, then one may conclude that some children suffer to this extent as well. In an attempt to alleviate the suffering of extremely ill neonates, the University Medical Center Groningen developed a protocol for neonatal euthanasia. In this article, I first present the ethical justifications for VAE and discuss how these arguments relate to euthanizing ill neonates. I then argue that, even if one accepts the justification for VAE in adults, neonatal euthanasia cannot be supported, primarily because physicians and parents can never accurately assess the suffering of children. I argue that without the testament of the patient herself as to the nature and magnitude of her suffering, physicians can never accurately weigh the benefits and burdens of a child's life, and therefore any such system would condemn to death some children whose suffering is not unbearable. I conclude that because the primary duty of physicians is to never harm their patients, neonatal euthanasia cannot be supported.

Special Inspector General for Afghanistan Reconstruction Quarterly Report to the United States Congress

DTIC Science & Technology

2014-07-30

good alternatives. As the World Bank observes of Afghanistan, “Education levels are too low and the manufacturing sector too underdeveloped (in size...generally provided through loans at zero- percent interest rates. Source: SIGAR, Audit 14-16, Afghanistan’s Banking Sector : The Central Bank’s Capacity... banking and financial sector , which has not recovered from the 2010 Kabul Bank crisis, suffers from inadequate regulation and oversight

CD22: A Promising Target for Acute Lymphoblastic Leukemia Treatment | Center for Cancer Research

Cancer.gov

There are about 4,000 new cases of acute lymphoblastic leukemia (ALL) in the United States each year. Great improvements have been made in the treatment of ALL, but many patients suffer from side effects of standard therapy and continue to die of this disease. One of the most promising therapeutic strategies includes engineering T cells with a chimeric antigen receptor (CAR)

Bird-friendly recommendations for bottomland forests in the Carolinas: birds and people on common ground

Treesearch

Norman Brunswig; Sharon Richardson; Matthew Johnson; Brandon Heitkamp

2016-01-01

Bottomland hardwood forests have suffered tremendous losses in the United States. Yet they support some of the densest breeding populations of imperiled migratory song birds in the eastern US, providing nesting habitat for 49 species, 32 of which share some Conservation Status. Traditional management for bottomland hardwood forests in the southeast has tended to rely...

Medical Diplomacy in the United States Army: A Concept Whose Time Has Come

DTIC Science & Technology

2008-06-13

available in the US military personnel inventory when the need arose. “The AMEDD might consider developing a PROFIS-like system to identify TDA assigned...effectively, medical diplomacy can alleviate suffering, as well as provide stability, through economic development , and legitimacy to the supported...well as provide stability, through economic development , and legitimacy to the supported government. These actions collectively deny refuge to

Market Reactions to Publicly Announced Privacy and Security Breaches Suffered by Companies Listed on the United States Stock Exchanges: A Comparative Empirical Investigation

ERIC Educational Resources Information Center

Coronado, Adolfo S.

2012-01-01

Using a sample of security and privacy breaches the present research examines the comparative announcement impact between the two types of events. The first part of the dissertation analyzes the impact of publicly announced security and privacy breaches on abnormal stock returns, the change in firm risk, and abnormal trading volume are measured.…

United States-Canada Trade and Economic Relationship: Prospects and Challenges

DTIC Science & Technology

2009-05-13

capita income gap has proven worrisome to Canadian policymakers as it raises questions about Canadian productivity and competitiveness . In terms of...Canada suffers from productivity problems in other sectors of its economy, its automotive plants are among the most competitive in North America...the U.S. dollar in 2007-8. Another major competitive advantage is Canada’s national health system, which reportedly relieves Canadian automakers of

Impact of the great recession on the forest products industry in the western United States

Treesearch

Charles E. Keegan; Collin B. Sorenson; Todd A. Morgan; Jean M. Daniels; Steven W. Hayes

2012-01-01

Wood product prices and production fell dramatically in 2009 as a severe recession and massive decline in U.S. housing led to a global financial crisis. In 2009 and 2010, virtually every major western mill suffered curtailments and 30 large mills closed permanently. Sales value of wood and paper products in the West dropped from $49 billion in 2005 to $34 billion in...

JPRS Report, China.

DTIC Science & Technology

1991-03-19

drunk too much began to vomit, territory and pay an indemnity, the beaten ones having "I fuck your mother. Barf. Barf. I suffered three years for to...Trade Reform [FUJIAN LUNTANJINGJI SHEHJIBAN No I1] ..... 61 Increased Building Material Exports During Eighth 5- Year Plan [XINHUA...several years , there has been an excellent the United States and the Soviet Union is a major beginning made in the field of disarmament. This has

Paternalism and its discontents: motorcycle helmet laws, libertarian values, and public health.

PubMed

Jones, Marian Moser; Bayer, Ronald

2007-02-01

The history of motorcycle helmet legislation in the United States reflects the extent to which concerns about individual liberties have shaped the public health debate. Despite overwhelming epidemiological evidence that motorcycle helmet laws reduce fatalities and serious injuries, only 20 states currently require all riders to wear helmets. During the past 3 decades, federal government efforts to push states toward enactment of universal helmet laws have faltered, and motorcyclists' advocacy groups have been successful at repealing state helmet laws. This history raises questions about the possibilities for articulating an ethics of public health that would call upon government to protect citizens from their own choices that result in needless morbidity and suffering.

Paternalism & Its Discontents: Motorcycle Helmet Laws, Libertarian Values, and Public Health

PubMed Central

Jones, Marian Moser; Bayer, Ronald

2007-01-01

The history of motorcycle helmet legislation in the United States reflects the extent to which concerns about individual liberties have shaped the public health debate. Despite overwhelming epidemiological evidence that motorcycle helmet laws reduce fatalities and serious injuries, only 20 states currently require all riders to wear helmets. During the past 3 decades, federal government efforts to push states toward enactment of universal helmet laws have faltered, and motorcyclists’ advocacy groups have been successful at repealing state helmet laws. This history raises questions about the possibilities for articulating an ethics of public health that would call upon government to protect citizens from their own choices that result in needless morbidity and suffering. PMID:17194856

Using international emotional picture sets in countries suffering from violence.

PubMed

Okon-Singer, Hadas; Kofman, Ora; Tzelgov, Joseph; Henik, Avishai

2011-04-01

It is hypothesized that ratings of emotional stimuli are affected by a constant threat of traumatic events. Ratings of valence and arousal on the International Affective Picture System from young adults in the United States were compared to those of young Israeli adults. Israelis rated the pictures as less negative and less positive than did participants from the United States. Israeli women gave higher arousal ratings compared to the American women. These differences may be due to compulsory military service in Israel, during which exposure to traumatic events is more likely to occur, and to the timing of the study which followed a year of frequent suicide bomb attacks. The authors suggest that these findings may reflect mild symptoms of stress disorders. Copyright © 2011 International Society for Traumatic Stress Studies.

Qualification testing of solar photovoltaic powered refrigerator freezers for medical use in remote geographic locations

NASA Astrophysics Data System (ADS)

Kaszeta, W. J.

1982-12-01

One of the primary obstacles to the application of vaccination in developing countries is the lack of refrigerated storage. Vaccines exposed to elevated temperatures suffer a permanent loss of potency. Photovoltaic (PV) powered refrigerator/freezer (R/F) units could surmount the problem of refrigeration in remote areas where no reliable commercial power supply is available. The performance measurements of two different models of PV powered R/F units for medical use are presented. Qualification testing consisted of four major procedures: no-load pull down, ice making, steady-state (maintenance), and holdover. Both R/F units met the major World Health Organization (WHO) requirements. However, the testing performed does not provide complete characterization of the two units; such information could be derived only from further extensive test procedures.

Qualification testing of solar photovoltaic powered refrigerator freezers for medical use in remote geographic locations

NASA Technical Reports Server (NTRS)

Kaszeta, W. J.

1982-01-01

One of the primary obstacles to the application of vaccination in developing countries is the lack of refrigerated storage. Vaccines exposed to elevated temperatures suffer a permanent loss of potency. Photovoltaic (PV) powered refrigerator/freezer (R/F) units could surmount the problem of refrigeration in remote areas where no reliable commercial power supply is available. The performance measurements of two different models of PV powered R/F units for medical use are presented. Qualification testing consisted of four major procedures: no-load pull down, ice making, steady-state (maintenance), and holdover. Both R/F units met the major World Health Organization (WHO) requirements. However, the testing performed does not provide complete characterization of the two units; such information could be derived only from further extensive test procedures.

Substance use during pregnancy: time for policy to catch up with research

PubMed Central

Lester, Barry M; Andreozzi, Lynne; Appiah, Lindsey

2004-01-01

The phenomenon of substance abuse during pregnancy has fostered much controversy, specifically regarding treatment vs. punishment. Should the pregnant mother who engages in substance abuse be viewed as a criminal or as someone suffering from an illness requiring appropriate treatment? As it happens, there is a noticeably wide range of responses to this matter in the various states of the United States, ranging from a strictly criminal perspective to one that does emphasize the importance of the mother's treatment. This diversity of dramatically different responses illustrates the failure to establish a uniform policy for the management of this phenomenon. Just as there is lack of consensus among those who favor punishment, the same lack of consensus characterizes those states espousing treatment. Several general policy recommendations are offered here addressing the critical issues. It is hoped that by focusing on these fundamental issues and ultimately detailing statistics, policymakers throughout the United States will consider the course of action that views both pregnant mother and fetus/child as humanely as possible. PMID:15169566

Loneliness as a public health issue: the impact of loneliness on health care utilization among older adults.

PubMed

Gerst-Emerson, Kerstin; Jayawardhana, Jayani

2015-05-01

We aimed to determine whether loneliness is associated with higher health care utilization among older adults in the United States. We used panel data from the Health and Retirement Study (2008 and 2012) to examine the long-term impact of loneliness on health care use. The sample was limited to community-dwelling persons in the United States aged 60 years and older. We used negative binomial regression models to determine the impact of loneliness on physician visits and hospitalizations. Under 2 definitions of loneliness, we found that a sizable proportion of those aged 60 years and older in the United States reported loneliness. Regression results showed that chronic loneliness (those lonely both in 2008 and 4 years later) was significantly and positively associated with physician visits (β = 0.075, SE = 0.034). Loneliness was not significantly associated with hospitalizations. Loneliness is a significant public health concern among elders. In addition to easing a potential source of suffering, the identification and targeting of interventions for lonely elders may significantly decrease physician visits and health care costs.

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

Dickson, R.B.

Indoor air pollution (IAP) is ranked by the Environmental Protection Agency (EPA) among the top five environmental risks to human health. The World Health Organization estimates that nearly one in every six commercial buildings in the United States suffers from sick-building syndrome and that occupants of another one in twelve suffer from building-related illnesses. Indoor air quality (IAQ) problems cost American business $10 billion per year through lowered productivity, absenteeism, and medical costs. Yet despite the importance and high cost of IAQ problems, indoor air is not yet specifically addressed in any federal regulatory program. The reason probably is becausemore » indoor air is a quanitatively different environment in which traditional modes of regulation, based on pollutant-by pollutant risk assessments, are of limited utility. This paper covers the following topics: four factors influencing IAQ regulation; EPA regulation of indoor air; the role of the consumer product safety commission; OSHA and IAQ issues; state regulation and economic concerns; the pressure for legislation.« less

The United States Humanitarian Demining Program: Civil-Military Relations in Humanitarian Demining

DTIC Science & Technology

2015-05-23

human suffering. The result was ‘humanitarian demining’, a new term which involves the removal of emplaced mines and provides information and education ...determine whether to approve the request. If approved, the HDP would design a demining/land mine education program to meet the requesting nation’s needs.31...11 Secretary of Defense establish a program to educate , train, and advise other nations on the establishment of humanitarian demining programs

Geopolitics, Strategy and U.S. Interests. Revision.

DTIC Science & Technology

1986-03-01

first pub. 1942), p. vii. 2. Saul B. Cohen, Geography and Politics in a Divided World (London: Methuen, 1964), p. 24. 1 ’% LA brand of statecraft. This...essentially in a landlocked condition. Soviet power projection beyond Eurasia could be effected only on Western sufferance, given that the maritime...Weltpolitik is effectively checkable today by the United States and her allies, with their control of the critical "Rimland" geography * of Eurasia, just as

The Toughest Test: The Student Loan Liquidity Crisis of 2007-08 in Texas. A Report to the 81st Regular Session of the Texas Legislature

ERIC Educational Resources Information Center

Webster, Jeff; McQueen, Carla; Creusere, Marlena; Lukens, Leslie

2008-01-01

The credit market in the United States currently suffers from a rare and serious disruption. Once flowing with liquidity, the creativity and vibrancy of these markets helped fuel an economy that had been the envy of the world. Poor repayment performance in the subprime mortgage market has now reduced the availability of funds needed for other…

United States Air Force F-35A Operational Basing Environmental Impact Statement. Appendix E: Comments

DTIC Science & Technology

2013-09-01

such as final, technical, interim, memorandum, master’s thesis, progress, quarterly, research , special, group study, etc. 3. DATES COVERED...appear in the report, e.g. 001; AFAPL30480105. 6. AUTHOR(S). Enter name(s) of person(s) responsible for writing the report, performing the research ...negatively impacted by the noise] SAFTY ALL NEW military aircraft designs suffer crashes during their initial development peri~ Bringing the F-35

The Cultural Nature of Valued Skills: A Qualitative Investigation of Postsecondary Science Education and the "Skills Gap" in Wisconsin. WCER Working Paper No. 2016-06

ERIC Educational Resources Information Center

Benbow, Ross J.; Hora, Matthew T.

2016-01-01

The narrative of the "skills gap," or the notion that the United States economy suffers because employers are not able to find job applicants with workplace-ready skills (e.g., American Society for Training and Development 2012), has become an influential rallying cry in higher education funding circles in recent years. It is with these…

The Next Lightweight Fighter: Not Your Grandfather’s Combat Aircraft

DTIC Science & Technology

2013-08-01

devastat- ing Arabian quake in Somalia, which has almost no infrastructure and suffers from ongoing clan warfare. The United States deployed forces to...Kassim, which the quake had virtually leveled. A joint task force based in Djibouti stood up to direct the relief effort, exercising airborne com- mand...the earth prevent low-altitude or dis- tant aircraft from looking into “the next valley” directly. Consequently, many a reconnaissance mission or

JPRS Report, China

DTIC Science & Technology

1989-10-23

reason why China was successful in the "dump- ing" proceedings concerning Chinese menthol sold to the United States was, we may say, that the Chinese...presented actual material that successfully proved that the injury suffered by the U.S. industry was not at all due to the importation of Chinese menthol ...but was brought about by wrong assessments on the part of the U.S. firms on their menthol supply and demand situation and on the inter- national

A Tale of Two Health-Care Systems: Cost-Utility Analysis of Open Carpal Tunnel Release in Canada and the United States

PubMed Central

Kaur, Manraj N.; Tolliver, Tyson; Longo, Christopher J.; Naam, Nash H.; Thoma, Achilles

2017-01-01

Purpose: Canadian health care is often criticized for extended wait times, whereas the United States suffers from increased costs. The purpose of this pilot study was to determine the cost-utility of open carpal tunnel release in Canada versus the United States. Methods: A prospective cohort study evaluated patients undergoing open carpal tunnel release at an institution in Canada and the United States. All costs from a societal perspective were captured. Utility was measured using validated health-related quality of life (HRQOL) scales—the EuroQol-5D and the Michigan Hand Outcome Questionnaire. Results: Twenty-one patients at the Canadian site and 8 patients at the US site participated. Mean total costs were US $1581 ± $1965 and $2179 (range: $1421-$2741) at the Canadian and US sites, respectively. Health-related quality of life demonstrated significant improvements following surgery (P < .05). Patient utilities preoperatively and at 6 weeks and 3 months postoperatively were 0.72 ± 0.20, 0.86 ± 0.11, and 0.83 ± 0.16 at the Canadian site and 0.81 ± 0.09, 0.86 ± 0.10, and 0.86 ± 0.12 at the US site. Improvements in HRQOL directly related to surgery were not significantly different between patients in Canada and the United States. American patients, however, attained improved HRQOL sooner due to shorter wait times (27 ± 10 vs 214 ± 119 days; P < .001). The incremental cost-utility of the US system was $7758/quality-adjusted life year gained compared to the Canadian system. Sensitivity analyses confirmed that these results were robust. Conclusion: This pilot study suggests that carpal tunnel surgery is more cost-effective in the United States due to prolonged wait times in Canada. PMID:29026806

Healthcare: affordable quality coverage for all.

PubMed

Lee, Keat Jin

2009-06-01

The quality of medical care available in the United States is the best in the world. However, today's American healthcare delivery system is unacceptable. It is too expensive, disjointed, and wasteful. The amount spent on healthcare in the United States is sufficient to meet everyone's needs; the reason it does not is that the money is misspent. Healthcare makes up 16 percent of the gross domestic product, or $2.3 trillion, yet 46 million people are uninsured, the majority of people are underinsured, and even those with insurance suffer significant hassles in receiving healthcare. Medical errors occur at alarming rates. The lack of quality measures to define best practices leads to a wide variation of practices and costs. Fragmented healthcare leads to errors. The goal of this paper is to explore a set of 20 comprehensive steps to begin reform of healthcare in this country.

An Empirical Study of Chronic Diseases in the United States: A Visual Analytics Approach to Public Health

PubMed Central

Raghupathi, Wullianallur; Raghupathi, Viju

2018-01-01

In this research we explore the current state of chronic diseases in the United States, using data from the Centers for Disease Control and Prevention and applying visualization and descriptive analytics techniques. Five main categories of variables are studied, namely chronic disease conditions, behavioral health, mental health, demographics, and overarching conditions. These are analyzed in the context of regions and states within the U.S. to discover possible correlations between variables in several categories. There are widespread variations in the prevalence of diverse chronic diseases, the number of hospitalizations for specific diseases, and the diagnosis and mortality rates for different states. Identifying such correlations is fundamental to developing insights that will help in the creation of targeted management, mitigation, and preventive policies, ultimately minimizing the risks and costs of chronic diseases. As the population ages and individuals suffer from multiple conditions, or comorbidity, it is imperative that the various stakeholders, including the government, non-governmental organizations (NGOs), policy makers, health providers, and society as a whole, address these adverse effects in a timely and efficient manner. PMID:29494555

Welfare, law and ethics in the veterinary intensive care unit: (A discussion of the different types of suffering that patients may endure in the veterinary intensive care unit, the legal limits to that suffering, and the ethics underpinning at what point that suffering becomes 'un-necessary').

PubMed

Fordyce, Peter S

2017-03-01

In UK law, allowing an animal protected under the Animal Welfare Act 2006 (AWA 2006) (as devolved) to suffer 'unnecessarily' may render the person responsible for it to prosecution. The act does not define suffering, although 'case law' suggests that suffering encompasses more than pain. Clinicians responsible for animals under their care in the intensive care unit (ICU) are likely to also be responsible in law for the welfare of those animals, and may be called upon to justify why any suffering was necessary, or more likely, why they did not act to end any suffering when it became 'unnecessary'. As animals are considered to be 'property' in law, the legal requirement to prevent 'unnecessary suffering' may conflict with the owner's property rights. Additionally, professional conflict may arise between the clinicians whose opinion of where the border between 'heroic treatment' and 'futile treatment' lays. Different types of suffering that might be relevant to clinical and ethical decision making for patients in the ICU are discussed, with suggestions for how these might be categorised, measured and recorded, so that objective data is available on which discussions about the animal's actual and projected welfare can be held with the animal's owner, and other clinicians involved in the case. The development of 'welfare scoring systems' for the ICU may assist clarifying the point at which heroic treatment is becoming futile, and therefore suffering becoming unnecessary, and place veterinary anaesthetists in an even stronger position to act as 'advocate for the animal' in their care. Copyright © 2017 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.

Management of end-stage heart failure: a perspective on the Arab Gulf states

PubMed Central

Al Habeeb, Waleed; Stewart, Garrick C.; Mudge, Gilbert H.

2009-01-01

The ever expanding epidemic of end-stage heart failure represents one of the greatest challenges of modern cardiovascular medicine. With medical treatments hampered by significant limitations, physicians caring for patients with advanced heart disease have turned to cardiac transplantation and durable mechanical circulatory assist devices as definitive therapies. These advanced therapeutic modalities are not widely available outside the United States and Europe, but nevertheless offer enormous potential for patients in the Arab Gulf suffering from end-stage heart failure. This review will discuss the management of end-stage heart failure in the Gulf States, with an emphasis on therapies best utilized within a framework of regional cooperation and coordination. PMID:19847084

Resistance Begins with the First Foreign Footstep: China and Nicaragua

DTIC Science & Technology

2013-03-01

arose in León and Granada . The rebels in León rallied under a former Zelayista, Benjamin Zeledón, while a recently ousted leader of the 17...coalition, Luis Mena, led the forces in Granada . While the United States entered the conflict under the auspices of neutrality, its actions clearly...arriving in Granada , Butler discovered that Mena suffered from a debilitating disease and had lost the will to fight. In exchange for safe passage

Drug-induced iatrogenic intraparenchymal hemorrhage.

PubMed

Lapsiwala, Samir; Moftakhar, Roham; Badie, Behnam

2002-07-01

Intracerebral hemorrhage is bleeding into the brain parenchyma with possible extension into the ventricles and subarachnoid space. Each year, approximately 37,000 to 52,400 people suffer from intraparenchymal hemorrhage (IPH) in the United States. This rate is expected to rise dramatically in the next few decades as a result of the increasing age of the population and a change in racial demographics. IPH accounts for 8% to 13% of all stroke cases and is associated with the highest mortality rate.

Land Disputes Unearth Shaky Legal Foundation: Will Liberias Land Reform Provide Stability

DTIC Science & Technology

2014-04-01

United States by the Indian Reorganization Act of 1934 in communities that never contemplated formal tribal organization before, and as such, remains...example is the case of a Malaysian company, Sime Darby, and the Vai people of Grand Cape Mount. The people of Grand Cape Mount first suffered when BF...community land continues to occur in contemporary Liberia, and has resulted in years of litigation. One example involves community land owned by Chief Bah

Coastal sedimentary research examines critical issues of national and global priority

USGS Publications Warehouse

Fletcher, Chip; Anderson, John; Crook, Keith A.W.; Kaminsky, George; Larcombe, Piers; Murray-Wallace, Colin V.; Sansone, Frank; Scott, David B.; Riggs, Stan; Sallenger, Asbury; Shennan, Ian; Thieler, E. Robert; Wehmiller, John F.

2000-01-01

An international conference was held recently in Honolulu, Hawaii, to examine and plan for coastal sedimentary research in the United States and globally. Participants agreed that sedimentary coastal environments constitute a critical national and global resource that suffers widespread degradation due to human impacts. Moreover, human population growth and inappropriate development in the coastal zone are escalating public asset losses due to coastal hazards and placing large numbers of communities at growing risk (Figure 1).

CD22: A Promising Target for Acute Lymphoblastic Leukemia Treatment | Center for Cancer Research

Cancer.gov

There are about 4,000 new cases of acute lymphoblastic leukemia (ALL) in the United States each year. Great improvements have been made in the treatment of ALL, but many patients suffer from side effects of standard therapy and continue to die of this disease. One of the most promising therapeutic strategies includes engineering T cells with a chimeric antigen receptor (CAR) that alters T cell specificity and function to recognize tumor antigens.

Suffering, meaning, and bioethics.

PubMed

Engelhardt, H Tristram

1996-08-01

Suffering evokes moral and metaphysical reflection, the bioethics of suffering concerns the proper ethos of living with suffering. Because empirical and philosophical explorations of suffering are imprisoned in the world of immanent experience, they cannot reach to a transcendent meaning. Even if religious and other narratives concerning the meaning of suffering have no transcendent import, they can have aesthetic and moral significance. This understanding of narratives of suffering and of their custodians has substantial ecumenical implications: chaplains can function as general custodians of narratives and sustainers of a generic religious meaning. This understanding is contrary to traditional Christianity, which discloses a transcendent significance of human suffering found in a very particular history involving particular persons: Christ as the second Adam through the submission of the second Eve has taken on our nature so that we can be united with God. Human suffering is tied to human sin, not simply as a punishment for sin, much less as an opportunity to discharge a supposed temporal punishment due to sin. Human suffering is the result of our rebellious free choices. It provides an opportunity for humility and submission, so that, united to the cross of Christ, sin can be forgiven and suffering set aside in the Resurrection. Knowledge of this framing context for all human suffering is accessible not through rational argument. It is a knowledge garnered through repentance, purification of the heart, illumination by God's grace, and unification with God. Christian bioethics is embedded in the narrative of suffering, which is part of the history of salvation and which encompasses and places all of medicine in its terms.

Nurses' perspectives on the suffering of preterm infants.

PubMed

Korhonen, Anne; Haho, Annu; Pölkki, Tarja

2013-11-01

The concept of suffering is discussed among those who are cognitively aware and verbally capable to express their suffering. Due to immaturity, preterm infants' abilities to express suffering are limited. Relieving suffering is an ethical and juridical demand of good nursing care. The purpose of this study is to describe nurses' perceptions of the suffering of preterm infants. A descriptive qualitative approach was selected. Data were collected from essays written by nurses (n = 19) working in the neonatal intensive care unit. Inductive content analysis guided by the research question was performed. The nurses described individually determined suffering of the preterm infants according to four categories: suffering ruled by maturation, existence of suffering, individual threshold of suffering and interpreting the cues of suffering. Suffering of preterm infants is manifested by population-specific features, emphasising the need to develop sensitive interventions for relieving their suffering.

Limitations to the study of man in the United States space program

NASA Technical Reports Server (NTRS)

Bishop, Phillip A.; Greenisen, Mike

1992-01-01

Research on humans conducted during space flight is fraught both with great opportunities and great obstacles. The purpose of this paper is to review some of the limitations to United States research in space in the hope that an informed scientific community may lead to more rapid and efficient solution of these problems. Limitations arise because opportunities to study the same astronauts in well-controlled situations on repeated space flights are practically non-existent. Human research opportunities are further limited by the necessity of avoiding simultaneous mutually-interfereing experiments. Environmental factors including diet and other physiological perturbations concomitant with space flight also complicates research design and interpretation. Technical limitations to research methods and opportunities further restrict the development of the knowledge base. Finally, earth analogues of space travel all suffer from inadequacies. Though all of these obstacles will eventually be overcome; creativity, diligence, and persistence are required to further our knowledge of humans in space.

Hospital costs and specialization: benefits of limiting the number of product lines.

PubMed

Eastaugh, Steven R

2009-01-01

Trends in hospital specialization are studied using multiple regression analysis for the period 1999-2008. The observed 31.3 percent rise in specialization was associated with a 9.5 percent decline in unit cost per admission. The number of specialized hospitals has grown by 149 percent in the past decade. Other hospitals are getting more specialized by reducing their product lines. Specialization has been highest in competitive West Coast markets and lowest in the rate-regulated states (New York and Massachusetts). Hospitals have less incentive to contain costs by decreasing the array of services offered in stringent rate-setting states. The term "underspecialization" is advanced to capture the inability of some hospitals to selectively prune out product lines in order to specialize. Such hospitals spread resources so thin that many good departments suffer. Unit cost per case (DRG-adjusted) is higher in the less specialized hospitals.

Loneliness as a Public Health Issue: The Impact of Loneliness on Health Care Utilization Among Older Adults

PubMed Central

Jayawardhana, Jayani

2015-01-01

Objectives. We aimed to determine whether loneliness is associated with higher health care utilization among older adults in the United States. Methods. We used panel data from the Health and Retirement Study (2008 and 2012) to examine the long-term impact of loneliness on health care use. The sample was limited to community-dwelling persons in the United States aged 60 years and older. We used negative binomial regression models to determine the impact of loneliness on physician visits and hospitalizations. Results. Under 2 definitions of loneliness, we found that a sizable proportion of those aged 60 years and older in the United States reported loneliness. Regression results showed that chronic loneliness (those lonely both in 2008 and 4 years later) was significantly and positively associated with physician visits (β = 0.075, SE = 0.034). Loneliness was not significantly associated with hospitalizations. Conclusions. Loneliness is a significant public health concern among elders. In addition to easing a potential source of suffering, the identification and targeting of interventions for lonely elders may significantly decrease physician visits and health care costs. PMID:25790413

Female cluster headache in the United States of America: what are the gender differences? Results from the United States Cluster Headache Survey.

PubMed

Rozen, Todd D; Fishman, Royce S

2012-06-15

To present results from the United States Cluster Headache Survey regarding gender differences in cluster headache demographics, clinical characteristics, diagnostic delay, triggers, treatment response and personal burden. Very few studies have looked at the gender differences in cluster headache presentation. The United States Cluster Headache Survey is the largest study of cluster headache sufferers ever completed in the United States and it is also the largest study of female cluster headache patients ever presented. The total survey consisted of 187 multiple choice questions which dealt with various issues related to cluster headache including: demographics, clinical characteristics, concomitant medical conditions, family history, triggers, smoking history, diagnosis, treatment response and personal burden. A group of questions were specifically targeted to female cluster headache patients. The survey was placed on a website from October to December 2008. For all survey responders the diagnosis of cluster headache needed to be made by a neurologist but there was no validation of the headache diagnosis by the authors. 1134 individuals completed the survey (816 male, 318 female). Key Points that define the differences between female and male cluster headache include: a. Age of onset: women develop cluster headache at an earlier age than men and are more likely to develop a second peak of cluster headache onset after 50 years of age. b. Family history: woman cluster headache sufferers are more likely to have a family history of both cluster headache and migraine and have an increased familial risk of Parkinson's disease. c. Comorbid conditions: female cluster headaches sufferers are significantly more likely to experience depression and have asthma than males. d. Aura issues: aura with cluster headache is equally common in both sexes, but aura duration is shorter in women. Women are much more likely to experience sensory, language and brainstem auras. e. Pain location: cluster headache pain is typically retro-orbital in location in both sexes but women are significantly more likely to experience cluster headache pain in the jaw, cheek and ear than men. f. Associated symptoms: women with cluster headache develop more “migrainous” associated symptoms than men, especially nausea and they are also more likely to have self-injurious behavior than men. g. Triggers: women with cluster headache are much less likely to have alcohol trigger a headache, but are significantly more likely to have “migrainous” triggers for their cluster headaches than men. h. Smoking issues: women are much less likely to have a smoking history than male cluster headache sufferers, more likely to have never smoked prior to cluster headache onset. i. Cycle issues: spring and fall are the most common time to start a cluster headache cycle in both sexes. Women are statistically significantly less likely to start a cluster headache cycle in the months of October–December than men. Women have more attacks per day and higher pain intensity nighttime attacks than men. j. in regard to acute treatment women statistically were less response to sumatriptan injectable and nasal spray than men, but statistically more likely to respond to inhaled lidocaine. There was equal efficacy in the sexes to inhaled oxygen but slower response in women. For preventive treatment no significant gender differences were noted, but overall women were less responsive to almost all preventives than men. k. Diagnostic delay: there remains a significant diagnostic delay for cluster headache patients in both sexes but women were more likely to be diagnosed after 10 years of symptom onset than males and significantly fewer women were diagnosed correctly at an initial physician visit than men. l. Female specific issues: cluster headache does not appear to be influenced by menses or menopause but 50% of the survey responders stated their headaches improved with pregnancy. Cluster headache does not appear to alter fertility rates in female cluster headache sufferers. m. Personal burden: cluster headache causes significantly more personal burden in women than men with more loss of employment and/or need of disability, as well as more homebound days. Overall women and men with cluster headache have a similar presentation but there are some distinct differences that have been suggested in smaller studies of female cluster headache that we have now verified, while some of our study conclusions have not been shown previously. One major limitation to the study is a lack of validation of diagnosis. A substantial false positive cluster headache diagnosis rate, especially in females, cannot be excluded by the study methods utilized. Copyright © 2012 Elsevier B.V. All rights reserved.

2012 National Strategy for Suicide Prevention: Goals and Objectives for Action. A Report of the U.S. Surgeon General and of the National Action Alliance for Suicide Prevention

ERIC Educational Resources Information Center

Substance Abuse and Mental Health Services Administration, 2012

2012-01-01

Suicide is a serious public health problem that causes immeasurable pain, suffering, and loss to individuals, families, and communities nationwide. Many people may be surprised to learn that suicide was one of the top 10 causes of death in the United States in 2009. And death is only the tip of the iceberg. For every person who dies by suicide,…

Aiding the Eye, Watching the Brain: James Weiland, IEEE Fellow, explores the unique challenges of retinal prostheses.

PubMed

Grifantini, Kristina

2017-01-01

The retina is a sophisticated neural network that provides humans with high-resolution vision. And for those who suffer from retinal disease or deterioration, particularly age-related macular degeneration (the leading cause of blindness among people over the age of 50 in the United States), a better understanding of how to stimulate the retina or completely override its path to the area of the brain that processes vision may offer hope to restore sight.

Stroke and the american presidency.

PubMed

Meschia, J; Safirstein, B E; Biller, J

1997-01-01

Eight past presidents of the United States have suffered at least one stroke: John Quincy Adams, John Tyler, Millard Fillmore, Andrew Johnson, Chester Arthur, Woodrow Wilson, Franklin Delano Roosevelt, and Richard Milhous Nixon. Survival from time of last stroke was greater than one month in only President John Tyler. Nixon represents the first president to be on scientifically validated prophylaxis (warfarin). He was also the first president to be considered for a controlled therapeutic trial in acute stroke and the first to have had an advanced directive regarding terminal care.

Hostile Outsider or Influential Insider? The United States and the International Criminal Court

DTIC Science & Technology

2007-03-28

World War II ushered in both the Nazi menace, with its Holocaust and countless similar atrocities,9 and the Japanese Imperial Army, complete with...policies of Nazi Germany became known to the public, called it “a crime with no name.” Alain Destexhe, Rwanda and Genocide in the Twentieth Century...suffered were Jews condemned to inhuman treatment and death simply because of their race. The Nazis had made special efforts to wipe out those they

Impact of double counting and transfer bias on estimated rates and outcomes of acute myocardial infarction.

PubMed

Westfall, J M; McGloin, J

2001-05-01

Ischemic heart disease is the leading cause of death in the United States. Recent studies report inconsistent findings on the changes in the incidence of hospitalizations for ischemic heart disease. These reports have relied primarily on hospital discharge data. Preliminary data suggest that a significant percentage of patients suffering acute myocardial infarction (MI) in rural communities are transferred to urban centers for care. Patients transferred to a second hospital may be counted twice for one episode of ischemic heart disease. To describe the impact of double counting and transfer bias on the estimation of incidence rates and outcomes of ischemic heart disease, specifically acute MI, in the United States. Analysis of state hospital discharge data from Kansas, Colorado (State Inpatient Database [SID]), Nebraska, Arizona, New Jersey, Michigan, Pennsylvania, and Illinois (SID) for the years 1995 to 1997. A matching algorithm was developed for hospital discharges to determine patients counted twice for one episode of ischemic heart disease. Validation of our matching algorithm. Patients reported to have suffered ischemic heart disease (ICD9 codes 410-414, 786.5). Number of patients counted twice for one episode of acute MI. It is estimated that double count rates range from 10% to 15% for all states and increased over the 3 years. Moderate sized rural counties had the highest estimated double count rates at 15% to 20% with a few counties having estimated double count rates a high as 35% to 50%. Older patients and females were less likely to be double counted (P <0.05). Double counting patients has resulted in a significant overestimation in the incidence rate for hospitalization for acute MI. Correction of this double counting reveals a significantly lower incidence rate and a higher in-hospital mortality rate for acute MI. Transferred patients differ significantly from nontransferred patients, introducing significant bias into MI outcome studies. Double counting and transfer bias should be considered when conducting and interpreting research on ischemic heart disease, particularly in rural regions.

To understand and alleviate suffering in a caring culture.

PubMed

Lindholm, L; Eriksson, K

1993-09-01

The purpose of this study is to help understand what suffering is, i.e. how patients and nurses describe suffering, and how suffering can be alleviated. The study has a descriptive-explorative design and its approach is phenomenological-hermeneutical. The informant (research group) are 11 nurses (nurses, doctors, hospital theologians) and five patients in a social-psychiatric nursing unit, based on Christian ideology. The results of the study show that the 'what' of suffering is unclear. The nurses tend to describe more the 'why' of suffering, i.e. the reason for suffering. The what of suffering is pain, fear, despair, lack of strength. It is a form of lack of freedom and non-motion. It is a struggle between wanting and knowing, between guilt and responsibility. The form of suffering tends to mould the caring relation. To be touched in some way by another in a meeting can alleviate the deepest suffering. Compassion will always alleviate suffering.

Distribution and abundance of snowy plovers in eastern North America, the Caribbean, and the Bahamas

USGS Publications Warehouse

Gorman, Leah; Haig, Susan M.

2002-01-01

Snowy Plovers (Charadrius alexandrinus) are small, partially migrant shorebirds that are broadly distributed across North America. Snowy Plover distribution west of the Rocky Mountains has been well described. However, distribution and abundance east of the Rocky Mountains has not received much attention despite current status and ESA listing concerns for Snowy Plovers in the southeastern United States and the Caribbean. Thus, a first step in developing a monitoring program for Snowy Plovers is to understand the species' distribution. We summarize information on distribution and abundance of Snowy Plovers in the eastern United States, Caribbean, and Bahamas. Breeding and winter distribution maps for the continental United States were generated from a database of 3563 records from 388 sites in continental North America constructed from International Shorebird Survey (ISS), Christmas Bird Count (CBC), unpublished field data, and published accounts. Comparison of maximum counts per site (1980–present) indicated the number of breeding Snowy Plovers was greatest in Kansas and Oklahoma, while the greatest number of wintering birds occurred in the Laguna Madre of Texas and Mexico. Snowy Plovers concentrate at sites in Oklahoma and Texas during migration, with higher concentrations on the upper Texas coast in spring compared to fall migration. Data regarding historic abundance and trends are limited but suggest that Snowy Plovers in the eastern United States may have experienced regional population declines and may have suffered a range contraction in Texas. Serious concerns about the conservation status of Snowy Plovers in the eastern United States, the Caribbean, and the Bahamas indicate an immediate need for systematic surveys and up-to-date population estimates.

Woodrow Wilson's hidden stroke of 1919: the impact of patient-physician confidentiality on United States foreign policy.

PubMed

Menger, Richard P; Storey, Christopher M; Guthikonda, Bharat; Missios, Symeon; Nanda, Anil; Cooper, John M

2015-07-01

World War I catapulted the United States from traditional isolationism to international involvement in a major European conflict. Woodrow Wilson envisaged a permanent American imprint on democracy in world affairs through participation in the League of Nations. Amid these defining events, Wilson suffered a major ischemic stroke on October 2, 1919, which left him incapacitated. What was probably his fourth and most devastating stroke was diagnosed and treated by his friend and personal physician, Admiral Cary Grayson. Grayson, who had tremendous personal and professional loyalty to Wilson, kept the severity of the stroke hidden from Congress, the American people, and even the president himself. During a cabinet briefing, Grayson formally refused to sign a document of disability and was reluctant to address the subject of presidential succession. Wilson was essentially incapacitated and hemiplegic, yet he remained an active president and all messages were relayed directly through his wife, Edith. Patient-physician confidentiality superseded national security amid the backdrop of friendship and political power on the eve of a pivotal juncture in the history of American foreign policy. It was in part because of the absence of Woodrow Wilson's vocal and unwavering support that the United States did not join the League of Nations and distanced itself from the international stage. The League of Nations would later prove powerless without American support and was unable to thwart the rise and advance of Adolf Hitler. Only after World War II did the United States assume its global leadership role and realize Wilson's visionary, yet contentious, groundwork for a Pax Americana. The authors describe Woodrow Wilson's stroke, the historical implications of his health decline, and its impact on United States foreign policy.

Welcome to the wild west: protecting access to cross border fertility care in the United States.

PubMed

Mutcherson, Kimberley M

2012-01-01

As has been the case with other types of medical tourism, the phenomenon of cross border fertility care ("CBFC") has sparked concern about the lack of global or even national harmonization in the regulation of the fertility industry. The diversity of laws around the globe leads would-be parents to forum shop for a welcoming place to make babies. Focusing specifically on the phenomenon of travel to the United States, this Article takes up the question of whether there should be any legal barriers to those who come to the United States seeking CBFC. In part, CBFC suffers from the same general concerns raised about the use of fertility treatment in general, but it is possible to imagine a subset of arguments that would lead to forbidding or at least discouraging people from coming to the United States for CBFC, either as a matter of law or policy. This paper stands in opposition to any such effort and contemplates the moral and ethical concerns about CBFC and how, and if, those concerns warrant expression in law. Part I describes the conditions that lead some couples and individuals to leave their home countries to access fertility treatments abroad and details why the United States, with its comparatively liberal regulation of ART, has become a popular CBFC destination for travelers from around the world. Part II offers and refutes arguments supporting greater domestic control over those who seek to satisfy their desires for CBFC in the United States by reasserting the importance of the right of procreation while also noting appropriate concerns about justice and equality in the market for babies. Part III continues the exploration of justice by investigating the question of international cooperation in legislating against perceived wrongs. This Part concludes that consistent legislation across borders is appropriate where there is consensus about the wrong of an act, but it is unnecessary and inappropriate where there remain cultural conflicts about certain practices—in this case assisted reproduction.

Response of parents to learning that their child is homosexual and concern over AIDS: a national study.

PubMed

Robinson, B E; Walters, L H; Skeen, P

1989-01-01

This study was a survey of 402 parents of gay and lesbian children from the northeastern, southern, midwestern, and western regions of the United States. Of particular interest was parental response to the knowledge of their child's homosexuality and the AIDS outbreak. Although parents suffered emotional upset upon learning of their children's homosexuality, many progressed through a five-stage grief process that ended with acceptance. Fear of the spread of AIDS, that their offspring might contract AIDS, or that their child might suffer from the backlash related to AIDS were concerns for most parents. Attitudes toward AIDS were not very different between mothers and fathers. However, older parents were more likely to have more positive attitudes toward AIDS than younger parents, and liberal parents were more likely to have a more positive outlook than their conservative counterparts.

"It's as bad as anything can be": Patients, identity, and the influenza pandemic.

PubMed

Bristow, Nancy K

2010-04-01

Americans were stunned when pandemic influenza hit the United States in 1918. Recent advances in bacteriology and public health allowed Americans to imagine a future free of infectious disease, even as their familiarity with influenza tempered their fears of it. They soon realized this influenza was something unprecedented, as it shocked them with its pace, virulence, mortality patterns, and symptoms. Patients endured and frequently succumbed to a miserable illness, their suffering often made worse by the chaotic circumstances the epidemic produced in families and communities and shaped in significant and sometimes discriminatory ways by their gender, class, and race. While the nation's public culture soon forgot the epidemic, it lived on in lives changed irrevocably by its consequences. As they face present and future influenza pandemics, Americans can learn from this earlier experience, guarding against identity-based discrimination and acknowledging and remembering the grief and loss fellow citizens suffered.

Mechanical and Thermal Properties of Dental Composites Cured with CAD/CAM Assisted Solid-State Laser

PubMed Central

De Santis, Roberto; Gloria, Antonio; Maietta, Saverio; Martorelli, Massimo; De Luca, Alessandro; Spagnuolo, Gianrico; Riccitiello, Francesco; Rengo, Sandro

2018-01-01

Over the last three decades, it has been frequently reported that the properties of dental restorative composites cured with argon laser are similar or superior to those achieved with conventional halogen and light emitting diode (LED) curing units. Whereas laser curing is not dependent on the distance between the curing unit and the material, such distance represents a drawback for conventional curing units. However, a widespread clinical application of this kind of laser remains difficult due to cost, heavy weight, and bulky size. Recently, with regard to the radiation in the blue region of the spectrum, powerful solid-state lasers have been commercialized. In the current research, CAD (computer-aided design)/CAM (computer-aided manufacturing) assisted solid-state lasers were employed for curing of different dental restorative composites consisting of micro- and nanoparticle-reinforced materials based on acrylic resins. Commercial LED curing units were used as a control. Temperature rise during the photopolymerisation process and bending properties were measured. By providing similar light energy dose, no significant difference in temperature rise was observed when the two light sources provided similar intensity. In addition, after 7 days since curing, bending properties of composites cured with laser and LED were similar. The results suggested that this kind of laser would be suitable for curing dental composites, and the curing process does not suffer from the tip-to-tooth distance. PMID:29584683

[The primiparae couple's experience of childbirth: quantitative study].

PubMed

Moreau, A; Kopff-Landas, A; Séjourné, N; Chabrol, H

2009-03-01

The aim of this research was to study childbirth experience for the primiparae couple and their emotional state in early post-partum. Thirty-three couples were interviewed 2 days after the birth. A questionnaire on childbirth experience and the EPDS were carried out. According to the results, mothers feel less satisfied, less calm, more useful and suffer more than fathers. Moreover, they consider father's participation more active and more supportive than themselves assess it. Experience of childbirth is linked with parent's emotional state in early postpartum. These results stress the importance to take into account the woman, the men and the couple as three separate and singular units and to create space for dialogue before and after childbirth.

Low-loss and broadband anomalous Floquet topological insulator for airborne sound

NASA Astrophysics Data System (ADS)

Peng, Yu-Gui; Shen, Ya-Xi; Zhao, De-Gang; Zhu, Xue-Feng

2017-04-01

Anomalous Floquet topological insulators (AFIs) for airborne sound have recently been realized in experiments. However, the implemented version suffers from significant loss and narrowband due to thermal viscosity and dispersive coupling strength between unit-cells. Here, we propose a solution for realizing low-loss and broadband acoustic AFI. We show that the loss after passing through one unit-cell can be less than 2% for the topological edge states. It is also theoretically unveiled that in the frequency range of nearly unitary coupling (˜0.97 from 4.8 kHz to 7.0 kHz in our case), around 84% corresponds to topological bands. Our proposal may promote the application of large-dimension acoustic topological devices.

An overview of medical malpractice litigation and the perceived crisis.

PubMed

Litvin, S Gerald

2005-04-01

In this overview of medical malpractice litigation in the United States, practical and philosophic aspects of the so-called malpractice litigation crisis are addressed. After reviewing the historical, legal rationale for compensating victims of negligent conduct by others, attention is focused on the plight of physicians who are charged with medical negligence and the oppressive insurance premiums that impose a heavy burden on all health care providers, particularly those in the surgical fields. A variety of political solutions advanced to "correct" the problem is reviewed. A historical prospective of malpractice litigation in the United States is presented together with an analysis of various legislative proposals--many of which have already been enacted in various states that will ostensibly "cure" the problems that concern clinicians. Consideration of the various legislative proposals includes: arbitrary limits on pain and suffering awards (caps); elimination of joint and several liability; regulation of attorneys fees; elimination of the collateral source rule; abrogation of punitive damages; proposals for periodic payments; and statutes of repose. Various procedural changes in the processing of malpractice claims are reviewed and analyzed from the perspective of both fairness and efficacy.

Anticholinergic Toxicity Secondary to Overuse of Topricin Cream, a Homeopathic Medication

PubMed Central

Regina, Angela; Jesin, Raphael C; Deeb, Liliane; Steinberg, Eric; Majlesi, Nima

2018-01-01

Adverse reactions from over-the-counter medications present a challenge to physicians. Homeopathic medicine is an alternative practice, originating in Germany and gaining popularity in the United States. It utilizes dilute preparations of substances in order to treat and cure disease. Patients may potentially suffer serious effects from the use of these products as the contents and concentrations are often unclear. Here, we describe a case of suspected atropine toxicity due to the overuse of a topical homeopathic cream, Topricin, which contains belladonna, a plant containing atropine. PMID:29736357

Liberty and Security in a Changing World: Report and Recommendations of The President’s Review Group on Intelligence and Communications Technologies

DTIC Science & Technology

2013-12-12

self-government and economic growth. The United States Government should reaffirm the 2011 International Strategy for Cyberspace. It should stress ...intimidated, or cowed by government officials. If they are, it is “We the People” who will suffer. Part of the responsibility of our free press is...noted that if a similar or worse incident or series of attacks were to occur in the future, many Americans, in the fear and heat of the moment

Update on obstructive sleep apnea and its relation to COPD

PubMed Central

Mieczkowski, Brian; Ezzie, Michael E

2014-01-01

Chronic obstructive pulmonary disease (COPD) is a common and preventable lung disease that affects millions of people in the United States. Sleep disorders including obstructive sleep apnea (OSA) are also common. It is not surprising that many people with COPD also suffer from OSA. This relationship, however, puts people at risk for more nocturnal desaturations and potential complications related to this, including pulmonary hypertension and heart rhythm disturbances. This update focuses on the physiology of sleep disturbances in COPD as well as the clinical implications of OSA in COPD. PMID:24748786

Dr Amos G Babcock - fact or fiction?

PubMed

Smith, Douglas

2014-11-01

The War of 1812-14 between the United States of America and Great Britain gave rise to several journals relating the sufferings of prisoners of war confined in prison ships and gaols in England. One of these is A Journal of a Young Man from Massachusetts, said to have been written by Dr Amos G Babcock, an American ship's surgeon, and first published in 1816. This article sets out arguments for and against the truth of this assertion. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Korean atomic bomb victims.

PubMed

Sasamoto, Yukuo

2009-01-01

After colonizing Korea, Japan invaded China, and subsequently initiated the Pacific War against the United States, Britain, and their allies. Towards the end of the war, U.S. warplanes dropped atomic bombs on Hiroshima and Nagasaki, which resulted in a large number of Koreans who lived in Hiroshima and Nagasaki suffering from the effects of the bombs. The objective of this paper is to examine the history of Korea atomic bomb victims who were caught in between the U.S., Japan, the Republic of Korea (South Korea) and the Democratic People's Republic of Korea (North Korea).

Mercy Killings in Combat: Ending the Suffering of Gravely Wounded Combatants -- A Brief History, Applicable Law, Recent Prosecutions, and Proposals for Much Needed Change

DTIC Science & Technology

2006-04-01

Recent combat-related mercy killings 10 D. Roadmap for change 10 II. Survey of the history of combat-related mercy killings 14 A. General reports of...part of armed conflict for thousands of years ,4 and since the United States is currently engaged in multiple military operations that require long...Defense Authorization Request for Fiscal Year 2007 and the Future Years Defense Program: Hearing Before the S. Comm. on Armed Svcs., 109th Cong., 2d Sess

Construct Validity and Reliability of the Beliefs Toward Mental Illness Scale for American, Japanese, and Korean Women.

PubMed

Saint Arnault, Denise M; Gang, Moonhee; Woo, Seoyoon

2017-11-01

The aim of this study was to evaluate the psychometric properties of the Beliefs Toward Mental Illness Scale (BMI) across women from the United States, Japan, and South Korea. A cross-sectional study design was employed. The sample was 564 women aged 21-64 years old who were recruited in the United States and Korea (American = 127, Japanese immigrants in the United States = 204, and Korean = 233). We carried out item analysis, construct validity by confirmatory factor analysis (CFA), and internal consistency using SPSS Version 22 and AMOS Version 22. An acceptable model fit for a 20-item BMI (Beliefs Toward Mental Illness Scale-Revised [BMI-R]) with 3 factors was confirmed using CFA. Construct validity of the BMI-R showed to be all acceptable; convergent validity (average variance extracted [AVE] ≥0.5, construct reliability [CR] ≥0.7) and discriminant validity (r = .65-.89, AVE >.79). The Cronbach's alpha of the BMI-R was .92. These results showed that the BMI was a reliable tool to study beliefs about mental illness across cultures. Our findings also suggested that continued efforts to reduce stigma in culturally specific contexts within and between countries are necessary to promote help-seeking for those suffering from psychological distress.

JPRS Report, Soviet Union, Foreign Military Review, No. 2, February 1987

DTIC Science & Technology

1987-09-15

Losses to the U. S. population may reach 35 million people. The authors note that in the event that U. S. strategic nuclear forces are used...reserves created to carry out offensive operation (Khyber) (begun at the end of February 1984«), and suffering substantial losses (approximately 20,000...The two sides restored the combat effectiveness of their large units and units, which had suffered heavy losses , and prepared for new battles. The

In praise of anesthesia: Two case studies of pain and suffering during major surgical procedures with and without anesthesia in the United States Civil War-1861-65.

PubMed

Albin, Maurice S

2017-12-29

Background The United States Civil War (1861-1865) pitted the more populous industrialized North (Union) against the mainly agricultural slaveholding South (Confederacy). This conflict cost an enormous number of lives, with recent estimates mentioning a total mortality greater than 700,000 combatants [1]. Although sulfuric ether (ETH) and chloroform (CHL) were available since Morton's use of the former in 1846 and the employment of the latter in 1847, and even though inhalational agents were used in Crimean war (1853-1856) and the Mexican-American War (1846-1848), the United States Civil War gave military surgeons on both sides the opportunity to experience the use of these two agents because of the large number of casualties. Methods Research of historic archives illustrates the dramatic control of surgical pain made possible with introduction of two general anesthetic and analgesic drugs in 1846 and 1847. Results An appreciation of the importance of anesthesia during surgical procedures can be noted in the poignant and at times hair raising cases of two left arm amputations carried out under appalling circumstances during the United States Civil War. In the first-case the amputation was delayed for nearly five days after the wounding of Private Winchell who served in an elite sharpshooter brigade and was captured by the Confederate Army during battle. The amputation was performed without anesthesia and the voice of the Private himself narrates his dreadful experience. The postoperative course was incredible as he received no analgesia and survived a delirious comatose state lying on the ground in the intense summer heat. Thomas Jonathan "Stonewall" Jackson was a famous ascetic Confederate General who helped defeat the Union forces at the Battle of Chancellorsville on May 2, 1863. In the ensuing near-darkness, Jackson was fired upon by his own friendly troops where he suffered multiple gunshot wounds on his right hand as well as a ball in the upper humerus of the left arm similar to that of Private Winchell. Transported to a field hospital about thirty miles away, the evacuation was carried out under artillery fire and the General dropped from the stretcher at least twice before arriving at the field hospital. There, a team of surgeons operated on "Stonewall", using open drop chloroform, the surgery taking 50 min, anesthesia times of one hour with General Jackson awake and speaking with clarity shortly after the termination of the anesthesia. A brief explanation of the use of anesthetics in the military environment during the Crimean, Mexican American and the United States Civil War is also presented. Conclusion and implications Two case stories illustrate the profound improvement in surgical pain made possible with ether and chloroform only 160 years ago. Surgeons and patients nowadays have no ideas what these most important improvements in modern medicine means, unless "reliving" the true hell of pain surgery was before ether and chloroform.

Morphological, Cultural, Biochemical, and Serological Comparison of Japanese Strains of Vibrio parahemolyticus with Related Cultures Isolated in the United States

PubMed Central

Twedt, Robert M.; Spaulding, Procter L.; Hall, Herbert E.

1969-01-01

Morphological, cultural, biochemical, and serological characteristics of 79 strains of Vibrio parahemolyticus isolated from patients suffering from gastroenteric disease in Japan were compared with 17 suspected V. parahemolyticus cultures isolated from wound infections and 14 nonpathogenic vibrios isolated from an estuarine environment in the United States. These groups were differentiated on the basis of several key reactions which included: the range of growth temperature and salt tolerance; the production of catalase and acetoin; the hydrolysis of starch; the fermentation and utilization as single carbon source of sucrose, cellobiose, and arabinose; and the ability to swarm on 1% agar. The separation of the groups on the basis of cultural and biochemical analyses was confirmed by means of slide agglutinations with specific anti-K antisera. The results of this study strongly suggest that the wound infection isolates are V. parahemolyticus species which are easily distinguished from the nonpathogenic estuarine vibrios. PMID:5784207

Morphological, cultural, biochemical, and serological comparison of Japanese strains of Vibrio parahemolyticus with related cultures isolated in the United States.

PubMed

Twedt, R M; Spaulding, P L; Hall, H E

1969-05-01

Morphological, cultural, biochemical, and serological characteristics of 79 strains of Vibrio parahemolyticus isolated from patients suffering from gastroenteric disease in Japan were compared with 17 suspected V. parahemolyticus cultures isolated from wound infections and 14 nonpathogenic vibrios isolated from an estuarine environment in the United States. These groups were differentiated on the basis of several key reactions which included: the range of growth temperature and salt tolerance; the production of catalase and acetoin; the hydrolysis of starch; the fermentation and utilization as single carbon source of sucrose, cellobiose, and arabinose; and the ability to swarm on 1% agar. The separation of the groups on the basis of cultural and biochemical analyses was confirmed by means of slide agglutinations with specific anti-K antisera. The results of this study strongly suggest that the wound infection isolates are V. parahemolyticus species which are easily distinguished from the nonpathogenic estuarine vibrios.

Testing healthy immigrant effects among late life immigrants in the United States: using multiple indicators.

PubMed

Choi, Sunha H

2012-04-01

This study tested a healthy immigrant effect (HIE) and postimmigration health status changes among late life immigrants. Using three waves of the Second Longitudinal Study of Aging (1994-2000) and the linked mortality file through 2006, this study compared (a) chronic health conditions, (b) longitudinal trajectories of self-rated health, (c) longitudinal trajectories of functional impairments, and (d) mortality between three groups (age 70+): (i) late life immigrants with less than 15 years in the United States (n = 133), (ii) longer term immigrants (n = 672), and (iii) U.S.-born individuals (n = 8,642). Logistic and Poisson regression, hierarchical generalized linear modeling, and survival analyses were conducted. Late life immigrants were less likely to suffer from cancer, had lower numbers of chronic conditions at baseline, and displayed lower hazards of mortality during the 12-year follow-up. However, their self-rated health and functional status were worse than those of their counterparts over time. A HIE was only partially supported among older adults.

The determination of effective injury controls for metal-cutting lathe operators.

PubMed

Etherton, J R; Trump, T R; Jensen, R C

1981-01-01

Operators of metal-working lathes are one of the largest manufacturing machine worker populations in the United States. Machines (other than vehicular) account for over 10% of occupational injuries each year. An estimated 3,400 operators of metal-working lathes suffer lost-time injuries annually in the United States. Some of these are fatal. Therefore an investigation was undertaken to determine methods for reducing injuries to lathe operators. Three methods were used: (i) review of injury reports, (ii) human factors analysis, and (iii) fault-tree procedures. The investigation followed the man-machine systems approach of looking for injury-producing dysfunctions between the lathe and the lathe operator. The major sources of injury were found to be chips and workholding devices. Secondary tasks were found to be more hazardous than is generally recognized. The use of three methods for approaching the problem was found to be useful in that injury controls were identified which are likely to be adopted because of their potential for improving safety without adversely affecting productivity.

Toward an Integrated Research Agenda for Critical Illness in Aging

PubMed Central

Milbrandt, Eric B.; Eldadah, Basil; Nayfield, Susan; Hadley, Evan; Angus, Derek C.

2010-01-01

Aging brings an increased predisposition to critical illness. Patients older than 65 years of age account for approximately half of all intensive care unit (ICU) admissions in the United States, a proportion that is expected to increase considerably with the aging of the population. Emerging research suggests that elderly survivors of intensive care suffer significant long-term sequelae, including accelerated age-related functional decline. Existing evidence-based interventions are frequently underused and their efficacy untested in older subjects. Improving ICU outcomes in the elderly will require not only better methods for translating sound science into improved ICU practice but also an enhanced understanding of the underlying molecular, physiological, and pathophysiological interactions of critical illness with the aging process itself. Yet, significant barriers to research for critical illness in aging exist. We review the state of knowledge and identify gaps in knowledge, research opportunities, and barriers to research, with the goal of promoting an integrated research agenda for critical illness in aging. PMID:20558632

"I didn't feel like I was a person anymore": realigning full adult personhood after ostomy surgery.

PubMed

Ramirez, Michelle; Altschuler, Andrea; McMullen, Carmit; Grant, Marcia; Hornbrook, Mark; Krouse, Robert

2014-06-01

Colorectal cancer (CRC) is the third most common cancer in the United States. For some CRC patients, cancer treatment involves creating a permanent or temporary intestinal ostomy. Having an ostomy often results in complex social and physical concerns-including unpredictable and at times publicly noticeable bowel output. In this article, we discuss findings from 30 in-depth interviews with female CRC survivors with ostomies in the western United States. We highlight how having an ostomy disrupts culturally sanctioned practices of continence that mark the attainment of full-adult personhood. We discuss how survivors reclaim a sense of full personhood after ostomy surgery through a process of realignment that entails both learning how to manage ostomy equipment to conceal bowel activity and reappraising their illness and suffering. We suggest that the anthropological categories of personhood and personhood realignment be incorporated into research and interventions aimed at increasing support among cancer survivors living with bodily impairments. © 2014 by the American Anthropological Association.

“I Didn’t Feel Like I Was a Person Anymore”: Realigning Full Adult Personhood after Ostomy Surgery

PubMed Central

Ramirez, Michelle; Altschuler, Andrea; McMullen, Carmit; Grant, Marcia; Hornbrook, Mark; Krouse, Robert

2016-01-01

Colorectal cancer (CRC) is the third most common cancer in the United States. For some CRC patients, cancer treatment involves creating a permanent or temporary intestinal ostomy. Having an ostomy often results in complex social and physical concerns—including unpredictable and at times publicly noticeable bowel output. In this article, we discuss findings from 30 in-depth interviews with female CRC survivors with ostomies in the western United States. We highlight how having an ostomy disrupts culturally sanctioned practices of continence that mark the attainment of full-adult personhood. We discuss how survivors reclaim a sense of full personhood after ostomy surgery through a process of realignment that entails both learning how to manage ostomy equipment to conceal bowel activity and reappraising their illness and suffering. We suggest that the anthropological categories of personhood and personhood realignment be incorporated into research and interventions aimed at increasing support among cancer survivors living with bodily impairments. PMID:24782269

Using Ozone Lidar to Investigate Sources of High Ozone Concentrations in the Western United States

NASA Astrophysics Data System (ADS)

Senff, C. J.; Langford, A. O.; Alvarez, R. J.; Brewer, Wm. A.; Banta, R. M.; Marchbanks, R. D.; Sandberg, S. P.; Weickmann, A. M.; Holloway, J. S.; Williams, E. J.

2016-06-01

We have used NOAA's Tunable Optical Profiler for Aerosol and oZone (TOPAZ) ozone lidar to investigate the sources of high surface ozone concentrations in two different regions of the western United States (US): the Uintah Basin in northeast Utah and Clark County in southern Nevada, which includes the city of Las Vegas. The Uintah Basin is a booming oil and gas producing region that often suffers from very high wintertime ozone concentrations. Clark County experiences violations of the US ozone standard primarily in spring and early summer despite a lack of any major local pollution sources. TOPAZ lidar observations, in conjunction with surface in situ measurements and model results, provided strong evidence that the high wintertime ozone concentrations in the Uintah Basin are primarily driven by local emissions associated with oil and gas exploration, whereas the Clark County ozone exceedances are often caused by ozone-rich air that is transported from the lower stratosphere all the way down to the earth's surface.

Technical Report of the Use of a Novel Eye Tracking System to Measure Impairment Associated with Mild Traumatic Brain Injury

PubMed Central

2017-01-01

This technical report details the results of an uncontrolled study of EyeGuide Focus, a 10-second concussion management tool which relies on eye tracking to determine the potential impairment of visual attention, an indicator often of mild traumatic brain injury (mTBI). Essentially, people who can visually keep steady and accurate attention on a moving object in their environment likely suffer from no impairment. However, if after a potential mTBI event, subjects cannot keep attention on a moving object in a normal way as demonstrated on their previous healthy baseline tests. This may indicate possible neurological impairment. Now deployed at multiple locations across the United States, Focus (EyeGuide, Lubbock, Texas, United States) to date, has recorded more than 4,000 test scores. Our data analysis of these results shows the promise of Focus as a low-cost, ocular-based impairment test for assessing potential neurological impairment caused by mTBI in subjects ages eight and older.  PMID:28630809

Technical Report of the Use of a Novel Eye Tracking System to Measure Impairment Associated with Mild Traumatic Brain Injury.

PubMed

Kelly, Michael

2017-05-15

This technical report details the results of an uncontrolled study of EyeGuide Focus, a 10-second concussion management tool which relies on eye tracking to determine the potential impairment of visual attention, an indicator often of mild traumatic brain injury (mTBI). Essentially, people who can visually keep steady and accurate attention on a moving object in their environment likely suffer from no impairment. However, if after a potential mTBI event, subjects cannot keep attention on a moving object in a normal way as demonstrated on their previous healthy baseline tests. This may indicate possible neurological impairment. Now deployed at multiple locations across the United States, Focus (EyeGuide, Lubbock, Texas, United States) to date, has recorded more than 4,000 test scores. Our data analysis of these results shows the promise of Focus as a low-cost, ocular-based impairment test for assessing potential neurological impairment caused by mTBI in subjects ages eight and older.

Does inequality erode social trust? Results from multilevel models of US states and counties.

PubMed

Fairbrother, Malcolm; Martin, Isaac W

2013-03-01

Previous research has argued that income inequality reduces people's trust in other people, and that declining social trust in the United States in recent decades has been due to rising levels of income inequality. Using multilevel models fitted to data from the General Social Survey, this paper substantially qualifies these arguments. We show that while people are less trusting in US states with higher income inequality, this association holds only cross-sectionally, not longitudinally; since the 1970s, states experiencing larger increases in inequality have not suffered systematically larger declines in trust. For counties, there is no statistically significant relationship either cross-sectionally or longitudinally. There is therefore only limited empirical support for the argument that inequality influences generalized social trust; and the declining trust of recent decades certainly cannot be attributed to rising inequality. Copyright © 2012 Elsevier Inc. All rights reserved.

Influenza A (H1N1) was not associated with obesity in pregnant women living in Toluca, México.

PubMed

Mendieta-Zerón, Hugo; Santillán-Benítez, Jonnathan G; Colín-Ferreira, María del Carmen; Montenegro-Cárdenas, Angela; Núñez-Delira, Cynthia N; Huitrón-Bravo, Gabriel G

2011-12-01

The aim was to verify whether being overweight could have played a critical role in cases of mortality caused by influenza A (H1N1) in pregnant women. This virus' prevalence was also analyzed among people suffering from acute respiratory disease being attended at the state of Mexico's Autonomous University's medical research centre. The clinical files of women having influenza A (H1N1) attending the Monica Pretelini maternal-perinatal hospital's (HMPMP) intensive care unit in Toluca, Mexico, were reviewed. According to international recommendations, clinical detection of possible new cases of this disease was kept an open as a second step. Five women suffering influenza A (H1N1) was attended at HMPMP's intensive care unit during 2009; only one survived. No differences in body mass index were found when comparing the anthropometric characteristics to another group of women affected by acute respiratory diseases; in fact, this parameter was below the limits for being overweight in both cases. No new case of influenza A (H1N1) was found after the first eight months of 2010. It could not be verified whether being overweight was a factor of higher mortality due to influenza A (H1N1) amongst pregnant women in the state of Mexico. The key to better survival for pregnant women hospitalized with influenza A (H1N1) seemed to be early treatment with oseltamivir. The cases decreased dramatically after the severe wave of the new pandemic due to unknown reasons.

Propofol administration to the maternal-fetal unit improved fetal EEG and influenced cerebral apoptotic pathway in preterm lambs suffering from severe asphyxia.

PubMed

Seehase, Matthias; Jennekens, Ward; Zwanenburg, Alex; Andriessen, Peter; Collins, Jennifer Jp; Kuypers, Elke; Zimmermann, Luc J; Vles, Johan Sh; Gavilanes, Antonio Wd; Kramer, Boris W

2015-12-01

Term and near-term infants are at high risk of developing brain injury and life-long disability if they have suffered from severe perinatal asphyxia. We hypothesized that propofol administration to the maternal-fetal unit can diminish cerebral injury in term and near-term infant fetuses in states of progressive severe asphyxia. Forty-four late preterm lambs underwent total umbilical cord occlusion (UCO) or sham treatment in utero. UCO resulted in global asphyxia and cardiac arrest. After emergency cesarean section under either maternal propofol or isoflurane anesthesia, the fetuses were resuscitated and subsequently anesthetized the same way as their mothers. Asphyctic lambs receiving isoflurane showed a significant increase of total and low-frequency spectral power in bursts indicating seizure activity and more burst-suppression with a marked increase of interburst interval length during UCO. Asphyctic lambs receiving propofol showed less EEG changes. Propofol increased levels of anti-apoptotic B-cell lymphoma-extra large (Bcl-xL) and phosphorylated STAT-3 and reduced the release of cytochrome c from the mitochondria and the protein levels of activated cysteinyl aspartate-specific protease (caspase)-3, -9, and N-methyl-d-aspartate (NMDA) receptor. Improvement of fetal EEG during and after severe asphyxia could be achieved by propofol treatment of the ovine maternal-fetal unit. The underlying mechanism is probably the reduction of glutamate-induced cytotoxicity by down-regulation of NMDA receptors and an inhibition of the mitochondrial apoptotic pathway.

Design of a 15N Molecular Unit to Achieve Long Retention of Hyperpolarized Spin State

NASA Astrophysics Data System (ADS)

Nonaka, Hiroshi; Hirano, Masashi; Imakura, Yuki; Takakusagi, Yoichi; Ichikawa, Kazuhiro; Sando, Shinsuke

2017-01-01

Nuclear hyperpolarization is a phenomenon that can be used to improve the sensitivity of magnetic resonance molecular sensors. However, such sensors typically suffer from short hyperpolarization lifetime. Herein we report that [15N, D14]trimethylphenylammonium (TMPA) has a remarkably long spin-lattice relaxation time (1128 s, 14.1 T, 30 °C, D2O) on its 15N nuclei and achieves a long retention of the hyperpolarized state. [15N, D14]TMPA-based hyperpolarized sensor for carboxylesterase allowed the highly sensitive analysis of enzymatic reaction by 15N NMR for over 40 min in phophate-buffered saline (H2O, pH 7.4, 37 °C).

Factors contributing to deep supercooling capability and cold survival in dwarf bamboo (Sasa senanensis) leaf blades.

PubMed

Ishikawa, Masaya; Oda, Asuka; Fukami, Reiko; Kuriyama, Akira

2014-01-01

Wintering Sasa senanensis, dwarf bamboo, is known to employ deep supercooling as the mechanism of cold hardiness in most of its tissues from leaves to rhizomes. The breakdown of supercooling in leaf blades has been shown to proceed in a random and scattered manner with a small piece of tissue surrounded by longitudinal and transverse veins serving as the unit of freezing. The unique cold hardiness mechanism of this plant was further characterized using current year leaf blades. Cold hardiness levels (LT20: the lethal temperature at which 20% of the leaf blades are injured) seasonally increased from August (-11°C) to December (-20°C). This coincided with the increases in supercooling capability of the leaf blades as expressed by the initiation temperature of low temperature exotherms (LTE) detected in differential thermal analyses (DTA). When leaf blades were stored at -5°C for 1-14 days, there was no nucleation of the supercooled tissue units either in summer or winter. However, only summer leaf blades suffered significant injury after prolonged supercooling of the tissue units. This may be a novel type of low temperature-induced injury in supercooled state at subfreezing temperatures. When winter leaf blades were maintained at the threshold temperature (-20°C), a longer storage period (1-7 days) increased lethal freezing of the supercooled tissue units. Within a wintering shoot, the second or third leaf blade from the top was most cold hardy and leaf blades at lower positions tended to suffer more injury due to lethal freezing of the supercooled units. LTE were shifted to higher temperatures (2-5°C) after a lethal freeze-thaw cycle. The results demonstrate that the tissue unit compartmentalized with longitudinal and transverse veins serves as the unit of supercooling and temperature- and time-dependent freezing of the units is lethal both in laboratory freeze tests and in the field. To establish such supercooling in the unit, structural ice barriers such as development of sclerenchyma and biochemical mechanisms to increase the stability of supercooling are considered important. These mechanisms are discussed in regard to ecological and physiological significance in winter survival.

Thinking Differently in Global Health in Oncology Using a Diagonal Approach: Harnessing Similarities, Improving Education, and Empowering an Alternative Oncology Workforce.

PubMed

Rodriguez, Natalia M; Brant, Jeannine M; Pendharkar, Dinesh; Arreola-Ornelas, Hector; Bhadelia, Afsan; de Lima Lopes, Gilberto; Knaul, Felicia M

2017-01-01

Cancer is a leading global cause of death, and diverse and minority populations suffer worse outcomes compared with white people from Western societies. Within the United States, African Americans and other blacks, Hispanics, Asians, and American Indians have lower cancer survival rates than whites. In the rest of the world, those from low- and middle-income countries have the greatest disparities, but even those from non-Western high-income countries such as Oman and the United Arab Emirates are diagnosed with cancer at later stages and suffer increased mortality. Although considerable differences exist among these populations, similarities and synergies are also apparent. Challenges can be very similar in reaching these populations effectively for cancer control to improve outcomes, and innovative strategies are needed to effectively make change. In this review, the authors discuss new approaches to the prevention and early detection of cancer as well as the implementation of programs in global oncology and put in evidence cultural similarities and challenges of different populations, highlighting strategies to improve cancer survival and quality care around the world through innovations in training and education, empowerment of an alternative workforce, and a diagonal approach to cancer care using case studies drawn from the authors' work and experience.

Intersecting vulnerabilities in professionals and patients in intensive care.

PubMed

Meunier-Beillard, Nicolas; Dargent, Auguste; Ecarnot, Fiona; Rigaud, Jean-Philippe; Andreu, Pascal; Large, Audrey; Quenot, Jean-Pierre

2017-12-01

In the context of healthcare delivery, the vulnerabilities of patients in the intensive care unit (ICU) are intricately linked with those experienced on a daily basis by caregivers in the ICU in a symbiotic relation, whereby patients who are suffering can in turn engender suffering in the caregivers. In the same way, caregivers who are suffering themselves may be a source of suffering for their patients. The vulnerabilities of both patients and caregivers in the ICU are simultaneously constituted through a process that is influenced on the one hand by the healthcare objectives of the ICU, and on the other hand, by the conformity of the patients who are managed in that ICU. The specific challenges of management in high-technology units such as an ICU may have consequences on the practices and work conditions of healthcare professionals. Constructing the patient, collectively redefining the patient's identity, and ascribing the patient to a specific healthcare trajectory enables professionals to circumscribe, contain and fight against the spectrum of extreme vulnerabilities of their patients. Imposing this normative framework is the sole means of guiding these professionals through their daily practices. In spite of this, situations of suffering remain a constitutive feature of the caregiving relation in the ICU.

The Global Online Sexuality Survey (GOSS): the United States of America in 2011 chapter II: phosphodiesterase inhibitors utilization among English speakers.

PubMed

Shaeer, Osama

2013-02-01

Utility of phosphodiesterase inhibitors (PDEi's) for the treatment of erectile dysfunction (ED) has been the focus of experimental and clinical studies. However, public preferences, attitudes, and experiences with PDEi's are rarely addressed from a population/epidemiology viewpoint. The Global Online Sexuality Survey (GOSS) is a worldwide epidemiologic study of sexuality and sexual disorders, first launched in the Middle East in 2010, followed by the United States in 2011. To describe the utilization rates, trends, and attitudes toward PDEi's in the United States in the year 2011. GOSS was randomly deployed to English-speaking male Web surfers in the United States via paid advertising on Facebook®, comprising 146 questions. Utilization rates and preferences for PDEi's by brand. Six hundred three subjects participated; mean age 53.43 years ± 13.9. Twenty-three point seven percent used PDEi's on more consistent basis, 37.5% of those with ED vs. 15.6% of those without ED (recreational users). Unrealistic safety concerns including habituation were pronounced. Seventy-nine point six percent of utilization was on prescription basis. PDEi's were purchased through pharmacies (5.3% without prescription) and in 16.5% over the Internet (68% without prescription). Nine point six percent nonprescription users suffered coronary heart disease. Prescription use was inclined toward sildenafil, generally, and particularly in severe cases, and shifted toward tadalafil in moderate ED and for recreational use, followed by vardenafil. Nonprescription utilization trends were similar, except in recreational use where sildenafil came first. In the United States unrealistic safety concerns over PDEi's utility exist and should be addressed. Preference for particular PDEi's over the others is primarily dictated by health-care providers, despite lack of guidelines that govern physician choice. Online and over-the-counter sales of PDEi's are common, and can expose a subset of users to health risks. Recreational use of PDEi's is common, and could be driven by undiagnosed premature ejaculation. © 2012 International Society for Sexual Medicine.

Perceptions of social conflicts among incarcerated adolescents with callous-unemotional traits: 'you're going to pay. It's going to hurt, but I don't care.'.

PubMed

Pardini, Dustin

2011-03-01

Delinquent youth with callous-unemotional (CU) traits may have a unique social-cognitive processing pattern that perpetuates their violent behavior. The current study examined the association between CU traits and the endorsement of deviant social goals during peer conflicts as well as expectancies and values regarding victim suffering following aggression. Participants included 156 (84 males, 72 females) adjudicated juveniles residing at two gender-specific residential facilities in an urban city within the southeastern United States. The association between CU traits and participants' ratings of their social goals in hypothetic conflict situations and outcome expectancies/values regarding victim suffering were examined after controlling for prior violence, intelligence, and demographic covariates.  CU traits were associated with an increased endorsement of social goals associated with revenge, dominance, and forced respect in social conflict situations. Adjudicated youth with CU traits were also less likely to endorse conflict avoidance and friendship building as important social goals when provoked by peers. There was no association between CU traits and expectations for victim suffering following aggression, but CU traits were significantly associated with lower levels of concern about victim suffering. These findings were significant after controlling for participants' prior history of violence, intelligence, and demographic covariates. Adjudicated youth with CU traits tend to emphasize power-oriented goals when provoked by peers and have little interest in rectifying social conflicts to build potential friendships with others. Juveniles with CU traits seem to be aware that their aggressive behavior will cause others to suffer, but they do not care when it does. © 2010 The Author. Journal of Child Psychology and Psychiatry © 2010 Association for Child and Adolescent Mental Health.

Life insurance, living benefits, and physician-assisted death.

PubMed

Parker, Frederick R; Rubin, Harvey W; Winslade, William J

2004-01-01

One of the most significant concerns about the legalization of physician-assisted death in the United States relates to the possibility that a chronically or terminally ill person would choose to end her or his life for financial reasons. Because we believe that the life insurance industry is uniquely poised to help minimize any such incentive, we submit that it has a moral obligation to do so. In particular, we propose that the industry encourage greater flexibility in the payout of policy benefits in the event an insured should be diagnosed with a terminal illness or suffer from intractable pain.

Legal Standards for Brain Death and Undue Influence in Euthanasia Laws.

PubMed

Pope, Thaddeus Mason; Okninski, Michaela E

2016-06-01

A major appellate court decision from the United States seriously questions the legal sufficiency of prevailing medical criteria for the determination of death by neurological criteria. There may be a mismatch between legal and medical standards for brain death, requiring the amendment of either or both. In South Australia, a Bill seeks to establish a legal right for a defined category of persons suffering unbearably to request voluntary euthanasia. However, an essential criterion of a voluntary decision is that it is not tainted by undue influence, and this Bill falls short of providing adequate guidance to assess for undue influence.

Vaginitis.

PubMed

Friedrich, E G

1985-06-01

Vaginitis is one of the most common complaints of women in the United States today. About 90% of patients with this problem suffer from infection of the vagina caused by Candida, Gardnerella, or Trichomonas. The diagnosis and effective treatment of these common infections depend on accurate identification of the entity, effective specific therapy, and restoration of the normal ecosystem of the vagina. At the same time women should be made aware that not all discharge means infection and that any attempts at self-treatment may only worsen their condition. Proper hygiene habits, dietary control, and management of stress are all helpful factors in the control of recurrent vaginal infections.

The disaster was my fault!

PubMed

Robertson, Mary M; Cavanna, Andrea E

2007-10-01

We report the case of a child affected by Gilles de la Tourette syndrome and comorbid obsessive-compulsive disorder who claimed to have caused the September 11, 2001 terrorist attacks in the United States by failing to accomplish a stereotyped compulsive ritual. Special attention is paid to the relationship between the patient's neuropsychiatric symptoms and the belief that he personally had influenced the outcome of an internationally notorious disaster. Prognostic and treatment implications are also presented, along with a review of the literature on the clinical and psychosocial impact of terrorist attacks and natural disasters on children suffering from neuropsychiatric disorders.

The evolution of hospice in America: nursing's role in the movement.

PubMed

Hoffmann, Rosemary L

2005-07-01

In the current society, many individuals fear death and the feelings of suffering and loneliness that often accompany death. Two visionaries in the United States, Florence Wald and Dr. Elisabeth Kubler-Ross, recognized these fears and planned the nation's first hospice movement in the 1970s. The hospice philosophy continues to prosper in the new millennium. In this article, the founding American hospice's philosophy, types of facilities, standards, health team composition, patient demographics, organizations, reimbursement, and research are compared and contrasted with those of the current hospice movement. Existing issues with the modern movement are also discussed.

Managing the Delivery of Health Care: What Can Health Care Learn From the Business Community?

PubMed

Sharan, Alok D; Millhouse, Paul W; West, Michael E; Schroeder, Gregory D; Vaccaro, Alexander R

2015-08-01

The passage of the Patient Protection and Affordable Care Act in March 2010 has resulted in dramatic changes to the delivery of health care in the United States toward a value-based system. While this is a significant change from the previous model, it presents an opportunity for high-quality health care providers to improve patient outcomes while also increasing revenue. However, those that lack a clear strategy to effectively implement change and communicate the increased value to the patients likely will suffer, regardless of how successful or prestigious they seem today.

Judgement days: moral attitudes in the wake of local disasters.

PubMed

Urbatsch, R

2016-01-01

The deaths and destruction stemming from a disaster are traumatic enough to implicate victims' beliefs not only about disasters themselves but also about other social and political concerns. In particular, disasters are associated with the scapegoating of out-groups, suggesting that even deep-rooted moral concerns may shift, at least temporarily, after disasters. This study uses exposure to local natural disaster fatalities to examine moral judgements regarding gays in United States surveys from 1984-98. Survey respondents whose county has suffered a disaster feel appreciably more negatively towards gays, even though most of the disasters in this data set are relatively small and local. The increased antipathy towards gays dissipates within months, and is most marked among those who had, before the disaster, considered themselves more religious. These results raise the possibility that some groups, especially those already marginalised by society, may suffer in a backlash in the wake of a natural disaster. © 2016 The Author(s). Disasters © Overseas Development Institute, 2016.

Beyond anti-Muslim sentiment: opposing the Ground Zero mosque as a means to pursuing a stronger America.

PubMed

Jia, Lile; Karpen, Samuel C; Hirt, Edward R

2011-10-01

Americans' opposition toward building an Islamic community center at Ground Zero has been attributed solely to a general anti-Muslim sentiment. We hypothesized that some Americans' negative reaction was also due to their motivation to symbolically pursue a positive U.S. group identity, which had suffered from a concurrent economic and political downturn. Indeed, when participants perceived that the United States was suffering from lowered international status, those who identified strongly with the country, as evidenced especially by a high respect or deference for group symbols, reported a stronger opposition to the "Ground Zero mosque" than participants who identified weakly with the country did. Furthermore, participants who identified strongly with the country also showed a greater preference for buildings that were symbolically congruent than for buildings that were symbolically incongruent with the significance of Ground Zero, and they represented Ground Zero with a larger symbolic size. These findings suggest that identifying group members' underlying motivations provides unusual insights for understanding intergroup conflict.

How is animal welfare addressed in Canada's emergency response plans?

PubMed

Wittnich, Carin; Belanger, Michael

2008-01-01

In 2005, Hurricanes Katrina and Rita clearly revealed that even in the United States the welfare of companion animals and nonhuman animals in the wild, zoo, or aquarium was not considered within the evacuation plans for their human caretakers (owners). The lack of proper planning and trained individuals resulted in a huge loss of animal life as well as suffering and trauma to both animals and their owners. The present Canadian Federal Emergency Response Plan does not have adequate procedures for the evacuation of animals together with their owners, nor do Canada or the provinces and territories have a plan in place that consists of properly trained and equipped individuals to respond to this aspect of disaster management. The Canadian Veterinary Reserve (CVR) was thus organized at a national level to respond properly to disasters or emergencies of all types and thereby reduce animal suffering and loss of life. This article describes the formation of the CVR and its anticipated national role in addressing animal welfare during times of catastrophic need.

Disciplining addictions: the bio-politics of methadone and heroin in the United States.

PubMed

Bourgois, P

2000-06-01

Biomedical understanding of methadone as a magic-bullet pharmacological block to the euphoric effects of heroin is inconsistent with epidemiological and clinical data. An ethnographic perspective on the ways street-based heroin addicts experience methadone reveals the quagmire of power relations that shape drug treatment in the United States. The phenomenon of the methadone clinic is an unhappy compromise between competing discourses: A criminalizing morality versus a medicalizing model of addiction-as-a-brain-disease. Treatment in this context becomes a hostile exercise in disciplining the unruly misuses of pleasure and in controlling economically unproductive bodies. Most of the biomedical and epidemiological research literature on methadone obscures these power dynamics by technocratically debating dosage titrations in a social vacuum. A foucaultian critique of the interplay between power and knowledge might dismiss debates over the Swiss experiments with heroin prescription as merely one more version of biopower disciplining unworthy bodies. Foucault's ill-defined concept of the specific intellectual as someone who confronts power relations on a practical technical level, however, suggests there can be a role for political as well as theoretical engagement with debates in the field of applied substance abuse treatment. Meanwhile, too many heroin addicts who are prescribed methadone in the United States suffer negative side effects that range from an accentuated craving for polydrug abuse to a paralyzing sense of impotence and physical and emotional discomfort.

What role can nurse leaders play in reducing the incidence of pressure sores?

PubMed

Wurster, Joan

2007-01-01

Pressure sores have plagued the nursing profession for many years as a major health care problem in terms of a patient's suffering and financial cost. Pressure sores are increasingly common in hospitalized patients in the United States with a 63% increase from 1993 to 2003. The nurse leader is accountable for the occurrence of pressure sores, a nurse-sensitive indicator, by a scorecard which is benchmarked against other facilities. The nurse leader must take a systematic approach in the prevention of pressure sores, with the strategy being consistent and motivating to the staff in order to improve patient outcome. The chief nursing officer, the unit manager, and the bedside nurse must all collaborate to prevent tissue injury in patients at risk for developing pressure sores and to promote wound healing in patients with existing breakdown.

Public health implications of same-sex marriage.

PubMed

Buffie, William C

2011-06-01

Significantly compromised health care delivery and adverse health outcomes are well documented for the lesbian, gay, bisexual, and transgender (LGBT) community in the United States compared with the population at large. LGBT individuals subject to societal prejudice in a heterosexist world also suffer from the phenomenon known as "minority stress," with its attendant negative mental and physical health effects. Reports in the medical and social science literature suggest that legal and social recognition of same-sex marriage has had positive effects on the health status of this at-risk community. Improved outcomes are to be expected because of the improved access to health care conferred by marriage benefits under federal or state law and as a result of attenuating the effects of institutionalized stigma on a sexual minority group.

Public Health Implications of Same-Sex Marriage

PubMed Central

2011-01-01

Significantly compromised health care delivery and adverse health outcomes are well documented for the lesbian, gay, bisexual, and transgender (LGBT) community in the United States compared with the population at large. LGBT individuals subject to societal prejudice in a heterosexist world also suffer from the phenomenon known as “minority stress,” with its attendant negative mental and physical health effects. Reports in the medical and social science literature suggest that legal and social recognition of same-sex marriage has had positive effects on the health status of this at-risk community. Improved outcomes are to be expected because of the improved access to health care conferred by marriage benefits under federal or state law and as a result of attenuating the effects of institutionalized stigma on a sexual minority group. PMID:21493934

Quality of Life and Everyday Activities in Patients with Primary Biliary Cirrhosis

PubMed Central

Selmi, Carlo; Gershwin, M. Eric; Lindor, Keith D.; Worman, Howard J.; Gold, Ellen B.; Watnik, Mitchell; Utts, Jessica; Invernizzi, Pietro; Kaplan, Marshall M.; Vierling, John M.; Bowlus, Christopher L.; Silveira, Marina G.; Bossi, Ilaria

2011-01-01

Primary biliary cirrhosis (PBC) is generally a slowly progressive disease that may lead to cirrhosis and liver failure. However, patients with PBC often suffer from a variety of symptoms long before the development of cirrhosis that include issues of daily living that have an impact on their work environment and their individual quality of life. We therefore examined multiple parameters by taking advantage of the database of our cohort of 1032 patients with PBC and 1041 matched controls. The data were obtained from patients from 23 tertiary referral centers throughout the United States and from rigorously matched controls by age, sex, ethnicity, and random-digit dialing. The data showed that patients with PBC were more likely than controls to have significant articular symptoms, a reduced ability to perform household chores, and the need for help with routine activities. Patients with PBC rated their overall activity similar or superior to that of controls; however, more of them reported limitations in their ability to carry out activities at work or at home and difficulties in everyday activities. PBC cases also more frequently reported limitations in participating in certain sports or exercises and pursuing various hobbies; however, they did not report significant limitations in social activities. In a multivariable analysis, household income, a diagnosis of systemic lupus erythematosus, limitations in work activities, a reduction in work secondary to disability, and church attendance were independently increased in PBC cases with respect to controls. Conclusion Our data indicate that the quality of life of patients with PBC in the United States is generally well preserved. Nevertheless, patients with PBC suffer significantly more than controls from a variety of symptoms that are beyond the immediate impact of liver failure and affect their lifestyle, personal relationships, and work activities. PMID:18027862

[The elderly living alone and malnutrition. SOLGER Study].

PubMed

Paino Pardal, Lidia; Poblet I Montells, Laia; Ríos Álvarez, Laura

2017-10-01

This study aims to determine if there are any connections between living alone and suffering from malnutrition or having a risk of being malnourished, in people over 79years old in a Mediterranean population. A questionnaire was used in a cross-sectional and multicentre study conducted between June and December 2014 in three Primary Care Centres (PCC). A quota was chosen for each centre, including all patients over 79years, with a total of 167 people. Was performed using SPSS. A first descriptive part was performed by calculating Chi squared and Student-t tests, and a second part in which logistic regression was used to determine if living was only related to the Mini Nutritional Assessment (MNA) adjusted to age. The scores of the nutritional study by MNA showed no differences between the groups according to the family unit as a differentiating factor. On the other hand, age does seem to be a determining factor. Patients over 79years old and who live alone are nearly always independent for daily life activities, and often have a better state of physical and mental health. These factors could explain their better nutritional status, as living alone is not associated with states of malnutrition or having the risk of suffer from it. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Alcohol industry self-regulation: who is it really protecting?

PubMed

Noel, Jonathan; Lazzarini, Zita; Robaina, Katherine; Vendrame, Alan

2017-01-01

Self-regulation has been promoted by the alcohol industry as a sufficient means of regulating alcohol marketing activities. However, evidence suggests that the guidelines of self-regulated alcohol marketing codes are violated routinely, resulting in excessive alcohol marketing exposure to youth and the use of content that is potentially harmful to youth and other vulnerable populations. If the alcohol industry does not adhere to its own regulations the purpose and design of these codes should be questioned. Indeed, implementation of alcohol marketing self-regulation in Brazil, the United Kingdom and the United States was likely to delay statutory regulation rather than to promote public health. Moreover, current self-regulation codes suffer from vague language that may allow the industry to circumvent the guidelines, loopholes that may obstruct the implementation of the codes, lax exposure guidelines that can allow excessive youth exposure, even if properly followed, and a standard of review that may be inappropriate for protecting vulnerable populations. Greater public health benefits may be realized if legislative restrictions were applied to alcohol marketing, and strict statutory alcohol marketing regulations have been implemented and defended successfully in the European Union, with European courts declaring that restrictions on alcohol marketing are proportional to the benefits to public health. In contrast, attempts to restrict alcohol marketing activities in the United States have occurred through private litigation and have been unsuccessful. None the less, repeated violations of industry codes may provide legislators with sufficient justification to pass new legislation and for such legislation to withstand constitutional review in the United States and elsewhere. © 2016 Society for the Study of Addiction.

Intersecting vulnerabilities in professionals and patients in intensive care

PubMed Central

Dargent, Auguste; Ecarnot, Fiona; Rigaud, Jean-Philippe; Andreu, Pascal; Large, Audrey; Quenot, Jean-Pierre

2017-01-01

In the context of healthcare delivery, the vulnerabilities of patients in the intensive care unit (ICU) are intricately linked with those experienced on a daily basis by caregivers in the ICU in a symbiotic relation, whereby patients who are suffering can in turn engender suffering in the caregivers. In the same way, caregivers who are suffering themselves may be a source of suffering for their patients. The vulnerabilities of both patients and caregivers in the ICU are simultaneously constituted through a process that is influenced on the one hand by the healthcare objectives of the ICU, and on the other hand, by the conformity of the patients who are managed in that ICU. The specific challenges of management in high-technology units such as an ICU may have consequences on the practices and work conditions of healthcare professionals. Constructing the patient, collectively redefining the patient’s identity, and ascribing the patient to a specific healthcare trajectory enables professionals to circumscribe, contain and fight against the spectrum of extreme vulnerabilities of their patients. Imposing this normative framework is the sole means of guiding these professionals through their daily practices. In spite of this, situations of suffering remain a constitutive feature of the caregiving relation in the ICU. PMID:29302595

Bear mauling: a descriptive review.

PubMed

Dieter, R A; Dieter, D L; Dieter, R A; Forbes, B

2001-11-01

Provide a descriptive review of bear and human interactions in the United States. Descriptive review. The bear population in the United States includes the grizzly bear, the polar bear, and the black bear, including the glacier phase or blue bear. As the human population grew and remote or wilderness access improved, the bear population suffered both in total numbers and safe habitat. Conservation efforts, such as hunting restrictions and habitat enhancement, have helped to increase the total numbers of bears on the North American continent. The chance of a human encountering a bear increases as the remote bear territory diminishes. Bear incidents are widely publicized, though few serious incidents occur. The authors have direct knowledge of these bear-human encounters in Alaska. Serious human injuries from black bears, or maulings, including fatalities are uncommon. Grizzly bears when trapped or stimulated may be very dangerous. The polar bear sees everything that moves or has color, as potential food, and therefore, will attack seemingly unprovoked. The chance of a human encountering a bear increases as the remote bear territory diminishes. Bear incidents are widely publicized, though few serious incidents occur.

Just compensation: a no-fault proposal for research-related injuries

PubMed Central

Henry, Leslie Meltzer; Larkin, Megan E.; Pike, Elizabeth R.

2015-01-01

Biomedical research, no matter how well designed and ethically conducted, carries uncertainties and exposes participants to risk of injury. Research injuries can range from the relatively minor to those that result in hospitalization, permanent disability, or even death. Participants might also suffer a range of economic harms related to their injuries. Unlike the vast majority of developed countries, which have implemented no-fault compensation systems, the United States continues to rely on the tort system to compensate injured research participants—an approach that is no longer morally defensible. Despite decades of US advisory panels advocating for no-fault compensation, little progress has been made. Accordingly, this article proposes a novel and necessary no-fault compensation system, grounded in the ethical notion of compensatory justice. This first-of-its-kind concrete proposal aims to treat like cases alike, offer fair compensation, and disburse compensation with maximum efficiency and minimum administrative cost. It also harmonizes national and international approaches—an increasingly important goal as research becomes more globalized, multi-site trials grow in number, and institutions and sponsors in the United States move to single-IRB review. PMID:27774216

Clinical peer review in the United States: history, legal development and subsequent abuse.

PubMed

Vyas, Dinesh; Hozain, Ahmed E

2014-06-07

The Joint Commission on Accreditation requires hospitals to conduct peer review to retain accreditation. Despite the intended purpose of improving quality medical care, the peer review process has suffered several setbacks throughout its tenure. In the 1980s, abuse of peer review for personal economic interest led to a highly publicized multimillion-dollar verdict by the United States Supreme Court against the perpetrating physicians and hospital. The verdict led to decreased physician participation for fear of possible litigation. Believing that peer review was critical to quality medical care, Congress subsequently enacted the Health Care Quality Improvement Act (HCQIA) granting comprehensive legal immunity for peer reviewers to increase participation. While serving its intended goal, HCQIA has also granted peer reviewers significant immunity likely emboldening abuses resulting in Sham Peer Reviews. While legal reform of HCQIA is necessary to reduce sham peer reviews, further measures including the need for standardization of the peer review process alongside external organizational monitoring are critical to improving peer review and reducing the prevalence of sham peer reviews.

Clinical peer review in the United States: History, legal development and subsequent abuse

PubMed Central

Vyas, Dinesh; Hozain, Ahmed E

2014-01-01

The Joint Commission on Accreditation requires hospitals to conduct peer review to retain accreditation. Despite the intended purpose of improving quality medical care, the peer review process has suffered several setbacks throughout its tenure. In the 1980s, abuse of peer review for personal economic interest led to a highly publicized multimillion-dollar verdict by the United States Supreme Court against the perpetrating physicians and hospital. The verdict led to decreased physician participation for fear of possible litigation. Believing that peer review was critical to quality medical care, Congress subsequently enacted the Health Care Quality Improvement Act (HCQIA) granting comprehensive legal immunity for peer reviewers to increase participation. While serving its intended goal, HCQIA has also granted peer reviewers significant immunity likely emboldening abuses resulting in Sham Peer Reviews. While legal reform of HCQIA is necessary to reduce sham peer reviews, further measures including the need for standardization of the peer review process alongside external organizational monitoring are critical to improving peer review and reducing the prevalence of sham peer reviews. PMID:24914357

The smart meter and a smarter consumer: quantifying the benefits of smart meter implementation in the United States.

PubMed

Cook, Brendan; Gazzano, Jerrome; Gunay, Zeynep; Hiller, Lucas; Mahajan, Sakshi; Taskan, Aynur; Vilogorac, Samra

2012-04-23

The electric grid in the United States has been suffering from underinvestment for years, and now faces pressing challenges from rising demand and deteriorating infrastructure. High congestion levels in transmission lines are greatly reducing the efficiency of electricity generation and distribution. In this paper, we assess the faults of the current electric grid and quantify the costs of maintaining the current system into the future. While the proposed "smart grid" contains many proposals to upgrade the ailing infrastructure of the electric grid, we argue that smart meter installation in each U.S. household will offer a significant reduction in peak demand on the current system. A smart meter is a device which monitors a household's electricity consumption in real-time, and has the ability to display real-time pricing in each household. We conclude that these devices will provide short-term and long-term benefits to utilities and consumers. The smart meter will enable utilities to closely monitor electricity consumption in real-time, while also allowing households to adjust electricity consumption in response to real-time price adjustments.

Work-related deaths among youth: Understanding the contribution of US child labor violations.

PubMed

Rauscher, Kimberly J; Myers, Douglas J; Miller, Mary E

2016-11-01

Evidence shows that violations of the United States (US) child labor regulations are common. The main purpose of this study was to investigate the magnitude and nature of work-related deaths among youth involving violations of US child labor regulations. We analyzed Census of Fatal Occupational Injury data from 2001 to 2012 using descriptive statistics and Chi-square tests. Between 2001 and 2012, 406 workers under age 18 were recorded in the CFOI as having suffered a fatal work-related injury. Among these cases, 233 were covered by the US child labor regulations. Forty-three percent of these cases involved at least one violation. The majority of cases that were not covered by the regulations involved decedents working on their family's farms (N = 139). Violations of federal child labor regulations are a significant contributor to work-related deaths among youth in the United States. Increased investment in enforcement is needed to prevent further young worker deaths involving child labor violations. Am. J. Ind. Med. 59:959-968, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Occurrence of cervical spine injuries during the rugby scrum.

PubMed

Wetzler, M J; Akpata, T; Laughlin, W; Levy, A S

1998-01-01

A retrospective study of cervical spine injuries that occurred during the rugby scrum in the United States was undertaken. In the U.S., from 1970 to 1996, 36 (58%) of the 62 documented injured players injured their cervical spines during the scrum. Thirty-five men (97%) and one woman (3%) were injured. Twenty-three of the injuries (64%) occurred when the opposing packs came together (engagement), and 13 (36%) occurred when the scrum collapsed. Twenty-eight (78%) hookers, seven (19%) props, and one (3%) second-row player were injured. Twenty (56%) hookers and three (8%) props were hurt during engagement. Eight hookers (22%), four props (11%), and one second-row player (3%) were injured when the scrum collapsed. Significantly more injuries occurred during engagement than during collapse, and hookers were injured significantly more than props. We conclude that in the rugby scrum in the U.S., the hooker suffers most of the cervical spine injuries (78% in this study) and this position is by far the most vulnerable. This study should be used to develop rugby law (rule) changes and educate players, coaches, and referees in United States rugby.

Social support seeking and self-efficacy-building strategies in enhancing the emotional well-being of informal HIV/AIDS caregivers in Ibadan, Oyo state, Nigeria.

PubMed

Okeke, Bernedette Okwuchukwu

2016-01-01

This study examined the relative efficacy of social support seeking (SSS) and self-efficacy building (SEB) in the management of emotional well-being of caregivers of people suffering from HIV/AIDS. It was based at the United States President's Emergency Plan for AIDS Relief (PEPFAR) center in the University College Hospital, Ibadan, Oyo state, being the first and the largest teaching hospital in Nigeria. A 3 × 2 factorial design consisting of treatment and a control group was used. The columns have two levels of gender being male and female caregivers. One-hundred and sixty-five (165) caregivers who were taking care of people that are suffering from HIV/AIDS were purposively selected and randomly assigned to the treatment groups and control. The treatment was carried out for a period of eight weeks. Two null hypotheses were tested, both at .05 levels of significance. Data were collected with the use of standardized intruments rating scale; social support scale, general self-efficacy scale and emotional well-being scale. ANCOVA was used to establish significant treatment effects with the pretest as covariate. Even though SSS and SEB were both found to be effective in enhancing the emotional well-being of informal caregivers in this study when compared to the controls, SSS was significantly more effective than SEB in achieving this goal. Since the HIV/AIDS patients cannot be adequately cared for in the hospital settings due to severe shortages of material, personnel and time, serious efforts should be made by the three levels of the health care system viz: the primary, secondary and tertiary health care systems, to encourage the employment of the psychological management of caregivers of people suffering from HIV/AIDS. Also, the psychologists, clinical psychologists and the significant others should be encouraged to employ this psychological management in the care of HIV/AIDS informal caregivers.

Social support seeking and self-efficacy-building strategies in enhancing the emotional well-being of informal HIV/AIDS caregivers in Ibadan, Oyo state, Nigeria

PubMed Central

Okeke, Bernedette Okwuchukwu

2016-01-01

Abstract This study examined the relative efficacy of social support seeking (SSS) and self-efficacy building (SEB) in the management of emotional well-being of caregivers of people suffering from HIV/AIDS. It was based at the United States President's Emergency Plan for AIDS Relief (PEPFAR) center in the University College Hospital, Ibadan, Oyo state, being the first and the largest teaching hospital in Nigeria. A 3 × 2 factorial design consisting of treatment and a control group was used. The columns have two levels of gender being male and female caregivers. One-hundred and sixty-five (165) caregivers who were taking care of people that are suffering from HIV/AIDS were purposively selected and randomly assigned to the treatment groups and control. The treatment was carried out for a period of eight weeks. Two null hypotheses were tested, both at .05 levels of significance. Data were collected with the use of standardized intruments rating scale; social support scale, general self-efficacy scale and emotional well-being scale. ANCOVA was used to establish significant treatment effects with the pretest as covariate. Even though SSS and SEB were both found to be effective in enhancing the emotional well-being of informal caregivers in this study when compared to the controls, SSS was significantly more effective than SEB in achieving this goal. Since the HIV/AIDS patients cannot be adequately cared for in the hospital settings due to severe shortages of material, personnel and time, serious efforts should be made by the three levels of the health care system viz: the primary, secondary and tertiary health care systems, to encourage the employment of the psychological management of caregivers of people suffering from HIV/AIDS. Also, the psychologists, clinical psychologists and the significant others should be encouraged to employ this psychological management in the care of HIV/AIDS informal caregivers. PMID:26831832

Witnesses to mute suffering: quality of life, intellectual disability, and the harm standard.

PubMed

Freitag, Lisa C

2015-01-01

Decisions to override a parental request to withhold or withdraw treatment in the neonatal intensive care unit are often made based on the harm standard, with death being cast as the ultimate harm. However, often the treatment itself is not without harm, and the suffering engendered is undergone by an infant who is neither able to understand it nor express its presence. We can draw upon anticipated future quality of life to justify the present suffering, but are in a quandary when that future is not guaranteed or is likely to hold little but further suffering. I propose that conflicts over continuing treatment are based both on disagreements about the desirability of possible futures, and on differing perceptions of the infant's current level of suffering. Those of us who witness the suffering of these tiny, mute infants all bear some responsibility to insure that their suffering is not without purpose. Copyright 2015 The Journal of Clinical Ethics. All rights reserved.

People's experiences of suffering a lower limb fracture and undergoing surgery.

PubMed

Forsberg, Angelica; Söderberg, Siv; Engström, Åsa

2014-01-01

To describe people's experiences of suffering a lower limb fracture and undergoing surgery, from the time of injury through to the care given at the hospital and recovery following discharge. There is a lack of research on people's experiences of suffering a lower limb fracture and undergoing surgery - from injury to recovery. A qualitative approach was used. Interviews with nine participants were subjected to thematic content analysis. One theme was expressed: from realising the seriousness of the injury to regaining autonomy. Participants described feelings of frustration and helplessness when realising the seriousness of their injury. The wait prior to surgery was a strain and painful experience, and participants needed orientation for the future. They expressed feelings of vulnerability about being in the hands of staff during surgery. After surgery, in the postanaesthesia unit, participants expressed a need to have control and to feel safe in their new situation. To mobilise and regain their autonomy was a struggle, and participants stated that their recovery was extended. Participants found themselves in a new and unexpected situation and experienced pain, vulnerability and a striving for control during the process, that is, 'from realising the seriousness of the injury to regaining autonomy'. How this is managed depends on how the patient's needs are met by nurses. The nursing care received while suffering a lower limb fracture and undergoing surgery should be situation specific as well as individual specific. The safe performance of technical interventions and the nurse's comprehensive explanations of medical terms may help the patient to feel secure during the process. © 2013 John Wiley & Sons Ltd.

Economic development and wage inequality: A complex system analysis

PubMed Central

Pugliese, Emanuele; Pietronero, Luciano

2017-01-01

Adapting methods from complex system analysis, this paper analyzes the features of the complex relationship between wage inequality and the development and industrialization of a country. Development is understood as a combination of a monetary index, GDP per capita, and a recently introduced measure of a country’s economic complexity: Fitness. Initially the paper looks at wage inequality on a global scale, over the time period 1990–2008. Our empirical results show that globally the movement of wage inequality along with the ongoing industrialization of countries has followed a longitudinally persistent pattern comparable to the one theorized by Kuznets in the fifties: countries with an average level of development suffer the highest levels of wage inequality. Next, the study narrows its focus on wage inequality within the United States. By using data on wages and employment in the approximately 3100 US counties over the time interval 1990–2014, it generalizes the Fitness-Complexity metric for geographic units and industrial sectors, and then investigates wage inequality between NAICS industries. The empirical time and scale dependencies are consistent with a relation between wage inequality and development driven by institutional factors comparing countries, and by change in the structural compositions of sectors in a homogeneous institutional environment, such as the counties of the United States. PMID:28926577

Economic development and wage inequality: A complex system analysis.

PubMed

Sbardella, Angelica; Pugliese, Emanuele; Pietronero, Luciano

2017-01-01

Adapting methods from complex system analysis, this paper analyzes the features of the complex relationship between wage inequality and the development and industrialization of a country. Development is understood as a combination of a monetary index, GDP per capita, and a recently introduced measure of a country's economic complexity: Fitness. Initially the paper looks at wage inequality on a global scale, over the time period 1990-2008. Our empirical results show that globally the movement of wage inequality along with the ongoing industrialization of countries has followed a longitudinally persistent pattern comparable to the one theorized by Kuznets in the fifties: countries with an average level of development suffer the highest levels of wage inequality. Next, the study narrows its focus on wage inequality within the United States. By using data on wages and employment in the approximately 3100 US counties over the time interval 1990-2014, it generalizes the Fitness-Complexity metric for geographic units and industrial sectors, and then investigates wage inequality between NAICS industries. The empirical time and scale dependencies are consistent with a relation between wage inequality and development driven by institutional factors comparing countries, and by change in the structural compositions of sectors in a homogeneous institutional environment, such as the counties of the United States.

Physicians in US Prisons in the Era of Mass Incarceration

PubMed Central

Allen, Scott A.; Wakeman, Sarah E.; Cohen, Robert L.; Rich, Josiah D.

2011-01-01

The United States leads the world in creating prisoners, incarcerating one in 100 adults and housing 25% of the world’s prisoners. Since the 1976, the US Supreme Court ruling that mandated health care for inmates, doctors have been an integral part of the correctional system. Yet conditions within corrections are not infrequently in direct conflict with optimal patient care, particularly for those suffering from mental illness and addiction. In addition to providing and working to improve clinical care for prisoners, physicians have an opportunity and an obligation to advocate for reform in the system of corrections when it conflicts with patient well-being. PMID:22049298

The birth of a house call practice.

PubMed

De Leon, Fidias E

2009-01-01

Increasingly, physicians of all specialties are frustrated with the complex, unrewarding system of third-party billing in the United States. It has led many physicians to wonder how best to change their practice to ameliorate these challenges or leave their practice altogether. It is possible that family physicians suffer most because they are trained to provide comprehensive care to all comers, regardless of reimbursement status. What they may not know is that leaving the practice might be the best thing for everyone, and it doesn't necessarily mean leaving medicine! As I realized during my experiences working in South Florida, transitioning to a house call practice can be emotionally and financially rewarding.

Risk of fractures in an intermediate care facility for persons with mental retardation.

PubMed

Tannenbaum, T N; Lipworth, L; Baker, S

1989-01-01

The epidemiology of fractures among 553 residents of an intermediate care facility for persons with mental retardation was examined. In a 10-month period, 61 fractures occurred among 55 residents; application of fracture rates in the United States revealed an expected number of 15 fractures among the 553 residents, p less than .001. Although 52% of fractures involved small bones of the hands and feet, elderly residents were more likely to fracture major bones and to suffer their fractures from a fall than were younger residents. The relationship between potential risk factors and fracture risk were examined and implications for preventive and rehabilitative measures discussed.

Physicians in US Prisons in the Era of Mass Incarceration.

PubMed

Allen, Scott A; Wakeman, Sarah E; Cohen, Robert L; Rich, Josiah D

2010-12-01

The United States leads the world in creating prisoners, incarcerating one in 100 adults and housing 25% of the world's prisoners. Since the 1976, the US Supreme Court ruling that mandated health care for inmates, doctors have been an integral part of the correctional system. Yet conditions within corrections are not infrequently in direct conflict with optimal patient care, particularly for those suffering from mental illness and addiction. In addition to providing and working to improve clinical care for prisoners, physicians have an opportunity and an obligation to advocate for reform in the system of corrections when it conflicts with patient well-being.

Beyond Pain: Nurses' Assessment of Patient Suffering, Dignity, and Dying in the Intensive Care Unit.

PubMed

Su, Amanda; Lief, Lindsay; Berlin, David; Cooper, Zara; Ouyang, Daniel; Holmes, John; Maciejewski, Renee; Maciejewski, Paul K; Prigerson, Holly G

2018-06-01

Deaths in the intensive care unit (ICU) are increasingly common in the U.S., yet little is known about patients' experiences at the end of life in the ICU. The objective of this study was to determine nurse assessment of symptoms experienced, and care received by ICU patients in their final week, and their associations with nurse-perceived suffering and dignity. From September 2015 to March 2017, nurses who cared for 200 ICU patients who died were interviewed about physical and psychosocial dimensions of patients' experiences. Medical chart abstraction was used to document baseline patient characteristics and care. The patient sample was 61% males, 70.2% whites, and on average 66.9 (SD 15.1) years old. Nurses reported that 40.9% of patients suffered severely and 33.1% experienced severe loss of dignity. The most common symptoms perceived to contribute to suffering and loss of dignity included trouble breathing (44.0%), edema (41.9%), and loss of control of limbs (36.1%). Most (n = 9) remained significantly (P < 0.05) associated with suffering, after adjusting for physical pain, including fever/chills, fatigue, and edema. Most patients received vasopressors and mechanical ventilation. Renal replacement therapy was significantly (<0.05) associated with severe suffering (adjusted odds ratio [AOR] 2.53) and loss of dignity (AOR 3.15). Use of feeding tube was associated with severe loss of dignity (AOR 3.12). Dying ICU patients are perceived by nurses to experience extreme indignities and suffer beyond physical pain. Attention to symptoms such as dyspnea and edema may improve the quality of death in the ICU. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Disparities in Breast Cancer Incidence, Mortality, and Quality of Care among African American and European American Women in South Carolina.

PubMed

Samson, Marsha E; Porter, Nancy G; Hurley, Deborah M; Adams, Swann A; Eberth, Jan M

2016-01-01

Breast cancer is the most frequently diagnosed cancer among women and the second-leading cause of female cancer deaths in the United States. African Americans and other minorities in the United States experience lower survival rates and have a worse prognosis than European Americans despite European Americans having a much higher incidence of the disease. Adherence to breast cancer treatment-quality measures is limited, particularly when the data are stratified by race/ethnicity. We aimed to examine breast cancer incidence and mortality trends in South Carolina by race and explore possible racial disparities in the quality of breast cancer treatment received in South Carolina. African Americans have high rates of mammography and clinical breast examination screenings yet suffer lower survival compared with European Americans. For most treatment-quality metrics, South Carolina fairs well in comparison to the United States as a whole; however, South Carolina hospitals overall lag behind South Carolina Commission on Cancer-accredited hospitals for all measured quality indicators, including needle biopsy utilization, breast-conserving surgeries, and timely use of radiation therapy. Accreditation may a play a major role in increasing the standard of care related to breast cancer diagnosis and treatment. These descriptive findings may provide significant insight for future interventions and policies aimed at eliminating racial/ethnic disparities in health outcomes. Further risk-reduction approaches are necessary to reduce minority group mortality rates, especially among African American women.

School Board of Nassau County, Florida v. Arline.

PubMed

1987-03-03

After suffering a third relapse of tuberculosis in two years, an elementary school teacher in Nassau County, Florida, was discharged by the local public school board. In her complaint against the board, the teacher asserted that her dismissal violated a section of the federal Rehabilitation Act prohibiting federally funded state programs from discriminating against handicapped individuals solely by reason of handicap. In reaching its conclusion that a person afflicted with tuberculosis may be a "handicapped individual" within the meaning of the Act, the United States Supreme Court reasoned that allowing an employer to justify discrimination by distinguishing between a disease's perceived contagious effects on others and its physical effects on the individual would be unfair. The Court, however, could not grant the relief requested until the lower court made findings about the actual risk of the disease's transmission to others.

Introduction of moribund category to OECD fish acute test and its effect on suffering and LC50 values.

PubMed

Rufli, Hans

2012-05-01

It has become common practice in many laboratories in Europe to introduce the criterion "moribund" to reduce the suffering in fish acute lethality tests. Fish with severe sublethal symptoms might be declared moribund and are removed from the test as soon as this occurs (premature discontinuation of experiment). Moribund fish affect main study outcomes as the median lethal concentration (LC50) derived on fish declared as moribund may be lower than the conventional LC50. This was evaluated by a retrospective analysis of 328 fish acute toxicity tests of an industry laboratory based on five different definitions of moribund, and of 111 tests from 10 other laboratories from Europe and the United States. Using the criterion of moribund 10 to 23% of the fish were being declared as moribund in 49 to 79% of the studies. In 36 to 52% of the studies, the LC50(moribund) was lower than the conventional LC50 depending on the definitions of moribund. An inclusion of the moribund criterion in an updated Organisation for Economic Cooperation and Development guideline for the acute fish toxicity test would reduce the period of suffering by up to 92 h, lowering the value of the main toxicity endpoint by a factor of approximately 2, and maximal by a factor of approximately 16. Copyright © 2012 SETAC.

Reducing the risk of injury from table saw use: the potential benefits and costs of automatic protection.

PubMed

Graham, John D; Chang, Joice

2015-02-01

The use of table saws in the United States is associated with approximately 28,000 emergency department (ED) visits and 2,000 cases of finger amputation per year. This article provides a quantitative estimate of the economic benefits of automatic protection systems that could be designed into new table saw products. Benefits are defined as reduced health-care costs, enhanced production at work, and diminished pain and suffering. The present value of the benefits of automatic protection over the life of the table saw are interpreted as the switch-point cost value, the maximum investment in automatic protection that can be justified by benefit-cost comparison. Using two alternative methods for monetizing pain and suffering, the study finds switch-point cost values of $753 and $561 per saw. These point estimates are sensitive to the values of inputs, especially the average cost of injury. The various switch-point cost values are substantially higher than rough estimates of the incremental cost of automatic protection systems. Uncertainties and future research needs are discussed. © 2014 Society for Risk Analysis.

Anxious? Depressed? You might be suffering from capitalism: Contradictory class locations and the prevalence of depression and anxiety in the United States

PubMed Central

Prins, Seth J.; Bates, Lisa M.; Keyes, Katherine M.; Muntaner, Carles

2015-01-01

Despite a well-established social gradient for many mental disorders, evidence suggests that individuals near the middle of the social hierarchy suffer higher rates of depression and anxiety than those at the top or bottom. Although prevailing indicators of socioeconomic stratification (e.g., SES) cannot detect or easily explain such patterns, relational theories of social class, which emphasise political-economic processes and dimensions of power, might. We test whether the relational construct of contradictory class location, which embodies aspects of both ownership and labour, can explain this nonlinear pattern. Data on full-time workers from the National Epidemiologic Survey on Alcohol and Related Conditions (N=21,859) show that occupants of contradictory class locations have higher prevalence and odds of depression and anxiety than occupants of non-contradictory class locations. These findings suggest that the effects of class relations on depression and anxiety extend beyond those of SES, pointing to under-studied mechanisms in social epidemiology, e.g., domination and exploitation. PMID:26385581

Health transitions, fast and nasty: the case of Marshallese exposure to nuclear radiation.

PubMed

Pollock, Nancy J

2002-09-01

The concept of health transitions assumes that health status improves with the introduction of western medicine. In this paper I demonstrate that the health of the people of Rongelap, Marshall Islands, has undergone serious damage as a result of nuclear testing, and that women in particular have suffered unduly. Exposure to nuclear radiation over a period of almost fifty years has been recognised by US authorities as a major contributory cause to the high rates of cancers and birth defects suffered by the Rongelap people. Women's reproduction has been severely affected, as evidenced by the many stillbirths and small stature of children born alive. Two generations have been exposed to both background radiation and to radiation ingested with the local foods on which they rely in the absence of other food sources. Clean up has commenced only after this and other communities sought compensation from the United States. The Rongelap people will live with the effects of radiation for generations to come. This transition to ongoing health problems is thus a negative outcome of modern health transition.

Odor-Sensing System to Support Social Participation of People Suffering from Incontinence

PubMed Central

Ortiz Pérez, Alvaro; Kallfaß-de Frenes, Vera; Filbert, Alexander; Kneer, Janosch; Bierer, Benedikt; Held, Pirmin; Klein, Philipp; Wöllenstein, Jürgen; Benyoucef, Dirk; Kallfaß, Sigrid; Mescheder, Ulrich; Palzer, Stefan

2016-01-01

This manuscript describes the design considerations, implementation, and laboratory validation of an odor sensing module whose purpose is to support people that suffer from incontinence. Because of the requirements expressed by the affected end-users the odor sensing unit is realized as a portable accessory that may be connected to any pre-existing smart device. We have opted for a low-cost, low-power consuming metal oxide based gas detection approach to highlight the viability of developing an inexpensive yet helpful odor recognition technology. The system consists of a hotplate employing, inkjet-printed p-type semiconducting layers of copper(II) oxide, and chromium titanium oxide. Both functional layers are characterized with respect to their gas-sensitive behavior towards humidity, ammonia, methylmercaptan, and dimethylsulfide and we demonstrate detection limits in the parts-per-billion range for the two latter gases. Employing a temperature variation scheme that reads out the layer’s resistivity in a steady-state, we use each sensor chip as a virtual array. With this setup, we demonstrate the feasibility of detecting odors associated with incontinence. PMID:28036081

Odor-Sensing System to Support Social Participation of People Suffering from Incontinence.

PubMed

Ortiz Pérez, Alvaro; Kallfaß-de Frenes, Vera; Filbert, Alexander; Kneer, Janosch; Bierer, Benedikt; Held, Pirmin; Klein, Philipp; Wöllenstein, Jürgen; Benyoucef, Dirk; Kallfaß, Sigrid; Mescheder, Ulrich; Palzer, Stefan

2016-12-29

This manuscript describes the design considerations, implementation, and laboratory validation of an odor sensing module whose purpose is to support people that suffer from incontinence. Because of the requirements expressed by the affected end-users the odor sensing unit is realized as a portable accessory that may be connected to any pre-existing smart device. We have opted for a low-cost, low-power consuming metal oxide based gas detection approach to highlight the viability of developing an inexpensive yet helpful odor recognition technology. The system consists of a hotplate employing, inkjet-printed p-type semiconducting layers of copper(II) oxide, and chromium titanium oxide. Both functional layers are characterized with respect to their gas-sensitive behavior towards humidity, ammonia, methylmercaptan, and dimethylsulfide and we demonstrate detection limits in the parts-per-billion range for the two latter gases. Employing a temperature variation scheme that reads out the layer's resistivity in a steady-state, we use each sensor chip as a virtual array. With this setup, we demonstrate the feasibility of detecting odors associated with incontinence.

Continuous palliative sedation: not only a response to physical suffering.

PubMed

Swart, Siebe J; van der Heide, Agnes; van Zuylen, Lia; Perez, Roberto S G M; Zuurmond, Wouter W A; van der Maas, Paul J; van Delden, Johannes J M; Rietjens, Judith A C

2014-01-01

Palliative sedation is a medical intervention aimed at relieving symptoms that can no longer be controlled by conventional treatment. Ample knowledge is available regarding the nature of such symptoms, but there is no in-depth information regarding how health care workers decide about palliative sedation. The study objective was to investigate considerations concerning the indications for continuous palliative sedation (CPS) and issues that influence these considerations. The study consisted of qualitative interviews regarding patients who had recently received CPS. The study involved physicians and nurses working in general practice, nursing homes, and hospitals. Analyses by a multidisciplinary research team used the constant comparative method. Together with physical symptoms, psychological and existential suffering may combine to produce a refractory state for which other treatment options than CPS were not available or considered inappropriate. A limited life expectancy was by many considered crucial (e.g., to avoid hastening death) and by some less important (e.g., because the patient's suffering was considered to be key). Issues influencing the decision to use CPS related to patient preferences (e.g., dignity, not wanting to experience further suffering) or family issues (impact of suffering on family, family requesting CPS). The indication for CPS typically originates from physical symptoms and nonphysical problems producing a refractory state in which a patient suffers unbearably. In such states, preferences of patients and families and the life expectancy criterion are weighed against the severity of refractory symptoms. Therefore the use of CPS is not only a response to the physical suffering of patients in the dying phase.

State regulation of nuclear power and national energy policy

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

Moeller, J.W.

1992-12-31

In April 1983 and January 1984, the United States Supreme Court rendered two decisions that redefined the metes and bounds of federal preemption of commercial nuclear power plant regulation. In Pacific Gas & Electric Co. v. State Energy Resources Conservation and Development Commission (PG&E), the court decided that the Atomic Energy Act of 1954, as amended (the Act), did not preempt a California state law that established a moratorium on commercial nuclear power plant construction. In Silkwood v. Kerr-McGee Corporation, the Court also decided that the Act did not preempt a claim for damages under state tort law for radiologicalmore » injuries suffered in a nuclear fuel facility regulated by the United States Nuclear Regulatory Commission (NRC). The two decisions redefined the extent of federal preemption, under the Act and other federal law, of nuclear plant regulation as well as the extend of state regulation of nuclear plants. In the eight years since PG&E and Silkwood, numerous other developments have eroded further the breadth of federal preemption of commercial nuclear power plant regulation. This Article explores the developments, since PG&E and Silkwood, that have expanded further the scope of state and local regulation of commercial nuclear power plants. Specifically, the Article first identifies the extent of state and local participation in nuclear power regulation provided by the Act and other federal loan relevant to commercial nuclear power. Second, it discusses in detail the PG&E and Silkwood decisions. The Article also considers the impact of seven specific developments on the legislative implementation of a national energy policy that contemplates a role for nuclear power.« less

Pence, Putin, Mbeki and Their HIV/AIDS-Related Crimes Against Humanity: Call for Social Justice and Behavioral Science Advocacy.

PubMed

Kalichman, Seth C

2017-04-01

Indiana, a large rural state in the Midwestern United States, suffered the worst North American HIV outbreak among injection drug users in years. The Indiana state government under former Governor and current US Vice President Mike Pence fueled the HIV outbreak by prohibiting needle/syringe exchange and failed to take substantive action once the outbreak was identified. This failure in public health policy parallels the HIV epidemics driven by oppressive drug laws in current day Russia and is reminiscent of the anti-science AIDS denialism of 1999-2007 South Africa. The argument that Russian President Putin and former South African President Mbeki should be held accountable for their AIDS policies as crimes against humanity can be extended to Vice President Pence. Social and behavioral scientists have a responsibility to inform the public of HIV prevention realities and to advocate for evidence-based public health policies to prevent future outbreaks of HIV infection.

Changing attitudes and practices in foregoing life-sustaining treatments.

PubMed

Sprung, C L

1990-04-25

Advances in medical technology and practices have been associated with improved patient outcomes. At times, the price of this progress has included great financial costs and human suffering. During the last two decades, there have been significant changes in medical practices in America. In the late 1960s and early 1970s, the removal of a respirator or hydration or nutrition from a patient who was not brain dead was considered a deviation from accepted medical practices. In 1976, the Quinlan case allowed the removal of a ventilator from a patient in a persistent vegetative state. Subsequent court decisions in the 1980s have equated hydration and artificial feeding with other forms of life-sustaining treatments and have allowed their withdrawal in patients who were not terminally ill. Prominent physicians have recently stated that it is not immoral for a physician to assist in the rational suicide of a terminally ill patient. Active euthanasia programs in the United States are likely in the near future.

United States of America: health system review.

PubMed

Rice, Thomas; Rosenau, Pauline; Unruh, Lynn Y; Barnes, Andrew J; Saltman, Richard B; van Ginneken, Ewout

2013-01-01

This analysis of the United States health system reviews the developments in organization and governance, health financing, health-care provision, health reforms and health system performance. The US health system has both considerable strengths and notable weaknesses. It has a large and well-trained health workforce, a wide range of high-quality medical specialists as well as secondary and tertiary institutions, a robust health sector research program and, for selected services, among the best medical outcomes in the world. But it also suffers from incomplete coverage of its citizenry, health expenditure levels per person far exceeding all other countries, poor measures on many objective and subjective measures of quality and outcomes, an unequal distribution of resources and outcomes across the country and among different population groups, and lagging efforts to introduce health information technology. It is difficult to determine the extent to which deficiencies are health-system related, though it seems that at least some of the problems are a result of poor access to care. Because of the adoption of the Affordable Care Act in 2010, the United States is facing a period of enormous potential change. Improving coverage is a central aim, envisaged through subsidies for the uninsured to purchase private insurance, expanded eligibility for Medicaid (in some states) and greater protection for insured persons. Furthermore, primary care and public health receive increased funding, and quality and expenditures are addressed through a range of measures. Whether the ACA will indeed be effective in addressing the challenges identified above can only be determined over time. World Health Organization 2013 (acting as the host organization for, and secretariat of, the European Observatory on Health Systems and Policies).

Real-time sharing and expression of migraine headache suffering on Twitter: a cross-sectional infodemiology study.

PubMed

Nascimento, Thiago D; DosSantos, Marcos F; Danciu, Theodora; DeBoer, Misty; van Holsbeeck, Hendrik; Lucas, Sarah R; Aiello, Christine; Khatib, Leen; Bender, MaryCatherine A; Zubieta, Jon-Kar; DaSilva, Alexandre F

2014-04-03

Although population studies have greatly improved our understanding of migraine, they have relied on retrospective self-reports that are subject to memory error and experimenter-induced bias. Furthermore, these studies also lack specifics from the actual time that attacks were occurring, and how patients express and share their ongoing suffering. As technology and language constantly evolve, so does the way we share our suffering. We sought to evaluate the infodemiology of self-reported migraine headache suffering on Twitter. Trained observers in an academic setting categorized the meaning of every single "migraine" tweet posted during seven consecutive days. The main outcome measures were prevalence, life-style impact, linguistic, and timeline of actual self-reported migraine headache suffering on Twitter. From a total of 21,741 migraine tweets collected, only 64.52% (14,028/21,741 collected tweets) were from users reporting their migraine headache attacks in real-time. The remainder of the posts were commercial, re-tweets, general discussion or third person's migraine, and metaphor. The gender distribution available for the actual migraine posts was 73.47% female (10,306/14,028), 17.40% males (2441/14,028), and 0.01% transgendered (2/14,028). The personal impact of migraine headache was immediate on mood (43.91%, 6159/14,028), productivity at work (3.46%, 486/14,028), social life (3.45%, 484/14,028), and school (2.78%, 390/14,028). The most common migraine descriptor was "Worst" (14.59%, 201/1378) and profanity, the "F-word" (5.3%, 73/1378). The majority of postings occurred in the United States (58.28%, 3413/5856), peaking on weekdays at 10:00h and then gradually again at 22:00h; the weekend had a later morning peak. Twitter proved to be a powerful source of knowledge for migraine research. The data in this study overlap large-scale epidemiological studies, avoiding memory bias and experimenter-induced error. Furthermore, linguistics of ongoing migraine reports on social media proved to be highly heterogeneous and colloquial in our study, suggesting that current pain questionnaires should undergo constant reformulations to keep up with modernization in the expression of pain suffering in our society. In summary, this study reveals the modern characteristics and broad impact of migraine headache suffering on patients' lives as it is spontaneously shared via social media.

Spiritual and religious components of patient care in the neonatal intensive care unit: sacred themes in a secular setting.

PubMed

Catlin, E A; Guillemin, J H; Thiel, M M; Hammond, S; Wang, M L; O'Donnell, J

2001-01-01

We hypothesized that spiritual distress was a common, unrecognized theme for neonatal intensive care unit (NICU) care providers. An anonymous questionnaire form assigned to a data table in a relational database was designed. Surveys were completed by 66% of NICU staff. All respondents viewed a family's spiritual and religious concerns as having a place in patient care. Eighty-three percent reported praying for babies privately. Asked what theological sense they made of suffering of NICU babies, 2% replied that children do not suffer in the NICU. Regarding psychological suffering of families, the majority felt God could prevent this, with parents differing (p = 0.039) from nonparents. There exists a strong undercurrent of spirituality and religiosity in the study NICU. These data document actual religious and spiritual attitudes and practices and support a need for pastoral resources for both families and care providers. NICU care providers approach difficulties of their work potentially within a religious and spiritual rather than a uniquely secular framework.

Ethical challenges in pain management post-surgery.

PubMed

Rejeh, Nahid; Ahmadi, Fazlollah; Mohamadi, Eesa; Anoosheh, Moniereh; Kazemnejad, Anooshirvan

2009-03-01

This qualitative study describes ethical challenges faced by Iranian nurses in the process of pain management in surgical units. To address this issue, semistructured interviews were conducted with 26 nurses working in surgery units in three large university hospitals in Tehran. An analysis of the transcripts revealed three main categories: institutional limitations; nurses' proximity to and involvement with pain and suffering; and nurses' fallibility. Specific themes identified within the categories were: insufficient resources, medical hierarchy; difficulties with believing patients' complaints regarding pain and suffering; and experiencing the consequences of poor judgments. Our findings lead us to conclude that, as nurses are much closer to patients' pain and suffering than other health professionals, being aware of their ethical problems, and being able to reflect on them and discuss and learn from them, will reduce the burden of the ethical challenges faced. The findings will help nurses in other countries to devise suitable ways to reduce the ethical burdens they bear in their daily practice.

Migraines in Women: Current Evidence for Management of Episodic and Chronic Migraines.

PubMed

Deneris, Angela; Rosati Allen, Peggy; Hart Hayes, Emily; Latendresse, Gwen

2017-05-01

Migraine headache is a disabling brain disorder that affects millions of women in the United States. Many migraine sufferers are undertreated. Both inadequate treatment and overuse of abortive migraine medication can contribute to progression from episodic to chronic migraine disorders. A significant number of migraine headaches or severity of episodic migraine headaches warrants treatment with prophylactic medications for prevention. This clinical update reviews the pathophysiology and diagnosis of migraine headaches in women, discusses the efficacy of abortive and chronic pharmacologic treatment, and examines strategies to prevent progression from episodic migraine to chronic migraine. A discussion of treatment during pregnancy and lactation is included. © 2017 by the American College of Nurse-Midwives.

Fatalities due to dichloromethane in paint strippers: a continuing problem.

PubMed

Macisaac, Julia; Harrison, Robert; Krishnaswami, Janani; McNary, Jennifer; Suchard, Jeffrey; Boysen-Osborn, Megan; Cierpich, Hank; Styles, Laura; Shusterman, Dennis

2013-08-01

Exposure to dichloromethane (DCM or methylene chloride - CH₂ Cl₂ ) in paint strippers continues to be an avoidable source of morbidity and mortality. DCM has been under regulatory scrutiny by occupational and consumer product agencies since the identification of its carcinogenicity in the mid-1980s. We investigated two independent workplace incidents that resulted in three cases of DCM intoxication from paint stripper use. Each incident investigated resulted in a fatality. A third worker suffered obtundation requiring hospitalization and intubation. The continued occurrence of fatalities and other serious injuries due to DCM-containing paint strippers in the United States calls for a re-evaluation of existing regulatory strategies. Copyright © 2013 Wiley Periodicals, Inc.

The smart meter and a smarter consumer: quantifying the benefits of smart meter implementation in the United States

PubMed Central

2012-01-01

The electric grid in the United States has been suffering from underinvestment for years, and now faces pressing challenges from rising demand and deteriorating infrastructure. High congestion levels in transmission lines are greatly reducing the efficiency of electricity generation and distribution. In this paper, we assess the faults of the current electric grid and quantify the costs of maintaining the current system into the future. While the proposed “smart grid” contains many proposals to upgrade the ailing infrastructure of the electric grid, we argue that smart meter installation in each U.S. household will offer a significant reduction in peak demand on the current system. A smart meter is a device which monitors a household’s electricity consumption in real-time, and has the ability to display real-time pricing in each household. We conclude that these devices will provide short-term and long-term benefits to utilities and consumers. The smart meter will enable utilities to closely monitor electricity consumption in real-time, while also allowing households to adjust electricity consumption in response to real-time price adjustments. PMID:22540990

Prevalence and associated risk factors of burnout among US doctors of chiropractic.

PubMed

Williams, Shawn P; Zipp, Genevieve P

2014-01-01

The purpose of this study was to establish the frequency of burnout among doctors of chiropractic in the United States. Using a nonprobability convenience sampling methodology, we e-mailed the Maslach Burnout Inventory-Human Services Survey and a sociodemographic questionnaire to a randomized sample of licensed doctors of chiropractic (n = 8000). The survey return rate was 16.06%. Twenty-one percent of the participants had high emotional exhaustion (EE), 8% had low personal accomplishment, and 8% had high depersonalization. Significant differences (P < .001) were found in the level of EE, depersonalization, and personal accomplishment as a function of sex, time dedicated to clinical care and administrative duties, source of reimbursement, the type of practice setting, the nature of practitioners' therapeutic focus, the location of chiropractic college, self-perception of burnout, the effect of suffering from a work-related injury, the varying chiropractic philosophical perspectives, and the public's opinion of chiropractic. Although doctors of chiropractic in the United States who responded to the survey had a relatively low frequency of burnout, higher levels of EE remain workplace issues for this professional group. Copyright © 2014 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

Medicolegal aspects of complex behaviours arising from the sleep period: a review and guide for the practising sleep physician.

PubMed

Morrison, Ian; Rumbold, John M M; Riha, Renata L

2014-06-01

This review is aimed at summarizing the current state of knowledge regarding parasomnias, which have been implicated in medicolegal cases as well as providing guidance to those working within common-law jurisdictions regarding the technical aspects of the law. Sleepwalking and sexsomnia as a defence are being raised more frequently in criminal cases and there has been public debate on their validity. Unfortunately, expert evidence on forensic sleep disorders continues to be heavily opinion-based with the potential for miscarriages of justice seen in recent highly publicized cases. There is an apparent inertia in research into violent sleep disorders. We review the current state of forensic sleep science in the United Kingdom (UK) and abroad and discuss the need to formulate guidelines based on available evidence. We also highlight the pressing necessity for more research in this area as well as the need to reform the law, which is the subject of a recent Criminal Law Commission report in the United Kingdom. In time, this will facilitate the efficient, proportionate, and just disposal of violence arising from sleep, thus benefitting both society and the individual sufferer. Copyright © 2013 Elsevier Ltd. All rights reserved.

Floods in the United States: Magnitude and frequency

USGS Publications Warehouse

Jarvis, Clarence S.; ,

1936-01-01

From time immemorial floods have transformed beneficent river waters into a menace to humanity. Man's progress toward economic stability has been repeatedly halted or even thrown backward by the interruption of his efforts to make effective use of rivers and of valley lands. This handicap is not imposed by the destructiveness of large rivers alone, or of rivers in widely separated areas, for there are few if any streams, brooks, or rivulets that are not subject to flows beyond their channel capacities. Yet, though man for ages has suffered seriously from recurring floods, he has not been deterred from continuing to extend his activities in areas that are virtually foredoomed to flood damage.Today in the United States serious floods may occur in any section in any year, and even, in some regions, several times a year. Many of these floods leave behind them the tragedy of death and disease and of property irreparably damaged. The aggregate direct property damage caused by floods in this country has been estimated roughly to average $35,000,000 a year. In addition there are serious indirect and intangible losses of great but not precisely calculable magnitude.

Why it's time for a national health program in the United States.

PubMed Central

Waitzkin, H

1989-01-01

The United States lacks a coherent national health program. Current programs leave major gaps in coverage and recently have become more restrictive. Influential policies that have failed to correct crucial problems of the health-care system include competitive strategies, corporate intervention, and public-sector cutbacks with bureaucratic expansion. A national health program that combines elements of national health insurance and a national health service is a policy that would help solve current health-care problems. Previous proposals for national health insurance contained weaknesses that would need correction under a national program. Based on the experiences of other economically advanced countries, a national health program could provide universal entitlement to health care while controlling costs and improving the health-care system through structural reorganization. Current proposals for a national health program contain several basic principles dealing with the scope of services, copayments, financing, cost controls, physician and professional associations, personnel and distribution, prevention, and participation in policy making. Support for a national health program is growing rapidly. Such a program would help protect all people who live in this country from unnecessary illness, suffering, and early death. PMID:2735021

Panel Discussion: Near Real Time Imagery Intelligence How Will We Do It?

NASA Astrophysics Data System (ADS)

Andraitis, Arthur A.; Crane, Alfred C.; Daniels, George; Graham, Johnny; LaGesse, Francis R.

1987-02-01

This afternoon's panel discussion will address near real time imagery and intelligence--how will we do it? Our moderator is Arthur Andraitis, a consultant in intelligence reconnaissance systems and international marketing. He was commissioned in the United States Air Force out of the University of Idaho, and entered the Air Force in 1955 where he became an Image Intelligence Officer serving in a variety of intelligence and reconnaisance related assignments, including two tours each in Asia and Europe supporting tactical theater and national level operations. He also suffered through two Pentagon tours--one as Branch Chief of the Imagery Branch for the Assistant Chief of Staff for Intelligence. He was the U. S. National Coordinator for two NATO intelligence and reconnaissance panels, and served several assignments in support of special operations, which included a year with the special forces in Viet Nam where he flew many missions in L-19s, 01 and assault helicopters. He has been an advisor on intelligence and reconnaissance matters to several foreign countries. In 1978 he retired from the United States Air Force, went to work for Itek, and then became an independent consultant in intelligence and reconaissance systems. I would like to introduce Art Andraitis.

Defining Health in the Era of Value-Based Care: The Six Cs of Health and Healthcare.

PubMed

Warren, Mark

2017-02-22

While healthcare expenditure continues to increase overall health outcomes in the United States continue to be submarginal. The changes we make in our healthcare system need to be informed by a comprehensive and actionable definition of health that can unite patients, healthcare professionals, and policymakers. A literature review across multiple disciplines was conducted to assess a broad range of factors associated with health and well-being and based on this literature review a novel definition of health was developed. Development of a definition of health as the ability to dynamically recognize and resolve dissonance in one's physical, mental, social and spiritual worlds via cooperation with social and spiritual connections, the medical community and with the natural world in a way that fosters and promotes harmony, resilience, and relief from suffering. This definition is then expanded into six domains (connection, communication, creativity, cooperation, cost-consciousness, and computerization) which are applicable to individuals, society and the healthcare system and which form the basis for actionable guidelines to promote measurable and sustained change on a public health scale. Healthcare in the United States is changing and in order to move forward in an evidence-based and compassionate way, we need to understand what we mean by 'health' and how that definition can be operational at individual, societal, and public policy levels.

The effects of competition on premiums: using United Healthcare's 2015 entry into Affordable Care Act's marketplaces as an instrumental variable.

PubMed

Agirdas, Cagdas; Krebs, Robert J; Yano, Masato

2018-01-08

One goal of the Affordable Care Act is to increase insurance coverage by improving competition and lowering premiums. To facilitate this goal, the federal government enacted online marketplaces in the 395 rating areas spanning 34 states that chose not to establish their own state-run marketplaces. Few multivariate regression studies analyzing the effects of competition on premiums suffer from endogeneity, due to simultaneity and omitted variable biases. However, United Healthcare's decision to enter these marketplaces in 2015 provides the researcher with an opportunity to address this endogeneity problem. Exploiting the variation caused by United Healthcare's entry decision as an instrument for competition, we study the impact of competition on premiums during the first 2 years of these marketplaces. Combining panel data from five different sources and controlling for 12 variables, we find that one more insurer in a rating area leads to a 6.97% reduction in the second-lowest-priced silver plan premium, which is larger than the estimated effects in existing literature. Furthermore, we run a threshold analysis and find that competition's effects on premiums become statistically insignificant if there are four or more insurers in a rating area. These findings are robust to alternative measures of premiums, inclusion of a non-linear term in the regression models and a county-level analysis.

Effects of enhanced pacing modalities on health care resource utilization and costs in bradycardia patients: An analysis of the randomized MINERVA trial.

PubMed

Boriani, Giuseppe; Manolis, Antonis S; Tukkie, Raymond; Mont, Lluis; Pürerfellner, Helmut; Santini, Massimo; Inama, Giuseppe; Serra, Paolo; Gulizia, Michele; Samoilenko, Igor Vasilyevich; Wolff, Claudia; Holbrook, Reece; Gavazza, Federica; Padeletti, Luigi

2015-06-01

Many patients who suffer from bradycardia and need cardiac pacing also have atrial fibrillation (AF). New pacemaker algorithms, such as atrial preventive pacing and atrial antitachycardia pacing (DDDRP) and managed ventricular pacing (MVP), have been specifically designed to reduce AF occurrence and duration and to minimize the detrimental effects of right ventricular pacing. The randomized MINimizE Right Ventricular pacing to prevent Atrial fibrillation and heart failure trial established that DDDRP + MVP pacing modality reduced permanent AF in bradycardia patients as compared with standard dual-chamber pacing (DDDR). The aim of this study was to estimate the cost savings due to lower AF-related health care utilization events based on health care costs from the United States and the European Union. Dual-chamber pacemaker patients with a history of paroxysmal or persistent AF were randomly assigned to receive DDDR (n = 385) or the advanced features (DDDRP + MVP; n = 383). We used published health care costs from the United States and the European Union (Italy, Spain, and the United Kingdom) to estimate the costs associated with AF-related hospitalizations and emergency visits. The rate of AF-related hospitalizations was significantly lower in the DDDRP + MVP group than in the conventional pacemaker group (DDDR group; 42% reduction; incidence rate ratio 0.58). Similarly, a significant reduction of 68% was observed for AF-related emergency department visits (incidence rate ratio 0.32; P < .001). As a consequence, DDDRP + MVP could potentially reduce health care costs by 40%-44%. Over a ten-year period, the cost savings per 100 patients ranged from $35,702 in the United Kingdom to $121,831 in the United States. New pacing algorithms such as DDDRP + MVP used in the MINimizE Right Ventricular pacing to prevent Atrial fibrillation and heart failure trial successfully reduced AF-related health care utilization, resulting in significant cost savings to payers. Copyright © 2015 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Overview of entry risk predictions

NASA Astrophysics Data System (ADS)

Mrozinski, R.; Mendeck, G.; Cutri-Kohart, R.

Risk to people on the ground from uncontrolled entries of spacecraft is a primary concern when analyzing end-of-life disposal options for satellites. Countries must balance this risk with the need to mitigate an exponentially growing space debris population. Currently the United States does this via guidelines that call for a satellite to be disposed of in a controlled manner if an uncontrolled entry would be too risky to people on the ground. This risk is measured by a quantity called "casualty expectation", or E , where casualty expectation is defined as the expectedc number of people suffering death or injury due to a spacecraft entry event. If Ec exceeds 1 in 10,000, U. S. guidelines state that the entry should be controlled rather than uncontrolled. Since this guideline can have serious impacts on the cost, lifetime, and even the mission and functionality of a satellite, it is critical that this quantity be estimated well, and decision makers understand all assumptions and limitations inherent in the resulting value. This paper discusses several issues regarding estimates of casualty expectation, beginning with an overview of relevant United States policies and guidelines. The equation the space industry typically uses to estimate casualty expectation is presented, along with a look at the sensitivity of the results to the typical assumptions, models, and initial condition uncertainties. Differences in these modeling issues with respect to launch failure Ec estimates are included in the discussion. An alternate quantity to assess risks due to spacecraft entries is introduced. "Probability of casualty", or Pc , is defined as the probability of one or more instances of people suffering death or injury due to a spacecraft entry event. The equation to estimate Pc is derived, where the same assumptions, modeling, and initial condition issues for Ec apply. Several examples are then given of both Ec and Pc estimate calculations. Due to the difficult issues in estimating both Ec and Pc, it is argued that "true" absolute quantities can never be computed. However, E and Pc are ideal for relativec analyses against a standard tool that eliminates these issues. Such a tool is recommended for assessing compliance with requirements of regulating institutions.

20 CFR 416.1229 - Exclusion of payments received as compensation for expenses incurred or losses suffered as a...

Code of Federal Regulations, 2010 CFR

2010-04-01

... compensation for expenses incurred or losses suffered as a result of a crime. 416.1229 Section 416.1229... incurred or losses suffered as a result of a crime. (a) In determining the resources of an individual (and spouse, if any), any amount received from a fund established by a State to aid victims of crime is...

Cardiopulmonary resuscitation training in high school using avatars in virtual worlds: an international feasibility study.

PubMed

Creutzfeldt, Johan; Hedman, Leif; Heinrichs, LeRoy; Youngblood, Patricia; Felländer-Tsai, Li

2013-01-14

Approximately 300,000 people suffer sudden cardiac arrest (SCA) annually in the United States. Less than 30% of out-of-hospital victims receive cardiopulmonary resuscitation (CPR) despite the American Heart Association training over 12 million laypersons annually to conduct CPR. New engaging learning methods are needed for CPR education, especially in schools. Massively multiplayer virtual worlds (MMVW) offer platforms for serious games that are promising learning methods that take advantage of the computer capabilities of today's youth (ie, the digital native generation). Our main aim was to assess the feasibility of cardiopulmonary resuscitation training in high school students by using avatars in MMVM. We also analyzed experiences, self-efficacy, and concentration in response to training. In this prospective international collaborative study, an e-learning method was used with high school students in Sweden and the United States. A software game platform was modified for use as a serious game to train in emergency medical situations. Using MMVW technology, participants in teams of 3 were engaged in virtual-world scenarios to learn how to treat victims suffering cardiac arrest. Short debriefings were carried out after each scenario. A total of 36 high school students (Sweden, n=12; United States, n=24) participated. Their self-efficacy and concentration (task motivation) were assessed. An exit questionnaire was used to solicit experiences and attitudes toward this type of training. Among the Swedish students, a follow-up was carried out after 6 months. Depending on the distributions, t tests or Mann-Whitney tests were used. Correlation between variables was assessed by using Spearman rank correlation. Regression analyses were used for time-dependent variables. The participants enjoyed the training and reported a self-perceived benefit as a consequence of training. The mean rating for self-efficacy increased from 5.8/7 (SD 0.72) to 6.5/7 (SD 0.57, P<.001). In the Swedish follow-up, it subsequently increased from 5.7/7 (SD 0.56) to 6.3/7 (SD 0.38, P=.006). In the Swedish group, the mean concentration value increased from 52.4/100 (SD 9.8) to 62.7/100 (SD 8.9, P=.05); in the US group, the concentration value increased from 70.8/100 (SD 7.9) to 82.5/100 (SD 4.7, P<.001). We found a significant positive correlation (P<.001) between self-efficacy and concentration scores. Overall, the participants were moderately or highly immersed and the software was easy to use. By using online MMVWs, team training in CPR is feasible and reliable for this international group of high school students (Sweden and United States). A high level of appreciation was reported among these adolescents and their self-efficacy increased significantly. The described training is a novel and interesting way to learn CPR teamwork, and in the future could be combined with psychomotor skills training.

Cardiopulmonary Resuscitation Training in High School Using Avatars in Virtual Worlds: An International Feasibility Study

PubMed Central

Hedman, Leif; Heinrichs, LeRoy; Youngblood, Patricia; Felländer-Tsai, Li

2013-01-01

Background Approximately 300,000 people suffer sudden cardiac arrest (SCA) annually in the United States. Less than 30% of out-of-hospital victims receive cardiopulmonary resuscitation (CPR) despite the American Heart Association training over 12 million laypersons annually to conduct CPR. New engaging learning methods are needed for CPR education, especially in schools. Massively multiplayer virtual worlds (MMVW) offer platforms for serious games that are promising learning methods that take advantage of the computer capabilities of today’s youth (ie, the digital native generation). Objective Our main aim was to assess the feasibility of cardiopulmonary resuscitation training in high school students by using avatars in MMVM. We also analyzed experiences, self-efficacy, and concentration in response to training. Methods In this prospective international collaborative study, an e-learning method was used with high school students in Sweden and the United States. A software game platform was modified for use as a serious game to train in emergency medical situations. Using MMVW technology, participants in teams of 3 were engaged in virtual-world scenarios to learn how to treat victims suffering cardiac arrest. Short debriefings were carried out after each scenario. A total of 36 high school students (Sweden, n=12; United States, n=24) participated. Their self-efficacy and concentration (task motivation) were assessed. An exit questionnaire was used to solicit experiences and attitudes toward this type of training. Among the Swedish students, a follow-up was carried out after 6 months. Depending on the distributions, t tests or Mann-Whitney tests were used. Correlation between variables was assessed by using Spearman rank correlation. Regression analyses were used for time-dependent variables. Results The participants enjoyed the training and reported a self-perceived benefit as a consequence of training. The mean rating for self-efficacy increased from 5.8/7 (SD 0.72) to 6.5/7 (SD 0.57, P<.001). In the Swedish follow-up, it subsequently increased from 5.7/7 (SD 0.56) to 6.3/7 (SD 0.38, P=.006). In the Swedish group, the mean concentration value increased from 52.4/100 (SD 9.8) to 62.7/100 (SD 8.9, P=.05); in the US group, the concentration value increased from 70.8/100 (SD 7.9) to 82.5/100 (SD 4.7, P<.001). We found a significant positive correlation (P<.001) between self-efficacy and concentration scores. Overall, the participants were moderately or highly immersed and the software was easy to use. Conclusions By using online MMVWs, team training in CPR is feasible and reliable for this international group of high school students (Sweden and United States). A high level of appreciation was reported among these adolescents and their self-efficacy increased significantly. The described training is a novel and interesting way to learn CPR teamwork, and in the future could be combined with psychomotor skills training. PMID:23318253

AIDS and National Security

DTIC Science & Technology

2003-04-07

prevention and education programs. This increase in migrant workers is transforming local HIV epidemics and spreading the virus throughout the country.41...consumers, represents a huge, untapped market that would otherwise be promising for U.S. trade growth, but for the instability in the region, fueled...in states that are suffering from increasing HIV infection rates than waiting until those states fail and we suffer loss of trade or we are forced to

Seeking Chronic Pain Relief: A Hermeneutic Exploration.

PubMed

Smith, Crystal Lederhos; Severtsen, Billie; Vandermause, Roxanne; Barbosa-Leiker, Celestina; Wilson, Marian; Roll, John

2018-06-21

In the United States, chronic pain is experienced by over 39.4 million adults, many of whom are treated with opioid pain medications. This research presents an interpretation of the experience of seeking pain relief for a group of people taking opioid pain medications whose pain is not adequately controlled. A concurrent embedded mixed-methods design was used, including a Heideggerian hermeneutic qualitative approach that focuses on the participants' perceptions as a vehicle for understanding the phenomenon of seeking pain relief with descriptive quantitative data in a supporting role. Thirteen interviews and 15 surveys were analyzed, all of which met the following criteria: (1) self-reported chronic pain (persistent pain lasting a minimum of six months), (2) current use of prescription opioid medications, (3) pain not successfully controlled. The analysis revealed a paradox, which we describe as being lost/finding myself in the health care system. This paradox became the overarching pattern of experience that subsumed several dynamic, overlapping practices described in the patterns: (1) seeking relief as suffering; (2) being classified as an addict but not an addict; (3) living with pain as remembering; and (4) experiencing treatment modalities as fickle possibilities. Explication of and interpretive commentary on these patterns shift the focus from drug seeking to pain relief seeking behaviors in chronic pain sufferers. Such a shift could change the manner in which providers work with chronic pain sufferers to find appropriate treatment modalities. Copyright © 2018 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Measuring the suffering of end-stage dementia: reliability and validity of the Mini-Suffering State Examination.

PubMed

Aminoff, Bechor Z; Purits, Elena; Noy, Shlomo; Adunsky, Abraham

2004-01-01

Assessment of suffering is extremely important in dying end-stage dementia patients (ESDP). We have developed and examined the reliability and validity of the Mini-Suffering State Examination (MSSE), in 103 consecutive bedridden ESDP. Main outcome measures included inter-observer reliability and concurrent validity. Reliability of the MSSE questionnaire was satisfactory, with Cronbach alpha values of 0.735 and 0.718 for the two physicians (Ph-1, Ph-2), respectively. The kappa agreement coefficient was 0.791. There was a high agreement for seven items (kappa 0.882-0.972) and a substantial agreement for the other three items (kappa 0.621-0.682) of the MSSE. MSSE was validated versus the comfort assessment in dying with dementia (CAD-EOLD) scale and resulted in a significant Pearson correlation (r=-0.796, P<0.001). We conclude that the MSSE scale is a reliable and valid clinical tool, recommended for evaluating the severity of the patient's condition and the level of suffering of ESDP. Use of MSSE may improve medical management and facilitate communication between patients and caregivers.

["Lex Kendra" in New York, United States. Homicide, "revolving door psychiatry" and political response].

PubMed

Röttgers, H R; Nedjat, S

2001-03-01

The history, motivation and consequences of the New York State "Kendra's Law" as of August 1999 are reviewed. "Kendra's Law" was the consequence of the killing of a young woman, Kendra W., by a schizophrenic patient later convicted for second degree murder. Before, he had been repeatedly rejected when he sought treatment in state-run psychiatric facilities and was expelled several times from long-term hospitals despite a long history of violent behaviour when untreated. "Kendra's Law" now entitles physicians, case workers, roommates and families of untreated mentally ill persons to seek a court order forcing a patient to comply with treatment and, at the same time, compelling mental health institutions to grant this treatment. Additionally, the law and another bill signed in November 1999 provided for additional funding for the underfinanced state-run mental health system. "Kendra's Law" illustrates a bidirectional attempt to cope with the revolving door treatment situation of mentally ill in the State of New York by additional funding and additional possibilities to enforce treatment. The law illustrates the fundamental conflict between individual autonomy and the need for treatment of people suffering from severe mental illness.

Skin protection and breakdown in the ELBW infant. A national survey.

PubMed

Maguire, D P

1999-08-01

The purpose of this study was to learn how neonatal intensive care unit (NICU) nurses describe the problem of skin breakdown in the extremely low birth weight (ELBW) infant, examine interventions currently used to prevent and treat ELBW infant skin breakdown, and to learn how nurses describe and measure skin breakdown. Questionnaires were sent to 482 NICUs in the United States, and a response was requested from a registered nurse with at least 2 years NICU experience currently employed in the NICU who regularly managed ELBW infants. Questionnaires were returned from 215 NICUs (45%). Analysis revealed that an average of 21% of ELBW infants suffered skin breakdown during the 1st week of life. Nurses who reported the least problems with ELBW infant skin breakdown followed skin-care protocols that limited use of tape and made liberal use of Aquaphor to protect fragile skin. Recommendations from this study include the development of an objective tool to rate skin breakdown and further study of product efficacy used in the treatment of skin breakdown.

The Occurrence and Prevention of Foodborne Disease in Vulnerable People

PubMed Central

O'Brien, Sarah J.

2011-01-01

Abstract In developed countries, such as the United Kingdom and the United States, between 15% and 20% of the population show greater susceptibility than the general population to foodborne disease. This proportion includes people with primary immunodeficiency, patients treated with radiation or with immunosuppressive drugs for cancer and diseases of the immune system, those with acquired immune-deficiency syndrome and diabetics, people suffering from liver or kidney disease or with excessive iron in the blood, pregnant women, infants, and the elderly. Malnutrition and use of antacids, particularly proton-pump inhibitors, also increase susceptibility. We review the occurrence of infection by foodborne pathogens in these groups of people and measures to prevent infection. The nature and use of low microbial diets to reduce the risk of foodborne disease in immunocompromised patients are very variable. Diets for vulnerable people in care should exclude higher-risk foods, and vulnerable people in the community should receive clear advice about food safety, in particular avoidance of higher-risk foods and substitution of safer, nutritious foods. PMID:21561383

A Comparison of Satellite-Derived Snow Maps with a Focus on Ephemeral Snow in North Carolina

NASA Technical Reports Server (NTRS)

Hall, Dorothy K.; Fuhrmann, Christopher M.; Perry, L. Baker; Riggs, George A.; Robinson, David A.; Foster, James L.

2010-01-01

In this paper, we focus on the attributes and limitations of four commonly-used daily snowcover products with respect to their ability to map ephemeral snow in central and eastern North Carolina. We show that the Moderate-Resolution Imaging Spectroradiometer (MODIS) fractional snow-cover maps can delineate the snow-covered area very well through the use of a fully-automated algorithm, but suffer from the limitation that cloud cover precludes mapping some ephemeral snow. The semi-automated Interactive Multi-sensor Snow and ice mapping system (IMS) and Rutgers Global Snow Lab (GSL) snow maps are often able to capture ephemeral snow cover because ground-station data are employed to develop the snow maps, The Rutgers GSL maps are based on the IMS maps. Finally, the Advanced Microwave Scanning Radiometer for EOS (AMSR-E) provides some good detail of snow-water equivalent especially in deeper snow, but may miss ephemeral snow cover because it is often very thin or wet; the AMSR-E maps also suffer from coarse spatial resolution. We conclude that the southeastern United States represents a good test region for validating the ability of satellite snow-cover maps to capture ephemeral snow cover,

Cancer, culture, and health disparities: time to chart a new course?

PubMed

Kagawa-Singer, Marjorie; Dadia, Annalyn Valdez; Yu, Mimi C; Surbone, Antonella

2010-01-01

Little progress has been made over the last 40 years to eliminate the racial/ethnic differences in incidence, morbidity, avoidable suffering, and mortality from cancer that result from factors beyond genetic differences. More effective strategies to promote equity in access and quality care are urgently needed because the changing demographics of the United States portend that this disparity will not only persist but significantly increase. Such suffering is avoidable. The authors posit that culture is a prime factor in the persistence of health disparities. However, this concept of culture is still poorly understood, inconsistently defined, and ineffectively used in practice and research. The role of culture in the causal pathway of disparities and the potential impact of culturally competent cancer care on improving cancer outcomes in ethnic minorities has, thus, been underestimated. In this article, the authors provide a comprehensive definition of culture and demonstrate how it can be used at each stage of the cancer care continuum to help reduce the unequal burden of cancer. The authors conclude with suggestions for clinical practice to eliminate the disconnection between evidence-based, quality, cancer care and its delivery to diverse population groups.

A Cost‐Benefit Analysis of Government Compensation of Kidney Donors

PubMed Central

McCormick, F.; Ojo, A.; Roberts, J. P.

2016-01-01

Abstract From 5000 to 10 000 kidney patients die prematurely in the United States each year, and about 100 000 more suffer the debilitating effects of dialysis, because of a shortage of transplant kidneys. To reduce this shortage, many advocate having the government compensate kidney donors. This paper presents a comprehensive cost‐benefit analysis of such a change. It considers not only the substantial savings to society because kidney recipients would no longer need expensive dialysis treatments—$1.45 million per kidney recipient—but also estimates the monetary value of the longer and healthier lives that kidney recipients enjoy—about $1.3 million per recipient. These numbers dwarf the proposed $45 000‐per‐kidney compensation that might be needed to end the kidney shortage and eliminate the kidney transplant waiting list. From the viewpoint of society, the net benefit from saving thousands of lives each year and reducing the suffering of 100 000 more receiving dialysis would be about $46 billion per year, with the benefits exceeding the costs by a factor of 3. In addition, it would save taxpayers about $12 billion each year. PMID:26474298

Car radiator burns: a prevention issue.

PubMed

Rabbitts, Angela; Alden, Nicole E; Conlin, Tara; Yurt, Roger W

2004-01-01

Scald burns continue to be the major cause of injury to patients admitted to the burn center. Scald burns occurring from car radiator fluid comprise a significant subgroup. Although manufacturer warning labels have been placed on car radiators, these burns continue to occur. This retrospective review looks at all patients admitted to our burn center who suffered scald burns from car radiator fluid to assess the extent of this problem. During the study period, 86 patients were identified as having suffered scald burns as a result of contact with car radiator fluid. Seventy-one percent of the burn injuries occurred in the summer months. The areas most commonly burned were the head and upper extremities. Burn prevention efforts have improved greatly over the years; however, this study demonstrates that scald burns from car radiator fluid continue to cause physical, emotional, and financial devastation. The current radiator warning labels alone are not effective. The National Highway Traffic Safety Administration has proposed a new federal motor vehicle safety standard to aid in decreasing the number of scald burns from car radiators. The results of this study were submitted to the United States Department of Transportation for inclusion in a docket for federal legislation supporting these safety measures.

The clinicide phenomenon: an exploration of medical murder.

PubMed

Kaplan, Robert

2007-08-01

The aim of this paper is to explore the phenomenon of clinicide. The study of medical killers is barely in its infancy. Clinicide is the unnatural death of multiple patients in the course of treatment by a doctor. Serial medical killing is a relatively new phenomenon. The role model is Dr Marcel Petiot, the worst serial killer in French history. More recently, Dr Harold Shipman was Britain's worst serial killer and in the United States and Zimbabwe, Dr Michael Swango killed 60 patients. A number of doctors have such high patient death rates that it cannot be ignored. At some level, these doctors have an awareness of what they are doing, countered by an overweening refusal to acknowledge the implications or desist from further treatment. Treatment killer offences usually occur on the basis of serial mental illness, but may include the contentious area of euthanasia killing. Doctors have frequently been accomplices in state repression, brutality and genocide in direct contravention to their sanctioned role to relieve suffering and save life. They have become mass murderers on an exponential scale, making any comparison with a doctor killing his own patients almost risible. Many clinicidal doctors have extreme narcissistic personalities, a grandiose view of their own capability and inability to accept that they could be criticized or need assistance from other doctors. Such doctors develop a God-complex, getting a vicarious thrill out of ending suffering and by determining when a person dies.

Care and companionship in an isolating environment: Inmates attending to dying peers

PubMed Central

Hollenbeak, Christopher S.; Penrod, Janice; Smith, Carol A.; Kitt-Lewis, Erin; Crouse, Sarah B.

2013-01-01

The purpose of this study was to examine the values, beliefs, and perceptions of end-of-life (EOL) care held by inmates caring for peers approaching end of life. The study is part of a broader participatory action research project to infuse enhanced EOL care into state prisons. Face-to-face interviews using a semi-structured discussion guide were conducted with 17 male prisoners who were providing care for peers with advanced chronic illness and approaching end of life. Qualitative data were analyzed using content and thematic analyses. Key themes were: getting involved; living the role; and transforming self through caring for others. As well, contextual features at the organizational, peer, and personal levels were identified that either facilitated or impeded inmate caregiving. Provision of enhanced EOL care by inmate peers shows promise for improving prison community relations and morale, reducing suffering, and demonstrating care and compassion within the harsh prison environment. This study provides clear evidence that providing compassionate care for dying peers may result in transformative experiences for inmate caregivers. Implications for correctional nursing practice include providing training for inmate caregivers, including them in team meetings, and implementing grief support programs. Also, upholding nursing’s code of ethics and watching for predatory behavior are critical. “Prisons in the United States contain an ever growing number of aging men and women who…are incontinent, forgetful, suffering chronic illnesses, extremely ill, and dying” (Human Rights Watch, 2012, p. 4) PMID:24158099

Induction and Mentoring of Novice Teachers: A Scheme for the United Arab Emirates

ERIC Educational Resources Information Center

Ibrahim, Ali S.

2012-01-01

Induction and mentoring of novice teachers have gained considerable worldwide attention. However, in the United Arab Emirates, graduates from teacher education programmes are recruited as teachers without being provided with any formal school-based support. They suffer from stress, overload, and low self-esteem and a high percentage leave…

A Pain Research Agenda for the 21st Century

PubMed Central

Gereau, Robert W.; Sluka, Kathleen A.; Maixner, William; Savage, Seddon R.; Price, Theodore J.; Murinson, Beth B.; Sullivan, Mark D.; Fillingim, Roger B.

2015-01-01

Chronic pain represents an immense clinical problem. With tens of millions of people in the United States alone suffering from the burden of debilitating chronic pain, there is a moral obligation to reduce this burden by improving the understanding of pain and treatment mechanisms, developing new therapies, optimizing and testing existing therapies, and improving access to evidence-based pain care. Here, we present a goal-oriented research agenda describing the American Pain Society’s vision for pain research aimed at tackling the most pressing issues in the field. Perspective This article presents the American Pain Society’s view of some of the most important research questions that need to be addressed to advance pain science and to improve care of patients with chronic pain. PMID:25419990

Posttraumatic stress disorder among black Vietnam veterans.

PubMed

Allen, I M

1986-01-01

Because of racism in the military and racial and social upheaval in the United States during the Vietnam War years, as well as limited opportunities for blacks in the postwar period, black veterans of the Vietnam War often harbor conflicting feelings about their wartime experiences and have difficulty rationalizing brutality against the Vietnamese. As a result, black veterans suffer from posttraumatic stress disorder (PTSD) at a higher rate than white veterans. Diagnosis and treatment of PTSD in black veterans is complicated by the tendency to misdiagnose black patients, by the varied manifestations of PTSD, and by patients' frequent alcohol and drug abuse and medical, legal, personality, and vocational problems. The author presents his and others' recommendations about ways to treat black veterans with PTSD.

Reinforcement of osteogenesis with nanofabricated hydroxyapatite and GelMA nanocomposite

NASA Astrophysics Data System (ADS)

Meng, Zhaokai; Chitrakar, Chandani; Gaharwar, Akhilesh K.; Yakovlev, Vladislav V.

2015-02-01

Every year in the United States approximately 1.5 million people are suffering from bone fractures. Current treatment solutions include surgeries and grafting process; however, it does not show any osteoconductive action, which is an essential character for biomaterials. The main objective of the reported studies is to develop a novel nanocomposite comprising of hydroxyapatite nanospheres (~40nm) and gelatin methacrylate to promote bone regeneration without any osteoinductive factors. To validate our hypothesis that chemical and mechanical properties of nanocomposite get enhanced, we employed various characterization techniques including Brillouin and Raman spectroscopies. The results imply that hydroxyaoatite nanoparticles are capable of enhancing the macroscopic stiffness at the structural level. To the contrary, Brillouin spectroscopy suggests that the microscopic elasticity of the nanocomposite was weakened.

Lies and coercion: why psychiatrists should not participate in police and intelligence interrogations.

PubMed

Janofsky, Jeffrey S

2006-01-01

Police interrogators routinely use deceptive techniques to obtain confessions from criminal suspects. The United States Executive Branch has attempted to justify coercive interrogation techniques in which physical or mental pain and suffering may be used during intelligence interrogations of persons labeled unlawful combatants. It may be appropriate for law enforcement, military, or intelligence personnel who are not physicians to use such techniques. However, forensic psychiatry ethical practice requires honesty, striving for objectivity, and respect for persons. Deceptive and coercive interrogation techniques violate these moral values. When a psychiatrist directly uses, works with others who use, or trains others to use deceptive or coercive techniques to obtain information in police, military, or intelligence interrogations, the psychiatrist breaches basic principles of ethics.

Therapeutic cloning and tissue engineering.

PubMed

Koh, Chester J; Atala, Anthony

2004-01-01

A severe shortage of donor organs available for transplantation in the United States leaves patients suffering from diseased and injured organs with few treatment options. Scientists in the field of tissue engineering apply the principles of cell transplantation, material science, and engineering to construct biological substitutes that will restore and maintain normal function in diseased and injured tissues. Therapeutic cloning, where the nucleus from a donor cell is transferred into an enucleated oocyte in order to extract pluripotent embryonic stem cells, offers a potentially limitless source of cells for tissue engineering applications. The present chapter reviews recent advances that have occurred in therapeutic cloning and tissue engineering and describes applications of these new technologies that may offer novel therapies for patients with end-stage organ failure.

The pharmacologic management of nausea and vomiting of pregnancy.

PubMed

Niebyl, Jennifer R; Briggs, Gerald G

2014-02-01

Nausea and vomiting are common in early pregnancy. Forty percent or more of pregnant women may continue to suffer beyond the first trimester and 10% beyond the second trimester. A focus of the assessment is to confirm that the nausea and vomiting is due to the pregnancy and not some other cause. Nonpharmacologic options, particularly dietary modification, are a mainstay of treatment. For those who continue to experience symptoms, pharmacologic management can be employed. The combination of doxylamine succinate/pyridoxine hydrochloride was reintroduced in the United States following FDA approval in early 2013. The product was given a pregnancy safety rating of A and is recommended as first-line pharmacologic treatment for NVP. Other options include antihistamines, metoclopramide, ondansetron, phenothiazines, and after the first trimester, corticosteroids.

The Prophylactic Extraction of Third Molars: A Public Health Hazard

PubMed Central

Friedman, Jay W.

2007-01-01

Ten million third molars (wisdom teeth) are extracted from approximately 5 million people in the United States each year at an annual cost of over $3 billion. In addition, more than 11 million patient days of “standard discomfort or disability”—pain, swelling, bruising, and malaise—result postoperatively, and more than 11000 people suffer permanent paresthesia—numbness of the lip, tongue, and cheek—as a consequence of nerve injury during the surgery. At least two thirds of these extractions, associated costs, and injuries are unnecessary, constituting a silent epidemic of iatrogenic injury that afflicts tens of thousands of people with lifelong discomfort and disability. Avoidance of prophylactic extraction of third molars can prevent this public health hazard. PMID:17666691

[Post-polio syndrome. Part I. The "legacy" of forgotten disease, challenges for professionals and polio survivors].

PubMed

Matyja, Ewa

2012-01-01

The outcome of paralytic polio was believed to be a stable neurological state. Now, it is established that polio has an additional, slowly progressive phase, called post-polio syndrome (PPS) that develops 30-40 years after the acute poliomyelitis in 25-80% of paralytic and about 40% of nonparalytic polio survivors. The clinical symptoms are nonspecific and usually include muscle weakness, fatigue and muscle or joint pain. Some patients suffer from muscular atrophy, respiratory insufficiency, dysphagia, sleep disturbances or cold intolerance. The etiopathogenesis of PPS is unclear and many factors, such as dysfunction of the surviving motor units, aging, defects of neuromuscular transmission, persistence of viral infection and immunological mechanisms, are considered.

Cluster Headache Clinical Phenotypes: Tobacco Nonexposed (Never Smoker and No Parental Secondary Smoke Exposure as a Child) versus Tobacco-Exposed: Results from the United States Cluster Headache Survey.

PubMed

Rozen, Todd D

2018-05-01

To present results from the United States Cluster Headache Survey comparing the clinical presentation of tobacco nonexposed and tobacco-exposed cluster headache patients. Cluster headache is uniquely tied to a personal history of tobacco usage/cigarette smoking and, if the individual cluster headache sufferer did not smoke, it has been shown that their parent(s) typically did and that individual had significant secondary smoke exposure as a child. The true nontobacco exposed (no personal or secondary exposure) cluster headache sufferer has never been fully studied. The United States Cluster Headache Survey consisted of 187 multiple choice questions related to cluster headache including: patient demographics, clinical headache characteristics, family history, triggers, smoking history (personal and secondary), and headache-related disability. The survey was placed on a website from October through December 2008. One thousand one hundred thirty-four individuals completed the survey. One hundred thirty-three subjects or 12% of the surveyed population had no personal smoking/tobacco use history and no secondary smoke exposure as an infant/child, thus a nontobacco exposed population. In the nonexposed population, there were 87 males and 46 females with a gender ratio of 1.9:1. Episodic cluster headache occurred in 80% of nonexposed subjects. One thousand and one survey responders or 88% were tobacco-exposed (729 males and 272 females) with a gender ratio of 2.7:1. Eighty-three percent had a personal smoking history, while only 17% just had parents who smoked with secondary smoke exposure. Eighty-five percent of smokers had double exposure with a personal smoking history and secondary exposure as a child. Nonexposed cluster headache subjects are significantly more likely to develop cluster headache at ages 40 years and younger, while the exposed sufferers are significantly more likely to develop cluster headache at 40 years of age and older. Nonexposed patients have a statistically significant higher frequency of a migraine family history. The exposed population is statistically significantly more likely to have a history of head trauma 19% vs the nonexposed population 10% (P = .02). Tobacco exposed are significantly more likely to transition from episodic to chronic cluster headache (23% vs 14%, P = .02). Cranial autonomic symptoms as well as agitation are more common in tobacco exposed. Nonexposed are less likely to have specific cluster headache triggers. Exposed are significantly more likely to be triggered by alcohol. Tobacco exposed are significantly heavier caffeine users than nonexposed. Nonexposed are significantly more likely to have cluster headache cycles that vary throughout the year than exposed (52% vs 40%, P = .02). Exposed are much more likely to develop cluster headache from 12 am to 6 am than non exposed. Exposed experience significantly more frequent attacks per day and longer duration cycles than nonexposed. A significantly larger percent of the exposed population (57%) has suicidal ideations with their syndrome than nonexposed (43%) (P = .003). In regard to disability, both subtypes are disabled by their headaches, but exposed have more work related disability and lost home-days from headache. Both subgroups have a poor overall response to preventive and abortive medication outside of inhaled oxygen and injectable sumatriptan. Cluster headache sufferers who were never exposed to tobacco (personal or secondary as a child) appear to present uniquely compared to the tobacco exposed subgroup. The tobacco exposed clinical phenotype appears to have a more severe syndrome based on attack frequency, cycle duration, and headache related disability. Tobacco exposure is associated with cluster headache chronification. The nonexposed subtype appears to have an earlier age of onset, higher rate of familial migraine, and less circadian periodicity and daytime entrainment, suggesting a possible different underlying pathology than in the tobacco exposed sub-form. © 2018 American Headache Society.

Defining the Medical Intensive Care Unit in the Words of Patients and Their Family Members: A Freelisting Analysis.

PubMed

Auriemma, Catherine L; Lyon, Sarah M; Strelec, Lauren E; Kent, Saida; Barg, Frances K; Halpern, Scott D

2015-07-01

No validated conceptual framework exists for understanding the outcomes of patient- and family-centered care in critical care. To explore the meaning of intensive care unit among patients and their families by using freelisting. The phrase intensive care unit was used to prompt freelisting among intensive care unit patients and patients' family members. Freelisting is an anthropological technique in which individuals define a domain by listing all words that come to mind in response to a topic. Salience scores, derived from the frequency with which a word was mentioned, the order in which it was mentioned, and the length of each list, were calculated and analyzed. Among the 45 participants, many words were salient to both patients and patients' family members. Words salient solely for patients included consciousness, getting better, noisy, and personal care. Words salient solely for family members included sadness, busy, professional, and hope. The words suffering, busy, and team were salient solely for family members of patients who lived, whereas sadness, professionals, and hope were salient solely for family members of patients who died. The words caring and death were salient for both groups. Intensive care unit patients and their families define intensive care unit by using words to describe sickness, caring, medical staff, emotional states, and physical qualities of the unit. The results validate the importance of these topics among patients and their families in the intensive care unit and illustrate the usefulness of freelisting in critical care research. ©2015 American Association of Critical-Care Nurses.

20 CFR 627.315 - Benefits and working conditions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... to work for employers which do not comply with applicable labor laws, including wage and hour... with respect to injuries suffered by participants. Where a State's workers' compensation law is not applicable, recipients and subrecipients shall secure insurance coverage for injuries suffered by such...

Real-Time Sharing and Expression of Migraine Headache Suffering on Twitter: A Cross-Sectional Infodemiology Study

PubMed Central

Nascimento, Thiago D; DosSantos, Marcos F; Danciu, Theodora; DeBoer, Misty; van Holsbeeck, Hendrik; Lucas, Sarah R; Aiello, Christine; Khatib, Leen; Bender, MaryCatherine A; Zubieta, Jon-Kar

2014-01-01

Background Although population studies have greatly improved our understanding of migraine, they have relied on retrospective self-reports that are subject to memory error and experimenter-induced bias. Furthermore, these studies also lack specifics from the actual time that attacks were occurring, and how patients express and share their ongoing suffering. Objective As technology and language constantly evolve, so does the way we share our suffering. We sought to evaluate the infodemiology of self-reported migraine headache suffering on Twitter. Methods Trained observers in an academic setting categorized the meaning of every single “migraine” tweet posted during seven consecutive days. The main outcome measures were prevalence, life-style impact, linguistic, and timeline of actual self-reported migraine headache suffering on Twitter. Results From a total of 21,741 migraine tweets collected, only 64.52% (14,028/21,741 collected tweets) were from users reporting their migraine headache attacks in real-time. The remainder of the posts were commercial, re-tweets, general discussion or third person’s migraine, and metaphor. The gender distribution available for the actual migraine posts was 73.47% female (10,306/14,028), 17.40% males (2441/14,028), and 0.01% transgendered (2/14,028). The personal impact of migraine headache was immediate on mood (43.91%, 6159/14,028), productivity at work (3.46%, 486/14,028), social life (3.45%, 484/14,028), and school (2.78%, 390/14,028). The most common migraine descriptor was “Worst” (14.59%, 201/1378) and profanity, the “F-word” (5.3%, 73/1378). The majority of postings occurred in the United States (58.28%, 3413/5856), peaking on weekdays at 10:00h and then gradually again at 22:00h; the weekend had a later morning peak. Conclusions Twitter proved to be a powerful source of knowledge for migraine research. The data in this study overlap large-scale epidemiological studies, avoiding memory bias and experimenter-induced error. Furthermore, linguistics of ongoing migraine reports on social media proved to be highly heterogeneous and colloquial in our study, suggesting that current pain questionnaires should undergo constant reformulations to keep up with modernization in the expression of pain suffering in our society. In summary, this study reveals the modern characteristics and broad impact of migraine headache suffering on patients’ lives as it is spontaneously shared via social media. PMID:24698747

Plague Gives Surprises in the First Decade of the 21st Century in the United States and Worldwide

PubMed Central

Butler, Thomas

2013-01-01

Plague is an ancient disease caused by the bacterium Yersinia pestis and transmitted by rodent flea bites that continues to surprise us with first-ever events. This review documents plague in human cases in the 1st decade of the 21st century and updates our knowledge of clinical manifestations, transmission during outbreaks, diagnostic testing, antimicrobial treatment, and vaccine development. In the United States, 57 persons were reported to have the disease, of which seven died. Worldwide, 21,725 persons were affected with 1,612 deaths, for a case-fatality rate of 7.4%. The Congo reported more cases than any other country, including two large outbreaks of pneumonic plague, surpassing Madagascar, which had the most cases in the previous decade. Two United States scientists suffered fatal accidental exposures: a wildlife biologist, who carried out an autopsy on a mountain lion in Arizona in 2007, and a geneticist with subclinical hemochromatosis in Chicago, who was handling an avirulent strain of Y. pestis in 2009. Antimicrobial drugs given early after the onset of symptoms prevented many deaths; those recommended for treatment and prophylaxis included gentamicin, doxycycline, and fluoroquinolones, although fluoroquinolones have not been adequately tested in humans. Fleas that do not have their guts blocked by clotted blood meals were shown to be better transmitters of plague than blocked fleas. Under development for protection against bioterrorist use, a subunit vaccine containing F1 and V antigens of Y. pestis was administered to human volunteers eliciting antibodies without any serious side effects. These events, although showing progress, suggest that plague will persist in rodent reservoirs mostly in African countries burdened by poverty and civil unrest, causing death when patients fail to receive prompt antimicrobial treatment. PMID:24043686

Migration and stratification

PubMed Central

Jasso, Guillermina

2011-01-01

Migration and stratification are increasingly intertwined. One day soon it will be impossible to understand one without the other. Both focus on life chances. Stratification is about differential life chances - who gets what and why - and migration is about improving life chances - getting more of the good things of life. To examine the interconnections of migration and stratification, we address a mix of old and new questions, carrying out analyses newly enabled by a unique new data set on recent legal immigrants to the United States (the New Immigrant Survey). We look at immigrant processing and lost documents, depression due to the visa process, presentation of self, the race-ethnic composition of an immigrant cohort (made possible by the data for the first time since 1961), black immigration from Africa and the Americas, skin-color diversity among couples formed by U.S. citizen sponsors and immigrant spouses, and English fluency among children age 8–12 and their immigrant parents. We find, inter alia, that children of previously illegal parents are especially more likely to be fluent in English, that native-born U.S. citizen women tend to marry darker, that immigrant applicants who go through the visa process while already in the United States are more likely to have their documents lost and to suffer visa depression, and that immigration, by introducing accomplished black immigrants from Africa (notably via the visa lottery), threatens to overturn racial and skin color associations with skill. Our analyses show the mutual embeddedness of migration and stratification in the unfolding of the immigrants' and their children's life chances and the impacts on the stratification structure of the United States. PMID:26321771

Cardiovascular ischemic event rates in outpatients with symptomatic atherothrombosis or risk factors in the united states: insights from the REACH Registry.

PubMed

Eagle, Kim A; Hirsch, Alan T; Califf, Robert M; Alberts, Mark J; Steg, P Gabriel; Cannon, Christopher P; Brennan, Danielle M; Bhatt, Deepak L

2009-06-01

Atherothrombosis, defined as coronary artery, cerebrovascular, and peripheral arterial disease, is the leading cause of death in the United States. Limited data are available from outpatient populations to describe contemporary cardiovascular ischemic event rates and associated use of risk reduction treatments in patients with clinically manifest, or at risk for, atherothrombosis. The REduction of Atherothrombosis for Continued Health (REACH) Registry is an international, prospective, observational study of patients with either documented atherothrombotic syndromes or 3 or more risk factors designed to fill this knowledge gap. Baseline demographics and 1-year outcomes were evaluated for US patients enrolled in the REACH Registry. Multivariate analytic models were constructed using baseline characteristics to determine independent predictors of 1-year event rates. In the United States, 25,686 patients were enrolled into the registry. Among symptomatic patients (n = 19,069), 19% had disease in >or=1 arterial bed. As of July 2006, 1-year outcomes were available for 93.4% (n = 23,985) of patients. The composite cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke event rate was 4.3% for the overall population and highest in patients with triple bed disease (9.9%). There was a relatively high use of risk reduction medications among symptomatic patients. However, opportunity for improvement remains. Approximately 9% of symptomatic patients were not using any antithrombotic, 7% were not using any antihypertensive agents, and 17% were not taking a lipid-lowering agent, whereas >80% of patients suffered from hypertension or dyslipidemia. US patients with established atherothrombotic disease continue to experience high cardiovascular ischemic event rates; these rates increase in close association with polyvascular disease. Despite the use of risk reduction interventions, ideal secondary prevention of ischemic events has not been achieved.

The rate of preterm birth in the United States is affected by the method of gestational age assignment.

PubMed

Duryea, Elaine L; McIntire, Donald D; Leveno, Kenneth J

2015-08-01

The objective of the study was to examine the rate of preterm birth in the United States using 2 different methods of gestational age assignment and determine which method more closely correlates with the known morbidities associated with preterm birth. Using National Center for Health Statistics data from 2012 United States birth certificates, we computed the rate of preterm birth defined as a birth at 36 or fewer completed weeks with gestational age assigned using the obstetric estimate as specified in the revised birth certificate. This rate was then compared with the rate when gestational age is calculated using the last menstrual period alone. The rates of neonatal morbidities associated with preterm birth were examined for each method of assigning gestational age. The rate of preterm birth was 9.7% when the obstetric estimate is used to calculate gestational age, which is significantly different from the rate of 11.5% when gestational age is calculated using the last menstrual period alone. In addition, the neonates identified as preterm by obstetric estimate were more likely to qualify as low birthweight (54% vs 42%; P < .001) and suffer morbidities such as need for assisted ventilation and surfactant use than those identified with the last menstrual period alone. That is to say obstetric estimate is more sensitive and specific for preterm birth by all available markers of prematurity. The preterm birth rate is 9.7% vs 11.5% and more closely correlates with adverse neonatal outcomes associated with preterm birth when gestational age is assigned using the obstetric estimate. This method of gestational age assignment is currently used by most industrialized nations and should be considered for future reporting of US outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.

Early prediction of extreme stratospheric polar vortex states based on causal precursors

NASA Astrophysics Data System (ADS)

Kretschmer, Marlene; Runge, Jakob; Coumou, Dim

2017-08-01

Variability in the stratospheric polar vortex (SPV) can influence the tropospheric circulation and thereby winter weather. Early predictions of extreme SPV states are thus important to improve forecasts of winter weather including cold spells. However, dynamical models are usually restricted in lead time because they poorly capture low-frequency processes. Empirical models often suffer from overfitting problems as the relevant physical processes and time lags are often not well understood. Here we introduce a novel empirical prediction method by uniting a response-guided community detection scheme with a causal discovery algorithm. This way, we objectively identify causal precursors of the SPV at subseasonal lead times and find them to be in good agreement with known physical drivers. A linear regression prediction model based on the causal precursors can explain most SPV variability (r2 = 0.58), and our scheme correctly predicts 58% (46%) of extremely weak SPV states for lead times of 1-15 (16-30) days with false-alarm rates of only approximately 5%. Our method can be applied to any variable relevant for (sub)seasonal weather forecasts and could thus help improving long-lead predictions.

Economic Burden of Hospitalizations for Heat-Related Illnesses in the United States, 2001-2010.

PubMed

Schmeltz, Michael T; Petkova, Elisaveta P; Gamble, Janet L

2016-09-08

Understanding how heat waves affect morbidity and mortality, as well as the associated economic costs, is essential for characterizing the human health impacts of extreme heat under a changing climate. Only a handful of studies have examined healthcare costs associated with exposures to high temperatures. This research explores costs associated with hospitalizations for heat-related illness (HRI) in the United States using the 2001 to 2010 Nationwide Inpatient Sample (NIS). Descriptive statistics of patient data for HRI hospitalizations were examined and costs of hospitalizations were reported using the all-payer inpatient cost-to-charge ratio. Costs were examined using a log-gamma model with patient and hospital characteristics included as fixed effects. Adjusted mean costs were then compared across racial groups. The mean costs of HRI hospitalizations were higher among racial/ethnic minorities compared to Whites, who accounted for almost 65% of all HRI hospitalizations. Observed differences in costs based on income, insurance, and gender were also significant. These results suggest that these populations are suffering disproportionately from health inequity, thus, they could shoulder greater disease and financial burdens due to climate change. These findings may have important implications in understanding the economic impact public health planning and interventions will have on preventing hospitalizations related to extreme heat.

Improving Health Promotion to American Indians in the Midwest United States: Preferred Sources of Health Information and Its Use for the Medical Encounter

PubMed Central

Geana, Mugur V.; Greiner, K. Allen; Cully, Angelia; Talawyma, Myrietta; Daley, Christine Makosky

2014-01-01

American Indians and Alaska Natives suffer significant health disparities for many infectious and chronic diseases as compared to the general population. Providing accurate and culturally tailored health information to underserved groups has been shown to influence health behaviors and health outcomes. Little prior research has explored American Indians health information use and preferences. National representative sample surveys such as the Health Information National Trends Survey provide some data on minority groups but are underpowered to provide useful information on American Indians. The present study analyzes data from a survey of over 900 American Indians from the Midwest United States and explores their sources of health information, their preferences for information presentation, and their use of health information prior to and during medical encounters. We conclude that campaigns targeting Natives should be narrowly focused and be community driven or employing community resources. American Indians use a diversity of media sources to obtain health information, with the Internet being underutilized compared to the general population. Partnership with Indian Health Service providers and pharmacists, as well as traditional healers, in the development and dissemination of new health information for Natives may provide the “expert” tone needed to promote health improvements in American Indians. PMID:22477671

Injuries occurring in medical students during international medical rotations: a strategy toward maximizing safety.

PubMed

Galvin, Shannon; Robertson, Russell; Hargarten, Stephen

2012-06-01

The number of medical students traveling to nations outside the United States is steadily increasing. The Association of American Medical Colleges graduation questionnaire notes an increase from 2,838 students in 2001 to 3,799 students in 2009, the last year for which information is available. The risk of having any type of illness during international travel approaches 50%. Up to 19% of students will seek medical care on their return to the United States for illnesses. Most illnesses are benign and self limited. However, when deaths do occur, the leading causes are motor vehicle crashes and drownings. If air medical evacuation occurs, the most likely cause is an injury event. The authors review the literature to determine the risk of and type of illnesses and injuries suffered by travelers while overseas, especially medical volunteers. We describe the major categories of illness and injury risk and propose reasonable risk reduction and prevention strategies for prevention for injury, a relatively neglected area. We recommend that medical schools provide pre-travel training that includes injury prevention so that students are prepared not only for illness prevention but also for injury prevention. A focus on injury prevention, especially from motor vehicle crashes and drowning, is warranted given their role in causing death and serious injury to traveling students.

Diseases Transmitted by Man's Best Friend: The Dog.

PubMed

Jacob, Jerry; Lorber, Bennett

2015-08-01

The relationship between dogs and humans is ancient and mutually beneficial. Dogs have served people well as companions, workmates, guides, and protectors. However, on occasion, dogs may injure humans through biting or may transmit pathogens resulting in a large number of problems ranging from a trivial rash to life-threatening bacteremia. Given that there are more than 80 million pet dogs in the United States, it is worth knowing the potential problems that can result from canine exposure. Annually, almost 5 million people in the United States suffer a dog bite. Dog bite wounds become infected up to 15% of the time. In those who have had a splenectomy, a dog bite may transmit the bacterium Capnocytophaga canimorsus, leading to life-threatening bacteremia. Other illnesses that humans can acquire from dog contact include ringworm, diarrheal disease (salmonellosis, campylobacteriosis, and intestinal parasites), leptospirosis, brucellosis, Q fever, visceral larva migrans, and echinococcosis. Evidence exists that the family dog may serve as a reservoir for uropathogenic Escherichia coli that can lead to urinary tract infections among human household contacts. In this article we discuss dog-related infectious diseases as well as measures to minimize dog-associated illness (e.g., do not disturb sleeping dogs; HIV-infected persons who wish to acquire a puppy should have the dog's stool checked for Cryptosporidium).

A Systematic Review on the Use of Psychosocial Interventions in Conjunction With Medications for the Treatment of Opioid Addiction.

PubMed

Dugosh, Karen; Abraham, Amanda; Seymour, Brittany; McLoyd, Keli; Chalk, Mady; Festinger, David

2016-01-01

Opioid use and overdose rates have risen to epidemic levels in the United States during the past decade. Fortunately, there are effective medications (ie, methadone, buprenorphine, and oral and injectable naltrexone) available for the treatment of opioid addiction. Each of these medications is approved for use in conjunction with psychosocial treatment; however, there is a dearth of empirical research on the optimal psychosocial interventions to use with these medications. In this systematic review, we outline and discuss the findings of 3 prominent prior reviews and 27 recent publications of empirical studies on this topic. The most widely studied psychosocial interventions examined in conjunction with medications for opioid addiction were contingency management and cognitive behavioral therapy, with the majority focusing on methadone treatment. The results generally support the efficacy of providing psychosocial interventions in combination with medications to treat opioid addictions, although the incremental utility varied across studies, outcomes, medications, and interventions. The review highlights significant gaps in the literature and provides areas for future research. Given the enormity of the current opioid problem in the United States, it is critical to gain a better understanding of the most effective ways to deliver psychosocial treatments in conjunction with these medications to improve the health and well-being of individuals suffering from opioid addiction.

Stories about ourselves: How national narratives influence the diffusion of large-scale energy technologies

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

Malone, Elizabeth L.; Hultman, Nathan E.; Anderson, Kate

Examining past examples of rapid, transformational changes in energy technologies could help governments understand the factors associated with such transitions. We used an existing dataset to assess government strategies to connect new energy technologies with national narratives. Analyzing the diffusion stories told by experts, we demonstrate how governments connected the new technologies with their national narratives. The United States government supported the development of nuclear power after World War II with the national narrative that the United States was destined to improve creation, increasing the potential of raw materials exponentially for the nation’s good (“atoms for peace,” electricity “too cheapmore » to meter”). In Brazil, the development of sugar cane ethanol was supported by the government’s invoking the national narrative of suffering leading to knowledge and redemption, coupled with the quest for improved societal well-being (technological development to produce ethanol and employment for farmers). In Sweden, biomass energy was tied to the national narrative of local control, as well as love of nature and tradition (the use of natural products). We found strong evidence that the pairing of technological transformations with national narratives facilitated the successful development and implementation of these major energy technologies in the three cases analyzed here.« less

Psychiatric aspects of induced abortion.

PubMed

Stotland, Nada L

2011-08-01

Approximately one third of the women in the United States have an abortion during their lives. In the year 2008, 1.21 million abortions were performed in the United States (Jones and Koolstra, Perspect Sex Reprod Health 43:41-50, 2011). The psychiatric outcomes of abortion are scientifically well established (Adler et al., Science 248:41-43, 1990). Despite assertions to the contrary, there is no evidence that abortion causes psychiatric problems (Dagg, Am J Psychiatry 148:578-585, 1991). Those studies that report psychiatric sequelae suffer from severe methodological defects (Lagakos, N Engl J Med 354:1667-1669, 2006). Methodologically sound studies have demonstrated that there is a very low incidence of frank psychiatric illness after an abortion; women experience a wide variety of feelings over time, including, for some, transient sadness and grieving. However, the circumstances that lead a woman to terminate a pregnancy, including previous and/or ongoing psychiatric illness, are independently stressful and increase the likelihood of psychiatric illness over the already high baseline incidence and prevalence of mood and anxiety disorders among women of childbearing age. For optimal psychological outcomes, women, including adolescents, need to make autonomous and supported decisions about problem pregnancies. Clinicians can help patients facing these decisions and those who are working through feelings about having had abortions in the past.

Sexual orientation and sexual behavior among Latino and Asian Americans: implications for unfair treatment and psychological distress.

PubMed

Chae, David H; Ayala, George

2010-09-01

Research on the sexuality of Asians and Latinos in the United States has been sparse, and the studies that have been done suffer from a number of limitations. Using data from the National Latino and Asian American Study (2002-2003), this study examined self-identified sexual orientation and self-reported sexual behavior among Latinos (n = 2,554; age: M = 38.1, SE = 0.5) and Asians (n = 2,095; age: M = 41.5, SE = 0.8). This study also investigated implications for unfair treatment and psychological distress among sexual minorities identified in the sample. Results indicated heterogeneity in responses to items assessing sexual orientation and sexual behavior including differences in the adoption of lesbian, gay, or bisexual (LGB) identity by gender, ethnicity, nativity, and socioeconomic status. LGB sexual minorities reported higher levels of unfair treatment and psychological distress compared to their non-LGB-identified sexual minority counterparts, and unfair treatment was positively associated with psychological distress. Results highlight the need to consider multiple demographic factors in assessing sexuality, and also suggest that measures of both self-identified sexual orientation and sexual behavior should be collected. In addition, findings provide support for the deleterious influence of unfair treatment among Asians and Latinos in the United States.

Environmental Influences on Physical Activity among Rural Adults in Montana, United States: Views from Built Environment Audits, Resident Focus Groups, and Key Informant Interviews.

PubMed

Lo, Brian K; Morgan, Emily H; Folta, Sara C; Graham, Meredith L; Paul, Lynn C; Nelson, Miriam E; Jew, Nicolette V; Moffat, Laurel F; Seguin, Rebecca A

2017-10-04

Rural populations in the United States have lower physical activity levels and are at a higher risk of being overweight and suffering from obesity than their urban counterparts. This paper aimed to understand the environmental factors that influence physical activity among rural adults in Montana. Eight built environment audits, 15 resident focus groups, and 24 key informant interviews were conducted between August and December 2014. Themes were triangulated and summarized into five categories of environmental factors: built, social, organizational, policy, and natural environments. Although the existence of active living features was documented by environmental audits, residents and key informants agreed that additional indoor recreation facilities and more well-maintained and conveniently located options were needed. Residents and key informants also agreed on the importance of age-specific, well-promoted, and structured physical activity programs, offered in socially supportive environments, as facilitators to physical activity. Key informants, however, noted that funding constraints and limited political will were barriers to developing these opportunities. Since building new recreational facilities and structures to support active transportation pose resource challenges, especially for rural communities, our results suggest that enhancing existing features, making small improvements, and involving stakeholders in the city planning process would be more fruitful to build momentum towards larger changes.

UNITED STATES DENTAL PROFESSIONALS’ PERCEPTIONS OF DENTAL ANXIETY AND NEED FOR SEDATION IN PATIENTS WITH MENTAL ILLNESS

PubMed Central

Heaton, Lisa J.; Hyatt, Halee A.; Huggins, Kimberly Hanson; Milgrom, Peter

2012-01-01

Dental fear is a barrier to receiving dental care, particularly for those patients who also suffer from mental illnesses. The current study examined United States dental professionals’ perceptions of dental fear experienced by patients with mental illness, and frequency of sedation of patients with and without mental illness. Dentists and dental staff members (n = 187) completed a survey about their experiences in treating patients with mental illness. More participants agreed (79.8%) than disagreed (20.2%) that patients with mental illness have more anxiety regarding dental treatment (p < .001) than dental patients without mental illness. Further, significantly more participants reported mentally ill patients’ anxiety is “possibly” or “definitely” a barrier to both receiving (96.8%; p < .001) and providing (76.9%; p < .01) dental treatment. Despite reporting more fear in these patients, there were no significant differences in frequency of sedation procedures between those with and without mental illness, regardless of type of sedation (p’s > .05). This lack of difference in sedation for mentally ill patients suggests hesitancy on the part of dental providers to sedate patients with mental illness and highlights a lack of clinical guidelines for this population in the US. Suggestions are given for the assessment and clinical management of patients with mental illness. PMID:24876662

Stories about ourselves: How national narratives influence the diffusion of large-scale energy technologies

DOE PAGES

Malone, Elizabeth L.; Hultman, Nathan E.; Anderson, Kate; ...

2017-07-03

Examining past examples of rapid, transformational changes in energy technologies could help governments understand the factors associated with such transitions. We used an existing dataset to assess government strategies to connect new energy technologies with national narratives. Analyzing the diffusion stories told by experts, we demonstrate how governments connected the new technologies with their national narratives. The United States government supported the development of nuclear power after World War II with the national narrative that the United States was destined to improve creation, increasing the potential of raw materials exponentially for the nation’s good (“atoms for peace,” electricity “too cheapmore » to meter”). In Brazil, the development of sugar cane ethanol was supported by the government’s invoking the national narrative of suffering leading to knowledge and redemption, coupled with the quest for improved societal well-being (technological development to produce ethanol and employment for farmers). In Sweden, biomass energy was tied to the national narrative of local control, as well as love of nature and tradition (the use of natural products). We found strong evidence that the pairing of technological transformations with national narratives facilitated the successful development and implementation of these major energy technologies in the three cases analyzed here.« less

Intimate partner violence among undergraduate students of two universities of the state of Sao Paulo, Brazil.

PubMed

Flake, Tania Aldrighi; Barros, Claudia; Schraiber, Lilia B; Menezes, Paulo Rossi

2013-12-01

The prevalence of violence in intimate relationships, suffered or perpetrated, was estimated among undergraduate students, be it physical, psychological and sexual, describing the overlap between them. This is an original study and there is scarce literature on this matter in Brazil. Men and women were investigated and some issues on gender violence were discussed. The study is part of the multicenter survey "International Study of Violence in Dating - IDVS" conducted in 2002 - 2003, using its standardized instrument. A total of 362 students, from two universities in the state of São Paulo, one public and one private, answered the self-reported questionnaire, being 37% male and 63% female, mean age of 20 years old. Suffered and perpetrated intimate partner violence during life was examined. Among all interviewees, 75.9% suffered and 76.4% perpetrated some kind of violence throughout life. Psychological violence was the most prevalent type, followed by sexual violence, both suffered and perpetrated. The great superposition between suffered and perpetrated violence (83.9%) reflects the reciprocity of aggression, with no observed difference between men and women. The results of this study are consistent with previous literature on dating violence, which shows high prevalence of suffered and perpetrated violence, besides reciprocity for both men and women. Intervention actions at this stage of intimate relationships may potentially impact on subsequent marital partnership situations.

Shortcuts to adiabaticity for accelerated quantum state transfer

NASA Astrophysics Data System (ADS)

Baksic, Alexandre; Ribeiro, Hugo; Clerk, Aashish A.

Adiabatic transfer protocols are among the most powerful and interesting approaches to move quantum states between two different systems. While having many advantages, those schemes are necessarily slow, and hence can suffer from dissipation and noise in the target and/or source system. In this talk, we present an approach that allows to operate a state transfer much faster, without suffering from non-adiabatic errors. The key idea is to work with a basis of dressed states whose very definition incorporates the matrix elements which give rise to non-adiabatic transitions. By introducing additional control fields, we can ensure that the system ``rides'' these new dressed states during the protocol, thus allowing for a fast high fidelity state transfer. We discuss a recent experimental implementation of these ideas in an NV-center Λ-system, as well as extensions to state transfer problems involving propagating states.

Joined against Pain and Gathered in Hope: The Role of Hokies United

ERIC Educational Resources Information Center

Schneiter, Steven R.; MacEachran, Brianne

2008-01-01

After April 16, 2007, Hokies United needed to heal itself and the Virginia Tech community. "About Campus" editorial assistant Brianne MacEachran interviewed Steve Schneiter, a faculty co-creator of the campus group that has organized responses to tragedies since the events of September 11, 2001, about managing suffering, this time their own.…

Longboard and skateboard injuries.

PubMed

Keays, Glenn; Dumas, Alex

2014-08-01

The causes and events related to skateboarding injuries have been widely documented. However, little is known about longboard-related injuries. With five deaths linked to longboarding in the United States and Canada in 2012, some cities are already considering banning the practice. This study compared the types and causes of longboarding-related injuries to those associated with skateboarding. We conducted a retrospective cohort study, using an emergency-based surveillance system, on patients under the age of 18 who had been injured while longboarding or skateboarding between 2006 and 2010. A total of 287 longboarding and 4198 skateboarding cases were identified. There were more females in the longboarding group (18.8%) than in the skateboarding one (10.7%, p < 0.002). All the injured longboarders were older than 10 years of age while a fifth of the injured skateboarders were under the age of 11. Longboarders' injuries occurred mainly on streets and roads (75.3% vs. 34.3% in skateboarders, p < 0.000) and rarely in skate parks (1.4% vs. 26.4% in skateboarders, p < 0.000). Longboarders suffered twice as many injuries to their heads and necks (23.3% vs. 13.1%, p < 0.000) and twice as many severe neurological traumas (8.6 vs. 3.7%, p < 0.000) while skateboarders suffered more injuries to their lower extremities (33.7% vs. 24.7%, p < 0.002). Longboarding is associated with a different pattern of injuries than skateboarding. Because longboarders suffer more intracranial injuries, the importance of helmet use should be especially strongly reinforced. Copyright © 2014 Elsevier Ltd. All rights reserved.

Three Generations, Three Wars: African American Veterans.

PubMed

Black, Helen K

2016-02-01

This article emerged from pilot research exploring experiences of war and suffering among African American veterans who served in World War II, Korean War, and Vietnam War. Men's experiences as soldiers reflected both racism and the social change that occurred in the Unites States while they served. We used techniques of narrative elicitation, conducting qualitative, ethnographic interviews with each of five veterans in his home. Interviews focused on unique and shared experiences as an African American man and a soldier. Three important themes emerged: (a) Expectations related to War--Although men viewed service to country as an expected part of life, they also expected equal treatment in war, which did not occur; (b) Suffering as an African American--Informants interpreted experiences of suffering in war as related to the lower status of African American servicemen; and (c) Perception of present identity--Each man was honed by the sum of his experiences, including those of combat, racism, and postwar opportunities and obstacles. From 40 to 70 years after the wars were fought, there are few scholarly narrative studies on African American veterans, despite the fact that Korean War Veterans are entering old-old age and few World War II Veterans are alive. The value of pilot research that offers narratives of unheard voices is significant; larger studies can interview more African American veterans to advance knowledge that might soon be lost. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Current Allergic Rhinitis Experiences Survey (CARES): Health-care practitioners' awareness, attitudes and practices.

PubMed

Blaiss, Michael S; Fromer, Leonard M; Jacob-Nara, Juby A; Long, Randall M; Mannion, Karen M; Lauersen, Lori A

2014-01-01

Allergic rhinitis (AR) is a common health problem in the United States, with significant comorbidities and impairment of quality of life despite the availability of many prescription (Rx) and over-the-counter (OTC) medications. The health-care practitioners (HCPs) arm of the Current Allergic Rhinitis Experiences Survey (CARES) assessed HCPs' perceptions about the current management of AR. This U.S.-based national survey included 375 primary care physicians and 375 nurse practitioners/physician assistants. Participants were screened to ensure that they treat ≥15 AR sufferers per month during allergy season. The majority of HCPs (86%) agreed that AR patients can easily recognize allergy symptoms after diagnosis and that 57% of their patients come to them self-recognizing their symptoms. A total of 82% strongly agreed that AR sufferers are primarily diagnosed via history and physical and do not typically undergo diagnostic testing until after pharmacologic intervention. HCPs reported that 63-77% of AR sufferers can easily manage AR once treatment is established. According to surveyed HCPs, OTC medication should precede an Rx medication for AR management. A total of 82% HCPs considered intranasal steroids (INSs) to be the gold standard AR treatment and have minimal safety concerns about INS use. HCPs perceive that patients can easily recognize and self-manage their AR symptoms. Patient history/symptoms and physical examination are the primary methods of AR diagnosis. INSs are considered the gold standard for treatment of AR. However, most HCPs feel OTC medication should be tried before Rx medication for AR management.

The patient experience of intensive care: a meta-synthesis of Nordic studies.

PubMed

Egerod, Ingrid; Bergbom, Ingegerd; Lindahl, Berit; Henricson, Maria; Granberg-Axell, Anetth; Storli, Sissel Lisa

2015-08-01

Sedation practices in the intensive care unit have evolved from deep sedation and paralysis toward lighter sedation and better pain management. The new paradigm of sedation has enabled early mobilization and optimized mechanical ventilator weaning. Intensive care units in the Nordic countries have been particularly close to goals of lighter or no sedation and a more humane approach to intensive care. The aim of our study was to systematically review and reinterpret newer Nordic studies of the patient experience of intensive care to obtain a contemporary description of human suffering during life-threatening illness. We conducted a meta-synthesis in which we collected, assessed, and analyzed published qualitative studies with the goal of synthesizing these findings into a new whole. Analysis was based on the scientific approach of Gadamerian hermeneutics. Nordic intensive care units. Patients in Nordic intensive care units. We performed a literature search of qualitative studies of the patient experience of intensive care based on Nordic publications in 2000-2013. We searched the following databases: PubMed, CINAHL, Scopus, and PsycINFO. Each original paper was assessed by all authors using the Critical Appraisal Skills Program instrument for qualitative research. We included 22 studies, all of which provided direct patient quotes. The overarching theme was identified as: The patient experience when existence itself is at stake. We constructed an organizing framework for analysis using the main perspectives represented in the included studies: body, mind, relationships, and ICU-environment. Final analysis and interpretation resulted in the unfolding of four themes: existing in liminality, existing in unboundedness, existing in mystery, and existing on the threshold. Our main finding was that human suffering during intensive care is still evident although sedation is lighter and the environment is more humane. Our interpretation suggested that patients with life-threatening illness descend into a liminal state, where they face the choice of life or death. Caring nurses and family members play an important role in assisting the patient to transition back to life. Copyright © 2015 Elsevier Ltd. All rights reserved.

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.

Population health and medicine: Policy and financial drivers.

PubMed

Lavigne, Jill E; Brown, Jack; Matzke, Gary R

2017-09-15

The financial and policy levers of population health and potential opportunities for pharmacists are described. Three long-standing problems drive the focus on population health: (1) the United States suffers far worse population health outcomes compared with those of other developed nations that spend significantly less on healthcare, (2) the U.S. healthcare system's focus on "sick care" fails to address upstream prevention and population health improvement, and (3) financial incentives for healthcare delivery are poorly aligned with improvements in population health outcomes. The Patient Protection and Affordable Care Act of 2010 (ACA) was arguably the first major healthcare legislation since 1965 and had 3 main strategies for improving population health: expand health insurance coverage, control healthcare costs, and improve the healthcare delivery system. Federal and state legislation as well as Medicare and Medicaid financing strategies have designated mechanisms to reward advances in population outcomes since the passage of the ACA. States are responsible for many of the factors that affect population health, and a bipartisan effort that builds upon state and federal collaboration will likely be needed to implement the necessary health policy initiative. Population health issues affect productivity in the United States; conversely, improvements in population health may increase productivity, helping to offset the rising federal debt. Employers are in a position to improve population health and consequently help reduce the federal debt by addressing lifestyle, chronic disease, poverty, and inequality. National pharmacy organizations, regulatory bodies, and journal editors need to collectively agree to a threshold of quality and rigor for publication and endorsement. Knowledge of the policy and financial drivers of population health may both support pharmacists' efforts to improve population outcomes and identify opportunities for professional advancement. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Characteristics of persons with severe mental illness who have been incarcerated for murder.

PubMed

Matejkowski, Jason C; Cullen, Sara W; Solomon, Phyllis L

2008-01-01

In this descriptive study, we analyzed data collected from multiple state agencies on 95 persons with severe mental illness who were convicted of murder in Indiana between 1990 and 2002. Subjects were predominantly suffering from a mood disorder, were white and male with a high school education or equivalent, were living in stabilized housing, and, to a lesser degree, were involved in significant intimate and familial relationships. Rage or anger, overwhelmingly directed toward intimate or familial relations by the use of a firearm or sharp object, was the most frequently mentioned motive for murder. Most of those studied had been raised in households with significant family dysfunction, had extensive histories of substance abuse and criminality, and had received little treatment for their mental and substance use disorders. Findings are contextualized and compared with similarly descriptive studies of nonlethal violence and persons with a mental illness; hospitalized, schizophrenic and psychotic murderers; and homicide offenders outside the United States.

The post-disaster negative health legacy: pregnancy outcomes in Louisiana after Hurricane Andrew.

PubMed

Antipova, Anzhelika; Curtis, Andrew

2015-10-01

Disasters and displacement increasingly affect and challenge urban settings. How do pregnant women fare in the aftermath of a major disaster? This paper investigates the effect of pregnancies in disaster situations. The study tests a hypothesis that pregnant women residing in hurricane-prone areas suffer higher health risks. The setting is Louisiana in the Gulf Coast, United States, a state that continually experiences hurricane impacts. The time period for the analysis is three years following the landfall of Hurricane Andrew in 1992. We analysed low birth weight and preterm deliveries before and after landfall, as a whole and by race. Findings support an association between hazards and health of a community and indicate that pregnant women in the affected area, irrespective of race, are more likely to experience preterm deliveries compared to pre-event births. Results suggest there is a negative health legacy impact in Louisiana as a result of hurricane landfall. © 2015 The Author(s). Disasters © Overseas Development Institute, 2015.

Retained satellite information influences performance of GPS devices in a forested ecosystem

Treesearch

Katie M. Moriarty; Clinton W. Epps

2015-01-01

Global Positioning System (GPS) units used in animal telemetry often suffer from nonrandom data loss and location error. GPS units use stored satellite information to estimate locations, including almanac and ephemeris data reflecting satellite positions at weekly and at <4-hr temporal scales, respectively. Using the smallest GPS collars (45–51 g) available for...

Low bone mineral density and fragility fractures in permanent vegetative state patients.

PubMed

Oppl, Bastian; Michitsch, Gabriele; Misof, Barbara; Kudlacek, Stefan; Donis, Johann; Klaushofer, Klaus; Zwerina, Jochen; Zwettler, Elisabeth

2014-01-01

Disuse of the musculoskeletal system causes bone loss. Whether patients in vegetative state, a dramatic example of immobilization after severe brain injury, suffer from bone loss and fractures is currently unknown. Serum markers of bone turnover, bone mineral density (BMD) measurements, and clinical data were cross-sectionally analyzed in 30 consecutive vegetative state patients of a dedicated apallic care unit between 2003 and 2007 and compared with age- and sex-matched healthy individuals. Vegetative state patients showed low calcium levels and vitamin D deficiency compared with healthy controls. Serum bone turnover markers revealed high turnover as evidenced by markedly elevated carboxy-terminal telopeptide of type I collagen (β-crosslaps) and increased levels of alkaline phosphatase. BMD measured by dual-energy X-ray absorptiometry (DXA) scanning showed strongly decreased T- and Z-scores for hip and spine. Over a period of 5 years, 8 fragility fractures occurred at peripheral sites in 6 of 30 patients (n = 3 femur, n = 2 tibia, n = 2 fibula, n = 1 humerus). In conclusion, high bone turnover and low BMD is highly prevalent in vegetative state patients, translating into a clinically relevant problem as shown by fragility fractures in 20% of patients over a time period of 5 years. . © 2014 American Society for Bone and Mineral Research.

Development of a high temperature storage unit for integration with solar dynamic systems

NASA Astrophysics Data System (ADS)

Staehle, H. J.; Lindner, F.

1989-08-01

Lithium fluoride in its capacity as a suitable energy storage material is investigated. Energy is stored as latent heat by melting the LiF. The energy is later released during recrystallization of the salt. Drawbacks to this system are described. The high corrosivity in molten state may lead to container failure in long term use. In order to avoid destruction of canisters, a graphite container is developed as graphite is not wetted by liquid LiF and thus does not suffer any corrosion. In order to match the mechanical forces caused by the volume increase during melting, a channel-like internal structure is tested. The melt formed first can expand into these channels and no pressure is built up. The results of these tests are presented.

Perinatal outcome and the social contract--interrelationships between health and humanity.

PubMed

Gorski, P A

1998-01-01

Rates of infant mortality and prematurity or low birth weight serve as indirect measures of the health of a nation. This paper presents current population data documenting the still serious problem of perinatal outcome in the United States as well as in other economically developed countries. International comparisons suggest that nations with the greatest inequality of income and social opportunity also have the most adverse perinatal, child, and adult health outcomes. Furthermore, the data assert that these effects are independent of average national wealth or gross national economic productivity. Health status differs by social class and race, even among the most affluent sectors of the population. All social classes, even the wealthiest, suffer the health consequences of social inequalities. An explanatory sociopsychologic theory of causality is proposed.

High-tech and low-tech orthopaedic surgery in Sub-Saharan Africa.

PubMed

Kluge, Wolfram H; Bauer, Heike I

2002-01-01

BACKGROUND: Zambia's governmental health system suffers from shortage of surgical supplies and poor management skills for the sparse resources at hand. The situation has been worsened by the dual epidemics of HIV disease and tuberculosis. On the other hand the private medical sector has benefited greatly from less bureaucracy under the goverment of the Movement for Multi-party Democracy. DISCUSSION: The Zambian-Italian Orthopaedic Hospital in Lusaka is a well organized small unit providing free treatment of physically disabled children. The running costs are met from the fees charged for private consultations, supplemented by donations. State of the art surgical techniques are being used for congenital and acquired musculo-skeletal abnormalities. Last year 513 patients were operated upon free of charge and 320 operations were performed on private patients.

Therapeutic cloning applications for organ transplantation.

PubMed

Koh, Chester J; Atala, Anthony

2004-04-01

A severe shortage of donor organs available for transplantation in the United States leaves patients suffering from diseased and injured organs with few treatment options. Scientists in the field of tissue engineering apply the principles of cell transplantation, material science, and engineering to construct biological substitutes that will restore and maintain normal function in diseased and injured tissues. Therapeutic cloning, where the nucleus from a donor cell is transferred into an enucleated oocyte in order to extract pluripotent embryonic stem cells, offers a potentially limitless source of cells for tissue engineering applications. The present chapter reviews recent advances that have occurred in therapeutic cloning and tissue engineering and describes applications of these new technologies that may offer novel therapies for patients with end-stage organ failure. Copyright 2004 Elsevier B.V.

Algorithms for the assessment and management of insomnia in primary care

PubMed Central

Hilty, Donald; Young, Julie S; Bourgeois, James A; Klein, Sally; Hardin, Kimberly A

2009-01-01

Insomnia is a leading cause of sleep disturbance in primary care practice affecting >30% of people in the United States and can result in psychological and physiological consequences. We aim for a focused discussion of some of the underpinnings of insomnia and practical tips for management (eg, algorithms). A PubMed search was conducted using English language papers between 1997–2007, with the terms “sleep,” “insomnia”; “primary care” and “clinics”; “comorbid conditions”; “treatment” and “management.” Sleep, psychiatric and medical disorders significantly affect sleep, causing patient suffering, potentially worsening of other disorders and increasing the use of primary care services. We provide an outline for practical assessment and treatment of insomnia in primary care, including the strengths and weaknesses of medications. PMID:19936140

Enhancing patient well-being: advocacy or negotiation?

PubMed Central

Bird, A W

1994-01-01

The United Kingdom Central Council for Nursing, Midwifery and Health Visitors (UKCC) document, Exercising Accountability, states that the role of patient's advocate is an essential aspect of good professional nursing practice (1). The author examines the case for and against the nurse being the best person to act as advocate, and critically evaluates the criteria of advocacy. The problematic moral issues arising are discussed, and a case made for negotiation between the members of the multidisciplinary team and the patient/client (or a significant person to the patient) in order to promote the well-being of the patient and to minimise suffering. She concludes that the health care professional's (including the nurse's) role is to help people to assert control over the factors which affect their lives, that is empowerment, rather than advocacy. PMID:7996560

Principle-based ethics and nurses' attitudes towards artificial feeding.

PubMed

Day, L; Drought, T; Davis, A J

1995-02-01

Nurses often institute artificial feeding for patients who would otherwise starve. Recently, the courts in the United States have favoured withholding or withdrawing feedings from patients who currently refuse or previously gave some indication they would refuse artificial nutrition and hydration. This paper investigates under what circumstances nurses feel justified in withholding artificial nutrition and hydration. Structured interviews were conducted with 40 cancer care nurses from two sites, and 40 dementia care nurses from two sites. The interviews were based on two vignettes, one involving an alert patient with terminal cancer, the other a patient suffering end-stage Alzheimer's dementia, and were analysed for themes coinciding with principles of deontological ethics. Investigators found that autonomy, beneficence and non-maleficence most often guided nurses' decisions to withhold or implement artificial feeding.

Geriatric depression in advanced cancer patients: the effect of cognitive and physical functioning.

PubMed

Mystakidou, Kyriaki; Parpa, Efi; Tsilika, Eleni; Panagiotou, Irene; Zygogianni, Anna; Giannikaki, Eugenia; Gouliamos, Athanasios

2013-04-01

The aims of the current study were to evaluate geriatric depression and its risk factors in advanced cancer patients. A cross-sectional study was carried out in a palliative care unit in Greece. Patients completed the Geriatric Depression Scale, the M. D. Anderson Symptoms Instrument (MDASI), the Activities of Daily Living and the Mini-Mental State Examination. Patients were included if they were aged >65 years, if they had cancer, were able to communicate and had agreed to sign informed consent. The final sample consisted of 92 elderly advanced cancer patients. The prevalence of depression was found to be 67.4%. The univariate comparison between the depressed elderly and non-depressed group showed that patients with metastases were found to be 2.2-fold more likely to suffer from geriatric depression compared with those without metastases (P = 0.074). Patients with moderate or severe cognitive impairment were found to be 3.61-fold more likely to suffer from geriatric depression in comparison with those with normal cognitive function (P = 0.019). In the multiple logistic regression analysis, elderly with cognitive impairment were 3.3-fold more likely to have geriatric depression than those without (adjusted odds ratio = 3.3 [95% CI 0.99-10.74], P = 0.052) and MDASI factor 1 was consistently a significant risk factor for depression in the elderly; when MDASI factor 1 increased by 1 unit, the odds of being classified as depressed increased by 7.6%. The present study found that cognitive impairment and symptoms such as enjoyment of life, walking, relationship with people, general activity, sadness and pain (MDASI F1) are strong independent predictors of depression in the elderly. © 2012 Japan Geriatrics Society.

End-of-life decisions in Dutch neonatal intensive care units.

PubMed

Verhagen, A A Eduard; Dorscheidt, Jozef H H M; Engels, Bernadette; Hubben, Joep H; Sauer, Pieter J

2009-10-01

To clarify the practice of end-of-life decision making in severely ill newborns. Retrospective descriptive study with face-to-face interviews. The 10 neonatal intensive care units in the Netherlands from October 2005 to September 2006. All 367 newborn infants who died in the first 2 months of life in Dutch neonatal intensive care units. Adequate documentation was available in 359 deaths. Presence of end-of-life decisions, classification of deaths in 3 groups, and physicians' considerations leading to end-of-life decisions. An end-of-life decision preceded death in 95% of cases, and in 5% treatment was continued until death. Of all of the deaths, 58% were classified as having no chance of survival and 42% were stabilized newborns with poor prognoses. Withdrawal of life-sustaining therapy was the main mode of death in both groups. One case of deliberate ending of life was found. In 92% of newborns with poor prognoses, end-of-life decisions were based on patients' future quality of life and mainly concerned future suffering. Considerations regarding the infant's present state were made in 44% of infants. Virtually all deaths in Dutch neonatal intensive care units are preceded by the decision to withdraw life-sustaining treatment and many decisions are based on future quality of life. The decision to deliberately end the life of a newborn may occur less frequently than was previously assumed.

Utilization of Standardized Mental Health Assessments in Anthropological Research: Possibilities and Pitfalls.

PubMed

Mendenhall, Emily; Yarris, Kristin; Kohrt, Brandon A

2016-12-01

In the past decade anthropologists working the boundary of culture, medicine, and psychiatry have drawn from ethnographic and epidemiological methods to interdigitate data and provide more depth in understanding critical health problems. But rarely do these studies incorporate psychiatric inventories with ethnographic analysis. This article shows how triangulation of research methods strengthens scholars' ability (1) to draw conclusions from smaller data sets and facilitate comparisons of what suffering means across contexts; (2) to unpack the complexities of ethnographic and narrative data by way of interdigitating narratives with standardized evaluations of psychological distress; and (3) to enhance the translatability of narrative data to interventionists and to make anthropological research more accessible to policymakers. The crux of this argument is based on two discrete case studies, one community sample of Nicaraguan grandmothers in urban Nicaragua, and another clinic-based study of Mexican immigrant women in urban United States, which represent different populations, methodologies, and instruments. Yet, both authors critically examine narrative data and then use the Center for Epidemiologic Studies Depression Scale to further unpack meaning of psychological suffering by analyzing symptomatology. Such integrative methodologies illustrate how incorporating results from standardized mental health assessments can corroborate meaning-making in anthropology while advancing anthropological contributions to mental health treatment and policy.

The role of the health insurance industry in perpetuating suboptimal pain management.

PubMed

Schatman, Michael E

2011-03-01

Unlike pain practitioners, health care insurers in the United States are not expected to function according to a system of medical ethics. Rather, they are permitted to function under the business "ethic" of cost-containment and profitability. Despite calls for balancing the disparate agendas of stakeholders in pain management in a pluralistic system, the health insurance industry has continued to fail to take the needs of suffering chronic pain patients into consideration in developing and enacting their policies that ultimately dictate the quality and quantity of pain management services available to enrollees. This essay examined these self-serving strategies, which include failure to reimburse services and certain medications irrespective of their evidence-bases for clinical efficacy and cost-efficiency; "carving out" specific services from interdisciplinary treatment programs; and delaying and/or interrupting the provision of medically necessary treatment. Blatant and more subtle strategies utilized by insurers to achieve these ethically questionable goals are examined. Additionally, this essay addressed some of the insurance industry's efforts to delegitimize chronic pain and its treatment as a whole. The author concludes that the outlook for chronic pain sufferers is not particularly bright, until such time that a not-for-profit single-payer system replaces the current treatment/reimbursement paradigm. Wiley Periodicals, Inc.

Utilization of Standardized Mental Health Assessments in Anthropological Research: Possibilities and Pitfalls

PubMed Central

Mendenhall, Emily; Yarris, Kristin; Kohrt, Brandon A.

2017-01-01

In the past decade anthropologists working the boundary of culture, medicine, and psychiatry have drawn from ethnographic and epidemiological methods to interdigitate data and provide more depth in understanding critical health problems. But rarely do these studies incorporate psychiatric inventories with ethnographic analysis. This article shows how triangulation of research methods strengthens scholars’ ability (1) to draw conclusions from smaller data sets and facilitate comparisons of what suffering means across contexts; (2) to unpack the complexities of ethnographic and narrative data by way of interdigitating narratives with standardized evaluations of psychological distress; and (3) to enhance the translatability of narrative data to interventionists and to make anthropological research more accessible to policymakers. The crux of this argument is based on two discrete case studies, one community sample of Nicaraguan grandmothers in urban Nicaragua, and another clinic-based study of Mexican immigrant women in urban United States, which represent different populations, methodologies, and instruments. Yet, both authors critically examine narrative data and then use the Center for Epidemiologic Studies Depression Scale to further unpack meaning of psychological suffering by analyzing symptomatology. Such integrative methodologies illustrate how incorporating results from standardized mental health assessments can corroborate meaning-making in anthropology while advancing anthropological contributions to mental health treatment and policy. PMID:27553610

Using direct-to-consumer marketing strategies with obsessive-compulsive disorder in the nonprofit sector.

PubMed

Szymanski, Jeff

2012-06-01

Three to four million individuals struggle with obsessive-compulsive disorder (OCD) in the United States at any given time. OCD can be a debilitating disorder associated with significant quality-of-life and occupational impairment. First-line treatments for OCD (selective serotonin reuptake inhibitors and exposure and response prevention therapy) have been shown to be effective; yet, many individuals suffering from OCD experience multiple barriers to accessing these treatments. In fact, it can take as many as 17 years from onset of symptoms to effective treatment. Given the need to increase access to and utilization of effective treatments, direct-to-consumer marketing in the context of OCD appears crucial. The International OCD Foundation (formerly the Obsessive Compulsive Foundation) was established as a nonprofit organization with a mission to educate the public and mental health professionals about appropriate practice guidelines, raise awareness of the disorder, and ensure that individuals looking for treatment find the necessary resources. This paper reviews the obstacles those struggling with OCD face in their attempts to alleviate suffering, as well as the direct-to-consumer strategies and tactics used by the International OCD Foundation to improve access to empirically supported, effective treatment. Copyright © 2011. Published by Elsevier Ltd.

Spontaneous Intracerebral Hemorrhage Image Analysis Methods: A Survey

NASA Astrophysics Data System (ADS)

Pérez, Noel; Valdés, Jose; Guevara, Miguel; Silva, Augusto

Spontaneous intracerebral hemorrhages (ICH) account for 10-30% of all strokes and are a result of acute bleeding into the brain due to ruptures of small penetrating arteries. Despite major advancements in the management of ischemic strokes and other causes of hemorrhagic strokes, such as ruptured aneurysm, arteriovenous malformations (AVMs), or cavernous angioma, during the past several decades, limited progress has been made in the treatment of ICH, and the prognosis for patients who suffer them remains poor. The societal impact of these hemorrhagic strokes is magnified by the fact that affected patients typically are a decade younger than those afflicted with ischemic strokes. The ICH continues to kill or disable most of their victims. Some studies show that those who suffer ICH have a 30-day mortality rate of 35-44% and a 6-month mortality rate approaching 50%. Approximately 700,000 new strokes occur in the United States annually and approximately 15% are hem-orrhagic strokes related to ICH. The poor outcome associated with ICH is related to the extent of brain damage. ICH produces direct destruction and compression of surrounding brain tissue. Direct compression causes poor perfusion and venous drainage to surrounding penumbra at risk, resulting in ischemia to the tissues that most need perfusion [16].

Cultural barriers to health care for southeast Asian refugees.

PubMed Central

Uba, L

1992-01-01

Many Southeast Asians now living in the United States experience severe health problems, attributable to physical trauma and inadequate health care in Asia, and low socioeconomic status in this country. Evidence indicates that despite their health problems, Southeast Asian refugees underuse the American health care system. Cultural reasons for this underuse are examined. Southeast Asian cultural attitudes toward suffering, such as beliefs that suffering is inevitable or that one's life span is predetermined, can cause Southeast Asians not to seek health care. Cultural beliefs about the sources of illness and correspondingly appropriate forms of treatment can be a barrier to Western health care. Many lack familiarity with Western diagnostic techniques and treatments and thus are apprehensive. Health care providers' ignorance of Southeast Asian cultures can interfere with communication with patients, resulting in culturally irrelevant services or misinterpretation of side effects of Southeast Asian folk medicines. Southeast Asians' lack of familiarity with American culture can make health care services geographically and economically inaccessible and can cause Southeast Asians to be ignorant of available services or how to access them. An understanding of Southeast Asian cultures and additional outreach efforts by Western medical practitioners and health care providers are needed to improve the use of health care services by Southeast Asian refugees in this country. PMID:1410235

A Cost-Benefit Analysis of Government Compensation of Kidney Donors.

PubMed

Held, P J; McCormick, F; Ojo, A; Roberts, J P

2016-03-01

From 5000 to 10 000 kidney patients die prematurely in the United States each year, and about 100 000 more suffer the debilitating effects of dialysis, because of a shortage of transplant kidneys. To reduce this shortage, many advocate having the government compensate kidney donors. This paper presents a comprehensive cost-benefit analysis of such a change. It considers not only the substantial savings to society because kidney recipients would no longer need expensive dialysis treatments--$1.45 million per kidney recipient--but also estimates the monetary value of the longer and healthier lives that kidney recipients enjoy--about $1.3 million per recipient. These numbers dwarf the proposed $45 000-per-kidney compensation that might be needed to end the kidney shortage and eliminate the kidney transplant waiting list. From the viewpoint of society, the net benefit from saving thousands of lives each year and reducing the suffering of 100 000 more receiving dialysis would be about $46 billion per year, with the benefits exceeding the costs by a factor of 3. In addition, it would save taxpayers about $12 billion each year. © 2015 The Authors. American Journal of Transplantation published by Wiley Periodicals, Inc. on behalf of American Society of Transplant Surgeons.

Alleviating cancer patients' suffering: whose responsibility is it?

PubMed

Grau, Jorge

2009-07-01

In medicine, we have historically been better at learning about the body and disease than we have at understanding the human beings who come to us with the ailments. We have acted to relieve pain, consoling patients and families as a complement, but done little to understand and alleviate suffering as a fundamental part of our practice. In fact, only in more recent decades has "suffering" been conceptualized as something apart from pain, associated with distress and its causes. It was Eric T. Cassell, in his ground-breaking work in the 1980s, who posed the need to consider alleviation of suffering and treatment of illness as twin-and equally important-obligations of the medical profession. Suffering is defined as a negative, complex emotional and cognitive state, characterized by feeling under constant threat and powerless to confront it, having drained the physical and psycho-social resources that might have made resistance possible. This unique depletion of personal resources is key to understanding suffering.

Accessing Inpatient Rehabilitation after Acute Severe Stroke: Age, Mobility, Prestroke Function and Hospital Unit Are Associated with Discharge to Inpatient Rehabilitation

ERIC Educational Resources Information Center

Hakkennes, Sharon; Hill, Keith D.; Brock, Kim; Bernhardt, Julie; Churilov, Leonid

2012-01-01

The objective of this study was to identify the variables associated with discharge to inpatient rehabilitation following acute severe stroke and to determine whether hospital unit contributed to access. Five acute hospitals in Victoria, Australia participated in this study. Patients were eligible for inclusion if they had suffered an acute severe…

20 CFR 667.274 - What health and safety standards apply to the working conditions of participants in activities...

Code of Federal Regulations, 2010 CFR

2010-04-01

... employment. (2) If a State workers' compensation law applies to a participant in work experience, workers' compensation benefits must be available for injuries suffered by the participant in such work experience. If a... must be secured for injuries suffered by the participant in the course of such work experience. ...

20 CFR 667.274 - What health and safety standards apply to the working conditions of participants in activities...

Code of Federal Regulations, 2011 CFR

2011-04-01

... employment. (2) If a State workers' compensation law applies to a participant in work experience, workers' compensation benefits must be available for injuries suffered by the participant in such work experience. If a... must be secured for injuries suffered by the participant in the course of such work experience. ...

The effect of religion on the perception of health states among adults in the United Arab Emirates: a qualitative study.

PubMed

Elbarazi, Iffat; Devlin, Nancy J; Katsaiti, Marina-Selini; Papadimitropoulos, Emmanuel A; Shah, Koonal K; Blair, Iain

2017-10-05

Investigate how religion may affect the perception of health states among adults in the United Arab Emirates and the implications for research on self-reported health and quality of life and the use of values in cost-effectiveness analysis. Qualitative analysis of short-structured interviews with adult Emiratis carried out by a market research agency.The COREQ criteria have been used where appropriate to guide the reporting of our findings. Participants were recruited from shopping malls and other public places in the cities of Al Ain and Abu Dhabi. Two hundred adult Emiratis broadly representative of the Emirati population in terms of age and gender. Eighty one per cent of participants said that their perception of health states was influenced by their spiritual or religious beliefs. The two overarching themes that seemed to explain or classify these influences were 'fatalism' and 'preservation of life'. Subthemes included powerlessness to change what is preordained by God, fear of disability (particularly diminished mobility) and appreciation of health and life and the requirement to look after one's health. A final theme was that of acceptance, with respondents expressing a willingness to endure suffering and disability with patience in the expectation of rewards in the hereafter. Our results emphasise the need for further work to establish locally relevant value sets for Muslim majority countries in the Middle East and elsewhere for use in health technology assessment decision-making, rather than relying on value sets from other regions. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Preconception care: screening and management of chronic disease and promoting psychological health

PubMed Central

2014-01-01

Introduction A large proportion of women around the world suffer from chronic diseases including mental health diseases. In the United States alone, over 12% of women of reproductive age suffer from a chronic medical condition, especially diabetes and hypertension. Chronic diseases significantly increase the odds for poor maternal and newborn outcomes in pregnant women. Methods A systematic review and meta-analysis of the evidence was conducted to ascertain the possible impact of preconception care for preventing and managing chronic diseases and promoting psychological health on maternal, newborn and child health outcomes. A comprehensive strategy was used to search electronic reference libraries, and both observational and clinical controlled trials were included. Cross-referencing and a separate search strategy for each preconception risk and intervention ensured wider study capture. Results Maternal prepregnancy diabetic care is a significant intervention that reduces the occurrence of congenital malformations by 70% (95% Confidence Interval (CI): 59-78%) and perinatal mortality by 69% (95% CI: 47-81%). Furthermore, preconception management of epilepsy and phenylketonuria are essential and can optimize maternal, fetal and neonatal outcomes if given before conception. Ideally changes in antiepileptic drug therapy should be made at least 6 months before planned conception. Interventions specifically targeting women of reproductive age suffering from a psychiatric condition show that group-counseling and interventions leading to empowerment of women have reported non-significant reduction in depression (economic skill building: Mean Difference (MD) -7.53; 95% CI: -17.24, 2.18; counseling: MD-2.92; 95% CI: -13.17, 7.33). Conclusion While prevention and management of the chronic diseases like diabetes and hypertension, through counseling, and other dietary and pharmacological intervention, is important, delivering solutions to prevent and respond to women’s psychological health problems are urgently needed to combat this leading cause of morbidity. PMID:25415675

Vaccination Rates among Adolescents in Minnesota as Compared with the United States: Not "Above Average".

PubMed

Jacobson, Robert M; Rogacki, Brianna; Thompson, David M; Roberts, James R; Margolis, Benyamin; Darden, Paul M

2015-01-01

Because adolescents make relatively few visits to clinics for preventive care, their vaccination rates suffer. We examined rates among Minnesota youths to see how they compared with those among teens throughout the United States. We used National Immunization Survey-Teen (NIS-Teen) data to estimate vaccination rates for 13- to 17-year-olds in Minnesota from 2008 through 2013 and compared them to national rates for MCV4, Tdap and HPV vaccines. We also examined rates of provider recommendation for each of the three vaccines and rates of parental intention to vaccinate against HPV. We found rates for all three vaccinations increased between 2008 and 2013, but they continue to be low for both MCV4 (69%) and HPV (38% of females and 9% of males completed the three-dose series in 2013). Fortunately, the percentage of Minnesota clinicians recommending those vaccines is increasing (the percentage recommending HPV vaccination for females increased from 55% in 2008 to 74% in 2013; however, only 44% recommended it for males in 2013). The percentage of parents in Minnesota reporting intent to vaccinate their female children against HPV rose from 52% in 2008 to 58% in 2013; the percentage intending to vaccinate their male children rose from 16% in 2010 to 47% in 2013. Clinicians and public health officials must address how we can improve HPV vaccination rates among adolescents.

Effects of health care provider work hours and sleep deprivation on safety and performance.

PubMed

Lockley, Steven W; Barger, Laura K; Ayas, Najib T; Rothschild, Jeffrey M; Czeisler, Charles A; Landrigan, Christopher P

2007-11-01

There has been increasing interest in the impact of resident-physician and nurse work hours on patient safety. The evidence demonstrates that work schedules have a profound effect on providers' sleep and performance, as well as on their safety and that of their patients. Nurses working shifts greater than 12.5 hours are at significantly increased risk of experiencing decreased vigilance on the job, suffering an occupational injury, or making a medical error. Physicians-in-training working traditional > 24-hour on-call shifts are at greatly increased risk of experiencing an occupational sharps injury or a motor vehicle crash on the drive home from work and of making a serious or even fatal medical error. As compared to when working 16-hours shifts, on-call residents have twice as many attentional failures when working overnight and commit 36% more serious medical errors. They also report making 300% more fatigue-related medical errors that lead to a patient's death. The weight of evidence strongly suggests that extended-duration work shifts significantly increase fatigue and impair performance and safety. From the standpoint of both providers and patients, the hours routinely worked by health care providers in the United States are unsafe. To reduce the unacceptably high rate of preventable fatigue-related medical error and injuries among health care workers, the United States must establish and enforce safe work-hour limits.

Addiction, agency, and the politics of self-control: doing harm reduction in a heroin users' group.

PubMed

Gowan, Teresa; Whetstone, Sarah; Andic, Tanja

2012-04-01

Our 2007-2009 ethnography describes and analyses the practice of harm reduction in a heroin users' group in the midwestern United States. While dominant addiction interventions conceptualize the addict as powerless - either through moral or physical weakness - this group contested such "commonsense," treating illicit drug use as one of many ways that modern individuals attempt to "fill the void." Insisting on the destigmatization of addiction and the normalization of illicit drug use, the group helped its members work on incremental steps toward self-management. Although "Connection Points" had very limited resources to improve the lives of its members, our work suggests that the users' group did much to restore self-respect, rational subjectivity, and autonomy to a group historically represented as incapable of reason and self-control. As the users cohered as a community, they developed a critique of the oppressions suffered by "junkies," discussed their rights and entitlements, and even planned the occasional political action. Engaging with literature on the cultural construction of agency and responsibility, we consider, but ultimately complicate, the conceptualization of needle exchange as a "neoliberal" form of population management. Within the context of the United States' War on Drugs, the group's work on destigmatization, health education, and the practice of incremental control showed the potential for reassertions of social citizenship within highly marginal spaces. Copyright © 2012 Elsevier Ltd. All rights reserved.

Addressing the Global Burden of Chronic Kidney Disease Through Clinical and Translational Research

PubMed Central

Ojo, Akinlolu

2014-01-01

Worldwide, an estimated 200 million people have chronic kidney disease (CKD). In the United States, African Americans (AAs) have a four-fold excess risk of CKD compared to non-Hispanic white people and globally, people in the low-to-middle income countries of Asia and Sub-Saharan Africa have the highest rates of CKD. Annually, more than 500,000 individuals develop end-stage renal disease (or CKD stage 5) in Sub-Saharan Africa alone and the vast majority of these patients suffer premature mortality. The health care costs and economic burden of CKD are huge and not sustainable even in advanced Western countries. A recent discovery on the role of Apolipoprotein 1 (APOL1) G1 and G2 renal risk variants in AAs has a huge potential to unravel the etiology of CKD in both AA and other black populations. Under the National Institutes of Health (NIH)−sponsored Human Heredity and Health in Africa (H3Africa) initiative, a large prospective genetic study of CKD is being conducted in 8000 participants in four African countries (Ethiopia, Ghana, Kenya, and Nigeria; for a total population of 320 million). This and other basic research studies in the United States could potentially shed great insight into the genetics and biologic mechanisms involved in the excess predilection of Africans and AAs to CKD. PMID:25125737

Effectiveness of Universal School-Based Mental Health Awareness Programs Among Youth in the United States: A Systematic Review.

PubMed

Salerno, John P

2016-12-01

Stigmatizing attitudes toward mental illness and low mental health literacy have been identified as links to social adversity, and barriers to seeking and adhering to treatment among adolescents suffering from mental illness. Prior research has found that it is possible to improve these outcomes using school-based mental health awareness interventions. The purpose of this study was to review empirical literature pertaining to universal mental health awareness interventions aiming to improve mental health related outcomes among students enrolled in US K-12 schools, especially minorities vulnerable to health disparities. PsycINFO, Cochrane Library, PUBMED, and reference lists of relevant articles were searched for K-12 school-based mental health awareness interventions in the United States. Universal studies that measured knowledge, attitudes, and/or help-seeking pertinent to mental health were included. A total of 15 studies were selected to be part of the review. There were 7 pretest/post-test case series, 5 nonrandomized experimental trial, 1 Solomon 4-groups, and 2 randomized controlled trial (RCT) designs. Nine studies measuring knowledge, 8 studies measuring attitudes, and 4 studies measuring help-seeking, indicated statistically significant improvements. Although results of all studies indicated some level of improvement, more research on implementation of universal school-based mental health awareness programs is needed using RCT study designs, and long-term follow-up implementation. © 2016, American School Health Association.

Medical marijuana: medical necessity versus political agenda.

PubMed

Clark, Peter A; Capuzzi, Kevin; Fick, Cameron

2011-12-01

Marijuana is classified by the Drug Enforcement Agency (DEA) as an illegal Schedule I drug which has no accepted medical use. However, recent studies have shown that medical marijuana is effective in controlling chronic non-cancer pain, alleviating nausea and vomiting associated with chemotherapy, treating wasting syndrome associated with AIDS, and controlling muscle spasms due to multiple sclerosis. These studies state that the alleviating benefits of marijuana outweigh the negative effects of the drug, and recommend that marijuana be administered to patients who have failed to respond to other therapies. Despite supporting evidence, the DEA refuses to reclassify marijuana as a Schedule II drug, which would allow physicians to prescribe marijuana to suffering patients. The use of medical marijuana has continued to gain support among states, and is currently legal in 16 states and the District of Columbia. This is in stark contrast to the federal government's stance of zero-tolerance, which has led to a heated legal debate in the United States. After reviewing relevant scientific data and grounding the issue in ethical principles like beneficence and nonmaleficence, there is a strong argument for allowing physicians to prescribe marijuana. Patients have a right to all beneficial treatments and to deny them this right violates their basic human rights.

Medical marijuana: Medical necessity versus political agenda

PubMed Central

Clark, Peter A.; Capuzzi, Kevin; Fick, Cameron

2011-01-01

Summary Marijuana is classified by the Drug Enforcement Agency (DEA) as an illegal Schedule I drug which has no accepted medical use. However, recent studies have shown that medical marijuana is effective in controlling chronic non-cancer pain, alleviating nausea and vomiting associated with chemotherapy, treating wasting syndrome associated with AIDS, and controlling muscle spasms due to multiple sclerosis. These studies state that the alleviating benefits of marijuana outweigh the negative effects of the drug, and recommend that marijuana be administered to patients who have failed to respond to other therapies. Despite supporting evidence, the DEA refuses to reclassify marijuana as a Schedule II drug, which would allow physicians to prescribe marijuana to suffering patients. The use of medical marijuana has continued to gain support among states, and is currently legal in 16 states and the District of Columbia. This is in stark contrast to the federal government’s stance of zero-tolerance, which has led to a heated legal debate in the United States. After reviewing relevant scientific data and grounding the issue in ethical principles like beneficence and nonmaleficence, there is a strong argument for allowing physicians to prescribe marijuana. Patients have a right to all beneficial treatments and to deny them this right violates their basic human rights. PMID:22129912

Spontaneous transient rise of CD34 cells in peripheral blood after 72 hours in patients suffering from advanced malignancy with anemia: effect and prognostic implications of treatment with placental umbilical cord whole blood transfusion.

PubMed

Bhattacharya, N

2006-01-01

Cord blood, because of its rich mix of fetal and adult hemoglobin, platelet and WBC counts, and a plasma filled with cytokine and growth factors, as well as its hypoantigenic nature and altered metabolic profile, has all the potential of a real and safe alternative to adult blood during emergencies or any etiology of blood loss. In the present study transfusion-related CD34 levels of the peripheral blood from six randomly selected patients suffering from advanced clinical Stage IV malignancy were analyzed between 16 August 1999 and 16 May 2001. This study attempts to ascertain the fate of hematopoietic stem cells (CD34) after placental umbilical cord whole blood transfusion, as assessed from the peripheral blood CD34 level 72 hours after cord blood transfusion in sex- and HLA-randomized patients. Among the six cases, Case 2 (breast sarcoma) received the lowest amount of card blood (6 units), while Case 6 (breast cancer) received the largest amount (32 units). The youngest patient, suffering from non-Hodgkin's lymphoma (Case 3), was a 16-year-old boy who received eight units of cord blood to combat anemia. Other patients received amounts varying from 7-15 units: Case 4 received 15 units (metachronous lymph node metastatsis), Case 1 received 14 units (breast cancer), and Case 5 received seven units (lung cancer). There was no transfusion-related clinical immunological or nonimmunological reaction. Studies of CD34 levels showed an initial rise followed by a fall in two cases, two cases registered very little effect on the CD34 level, i.e., no change from the baseline, and one case demonstrated a very slow rise from the baseline. However, one case showed a frequent steep rise up to 99% and a sustained high CD34 level. This patient is alive with clinical remission of the disease. It appears from this preliminary study that freshly collected cord blood transfusion may cause a transient transplant impact of transfused cord blood CD34 stem cells on the host without provoking clinical graft vs host disease due to a of background immune suppression in advanced malignancy. The growth factor cytokine system of freshly collected cord blood may have a potentiating role on the immune system of the host.

The effect of religion on the perception of health states among adults in the United Arab Emirates: a qualitative study

PubMed Central

Elbarazi, Iffat; Devlin, Nancy J; Katsaiti, Marina-Selini; Papadimitropoulos, Emmanuel A; Shah, Koonal K; Blair, Iain

2017-01-01

Objectives Investigate how religion may affect the perception of health states among adults in the United Arab Emirates and the implications for research on self-reported health and quality of life and the use of values in cost-effectiveness analysis. Design Qualitative analysis of short-structured interviews with adult Emiratis carried out by a market research agency. The COREQ criteria have been used where appropriate to guide the reporting of our findings. Setting Participants were recruited from shopping malls and other public places in the cities of Al Ain and Abu Dhabi. Participants Two hundred adult Emiratis broadly representative of the Emirati population in terms of age and gender. Results Eighty one per cent of participants said that their perception of health states was influenced by their spiritual or religious beliefs. The two overarching themes that seemed to explain or classify these influences were ‘fatalism’ and ‘preservation of life’. Subthemes included powerlessness to change what is preordained by God, fear of disability (particularly diminished mobility) and appreciation of health and life and the requirement to look after one’s health. A final theme was that of acceptance, with respondents expressing a willingness to endure suffering and disability with patience in the expectation of rewards in the hereafter. Conclusions Our results emphasise the need for further work to establish locally relevant value sets for Muslim majority countries in the Middle East and elsewhere for use in health technology assessment decision-making, rather than relying on value sets from other regions. PMID:28982822

Regulatory requirements in the good manufacturing practice production of an epithelial cell graft for ocular surface reconstruction.

PubMed

Sheth-Shah, Radhika; Vernon, Amanda J; Seetharaman, Shankar; Neale, Michael H; Daniels, Julie T

2016-04-01

In the past decade, stem cell therapy has been increasingly employed for the treatment of various diseases. Subsequently, there has been a great interest in the manufacture of stem cells under good manufacturing practice, which is required by law for their use in humans. The cells for sight Stem Cell Therapy Research Unit, based at UCL Institute of Ophthalmology, delivers somatic cell-based and tissue-engineered therapies to patients suffering from blinding eye diseases at Moorfields Eye Hospital (London, UK). The following article is based on our experience in the conception, design, construction, validation and manufacturing within a good manufacturing practice manufacturing facility based in the UK. As such the regulations can be extrapolated to the 28 members stated within the EU. However, the principles may have a broad relevance outside the EU.

Occupational exposure to blood and body fluids: new postexposure prophylaxis recommendations. United States Occupational Safety and Health Administration.

PubMed

Cuny, E; Carpenter, W M

1998-04-01

Dental health care professionals continue to suffer exposure incidents from instruments contaminated with blood and/or body fluids from patients. Each of these cases requires that a rigid protocol be followed for their evaluation. New information regarding the risk factors for HIV-seroconversion following an exposure incident have been identified. Recent data has demonstrated that a 79 percent reduction in disease transmission may be possible with a new combination drug therapy. The anti-retroviral drugs included in this new regimen are now standard in the management of occupational exposure to HIV. Several factors set dentistry apart from other health care occupations, and these differences appear to have an effect on the risks associated with occupational exposures. This article explores these risk factors and the new recommendations for postexposure care.

Predictors of compliance with tornado warnings issued in Joplin, Missouri, in 2011.

PubMed

Paul, Bimal Kanti; Stimers, Mitchel; Caldas, Marcellus

2015-01-01

Joplin, a city in the southwest corner of Missouri, United States, suffered an EF-5 tornado in the late afternoon of 22 May 2011. This event, which claimed the lives of 162 people, represents the deadliest single tornado to strike the US since modern record-keeping began in 1950. This study examines the factors associated with responses to tornado warnings. Based on a post-tornado survey of survivors in Joplin, it reveals that tornado warnings were adequate and timely. Multivariate logistic regression identified four statistically significant determinants of compliance with tornado warnings: number of warning sources, whether respondents were at home when the tornado struck, past tornado experience, and gender. The findings suggest several recommendations, the implementation of which will further improve responses to tornado warnings. © 2014 The Author(s). Disasters © Overseas Development Institute, 2014.

Would You Let Your Child Play Football? Attitudes Toward Football Safety.

PubMed

Fedor, Andrew; Gunstad, John

2016-01-01

An estimated 1.6 million to 3.8 million sports-related concussions occur each year in the United States, and many are related to football. This has generated much discussion in the media on the perceived safety of the sport. In the current study, researchers asked 230 individuals various questions about attitudes toward safety in football. Approximately 92.6% of participants indicated they would allow their child to play football; these participants were more likely to be female (χ(2) = 5.23, p > .05), were slightly younger (t= -2.52, p < .05), and believed an athlete could suffer a higher number of concussions before becoming excessive (t = 2.06, p < .05). Findings suggest most individuals are comfortable with their children playing football, and future studies are needed to clarify factors that inform this opinion.

Reflections on Hope and Its Implications for End-of-Life Care.

PubMed

Mattes, Malcolm D; Sloane, Michelle A

2015-05-01

Physicians caring for individuals with life-altering, incurable illnesses often have a desire to convey a sense of hope while also helping their patients prepare for the end of life to minimize unnecessary suffering and grief. Unfortunately, in the United States, most people receive more-aggressive treatments toward the end of life than studies would suggest that they desire. This reflects the challenging task of balancing optimism and realism, and how providing a false sense of hope for a cure for too long a time while avoiding advance care planning may contribute significantly to the problem. This article explores the interplay of hope and advance care planning, and suggests a need for excellent individualized communication in the setting of advanced cancer to improve end-of-life care. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

[Improving comprehension and communication of risks about health].

PubMed

García-Retamero, Rocío; Galesic, Mirta; Gigerenzer, Gerd

2011-11-01

Many patients have severe difficulties grasping several numerical concepts that are related to their health, such as, for instance, the risk of suffering various diseases. Visual aids have been proposed as a promising method for enhancing risk communication and comprehension. In medical practice, however, not all patients benefit from visual aids. In a study conducted on a probabilistic, representative national sample in the United States, we identified a group of patients for whom visual aids are most useful: Those who have low numeracy but high graphical literacy skills. These patients have high scores in three abilities involved in graph comprehension: (1) the ability to read the data, (2) the ability to read the relations between the data, and (3) the ability to read beyond the data. Our results can have important implications for medical practice and for risk communication about health.

Equipment Standards: History, Litigation, and Advice

PubMed Central

Hedley-Whyte, John; Milamed, Debra R.

1999-01-01

Summary The authors present a concise history of the development of national and international standards for surgical equipment. Standards-writing organizations, surgical and other specialty societies, universities, test houses, and the U.S. government have influenced this process, which is now manifested in complex interactions between national and international standards-writing organizations, and in CE (Conformité Europeene) marks being placed on surgical equipment in the United States and elsewhere. The history of litigation in standards development is also reviewed. Recommendations to maximize patient safety and to help ensure successful, cost-effective defense in litigation for surgeons who use equipment and may suffer its malfunctions are given. Overall, the complicated oversight of surgical equipment standards and the approval process appears to be contributing to the improving and outstanding results of U.S. surgery reported by the U.S. government. PMID:10400045

Depression after traumatic brain injury: a biopsychosocial cultural perspective.

PubMed

Roy, Durga; Jayaram, Geetha; Vassila, Alex; Keach, Shari; Rao, Vani

2015-02-01

There are several challenges in diagnosing and treating mental illness amongst South Asians. Often times, formulating a patient's case presentation cannot adequately be accomplished strictly using a biopsychosocial model. The cultural components play an imperative role in explaining certain psychiatric symptoms and can guide treatment. With the growing population of immigrants coming to the United States, many of which require treatment for mental illness, it is essential that clinicians be cognizant in incorporating cultural perspectives when treating such patients. The authors describe the case of a 24-year old South Asian male who suffered an exacerbation of a depressive syndrome after a traumatic brain injury. Using a biopsychosocial cultural approach, this case highlights how South Asian cultural values can contribute to and incite psychiatric symptoms while simultaneously providing protective drivers for treatment outcomes. Copyright © 2014 Elsevier B.V. All rights reserved.

Hypnotherapy: the salutogenic solution to dealing with phobias.

PubMed

Williamson, Maria; Gregory, Colette

2015-05-01

Evidence suggests that around a quarter of women can suffer from an intense fear of giving birth (tocophobia). This can be costly to these women in terms of enduring negative effects of the increased use of medical interventions associated with tocophobia. Other phobias, such as white coat hypertension, can also be problematic in pregnancy. This article describes the establishment of a hypnotherapy service within the antenatal day assessment unit at East Lancashire Hospitals NHS Trust and recounts a recent case study in which the use of hypnotherapy was employed to help Rebecca, a white coat hypertension sufferer, to successfully manage her condition.

Retrospective cost-effectiveness analyses for polio vaccination in the United States.

PubMed

Thompson, Kimberly M; Tebbens, Radboud J Duintjer

2006-12-01

The history of polio vaccination in the United States spans 50 years and includes different phases of the disease, multiple vaccines, and a sustained significant commitment of resources. We estimated cost-effectiveness ratios and assessed the net benefits of polio vaccination applicable at various points in time from the societal perspective and we discounted these back to appropriate points in time. We reconstructed vaccine price data from available sources and used these to retrospectively estimate the total costs of the U.S. historical polio vaccination strategies (all costs reported in year 2002 dollars). We estimate that the United States invested approximately US dollars 35 billion (1955 net present value, discount rate of 3%) in polio vaccines between 1955 and 2005 and will invest approximately US dollars 1.4 billion (1955 net present value, or US dollars 6.3 billion in 2006 net present value) between 2006 and 2015 assuming a policy of continued use of inactivated poliovirus vaccine (IPV) for routine vaccination. The historical and future investments translate into over 1.7 billion vaccinations that prevent approximately 1.1 million cases of paralytic polio and over 160,000 deaths (1955 net present values of approximately 480,000 cases and 73,000 deaths). Due to treatment cost savings, the investment implies net benefits of approximately US dollars 180 billion (1955 net present value), even without incorporating the intangible costs of suffering and death and of averted fear. Retrospectively, the U.S. investment in polio vaccination represents a highly valuable, cost-saving public health program. Observed changes in the cost-effectiveness ratio estimates over time suggest the need for living economic models for interventions that appropriately change with time. This article also demonstrates that estimates of cost-effectiveness ratios at any single time point may fail to adequately consider the context of the investment made to date and the importance of population and other dynamics, and shows the importance of dynamic modeling.

Occupational injury and illness in the United States. Estimates of costs, morbidity, and mortality.

PubMed

Leigh, J P; Markowitz, S B; Fahs, M; Shin, C; Landrigan, P J

1997-07-28

To estimate the annual incidence, the mortality and the direct and indirect costs associated with occupational injuries and illnesses in the United States in 1992. Aggregation and analysis of national and large regional data sets collected by the Bureau of Labor Statistics, the National Council on Compensation Insurance, the National Center for Health Statistics, the Health Care Financing Administration, and other governmental bureaus and private firms. To assess incidence of and mortality from occupational injuries and illnesses, we reviewed data from national surveys and applied an attributable risk proportion method. To assess costs, we used the human capital method that decomposes costs into direct categories such as medical and insurance administration expenses as well as indirect categories such as lost earnings, lost home production, and lost fringe benefits. Some cost estimates were drawn from the literature while others were generated within this study. Total costs were calculated by multiplying average costs by the number of injuries and illnesses in each diagnostic category. Approximately 6500 job-related deaths from injury, 13.2 million nonfatal injuries, 60,300 deaths from disease, and 862,200 illnesses are estimated to occur annually in the civilian American workforce. The total direct ($65 billion) plus indirect ($106 billion) costs were estimated to be $171 billion. Injuries cost $145 billion and illnesses $26 billion. These estimates are likely to be low, because they ignore costs associated with pain and suffering as well as those of within-home care provided by family members, and because the numbers of occupational injuries and illnesses are likely to be undercounted. The costs of occupational injuries and illnesses are high, in sharp contrast to the limited public attention and societal resources devoted to their prevention and amelioration. Occupational injuries and illnesses are an insufficiently appreciated contributor to the total burden of health care costs in the United States.

The prevalence and comorbidity of social anxiety disorder among United States Latinos: a retrospective analysis of data from 2 national surveys.

PubMed

Polo, Antonio J; Alegría, Margarita; Chen, Chih-Nan; Blanco, Carlos

2011-08-01

Social anxiety disorder (SAD) is increasingly being recognized as a prevalent, unremitting, and highly comorbid disorder, yet studies focusing on this disorder among US Latinos and immigrant populations are not available. This article evaluates ethnic differences in the prevalence and comorbidity of SAD as well as the clinical and demographic characteristics associated with SAD. Cultural and contextual factors associated with risk of SAD are also examined within the Latino population more specifically. Data are analyzed from the National Latino and Asian American Study and the National Comorbidity Survey-Replication. Both studies utilized the World Health Organization-Composite International Diagnostic Interview, which estimates the prevalence of lifetime and 12-month psychiatric disorders according to DSM-IV criteria. Latinos reported a lower lifetime and 12-month SAD prevalence and a later age at onset than US-born non-Latino whites. On the other hand, Latinos diagnosed with 12-month SAD reported higher impairment across home, work, and relationship domains than their non-Latino white counterparts. Relative to non-Latino whites, Latinos who entered the United States after the age of 21 years were less likely to have lifetime SAD comorbidity with drug abuse and dependence and more likely to report lifetime SAD comorbidity with agoraphobia. The pattern of risk and associated characteristics of SAD varies for Latinos as compared to non-Latino whites. This is reflected by differences between these 2 groups across SAD prevalence, onset, impairment, and comorbidity. The particularly high comorbidity found with agoraphobia among Latinos who arrive in the United States as adults suggests that cultural factors and timing of immigration play a role in the manifestation and course of anxiety disorders. Interventions designed to decrease the levels of impairment associated with SAD are needed as well as efforts to target Latinos suffering from this disorder, specifically. © Copyright 2011 Physicians Postgraduate Press, Inc.

Listeria, Then and Now: A Call to Reevaluate Patient Teaching Based on Analysis of US Federal Databases, 1998-2016.

PubMed

Simon, Katya; Simon, Valentina; Rosenzweig, Rachel; Barroso, Rebeca; Gillmor-Kahn, Mickey

2018-05-01

Listeria monocytogenes is a foodborne pathogen capable of crossing the placental-fetal barrier; infection with the bacterium causes listeriosis. An exposed fetus may suffer blindness, neurological damage including meningitis, or even death. The adverse consequences of listeriosis place the infection on the federally reportable disease list. Primary prevention relies on women avoiding 6 categories of foods most likely to be contaminated with L monocytogenes, as indicated in guidelines developed by the Centers for Disease Control and Prevention (CDC), adapted by the American College of Obstetricians and Gynecologists (ACOG) in 2014, and reaffirmed without changes by ACOG in 2016. This report contains a critical evaluation of United States listeriosis prevention guidelines. Between 1998 and 2016, there were 876 identified listeriosis events documented in the illness and recall databases maintained by the CDC, Food and Drug Administration (FDA), and United States Department of Agriculture - Food Safety and Inspection Service (USDA-FSIS). Each contaminated food was manually compared to the existing listeriosis avoidance guidelines, placing each event within or outside the guidelines. Trends were analyzed over time. Database analysis demonstrates that prior to the year 2000, abiding by the current guidelines would have prevented all reported listeriosis cases. However, in 2015 and 2016, only 5% of confirmed L monocytogenes infections originated from the 6 food groups listed in the CDC and ACOG guidelines. Similar trends emerged for food processing plant recalls (USDA-FSIS database) and grocery store recalls (FDA database). The total number of listeriosis illnesses in the United States doubled from 2007 to 2014. A gradual shift in detection of L monocytogenes contamination in ready-to-eat meals, frozen foods, and ready-to-eat salads has occurred. Another emerging culprit is pasteurized dairy products. Revision of listeriosis avoidance guidelines by a consensus-seeking, multidisciplinary task force, is needed. © 2018 by the American College of Nurse-Midwives.

Skin lighteners, Black consumers and Jewish entrepreneurs in South Africa.

PubMed

Thomas, Lynn M

2012-01-01

This article considers the rise and decline of South Africa's lucrative and controversial skin-lighteners market through examination of the business history of the largest manufacturers, Abraham and Solomon Krok, and their evolving personas as millionaires and philanthropists. Such examination reveals how the country's skin-lighteners trade emerged as part of the broader growth of a black consumer market after the Second World War and how elements of that market became the target of anti-apartheid protests in subsequent decades. It also demonstrates how the Kroks' experiences as second-generation Jewish immigrants shaped their involvement in the trade and how, later, their self-identification as Jewish philanthropists informed their efforts to rehabilitate their reputations following South Africa's 1990 ban on all skin lighteners. Such efforts include the building of Johannesburg's highly acclaimed Apartheid Museum, modelled after the United States Holocaust Memorial Museum. This article explores the profound ironies that some South Africans see in the fact that a museum dedicated to commemorating those who suffered under and, ultimately, triumphed against state racism was financed by a family fortune generated through the sale of skin lighteners to black consumers.

Developing Children's Awareness of the Human-Animal Bond: An Assessment of the Experiences and Benefits that Children Receive in the United Animal Nation's Humane Education Ambassador Readers (HEAR) Program

ERIC Educational Resources Information Center

Stokes, Laura

2009-01-01

In 2007, the United Animal Nations (UAN) launched the Humane Education Ambassador Readers (HEAR), an innovation that focused on mitigation of animal suffering through education. In the HEAR program, adult volunteers read carefully selected story books to children in grades 3-6 in schools or other educational settings, and hold discussions with the…

The Cognitive Abilities and Skills of Children Who Suffer from Attention Deficit and Hyperactivity Disorder (ADHD) in Kuwait State

ERIC Educational Resources Information Center

Mohammed, Ali Mohammed Haidar

2016-01-01

The present study aims to identify the level of cognitive skills and abilities of children who suffer from the Attention Deficit and Hyperactivity Disorder (ADHD) and the differences in the level of cognitive skills and abilities according to the age group and the level of academic achievement. To achieve the objective of the study, a…

The Happy and Suffering Student? Rousseau's "Emile" and the Path Not Taken in Progressive Educational Thought

ERIC Educational Resources Information Center

Mintz, Avi I.

2012-01-01

One of the mantras of progressive education is that genuine learning ought to be exciting and pleasurable, rather than joyless and painful. To a significant extent, Jean-Jacques Rousseau is associated with this mantra. In a theme of "Emile" that is often neglected in the educational literature, however, Rousseau stated that "to suffer is the first…

An ethics of suffering: does it solve the problems we want to solve?: commentary.

PubMed

Edwards, Barbara Springer

1991-01-01

Erich H. Loewy proposes to elevate the moral obligation to prevent and relieve suffering to the level of a prima facie moral duty by delineating which beings are of primary moral worth and which are of secondary moral worth. Sentient beings have a capacity to suffer and are therefore of primary moral worth. Beings that are insentient cannot suffer; therefore such beings are only of secondary moral worth. Objects of secondary moral worth include patients in a persistent vegetative state (PVS) and brain-dead patients. This proposal, he says, would solve a number of problems in clinical bioethics. First, it would help to clarify our moral duties at the bedside. And secondly, by creating a hierarchy of moral values, it helps to differentiate which patients are owed our primary allegiance and resources. Despite his extensive and painstaking proof, I believe several questions remain about the use of the "capacity of sentient beings to suffer" as a basis for a universal grounding in ethics.

[Life and medical missionary activities of Esther K. Pak (1877-1910)].

PubMed

Lee, Bang Weon

2007-12-01

Esther K. Pak (1876-1910) is believed as the first medical doctor in Korea. Esther's life can be largely reviewed in three parts: school-hood at EwhaHaktang (currently Ewha Womans University), Education in the United States, and medical missionary work after coming back to Korea from the United States. The foreign Methodist missionaries was able to enter Korea after opening of its ports and establishing its diplomatic relationship with the United States. Esther met modern sciences and Christianity at EwhaHaktang, which was founded by those missionaries. She could dream of being an American-style medical doctor in the future, while she assisted medical missionaries at PoKuNyoKwan in EwhaHaktang. She could get substantial academic help from those missionaries. With the support of Dr. Rosetta Sherwood Hall, who first introduced the world of medial science to Esther in a real sense, Esther went to the United States to study the field in 1894. While learning it, she suffered from academic frustration, economic difficulty, her husband's death and so on, but she eventually got over those adversities and completed the four years of academic courses to become a medical doctor. Her religious faith and will to help Koreans as a doctor encouraged her to finish what she had originally planned. Esther came back to Korea in 1900 and began to work earnestly as a medical missionary delegated from Woman's Foreign Missionary Society. At PoKuNyoKwan in Seoul and Woman's Hospital in Pyongyang, She performed medical work and enlightenment campaign against the superstitious healing conduct. Esther also took part in the circuit missionary performances. She devoted herself for evangelical work at Bible Institute as well. Esther's activity made people understand the effectiveness of education. She helped people to recognize education for woman, occidental medical treatment and Christianity in a positive way. On April 28, 1909, based on these excellent performances for the social development, she was invited, honored and granted a testimonial at the first welcoming ceremony, which was held by the united body of civilians and officials, for students studying abroad. But on April 13, 1910, about one year after the ceremony, she died of illness. She was 34. Although she was born at the turbulent last period of Korea Empire and lived for only 34 years, Esther's medical missionary work was evaluated as the opening of woman's participation in medical science in Korea. Not only in the 'woman's' but also in 'whole' field of medical science, her performance left significant marks in woman's and Christian history in Korea as well.

Recent Advances in Hydrocortisone Replacement Treatment.

PubMed

Mallappa, Ashwini; Debono, Miguel

2016-01-01

Since the first use of cortisone in patients around 65 years ago, the use of synthetic glucocorticoids has made a crucial impact on the treatment of several diseases in medicine. Although significant reductions in morbidity and mortality have occurred in patients suffering from cortisol deficiency, conventional hydrocortisone replacement treatment is still inadequate. A major limitation is that it fails to replace cortisol in a physiological manner. Cortisol has a distinct circadian rhythm and acts as a secondary messenger synchronizing the central to peripheral clocks, hence playing a key role in biological processes and the circadian timing system. Circadian misalignment has been associated with ill-health and so nonphysiological glucocorticoid treatment could explain the increased mortality rate, poor quality of life and metabolic complications in patients suffering from adrenal insufficiency. Attempts at replacing cortisol in a physiological manner have shown significant progress in the past decade with the development of modified-release formulations of hydrocortisone (Chronocort® and Plenadren®) and continuous subcutaneous hydrocortisone infusions. Initial studies investigating the use of these replacement regimens are promising, demonstrating both clinical and biochemical improvement. Larger studies are needed to determine whether this novel approach enhances long-term outcomes in both children and adults with cortisol deficiency. This is a work of the U.S. Government and is not subject to copyright protection in the United States. Foreign copyrights may apply. Published by S. Karger AG, Basel.

Migrants suffering violence while in transit through Mexico: factors associated with the decision to continue or turn back.

PubMed

Servan-Mori, Edson; Leyva-Flores, Rene; Infante Xibille, Cesar; Torres-Pereda, Pilar; Garcia-Cerde, Rodrigo

2014-02-01

To identify and analyze the factors associated with the decision of migrants suffering violence while in transit through Mexico, to continue on their trip or turn back. Cross-sectional study combining quantitative and qualitative analyses. Socio-demographic and health characteristics, as well as types of violence and factors associated with the decision to continue on the trip, were explored for 862 migrants. 35 migrants were interviewed to explore their perceptions of migration, socioeconomic and political situations in their countries of origin, risks, violence experienced, and the decision to continue on their trip. Of the 862 migrants, 21.1% experienced violence during their transit through Mexico towards the USA. Of these, 88.5% decided to continue on their journey. This decision was positively associated with age (OR = 1.075, p < 0.05), number of children (OR = 3.161, p < 0.10), homicide rate in the country of origin (OR = 1.043, p < 0.10) and proximity to the northern border. No differences were observed by sex, schooling, days in transit and the presence of health problems. The decision to continue the journey to the United States was related to structural factors in the countries of origin, rather than risks in transit. It is necessary to implement mechanisms to promote and protect the human rights of migrants during their whole journey (origin, transit and destination).

Urinary Bladder Distention Evoked Visceromotor Responses as a Model for Bladder Pain in Mice

PubMed Central

Sadler, Katelyn E.; Stratton, Jarred M.; Kolber, Benedict J.

2014-01-01

Approximately 3-8 million people in the United States suffer from interstitial cystitis/bladder pain syndrome (IC/BPS), a debilitating condition characterized by increased urgency and frequency of urination, as well as nocturia and general pelvic pain, especially upon bladder filling or voiding. Despite years of research, the cause of IC/BPS remains elusive and treatment strategies are unable to provide complete relief to patients. In order to study nervous system contributions to the condition, many animal models have been developed to mimic the pain and symptoms associated with IC/BPS. One such murine model is urinary bladder distension (UBD). In this model, compressed air of a specific pressure is delivered to the bladder of a lightly anesthetized animal over a set period of time. Throughout the procedure, wires in the superior oblique abdominal muscles record electrical activity from the muscle. This activity is known as the visceromotor response (VMR) and is a reliable and reproducible measure of nociception. Here, we describe the steps necessary to perform this technique in mice including surgical manipulations, physiological recording, and data analysis. With the use of this model, the coordination between primary sensory neurons, spinal cord secondary afferents, and higher central nervous system areas involved in bladder pain can be unraveled. This basic science knowledge can then be clinically translated to treat patients suffering from IC/BPS. PMID:24798516

Estimating patient-specific and anatomically correct reference model for craniomaxillofacial deformity via sparse representation

PubMed Central

Wang, Li; Ren, Yi; Gao, Yaozong; Tang, Zhen; Chen, Ken-Chung; Li, Jianfu; Shen, Steve G. F.; Yan, Jin; Lee, Philip K. M.; Chow, Ben; Xia, James J.; Shen, Dinggang

2015-01-01

Purpose: A significant number of patients suffer from craniomaxillofacial (CMF) deformity and require CMF surgery in the United States. The success of CMF surgery depends on not only the surgical techniques but also an accurate surgical planning. However, surgical planning for CMF surgery is challenging due to the absence of a patient-specific reference model. Currently, the outcome of the surgery is often subjective and highly dependent on surgeon’s experience. In this paper, the authors present an automatic method to estimate an anatomically correct reference shape of jaws for orthognathic surgery, a common type of CMF surgery. Methods: To estimate a patient-specific jaw reference model, the authors use a data-driven method based on sparse shape composition. Given a dictionary of normal subjects, the authors first use the sparse representation to represent the midface of a patient by the midfaces of the normal subjects in the dictionary. Then, the derived sparse coefficients are used to reconstruct a patient-specific reference jaw shape. Results: The authors have validated the proposed method on both synthetic and real patient data. Experimental results show that the authors’ method can effectively reconstruct the normal shape of jaw for patients. Conclusions: The authors have presented a novel method to automatically estimate a patient-specific reference model for the patient suffering from CMF deformity. PMID:26429255

Mexican immigration to the US, the occurrence of violence and the impact of mental disorders

PubMed Central

Borges, Guilherme; Rafful, Claudia; Tancredi, Daniel J.; Saito, Naomi; Aguilar-Gaxiola, Sergio; Medina Mora, Maria-Elena; Breslau, Joshua

2014-01-01

Background International migration is likely to increase the occurrence of violence but little research is available to confirm this hypothesis. Objective To study immigration, US nativity and return migration as risk factors for violence among people of Mexican origin in the US and Mexico. Methods Cross-sectional surveys in the United States (2001–2003; n= 1213) and Mexico (2001–2002; n=2362). Discrete time survival models were used. The reference group was the Mexicans living in Mexico without migrant experience or a migrant relative. Results Mexican immigrants in the US have lower risk for any violence (hazard rate [HR]= 0.5, 95% Confidence Interval [CI]= 0.4–0.7). US born Mexican-Americans were at higher risk for violence victimization of a sexual nature (for sexual assault HR=2.5, CI=1.7–3.7). Return migrants were at increased risk for being kidnapped or held hostage (HR=2.8, CI=1.1–7.1). Compared to those without a mental disorder, those with a mental disorder were more likely to suffer any violence (HR= 2.3, CI=1.9– 2.7), regardless of the migrant experience. Conclusions The impact of immigration on the occurrence of violence is more complex than usually believed. Return migrants are more likely to suffer violence such as being held hostage or beaten for someone not a partner. PMID:23904022

Mindfulness-Based Interventions for Hematology and Oncology Patients with Pain.

PubMed

Hess, Denise

2018-06-01

Pain is a reality for approximately half of all of patients with cancer and can negatively affect patient cognitive and emotional states, resulting in "total pain." Total pain may not respond to pharmacologic interventions and may pave the way for the onset of suffering, where suffering is defined as physical pain accompanied by negative cognitive interpretations. Mindfulness-based interventions provide an alternate interpretive framework for both pain and suffering and may lessen a patient's experience of pain. Mindfulness-based interventions have the potential to alter a patient's relationship to pain, reducing pain catastrophizing, and enhancing patient reported overall well-being. Copyright © 2018 Elsevier Inc. All rights reserved.

Fallen uterus: social suffering, bodily vigor, and social support among women in rural Mexico.

PubMed

Smith-Oka, Vania

2014-03-01

This article focuses on rural indigenous Mexican women's experiences with uterine prolapse, particularly the illness's expression of social suffering. Drawing on ethnographic research conducted during 2004-2005 and 2007 in a Nahua village in the state of Veracruz, the article analyzes the multifactorial nature of women's social suffering. Results show that the roots of uterine displacement for the women lie in lack of social relations and in perceptions of bodily vigor. Additionally, inequality present in the women's interactions with mainstream Mexico brings into focus the larger structural factors that shape their reproductive health. The implications of research on the effect of social support on women's embodiment of social suffering can extend beyond one illness, linking it to broader issues shaping the health of marginalized populations. © 2014 by the American Anthropological Association.

[Symptoms of anxiety and depression in atopic eczema/dermatitis syndrome].

PubMed

Brzoza, Zenon; Badura-Brzoza, Karina; Nowakowski, Marek; Matysiakiewicz, Jerzy; Rogala, Barbara; Hese, Robert T

2005-01-01

The presence of chronic disease is a risk factor for the development of mood disturbances and panic disorders. They can influence the course of disease and effectiveness of therapy. Depression may be the cause of making light doctor's advice. Anxious patients often aggravate symptoms of the disease. To study symptoms of anxiety and depression in patients suffering from atopic eczema/dermatitis syndrome (ZAZS). Material. We studied 38 patients suffering from adequately controlled moderate ZAZS and 62 volunteers in the control group. Mental status of subjects was assessed by means of State and Trait Anxiety Inventory (STAI) and Beck Depression Inventory (BDI) questionnaires. ZAZS patients demonstrated higher intensity of anxiety (as a trait and as a state) than healthy subjects. Intensity and prevalence of depression in the atopic eczema/ dermatitis syndrome group was higher than in the control group. Patients suffering from atopic/eczema dermatitis syndrome are pre-disposed to anxiety and depression manifestation. Even adequately controlled symptoms of atopic/eczema dermatitis syndrome may be the cause of those disturbances' occurrence.

Enhancing Trilateral Disaster Preparedness and Relief Cooperation between Japan, U.S. and Australia: Approaches from Various Civil-Military Perspectives

DTIC Science & Technology

2013-07-01

Humanitarian Response Depot (in Malaysia ) UNISDR United Nations International Strategy for Disaster Reduction UNOCHA United Nations Office for the...suffered two different types of disasters—(1) the earthquake and tsunami and (2) large-scale radioactive contamination , we focus our analysis on the...trends of the decline in energy, food and water sufficiency, and the increase in HIV transmission, drug addiction and people smuggling “will have

Response to Erich Loewy: commentary.

PubMed

Thomasma, David C

1991-01-01

The capacity to suffer, the vulnerability with respect to suffering, confers on all animals with that capacity (not just human beings) a prima facie right not to be caused suffering. Nurturing in order to stave off such suffering is the first act of the community toward the individual, primarily in infancy. Hence for Loewy, autonomy, the gradual growth of self-determination in individuals, is grounded in a broader moral commitment of the community, that of beneficence. This is the critical point in his argument, for it represents a wholesale critique of modern libertarianism. Libertarians, in contrast to Loewy's argument, seem to ground the nature of the community in the prima facie right of autonomy. For Loewy, the community not only has an obligation to refrain from harming individuals (nonmaleficence), but it also has an active duty to ameliorate and prevent, as far as possible, the suffering of its members. Thus, if there is a social contract, it is one of nurturing one another to overcome the vulnerability of suffering, not primarily one of protecting autonomy. This is most significant for clinical ethics as well. Once the primary obligation to ameliorate suffering is no longer necessary, when the individual loses or does not have the primary moral worth prompted by the capacity to suffer, then secondary and symbolic obligations emerge. Loewy is thereby able to suggest a "calculus" of moral worth, wherein our obligations to individuals in a permanent vegetative state or to anencephalics (almost always the individual will have lost the capacity to suffer through some cerebral event) must be weighed against other primary obligations. Although Loewy admits that grounding clinical ethics in the capacity to suffer might be "thin," it nevertheless prompts serious discussion about the nature of the "good" in good clinical ethics decisions.

National health insurance in America--can we practice with it? Can we continue to practice without it?

PubMed Central

Grumbach, K

1989-01-01

Health insurance in the United States is failing patients and physicians alike. In this country 37 million uninsured face economic barriers to care, and the health of many suffers as a result. The "corporatization" of medical care threatens professional values with an unprecedented administrative and commercial intrusion into the daily practice of medicine. Competitive strategies have also failed their most ostensible goal--cost control. In contrast, Canada offers a model of a national health insurance plan that provides universal and comprehensive coverage, succeeds at restraining health care inflation, and does little to abrogate the clinical autonomy of physicians in private practice. I propose that American physicians relent in their historical opposition to national health insurance and participate in the development of a universal, public insurance plan responsive to the needs of both patients and physicians. Images PMID:2672604

Limitations to the study of man in space in the U.S. space program

NASA Technical Reports Server (NTRS)

Bishop, Phillip A.; Greenisen, Mike

1993-01-01

Research on humans conducted during spaceflight is fraught both with great opportunities and great obstacles. The purpose of this paper is to review some of the limitations to research in space in the United States with hope that an informed scientific community may lead to more rapid and efficient solution of these problems. Limitations arise because opportunities to study the same astronauts in well-controlled situations on repeated spaceflights are practically non-existent. Human research opportunities are further limited by the necessity of avoiding simultaneous mutually-interfering experiments. Environmental factors, including diet and other physiological perturbations concomitant with spaceflight, also complicate research design and interpretation. Technical limitations to research methods and opportunities further restrict the development of the knowledge base. Finally, Earth analogues of space travel all suffer from inadequacies. Though all of these obstacles will eventually be overcome, creativity, diligence, and persistence are required to further our knowledge of humans in space.

Mining Twitter Data to Improve Detection of Schizophrenia

PubMed Central

McManus, Kimberly; Mallory, Emily K.; Goldfeder, Rachel L.; Haynes, Winston A.; Tatum, Jonathan D.

2015-01-01

Individuals who suffer from schizophrenia comprise I percent of the United States population and are four times more likely to die of suicide than the general US population. Identification of at-risk individuals with schizophrenia is challenging when they do not seek treatment. Microblogging platforms allow users to share their thoughts and emotions with the world in short snippets of text. In this work, we leveraged the large corpus of Twitter posts and machine-learning methodologies to detect individuals with schizophrenia. Using features from tweets such as emoticon use, posting time of day, and dictionary terms, we trained, built, and validated several machine learning models. Our support vector machine model achieved the best performance with 92% precision and 71% recall on the held-out test set. Additionally, we built a web application that dynamically displays summary statistics between cohorts. This enables outreach to undiagnosed individuals, improved physician diagnoses, and destigmatization of schizophrenia. PMID:26306253

Imported fenproporex-based diet pills from Brazil: a report of two cases.

PubMed

Cohen, Pieter A

2009-03-01

Banned amphetamine-based anorectics are illicitly imported into the United States (US), but little is known regarding the harm these diet pills pose to US residents. A 26-year-old woman using imported diet pills presented with a two-year history of intermittent chest pains, palpitations, headaches and insomnia. Urine toxicology screen detected amphetamines and benzodiazepines. Fenproporex and chlordiazepoxide were detected in her pills. Her symptoms resolved after she stopped using diet pills. A 38-year-old man using imported diet pills presented after his occupational urine screen was significantly positive for amphetamine. Fenproporex and fluoxetine were detected in his pills. These cases illustrate the potential harm from imported prescription diet pills that combine fenproporex with benzodiazepines, antidepressants, diuretics, laxatives and other substances. Increasing physicians' awareness of imported diet pill use may improve care of patients suffering from the pills' many adverse effects.

Imported Fenproporex-based Diet Pills from Brazil: A Report of Two Cases

PubMed Central

2008-01-01

Banned amphetamine-based anorectics are illicitly imported into the United States (US), but little is known regarding the harm these diet pills pose to US residents. A 26-year-old woman using imported diet pills presented with a two-year history of intermittent chest pains, palpitations, headaches and insomnia. Urine toxicology screen detected amphetamines and benzodiazepines. Fenproporex and chlordiazepoxide were detected in her pills. Her symptoms resolved after she stopped using diet pills. A 38-year-old man using imported diet pills presented after his occupational urine screen was significantly positive for amphetamine. Fenproporex and fluoxetine were detected in his pills. These cases illustrate the potential harm from imported prescription diet pills that combine fenproporex with benzodiazepines, antidepressants, diuretics, laxatives and other substances. Increasing physicians’ awareness of imported diet pill use may improve care of patients suffering from the pills’ many adverse effects. PMID:19096898

A crash course in Chinese herbology for the psychopharmocological prescriber.

PubMed

White, Kathryn P

2009-12-01

Given the unparalleled popularity of botanicals in the United States, it is safe to say that almost every psychopharmacological prescriber will see some patients using Chinese herbs. Data show that between 36% and 42% of Americans use complementary and alternative medicine (CAM) each year and that persons suffering from depression and anxiety (67%) use CAM services significantly more than do their nonanxious and nondepressed counterparts (39%). This article gives an overview of several classical Chinese medical single herbs and herbal formulas commonly used for persons with psychiatric disorders and discusses some of the herbs that have the potential to interact with various pharmaceutical drugs. In addition, the article reviews scientific evidence and, at times, the lack thereof to validate the use of Chinese herbs and formulas in treating psychiatric conditions. Overall, the article seeks to prepare the pharmacological prescriber for working with patients concomitantly taking psychiatric medications and Chinese herbs.

Targeted complement inhibition as a promising strategy for preventing inflammatory complications in hemodialysis

PubMed Central

DeAngelis, Robert A.; Reis, Edimara S.; Ricklin, Daniel; Lambris, John D.

2012-01-01

Hemodialysis is the most common method used to remove waste and hazardous products of metabolism in patients suffering from renal failure. Hundreds of thousands of people with end-stage renal disease undergo hemodialysis treatment in the United States each year. Strikingly, the 5-year survival rate for all dialysis patients is only 35%. Most of the patients succumb to cardiovascular disease that is exacerbated by the chronic induction of inflammation caused by contact of the blood with the dialysis membrane. The complement system, a strong mediator of pro-inflammatory networks, is a key contributor to such biomaterial-induced inflammation. Though only evaluated in experimental ex vivo settings, specific targeting of complement activation during hemodialysis has uncovered valuable information that points towards the therapeutic use of complement inhibitors as means to control the unwelcomed inflammatory responses and consequent pathologies in hemodialysis patients. PMID:22964235

HIV-1, Reactive Oxygen Species and Vascular Complications

PubMed Central

Porter, Kristi M.; Sutliff, Roy L.

2012-01-01

Over 1 million people in the United States and 33 million individuals worldwide suffer from HIV/AIDS. Since its discovery, HIV/AIDS has been associated with an increased susceptibility to opportunistic infection due to immune dysfunction. Highly active antiretroviral therapies (HAART) restore immune function and, as a result, people infected with HIV-1 are living longer. This improved survival of HIV-1 patients has revealed a previously unrecognized risk of developing vascular complications, such as atherosclerosis and pulmonary hypertension. The mechanisms underlying these HIV-associated vascular disorders are poorly understood. However, HIV-induced elevations in reactive oxygen species, including superoxide and hydrogen peroxide, may contribute to vascular disease development and progression by altering cell function and redox-sensitive signaling pathways. In this review, we summarize the clinical and experimental evidence demonstrating HIV- and HIV antiretroviral therapy-induced alterations in reactive oxygen species (ROS) and how these effects likely contribute to vascular dysfunction and disease. PMID:22564529

Legal-age students' provision of alcohol to underage college students: an exploratory study.

PubMed

Brown, Richard L; Matousek, Therese A; Radue, Mary B

2009-01-01

The authors investigated the magnitude and cultural context of legal-age university students' provision of alcohol to underage students and how such alcohol provision might be deterred. 130 legal-age students at a midwestern university in the United States were randomly selected. The authors assessed 16 focus groups and a thematic analysis. Most participants reported frequent alcohol provision. Most denied moral responsibility for any negative consequences that recipients might suffer. Small numbers of participants, chiefly women, would decrease alcohol provision after education on the sexual risks to underage females. Larger numbers would decrease provision in response to consistent law enforcement, severe legal and disciplinary penalties, and education on severe penalties. Legal-age students' provision of alcohol to underage students is an integral part of college students' drinking culture. As a deterrent, an enforcement-based campaign may be more effective than an educational campaign on the possible negative consequences of alcohol for underage students.

Internet Addiction: A Brief Summary of Research and Practice

PubMed Central

Cash, Hilarie; Rae, Cosette D; Steel, Ann H; Winkler, Alexander

2012-01-01

Problematic computer use is a growing social issue which is being debated worldwide. Internet Addiction Disorder (IAD) ruins lives by causing neurological complications, psychological disturbances, and social problems. Surveys in the United States and Europe have indicated alarming prevalence rates between 1.5 and 8.2% [1]. There are several reviews addressing the definition, classification, assessment, epidemiology, and co-morbidity of IAD [2-5], and some reviews [6-8] addressing the treatment of IAD. The aim of this paper is to give a preferably brief overview of research on IAD and theoretical considerations from a practical perspective based on years of daily work with clients suffering from Internet addiction. Furthermore, with this paper we intend to bring in practical experience in the debate about the eventual inclusion of IAD in the next version of the Diagnostic and Statistical Manual of Mental Disorders (DSM). PMID:23125561

The ethics of deactivating a pacemaker in a pacing-dependent patient: reflections on a case study.

PubMed

Malpas, Phillipa J; Cooper, Lisa

2012-11-01

The decision to deactivate a pacemaker in a pacing-dependent patient is troubling for some health professionals who may regard such interventions as hastening death and therefore ethically impermissible. This may be especially concerning in situations where a patient is unable to clearly state what their preferences may be and the decision--were it to be made--will almost certainly result in the patient's immediate death. In this discussion, we reflect on some of the ethical aspects that arise when JP, a 75-year-old woman who is pacing dependent, suffers a significant brain injury, and the family request that her pacemaker be deactivated. Taking into account the clinical reality of her situation, the united wishes and loving concern of her husband and family, and their substituted judgment regarding her likely preferences, we claim that the decision to deactivate her pacemaker was ethically sound.

Innovative Oral Treatments of Uterine Leiomyoma

PubMed Central

Sabry, Mohamed; Al-Hendy, Ayman

2012-01-01

Uterine fibroids (leiomyoma), the benign tumors of the uterine wall, are very common cause of morbidity in reproductive age women usually in the form of excessive vaginal bleeding, chronic pelvic pain, miscarriage and infertility. These tumors are the leading indication for hysterectomy in the United States. Uterine fibroids are about 4 times higher in blacks compared to whites and constitute a major health disparity challenge. The estimated cost of uterine fibroids is up to $34.4 billion annually. Additionally, women who suffer from this disease and desire to maintain their future fertility have very limited treatment choices. Currently, there is no effective long-term medicinal treatment for uterine fibroids. While surgery has traditionally been the gold standard for the treatment of uterine fibroids, there is growing interest towards orally administered medications for the management of leiomyoma-related symptoms. In this paper, we will discuss these promising innovative oral medical treatments in detail. PMID:22518167

Eye-Tracking Evidence that Happy Faces Impair Verbal Message Comprehension: The Case of Health Warnings in Direct-to-Consumer Pharmaceutical Television Commercials

PubMed Central

Russell, Cristel Antonia; Swasy, John L.; Russell, Dale Wesley; Engel, Larry

2017-01-01

Risk warning or disclosure information in advertising is only effective in correcting consumers’ judgments if enough cognitive capacity is available to process that information. Hence, comprehension of verbal warnings in TV commercials may suffer if accompanied by positive visual elements. This research addresses this concern about cross-modality interference in the context of direct-to-consumer (DTC) pharmaceutical commercials in the United States by experimentally testing whether positive facial expressions reduce consumers’ understanding of the mandated health warning. A content analysis of a sample of DTC commercials reveals that positive facial expressions are more prevalent during the verbal warning act of the commercials than during the other acts. An eye-tracking experiment conducted with specially produced DTC commercials, which vary the valence of characters’ facial expressions during the health warning, provides evidence that happy faces reduce objective comprehension of the warning. PMID:29269979

The Landers earthquake; preliminary instrumental results

USGS Publications Warehouse

Jones, L.; Mori, J.; Hauksson, E.

1992-01-01

Early on the morning of June 28, 1992, millions of people in southern California were awakened by the largest earthquake to occur in the western United States in the past 40 yrs. At 4:58 a.m PDT (local time), faulting associated with the magnitude 7.3 earthquake broke through to earth's surface near the town of Landers, California. the surface rupture then propagated 70km (45 mi) to the north and northwest along a band of faults passing through the middle of the Mojave Desert. Fortunately, the strongest shaking occurred in uninhabited regions of the Mojave Desert. Still one child was killed in Yucca Valley, and about 400 people were injured in the surrounding area. the desert communities of Landers, Yucca Valley, and Joshua Tree in San Bernardino Country suffered considerable damage to buildings and roads. Damage to water and power lines caused problems in many areas. 

Citizen science, GIS, and the global hunt for landslides

NASA Astrophysics Data System (ADS)

Juang, C.; Stanley, T.; Kirschbaum, D.

2017-12-01

Landslides occur across the United States and around the world, causing much suffering and infrastructure damage. Many of these events have been recorded in the Global Landslide Catalog (GLC), a worldwide record of recently rainfall-triggered landslides. The extent and composition of this database has been affected by the limits of media search tools and available staffing. Citizen scientists could expand the effort exponentially, as well as diversify the knowledge base of the research team. In order to enable this collaboration the NASA Center for Climate Simulation has created a GIS portal for viewing, editing, and managing the GLC. The data is also exposed through a Rest API, for easy incorporation into geospatial websites by third parties. Future developments may include the ability to store polygons delineating large landslides, digitization from recent satellite imagery, and the establishment of a community for international landslide research that is open to both lay and academic users.

Limitations to the study of man in space in the U.S. space program.

PubMed

Bishop, P A; Greenisen, M

1993-03-01

Research on humans conducted during spaceflight is fraught both with great opportunities and great obstacles. The purpose of this paper is to review some of the limitations to research in space in the United States with hope that an informed scientific community may lead to more rapid and efficient solution of these problems. Limitations arise because opportunities to study the same astronauts in well-controlled situations on repeated spaceflights are practically non-existent. Human research opportunities are further limited by the necessity of avoiding simultaneous mutually-interfering experiments. Environmental factors, including diet and other physiological perturbations concomitant with spaceflight, also complicate research design and interpretation. Technical limitations to research methods and opportunities further restrict the development of the knowledge base. Finally, Earth analogues of space travel all suffer from inadequacies. Though all of these obstacles will eventually be overcome, creativity, diligence, and persistence are required to further our knowledge of humans in space.

Animal rights and animal experimentation. Implications for physicians.

PubMed Central

Gelpi, A. P.

1991-01-01

Practicing physicians are just becoming aware of the animal rights movement, which during the 1980s spawned numerous acts of violence against research facilities throughout the United States. The animal rightists are challenging physicians to show moral justification for the human exploitation of nature and the world of subhuman species. They have aroused public interest in animal welfare, sparked protective legislation for experimental animals, and indirectly encouraged the creation of committees to oversee the conduct of animal experimentation and the conditions of animal confinement. This controversy has necessitated a closer look at the questions of animal experimentation and animal rights against the backdrop of human experimentation and human rights. Physicians and specialists in animal care seek to alleviate suffering and anxiety, and, as moderates, they may be able to bring both sides of the animal rights controversy together in a spirit of mutual tolerance and in the common cause of promoting both human and animal welfare. PMID:1949772

Does direct-to-consumer advertising affect patients' choice of pain medications?

PubMed

Liu, Yifei; Doucette, William R

2008-04-01

In the United States, direct-to-consumer advertising (DTCA) has grown rapidly to promote prescription medications, including analgesics. Few studies in the literature directly examine the association between DTCA and patients' choice of pain medications. This article discusses how DTCA affects such choice from a behavioral perspective, because DTCA-prompted behaviors are important indicators of DTCA's influence. After DTCA exposure, patients may request prescriptions, seek further medication information, and ask about advertised conditions. Patients who suffer from pain may seek more communication with their health care providers because they are cautious about the information quality of DTCA, mainly because of the recall of rofecoxib (Vioxx; Merck, Whitehouse Station, NJ). However, the availability and DTCA of over-the-counter analgesics complicate their treatment choice. Patients could use DTCA as a tool to launch health communication and make an informed treatment choice with the guidance of their health care providers.

Video Observations Encompassing the 2002 Leonid Storm: First Results and a Revised Photometric Procedure for Video Meteor Analysis

NASA Technical Reports Server (NTRS)

Cooke, William J.; Suggs, Robert; Swift, Wesley; Gural, Peter S.; Brown, Peter; Ellis, Jim (Technical Monitor)

2002-01-01

During the 2001 Leonid storm, Marshall Space Flight Center, with the cooperation of the University of Western Ontario and the United States Air Force, deployed 6 teams of observers equipped with intensified video systems to sites located in North America, the Pacific, and Mongolia. The campaign was extremely successful, with the entire period of enhanced Leonid activity (over 16 hours) captured on video tape in a consistent manner. We present the first results from the analysis of this unique, 2 terabyte data set and discuss the problems involved in reducing large amounts of video meteor data. In particular, the question of how to determine meteor masses though photometric analysis will be re-examined, and new techniques will be proposed that eliminate some of the deficiencies suffered by the techniques currently employed in video meteor analysis.

Leonard Wood: surgeon, soldier, administrator.

PubMed

Craddock, W L

1995-01-01

Leonard Wood's (1860-1927) 42 years of distinguished service to the United States are covered herein. Wood received the Congressional Medal of Honor for the capture of the Apaches. He was commander of the famous "Rough Riders," and was distinguished for his Cuban labors as Military Governor. As Army Chief of Staff, he and Theodore Roosevelt pursued the problems of military preparedness for America's involvement in World War I. After World War I, Wood quelled disruptive situations caused by growing industrial problems. He became a supporter of veterans' rights, enrolling 27,000 veterans in college and providing them with the necessary education that would help solve the problems of four million veterans. After being operated on successfully for a brain tumor by Harvey Cushing in 1910, he suffered a recurrence while serving his second tour as the Philippines' Military Governor. Returning home, he died in 1927 during the second surgery.

Severe Mental Illness, Somatic Delusions, and Attempted Mass Murder.

PubMed

Sarteschi, Christine M

2016-01-01

A case of an attempted mass shooting at a large psychiatric hospital in the United States by a 30-year-old male with severe mental illness, somatic delusions, and exceptional access to healthcare professionals is reported. Six persons were shot, one died at the scene, and the shooter was then killed by the police. Data were gathered from court documents and media accounts. An analysis of the shooter's psychiatric history, his interactions with healthcare professionals, and communications prior to the shooting suggest a rare form of mass murder, a random attack by a documented psychotic and delusional individual suffering with somatic delusions. Despite his being psychotic, the killer planned the attack and made a direct threat 1 month prior to the shootings. This case highlights problems with the healthcare system, indicating that it might be ill equipped to appropriately deal with severe mental illness. © 2015 American Academy of Forensic Sciences.

Neck pain: manipulating the upper back helps lessen pain and improve neck motion.

PubMed

2011-09-01

Neck pain is very common. In the United States, between 30% and 50% of people suffer from an aching neck each year. Although neck pain can be caused by injury, most of this pain results from more gradual stresses, such as particular sitting, standing, or work postures, lifting patterns, or sleeping positions. Typical neck pain can also cause headaches, pain between your shoulders, or a feeling of knots in your neck and upper back muscles. Although manual therapy, sometimes called "manipulation," is a common treatment for many types of spine pain, some people are uncomfortable having their necks manipulated. Recently, though, researchers have tested the benefits of a thrust manipulation of the upper back to treat neck pain. A study published in the September 2011 issue of JOSPT provides new insight and an evidence-based summary of the benefits of manipulating the upper back to ease and eliminate neck pain.

The ethical "elephant" in the death penalty "room".

PubMed

Keane, Michael

2008-10-01

The United States Supreme Court recently ruled that execution by a commonly used protocol of drug administration does not represent cruel or unusual punishment. Various medical journals have editorialized on this drug protocol, the death penalty in general and the role that physicians play. Many physicians, and societies of physicians, express the opinion that it is unethical for doctors to participate in executions. This Target Article explores the harm that occurs to murder victims' relatives when an execution is delayed or indefinitely postponed. By using established principles in psychiatry and the science of the brain, it is shown that victims' relatives can suffer brain damage when justice is not done. Conversely, adequate justice can reverse some of those changes in the brain. Thus, physician opposition to capital punishment may be contributing to significant harm. In this context, the ethics of physician involvement in lethal injection is complex.

Ethnofederalism and the Accommodation of Ethnic Minorities in Burma: United They Stand

DTIC Science & Technology

2013-06-01

perform that role. The two defining criteria are thus met, but with significant limitations. 3. Stepan’s Variables Stepan offers more concrete ...rights book, Suffering in Silence, published in 2000. Rape, burnt villages, confiscated food stores, mutilated livestock, and indiscriminate

[Clinical epidemiological assessments on 3521 patients suffering from road traffic injuries, in relation with trauma localisation and severity, assisted in "Sf. Ioan" Emergency Unit, during 2002-2009].

PubMed

Manole, M; Ciuhodaru, T; Zanoschi, Georgeta; Manole, Alina; Ivan, A

2011-01-01

The aim of study was to assess road traffic injuries in relation with their localisation and severity. A sample of 3521 patients suffering from road traffic injuries and assisted in "Sf. Ioan" Emergency Unit, Iaşi, Romania was assess regarding age group, sex and residence area, type of lesions and ther localisation and severity, between 2002-2009. Data were collected using a special epidemiological inquiry and processed using SPSS and MS Excel statistical softs. The incidence of road traffic injuries increased during the last decade, with a report men/women of 1.5, urban and 21-30 age group predominance. The most frequent were leg fractures (16.7%) and thoracal contusions (19.1%), cranial and facial trauma (32.4%), with open injuries (10.5%). Prevention programmes with a high efficiency at the national level, as well as a concret identification of risk factors with a multidisciplinar approach of road traffic accidents, are needed.

Experience of Discrimination Among U.S. Chinese Older Adults

PubMed Central

Chen, Ruijia; Simon, Melissa A.

2014-01-01

Background. Experiences of discrimination are detrimental to health and well-being. This study aimed to examine experiences of discrimination and responses to unfair treatment among community-dwelling U.S. Chinese older adults. Method. Guided by a community-based participatory research approach, 3,159 community-dwelling Chinese older adults aged 60 years and older in the Greater Chicago area were interviewed in person between 2011 and 2013. Results. Of the 3,159 participants interviewed, 58.9% were women and the mean age was 72.8 years. A total of 671 (21.3%) participants reported having experienced discrimination and 1,454 (48.2%) reported passive response to unfair treatment. Older adults living in Chicago’s Chinatown had the lowest prevalence of perceived discrimination compared with those living in other areas. Younger age, higher education, higher income, fewer children, more years in the United States, more years in the community, poorer health status, lower quality of life, and worsening health over the last year were associated with higher frequency of discrimination reported. Younger age, higher education, higher income, being married, living with more people, having fewer children, more years in the United States, and better health over the past year were associated with engaged responses to unfair treatment. Conclusion. U.S. Chinese older adults suffered considerable discrimination, but tended to have passive responses to unfair treatment. Future longitudinal studies are needed to improve our understanding of the risk factors and outcomes associated with discrimination among U.S. Chinese older adults. PMID:25326642

Pathogen webs in collapsing honey bee colonies.

PubMed

Cornman, R Scott; Tarpy, David R; Chen, Yanping; Jeffreys, Lacey; Lopez, Dawn; Pettis, Jeffery S; vanEngelsdorp, Dennis; Evans, Jay D

2012-01-01

Recent losses in honey bee colonies are unusual in their severity, geographical distribution, and, in some cases, failure to present recognized characteristics of known disease. Domesticated honey bees face numerous pests and pathogens, tempting hypotheses that colony collapses arise from exposure to new or resurgent pathogens. Here we explore the incidence and abundance of currently known honey bee pathogens in colonies suffering from Colony Collapse Disorder (CCD), otherwise weak colonies, and strong colonies from across the United States. Although pathogen identities differed between the eastern and western United States, there was a greater incidence and abundance of pathogens in CCD colonies. Pathogen loads were highly covariant in CCD but not control hives, suggesting that CCD colonies rapidly become susceptible to a diverse set of pathogens, or that co-infections can act synergistically to produce the rapid depletion of workers that characterizes the disorder. We also tested workers from a CCD-free apiary to confirm that significant positive correlations among pathogen loads can develop at the level of individual bees and not merely as a secondary effect of CCD. This observation and other recent data highlight pathogen interactions as important components of bee disease. Finally, we used deep RNA sequencing to further characterize microbial diversity in CCD and non-CCD hives. We identified novel strains of the recently described Lake Sinai viruses (LSV) and found evidence of a shift in gut bacterial composition that may be a biomarker of CCD. The results are discussed with respect to host-parasite interactions and other environmental stressors of honey bees.

The Obesity Epidemic: Challenges, Health Initiatives, and Implications for Gastroenterologists

PubMed Central

Hurt, Ryan T.; Kulisek, Christopher; Buchanan, Laura A.

2010-01-01

Obesity is the next major epidemiologic challenge facing today's doctors, with the annual allocation of healthcare resources for the disease and related comorbidities projected to exceed $150 billion in the United States. The incidence of obesity has risen in the United States over the past 30 years; 60% of adults are currently either obese or overweight. Obesity is associated with a higher incidence of a number of diseases, including diabetes, cardiovascular disease, and cancer. Consumption of fast food, trans fatty acids (TFAs), and fructose—combined with increasing portion sizes and decreased physical activity—has been implicated as a potential contributing factor in the obesity crisis. The use of body mass index (BMI) alone is of limited utility for predicting adverse cardiovascular outcomes, but the utility of this measure may be strengthened when combined with waist circumference and other anthropomorphic measurements. Certain public health initiatives have helped to identify and reduce some of the factors contributing to obesity. In New York City and Denmark, for example, such initiatives have succeeded in passing legislation to reduce or remove TFAs from residents' diets. The obesity epidemic will likely change practice for gastroenterologists, as shifts will be seen in the incidence of obesity-related gastrointestinal disorders, disease severity, and the nature of comorbidities. The experience gained with previous epidemiologic problems such as smoking should help involved parties to expand needed health initiatives and increase the likelihood of preventing future generations from suffering the consequences of obesity. PMID:21301632

Use of telemedicine to improve burn care in Ukraine.

PubMed

Fuzaylov, Gennadiy; Knittel, Justin; Driscoll, Daniel N

2013-01-01

Global burn injuries have been described as the "forgotten public health crises" by the World Health Organization. Nearly 11 million people a year suffer burns severe enough to require medical attention; more people are burned each year than are infected with human immunodeficiency virus/acquired immunodeficiency syndrome and tuberculosis combined. Telemedicine has the potential to link experts in specialized fields, such as burn care, to regions of the world that have limited or no access to such specialized care. A multilevel telemedicine program was developed between Massachusetts General Hospital/Shriners Hospital in Boston, Massachusetts, and City Hospital #8 in Lviv, Ukraine. The program should lead to a sustainable improvement in the care of burn victims in Ukraine. The authors helped establish a Learning Center at City Hospital #8 in Lviv, Ukraine, through which they were able to consult from Shriners Hospital in Boston, on a total of 14 acute burn patients in Ukraine. This article discusses two case reports with the use of telemedicine and how it has allowed the authors to provide not only acute care consultation on an international scale, but also to arrange for direct expert examination and international transport to their specialized burn center in the United States. The authors have established a program through doctors from Massachusetts General Hospital/Shriner's Hospital in Boston, which works with a hospital in Ukraine and has provided acute consultation, as well as patient transportation to the United States for treatment and direct assessment.

West Nile virus transmission and ecology in birds

USGS Publications Warehouse

McLean, R.G.; Ubico, S.R.; Docherty, D.E.; Hansen, W.R.; Sileo, L.; Mcnamara, T.S.

2001-01-01

The ecology of the strain of West Nile virus (WNV) introduced into the United States in 1999 has similarities to the native flavivirus, St. Louis encephalitis (SLE) virus, but has unique features not observed with SLE virus or with WNV in the old world. The primary route of transmission for most of the arboviruses in North America is by mosquito, and infected native birds usually do not suffer morbidity or mortality. An exception to this pattern is eastern equine encephalitis virus, which has an alternate direct route of transmission among nonnative birds, and some mortality of native bird species occurs. The strain of WNV circulating in the northeastern United States is unique in that it causes significant mortality in exotic and native bird species, especially in the American crow (Corvus brachyrhynchos). Because of the lack of information on the susceptibility and pathogenesis of WNV for this species, experimental studies were conducted at the USGS National Wildlife Health Center. In two separate studies, crows were inoculated with a 1999 New York strain of WNV, and all experimentally infected crows died. In one of the studies, control crows in regular contact with experimentally inoculated crows in the same room but not inoculated with WNV succumbed to infection. The direct transmission between crows was most likely by the oral route. Inoculated crows were viremic before death, and high titers of virus were isolated from a variety of tissues. The significance of the experimental direct transmission among captive crows is unknown.

[Evaluation of autonomy in chronic mental patients. Problems, assessment tools, results].

PubMed

Leguay, D

1995-01-01

The autonomy of adult patients suffering from chronic psychiatric disorders is a notion in which we need to take an interest due to evolutions in patient care. The tendency of deinstitutionalization in the United States, in Italy and to a lesser degree in France has generated certain perverse effects when: capacities for self sufficiency, learning abilities to be developed, and substitutes to be set up, were not correctly evaluated from the outset. Many methods conceived mainly in the United States and in Canada were elaborated with such a diversity of approaches that, even today, for self-sufficiency, an instrument for evaluation which is universally prevalent and used, still does not exist in the way that has been possible for other clinical dimensions. The ability to accomplish the daily tasks for survival, the ability to reach decisions in life, the ability to enter into and sustain relationships with others do not embrace the dimensions explored by the scales of general psychopathology, of functional repercussions or of the quality of life. Moreover, the evaluation of these abilities is highly dependent on cultural characteristics. To adapt the existing methods to the French sociological realities or to conceive and elaborate simple and reliable procedures from our practices in professional and social reinsertion is a compulsory step in developing research in this field. Public Authorities and the teams on the ground should grasp the characteristics for innovation and its abilities for raising the hopes of patients, every bit as much as the actual progress in therapeutic practice.

The impact of socioeconomic inequalities and lack of health insurance on physical functioning among middle-aged and older adults in the United States.

PubMed

Kim, Jinhyun; Richardson, Virginia

2012-01-01

Socioeconomic inequalities and lack of private health insurance have been viewed as significant contributors to health disparities in the United States. However, few studies have examined their impact on physical functioning over time, especially in later life. The current study investigated the impact of socioeconomic inequalities and lack of private health insurance on individuals' growth trajectories in physical functioning, as measured by activities of daily living. Data from the Health and Retirement Study (1994-2006) were used for this study, 6519 black and white adults who provided in-depth information about health, socioeconomic, financial and health insurance information were analysed. Latent growth curve modelling was used to estimate the initial level of physical functioning and its rate of change over time. Results showed that higher level of income and assets and having private health insurance significantly predicted better physical functioning. In particular, decline in physical functioning was slower among those who had private health insurance. Interestingly, changes in economic status, such as decreases in income and assets, had a greater impact on women's physical functioning than on men's. Black adults did not suffer more rapid declines in physical functioning than white adults after controlling for socioeconomic status. The current longitudinal study suggested that anti-poverty and health insurance policies should be enhanced to reduce the negative impact of socioeconomic inequalities on physical functioning throughout an individual's life course. © 2011 Blackwell Publishing Ltd.

Loss of biodiversity in a conservation unit of the Brazilian Atlantic Forest: the effect of introducing non-native fish species.

PubMed

Fragoso-Moura, E N; Oporto, L T; Maia-Barbosa, P M; Barbosa, F A R

2016-02-01

The introduction of species has become an important problem for biodiversity and natural ecosystem conservation. The lake system of the middle Rio Doce (MG, Brazil) comprises c. 200 lakes at various conservation states, of which 50 are located within the Rio Doce State Park (PERD). Previous studies had verified several of these lakes suffered non-native fishes introductions and the presence of these species needs for the implementation of actions aiming at not only their control but also the preservation of the native species. This study discusses the effects of non-native fish species in the largest conservation unit of Atlantic Forest in Minas Gerais, southeast of Brazil, using data from 1983 to 2010 distributed as follow: data prior to 2006 were obtained from previous studies, and data from September 2006 to July 2010 were obtained in Lake Carioca at four sampling stations using gillnets, seine nets and sieve. A total of 17 fish species was collected (2006-2010) of which five were introduced species. Among the small to medium size native species (30 to 2000 mm standard length) seven had disappeared, two are new records and one was recaptured. The non-native species Cichla kelberi (peacock bass) and Pygocentrus nattereri (red piranha) are within the most abundant captured species. Integrated with other actions, such as those preventing new introductions, a selective fishing schedule is proposed as an alternative approach to improve the conservation management actions and the local and regional biodiversity maintenance.

Computational analysis of an axial flow pediatric ventricular assist device.

PubMed

Throckmorton, Amy L; Untaroiu, Alexandrina; Allaire, Paul E; Wood, Houston G; Matherne, Gaynell Paul; Lim, David Scott; Peeler, Ben B; Olsen, Don B

2004-10-01

Longer-term (>2 weeks) mechanical circulatory support will provide an improved quality of life for thousands of pediatric cardiac failure patients per year in the United States. These pediatric patients suffer from severe congenital or acquired heart disease complicated by congestive heart failure. There are currently very few mechanical circulatory support systems available in the United States as viable options for this population. For that reason, we have designed an axial flow pediatric ventricular assist device (PVAD) with an impeller that is fully suspended by magnetic bearings. As a geometrically similar, smaller scaled version of our axial flow pump for the adult population, the PVAD has a design point of 1.5 L/min at 65 mm Hg to meet the full physiologic needs of pediatric patients. Conventional axial pump design equations and a nondimensional scaling technique were used to estimate the PVAD's initial dimensions, which allowed for the creation of computational models for performance analysis. A computational fluid dynamic analysis of the axial flow PVAD, which measures approximately 65 mm in length by 35 mm in diameter, shows that the pump will produce 1.5 L/min at 65 mm Hg for 8000 rpm. Fluid forces (approximately 1 N) were also determined for the suspension and motor design, and scalar stress values remained below 350 Pa with maximum particle residence times of approximately 0.08 milliseconds in the pump. This initial design demonstrated acceptable performance, thereby encouraging prototype manufacturing for experimental validation.

Environmental Noise Pollution in the United States: Developing an Effective Public Health Response

PubMed Central

Hammer, Monica S.; Swinburn, Tracy K.

2013-01-01

Background: Tens of millions of Americans suffer from a range of adverse health outcomes due to noise exposure, including heart disease and hearing loss. Reducing environmental noise pollution is achievable and consistent with national prevention goals, yet there is no national plan to reduce environmental noise pollution. Objectives: We aimed to describe some of the most serious health effects associated with noise, summarize exposures from several highly prevalent noise sources based on published estimates as well as extrapolations made using these estimates, and lay out proven mechanisms and strategies to reduce noise by incorporating scientific insight and technological innovations into existing public health infrastructure. Discussion: We estimated that 104 million individuals had annual LEQ(24) levels > 70 dBA (equivalent to a continuous average exposure level of >70 dBA over 24 hr) in 2013 and were at risk of noise-induced hearing loss. Tens of millions more may be at risk of heart disease, and other noise-related health effects. Direct regulation, altering the informational environment, and altering the built environment are the least costly, most logistically feasible, and most effective noise reduction interventions. Conclusion: Significant public health benefit can be achieved by integrating interventions that reduce environmental noise levels and exposures into the federal public health agenda. Citation: Hammer MS, Swinburn TK, Neitzel RL. 2014. Environmental noise pollution in the United States: developing an effective public health response. Environ Health Perspect 122:115–119; http://dx.doi.org/10.1289/ehp.1307272 PMID:24311120

[Consequence of secondary complications during the rehabilitation of patients with severe brain injury].

PubMed

Dénes, Zoltán

2009-01-25

Recovery from brain injury is not only determined by the primary injury, but a very important element is the development of secondary complications which have a major role in determining the possibility of the achievement of available maximal functional abilities and the quality of life of the patients and their family after rehabilitation. This is why during medical treatment the prevention of secondary complications is at least as important as the prevention of primary injury. Determination of the most important secondary complications after severe brain injury, and observation of these effects on the rehabilitation process. Retrospective study in the Brain Injury Rehabilitation unit of the National Institute for Medical Rehabilitation in Hungary. 166 patients were treated with brain injury; the mean age of the patients was 33 (8-83) years in 2004. The majority of patients suffered traumatic brain injury in traffic accidents (125/166), while the rest of them through falls or acts of violence. Sixty-four patients were admitted directly from an intensive care unit, 18 from a second hospital ward (traumatology, neurosurgery or neurology) and the rest of the patients were treated in several different units before they were admitted for rehabilitation. The time that has elapsed between injury and rehabilitation admission was 50 days (21-177). At the time of admission 27 patients were in a vegetative state, 38 patients in a minimal conscious state, and 101 patients had already regained consciousness. 83 patients were hemiparetic, 54 presented tetraparesis, and 1 paraparesis, but 28 patients were not paretic. The most frequent complications in patients with severe brain injury at admission in our rehabilitation unit were: contractures (47%), pressure sores (35%), respiratory (14%) and urinary (11%) tract infections, malnutrition (20%). The functional outcome was worse in the cases arriving with secondary complications during the same rehabilitation period. The length of stay in the rehabilitation unit was much longer in these cases. We strongly suggest that actions to prevent secondary complications must be started at the acute care unit. After acute care, rehabilitation of patients with severe brain injury should be performed in specialised centers with multidisciplinary team for different functional deficits (physical, cognitive, communicative, psycho-social impairments). Early and direct admission from the neurologic intensive care unit to the rehabilitation centrum seems to be optimal for best patient outcome, because this lowers the chance for the development of secondary complications.

Projection of the year 2050 burden of diabetes in the US adult population: dynamic modeling of incidence, mortality, and prediabetes prevalence

PubMed Central

2010-01-01

Background People with diabetes can suffer from diverse complications that seriously erode quality of life. Diabetes, costing the United States more than $174 billion per year in 2007, is expected to take an increasingly large financial toll in subsequent years. Accurate projections of diabetes burden are essential to policymakers planning for future health care needs and costs. Methods Using data on prediabetes and diabetes prevalence in the United States, forecasted incidence, and current US Census projections of mortality and migration, the authors constructed a series of dynamic models employing systems of difference equations to project the future burden of diabetes among US adults. A three-state model partitions the US population into no diabetes, undiagnosed diabetes, and diagnosed diabetes. A four-state model divides the state of "no diabetes" into high-risk (prediabetes) and low-risk (normal glucose) states. A five-state model incorporates an intervention designed to prevent or delay diabetes in adults at high risk. Results The authors project that annual diagnosed diabetes incidence (new cases) will increase from about 8 cases per 1,000 in 2008 to about 15 in 2050. Assuming low incidence and relatively high diabetes mortality, total diabetes prevalence (diagnosed and undiagnosed cases) is projected to increase from 14% in 2010 to 21% of the US adult population by 2050. However, if recent increases in diabetes incidence continue and diabetes mortality is relatively low, prevalence will increase to 33% by 2050. A middle-ground scenario projects a prevalence of 25% to 28% by 2050. Intervention can reduce, but not eliminate, increases in diabetes prevalence. Conclusions These projected increases are largely attributable to the aging of the US population, increasing numbers of members of higher-risk minority groups in the population, and people with diabetes living longer. Effective strategies will need to be undertaken to moderate the impact of these factors on national diabetes burden. Our analysis suggests that widespread implementation of reasonably effective preventive interventions focused on high-risk subgroups of the population can considerably reduce, but not eliminate, future increases in diabetes prevalence. PMID:20969750

Neurologic complications of lightning injuries.

PubMed Central

Cherington, M; Yarnell, P R; London, S F

1995-01-01

Over the past ten years, we have cared for 13 patients who suffered serious neurologic complications after being struck by lightning. The spectrum of neurologic lesions includes the entire neuraxis from the cerebral hemispheres to the peripheral nerves. We describe these various neurologic disorders with regard to the site of the lesion, severity of the deficit, and the outcome. Damage to the nervous system can be a serious problem for patients struck by lightning. Fatalities are associated with hypoxic encephalopathy in patients who suffered cardiac arrests. Patients with spinal cord lesions are likely to have permanent sequelae and paralysis. New technology for detecting lightning with wideband magnetic direction finders is useful in establishing lightning-flash densities in each state. Florida and the Gulf Coast states have the highest densities. Colorado and the Rocky Mountain states have the next highest. Images PMID:7785254

Women are the answer. Interview by Colin Parish.

PubMed

Lewis, Stephen

Women are suffering in far greater numbers than men in the HIV/AIDS disaster in Africa. Stephen Lewis, the United Nations special envoy for HIV/AIDS in Africa, says a global approach is needed to stem the tide of misery. Nurses can play their part too.

Five-year measurements of Unit 3, Waiakea Arboretum, Hawaii

Treesearch

Stanley B. Carpenter; George B. Richmond

1965-01-01

Measurements were taken of 25 exotic tree species planted in 1959 in the Waiakea Arboretum near Hilo, Hawaii. After 5 years, some species show good survival and growth, but seven pines failed to survive. All plantings have suffered from shallow soil, and competition from wild vegetation.

Critical role of the March of Dimes in the expansion of newborn screening.

PubMed

Howse, Jennifer L; Weiss, Marina; Green, Nancy S

2006-01-01

Expansion of newborn screening (NBS) has been driven primarily by a combination of advances in technology and medical treatment, and the sustained advocacy efforts of consumers and voluntary health organizations. The longstanding leadership of the March of Dimes has been credited by many as a critical factor in the expansion and improvement of state NBS programs. From the historic vantage point of four decades of March of Dimes involvement with newborn screening, this report reviews the unique origin of the first newborn screening test, and identifies from this point of origin several of the elements which still define the evolution of advocacy for NBS today. It also documents activities at the federal level and in seven states that have lead to expanded screening for newborns. Advances in NBS technology and medical treatment have informed policy development. Mobilization of volunteers and focused advocacy activities have brought about expansion of screening opportunities for newborns across the United States. But more work is needed. Continued application of the effective strategies identified in this report will help assure that all families have the best possible chance of assuring that their newborns do not have to suffer the complications of conditions that we know can be treated effectively. Copyright (c) 2006 Wiley-Liss, Inc.

'Aid-in-dying' and the taking of human life.

PubMed Central

Campbell, C S

1992-01-01

In several US states, the legalisation of euthanasia has become a question for voters to decide in public referenda. This democratic approach in politics is consistent with notions of personal autonomy in medicine, but the right of choice does not mean all choices are morally equal. A presumption against the taking of human life is embedded in the formative moral traditions of society; human life does not have absolute value, but we do and should impose a strict burden of justification for exceptions to the presumption, as exemplified by the moral criteria invoked to justify self-defence, capital punishment, or just war. These criteria can illuminate whether another exception should be carved out for doctor-assisted suicide or active euthanasia. It does not seem, in the United States at any rate, that all possible alternatives to affirm the control and dignity of the dying patient and to relieve pain and suffering, short of taking life, have been exhausted. Moreover, the procedural safeguards built into many proposals for legalised euthanasia would likely be undone by the sorry state of the US health care system, with its lack of universal access to care, chronic cost-containment ills, a litigious climate, and socioeconomic barriers to care. There remains, however, common ground in the quest for humane care of the dying. PMID:1404279

The study of life change unit as stressor agents among Tehran University of Medical Sciences Hospitals' employees.

PubMed

Dargahi, Hossein; Sharifiy Yazdi, Mohammad Kazem

2010-01-01

Life crises as stressor agents can disrupt the best stress management regime. Different life crises have different impacts. A standard scale to rate change and its related stress impact has been developed commonly referred to as LCU (life change unit) rating. This allocates a number of life crisis units or life change units (LCUs) to different event and then evaluates them and takes action accordingly. This idea behind this approach of is to rundown the LCU table, totaling the LCUs for life crisis that have occurred in the previous one year. A cross-sectional, descriptive and analytical study was conducted among 900 Tehran University of Medical Sciences (TUMS) employees by a Holms and Rahe LCU questionnaire at 15 hospitals. The respondents were asked to determine their demographic information, list of stress symptoms which suffered from these diseases in the previous one year and finally, responded to 45 Life Change Unit as stressful life events and the value of each in "stress units" which occurred in the previous one year. The results showed that there is significant correlation between the employees LCU rating by sex, educational degree and size of hospital. Also we found that there are significant correlations between the employees stress symptoms with their LCU rating. Totally, 40% of the employees have less than 150 LCU rating (normal range) and 60% of them have 150-300 or more than 300 LCU rating (abnormal range). In conclusion most of TUMS hospitals' employees who had stress symptoms have more LCU rating. One third of these employees are not in danger of suffering the illness effect, while two third of them are in danger.

A Three-Lesson Teaching Unit Significantly Increases High School Students’ Knowledge about Epilepsy and Positively Influences Their Attitude towards This Disease

PubMed Central

Simon, Uwe K.; Gesslbauer, Lisa; Fink, Andreas

2016-01-01

Epilepsy is not a regular topic in many countries’ schools. Thus many people harbor misconceptions about people suffering from this disease. It was our aim to a) examine what grade ten students know and believe about epilepsy, and b) to develop and test a teaching unit to improve their knowledge and attitude. The test group comprised eight grade ten classes from six different Austrian high schools (54 girls and 51 boys aged 14–17), the control group (no intervention) five grade ten classes from the same schools (26 girls and 37 boys aged 14–17). The teaching unit consisted of three 45-min lessons using different methods and material. Changes in knowledge about and attitude towards epilepsy as a result of the intervention were psychometrically assessed in a pre-test intervention post-test design (along with a follow-up assessment two months after the intervention) by means of a questionnaire capturing different facets of epilepsy-related knowledge and attitude. Across all knowledge/attitude domains, students of the test group had a significantly improved knowledge about and a more positive attitude towards epilepsy and people suffering from it after the teaching unit. However, starting levels were different between the five knowledge/attitude domains tested. Medical background knowledge was lowest and consequently associated with the highest increase after the intervention. This study shows that epilepsy-related knowledge of many grade ten high school students is fragmentary and that some harbor beliefs and attitudes which require improvement. Our comprehensive but concise teaching unit significantly increased knowledge about epilepsy and positively influenced attitude towards individuals with epilepsy. Thus we recommend implementing this unit into regular school curricula. PMID:26919557

Employment of Direct Fire Systems during Offensive Operations

DTIC Science & Technology

1990-06-01

problems, this criteria suffers from a lack of offensive direct fire planning as part 115 of the scheme of maneuver. Limited TTP discussion in the...these specific occurrences. Doctrine writers could develop TTP to do so. This problem could involve unit training practices. If units differentiate ...10 0 0 0 5 PURPOSE) 4. - IDENTIFIES DIRECT FIRE I 76 15 20 130 21 15 115 R&S PRIORITY (PIR/IR) 5. - IDENTIFIES ENGAGEMENT 1 5 10 0 25 16 0 0 PRIORITY

KSC-2009-2521

NASA Image and Video Library

2009-04-02

CAPE CANAVERAL, Fla. – In the Payload Hazardous Servicing Facility at NASA's Kennedy Space Center in Florida, technicians help with the installation of the Science Instrument Command and Data Handling Unit, or SIC&DH, on the Multi-Use Lightweight Equipment Carrier. The SIC&DH will be installed on the Hubble Space Telescope during space shuttle Atlantis' STS-125 mission. This unit will replace the one that suffered a failure aboard the orbiting telescope on Sept. 27, 2008. Atlantis is targeted for launch on May 12. Photo credit: NASA/Dimitri Gerondidakis

KSC-2009-2520

NASA Image and Video Library

2009-04-02

CAPE CANAVERAL, Fla. – In the Payload Hazardous Servicing Facility at NASA's Kennedy Space Center in Florida, technicians help with the installation of the Science Instrument Command and Data Handling Unit, or SIC&DH, on the Multi-Use Lightweight Equipment Carrier. The SIC&DH will be installed on the Hubble Space Telescope during space shuttle Atlantis' STS-125 mission. This unit will replace the one that suffered a failure aboard the orbiting telescope on Sept. 27, 2008. Atlantis is targeted for launch on May 12. Photo credit: NASA/Dimitri Gerondidakis

KSC-2009-2522

NASA Image and Video Library

2009-04-02

CAPE CANAVERAL, Fla. – In the Payload Hazardous Servicing Facility at NASA's Kennedy Space Center in Florida, technicians look over the Science Instrument Command and Data Handling Unit, or SIC&DH, installed on the Multi-Use Lightweight Equipment Carrier. The SIC&DH will be installed on the Hubble Space Telescope during space shuttle Atlantis' STS-125 mission. This unit will replace the one that suffered a failure aboard the orbiting telescope on Sept. 27, 2008. Atlantis is targeted for launch on May 12. Photo credit: NASA/Dimitri Gerondidakis

KSC-2009-2523

NASA Image and Video Library

2009-04-02

CAPE CANAVERAL, Fla. – In the Payload Hazardous Servicing Facility at NASA's Kennedy Space Center in Florida, technicians check the Multi-Use Lightweight Equipment Carrier where the Science Instrument Command and Data Handling Unit, or SIC&DH, is being installed. The SIC&DH will be installed on the Hubble Space Telescope during space shuttle Atlantis' STS-125 mission. This unit will replace the one that suffered a failure aboard the orbiting telescope on Sept. 27, 2008. Atlantis is targeted for launch on May 12. Photo credit: NASA/Dimitri Gerondidakis

Understanding Soviet Naval Developments

DTIC Science & Technology

1991-07-01

submarine noise reduction technology. A single-unit experimental, deep diving SSN. SSBN in a process that converted the unit to dubbed the MIKE class, was...is second only to that of Ja- ties. When the Soviet MIKE SSN suffered a pan in total catch tonnage each year. fire in the Norwegian Sea in April of... sharpl \\ tapered nose providing better o~er-the-nose visibil- ity: this change ’. as miade possible by the absence of’ the MIiG-23’s air intercept radar

Buddhism and medical futility.

PubMed

Chan, Tuck Wai; Hegney, Desley

2012-12-01

Religious faith and medicine combine harmoniously in Buddhist views, each in its own way helping Buddhists enjoy a more fruitful existence. Health care providers need to understand the spiritual needs of patients in order to provide better care, especially for the terminally ill. Using a recently reported case to guide the reader, this paper examines the issue of medical futility from a Buddhist perspective. Important concepts discussed include compassion, suffering, and the significance of the mind. Compassion from a health professional is essential, and if medical treatment can decrease suffering without altering the clarity of the mind, then a treatment should not be considered futile. Suffering from illness and death, moreover, is considered by Buddhists a normal part of life and is ever-changing. Sickness, old age, birth, and death are integral parts of human life. Suffering is experienced due to the lack of a harmonious state of body, speech, and mind. Buddhists do not believe that the mind is located in the brain, and, for Buddhists, there are ways suffering can be overcome through the control of one's mind.

Health outcomes and quality of life of residents of shared-housing arrangements compared to residents of special care units - results of the Berlin DeWeGE-study.

PubMed

Wolf-Ostermann, Karin; Worch, Andreas; Fischer, Thomas; Wulff, Ines; Gräske, Johannes

2012-11-01

To compare different health outcomes as well as quality of life (QoL) between people with dementia living in shared-housing arrangements (SHA) and special care units (SCU) in nursing homes. Often situated in large apartments in mostly urban settings, SHA are a specific German kind of small-scale living facilities for older care-dependent persons, predominantly suffering from dementia. SHA are completely disconnected from traditional nursing homes. In a longitudinal design, all new residents of SHA and SCU suffering with dementia in Berlin were surveyed for one year. They were assessed when they moved into the SHA or SCU and again 6 and 12 months later. We surveyed physical and psychological health outcomes including ADL-functioning (Barthel), neuropsychiatric symptoms of dementia (NPI) and challenging behaviour (Cohen-Mansfield agitation inventory) as well as QoL (Qualidem). Fifty-six persons (43 women, 13 men) were recruited into the longitudinal study. The average age was 82·5 years at admission, participants mostly had a moderate level of cognitive impairment (mean Mini Mental State Examination = 13·3), prevalence of neuropsychiatric symptoms was high. During the one-year follow-up, analyses show a significant decrease in cognitive abilities but also of neuropsychiatric symptoms in both groups. In SHA, QoL increases on average during the one-year study period. Both types of facilities attract slightly different populations according to our data. Comparison of SHA residents to SCU residents documented no significant beneficial effects of settings in terms of health outcomes. As no clear advantage of either SHA or SCU in nursing homes can be demonstrated for residents with dementia who move in newly, it is impossible to give a clear evidence-based recommendation and the decision for one setting or the other can be made according solely to personal preference of the resident. © 2012 Blackwell Publishing Ltd.

7 CFR 1160.104 - United States.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 9 2012-01-01 2012-01-01 false United States. 1160.104 Section 1160.104 Agriculture... Definitions § 1160.104 United States. United States means the 48 contiguous states in the continental United States and the District of Columbia, except that United States means the 50 states of the United States...

7 CFR 1160.104 - United States.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 9 2011-01-01 2011-01-01 false United States. 1160.104 Section 1160.104 Agriculture... Definitions § 1160.104 United States. United States means the 48 contiguous states in the continental United States and the District of Columbia, except that United States means the 50 states of the United States...

7 CFR 1160.104 - United States.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 9 2014-01-01 2013-01-01 true United States. 1160.104 Section 1160.104 Agriculture... Definitions § 1160.104 United States. United States means the 48 contiguous states in the continental United States and the District of Columbia, except that United States means the 50 states of the United States...

7 CFR 1160.104 - United States.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 9 2013-01-01 2013-01-01 false United States. 1160.104 Section 1160.104 Agriculture... Definitions § 1160.104 United States. United States means the 48 contiguous states in the continental United States and the District of Columbia, except that United States means the 50 states of the United States...

7 CFR 1160.104 - United States.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 9 2010-01-01 2009-01-01 true United States. 1160.104 Section 1160.104 Agriculture... Definitions § 1160.104 United States. United States means the 48 contiguous states in the continental United States and the District of Columbia, except that United States means the 50 states of the United States...

UK: House of Lords recognizes that privacy rights include protection of mental health.

PubMed

Ketter, Arryn

2004-12-01

Razgar, an Iraqi national, had claimed asylum in the United Kingdom. He was not HIV-positive. He suffered from a psychiatric disability and was challenging an order that he be removed to a third country on the basis that it would detrimentally affect his mental health.

From "Hell No!" to "Que Paso?": Interrogating a Hispanic-Serving Institution Possibility

ERIC Educational Resources Information Center

Lara, Dulcinea; Lara, Antonio

2012-01-01

Some Hispanic students are making it through the Eurocentric, United Statesian education pipeline, but exponentially more are failing. Meanwhile, poor Chican@ communities are disproportionately suffering from unemployment, low levels of education, chronic illness, pollution, and myriad social ills. At this historical crossroads, it behooves…

Production and supply of high-quality food protein for human consumption: Sustainability, challenges, and innovations

USDA-ARS?s Scientific Manuscript database

The Food and Agriculture Organization of the United Nations estimates that 843 million people worldwide are hungry and a greater number suffer from nutrient deficiencies. Approximately one billion people have inadequate protein intake. The challenge of preventing hunger and malnutrition will become ...

Reducing Energy Burden with Solar: Colorado's Strategy and Roadmap for

Science.gov Websites

-income residents suffer from a high energy burden, which can force these residents to choose between . The report concludes with a roadmap other states might consider when developing their own low-income states might learn from the state's experience when they design their own programs. The report concludes

Florida: The State and Its Educational System.

ERIC Educational Resources Information Center

Hodgkinson, Harold L.

For most of this century, Florida's economy has been one of the "boom or bust" variety; however, since the 1960s, the economy has diversified, bringing in a variety of "high tech" manufacturing and high-end service businesses to the state. Still, wages in agriculture and tourism are so low that the state suffers in terms of per…

31 CFR 515.321 - United States; continental United States.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false United States; continental United... General Definitions § 515.321 United States; continental United States. The term United States means the United States and all areas under the jurisdiction or authority thereof, including the Trust Territory of...

31 CFR 535.321 - United States; continental United States.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false United States; continental United... General Definitions § 535.321 United States; continental United States. The term United States means the United States and all areas under the jurisdiction or authority thereof including the Trust Territory of...

31 CFR 535.321 - United States; continental United States.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false United States; continental United... General Definitions § 535.321 United States; continental United States. The term United States means the United States and all areas under the jurisdiction or authority thereof including the Trust Territory of...

31 CFR 535.321 - United States; continental United States.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States; continental United... General Definitions § 535.321 United States; continental United States. The term United States means the United States and all areas under the jurisdiction or authority thereof including the Trust Territory of...

31 CFR 515.321 - United States; continental United States.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States; continental United... General Definitions § 515.321 United States; continental United States. The term United States means the United States and all areas under the jurisdiction or authority thereof, including the Trust Territory of...

31 CFR 515.321 - United States; continental United States.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false United States; continental United... General Definitions § 515.321 United States; continental United States. The term United States means the United States and all areas under the jurisdiction or authority thereof, including the Trust Territory of...

31 CFR 500.321 - United States; continental United States.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false United States; continental United... General Definitions § 500.321 United States; continental United States. The term United States means the United States and all areas under the jurisdiction or authority thereof, including U.S. trust territories...

31 CFR 515.321 - United States; continental United States.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false United States; continental United... General Definitions § 515.321 United States; continental United States. The term United States means the United States and all areas under the jurisdiction or authority thereof, including the Trust Territory of...

31 CFR 535.321 - United States; continental United States.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false United States; continental United... General Definitions § 535.321 United States; continental United States. The term United States means the United States and all areas under the jurisdiction or authority thereof including the Trust Territory of...

31 CFR 535.321 - United States; continental United States.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false United States; continental United... General Definitions § 535.321 United States; continental United States. The term United States means the United States and all areas under the jurisdiction or authority thereof including the Trust Territory of...

31 CFR 515.321 - United States; continental United States.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false United States; continental United... General Definitions § 515.321 United States; continental United States. The term United States means the United States and all areas under the jurisdiction or authority thereof, including the Trust Territory of...

Awareness Enhancing and Monitoring Device plus Habit Reversal in the Treatment of Trichotillomania: An Open Feasibility Trial.

PubMed

Himle, Joseph A; Bybee, Deborah; O'Donnell, Lisa A; Weaver, Addie; Vlnka, Sarah; DeSena, Daniel T; Rimer, Jessica M

2018-01-01

Habit Reversal Therapy (HRT) is helpful for many persons suffering from trichotillomania. However successful habit reversal therapy requires awareness of hair pulling behaviors. Available methods to monitor hair pulling behaviors are less than ideal, particularly when sufferers are unaware of their pulling-related behaviors. This open feasibility trial included 20 persons with trichotillomania who were treated with nine weeks of HRT with experienced clinicians following a well-established HRT protocol. HRT was augmented with an electronic Awareness Enhancing and Monitoring Device (AEMD) designed to alert users of hand to head contact and to monitor the frequency of pulling-related behaviors. The AEMD included a neck unit and two wrist units, each equipped with vibrating alert functions. The results of the open trial revealed significant improvements in trichotillomania symptoms as measured by clinician and self-report rating scales. Most participants met study criteria for HRT completion and treatment effects were large. Participants reported that the AEMD, when operational, was effective in alerting participants to TTM-related behaviors. The monitoring function of the AEMD did not operate as designed. Subjective feedback focused on the AEMD concept was positive but AEMD reliability problems and complaints about the wearability the units were common. Recommendations for AEMD design modifications were included.

School Start Times for Middle School and High School Students - United States, 2011-12 School Year.

PubMed

Wheaton, Anne G; Ferro, Gabrielle A; Croft, Janet B

2015-08-07

Adolescents who do not get enough sleep are more likely to be overweight; not engage in daily physical activity; suffer from depressive symptoms; engage in unhealthy risk behaviors such as drinking, smoking tobacco, and using illicit drugs; and perform poorly in school. However, insufficient sleep is common among high school students, with less than one third of U.S. high school students sleeping at least 8 hours on school nights. In a policy statement published in 2014, the American Academy of Pediatrics (AAP) urged middle and high schools to modify start times as a means to enable students to get adequate sleep and improve their health, safety, academic performance, and quality of life. AAP recommended that "middle and high schools should aim for a starting time of no earlier than 8:30 a.m.". To assess state-specific distributions of public middle and high school start times and establish a pre-recommendation baseline, CDC and the U.S. Department of Education analyzed data from the 2011-12 Schools and Staffing Survey (SASS). Among an estimated 39,700 public middle, high, and combined schools* in the United States, the average start time was 8:03 a.m. Overall, only 17.7% of these public schools started school at 8:30 a.m. or later. The percentage of schools with 8:30 a.m. or later start times varied greatly by state, ranging from 0% in Hawaii, Mississippi, and Wyoming to more than three quarters of schools in Alaska (76.8%) and North Dakota (78.5%). A school system start time policy of 8:30 a.m. or later provides teenage students the opportunity to achieve the 8.5-9.5 hours of sleep recommended by AAP and the 8-10 hours recommended by the National Sleep Foundation.

Driving reaction times in patients with foot and ankle pathology before and after image-guided injection: pain relief without improved function.

PubMed

Talusan, Paul G; Miller, Christopher P; Save, Ameya V; Reach, John S

2015-04-01

Foot and ankle pathology is common in the driving population. Local anesthetic steroid injections are frequent ambulatory treatments. Brake reaction time (BRT) has validated importance in motor vehicle safety. There are no prior studies examining the effect of foot and ankle pathology and injection treatment on the safe operation of motor vehicles. We studied BRT in patients with foot and ankle musculoskeletal disease before and after image-guided injection treatment. A total of 37 participants were enrolled. Image-guided injections of local anesthetic and steroid were placed into the pathological anatomical location of the right or left foot and ankles. A driving reaction timer was used to measure BRTs before and after injection. Patients suffering right "driving" and left "nondriving" pathology as well as a healthy control group were studied. All patients reported >90% pain relief postinjection. All injections were confirmed to be accurate by imaging. Post hoc Bonferonni analysis demonstrated significant difference between the healthy group and the right-sided injection group (P = .008). Mean BRT for healthy controls was 0.57 ± 0.11 s. Patients suffering right foot and ankle disease displayed surprisingly high BRTs (0.80 ± 0.23 s preinjection and 0.78 ± 0.16 s postinjection, P > .99). Left nondriving foot and ankle pathology presented a driving hazard as well (BRT of 0.75 ± 0.12 s preinjection and 0.77 ± 0.12 s postinjection, P > .99). Injections relieved pain but did not significantly alter BRT (P > .99 for all). Patients suffering chronic foot and ankle pathology involving either the driving or nondriving side have impaired BRTs. This preexisting driving impairment has not previously been reported and exceeds recommended cutoff safety values in the United States. Despite symptom improvement, there was no statistically significant change in BRT following image-guided injection in either foot and ankle. Therapeutic, Level II: Prospective Comparative Study. © 2014 The Author(s).

Characterization of urge to cough and cough symptoms associated with the common cold: results of a US internet survey.

PubMed

Eccles, Ron; Dicpinigaitis, Peter; Turner, Ronald B; Druce, Howard M; Adeleke, Maryann; Mann, Ashley L

2016-06-01

Our knowledge of cough physiology is limited despite years of study. Even less is known about the sensation of urge to cough. Given that limited clinical data are available about urge to cough and cough attributes during a common cold, we sought to gain insights into experiences and perceptions related to these symptoms. An internet survey consisting of 51 questions was fielded in the United States. Eligible survey participants included men and women aged 18 years and older who had suffered from a cold with cough within the three months preceding the survey. Participants who confirmed suffering from recurrent cough, asthma, chronic bronchitis, chronic obstructive pulmonary disease, cystic fibrosis, or gastrointestinal reflux were excluded. Of 19,530 initial respondents, 8011 had a cold in the past three months. Of these, 6484 (81%) had experienced cough symptoms; 2708 respondents with cough due to cold and no exclusionary condition made up the analysis sample. Most respondents (62%) reported that cough developed one to two days after the onset of cold symptoms, and 45% felt that cough worsened their other cold symptoms. In 69% of respondents, cough outlasted other cold symptoms. Urge to cough was reported by 98% of respondents, and among these respondents, 64% described it as uncontrollable and 65% rated severity as moderate. More than half of respondents (57%) considered the sensation of urge to cough and the act of coughing as equally bothersome. Although urge to cough and inability to control cough were the most bothersome aspects of cough due to cold, few (<20%) respondents asked healthcare providers for treatment recommendations. Symptoms of urge to cough and cough are common and have a significant impact on cold sufferers. Understanding attributes of these symptoms may provide insights for effective management and the development of novel treatment strategies.

[Neoliberalism in health: the torture of the health care workers of the Bogota's Instituto Materno Infantil (child and maternity hospital)].

PubMed

Abadía, César B; Pinilla, María Y A; Ariza, Katerine R; Ruíz, Héctor C S

2012-06-01

To link, from a historical point of view, the most significant transformations of the Instituto Materno Infantil (IMI) [the oldest child and maternity hospital of the country] during its process of crisis, closure and liquidation with the experiences of the hospital workers. To find experience-based and theoretical elements that can interconnect the process of health care privatization of the country with the workers' experiences of resistance and pain/suffering. Critically-oriented ethnography based on continuous collective field work, historical research (primary and secondary sources) and semi-structured interviews with 5 women who worked at the IMI for more than 15 years. A time line of 4 main periods: Los años de gloria [The golden years] (up to 1990); Llega el neoliberalismo [Neoliberalism arrives] (1990-2000); La crisis y las resistencias [Crisis and resistances] (2001-2005); and Liquidación [Liquidation (2006-20??)]. The narratives of the interviewed women unveil multiple aggressions that have intensified since 2006, have caused pain and suffering and are examples of violations of human and labour rights. We suggest to analyze the links between the different kinds of violence and pain and suffering as torture. This category is defined as the set of violent actions that cause physical and emotional pain, which are performed by actors in positions of power over other people who challenge that power and are part of modern States' ideological principles around a defined moral social order. For the IMI workers' case, the ideological principle that is being challenged is health care neoliberalism. From the analyses of bureaucracy, confinement, torturing agents, and the breaking-off of the body-mind unit we conclude that this relationship between neoliberalism and torture aims to eliminate the last health care workers of the country who had job stability and full-benefits through public labour contracts. Their elimination furthers the accumulation of capital generated by increasing over-exploitation of labour and commodification of health care.

Selenium, fluorine, and arsenic in surficial materials of the conterminous United States

USGS Publications Warehouse

Shacklette, Hansford T.; Boerngen, Josephine G.; Keith, John R.

1974-01-01

Concentrations of selenium, fluorine, and arsenic in 912, 911, and 910 samples, respectively, of soils and other regoliths from sites approximately 50 miles (80 km) apart throughout the United States are represented on maps by symbols showing five ranges of values. Histograms of the concentrations of these elements are also given. The geometric-mean concentrations (ppm) in the samples, grouped by area, are as follows: Selenium-- Entire United States, 0.31; Western United States, 0.25; and Eastern United States, 0.39. Fluorine-- Entire United States, 180; Western United States, 250; and Eastern United States, 115. Arsenic-- Entire United States, 5.8; Western United States, 6.1; and Eastern United States, 5.4.

The core of love when caring for patients suffering from addiction.

PubMed

Thorkildsen, Kari M; Eriksson, Katie; Råholm, Maj-Britt

2015-06-01

Drug addiction is a serious health problem. The aim of this study was to gain an understanding of the core of love when caring for patients suffering from addiction. The study had a hermeneutical approach. Four nurses working at a detoxification unit were interviewed. Data were interpreted using a hermeneutical text interpretation based on Gadamer's hermeneutics. The results revealed the core of love in four dimensions: love as an inner driving force, searching for the human being behind the addiction, faith in the inner power of human beings and love as a movement of giving and receiving. The hermeneutical interpretation revealed the core of love as sacrifice, showing that sacrifice is an ethical dimension and that sacrifice involves searching for the patient's ontological suffering. Sacrifice is connected to faith, and faith in love is decisive for a life without drugs. Sacrifice involves being mutual gifts to one another, a self-reinforcing motion of sacrifice that energizes the nurses to go on with their work. © 2014 Nordic College of Caring Science.

Abuse of power in relationships and sexual health.

PubMed

Gesink, Dionne; Whiskeyjack, Lana; Suntjens, Terri; Mihic, Alanna; McGilvery, Priscilla

2016-08-01

STI rates are high for First Nations in Canada and the United States. Our objective was to understand the context, issues, and beliefs around high STI rates from a nêhiyaw (Cree) perspective. Twenty-two in-depth interviews were conducted with 25 community participants between March 1, 2011 and May 15, 2011. Interviews were conducted by community researchers and grounded in the Cree values of relationship, sharing, personal agency and relational accountability. A diverse purposive snowball sample of community members were asked why they thought STI rates were high for the community. The remainder of the interview was unstructured, and supported by the interviewer through probes and sharing in a conversational style. Modified grounded theory was used to analyze the narratives and develop a theory. The main finding from the interviews was that abuse of power in relationships causes physical, mental, emotional and spiritual wounds that disrupt the medicine wheel. Wounded individuals seek medicine to stop suffering and find healing. Many numb suffering by accessing temporary medicines (sex, drugs and alcohol) or permanent medicines (suicide). These medicines increase the risk of STIs. Some seek healing by participating in ceremony and restoring relationships with self, others, Spirit/religion, traditional knowledge and traditional teachings. These medicines decrease the risk of STIs. Younger female participants explained how casual relationships are safer than committed monogamous relationships. Resolving abuse of power in relationships should lead to improvements in STI rates and sexual health. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Dose-response effects for depression and Schizophrenia management on hospital utilization in Illinois Medicaid: a multivariate regression analysis.

PubMed

Berg, Gregory D; Donnelly, Shawn; Warnick, Kathleen; Medina, Wendie; Miller, Mary

2014-07-03

The prevalence of schizophrenia and depression in the United States is far higher among Medicaid recipients than in the general population. Individuals suffering from mental illness, including schizophrenia and depression, also have higher rates of emergency department utilization, which is costly and may not generate the positive health outcomes desired. Disease management programs strive to help individuals suffering from chronic illnesses better manage their condition(s) and seek health care in the appropriate settings. The objective of this manuscript is to estimate a dose-response impact on hospital inpatient and emergency room utilizations for any reason by Medicaid recipients with depression or schizophrenia who received disease management contacts. Multivariate regression analysis of panel data taken from administrative claims was conducted to test the hypothesis that increased contacts lower the likelihood of all-cause inpatient admissions and emergency room visits. Subjects included 6,274 members of Illinois' non-institutionalized Medicaid-only aged, blind or disabled population diagnosed with depression or schizophrenia. The statistical measure is the odds ratio. The odds ratio association is between the monthly utilization indicators and the number of contacts (doses) a member had for each particular disease management intervention. Higher numbers of intervention contacts for Medicaid recipients diagnosed with depression or schizophrenia were associated with statistically significant reductions in all-cause inpatient admissions and emergency room utilizations. There is a high correlation between depression and schizophrenia disease management contacts and lowered all-cause hospital inpatient and emergency room utilizations.

[Late effects of massive psychic trauma. Holocaust survivors 50 years later].

PubMed

Robinson, S; Rebaudengo-Rosca, P; Rapaport, M

1993-03-01

The authors report the results of a study aimed at examining the present mental state, adjustment and lifestyle of a non-clinical sample of Holocaust survivors aged 60 and over. Most the interviewees have suffered since the war from various psychic symptoms, the so-called "survivor syndrome". Concentration camp survivors form a special group whose level of suffering appears greater and more severe than other survivors. In spite of continuous mental suffering Holocaust survivors have succeeded in adjusting well. They hold top positions at work, are socially successful and have stable family nuclei. They behave as if they need to fulfil the expectations of all those who perished in the Holocaust. Only 4 subjects reported a latency period before the appearance of symptoms.

Evaluating the medical malpractice system and options for reform.

PubMed

Kessler, Daniel P

2011-01-01

The U.S. medical malpractice liability system has two principal objectives: to compensate patients who are injured through the negligence of healthcare providers and to deter providers from practicing negligently. In practice, however, the system is slow and costly to administer. It both fails to compensate patients who have suffered from bad medical care and compensates those who haven't. According to opinion surveys of physicians, the system creates incentives to undertake cost-ineffective treatments based on fear of legal liability--to practice "defensive medicine." The failures of the liability system and the high cost of health care in the United States have led to an important debate over tort policy. How well does malpractice law achieve its intended goals? How large of a problem is defensive medicine and can reforms to malpractice law reduce its impact on healthcare spending? The flaws of the existing system have led a number of states to change their laws in a way that would reduce malpractice liability--to adopt "tort reforms." Evidence from several studies suggests that wisely chosen reforms have the potential to reduce healthcare spending significantly with no adverse impact on patient health outcomes.

Crush Testing at Oak Ridge National Laboratory

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

Feldman, Matthew R

2011-01-01

The dynamic crush test is required in the certification testing of some small Type B transportation packages. International Atomic Energy Agency regulations state that the test article must be 'subjected to a dynamic crush test by positioning the specimen on the target so as to suffer maximum damage.' Oak Ridge National Laboratory (ORNL) Transportation Technologies Group performs testing of Type B transportation packages, including the crush test, at the National Transportation Research Center in Knoxville, Tennessee (United States). This paper documents ORNL's experiences performing crush tests on several different Type B packages. ORNL has crush tested five different drum-type packagemore » designs, continuing its 60 year history of RAM package testing. A total of 26 crush tests have been performed in a wide variety of package orientations and crush plate CG alignments. In all cases, the deformation of the outer drum created by the crush test was significantly greater than the deformation damage caused by the 9 m drop test. The crush test is a highly effective means for testing structural soundness of smaller nondense Type B shipping package designs. Further regulatory guidance could alleviate the need to perform the crush test in a wide range of orientations and crush plate CG alignments.« less

31 CFR 596.313 - United States person.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false United States person. 596.313 Section... General Definitions § 596.313 United States person. The term United States person means any United States... States, or any person in the United States. ...

31 CFR 596.313 - United States person.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false United States person. 596.313 Section... General Definitions § 596.313 United States person. The term United States person means any United States... States, or any person in the United States. ...

31 CFR 596.313 - United States person.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false United States person. 596.313 Section... General Definitions § 596.313 United States person. The term United States person means any United States... States, or any person in the United States. ...

OPHIDIOMYCES OPHIODIICOLA ON A CAPTIVE BLACK RACER (COLUBER CONSTRICTOR) AND A GARTER SNAKE (THAMNOPHIS SIRTALIS) IN PENNSYLVANIA.

PubMed

Ohkura, Mana; Worley, Jeremy J; Hughes-Hallett, James E; Fisher, Jenny S; Love, Brenda C; Arnold, A Elizabeth; Orbach, Marc J

2016-03-01

Two snakes were presented to the Pennsylvania State University Animal Diagnostic Laboratory with one suffering from external lesions where the scales were raised and discolored, and the other with oral lesions and swelling extending to the left eye, which was opaque. Histopathological analysis revealed multifocal granulomas containing fungal hyphae. Morphological and DNA sequence analyses revealed both suffered from infection by Ophidiomyces ophiodiicola, an emerging pathogen of snakes. This is the first report of this disease in Pennsylvania.

Online Testing Suffers Setbacks in Multiple States

ERIC Educational Resources Information Center

Davis, Michelle R.

2013-01-01

Widespread technical failures and interruptions of recent online testing in a number of states have shaken the confidence of educators and policymakers in high-tech assessment methods and raised serious concerns about schools' technological readiness for the coming common-core online tests. The glitches arose as many districts in the 46 states…

Clamping characteristics study on different types of clamping unit

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

Jiao, Zhiwei; Liu, Haichao; Xie, Pengcheng

2015-05-22

Plastic products are becoming more and more widely used in aerospace, IT, digital electronics and many other fields. With the development of technology, the requirement of product precision is getting higher and higher. However, type and working performance of clamping unit play a decisive role in product precision. Clamping characteristics of different types of clamping unit are discussed in this article, which use finite element numerical analysis method through the software ABAQUS to study the clamping uniformity, and detect the clamping force repeatability precision. The result shows that compared with toggled three-platen clamping unit, clamping characteristics of internal circulation two-platenmore » clamping unit are better, for instance, its mold cavity deformation and force that bars and mold parting surface suffered are more uniform, and its clamping uniformity and repeatability precision is also better.« less

Art Therapy on a Hospital Burn Unit: A Step towards Healing and Recovery.

ERIC Educational Resources Information Center

Russel, Johanna

1995-01-01

Describes how art therapy can benefit patients hospitalized due to severe burns, who suffer psychological as well as physical trauma. Outlines the psychological phases, identifies how burn patients typically experience their healing process, and discusses how art therapy can assist the patient at each stage of the recovery process. (JPS)

"Standards Will Drop"--and Other Fears about the Equality Agenda in Higher Education

ERIC Educational Resources Information Center

Brink, Chris

2009-01-01

I discuss, on the basis of experience in Australia, South Africa, and the United Kingdom, some common fears and negative opinions about the equality agenda in higher education. These include: (1) "Standards will drop."; (2) "Our reputation will suffer."; (3) "It's not our problem."; (4) "It's social…

Factors affecting the United Nations' response to natural disasters: what determines the allocation of the Central Emergency Response Fund?

PubMed

Robinson, Tyler D; Oliveira, Thiago M; Kayden, Stephanie

2017-10-01

Natural disasters can overwhelm the domestic response of a country, leaving it dependent on external humanitarian relief. The Central Emergency Response Fund (CERF) of the United Nations centralises humanitarian funding and thus allows for a rapid response. This study combined data to analyse the factors that affected the allocation of CERF funding to countries that suffered a natural disaster between 2007 and 2013. It generated descriptive statistics and information on relative risks, and performed regressions of CERF funding across countries. There were 4,346 disasters in total in 188 countries between 2007 and 2013. CERF provided USD 2.98 billion to 87 countries, comprising 3.3 per cent of their total humanitarian funding. CERF more frequently supplied aid to countries in North Africa and the Middle East, and to those that had suffered geophysical disasters. Appropriately, it funds vulnerable countries experiencing severe natural disasters, yet its funding may be affected by variables beyond severity and vulnerability. Further investigation is warranted, therefore. © 2017 The Author(s). Disasters © Overseas Development Institute, 2017.

Skepticism, empathy, and animal suffering.

PubMed

Aaltola, Elisa

2013-12-01

The suffering of nonhuman animals has become a noted factor in deciding public policy and legislative change. Yet, despite this growing concern, skepticism toward such suffering is still surprisingly common. This paper analyzes the merits of the skeptical approach, both in its moderate and extreme forms. In the first part it is claimed that the type of criterion for verification concerning the mental states of other animals posed by skepticism is overly (and, in the case of extreme skepticism, illogically) demanding. Resting on Wittgenstein and Husserl, it is argued that skepticism relies on a misguided epistemology and, thus, that key questions posed by it face the risk of absurdity. In the second part of the paper it is suggested that, instead of skepticism, empathy together with intersubjectivity be adopted. Edith Stein's take on empathy, along with contemporary findings, are explored, and the claim is made that it is only via these two methods of understanding that the suffering of nonhuman animals can be perceived.

Short Stature and Access to Lung Transplantation in the United States. A Cohort Study

PubMed Central

Sell, Jessica L.; Bacchetta, Matthew; Goldfarb, Samuel B.; Park, Hanyoung; Heffernan, Priscilla V.; Robbins, Hilary A.; Shah, Lori; Raza, Kashif; D’Ovidio, Frank; Sonett, Joshua R.; Arcasoy, Selim M.

2016-01-01

Rationale: Anecdotally, short lung transplant candidates suffer from long waiting times and higher rates of death on the waiting list compared with taller candidates. Objectives: To examine the relationship between lung transplant candidate height and waiting list outcomes. Methods: We conducted a retrospective cohort study of 13,346 adults placed on the lung transplant waiting list in the United States between 2005 and 2011. Multivariable-adjusted competing risk survival models were used to examine associations between candidate height and outcomes of interest. The primary outcome was the time until lung transplantation censored at 1 year. Measurements and Main Results: The unadjusted rate of lung transplantation was 94.5 per 100 person-years among candidates of short stature (<162 cm) and 202.0 per 100 person-years among candidates of average stature (170–176.5 cm). After controlling for potential confounders, short stature was associated with a 34% (95% confidence interval [CI], 29–39%) lower rate of transplantation compared with average stature. Short stature was also associated with a 62% (95% CI, 24–96%) higher rate of death or removal because of clinical deterioration and a 42% (95% CI, 10–85%) higher rate of respiratory failure while awaiting lung transplantation. Conclusions: Short stature is associated with a lower rate of lung transplantation and higher rates of death and respiratory failure while awaiting transplantation. Efforts to ameliorate this disparity could include earlier referral and listing of shorter candidates, surgical downsizing of substantially oversized allografts for shorter candidates, and/or changes to allocation policy that account for candidate height. PMID:26554631

Mental health treatment-related stigma and professional help seeking among student veterans.

PubMed

Currier, Joseph M; McDermott, Ryon C; McCormick, Wesley H

2017-11-01

Record numbers of military veterans are enrolling at colleges/universities across the United States. Although a substantive subset might suffer from mental health problems, the majority of these students might not be amenable to utilizing services. The purpose of this study was to examine the role of treatment-related stigma in intentions to seek professional help among undergraduate student veterans at a university on the U.S. Gulf Coast. Focusing on 251 veterans and a gender-matched comparison group of 251 nonveterans, student veterans endorsed higher probabilities of seeking care from physicians (d = .77) and psychologists or other professionals (d = .67). In addition, nonveteran students had greater self-stigma about seeking help (d = -.27) but veterans had more negative beliefs about treatment efficacy (d = 1.07). When compared with veterans who did not exceed clinical thresholds, those with a probable need for treatment had more stigma (ds = .63). Multivariate analyses also revealed an inverse main effect of self-stigma on intentions to seek help from both professional categories. However, military experience differentially moderated associations between treatment-related beliefs and intentions to seek mental health services. Finally, exploratory analyses identified that student veterans were most likely to engage in therapy/counseling at a Veterans Affairs Medical Center or Clinic, Vet Center, or other noninstitutionally sponsored settings in the community (e.g., private practices, faith-based organizations). Looking ahead, these findings will inform research and the provision of services for addressing the mental health needs of this substantive subpopulation of college students in the United States. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Pathogen Webs in Collapsing Honey Bee Colonies

PubMed Central

Cornman, R. Scott; Tarpy, David R.; Chen, Yanping; Jeffreys, Lacey; Lopez, Dawn; Pettis, Jeffery S.; vanEngelsdorp, Dennis; Evans, Jay D.

2012-01-01

Recent losses in honey bee colonies are unusual in their severity, geographical distribution, and, in some cases, failure to present recognized characteristics of known disease. Domesticated honey bees face numerous pests and pathogens, tempting hypotheses that colony collapses arise from exposure to new or resurgent pathogens. Here we explore the incidence and abundance of currently known honey bee pathogens in colonies suffering from Colony Collapse Disorder (CCD), otherwise weak colonies, and strong colonies from across the United States. Although pathogen identities differed between the eastern and western United States, there was a greater incidence and abundance of pathogens in CCD colonies. Pathogen loads were highly covariant in CCD but not control hives, suggesting that CCD colonies rapidly become susceptible to a diverse set of pathogens, or that co-infections can act synergistically to produce the rapid depletion of workers that characterizes the disorder. We also tested workers from a CCD-free apiary to confirm that significant positive correlations among pathogen loads can develop at the level of individual bees and not merely as a secondary effect of CCD. This observation and other recent data highlight pathogen interactions as important components of bee disease. Finally, we used deep RNA sequencing to further characterize microbial diversity in CCD and non-CCD hives. We identified novel strains of the recently described Lake Sinai viruses (LSV) and found evidence of a shift in gut bacterial composition that may be a biomarker of CCD. The results are discussed with respect to host-parasite interactions and other environmental stressors of honey bees. PMID:22927991

Burden of allergic rhinitis: allergies in America, Latin America, and Asia-Pacific adult surveys.

PubMed

Meltzer, Eli O; Blaiss, Michael S; Naclerio, Robert M; Stoloff, Stuart W; Derebery, M Jennifer; Nelson, Harold S; Boyle, John M; Wingertzahn, Mark A

2012-01-01

Allergic rhinitis (AR; also nasal allergies or "hay fever") is a chronic upper airway inflammatory disease that affects ∼60 million adults and children in the United States. The duration and severity of AR symptoms contribute to a substantial burden on patients' quality of life (QoL), sleep, work productivity, and activity. This study was designed to examine symptoms, QoL, productivity, comorbidities, disease management, and pharmacologic treatment of AR in United States and ex-U.S. sufferers. Allergies in America was a comprehensive telephone-based survey of 2500 adults with AR. These data are compared and contrasted with findings from the Pediatric Allergies in America, Allergies in Latin America, and Allergies in Asia-Pacific telephone surveys. The prevalence of physician-diagnosed AR was 14% in U.S. adults, 7% in Latin America adults, and 9% in Asia-Pacific adults. Nasal congestion is the most common and bothersome symptom for adults. Approximately two-thirds of adults rely on medication to relieve intolerable AR symptoms. Incomplete relief, slow onset, <24-hour relief, and reduced efficacy with sustained use were commonly reported with AR medications, including intranasal corticosteroids. One in seven U.S. adults reported achieving little to no relief with AR medications. Bothersome adverse effects of AR medications included drowsiness, a drying feeling, medication dripping down the throat, and bad taste. Perception of inadequate efficacy was the leading cause of medication discontinuation or change and contributed to treatment dissatisfaction. These findings support the assertion that AR burden has been substantially underestimated and identify several important challenges to successful management of AR.

Food insecurity, chronic illness, and gentrification in the San Francisco Bay Area: An example of structural violence in United States public policy.

PubMed

Whittle, Henry J; Palar, Kartika; Hufstedler, Lee Lemus; Seligman, Hilary K; Frongillo, Edward A; Weiser, Sheri D

2015-10-01

Food insecurity continues to be a major challenge in the United States, affecting 49 million individuals. Quantitative studies show that food insecurity has serious negative health impacts among individuals suffering from chronic illnesses, including people living with HIV/AIDS (PLHIV). Formulating effective interventions and policies to combat these health effects requires an in-depth understanding of the lived experience and structural drivers of food insecurity. Few studies, however, have elucidated these phenomena among people living with chronic illnesses in resource-rich settings, including in the United States. Here we sought to explore the experiences and structural determinants of food insecurity among a group of low-income PLHIV in the San Francisco Bay Area. Thirty-four semi-structured in-depth interviews were conducted with low-income PLHIV receiving food assistance from a local non-profit in San Francisco and Alameda County, California, between April and June 2014. Interview transcripts were coded and analysed according to content analysis methods following an inductive-deductive approach. The lived experience of food insecurity among participants included periods of insufficient quantity of food and resultant hunger, as well as long-term struggles with quality of food that led to concerns about the poor health effects of a cheap diet. Participants also reported procuring food using personally and socially unacceptable strategies, including long-term dependence on friends, family, and charity; stealing food; exchanging sex for food; and selling controlled substances. Food insecurity often arose from the need to pay high rents exacerbated by gentrification while receiving limited disability income--​a situation resulting in large part from the convergence of long-standing urban policies amenable to gentrification and an outdated disability policy that constrains financial viability. The experiences of food insecurity described by participants in this study can be understood as a form of structural violence, motivating the need for structural interventions at the policy level that extend beyond food-specific solutions. Copyright © 2015 Elsevier Ltd. All rights reserved.

The Economic Burden of Musculoskeletal Disease in Children and Adolescents in the United States.

PubMed

Rosenfeld, Scott B; Schroeder, Katherine; Watkins-Castillo, Sylvia I

2018-04-01

Musculoskeletal conditions are among the most common and costly conditions suffered by Americans. In 2011, there was an estimated $213 billion in annual cost of direct treatment for and lost wages due to musculoskeletal disease in the United States. Data on economic burden, however, comes mostly from the adult population, with significantly less information regarding the burden of these conditions in young patients available. The purpose of this report is to provide data on the economic burden of musculoskeletal diseases in children and adolescents in the United States. Eleven diagnosis categories were identified, with health care visits and hospitalization data derived from ICD-9-CM codes for each of the conditions searched. The largest database utilized was the Healthcare Cost and Utilization Project (HCUP) Kids' Inpatient Database (KID). Total visits came from the KID, HCUP NEDS (emergency department), NCHS NHAMCS OP (outpatient), and NCHS NAMCS (physician office) databases. The National Health Interview Survey (NHIS) child sample was additionally searched to obtain patient/parent-reported data. In 2012, more than 19 million children and adolescents received treatment in medical centers, physicians' offices, and hospitals for a musculoskeletal-related condition. The most common reason for treatment (68%) was traumatic injury, followed by a pain syndrome (13%) and deformity (9%). Total hospital charges in 2012 for children and adolescents with a primary musculoskeletal-related diagnosis totaled $7.6 billion. Trauma (43%) and deformity (38%) were the major contributors to total hospital charges. Although we found that hospital-related charges for musculoskeletal diseases for children and adolescents in 2012 totaled $7.6 billion, this number underestimates the total cost for all pediatric musculoskeletal conditions. Musculoskeletal conditions accounted for 5.4% of hospital charges in the pediatric population. However, only 1.4% of pediatric research funding is designated to musculoskeletal research. Going forward, the data in this report may be used to further research and to stimulate development of better methods with which to measure the direct and indirect costs of musculoskeletal conditions in children. Level IV-economic and decision analysis.

KSC-2009-2517

NASA Image and Video Library

2009-04-02

CAPE CANAVERAL, Fla. – In the Payload Hazardous Servicing Facility at NASA's Kennedy Space Center in Florida, a technician prepares the Science Instrument Command and Data Handling Unit, or SIC&DH, for its move to the Multi-Use Lightweight Equipment Carrier in the facility. The SIC&DH will be installed on the Hubble Space Telescope during space shuttle Atlantis' STS-125 mission. This unit will replace the one that suffered a failure aboard the orbiting telescope on Sept. 27, 2008. Atlantis is targeted for launch on May 12. Photo credit: NASA/Dimitri Gerondidakis

KSC-2009-2516

NASA Image and Video Library

2009-04-02

CAPE CANAVERAL, Fla. – In the Payload Hazardous Servicing Facility at NASA's Kennedy Space Center in Florida, technicians look over the Science Instrument Command and Data Handling Unit, or SIC&DH. The SIC&DH will be installed on the Multi-Use Lightweight Equipment Carrier in the facility. The SIC&DH will be installed on the Hubble Space Telescope during space shuttle Atlantis' STS-125 mission. This unit will replace the one that suffered a failure aboard the orbiting telescope on Sept. 27, 2008. Atlantis is targeted for launch on May 12. Photo credit: NASA/Dimitri Gerondidakis

KSC-2009-2519

NASA Image and Video Library

2009-04-02

CAPE CANAVERAL, Fla. – In the Payload Hazardous Servicing Facility at NASA's Kennedy Space Center in Florida, the Science Instrument Command and Data Handling Unit, or SIC&DH, is moved toward the Multi-Use Lightweight Equipment Carrier in the background, where it will be installed. The SIC&DH will be installed on the Hubble Space Telescope during space shuttle Atlantis' STS-125 mission. This unit will replace the one that suffered a failure aboard the orbiting telescope on Sept. 27, 2008. Atlantis is targeted for launch on May 12. Photo credit: NASA/Dimitri Gerondidakis

KSC-2009-2518

NASA Image and Video Library

2009-04-02

CAPE CANAVERAL, Fla. – In the Payload Hazardous Servicing Facility at NASA's Kennedy Space Center in Florida, the Science Instrument Command and Data Handling Unit, or SIC&DH, is moved toward the Multi-Use Lightweight Equipment Carrier in the background, where it will be installed. The SIC&DH will be installed on the Hubble Space Telescope during space shuttle Atlantis' STS-125 mission. This unit will replace the one that suffered a failure aboard the orbiting telescope on Sept. 27, 2008. Atlantis is targeted for launch on May 12. Photo credit: NASA/Dimitri Gerondidakis

31 CFR 560.510 - Transactions related to the resolution of disputes between the United States or United States...

Code of Federal Regulations, 2012 CFR

2012-07-01

... of disputes between the United States or United States nationals and the Government of Iran. 560.510... between the United States or United States nationals and the Government of Iran. (a) Except as otherwise... with awards, decisions or orders of the Iran-United States Claims Tribunal in The Hague, the...