WorldWideScience

Sample records for california medical association

  1. American Medical Association

    Science.gov (United States)

    ... AMA provides to help members save money. Residency & Career Planning Find out resources for a range of medical ... clinical questions using our reference tool View the Career Planning Resource Refinance your medical student loans Find leadership ...

  2. 78 FR 77447 - California Wind Energy Association, First Solar, Inc. v. California Independent System Operator...

    Science.gov (United States)

    2013-12-23

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission California Wind Energy Association, First Solar, Inc. v. California... Practice and Procedure, 18 CFR 385.206 (2013), California Wind Energy Association and First Solar,...

  3. Medication-wide association studies

    NARCIS (Netherlands)

    P.B. Ryan (Patrick); D. Madigan (David); P.E. Stang (Paul); M.J. Schuemie (Martijn); G. Hripcsak (G.)

    2013-01-01

    textabstractUndiscovered side effects of drugs can have a profound effect on the health of the nation, and electronic health-care databases offer opportunities to speed up the discovery of these side effects. We applied a "medication-wide association study" approach that combined multivariate analys

  4. [The centenary of the Israel Medical Association].

    Science.gov (United States)

    Levy, Nissim

    2012-01-01

    On January 12th 1912, six Jewish physicians and one pharmacist assembled in Tel-Aviv to proclaim the founding of the Jaffa Hebrew Medical Society. One year later the Jewish doctors of Jerusalem established the "Society of Hebrew Speaking Physicians". On 28th December, 1918 a few weeks after the end of World War 1, both organizations merged into the Hebrew Medical Association which later became the Israel Medical Association (I.M.A.). The Association played a leading role in the advancement of medicine in the Holy Land and was instrumental in imposing the Hebrew medical terminology in the newly founded State of Israel.

  5. Medical complications associated with earthquakes.

    Science.gov (United States)

    Bartels, Susan A; VanRooyen, Michael J

    2012-02-25

    Major earthquakes are some of the most devastating natural disasters. The epidemiology of earthquake-related injuries and mortality is unique for these disasters. Because earthquakes frequently affect populous urban areas with poor structural standards, they often result in high death rates and mass casualties with many traumatic injuries. These injuries are highly mechanical and often multisystem, requiring intensive curative medical and surgical care at a time when the local and regional medical response capacities have been at least partly disrupted. Many patients surviving blunt and penetrating trauma and crush injuries have subsequent complications that lead to additional morbidity and mortality. Here, we review and summarise earthquake-induced injuries and medical complications affecting major organ systems.

  6. The Medical Complications Associated with Purging

    Science.gov (United States)

    Forney, K. Jean; Buchman-Schmitt, Jennifer M.; Keel, Pamela K.; Frank, Guido K.W.

    2015-01-01

    Objective Purging behaviors, including self-induced vomiting, laxative abuse, and diuretic abuse, are present across many of the eating disorders. Here we review the major medical complications of these behaviors. Method Although we identified over 100 scholarly articles describing medical complications associated with purging, most papers involved case studies or small, uncontrolled samples. Given the limited evidence base, we conducted a qualitative (rather than systematic) review to identify medical complications that have been attributed to purging behaviors. Results Medical conditions affecting the teeth, esophagus, gastrointestinal system, kidneys, skin, cardiovascular system, and musculoskeletal system were identified, with self-induced vomiting causing the most medical complications. Conclusions Purging behavior can be associated with severe medical complications across all body systems. Mental health professionals should refer patients with purging behaviors to medical providers for screening and treatment as needed. The medical work-up for individuals with eating disorders should include a comprehensive metabolic panel, complete blood count, and a full body exam including the teeth to prevent severe complications. Medical providers should screen patients for purging behaviors and associated medical complications, even in the absence of an eating disorder diagnosis, to increase the detection of eating disorders. Recognizing the link between purging and medical complications can aid in identifying potential eating disorders, particularly those that often elude detection such as purging disorder. PMID:26876429

  7. Teratogenic Mechanisms Associated with Prenatal Medication Exposure

    NARCIS (Netherlands)

    van Gelder, Marleen M. H. J.; van Rooijl, Iris A. L. M.; de Jong-van den Berg, Lolkje T. W.; Roeleveld, Nel

    2014-01-01

    Birth defects may originate through multiple mechanisms and may be caused by a variety of possible exposures, including medications in early pregnancy. In this review, we describe six principal teratogenic mechanisms suspected to be associated with medication use: folate antagonism, neural crest cel

  8. Teratogenic mechanisms associated with prenatal medication exposure.

    Science.gov (United States)

    van Gelder, Marleen M H J; van Rooij, Iris A L M; de Jong-van den Berg, Lolkje T W; Roeleveld, Nel

    2014-01-01

    Birth defects may originate through multiple mechanisms and may be caused by a variety of possible exposures, including medications in early pregnancy. In this review, we describe six principal teratogenic mechanisms suspected to be associated with medication use: folate antagonism, neural crest cell disruption, endocrine disruption, oxidative stress, vascular disruption, and specific receptor- or enzyme-mediated teratogenesis. Knowledge about these mechanisms, for some of which evidence is mainly derived from animal models, may not only be relevant for etiologic and post-marketing research, but may also have implications for prescribing behavior for women of reproductive age. Since combinations of seemingly unrelated medications may have effects through similar teratogenic mechanisms, the risk of birth defects may be strongly increased in multi-therapy.

  9. Winter habitat associations of diurnal raptors in Californias Central Valley

    Science.gov (United States)

    Pandolrno, E.R.; Herzog, M.P.; Hooper, S.L.; Smith, Z.

    2011-01-01

    The wintering raptors of California's Central Valley are abundant and diverse. Despite this, little information exists on the habitats used by these birds in winter. We recorded diurnal raptors along 19 roadside survey routes throughout the Central Valley for three consecutive winters between 2007 and 2010. We obtained data sufficient to determine significant positive and negative habitat associations for the White-tailed Kite (Elanus leucurus), Bald Eagle {Haliaeetus leucocephalus), Northern Harrier (Circus cyaneus), Red-tailed Hawk (Buteo jamaicensis), Ferruginous Hawk (Buteo regalis), Rough-legged Hawk (Buteo lagopus), American Kestrel (Falco sparverius), and Prairie Falcon (Falco mexicanus). The Prairie Falcon and Ferruginous and Rough-legged hawks showed expected strong positive associations with grasslands. The Bald Eagle and Northern Harrier were positively associated not only with wetlands but also with rice. The strongest positive association for the White-tailed Kite was with wetlands. The Red-tailed Hawk was positively associated with a variety of habitat types but most strongly with wetlands and rice. The American Kestrel, Northern Harrier, and White-tailed Kite were positively associated with alfalfa. Nearly all species were negatively associated with urbanized landscapes, orchards, and other intensive forms of agriculture. The White-tailed Kite, Northern Harrier, Redtailed Hawk, Ferruginous Hawk, and American Kestrel showed significant negative associations with oak savanna. Given the rapid conversion of the Central Valley to urban and intensive agricultural uses over the past few decades, these results have important implications for conservation of these wintering raptors in this region.

  10. 76 FR 46651 - Petition for Rulemaking Submitted by the California Association of Marriage and Family Therapists

    Science.gov (United States)

    2011-08-03

    ... COMMISSION 10 CFR Part 26 Petition for Rulemaking Submitted by the California Association of Marriage and... Riemersma, on behalf of the California Association of Marriage and Family Therapists (the petitioner... the Code of Federal Regulations (10 CFR) 26.187(b) to add marriage and family therapists as...

  11. Early radiology and the National Medical Association.

    Science.gov (United States)

    Oestreich, Alan E

    2011-01-01

    Both the discovery of the x-ray and the founding of the National Medical Association (NMA) occurred in 1895. Radiologists have participated importantly in the NMA since the lecture of Dr Marcus F. Wheatland at the 1909 Annual Meeting in Boston, Massachusetts, which led to his election as president of the NMA for the following year. More recently, Dr Tracy M. Walton was president of the NMA in its centennial year. This article details early and continued participation in the NMA by radiologists, including the founding of the Section on Radiology in 1949, with its first chairman, Dr William E. Allen, Jr, longtime leader in radiology, the section, and the NMA.

  12. California Diploma Project Technical Report II: Alignment Study--Alignment Study of the Health Sciences and Medical Technology Draft Standards and California's Exit Level Common Core State Standards

    Science.gov (United States)

    McGaughy, Charis; de Gonzalez, Alicia

    2012-01-01

    The California Department of Education is in the process of revising the Career and Technical Education (CTE) Model Curriculum Standards. The Educational Policy Improvement Center (EPIC) conducted an investigation of the draft version of the Health Sciences and Medical Technology Standards (Health Science). The purpose of the study is to…

  13. Supporting medical education research quality: the Association of American Medical Colleges' Medical Education Research Certificate program.

    Science.gov (United States)

    Gruppen, Larry D; Yoder, Ernie; Frye, Ann; Perkowski, Linda C; Mavis, Brian

    2011-01-01

    The quality of the medical education research (MER) reported in the literature has been frequently criticized. Numerous reasons have been provided for these shortcomings, including the level of research training and experience of many medical school faculty. The faculty development required to improve MER can take various forms. This article describes the Medical Education Research Certificate (MERC) program, a national faculty development program that focuses exclusively on MER. Sponsored by the Association of American Medical Colleges and led by a committee of established medical education researchers from across the United States, the MERC program is built on a set of 11 interactive workshops offered at various times and places across the United States. MERC participants can customize the program by selecting six workshops from this set to fulfill requirements for certification. This article describes the history, operations, current organization, and evaluation of the program. Key elements of the program's success include alignment of program content and focus with needs identified by prospective users, flexibility in program organization and logistics to fit participant schedules, an emphasis on practical application of MER principles in the context of the participants' activities and interests, consistency in program content and format to ensure standards of quality, and a sustainable financial model. The relationship between the national MERC program and local faculty development initiatives is also described. The success of the MERC program suggests that it may be a possible model for nationally disseminated faculty development programs in other domains.

  14. Risk factors associated with leptospirosis in dogs from Northern California: 2001-2010.

    Science.gov (United States)

    Hennebelle, Janemarie H; Sykes, Jane E; Foley, Janet

    2014-10-01

    The present study was performed to identify risk factors for canine leptospirosis at a tertiary referral institution in northern California from 2001 through 2010 and to describe case characteristics. In this retrospective case-control study, 67 dogs with leptospirosis and 271 controls were evaluated at the William R. Pritchard Veterinary Medical Teaching Hospital (Davis, CA) from March, 2001 , through November, 2010. Medical records of cases and controls were analyzed to identify signalment, exposure history, and clinical signs that increased the risk for a diagnosis of leptospirosis. Among cases, most were vomiting and lethargic and had leukocytosis and azotemia. Total white cell count, neutrophil count, and monocyte count were higher in dogs with leptospirosis, whereas the platelet count was lower. Serum concentrations of urea nitrogen, creatinine, and bilirubin were elevated in dogs with leptospirosis as well. On average, case dogs were hospitalized for 11 days and had hospital bills exceeding $5000. Mortality was 13% of case dogs, with the predominant serovar being Pomona. Dogs with leptospirosis were more likely to reside in the central or south coast (odds ratio [OR]=7.33), Sierra Nevada foothills (OR=4.50), San Francisco Bay area (OR=4.2), and north coast (OR=2.85) of California when compared with controls. Dogs 5-10 years old (OR=3.22) or over 10 years old (OR=2.76) and herding (OR=3.1) or hound breed (OR=4.6) dogs were more likely to have leptospirosis than the control group. Leptospirosis was associated with acute renal failure in older, undervaccinated dogs. The regional distribution, large breed predisposition, and finding of predominantly Pomona serovar suggest wildlife or other contacts as an important route of exposure. Knowledge of risk factors, vaccination history, and clinical signs can increase an index of suspicion for leptospirosis and contribute to improved strategies for prevention of leptospirosis in dogs, understanding of the ecology of

  15. An Analysis of the Medical Costs of Obesity for Fifth Graders in California and Texas.

    Science.gov (United States)

    Levitt, Danielle E; Jackson, Allen W; Morrow, James R

    The prevalence of childhood obesity in the United States increased more than three-fold from 1976 - 1980 to 2007 - 2008. The Presidential Youth Fitness Program's FitnessGram® is the current method recommended by the President's Council on Fitness, Sports & Nutrition for assessing health-related fitness factors, including body composition. FitnessGram® data from California and Texas, the two most populous states, over a three-year time span indicate that more than one-third of fifth grade students, typically ten-year-olds, are obese. Previous studies report that an obese ten-year-old child who remains obese into adulthood will incur elevated direct medical costs beyond his or her normal-weight peers over a lifetime. The recommended elevated cost estimates are approximately $12,660 when comparing against a normal-weight child who gains weight as an adult and approximately $19,000 compared to a child who remains at normal weight as an adult. By applying these figures to FitnessGram® results from California and Texas, each group of fifth grade students in each of the two states will incur between $1.4 and $3.0 billion in direct medical costs over a lifetime. When the percentage of obese fifth graders is extrapolated to the rest of the United States' 4 million ten-year-olds, this results in more than $17 billion (accounting for adulthood weight gain) or $25 billion (not accounting for adulthood weight gain) in added direct lifetime medical costs attributable to obesity for this single-year age cohort. This information should be used to influence spending decisions and resource allocation to obesity reduction and prevention efforts.

  16. The medical-industrial complex, professional medical associations, and continuing medical education.

    Science.gov (United States)

    Schofferman, Jerome

    2011-12-01

    Financial relationships among the biomedical industries, physicians, and professional medical associations (PMAs) can be professional, ethical, mutually beneficial, and, most importantly, can lead to improved medical care. However, such relationships, by their very nature, present conflicts of interest (COIs). One of the greatest concerns regarding COI is continuing medical education (CME), especially because currently industry funds 40-60% of CME. COIs have the potential to bias physicians in practice, educators, and those in leadership positions of PMAs and well as the staff of a PMA. These conflicts lead to the potential to bias the content and type of CME presentations and thereby influence physicians' practice patterns and patient care. Physicians are generally aware of the potential for bias when industry contributes funding for CME, but they are most often unable to detect the bias. This may because it is very subtle and/or the educators themselves may not realize that they have been influenced by their relationships with industry. Following Accreditation Council for Continuing Medical Education guidelines and mandating disclosure that is transparent and complete have become the fallback positions to manage COIs, but such disclosure does not really mitigate the conflict. The eventual and best solutions to ensure evidence-based education are complete divestment by educators and leaders of PMAs, minimal and highly controlled industry funding of PMAs, blind pooling of any industry contributions to PMAs and CME, strict verification of disclosures, clear separation of marketing from education at CME events, and strict oversight of presentations for the presence of bias.

  17. International Medical Geology Association (IMGA) formed

    Institute of Scientific and Technical Information of China (English)

    Olle Selinus; Jose Centeno; Robert Finkelman

    2006-01-01

    @@ "Medical Geology" is defined as the science dealing with the relationship between natural geological factors and health problems in man and animals and understanding the influence of ordinary environmental factors on the geographical distribution of such health problems. Medical Geology is therefore a broad and complicated subject and if the problems to be addressed are to be understood, mitigated, or resolved, it will require interdisciplinary contributions from different scientific fields (involving geo-scientists,medical scientists, health professionals, veterinarians, and biologists, etc.). Medical Geology involves the whole geo-sphere and can be considered as dealing with ecosystem health.

  18. Factors Associated with Undertreatment of Medical Student Depression.

    Science.gov (United States)

    Tjia, Jennifer; Givens, Jane L.; Shea, Judy A.

    2005-01-01

    The authors measured factors associated with undertreatment of medical students' depression. They administered a cross-sectional Beck Depression Inventory and sociodemographic questionnaire to students at 1 medical school, defining their outcome measure as the use of counseling services or antidepressant medication. Of an estimated 450 available…

  19. 75 FR 51958 - California Association of Marriage and Family Therapists; Notice of Receipt of Petition for...

    Science.gov (United States)

    2010-08-24

    ... COMMISSION 10 CFR Part 26 California Association of Marriage and Family Therapists; Notice of Receipt of... Association of Marriage and Family Therapists (CAMFT) (petitioner). The petition was docketed by the NRC and... add marriage and family therapists (MFT) as substance abuse experts (SAEs). DATES: Submit comments...

  20. Effect of Brief Behavioral Intervention Program in Managing Stress in Medical Students from Two Southern California Universities

    OpenAIRE

    Bughi, Stephanie A.; Sumcad, Jennifer; Bughi, Stefan

    2009-01-01

    The study aims to assess 1) the prevalence of stress among a group of third and fourth year medical students (MS) from two Southern California universities and 2) the effect of a brief behavioral intervention program (BBIP) on stress management among the students instructed on stress intervention techniques. The stress level was determined by using the General Well Being Scale (GWBS), a self-report questionnaire designed by the National Center for Health Statistics.1 The stress testing was do...

  1. Medication Administration: Measuring Associate Degree Nursing Student Knowledge

    Science.gov (United States)

    Crowell, Debra L.

    2016-01-01

    The American Nurse Association's (ANA) provisions outline the commitment expected of nurses to protect the community from harm. Medication administration coincides with patient safety as a compelling obligation in nursing practice. The study's purpose was to examine retention of medication safety knowledge among first year nursing students, after…

  2. Characteristics associated with post-discharge medication errors

    Science.gov (United States)

    Mixon, Amanda S.; Myers, Amy P.; Leak, Cardella L.; Mary Lou Jacobsen, J.; Cawthon, Courtney; Goggins, Kathryn M.; Nwosu, Samuel; Schildcrout, Jonathan S.; Schnelle, John F.; Speroff, Theodore; Kripalani, Sunil

    2014-01-01

    Objective To examine the association of patient- and medication-related factors with post-discharge medication errors. Patients and Methods The Vanderbilt Inpatient Cohort Study (VICS) includes adults hospitalized with acute coronary syndromes (ACS) and/or acute decompensated heart failure (ADHF). We measured health literacy, subjective numeracy, marital status, cognition, social support, education, income, depression, global health status, and medication adherence in patients enrolled between October 2011 and August 2012. We used binomial logistic regression to determine predictors of discordance between the discharge medication list and patient-reported list during post-discharge medication review. Results Among 471 patients, mean age was 59 years; mean total number of medications reported was 12; and 17% had inadequate or marginal health literacy. Half (51%) of patients had ≥1 one discordant medication (i.e., appeared either on the discharge or patient-reported list but not both); 27% failed to report a medication on their discharge list; and 36% reported a medication not on their discharge list. Additionally, 59% had a misunderstanding in indication, dose, or frequency in a cardiac medication. In multivariable analyses, higher subjective numeracy (Odds Ratio (OR)=0.81, 95% Confidence Interval (CI) 0.67-0.98) was associated with lower odds of having discordant medications. For cardiac medications, participants with higher health literacy (OR=0.84, CI 0.74-0.95), higher subjective numeracy (OR=0.77, CI 0.63-0.95), and who were female (OR=0.60, CI 0.46-0.78) had lower odds of misunderstandings in indication, dose, or frequency. Conclusion Medication errors are present in approximately half of patients following hospital discharge and are more common among patients with lower numeracy or health literacy. PMID:24998906

  3. Compulsive gambling possibly associated with antiepileptic medication

    Directory of Open Access Journals (Sweden)

    Susanne Storrier

    2014-01-01

    Full Text Available Compulsive gambling is recognized with Parkinson's disease treatment with dopamine agonists but has not been reported with antiepileptic medications (AEMs in epilepsy. This is the first report regarding possible compulsive gambling, provoked by AEMs in a patient with idiopathic generalized epilepsy, who presented with nonconvulsive status epilepticus, having previously not achieved seizure control with carbamazepine, valproate, (VPA, topiramate, gabapentin (GPT, lamotrigine (LTG, and clobazam. Levetiracetam (LEV was added to VPA and GPT, which the patient was already taking and LTG subsequently retrialed. Following the reintroduction of LTG, she lost $4000–5000, which she concealed. With better seizure control, VPA and GPT were withdrawn, leaving her on LEV and LTG. With increased LTG dosage, she lost $50,000, prompting discovery of her gambling.

  4. Concern between medication non-adherence and diabetes associated depression

    OpenAIRE

    Krishnan Vengadaragava Chary; Porchelvan Swaminathan

    2016-01-01

    Background: Diabetes mellitus is one of the health disorders that acquire mankind immensely. An ominous twin of diabetes mellitus is diabetes associated depression which is often unrecognised in routine diabetic care. The objective of this study was to find the prevalence and correlation between medication adherence and diabetes associated depression. Methods: It is a conducted as cross sectional study using Morisky medication adherence scale to evaluate treatment adherence of type II diab...

  5. Association Between Sleep Hygiene and Sleep Quality in Medical Students

    OpenAIRE

    2010-01-01

    The aim of this study was to determine whether subjective sleep quality was reduced in medical students, and whether demographics and sleep hygiene behaviors were associated with sleep quality. A Web-based survey was completed by 314 medical students, containing questions about demographics, sleep habits, exercise habits, caffeine, tobacco and alcohol use, and subjective sleep quality (using the Pittsburgh Sleep Quality Index). Correlation and regression analyses tested for associations among...

  6. Association between adherence to medications for COPD and medications for other chronic conditions in COPD patients

    Science.gov (United States)

    Dhamane, Amol D; Schwab, Phil; Hopson, Sari; Moretz, Chad; Annavarapu, Srinivas; Burslem, Kate; Renda, Andrew; Kaila, Shuchita

    2017-01-01

    Background Patients with COPD often have multiple comorbidities requiring use of multiple medications, and adherence rates for maintenance COPD (mCOPD) medications are already known to be suboptimal. Presence of comorbidities in COPD patients, and use of medications used to treat those comorbidities (non-COPD medications), may have an adverse impact on adherence to mCOPD medications. Objective The objective of the study was to evaluate the association between non-adherence to mCOPD medications and non-COPD medications in COPD patients. Methods COPD patients were identified using a large administrative claims database. Selected patients were 40–89 years old and continuously enrolled for 12 months prior to and 24 months after the first identified COPD diagnosis (index date) during January 1, 2009 to December 31, 2010. Patients were required to have ≥1 prescription for a mCOPD medication within 365 days of the index date and ≥1 prescription for one of 12 non-COPD medication classes within ±30 days of the first COPD prescription. Adherence (proportion of days covered [PDC]) was measured during 365 days following the first COPD prescription. The association between non-adherence (PDC <0.8) to mCOPD and non-adherence to non-COPD medications was determined using logistic regression, controlling for baseline patient characteristics. Results A total of 14,117 patients, with a mean age of 69.9 years, met study criteria. Of these, 40.9% were males and 79.2% were non-adherent to mCOPD medications with a mean PDC of 0.47. Non-adherence to mCOPD medications was associated with non-adherence to 10 of 12 non-COPD medication classes (odds ratio 1.38–1.78, all P<0.01). Conclusion Adherence to mCOPD medications is low. Non-adherence (or adherence) to mCOPD medications is positively related to non-adherence (or adherence) to non-COPD medications, implying that the need to take medications prescribed for comorbid conditions does not adversely impact adherence to m

  7. California Association of Professors of Educational Administration: Promoting Equity and Excellence in Educational Leader Preparation

    Science.gov (United States)

    Dell'Olio, Franca; Jones, Albert; Jindra, Susan; Jungwirth, Linda; Lindsey, Delores B.; Lindsey, Randall B.; Mirci, Philip; Purrington, Linda; Moore-Steward, Thelma; Thomas, Chris; Ward, Cheryl; Winkelman, Peg; Wise, Don

    2014-01-01

    This feature article charts the efforts of the California Association of Professors of Educational Administration (CAPEA) to move from primarily a policy-driven organization that lacked a significant number of diverse members and perspectives to a values-driven organization committed to equity and cultural competency. This is a chronicle of the…

  8. New poecilostomatoid copepod (Anthessiidae) associated with the opisthobranch Discodoris heathi off California

    NARCIS (Netherlands)

    Humes, Arthur G.

    1997-01-01

    Katanthessius stocki new species, associated with the opisthobranch Discodoris heathi off California, is distinguished from Katanthessisus delamarei, its only congener, by its smaller size, the 1 – segmented endopod in leg 4, and the strongly recurved claw on the maxilliped of the male.

  9. Chronic Obstructive Pulmonary Disease Illness and Medication Beliefs are Associated with Medication Adherence.

    Science.gov (United States)

    Krauskopf, Katherine; Federman, Alex D; Kale, Minal S; Sigel, Keith M; Martynenko, Melissa; O'Conor, Rachel; Wolf, Michael S; Leventhal, Howard; Wisnivesky, Juan P

    2015-04-01

    Almost half of patients with COPD do not adhere to their medications. Illness and medication beliefs are important determinants of adherence in other chronic diseases. Using the framework of the Common Sense Model of Self-Regulation (CSM), we determined associations between potentially modifiable beliefs and adherence to COPD medications in a cohort of English- and Spanish-speaking adults with COPD from New York and Chicago. Medication adherence was assessed using the Medication Adherence Report Scale. Illness and medication beliefs along CSM domains were evaluated using the Brief Illness Perception Questionnaire (B-IPQ) and the Beliefs about Medications Questionnaire (BMQ). Unadjusted analysis (with Cohen's d effect sizes) and multiple logistic regression were used to assess the relationship between illness and medication beliefs with adherence. The study included 188 participants (47% Black, 13% Hispanics); 109 (58%) were non-adherent. Non-adherent participants were younger (p < 0.001), more likely to be Black or Hispanic (p = 0.001), to have reported low income (p = 0.02), and had fewer years of formal education (p = 0.002). In unadjusted comparisons, non-adherent participants reported being more concerned about their COPD (p = 0.011; Cohen's d = 0.43), more emotionally affected by the disease (p = 0.001; Cohen's d = 0.54), and had greater concerns about COPD medications (p < 0.001, Cohen's d = 0.81). In adjusted analyses, concerns about COPD medications independently predicted non-adherence (odds ratio: 0.52, 95% confidence interval: 0.36-0.75). In this cohort of urban minority adults, concerns about medications were associated with non-adherence. Future work should explore interventions to influence patient adherence by addressing concerns about the safety profile and long-term effects of COPD medications.

  10. Chronic Obstructive Pulmonary Disease Illness and Medication Beliefs are Associated with Medication Adherence

    Science.gov (United States)

    Krauskopf, Katherine; Federman, Alex D; Kale, Minal S; Sigel, Keith M; Martynenko, Melissa; O’Conor, Rachel; Wolf, Michael S; Leventhal, Howard; Wisnivesky, Juan P

    2015-01-01

    Almost half of patients with COPD do not adhere to their medications. Illness and medication beliefs are important determinants of adherence in other chronic diseases. Using the framework of the Common Sense Model of Self Regulation (CSM), we determined associations between potentially modifiable beliefs and adherence to COPD medications in a cohort of English- and Spanish-speaking adults with COPD from New York and Chicago. Medication adherence was assessed using the Medication Adherence Report Scale. Illness and medication beliefs along CSM domains were evaluated using the Brief Illness Perception Questionnaire (B-IPQ) and the Beliefs about Medications Questionnaire (BMQ). Unadjusted analysis (with Cohen’s d effect sizes) and multiple logistic regression were used to assess the relationship between illness and medication beliefs with adherence. The study included 188 participants (47% Black, 13% Hispanics); 109 (58%) were adherent. Non-adherent participants were younger (p<0.001), more likely to be Black or Hispanic (p=0.001), to have reported low income (p=0.02), and had fewer years of formal education (p=0.002). In unadjusted comparisons, non-adherent participants reported being more concerned about their COPD (p=0.011; Cohen’s d=0.43), more emotionally affected by the disease (p=0.001; Cohen’s d=0.54), and had greater concerns about COPD medications (p<0.001, Cohen’s d=0.81). In adjusted analyses, concerns about COPD medications independently predicted non-adherence (odds ratio: 0.52, 95% confidence interval: 0.36–0.75). In this cohort of urban minority adults, concerns about medications were associated with non-adherence. Future work should explore interventions to influence patient adherence by addressing concerns about the safety profile and long-term effects of COPD medications. PMID:24960306

  11. Association between sleep hygiene and sleep quality in medical students.

    Science.gov (United States)

    Brick, Cameron A; Seely, Darbi L; Palermo, Tonya M

    2010-01-01

    The aim of this study was to determine whether subjective sleep quality was reduced in medical students, and whether demographics and sleep hygiene behaviors were associated with sleep quality. A Web-based survey was completed by 314 medical students, containing questions about demographics, sleep habits, exercise habits, caffeine, tobacco and alcohol use, and subjective sleep quality (using the Pittsburgh Sleep Quality Index). Correlation and regression analyses tested for associations among demographics, sleep hygiene behaviors, and sleep quality. As hypothesized, medical students' sleep quality was significantly worse than a healthy adult normative sample (t = 5.13, p sleep quality in medical students was predicted by several demographic and sleep hygiene variables, and future research directions are proposed.

  12. Prevalence of self-medication in Brazil and associated factors

    Science.gov (United States)

    Arrais, Paulo Sérgio Dourado; Fernandes, Maria Eneida Porto; Pizzol, Tatiane da Silva Dal; Ramos, Luiz Roberto; Mengue, Sotero Serrate; Luiza, Vera Lucia; Tavares, Noemia Urruth Leão; Farias, Mareni Rocha; Oliveira, Maria Auxiliadora; Bertoldi, Andréa Dâmaso

    2016-01-01

    ABSTRACT OBJECTIVE To analyze the prevalence and associated factors regarding the use of medicines by self-medication in Brazil. METHODS This cross-sectional population-based study was conducted using data from the PNAUM (National Survey on Access, Use and Promotion of Rational Use of Medicines), collected between September 2013 and February 2014 by interviews at the homes of the respondents. All people who reported using any medicines not prescribed by a doctor or dentist were classified as self-medication practitioners. Crude and adjusted prevalence ratios (Poisson regression) and their respective 95% confidence intervals were calculated in order to investigate the factors associated with the use of self-medication by medicines. The independent variables were: sociodemographic characteristics, health conditions and access to and use of health services. In addition, the most commonly consumed medicines by self-medication were individually identified. RESULTS The self-medication prevalence in Brazil was 16.1% (95%CI 15.0–17.5), with it being highest in the Northeast region (23.8%; 95%CI 21.6–26.2). Following the adjusted analysis, self-medication was observed to be associated with females, inhabitants from the North, Northeast and Midwest regions and individuals that have had one, or two or more chronic diseases. Analgesics and muscle relaxants were the therapeutic groups most used for self-medication, with dipyrone being the most consumed medicines. In general, most of the medicines used for self-medication were classified as non-prescriptive (65.5%). CONCLUSIONS Self-medication is common practice in Brazil and mainly involves the use of non-prescription medicines; therefore, the users of such should be made aware of the possible risks. PMID:27982373

  13. Association between obesity and prescribed medication use in England.

    Science.gov (United States)

    Kinge, Jonas Minet; Morris, Stephen

    2014-12-01

    We investigate the association between obesity and use of prescribed medications in England. Data were taken from fourteen rounds of the Health Survey for England (1999-2012), which has measures of current prescribed medication use based on therapeutic classifications in the British National Formulary, and nurse-measured height and weight. We find that obesity has a statistically significant and positive association with use of a range of medicines for managing diseases associated with obesity. The mean probability of using any type of medication is 0.40 in those of normal weight, 0.44 in the overweight, 0.52 in obesity class I and 0.60 in obesity class II/III. Significant positive associations were found between obesity and the use of medication for diseases of the cardiovascular system, gastrointestinal system, respiratory system, and central nervous system, as well as for infections, endocrine system disorders, gynaecological/urinary disorders and musculoskeletal and joint disorders. Use of anti-obesity medication is low, even among those with class II/III obesity.

  14. Associations between patient factors and medication adherence: A Jordanian experience

    Directory of Open Access Journals (Sweden)

    Basheti IA

    2016-03-01

    Full Text Available Objective: To explore the effect of patient characteristics and health beliefs on their medication adherence. Methods: Patients (n=167 with chronic conditions (mean age 58.9; SD=13.54, 53% males were recruited from March 2009- to March 2010 using a cross sectional study design. Data collected included patients’ demographics, medical conditions, medications therapeutic regimen, frequency of physician visits and health beliefs. Patient self-reported adherence to medications was assessed by the researcher using a validated and published scale. Treatment related problems (TRPs were evaluated for each patient by competent clinical pharmacists. Associations between patient characteristics/health beliefs with adherence were explored. Results: About half of the patients (46.1% were non-adherent. A significant association was found between lower adherence and higher number of disease states (p<0.001, higher number of medications (p=0.001, and higher number of identified TRPs (p = 0.003. Patient adherence was positively affected by older age, higher educational level, and higher number of physician visits per month, while it was negatively affected by reporting difficulties with getting prescription refills on time. Conclusion: This study identified different factors that may negatively affect adherence, including higher number of medications and disease states, higher number of identified TRPs and inability to getting prescription refills on time. Hence, more care needs to be provided to patients with complex therapeutic regimens in order to enhance adherence.

  15. How commonly are known medical conditions associated with autism?

    Science.gov (United States)

    Barton, M; Volkmar, F

    1998-08-01

    Recent research has yielded increasing support for neurobiologic theories of autism. A number of family and twin studies support the role of genetics and have led to wide acceptance of autism as an organically based disorder. Controversy persists, however, over the role of congenital medical conditions in the etiology of autism. Two rather divergent views have emerged. One, advocated by Gillberg and colleagues, proposes that up to 30% of cases of autism are associated with a known medical condition. On the other hand, research by Rutter and colleagues suggests the incidence may be closer to 10%. In this retrospective study records on 211 subjects with autism and other developmental disorders are reviewed to determine the prevalence of associated medical conditions and its variability related to the system used to diagnose autism. Results suggest the prevalence of medical conditions with suspected etiologic relationship with autism varies between 10 and 15%, depending on the diagnostic system employed. Further variability in prevalence rates results from a less strict definition of "medical condition" and yields rates between 25 and 37%. Disparate findings in previous research may stem from variability in both diagnostic system employed and which medical conditions are considered significant in the etiology of autism.

  16. Female genital mutilation. Council on Scientific Affairs, American Medical Association.

    Science.gov (United States)

    1995-12-06

    Female genital mutilation is the medically unnecessary modification of female genitalia. Female genital mutilation typically occurs at about 7 years of age, but mutilated women suffer severe medical complications throughout their adult lives. Female genital mutilation most frequently occurs in Africa, the Middle East, and Muslim parts of Indonesia and Malaysia, and it is generally part of a ceremonial induction into adult society. Recent political and economic problems in these regions, however, have increased the numbers of students and refugees to the United States. Consequently, US physicians are treating an increasing number of mutilated patients. The Council on Scientific Affairs recommends that US physicians join the World Health Organization, the World Medical Association, and other major health care organizations in opposing all forms of medically unnecessary surgical modification of the female genitalia.

  17. The spectrum of nephrocutaneous diseases and associations: Inflammatory and medication-related nephrocutaneous associations.

    Science.gov (United States)

    Pascoe, Vanessa L; Fenves, Andrew Z; Wofford, Jay; Jackson, J Mark; Menter, Alan; Kimball, Alexandra Boer

    2016-02-01

    There are a significant number of dermatoses associated with renal abnormalities and disease, and dermatologists need to be keenly aware of their presence in order to avoid overlooking important skin conditions with potentially devastating renal complications. This review discusses important nephrocutaneous disease associations and recommendations for the appropriate urgency of referral to nephrology colleagues for diagnosis, surveillance, and early management of potential renal sequelae. Part II of this 2-part continuing medical education article addresses inflammatory and medication-related nephrocutaneous associations.

  18. Association between asthma and obesity among immigrant Asian Americans, California Health Interview Survey, 2001-2011.

    Science.gov (United States)

    Becerra, Benjamin J; Scroggins, Christy M; Becerra, Monideepa B

    2014-11-26

    Our objective was to study the comorbidity of asthma and obesity among foreign-born Asian Americans, by subgroups. Public data from the California Health Interview Survey, 2001-2011, were analyzed by using independent logistic regressions, yielding the association between asthma and obesity (Asian and standard cutoffs for body mass index [BMIs]) of 19,841 Asian American immigrant respondents. Chinese, Filipino, South Asian, and Japanese immigrants had a positive association between lifetime asthma and obesity, whereas among Korean immigrants, a positive association was found between lifetime asthma and overweight status (standard BMI cutoffs). Routine screening for this comorbidity is warranted among immigrant Asian Americans.

  19. Statistical study of seismicity associated with geothermal reservoirs in California

    Energy Technology Data Exchange (ETDEWEB)

    Hadley, D.M.; Cavit, D.S.

    1982-01-01

    Statistical methods are outlined to separate spatially, temporally, and magnitude-dependent portions of both the random and non-random components of the seismicity. The methodology employed compares the seismicity distributions with a generalized Poisson distribution. Temporally related events are identified by the distribution of the interoccurrence times. The regions studied to date include the Imperial Valley, Coso, The Geysers, Lassen, and the San Jacinto fault. The spatial characteristics of the random and clustered components of the seismicity are diffuse and appear unsuitable for defining the areal extent of the reservoir. However, from the temporal characteristics of the seismicity associated with these regions a general discriminant was constructed that combines several physical parameters for identifying the presence of a geothermal system.

  20. Does Moral Distress Differ Between California Certified Registered Nurse Anesthetists in Independent Versus Medically Supervised Practice: An Exploratory Study.

    Science.gov (United States)

    Dumouchel, Michael; Boytim, Michael; Gorman, Nicholas; Weismuller, Penny

    2015-06-01

    The purpose of this exploratory, descriptive study was to determine if moral distress levels differed between certified registered nurse anesthetists (CRNAs) working in medically supervised versus independent practice in California. A 63-question survey was administered to 1,190 California CRNAs. Moral distress was measured by the included Ethics Stress Scale. The response rate was 14.7%, yielding demographic and Ethics Stress scores for 175 respondents. Sixty-five participants answered an open-ended question about moral distress yielding qualitative data. Medically supervised CRNAs had a lower mean moral distress scores (176.8) versus independent practice CRNAs (187.8) (p = .002). Lower scores on the ESS indicate higher moral distress. Qualitative data demonstrated that CRNAs experienced moral distress in the following situations: when pressured to give anesthesia to unoptimized patients, when differences of opinion regarding anesthetic plans occurred, in dealing with end-of-life issues, when working with incompetent providers, and during interprofessional struggles between CRNAs and anesthesiologists. In order to reduce moral distress among CRNAs, implications for practice include increased administrative support, increased communication and reciprocated collegial respect between anesthesiologists and CRNAs, and CRNA representation on ethics committees.

  1. Update: mercury poisoning associated with beauty cream--Arizona, California, New Mexico, and Texas, 1996.

    Science.gov (United States)

    1996-07-26

    During September 1995-May 1996, the Texas Department of Health (TDH), the New Mexico Department of Health (NMDH), and the San Diego County (California) Health Department investigated three cases of mercury poisoning associated with the use of a mercury-containing beauty cream produced in Mexico. The ongoing investigation has found this product in shops and flea markets in the United States located near the U.S.-Mexico border, and a U.S. distributor has been identified in Los Angeles. The cream, marketed as "Crema de Belleza--Manning" for skin cleansing and prevention of acne, listed "calomel" (mercurous chloride [Hg2Cl2]) as an ingredient and contained 6% to 10% mercury by weight. This report presents findings of a continuing investigation by these health departments, the Arizona Dept of Health Services (ADHS), California State Department of Health Services (CSDHS), the Food and Drug Administration (FDA), and CDC.

  2. The "nuts and bolts" of implementing shared medical appointments: the Harvard Vanguard Medical Associates experience.

    Science.gov (United States)

    Berger-Fiffy, Jill

    2012-01-01

    Harvard Vanguard Medical Associates (Harvard Vanguard) decided to develop a Shared Medical Appointment (SMA) program in 2007 for a variety of reasons. The program has launched 86 SMAs in 17 specialties at 12 sites and has exceeded 13 000 patient visits. Currently, the practice offers 54 SMAs and is believed to be the largest program in the country. This article provides an overview regarding staffing, space and equipment, project planning, promotional materials, training programs, workflow development, and the use of quality improvement (ie, LEAN) tools used to monitor the work to be completed and the metrics to date.

  3. Frequency and risk factors associated with emergency medical readmissions in Galway University Hospitals.

    LENUS (Irish Health Repository)

    Gorman, J

    2010-06-01

    Unplanned readmissions of medical hospital patients have been increasing in recent years. We examined the frequency and associates of emergency medical readmissions to Galway University Hospitals (GUH).

  4. Measles outbreak associated with an arriving refugee - Los Angeles County, California, August-September 2011.

    Science.gov (United States)

    2012-06-01

    Measles is a highly communicable, acute viral illness with potential for severe complications, including death. Although endemic measles was eliminated in the United States in 2000 as a result of widespread vaccination, sporadic measles outbreaks still occur, largely associated with international travel from measles-endemic countries and pockets of unvaccinated persons. On August 26, 2011, the Los Angeles County Department of Public Health (LACDPH) was notified of suspected measles in a refugee from Burma who had arrived in Los Angeles, California, on August 24, after a flight from Kuala Lumpur, Malaysia. Passengers on the flight included 31 other refugees who then traveled to seven other states, widening the measles investigation and response activities. In California alone, 50 staff members from LACDPH and the California Department of Public Health (CDPH) interviewed and reinterviewed 298 contacts. Measles was diagnosed in three contacts of the index patient (patient A). The three contacts with measles were two passengers on the same flight as patient A and a customs worker; no secondary cases were identified. Delayed diagnosis of measles in patient A and delayed notification of health officials precluded use of measles-mumps-rubella (MMR) vaccine as an outbreak intervention. This outbreak emphasizes the importance of maintaining a high level of vaccination coverage and continued high vigilance for measles in the United States, particularly among incoming international travelers; clinicians should immediately isolate persons with suspected measles and promptly report them to health authorities.

  5. The Association of Academic Health Sciences Libraries' collaboration with the Association of American Medical Colleges, Medical Library Association, and other organizations.

    Science.gov (United States)

    Jenkins, Carol G; Bader, Shelley A

    2003-04-01

    The Association of Academic Health Sciences Libraries has made collaboration with other organizations a fundamental success strategy throughout its twenty-five year history. From the beginning its relationships with Association of American Medical Colleges and with the Medical Library Association have shaped its mission and influenced its success at promoting academic health sciences libraries' roles in their institutions. This article describes and evaluates those relationships. It also describes evolving relationships with other organizations including the National Library of Medicine and the Association of Research Libraries.

  6. Medical Care Provided Under California's Workers' Compensation Program: Effects of the Reforms and Additional Opportunities to Improve the Quality and Efficiency of Care.

    Science.gov (United States)

    Wynn, Barbara O; Timbie, Justin W; Sorbero, Melony E

    2011-01-01

    Since 2004, significant changes have been made to the California workers' compensation (WC) system. The Commission on Health and Safety and Workers' Compensation (CHSWC) asked the RAND Corporation to examine the impact that these changes have on the medical care provided to injured workers. This study synthesizes findings from interviews and available information regarding the implementation of the changes affecting WC medical care and identifies areas in which additional changes might increase the quality and efficiency of care delivered under the WC system. To improve incentives for efficiently providing medically appropriate care, California should revise its fee schedule allowances for services provided by hospitals to inpatients, freestanding ambulatory surgery centers, and physicians, create nonmonetary incentives for providing medically appropriate care in the medical provider network (MPN) context through more-selective contracting with providers and reducing medical review requirements for high-performing physicians; reduce incentives for inappropriate prescribing practices by curtailing in-office physician dispensing; and implement pharmacy benefit network regulations. To increase accountability for performance, California should revise the MPN certification process to place accountability for meeting MPN standards on the entity contracting with the physician network; strengthen Division of Workers' Compensation (DWC) authorities to provide intermediate sanctions for failure to comply with MPN requirements; and modify the Labor Code to remove payers and MPNs from the definition of individually identifiable data so that performance on key measures can be publicly available. To facilitate monitoring and oversight, California should provide DWC with more flexibility to add needed data elements to medical data reporting and provide penalties for a claim administrator failing to comply with the data-reporting requirements; require that medical cost

  7. Physicians' attitudes toward homosexuality and HIV: survey of a California Medical Society- revisited (PATHH-II).

    Science.gov (United States)

    Smith, Davey M; Mathews, Wm Christopher

    2007-01-01

    In 1982, Mathews et al. surveyed San Diego County Medical Society's (SDCMS) physicians about their attitudes toward homosexuality. They found significant differences in prevalence of homophobic attitudes by gender, year of medical school graduation, specialty, and practice setting. To assess current physicians' attitudes toward homosexuality and persons with HIV infection, an anonymous, self-administered, 17-item survey was mailed to all 4,385 members of the SDCMS and 1,271 UCSD physicians. The survey included items measuring attitudes toward homosexuality and toward entry to medical school and referral patterns, conditional on sexual orientation and HIV status of hypothetical referents. Only 3% of respondents would not admit a highly qualified homosexual applicant to medical school compared with 30% in 1982. Similarly, 9% would discontinue referrals to a gay pediatrician compared with 46% of respondents in 1982. Forty-two percent would not admit a "highly qualified but asymptomatic HIV-infected applicant with excellent response to antiretroviral therapy to medical school" and 66% would discontinue referral to a general surgeon known to be HIV infected. In multiple logistic regression analyses controlling for sex and medical school affiliation, significant (p school and degree of homophobia (model ROC = 0.77). This survey suggests a substantial reduction in homophobia since 1982. However, attitudes toward homosexuals and year of graduation from medical school appear to be significant predictors of attitudes toward persons with HIV infection.

  8. MEDICAL ISSUES ASSOCIATED WITH ANABOLIC STEROID USE: ARE THEY EXAGGERATED?

    Directory of Open Access Journals (Sweden)

    Jay R. Hoffman

    2006-06-01

    Full Text Available For the past 50 years anabolic steroids have been at the forefront of the controversy surrounding performance enhancing drugs. For almost half of this time no attempt was made by sports governing bodies to control its use, and only recently have all of the major sports governing bodies in North America agreed to ban from competition and punish athletes who test positive for anabolic steroids. These punitive measures were developed with the primary concern for promotion of fair play and eliminating potential health risks associated with androgenic-anabolic steroids. Yet, controversy exists whether these testing programs deter anabolic steroid use. Although the scope of this paper does not focus on the effectiveness of testing, or the issue of fair play, it is of interest to understand why many athletes underestimate the health risks associated from these drugs. What creates further curiosity is the seemingly well-publicized health hazards that the medical community has depicted concerning anabolic steroidabuse. Is there something that the athletes know, or are they simply naïve regarding the dangers? The focus of this review is to provide a brief history of anabolic steroid use in North America, the prevalence of its use in both athletic and recreational populations and its efficacy. Primary discussion will focus on health issues associated with anabolic steroid use with an examination of the contrasting views held between the medical community and the athletes that are using these ergogenic drugs. Existing data suggest that in certain circumstances the medical risk associated with anabolic steroid use may have been somewhat exaggerated, possibly to dissuade use in athletes

  9. Conceptualisations of masculinity and self-reported medication adherence among HIV-positive Latino men in Los Angeles, California, USA.

    Science.gov (United States)

    Galvan, Frank H; Bogart, Laura M; Wagner, Glenn J; Klein, David J; Chen, Ying-Tung

    2014-06-01

    HIV-positive Latino men have been found to have poorer medication adherence compared to Whites. This study sought to identify how cultural conceptualisations of masculinity are associated with self-reported medication adherence among Latino men. A total of 208 HIV-positive men reported the number of doses of antiretroviral medication missed in the previous seven days (dichotomised at 100% adherence versus less). Conceptualisations of masculinity consisted of traditional machismo (e.g., power and aggressive attitudes, which are normally associated with negative stereotypes of machismo) and caballerismo (e.g., fairness, respect for elders and the importance of family). Multivariate logistic regression was used to identify factors associated with adherence. The mean adherence was 97% (SD = 6.5%; range = 57-100%). In all, 77% of the participants reported 100% adherence in the previous seven days. Caballerismo was associated with a greater likelihood (OR = 1.77; 95% CI: 1.08-2.92; p = 0.03) and machismo with a lower likelihood (OR = 0.60; 95% CI: 0.38-0.95; p = 0.03) of medication adherence. In addition, higher medication side-effects were found to be associated with a lower likelihood (OR = 0.59; 95% CI: 0.43-0.81; p = 0.001) of medication adherence. These findings reinforce the importance of identifying cultural factors that may affect medication adherence among HIV-positive Latino men resident in the USA.

  10. Medical issues associated with anabolic steroid use: are they exaggerated?

    Science.gov (United States)

    Hoffman, Jay R; Ratamess, Nicholas A

    2006-01-01

    For the past 50 years anabolic steroids have been at the forefront of the controversy surrounding performance enhancing drugs. For almost half of this time no attempt was made by sports governing bodies to control its use, and only recently have all of the major sports governing bodies in North America agreed to ban from competition and punish athletes who test positive for anabolic steroids. These punitive measures were developed with the primary concern for promotion of fair play and eliminating potential health risks associated with androgenic-anabolic steroids. Yet, controversy exists whether these testing programs deter anabolic steroid use. Although the scope of this paper does not focus on the effectiveness of testing, or the issue of fair play, it is of interest to understand why many athletes underestimate the health risks associated from these drugs. What creates further curiosity is the seemingly well-publicized health hazards that the medical community has depicted concerning anabolic steroidabuse. Is there something that the athletes know, or are they simply naïve regarding the dangers? The focus of this review is to provide a brief history of anabolic steroid use in North America, the prevalence of its use in both athletic and recreational populations and its efficacy. Primary discussion will focus on health issues associated with anabolic steroid use with an examination of the contrasting views held between the medical community and the athletes that are using these ergogenic drugs. Existing data suggest that in certain circumstances the medical risk associated with anabolic steroid use may have been somewhat exaggerated, possibly to dissuade use in athletes. Key PointsFor many years the scientific and medical communities depicted a lack of efficacy and serious adverse effects from anabolic steroid use.Clinical case studies continue to link anabolic steroid administration with myocardial infarct, suicide, and cancer, evidence to support a cause and

  11. Association between CFL1 gene polymorphisms and spina bifida risk in a California population

    Directory of Open Access Journals (Sweden)

    Lammer Edward J

    2007-03-01

    Full Text Available Abstract Background CFL1 encodes human non-muscle cofilin (n-cofilin, which is an actin-depolymerizing factor and is essential in cytokinesis, endocytosis, and in the development of all embryonic tissues. Cfl1 knockout mice exhibit failure of neural tube closure at E10.5 and die in utero. We hypothesized that genetic variation within the human CFL1 gene may alter the protein's function and result in defective actin depolymerizing and cellular activity during neural tube closure. Such alterations may be associated with an increased risk for neural tube defects (NTDs. Methods Having re-sequenced the human CFL1 gene and identified five common single nucleotide polymorphisms (SNPs in our target population, we investigated whether there existed a possible association between the genetic variations of the CFL1 gene and risk of spina bifida. Samples were obtained from a large population-based case-control study in California. Allele association, genotype association and haplotype association were evaluated in two different ethnicity groups, non-Hispanic white and Hispanic white. Results Homozygosity for the minor alleles of the SNPs studied (rs652021, rs665306, rs667555, rs4621 and rs11227332 appeared to produce an increased risk for spina bifida. Subjects with the haplotype composed of all minor alleles (CCGGT appeared to have increased spina bifida risk (OR = 1.6, 95% CI: 0.9~2.9, however, this finding is not statistically significant likely due to limited sample size. Conclusion The sequence variation of human CFL1 gene is a genetic modifier for spina bifida risk in this California population.

  12. Developing Information on Energy Savings and Associated Costs and Benefits of Energy Efficient Emerging Technologies Applicable in California

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Tengfang; Slaa, Jan Willem; Sathaye, Jayant

    2010-12-15

    Implementation and adoption of efficient end-use technologies have proven to be one of the key measures for reducing greenhouse gas (GHG) emissions throughout the industries. In many cases, implementing energy efficiency measures is among one of the most cost effective investments that the industry could make in improving efficiency and productivity while reducing carbon dioxide (CO2) emissions. Over the years, there have been incentives to use resources and energy in a cleaner and more efficient way to create industries that are sustainable and more productive. With the working of energy programs and policies on GHG inventory and regulation, understanding and managing the costs associated with mitigation measures for GHG reductions is very important for the industry and policy makers around the world and in California. Successful implementation of applicable emerging technologies not only may help advance productivities, improve environmental impacts, or enhance industrial competitiveness, but also can play a significant role in climate-mitigation efforts by saving energy and reducing the associated GHG emissions. Developing new information on costs and savings benefits of energy efficient emerging technologies applicable in California market is important for policy makers as well as the industries. Therefore, provision of timely evaluation and estimation of the costs and energy savings potential of emerging technologies applicable to California is the focus of this report. The overall goal of the project is to identify and select a set of emerging and under-utilized energy-efficient technologies and practices as they are important to reduce energy consumption in industry while maintaining economic growth. Specifically, this report contains the results from performing Task 3 Technology Characterization for California Industries for the project titled Research Opportunities in Emerging and Under-Utilized Energy-Efficient Industrial Technologies, sponsored by

  13. Polypharmacy patterns: unravelling systematic associations between prescribed medications.

    Directory of Open Access Journals (Sweden)

    Amaia Calderón-Larrañaga

    Full Text Available OBJECTIVES: The aim of this study was to demonstrate the existence of systematic associations in drug prescription that lead to the establishment of patterns of polypharmacy, and the clinical interpretation of the associations found in each pattern. METHODS: A cross-sectional study was conducted based on information obtained from electronic medical records and the primary care pharmacy database in 2008. An exploratory factor analysis of drug dispensing information regarding 79,089 adult patients was performed to identify the patterns of polypharmacy. The analysis was stratified by age and sex. RESULTS: Seven patterns of polypharmacy were identified, which may be classified depending on the type of disease they are intended to treat: cardiovascular, depression-anxiety, acute respiratory infection (ARI, chronic obstructive pulmonary disease (COPD, rhinitis-asthma, pain, and menopause. Some of these patterns revealed a clear clinical consistency and included drugs that are prescribed together for the same clinical indication (i.e., ARI and COPD patterns. Other patterns were more complex but also clinically consistent: in the cardiovascular pattern, drugs for the treatment of known risk factors-such as hypertension or dyslipidemia-were combined with other medications for the treatment of diabetes or established cardiovascular pathology (e.g., antiplatelet agents. Almost all of the patterns included drugs for preventing or treating potential side effects of other drugs in the same pattern. CONCLUSIONS: The present study demonstrated the existence of non-random associations in drug prescription, resulting in patterns of polypharmacy that are sound from the pharmacological and clinical viewpoints and that exist in a significant proportion of the population. This finding necessitates future longitudinal studies to confirm some of the proposed causal associations. The information discovered would further the development and/or adaptation of clinical

  14. Associations with E-cigarette use among Asian American and Pacific Islander young adults in California.

    Science.gov (United States)

    Maglalang, Dale Dagar; Brown-Johnson, Cati; Prochaska, Judith J

    2016-12-01

    With attention to the rapidly growing market of electronic nicotine delivery systems (ENDS/e-cigarettes) and the fastest growing US ethnic minority group, the current study explored associations between awareness, perceived risks, and use of ENDS among Asian American and Pacific Islander (AAPI) young adults. AAPI young adults (ages 18-25) in California were recruited via social media, college classes, listservs for AAPI-serving non-profits, and snowball sampling to complete an anonymous survey between 2014 and 2015. The sample (N = 501) was 57% women, 15% LGBTQIA; with a mean age of 21; 26% foreign-born; identifying as Filipino (29%), Chinese (24%), Vietnamese (14%), mixed-AAPI heritage (13%), or 21% other. Nearly half the sample (44%) reported ever ENDS use; 11% were current users. Current ENDS use was twofold greater for: Filipino and Vietnamese compared to Chinese respondents; men versus women; LGBTQIA-identified respondents; those vocationally trained; and employed. Awareness of ENDS from peers/friends was most common and was associated with ever though not current ENDS use. Most respondents perceived ENDS as harmful (62%); low compared to high risk perception was associated with a three-fold greater likelihood of ever use and six-fold greater likelihood of current use. Popular flavors were fruit (49%, e.g., lychee, taro) and candy/sweets (26%). Current users viewed ENDS as a healthier alternative or quit aid for conventional cigarettes (42%); recreation/social use (33%) also was common. Findings indicate ENDS visibility among AAPI young adults in California with affinity for flavors and many engaging in trial and current use for harm reduction and recreational/social aims.

  15. SELF MEDICATION PATTERN, INCIDENCE AND FACTORS ASSOCIATED WITH IT, AMONG FIRST YEAR MBBS STUDENTS OF MEDICAL COLLEGE JAMMU

    Directory of Open Access Journals (Sweden)

    Nusrat

    2015-02-01

    Full Text Available Self - medication is quite common practice in general and particularly among medical students. Self - medication can be defined as obtaining and consuming medication without the advice of a clinician for treatment of an ailment. There can be many reasons for increased likelihood of self - medication among the medical students like easy access and senior medical student’s advice, easy access to physician’s samples, because of the white coat, from pharmacist / chemist shops. 1 However self - medication can be quite harmful and can be associated with significant morbidity and mortality. It could lead to various complications and side effects like - habituation and addiction, poisoning, hyper vitaminosis, antibiotic resistance and incorrect and delayed diagnosis, over diagnosis or under diagnosis, at times really serious and fatal consequences can occur. It results in wastage of resources, increase resistance of pathogens and can causes serious hazards like adverse drug reaction, prolonged suffering and drug dependence. This study was performed to assess and evaluate the incidence and awareness of self - medications among the medical students of first professional MBBS in medical college Ja mmu. A study on one hundred medical students of Jammu medical college was conducted to assess and evaluates the pattern of self - medication among these students. This study was done to know the frequencies and reasons and the pattern of self - medication among young medical students of Jammu region. A detail questionnaire was prepared and each student was asked to fill up the Performa and then the data was analyzed. It was found that self - medication is very common (90 % and is comparable to studies from other parts of the world. For most of them the reason for self - medication was common cold . The result emphasizes the amount of problem in the society about self - medication and lack of awareness about side effects. Hence more strict regulations are

  16. Basic research on cancer related to radiation associated medical researches

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jong In; Hwang, Dae Yong; Bang, Ho Yoon [and others

    2000-12-01

    Basic Research on Cancer related to Radiation Associated Medical Researches including 1. Establishment of animal model of colorectal cancer liver metastasis and measurement of angiogenesis, 2. Tissue expression of Tie-1 and Tie-2 in human colorectal cancer, 3. Enhancement of G2/Mphase Cell Fraction by Adenovirus-mediated p53 Gene Transfer in Ovarian Cancer Cell Lines, 4. Clinical Characteristics of the patients with Non-B Non-C Hepatocellular Carcinoma and Frequency of HBV, HCV and TTV Viremia in these Patients, 5. Significance of serum iron and ferritin in patients with stomach cancer, 6. Telomerase assay for early detection of lung cancer, 7. Study on the Usefulness of Aldehyde dehydrogenase-2 Genotyping for Risk Group of Alcohol-related Cancer Screening, 8. Gene therapy using hepatoma specific promoter, 9. Study on the Influence of DNA repair gene, XRCC1 Genotypes on the Risk of Head and Neck Cancer were performed.

  17. ASSOCIATION BETWEEN POSITIVE CANINE HEARTWORM (DIROFILARIA IMMITIS) ANTIGEN RESULTS AND PRESENCE OF ACANTHOCHEILONEMA ODENDHALI MICROFILARIA IN CALIFORNIA SEA LIONS (ZALOPHUS CALIFORNIANUS).

    Science.gov (United States)

    Krucik, David D R; Van Bonn, William; Johnson, Shawn P

    2016-03-01

    This study establishes a relationship between positive canine heartworm (Dirofilaria immitis) test results frequently observed in California sea lions (Zalophus californianus) and infection with the filarid nematode Acanthocheilonema odendhali. Four commercially available canine heartworm antigen tests were evaluated for cross-reaction with A. odendhali in California sea lions. Sera were tested from fifteen California sea lions with A. odendhali-associated microfilaremia, confirmed by blood smear, and with no evidence of D. immitis infection at necropsy. Ninety-five percent of tests were falsely positive for D. immitis. This study also determined that the prevalence of A. odendhali infection in stranded California sea lions from central California is approximately 23% by comparing the number of findings of mircofilaremia to the total number of California sea lions sampled at The Marine Mammal Center between 2005 and 2011, inclusive. Acanthocheilonema odenhali microfilaremia in California sea lions is likely to cross-react with canine heartworm antigen tests, and clinicians should interpret results with caution.

  18. Palliative sedation : not just normal medical practice. Ethical reflections on the Royal Dutch Medical Association's guideline on palliative sedation

    NARCIS (Netherlands)

    Janssens, Rien; van Delden, Johannes J. M.; Widdershoven, Guy A. M.

    2012-01-01

    The main premise of the Royal Dutch Medical Association's (RDMA) guideline on palliative sedation is that palliative sedation, contrary to euthanasia, is normal medical practice. Although we do not deny the ethical distinctions between euthanasia and palliative sedation, we will critically analyse t

  19. Factors associated with dropout in medical education: a literature review

    DEFF Research Database (Denmark)

    O'Neill, Lotte Dyhrberg; Wallstedt, Birgitta; Eika, Berit

    2011-01-01

    Medical school dropout may have negative consequences for society, patients, the profession, schools and dropouts. To our knowledge, the literature dealing with dropout from medical school has never been systematically and critically appraised.......Medical school dropout may have negative consequences for society, patients, the profession, schools and dropouts. To our knowledge, the literature dealing with dropout from medical school has never been systematically and critically appraised....

  20. Perceived need to take medication is associated with medication non-adherence in patients with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Zwikker HE

    2014-11-01

    Full Text Available Hanneke E Zwikker,1,2 Sandra van Dulmen,3–5 Alfons A den Broeder,1,2 Bart J van den Bemt,1,2,6 Cornelia H van den Ende1,2 1Department of Rheumatology, 2Department of Pharmacy, Sint Maartenskliniek, Nijmegen, the Netherlands; 3Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, the Netherlands; 4NIVEL (Netherlands Institute for Health Services Research, Utrecht, the Netherlands; 5Department of Health Science, Buskerud and Vestfold University College, Drammen, Norway; 6Department of Pharmacy, Radboud University Medical Centre, Nijmegen, the Netherlands Background: This is the first cross-sectional study that aims to examine associations between beliefs about medication and non-adherence in patients with rheumatoid arthritis (RA using disease-modifying antirheumatic drugs, taking potential psychological confounders into account.Methods: Eligible patients (diagnosed with RA for ≥1 year or ≥18 years, using greater than or equal to one disease-modifying antirheumatic drug were included by their rheumatologist during regular outpatient visits between September 2009 and September 2010. Included patients received questionnaires. The Beliefs about Medicines Questionnaire was used to measure the perceived need to take medication (necessity beliefs, the concerns about taking medication (concern beliefs, general medication beliefs, and attitudes toward taking medication. Medication non-adherence (no/yes was measured using the Compliance Questionnaire Rheumatology (CQR. Associations between beliefs and non-adherence, and the influence of demographical, clinical, and psychological factors (symptoms of anxiety/depression, illness cognitions, self-efficacy were assessed using logistic regression.Results: A total of 580 of the 820 eligible patients willing to participate were included in the analyses (68% female, mean age 63 years, 30% non-adherent to their medication. Weaker necessity beliefs (OR [odds ratio]: 0.8, 95% CI

  1. Firearm-associated deaths and hospitalizations--California, 1995-1996.

    Science.gov (United States)

    1999-06-18

    During 1995-1996, 27% of recorded injury-related deaths in California involved firearms (California Department of Health Services [CDHS], unpublished data, 1995-1996). In 1996, CDHS began passive surveillance of "severe" firearm-related injuries (i.e., resulting in death or hospitalization) with resources provided by the California Wellness Foundation. To characterize firearm-related injuries in California, CDHS analyzed death records and hospital discharge records for 1995 and 1996 (the most recent years for which population data are available to calculate rates). This report summarizes the results of the analysis, which indicate that most of the 21,985 firearm-related injuries and deaths resulted from assault.

  2. Association of an unusual marine mammal mortality event with Pseudo-nitzschia spp. Blooms along the southern California coastline.

    Science.gov (United States)

    de la Riva, Gretel Torres; Johnson, Christine Kreuder; Gulland, Frances M D; Langlois, Gregg W; Heyning, John E; Rowles, Teri K; Mazet, Jonna A K

    2009-01-01

    During 2002, 2,239 marine mammals stranded in southern California. This unusual marine mammal stranding event was clustered from April to June and consisted primarily of California sea lions (Zalophus californianus) and long-beaked common dolphins (Delphinus capensis) with severe neurologic signs. Intoxication with domoic acid (DA), a marine neurotoxin produced during seasonal blooms of Pseudo-nitzschia spp., was suspected. Definitively linking harmful algal blooms to large-scale marine mammal mortalities presents a substantial challenge, as does determining the geographic extent, species composition, and potential population impacts of marine mammal die-offs. For this reason, time series cross-correlation analysis was performed to test the temporal correlations of Pseudo-nitzschia blooms with strandings occurring along the southern California coastline. Temporal correlations were identified between strandings and blooms for California sea lions, long-beaked common dolphins, and short-beaked common dolphins (Delphinus delphis). Similar correlations were identified for bottlenose dolphins (Tursiops truncatus) and gray whales (Eschrichtius robustus), but small sample sizes for these species made associations more speculative. The timing of the blooms and strandings of marine mammals suggested that both inshore and offshore foraging species were affected and that marine biotoxin programs should include offshore monitoring sites. In addition, California sea lion-strandings appear to be a very sensitive indicator of DA in the marine environment, and their monitoring should be included in public health surveillance plans.

  3. Libraries in California: MedlinePlus

    Science.gov (United States)

    ... Library → Libraries in California URL of this page: https://medlineplus.gov/libraries/california.html Libraries in California ... Alameda, CA 94501 510-522-3700 ext. 3331 http://www.alamedahospital.org Anaheim Anaheim Regional Medical Center ...

  4. Long term marijuana users seeking medical cannabis in California (2001–2007: demographics, social characteristics, patterns of cannabis and other drug use of 4117 applicants

    Directory of Open Access Journals (Sweden)

    Bou-Matar Ché B

    2007-11-01

    Full Text Available Abstract Background Cannabis (marijuana had been used for medicinal purposes for millennia. Cannabinoid agonists are now attracting growing interest and there is also evidence that botanical cannabis is being used as self-medication for stress and anxiety as well as adjunctive therapy by the seriously ill and by patients with terminal illnesses. California became the first state to authorize medicinal use of cannabis in 1996, and it was recently estimated that between 250,000 and 350,000 Californians may now possess the physician's recommendation required to use it medically. More limited medical use has also been approved in 12 additional states and new initiatives are being considered in others. Despite that evidence of increasing public acceptance of "medical" use, a definitional problem remains and all use for any purpose is still prohibited by federal law. Results California's 1996 initiative allowed cannabis to be recommended, not only for serious illnesses, but also "for any other illness for which marijuana provides relief," thus maximally broadening the range of allowable indications. In effect, the range of conditions now being treated with federally illegal cannabis, the modes in which it is being used, and the demographics of the population using it became potentially discoverable through the required screening of applicants. This report examines the demographic profiles and other selected characteristics of 4117 California marijuana users (62% from the Greater Bay Area who applied for medical recommendations between late 2001 and mid 2007. Conclusion This study yielded a somewhat unexpected profile of a hitherto hidden population of users of America's most popular illegal drug. It also raises questions about some of the basic assumptions held by both proponents and opponents of current policy.

  5. A divergent variant of Grapevine leafroll-associated virus 3 is present in California

    Directory of Open Access Journals (Sweden)

    Seah YeeMey

    2012-10-01

    Full Text Available Abstract Background Grapevine leafroll-associated viruses are a problem for grape production globally. Symptoms are caused by a number of distinct viral species. During a survey of Napa Valley vineyards (California, USA, we found evidence of a new variant of Grapevine leafroll-associated virus 3 (GLRaV-3. We isolated its genome from a symptomatic greenhouse-raised plant and fully sequenced it. Findings In a maximum likelihood analysis of representative GLRaV-3 gene sequences, the isolate grouped most closely with a recently sequenced variant from South Africa and a partial sequence from New Zealand. These highly divergent GLRaV-3 variants have predicted proteins that are more than 10% divergent from other GLRaV-3 variants, and appear to be missing an open reading frame for the p6 protein. Conclusions This divergent GLRaV-3 phylogroup is already present in grape-growing regions worldwide and is capable of causing symptoms of leafroll disease without the p6 protein.

  6. The Mono Arch, eastern Sierra region, California: Dynamic topography associated with upper-mantle upwelling?

    Science.gov (United States)

    Jayko, A.S.

    2009-01-01

    A broad, topographic flexure localized east of and over the central and southern Sierra Nevada, herein named the Mono Arch, apparently represents crustal response to lithospheric and/or upper-mantle processes, probably dominated by mantle upwelling within the continental interior associated Pacific-North American plate-boundary deformation. This zone of flexure is identified through comparison between the topographic characteristics of the active Cascade volcanic arc and backarc regions with the analogous former arc and backarc in the Sierra Nevada and eastern Sierra Nevada. Serial topographic profiles measured normal to the modern Cascade backarc reveal an accordance of topographic lows defined by valley floors with an average minimum elevation of ???1400-1500m for over 175km to the southeast. Although the accordance drops in elevation slightly to the south, the modern Cascade backarc region is remarkably level, and is characterized by relief up to ???750m above this baseline elevation. By contrast, serial topographic profiles over the former arc and backarc transitions of the eastern Sierra region exhibit a regional anticlinal warping defined by accordant valley floors and by a late Miocene-early Pliocene erosion surface and associated deposits. The amplitude of this flexure above regionally flat baseline elevations to the east varies spatially along the length of the former Sierran arc, with a maximum of ???1000m centred over the Bridgeport Basin. The total zone of flexure is approximately 350km long N-S and 100km wide E-W, and extends from Indian Wells Valley in the south to the Sonora Pass region in the north. Previous geophysical, petrologic, and geodetic studies suggest that the Mono Arch overlies a zone of active mantle upwelling. This region also represents a zone crustal weakness formerly exploited by the middle-to-late Miocene arc and is presently the locus of seismic and volcanic activities. This seismic zone, which lies east of the Sierra Nevada block

  7. The Oral History Program: II. Personal views of health sciences librarianship and the Medical Library Association.

    Science.gov (United States)

    McKenzie, D; Pifalo, V

    1998-07-01

    The Medical Library Association Oral History Program uses accepted oral history techniques to collect and preserve interviews with members. The original taped interviews and transcripts are kept in the Medical Library Association archives and made available for research purposes; edited copies of the interviews are distributed through the National Network of Libraries of Medicine, and members are encouraged to borrow and read the histories. Summaries of forty-three interviews provide personal views on health sciences librarianship and the Medical Library Association.

  8. Associations Between Patient Characteristics and the Amount of Arthritis Medication Information Patients Receive.

    Science.gov (United States)

    Geryk, Lorie Love; Blalock, Susan; DeVellis, Robert F; Morella, Kristen; Carpenter, Delesha Miller

    2016-10-01

    Little is known about factors associated with the receipt of medication information among arthritis patients. This study explores information source receipt and associations between demographic and clinical/patient characteristics and the amount of arthritis medication information patients receive. Adult patients with osteoarthritis (OA) or rheumatoid arthritis (RA; n = 328) completed an online cross-sectional survey. Patients reported demographic and clinical/patient characteristics and the amount of arthritis medication information received from 15 information sources. Bivariate and multivariate linear regression analyses were used to investigate whether those characteristics were associated with the amount of medication information patients received. Arthritis patients received the most information from health professionals, followed by printed materials, media sources, and interpersonal sources. Greater receipt of information was associated with greater medication adherence, taking more medications, greater medication-taking concerns, more satisfaction with doctor medication-related support, and Black compared to White race. RA patients reported receiving more information compared to OA patients, and differences were found between RA patients and OA patients in characteristics associated with more information receipt. In conclusion, arthritis patients received the most medication information from professional sources, and both positive (e.g., greater satisfaction with doctor support) and negative (e.g., more medication-taking concerns) characteristics were associated with receiving more medication information.

  9. Factors Associated With False-Positive Emergency Medical Services Triage for Percutaneous Coronary Intervention

    Directory of Open Access Journals (Sweden)

    Yamamoto Swan, Pamela

    2009-11-01

    Full Text Available Background: In 2005, Orange County California Emergency Medical Services (EMS initiated a field 12-lead program to minimize time to emergency percutaneous coronary intervention (PCI for field-identified acute myocardial infarction (MI. As the program matured, “false-positive” (defined as no PCI or coronary artery occlusion upon PCI field MI activations have been identified as a problem for the program.Objectives: To identify potentially correctable factors associated with false-positive EMS triage to PCI centers.Methods: This was a retrospective, outcome study of EMS 12-lead cases from February 2006 to June 2007. The study system exclusively used cardiac monitor internal interpretation algorithms indicating an acute myocardial infarction as the basis for triage. Indicators and variables were defined prior to the study. Data, including outcome, was from the Orange County EMS database, which included copies of 12-lead ECGs used for field triage. Negative odds ratios (OR of less than 1.0 for positive PCI were the statistical measure of interest.Results: Five hundred forty-eight patients were triaged from the field for PCI. We excluded 19 cases from the study because of death prior to PCI, refusal of PCI, and co-morbid illness (sepsis, altered consciousness that precluded PCI. Three hundred ninety-three (74.3% patients had PCI with significant coronary lesions found. False-positive field triages were associated with underlying cardiac rhythm of sinus tachycardia [OR = 0.38 (95% CI 0.23, 0.62]; atrial fibrillation [OR = 0.43 (95% CI = 0.20, 0.94]; an ECG lead not recorded [OR = 0.39 (95% CI = 0.20, 0.76]; poor ECG baseline [OR = 0.59 (95% CI = 0.25, 1.37]; One of three brands of monitors used in the field [OR = 0.35 (95% CI = 0.21, 0.59]; and female gender [OR = 0.50 (95% CI = 0.34, 0.75]. Age was not associated with false-positive triage as determined by ordinal regression (p=1.00.Conclusion: For the urban-suburban EMS field 12-lead program

  10. The association between the use of parents' and childrens' medication.

    NARCIS (Netherlands)

    Dijk, L. van; Cardol, M.

    2005-01-01

    Background: Family background influences medical consumption. For example, 22% of the variance in frequencies of contact with the GP in The Netherlands can be ascribed to family influence. Up to now not much is known about family influence in one particular area of medical consumption: the use of (p

  11. A Proteomic Characterization of Bordetella pertussis Clinical Isolates Associated with a California State Pertussis Outbreak

    Directory of Open Access Journals (Sweden)

    Yulanda M. Williamson

    2015-01-01

    Full Text Available Bordetella pertussis (Bp is the etiologic agent of pertussis (whooping cough, a highly communicable infection. Although pertussis is vaccine preventable, in recent years there has been increased incidence, despite high vaccine coverage. Possible reasons for the rise in cases include the following: Bp strain adaptation, waning vaccine immunity, increased surveillance, and improved clinical diagnostics. A pertussis outbreak impacted California (USA in 2010; children and preadolescents were the most affected but the burden of disease fell mainly on infants. To identify protein biomarkers associated with this pertussis outbreak, we report a whole cellular protein characterization of six Bp isolates plus the pertussis acellular vaccine strain Bp Tohama I (T, utilizing gel-free proteomics-based mass spectrometry (MS. MS/MS tryptic peptide detection and protein database searching combined with western blot analysis revealed three Bp isolates in this study had markedly reduced detection of pertactin (Prn, a subunit of pertussis acellular vaccines. Additionally, antibody affinity capture technologies were implemented using anti-Bp T rabbit polyclonal antisera and whole cellular proteins to identify putative immunogens. Proteome profiling could shed light on pathogenesis and potentially lay the foundation for reduced infection transmission strategies and improved clinical diagnostics.

  12. Lead exposure in free-flying turkey vultures is associated with big game hunting in California.

    Directory of Open Access Journals (Sweden)

    Terra R Kelly

    Full Text Available Predatory and scavenging birds are at risk of lead exposure when they feed on animals injured or killed by lead ammunition. While lead ammunition has been banned from waterfowl hunting in North America for almost two decades, lead ammunition is still widely used for hunting big game and small game animals. In this study, we evaluated the association between big game hunting and blood lead concentration in an avian scavenger species that feeds regularly on large mammals in California. We compared blood lead concentration in turkey vultures within and outside of the deer hunting season, and in areas with varying wild pig hunting intensity. Lead exposure in turkey vultures was significantly higher during the deer hunting season compared to the off-season, and blood lead concentration was positively correlated with increasing wild pig hunting intensity. Our results link lead exposure in turkey vultures to deer and wild pig hunting activity at these study sites, and we provide evidence that spent lead ammunition in carrion poses a significant risk of lead exposure to scavengers.

  13. Fourth Medical Biotech Forum of the Chinese Medical Biotech Association. 8-10 August 2009, Dalian, China.

    Science.gov (United States)

    Felzmann, Thomas

    2009-10-01

    The Chinese Medical Biotech Association's Fourth Medical Biotech Forum held in Dalian, China included topics covering the biotechnology industry in China and new therapeutic developments in the field of immunological approaches to cancer treatment. This conference report highlights selected presentations on China's biotechnology development policy, tumor-specific antigens, clinical applications of antitumor immune therapy, and novel photodynamic tumor therapy. Investigational therapeutics discussed include astuprotimut-r (GlaxoSmithKline plc) and the dendritic cell vaccine Trivax (Trimed Biotech).

  14. Association of Race/Ethnicity, Socioeconomic Status, Acculturation, and Environmental Factors with Risk of Overweight Among Adolescents in California, 2003

    Directory of Open Access Journals (Sweden)

    Joel Gittelsohn, PhD

    2008-07-01

    Full Text Available IntroductionLittle has been published about racial/ethnic differences in the prevalence of overweight among adolescents that accounts in detail for socioeconomic status, acculturation, and behavioral and environmental factors. Increased understanding of factors associated with overweight can provide a rational basis for developing interventions to address the obesity epidemic in the United States.MethodsUsing a cross-sectional analysis of data from adolescents who participated in the California Health Interview Survey 2003, we estimated the prevalence of overweight and at risk of overweight, combined as a single measure (AROW, body mass index ≥85th percentile. We used logistic regression models to examine associations between AROW and risk factors.ResultsTwenty-nine percent of California adolescents were AROW. The prevalence of AROW differed significantly by sex and race. Boys were more likely than girls to be AROW (33% vs 25%. American Indians/Pacific Islanders/others (39% were at highest risk, followed by Hispanics (37%, blacks (35%, whites (23%, and Asians (15%. For boys, older age, Hispanic or American Indian/Pacific Islander/other race/ethnicity, lower education of parents, and longer residence in the United States were significantly associated with AROW. For girls, Hispanic or black race/ethnicity, lower education of parents, and poor dietary habits were significantly associated with AROW.ConclusionThe high prevalence of AROW among California adolescents in most racial/ethnic groups indicates the need for culturally specific and appropriate interventions to prevent and treat overweight.

  15. Medication details documented on hospital discharge: cross-sectional observational study of factors associated with medication non-reconciliation.

    LENUS (Irish Health Repository)

    Grimes, Tamasine C

    2012-02-01

    AIMS: Movement into or out of hospital is a vulnerable period for medication safety. Reconciling the medication a patient is using before admission with the medication prescribed on discharge, and documenting any changes (medication reconciliation) is recommended to improve safety. The aims of the study were to investigate the factors contributing to medication reconciliation on discharge, and identify the prevalence of non-reconciliation. METHODS: The study was a cross-sectional, observational survey using consecutive discharges from purposively selected services in two acute public hospitals in Ireland. Medication reconciliation, potential for harm and unplanned re-admission were investigated. RESULTS: Medication non-reconciliation was identified in 50% of 1245 inpatient episodes, involving 16% of 9569 medications. The majority of non-reconciled episodes had potential to result in moderate (63%) or severe (2%) harm. Handwritten rather than computerized discharges (adjusted odds ratio (adjusted OR) 1.60, 95% CI 1.11, 2.99), increasing number of medications (adjusted OR 1.26, 95% CI 1.21, 1.31) or chronic illness (adjusted OR 2.08, 95% CI 1.33, 3.24) were associated with non-reconciliation. Omission of endocrine, central nervous system and nutrition and blood drugs was more likely on discharge, whilst omission on admission and throughout inpatient care, without documentation, was more likely for obstetric, gynaecology and urinary tract (OGU) or respiratory drugs. Documentation in the discharge communication that medication was intentionally stopped during inpatient care was less likely for cardiovascular, musculoskeletal and OGU drugs. Errors involving the dose were most likely for respiratory drugs. CONCLUSIONS: The findings inform strategies to facilitate medication reconciliation on discharge from acute hospital care.

  16. Medication details documented on hospital discharge: cross-sectional observational study of factors associated with medication non-reconciliation

    Science.gov (United States)

    Grimes, Tamasine C; Duggan, Catherine A; Delaney, Tim P; Graham, Ian M; Conlon, Kevin C; Deasy, Evelyn; Jago-Byrne, Marie-Claire; O' Brien, Paul

    2011-01-01

    AIMS Movement into or out of hospital is a vulnerable period for medication safety. Reconciling the medication a patient is using before admission with the medication prescribed on discharge, and documenting any changes (medication reconciliation) is recommended to improve safety. The aims of the study were to investigate the factors contributing to medication reconciliation on discharge, and identify the prevalence of non-reconciliation. METHODS The study was a cross-sectional, observational survey using consecutive discharges from purposively selected services in two acute public hospitals in Ireland. Medication reconciliation, potential for harm and unplanned re-admission were investigated. RESULTS Medication non-reconciliation was identified in 50% of 1245 inpatient episodes, involving 16% of 9569 medications. The majority of non-reconciled episodes had potential to result in moderate (63%) or severe (2%) harm. Handwritten rather than computerized discharges (adjusted odds ratio (adjusted OR) 1.60, 95% CI 1.11, 2.99), increasing number of medications (adjusted OR 1.26, 95% CI 1.21, 1.31) or chronic illness (adjusted OR 2.08, 95% CI 1.33, 3.24) were associated with non-reconciliation. Omission of endocrine, central nervous system and nutrition and blood drugs was more likely on discharge, whilst omission on admission and throughout inpatient care, without documentation, was more likely for obstetric, gynaecology and urinary tract (OGU) or respiratory drugs. Documentation in the discharge communication that medication was intentionally stopped during inpatient care was less likely for cardiovascular, musculoskeletal and OGU drugs. Errors involving the dose were most likely for respiratory drugs. CONCLUSIONS The findings inform strategies to facilitate medication reconciliation on discharge from acute hospital care. PMID:21284705

  17. The Annual Awards of the Association of American Medical Colleges.

    Science.gov (United States)

    Journal of Medical Education, 1982

    1982-01-01

    The presentation of the Abraham Flexner Award for Distinguished Service to Medical Education to Sherman M. Mellinkoff and the AAMC Award for Distinguished Research in the Biomedical Sciences to J. Michael Bishop is described. (MLW)

  18. Organizational factors and change strategies associated with medical home transformation.

    Science.gov (United States)

    Solberg, Leif I; Stuck, Logan H; Crain, A Lauren; Tillema, Juliana O; Flottemesch, Thom J; Whitebird, Robin R; Fontaine, Patricia L

    2015-01-01

    There is limited information about how to transform primary care practices into medical homes. The research team surveyed leaders of the first 132 primary care practices in Minnesota to achieve medical home certification. These surveys measured priority for transformation, the presence of medical home practice systems, and the presence of various organizational factors and change strategies. Survey response rates were 98% for the Change Process Capability Questionnaire survey and 92% for the Physician Practice Connections survey. They showed that 80% to 100% of these certified clinics had 15 of the 18 organizational factors important for improving care processes and that 60% to 90% had successfully used 16 improvement strategies. Higher priority for this change (P = .001) and use of more strategies (P = .05) were predictive of greater change in systems. Clinics contemplating medical home transformation should consider the factors and strategies identified here and should be sure that such a change is indeed a high priority for them.

  19. Medication Errors Associated with Look-alike/Sound-alike Drugs: A Brief Review

    OpenAIRE

    2015-01-01

    The existence of confusing drug names is one of the most common causes of medication errors. There are many types of medication errors: wrong drug, wrong dose, wrong route of administration, wrong patient etc. Misreading medication names that look similar is a common mistake. These look-alike medication names may also sound alike and can lead to errors associated with verbal prescriptions. Similar sounding drugs may produce confusion and may lead to unintended interchange of drugs causing har...

  20. Study of Association of Psychological Stress and Depression among Undergraduate Medical Students in Pondicherry

    OpenAIRE

    Devi Kittu, Rohan Patil

    2013-01-01

    Background: Medical education across the globe is perceived as being inherently stressful. Studies on psychological problems such as stress, depression and anxiety among medical students have found that these disorders are under diagnosed and under treated. In this background the present study was undertaken with the objectives to assess the magni-tude of depression and its association with stress among medical students. Methods: A Cross sectional study was undertaken among 235 medical st...

  1. Anticoagulant medication errors in nursing homes: characteristics, causes, outcomes, and association with patient harm.

    Science.gov (United States)

    Desai, Rishi J; Williams, Charlotte E; Greene, Sandra B; Pierson, Stephanie; Hansen, Richard A

    2013-01-01

    Appropriate and safe use of medications is an important aspect of quality of care in nursing home patients. Because of their complex medication use process, anticoagulants are prone to medication errors in the frail elderly. Therefore, we designed this study to characterize anticoagulant medication errors and to evaluate their association with patient harm using individual medication error incidents reported by all North Carolina nursing homes to the Medication Error Quality Initiative (MEQI) during fiscal years 2010-2011. Characteristics, causes, and specific outcomes of harmful anticoagulant medication errors were reported as frequencies and proportions and compared between anticoagulant errors and other medication errors using chi-square tests. A multivariate logistic regression model explored the relationship between anticoagulant medication errors and patient harm, controlling for patient- and error-related factors.

  2. National Weather Service, Emergency Medical Services, Scripps Institution of Oceanography/UCSD and California EPA Collaboration on Heat Health Impact and Public Notification for San Diego County

    Science.gov (United States)

    Tardy, A. O.; Corcus, I.; Guirguis, K.

    2015-12-01

    The National Weather Service (NWS) has issued official heat alerts in the form of either a heat advisory or excessive heat warning product to the public and core partners for many years. This information has traditionally been developed through the use of triggers for heat indices which combine humidity and temperature. The criteria typically used numeric thresholds and did not consider impact from a particular heat episode, nor did it factor seasonality or population acclimation. In 2013, the Scripps Institution of Oceanography, University of California, San Diego in collaboration with the Office of Environmental Health Hazard Assessment, of the California Environmental Protection Agency and the NWS completed a study of heat health impact in California, while the NWS San Diego office began modifying their criteria towards departure from climatological normal with much less dependence on humidity or heat index. The NWS changes were based on initial findings from the California Department of Public Health, EpiCenter California Injury Data Online system which documents heat health impacts. Results from the UCSD study were finalized and published in 2014; they supported the need for significant modification of the traditional criteria. In order to better understand the impacts of heat on community health, medical outcome data were provided by the County of San Diego Emergency Medical Services Branch, which is charged by the County's Public Health Officer to monitor heat-related illness and injury daily from June through September. The data were combined with UCSD research to inform the modification of local NWS heat criteria and establish trigger points to pilot new procedures for the issuance of heat alerts. Finally, practices and procedures were customized for each of the county health departments in the NWS area of responsibility across extreme southwest California counties in collaboration with their Office of Emergency Services. The end result of the

  3. Factors Associated With Overweight and Obesity Among Mexican Americans and Central Americans: Results From the 2001 California Health Interview Survey

    Directory of Open Access Journals (Sweden)

    Janice V. Bowie, PhD, MPH

    2007-01-01

    Full Text Available IntroductionHispanics are the fastest growing demographic group in the United States; however, “Hispanic” is a broad term that describes people who are from or whose ancestors are from multiple countries of origin. This study examines, separately, the social, cultural, and behavioral factors associated with overweight and obesity among Mexican American adults and among Central American adults. MethodsTo estimate the prevalence of overweight and obesity among Mexican and Central Americans living in California, we conducted a cross-sectional analysis of data from the 2001 California Health Interview Survey using SUDAAN software to account for the survey’s multistage sampling design.ResultsOf the 8304 Mexican Americans participating in the survey, 36.8% were overweight and 26.2% were obese. Of the 1019 Central Americans, 39.2% were overweight and 22.2% were obese. Among Mexican American men, age and marital status were associated with overweight and obesity; and education, acculturation, health insurance status, health status, and use of vitamins were associated with obesity only. Among Mexican American women, age, education, number of children, health status, and health behavior were associated with overweight and obesity. Among Central American men, age, education, and access to health care were associated with overweight, whereas marital status, acculturation, health care, and binge drinking were associated with obesity. Among Central American women, number of children was associated with overweight and obesity; and age and education were associated with obesity only. ConclusionsOur findings of high rates of overweight and obesity among Mexican and Central Americans in California indicate the need for a wide variety of effective weight-loss interventions targeting these populations, and the differences we found in the factors associated with overweight and obesity may suggest the need for unique intervention strategies for different

  4. Vertical tectonic deformation associated with the San Andreas fault zone offshore of San Francisco, California

    Science.gov (United States)

    Ryan, H. F.; Parsons, T.; Sliter, R. W.

    2008-10-01

    A new fault map of the shelf offshore of San Francisco, California shows that faulting occurs as a distributed shear zone that involves many fault strands with the principal displacement taken up by the San Andreas fault and the eastern strand of the San Gregorio fault zone. Structures associated with the offshore faulting show compressive deformation near where the San Andreas fault goes offshore, but deformation becomes extensional several km to the north off of the Golden Gate. Our new fault map serves as the basis for a 3-D finite element model that shows that the block between the San Andreas and San Gregorio fault zone is subsiding at a long-term rate of about 0.2-0.3 mm/yr, with the maximum subsidence occurring northwest of the Golden Gate in the area of a mapped transtensional basin. Although the long-term rates of vertical displacement primarily show subsidence, the model of coseismic deformation associated with the 1906 San Francisco earthquake indicates that uplift on the order of 10-15 cm occurred in the block northeast of the San Andreas fault. Since 1906, 5-6 cm of regional subsidence has occurred in that block. One implication of our model is that the transfer of slip from the San Andreas fault to a fault 5 km to the east, the Golden Gate fault, is not required for the area offshore of San Francisco to be in extension. This has implications for both the deposition of thick Pliocene-Pleistocene sediments (the Merced Formation) observed east of the San Andreas fault, and the age of the Peninsula segment of the San Andreas fault.

  5. Can poetry make better doctors? Teaching the humanities and arts to medical students and residents at the University of California, Irvine, College of Medicine.

    Science.gov (United States)

    Shapiro, Johanna; Rucker, Lloyd

    2003-10-01

    The Program in Medical Humanities & Arts at the University of California, Irvine, College of Medicine has been in existence for five years. The program was implemented to enhance aspects of professionalism including empathy, altruism, compassion, and caring toward patients, as well as to hone clinical communication and observational skills. It contains elective or required curriculum across all four years of medical school and required curriculum in two residency programs, organized according to structural principles of horizontal coherence, vertical complexity, and patient care applications. The program emphasizes small-group, interdisciplinary teaching and faculty development, and is notable for learners' use of creative projects to reflect on patients and themselves. Evaluation of the program indicates a positive response among learners. More systematic studies point to increases in empathy and positive attitudes toward the humanities as tools for professional development as a result of exposure to the program curriculum. Future directions include closer collaboration with the University of California, Irvine, Schools of the Arts and Humanities, involvement of local artists and writers, and development of a graduation with distinction in humanities for medical students.

  6. Endogenous ethanol production in trauma victims associated with medical treatment.

    Science.gov (United States)

    Moriya, F; Hashimoto, Y

    1996-08-01

    Four cases of trauma, where endogenous ethanol production was suspected to have been occurred in association with medical treatment, are reported. To discriminate endogenous ethanol produced de novo by bacteria from exogenous ethanol by drinking, various tissues and body fluids, such as brain and cerebrospinal fluid, together with blood obtained from various locations, were subjected to analysis for both ethanol and n-propanol. The first individual was a 40-year-old man who had been stabbed in the abdomen with a knife and had died of bleeding about 12 h after peritoneotomy, and autopsied 12 h later. In the heart blood, 0.44 mg/g ethanol and 0.005 mg/g n-propanol were detected. Ethanol levels in the cerebrospinal fluid, vitreous humor and brain, reflecting exogenous ethanol levels, were 0.08-0.16 mg/g, and no n-propanol was detected in any of the specimens. The second individual was a 45-year-old man who had been punched hard in the head and face and had died of traumatic shock about 12 h after hospitalization, and autopsied 12 h later. The heart blood concentrations of ethanol and n-propanol were 0.15 and 0.008 mg/g respectively, and a subdural hematoma contained only 0.05 mg/g ethanol and non n-propanol. The third individual was a 34-year-old man who suffered incised wounds of the left arm and head with a sickle and had died of hemorrhagic shock. In the heart blood, 0.30 mg/g ethanol and 0.026 mg/g n-propanol were detected; there was 0.04 mg/g ethanol and no n-propanol in the brain. The fourth individual was a 76-year-old woman who had been hit by a motorcycle and had died of liver rupture about 1 h after admission to a hospital. The heart blood contained 0.22 mg/g ethanol and 0.002 mg/g n-propanol. Only a trace of ethanol and no n-propanol were detected in the pericardial sac fluid and cerebrospinal fluid.

  7. Prevalence and associated factors of cigarette smoking among medical students at King Fahad Medical City in Riyadh of Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Abdulaziz F Al-Kaabba

    2011-01-01

    Full Text Available Objective: To determine the prevalence of smoking among medical students at the medical college at King Fahad Medical City in Riyadh, and assess the association between smoking and socio-demographical factors, smoking contacts, reasons for smoking and attempts to quit. Materials and Methods: Cross-sectional survey in which anonymous, self-administered questionnaire was used to survey the cigarette smoking habits of the first- and second-year medical students in the Faculty of Medicine, King Fahad Medical City in June 2009. Results: Overall 39.8 % of the investigated students (153 had smoked before, and 17.6% were current smokers. The mean age of initiating smoking was 15.8 (΁3.3. There were significantly more males than females. The most important reasons for smoking were leisure, imitation of other people and a means of relieving psychological pressure. Reasons for not smoking were mostly health and religion-based. Smokers tended to have friends who smoked. Conclusion: Cigarettes smoking is highly prevalent among medical students in the Faculty of Medicine, King Fahad Medical City. Contact with smokers particularly friends are the major risk factors for the initiation of the habit. Health and religious considerations are important motives for not smoking, quitting or attempting to quit. These findings can be of help in designing future intervention strategies.

  8. Study of Association of Psychological Stress and Depression among Undergraduate Medical Students in Pondicherry

    Directory of Open Access Journals (Sweden)

    Devi Kittu, Rohan Patil

    2013-01-01

    Full Text Available Background: Medical education across the globe is perceived as being inherently stressful. Studies on psychological problems such as stress, depression and anxiety among medical students have found that these disorders are under diagnosed and under treated. In this background the present study was undertaken with the objectives to assess the magni-tude of depression and its association with stress among medical students. Methods: A Cross sectional study was undertaken among 235 medical students in a private medical college, Pondicherry. Tools similar to General Health Questionaire (GHQ-12 and Beck depression Inventory (BDI was used to screen psychological stress and depression respectively. Results: The prevalence of depression was 71% among medical students. Psychological stress was associated with depression. Conclusion: Emphasize should be laid on the importance of screening for depression of medical students on a regular basis for early detection and rendering appropriate intervention like group counseling, stress management training etc. to protect the future professionals.

  9. Polypharmacy in older adults: Association Rule and Frequent-Set Analysis to evaluate concomitant medication use.

    Science.gov (United States)

    Held, Fabian; Le Couteur, David G; Blyth, Fiona M; Hirani, Vasant; Naganathan, Vasi; Waite, Louise M; Seibel, Markus J; Handelsman, David J; Cumming, Robert G; Allore, Heather G; Gnjidic, Danijela

    2017-02-01

    The aim of this study was to apply Association Rule and Frequent-Set analysis, and novel means of data visualisation to ascertain patterns of medication use and medication combinations contributing to medication group clusters according to geriatric syndrome status in older adults. Participants were community-dwelling men (aged ≥70 years, n=1686), Sydney, Australia. Medication exposure was categorised at medication class level and data were analysed according to geriatric syndrome status (presence of at least one syndrome including frailty, falls, cognitive impairment and urinary incontinence). Association Rule and Frequent-Set analysis were performed to identify "interesting" patterns of medication combinations that occur together. This analysis involves advanced computer algorithms that investigated all possible combinations of medications in the dataset in order to identify those which are observed more or much less frequently than expected. Frequent-Set Analysis demonstrated one unexpected medication combination, antiulcer and antidiabetic medications (3.5% of participants) in the overall population (n=1687). Frequency of medication combinations was similar in participants with (n=666) and without (n=1020) geriatric syndromes. Among participants with geriatric syndromes, the most frequent combinations included antigout with lipid-lowering agents (5.7%) followed by angiotensin II and diuretics combination (22%). This novel methodology can be used to detect common medication combinations overall by data visualisation, and against specific adverse drug reactions such as geriatric syndromes. This methodology may be a valuable pharmacovigilance approach to monitor large databases for the safety of medications.

  10. Riverbed clogging associated with a California riverbank filtration system: An assessment of mechanisms and monitoring approaches

    Science.gov (United States)

    Ulrich, Craig; Hubbard, Susan S.; Florsheim, Joan; Rosenberry, Donald O.; Borglin, Sharon; Trotta, Marcus; Seymour, Donald

    2015-01-01

    An experimental field study was performed to investigate riverbed clogging processes and associated monitoring approaches near a dam-controlled riverbank filtration facility in Northern California. Motivated by previous studies at the site that indicated riverbed clogging plays an important role in the performance of the riverbank filtration system, we investigated the spatiotemporal variability and nature of the clogging. In particular, we investigated whether the clogging was due to abiotic or biotic mechanisms. A secondary aspect of the study was the testing of different methods to monitor riverbed clogging and related processes, such as seepage. Monitoring was conducted using both point-based approaches and spatially extensive geophysical approaches, including: grain-size analysis, temperature sensing, electrical resistivity tomography, seepage meters, microbial analysis, and cryocoring, along two transects. The point monitoring measurements suggested a substantial increase in riverbed biomass (2 orders of magnitude) after the dam was raised compared to the small increase (∼2%) in fine-grained sediment. These changes were concomitant with decreased seepage. The decreased seepage eventually led to the development of an unsaturated zone beneath the riverbed, which further decreased infiltration capacity. Comparison of our time-lapse grain-size and biomass datasets suggested that biotic processes played a greater role in clogging than did abiotic processes. Cryocoring and autonomous temperature loggers were most useful for locally monitoring clogging agents, while electrical resistivity data were useful for interpreting the spatial extent of a pumping-induced unsaturated zone that developed beneath the riverbed after riverbed clogging was initiated. The improved understanding of spatiotemporally variable riverbed clogging and monitoring approaches is expected to be useful for optimizing the riverbank filtration system operations.

  11. Active season microhabitat and vegetation selection by giant gartersnakes associated with a restored marsh in California

    Science.gov (United States)

    Halstead, Brian J.; Valcarcel, Patricia; Wylie, Glenn D.; Coates, Peter S.; Casazza, Michael L.; Rosenberg, Daniel K.

    2016-01-01

    Studies of habitat selection can reveal important patterns to guide habitat restoration and management for species of conservation concern. Giant gartersnakes Thamnophis gigas are endemic to the Central Valley of California, where >90% of their historical wetland habitat has been converted to agricultural and other uses. Information about the selection of habitats by individual giant gartersnakes would guide habitat restoration by indicating which habitat features and vegetation types are likely to be selected by these rare snakes. We examined activity patterns and selection of microhabitats and vegetation types by adult female giant gartersnakes with radiotelemetry at a site composed of rice agriculture and restored wetlands using a paired case-control study design. Adult female giant gartersnakes were 14.7 (95% credible interval [CRI] = 9.4–23.7) times more likely to be active (foraging, mating, or moving) when located in aquatic habitats than when located in terrestrial habitats. Microhabitats associated with cover—particularly emergent vegetation, terrestrial vegetation, and litter—were positively selected by giant gartersnakes. Individual giant gartersnakes varied greatly in their selection of rice and rock habitats, but varied little in their selection of open water. Tules Schoenoplectus acutus were the most strongly selected vegetation type, and duckweed Lemna spp., water-primrose Ludwigia spp., forbs, and grasses also were positively selected at the levels of availability observed at our study site. Management practices that promote the interface of water with emergent aquatic and herbaceous terrestrial vegetation will likely benefit giant gartersnakes. Given their strong selection of tules, restoration of native tule marshes will likely provide the greatest benefit to these threatened aquatic snakes.

  12. Recommendations for responsible monitoring and regulation of clinical software systems. American Medical Informatics Association, Computer-based Patient Record Institute, Medical Library Association, Association of Academic Health Science Libraries, American Health Information Management Association, American Nurses Association.

    Science.gov (United States)

    Miller, R A; Gardner, R M

    1997-01-01

    In mid-1996, the FDA called for discussions on regulation of clinical software programs as medical devices. In response, a consortium of organizations dedicated to improving health care through information technology has developed recommendations for the responsible regulation and monitoring of clinical software systems by users, vendors, and regulatory agencies. Organizations assisting in development of recommendations, or endorsing the consortium position include the American Medical Informatics Association, the Computer-based Patient Record Institute, the Medical Library Association, the Association of Academic Health Sciences Libraries, the American Health Information Management Association, the American Nurses Association, the Center for Healthcare Information Management, and the American College of Physicians. The consortium proposes four categories of clinical system risks and four classes of measured monitoring and regulatory actions that can be applied strategically based on the level of risk in a given setting. The consortium recommends local oversight of clinical software systems, and adoption by healthcare information system developers of a code of good business practices. Budgetary and other constraints limit the type and number of systems that the FDA can regulate effectively. FDA regulation should exempt most clinical software systems and focus on those systems posing highest clinical risk, with limited opportunities for competent human intervention.

  13. Prevalence of self-medication practices and its associated factors in Urban Puducherry, India

    Directory of Open Access Journals (Sweden)

    Kalaiselvi Selvaraj

    2014-01-01

    Full Text Available Background and Objectives: Self medication is an important concern for health authorities at global level. This study was aimed to find the prevalence of self medication for allopathic drugs and associated factors among households of urban community. This study was also aimed at assessing the attitude of respondents who had experienced self-medication. Materials and Methods: This cross-sectional study was done in field practice area attached to a medical institution in urban Puducherry. A total of 352 subjects from 124 households were selected by random sampling. With pretested interview schedule, information regarding self-medication use in the past three months and associated sociodemographic factors, purpose, source of drug procurement, attitude toward self-medication use were collected. Results: Prevalence of self-medication was found to be 11.9%. Males, age >40 years and involving in moderate level activity of occupation, were found to be significantly associated with higher self-medication usage (P < 0.05. Fever (31%, headache (19%, and abdominal pain (16.7% are most common illnesses where self-medication is being used. Telling the symptoms to pharmacist (38.1% was the commonest method adopted to procure drugs by the users. Majority of the self-medication users expressed that self-medication is harmless (66.6% and they are going to use (90% and advice others also (73.8% to use self-medication drugs. Conclusion: Self-medication is an important health issue in this area. Health education of the public and regulation of pharmacies may help in limiting the self-medication practices.

  14. Medical and psychosocial associates of nonadherence in adolescents with cancer.

    Science.gov (United States)

    Hullmann, Stephanie E; Brumley, Lauren D; Schwartz, Lisa A

    2015-01-01

    The current study examined adherence to medication regimens among adolescents with cancer by applying the Pediatric Self-Management Model. Adolescents and their parents reported on adherence to medication, reasons for nonadherence, and patient-, family-, and community-level psychosocial variables. Adolescent- and parent-reported adherence were significantly correlated, with about half of the sample reporting perfect adherence. The majority reported "just forgot" as the most common reason for missed medication. Patient-, family-, and community-level variables were examined as predictors of adherence. With regard to individual factors, adolescents who endorsed perfect adherence reported a greater proportion of future-orientated goals and spent fewer days in outpatient clinic visits. For family factors, adolescents who endorsed perfect adherence reported greater social support from their family and were more likely to have a second caregiver who they perceived as overprotective. The community-level variable (social support from friends) tested did not emerge as a predictor of adherence. The results of this study provide direction for intervention efforts to target adolescent goals and family support in order to increase adolescent adherence to cancer treatment regimens.

  15. Factors associated with dropping out of medical school: a literature review

    DEFF Research Database (Denmark)

    O’Neill, Lotte Dyhrberg

    2010-01-01

    of Aarhus; Jan Hartvigsen, PhD, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark.   Title: Factors associated with dropping out of medical school: a literature review.      Background: Considerable resources are spent on medical school selection and the competition...... for places is usually fierce. Dropping out must therefore be the worst possible performance outcome in medical education. What do we know about factors associated with dropping out of medical school? Summary of work: A systematic critical literature review of the international peer-reviewed research...... literature on medical education is ongoing. Inclusion criteria are: Study population=medical students, outcome=dropout, follow up period=minimum 1 year, study designs=cohort/case-control/experimental. An experienced research librarian performed a primary search of the databases PubMed, ERIC, Psyc...

  16. Diversity of Diaporthe species associated with wood cankers of fruit and nut crops in northern California

    Science.gov (United States)

    Diaporthe ampelina, causal agent of Phomopsis cane and leaf spot of grapevine (Vitis vinifera L.), is also frequently isolated from grapevine wood, causing Phomopsis dieback. In California, Diaporthe species cause a wide range of symptoms not only on grape, but also other fruit and nut crops. To bet...

  17. Stress among Medical Students and Its Association with Substance Use and Academic Performance

    OpenAIRE

    Leta Melaku; Andualem Mossie; Alemayehu Negash

    2015-01-01

    Background. Chronic stress among medical students affects academic performance of students and leads to depression, substance use, and suicide. There is, however, a shortage of such research evidence in Ethiopia. Objective. We aimed to estimate the prevalence and severity of stress and its association with substance use and academic performance among medical students. Methods. A cross-sectional survey was conducted on a sample of 329 medical students at Jimma University. Data were collected u...

  18. Medication prescribing errors and associated factors at the pediatric wards of Dessie Referral Hospital, Northeast Ethiopia

    OpenAIRE

    Zeleke, Abebe; Chanie, Tesfahun; Woldie, Mirkuzie

    2014-01-01

    Background Medication error is common and preventable cause of medical errors and occurs as a result of either human error or a system flaw. The consequences of such errors are more harmful and frequent among pediatric patients. Objective To assess medication prescribing errors and associated factors in the pediatric wards of Dessie Referral Hospital, Northeast Ethiopia. Methods A cross-sectional study was carried out in the pediatric wards of Dessie Referral Hospital from February 17 to Marc...

  19. The Associations between Social Support, Health-Related Behaviors, Socioeconomic Status and Depression in Medical Students

    OpenAIRE

    Jeong, Yoolwon; Kim, Jin Young; Ryu, Jae Seon; Lee, Ko Eun; Ha, Eun Hee; Park, Hyesook

    2010-01-01

    OBJECTIVES The objective of this study was to estimate the prevalence of depression in medical students and to evaluate whether interpersonal social support, health-related behaviors, and socio-economic factors were associated with depression in medical students. METHODS The subjects in this study were 120 medical students in Seoul, Korea who were surveyed in September, 2008. The subjects were all women and over the age of 20. Their age, body mass index (BMI), quality of sleep, diet, househol...

  20. Stress and Coping Styles Are Associated with Severe Fatigue in Medical Students

    Science.gov (United States)

    Tanaka, Masaaki; Fukuda, Sanae; Mizuno, Kei; Kuratsune, Hirohiko; Watanabe, Yasuyoshi

    2009-01-01

    Fatigue is a common complaint among medical students and researchers consider it to be related to poor academic outcomes. The authors' goal in the present study was to determine whether stress and coping strategies were associated with fatigue in medical students. The study group consisted of 73 second-year healthy students attending the Osaka…

  1. Prevalence and associated factors of stress, anxiety and depression among prospective medical students.

    Science.gov (United States)

    Yusoff, Muhamad Saiful Bahri; Abdul Rahim, Ahmad Fuad; Baba, Abdul Aziz; Ismail, Shaiful Bahari; Mat Pa, Mohamad Najib; Esa, Ab Rahman

    2013-04-01

    Many studies have reported that the prevalence of psychological distress among medical students during medical training was high. However, there are very few studies exploring on the psychological health of prospective medical students. This study aimed to determine the prevalence and associated factors for stress, anxiety and depression symptoms among the prospective medical students. A cross-sectional study was done on two cohorts of applicants to a public medical school. A total of 839 applicants were invited to participate in the study. The 21-item Depression Anxiety Stress Scale was administered to the applicants after they completed interviews. A total of 743 (92.2%) applicants took part in the study. The prevalence of moderate to extremely severe level of stress, anxiety and depression were 3.6%, 54.5% and 1.9%, respectively. Stress was significantly associated with extra-curricular activity (pDepression was associated with academic performance in class (pdepression among entering medical students was low; however prevalence of anxiety was high which could be due to worry about the interviews to enter medical course. The associated factors of psychological distress among prospective medical students were related to academic, non-academic, parent education and cultural backgrounds.

  2. Associations of Pass-Fail Outcomes with Psychological Health of First-Year Medical Students in a Malaysian Medical School

    Directory of Open Access Journals (Sweden)

    Muhamad S. B. Yusoff

    2013-02-01

    Full Text Available Objectives: The demanding and intense environment of medical training can create excessive pressures on medical students that eventually lead to unfavorable consequences, either at a personal or professional level. These consequences can include poor academic performance and impaired cognitive ability. This study was designed to explore associations between pass-fail outcome and psychological health parameters (i.e. stress, anxiety, and depression symptoms. Methods: A cross-sectional study was conducted on a cohort of first-year medical students in a Malaysian medical school. The depression anxiety stress scale 21-item assessment (DASS-21 was administered to them right after the final paper of the first-year final examination. Their final examination outcomes (i.e. pass or fail were traced by using their student identity code (ID through the Universiti Sains Malaysia academic office. Results: A total of 194 (98.0% of medical students responded to the DASS-21. An independent t-test showed that students who passed had significantly lower stress, anxiety, and depression symptoms than those who failed the first-year final examination (P <0.05. Those who experienced moderate to high stress were at 2.43 times higher risk for failing the examination than those who experienced normal to mild stress. Conclusion: Medical students whofailed in the final examination had higher psychological distress than those who passed the examination. Those who experienced high stress levels were more likely to fail than those who did not. Reducing the psychological distress of medical students prior to examination may help them to perform better in the examination.

  3. Essentials of nutrition education in medical schools: a national consensus. American Medical Student Association's Nutrition Curriculum Project.

    Science.gov (United States)

    1996-09-01

    Medical students of the American Medical Student Association established the Nutrition Curriculum Project (NCP) with the goals of ensuring that adequate nutrition information be taught to medical students; ensuring that there be a framework for integration of nutrition topics at all levels of medical education; and formulating and disseminating essential information for nutrition assessment and management in clinical practice. As a first step, the NCP assembled a ten-member advisory board to develop a comprehensive list of nutrition topics deemed essential for the adequate training of physicians. The advisory board consisted of medical and nutrition educators, physicians, and clinical specialists representing major U.S. professional nutrition organizations. The NCP's director co-ordinated the decision-making process through its three iterations. Final accord on 92 topics was achieved with unanimous approval of the board in 1994. These topics, organized in five major categories, are offered as a guide to the reform of nutrition education and as the basis of a satisfactory nutrition curriculum.

  4. Report of the American Medical Student Association's Nutrition Curriculum Project. Essentials of nutrition education in medical schools: a national consensus.

    Science.gov (United States)

    1997-05-01

    Medical students of the American Medical Student Association established the Nutrition Curriculum Project (NCP) with the goals of ensuring that adequate nutrition information be taught to medical students; ensuring that there be a framework for integration of nutrition topics at all levels of medical education; and formulating and disseminating essential information for nutrition assessment and management in clinical practice. As a first step, the NCP assembled a ten-member advisory board to develop a comprehensive list of nutrition topics deemed essential for the adequate training of physicians. The advisory board consisted of medical and nutrition educators, physicians, and clinical specialists representing major U.S. professional nutrition organizations. The NCP's director coordinated the decision-making process through its three iterations. Final accord on 92 topics was achieved with unanimous approval of the board in 1994. These topics, organized in five major categories, are offered as a guide to the reform of nutrition education and as the basis of a satisfactory nutrition curriculum.

  5. Southern California Particle Center

    Data.gov (United States)

    Federal Laboratory Consortium — At the Southern California Particle Center, center researchers will investigate the underlying mechanisms that produce the health effects associated with exposure to...

  6. Tobacco smoking is causally associated with antipsychotic medication use and schizophrenia, but not with antidepressant medication use or depression

    DEFF Research Database (Denmark)

    Wium-Andersen, Marie Kim; Ørsted, David Dynnes; Nordestgaard, Børge Grønne

    2015-01-01

    BACKGROUND: Tobacco smoking is more common among patients with schizophrenia and depression than among healthy individuals. We tested the hypothesis that high tobacco smoking intensity is causally associated with antipsychotic medication use, schizophrenia, antidepressant medication use and....../or depression in the general population, and compared results with those for chronic obstructive pulmonary disease. METHODS: We used self-reported smoking intensity in cigarettes/day and a polymorphism in the CHRNA3 gene cluster (rs1051730) associated with smoking intensity, on 63,296 20-100-year......-old individuals from the Danish general population; 23,282 were never-smokers and 40,014 ever-smokers. For schizophrenia, we compared our results with those in the Psychiatric Genomics Consortium. RESULTS: In smokers, heterozygotes (CT) and homozygotes (TT) for rs1051730 genotype had higher smoking intensity...

  7. Workforce and Salary Survey Trends: Opportunities and Challenges for the American Association of Medical Dosimetrists

    Energy Technology Data Exchange (ETDEWEB)

    Mills, Michael D., E-mail: mdmill03@exchange.louisville.edu

    2015-07-01

    The American Association of Medical Dosimetrists (AAMD) designed and directed 2 surveys of the AAMD membership. The first was in 2011 and the second in 2014. There were a number of questions common to both surveys, and this article seeks to evaluate these common questions to determine trends among the professional membership of the AAMD. It is demonstrated that the observed trends are consistent with the goals and objectives established by the leadership of the AAMD and the Medical Dosimetry Certification Board (MDCB) for the medical dosimetry community. In addition, certain challenges and opportunities involving the scope of practice for the medical dosimetry profession are discussed.

  8. Factors associated with the prescription of antidepressive medication to breast cancer patients

    DEFF Research Database (Denmark)

    Suppli, Nis P; Deltour, Isabelle; Damkjaer, Lars H;

    2011-01-01

    We evaluated factors associated with use of antidepressant medication subsequent to a diagnosis of breast cancer. We also evaluated the effect of participation in a cancer rehabilitation program on use of antidepressants.......We evaluated factors associated with use of antidepressant medication subsequent to a diagnosis of breast cancer. We also evaluated the effect of participation in a cancer rehabilitation program on use of antidepressants....

  9. AMEDD Clinical Psychology Short Course Held in Letterman Army Medical Center, San Francisco, California on 5-9 February 1990

    Science.gov (United States)

    1990-02-02

    verified a rumor, passed along to him by Gregory Bateson , of an ancient tribal tradition presaging even a logical but radical development in family...Enlisted Soldiers; A Comparison of Profile Types on the 1986 Revision of the California Psychological Inventory Gregory P. Hollis 185 The AMEDD...Psychologist Kenneth D. Rollins and Gregory B. Laskow 201 Survey Results: Important Issues for Army Psychologists vi A. David Mangelsdorff, Gregory Laskow

  10. California Federal Savings and Loan Association v. Guerra, 13 January 1987.

    Science.gov (United States)

    1987-01-01

    The plaintiff employer and other similar employers challenged the constitutionality of a California law that required employers to provide female employees with up to four months unpaid pregnancy leave with reinstatement in the same or a substantially similar job. They claimed that the law was preempted by Title VII of the Civil Rights Act of 1964 because the 1964 Act, as amended by the Pregnancy Discrimination Act of 1978, required absolute neutrality in the treatment of pregnant employees with respect to other employees. Their position was that the California law discriminated in favor of pregnant employees. The Court rejected their claim. It held that the Pregnancy Discrimination Act was "a floor beneath which pregnancy disability benefits may not drop--not a ceiling above which they may not rise," and that the California law shared a common goal with the federal law of providing women with full rights in the workforce without denying them the right to full participation in family life. It ruled that there was nothing in the law that prevented employers from complying with the law and Title VII.

  11. Association of academic stress with sleeping difficulties in medical students of a Pakistani medical school: a cross sectional survey.

    Science.gov (United States)

    Waqas, Ahmed; Khan, Spogmai; Sharif, Waqar; Khalid, Uzma; Ali, Asad

    2015-01-01

    Introduction. Medicine is one of the most stressful fields of education because of its highly demanding professional and academic requirements. Psychological stress, anxiety, depression and sleep disturbances are highly prevalent in medical students. Methods. This cross-sectional study was undertaken at the Combined Military Hospital Lahore Medical College and the Institute of Dentistry in Lahore (CMH LMC), Pakistan. Students enrolled in all yearly courses for the Bachelor of Medicine and Bachelor of Surgery (MBBS) degree were included. The questionnaire consisted of four sections: (1) demographics (2) a table listing 34 potential stressors, (3) the 14-item Perceived Stress Scale (PSS-14), and (4) the Pittsburgh Quality of Sleep Index (PSQI). Logistic regression was run to identify associations between group of stressors, gender, year of study, student's background, stress and quality of sleep. Results. Total response rate was 93.9% (263/280 respondents returned the questionnaire). The mean (SD) PSS-14 score was 30 (6.97). Logistic regression analysis showed that cases of high-level stress were associated with year of study and academic-related stressors only. Univariate analysis identified 157 cases with high stress levels (59.7%). The mean (SD) PSQI score was 8.1 (3.12). According to PSQI score, 203/263 respondents (77%) were poor sleepers. Logistic regression showed that mean PSS-14 score was a significant predictor of PSQI score (OR 1.99, P academic stress and poor sleep quality among medical students. Many medical students reported using sedatives more than once a week. Academic stressors contributed significantly to stress and sleep disorders in medical students.

  12. Association of academic stress with sleeping difficulties in medical students of a Pakistani medical school: a cross sectional survey

    Directory of Open Access Journals (Sweden)

    Ahmed Waqas

    2015-03-01

    Full Text Available Introduction. Medicine is one of the most stressful fields of education because of its highly demanding professional and academic requirements. Psychological stress, anxiety, depression and sleep disturbances are highly prevalent in medical students.Methods. This cross-sectional study was undertaken at the Combined Military Hospital Lahore Medical College and the Institute of Dentistry in Lahore (CMH LMC, Pakistan. Students enrolled in all yearly courses for the Bachelor of Medicine and Bachelor of Surgery (MBBS degree were included. The questionnaire consisted of four sections: (1 demographics (2 a table listing 34 potential stressors, (3 the 14-item Perceived Stress Scale (PSS-14, and (4 the Pittsburgh Quality of Sleep Index (PSQI. Logistic regression was run to identify associations between group of stressors, gender, year of study, student’s background, stress and quality of sleep.Results. Total response rate was 93.9% (263/280 respondents returned the questionnaire. The mean (SD PSS-14 score was 30 (6.97. Logistic regression analysis showed that cases of high-level stress were associated with year of study and academic-related stressors only. Univariate analysis identified 157 cases with high stress levels (59.7%. The mean (SD PSQI score was 8.1 (3.12. According to PSQI score, 203/263 respondents (77% were poor sleepers. Logistic regression showed that mean PSS-14 score was a significant predictor of PSQI score (OR 1.99, P < 0.05.Conclusion. We found a very high prevalence of academic stress and poor sleep quality among medical students. Many medical students reported using sedatives more than once a week. Academic stressors contributed significantly to stress and sleep disorders in medical students.

  13. Association of medical students' reports of interactions with the pharmaceutical and medical device industries and medical school policies and characteristics: a cross-sectional study.

    Directory of Open Access Journals (Sweden)

    James S Yeh

    2014-10-01

    Full Text Available BACKGROUND: Professional societies use metrics to evaluate medical schools' policies regarding interactions of students and faculty with the pharmaceutical and medical device industries. We compared these metrics and determined which US medical schools' industry interaction policies were associated with student behaviors. METHODS AND FINDINGS: Using survey responses from a national sample of 1,610 US medical students, we compared their reported industry interactions with their schools' American Medical Student Association (AMSA PharmFree Scorecard and average Institute on Medicine as a Profession (IMAP Conflicts of Interest Policy Database score. We used hierarchical logistic regression models to determine the association between policies and students' gift acceptance, interactions with marketing representatives, and perceived adequacy of faculty-industry separation. We adjusted for year in training, medical school size, and level of US National Institutes of Health (NIH funding. We used LASSO regression models to identify specific policies associated with the outcomes. We found that IMAP and AMSA scores had similar median values (1.75 [interquartile range 1.50-2.00] versus 1.77 [1.50-2.18], adjusted to compare scores on the same scale. Scores on AMSA and IMAP shared policy dimensions were not closely correlated (gift policies, r = 0.28, 95% CI 0.11-0.44; marketing representative access policies, r = 0.51, 95% CI 0.36-0.63. Students from schools with the most stringent industry interaction policies were less likely to report receiving gifts (AMSA score, odds ratio [OR]: 0.37, 95% CI 0.19-0.72; IMAP score, OR 0.45, 95% CI 0.19-1.04 and less likely to interact with marketing representatives (AMSA score, OR 0.33, 95% CI 0.15-0.69; IMAP score, OR 0.37, 95% CI 0.14-0.95 than students from schools with the lowest ranked policy scores. The association became nonsignificant when fully adjusted for NIH funding level, whereas adjusting for year of

  14. Careers in Medical Physics and the American Association of Physicists in Medicine

    Science.gov (United States)

    Amols, Howard

    2006-03-01

    The American Association of Physicists in Medicine (AAPM), a member society of the AIP is the largest professional society of medical physicists in the world with nearly 5700 members. Members operate in medical centers, university and community hospitals, research laboratories, industry, and private practice. Medical physics specialties include radiation therapy physics, medical diagnostic and imaging physics, nuclear medicine physics, and medical radiation safety. The majority of AAPM members is based in hospital departments of radiation oncology or radiology and provide technical support for patient diagnosis and treatment in a clinical environment. Job functions include support of clinical care, calibration and quality assurance of medical devices such as linear accelerators for cancer therapy, CT, PET, MRI, and other diagnostic imaging devices, research, and teaching. Pathways into a career in medical physics require an advanced degree in medical physics, physics, engineering, or closely related field, plus clinical training in one or more medical physics specialties (radiation therapy physics, imaging physics, or radiation safety). Most clinically based medical physicists also obtain certification from the American Board of Radiology, and some states require licensure as well.

  15. Identification of Associations Between Prescribed Medications and Cancer

    DEFF Research Database (Denmark)

    Pottegård, Anton; Friis, Søren; Christensen, René dePont;

    2016-01-01

    PURPOSE: We present a systematic screening for identifying associations between prescribed drugs and cancer risk using the high quality Danish nationwide health registries. METHODS: We identified all patients (cases) with incident cancer in Denmark during 2000-2012 (n=278,485) and matched each ca...

  16. Characteristics associated with citation rate of the medical literature.

    Directory of Open Access Journals (Sweden)

    Abhaya V Kulkarni

    Full Text Available BACKGROUND: The citation rate for articles is viewed as a measure of their importance and impact; however, little is known about what features of articles are associated with higher citation rate. METHODOLOGY/PRINCIPAL FINDINGS: We conducted a cohort study of all original articles, regardless of study methodology, published in the Lancet, JAMA, and New England Journal of Medicine, from October 1, 1999 to March 31, 2000. We identified 328 articles. Two blinded, independent reviewers extracted, in duplicate, nine variables from each article, which were analyzed in both univariable and multivariable linear least-squares regression models for their association with the annual rate of citations received by the article since publication. A two-way interaction between industry funding and an industry-favoring result was tested and found to be significant (p = 0.02. In our adjusted analysis, the presence of industry funding and an industry-favoring result was associated with an increase in annual citation rate of 25.7 (95% confidence interval, 8.5 to 42.8 compared to the absence of both industry funding and industry-favoring results. Higher annual rates of citation were also associated with articles dealing with cardiovascular medicine (13.3 more; 95% confidence interval, 3.9 to 22.3 and oncology (12.6 more; 95% confidence interval, 1.2 to 24.0, articles with group authorship (11.1 more; 95% confidence interval, 2.7 to 19.5, larger sample size and journal of publication. CONCLUSIONS/SIGNIFICANCE: Large trials, with group authorship, industry-funded, with industry-favoring results, in oncology or cardiology were associated with greater subsequent citations.

  17. A Competency-Based Clinical Chemistry Course for the Associate Degree Medical Laboratory Technician Graduate in a Medical Technology Baccalaureate Program.

    Science.gov (United States)

    Buccelli, Pamela

    Presented is a project that developed a competency-based clinical chemistry course for associate degree medical laboratory technicians (MLT) in a medical technology (MT) baccalaureate program. Content of the course was based upon competencies expected of medical technologists at career-entry as defined in the statements adopted in 1976 by the…

  18. Medical Treatments for Endometriosis-Associated Pelvic Pain

    OpenAIRE

    2014-01-01

    The main sequelae of endometriosis are represented by infertility and chronic pelvic pain. Chronic pelvic pain causes disability and distress with a very high economic impact. In the last decades, an impressive amount of pharmacological agents have been tested for the treatment of endometriosis-associated pelvic pain. However, only a few of these have been introduced into clinical practice. Following the results of the controlled studies available, to date, the first-line treatment for endome...

  19. Medical treatments for endometriosis-associated pelvic pain.

    Science.gov (United States)

    Zito, Gabriella; Luppi, Stefania; Giolo, Elena; Martinelli, Monica; Venturin, Irene; Di Lorenzo, Giovanni; Ricci, Giuseppe

    2014-01-01

    The main sequelae of endometriosis are represented by infertility and chronic pelvic pain. Chronic pelvic pain causes disability and distress with a very high economic impact. In the last decades, an impressive amount of pharmacological agents have been tested for the treatment of endometriosis-associated pelvic pain. However, only a few of these have been introduced into clinical practice. Following the results of the controlled studies available, to date, the first-line treatment for endometriosis associated pain is still represented by oral contraceptives used continuously. Progestins represent an acceptable alternative. In women with rectovaginal lesions or colorectal endometriosis, norethisterone acetate at low dosage should be preferred. GnRH analogues may be used as second-line treatment, but significant side effects should be taken into account. Nonsteroidal anti-inflammatory drugs are widely used, but there is inconclusive evidence for their efficacy in relieving endometriosis-associated pelvic pain. Other agents such as GnRH antagonist, aromatase inhibitors, immunomodulators, selective progesterone receptor modulators, and histone deacetylase inhibitors seem to be very promising, but there is not enough evidence to support their introduction into routine clinical practice. Some other agents, such as peroxisome proliferator activated receptors-γ ligands, antiangiogenic agents, and melatonin have been proven to be efficacious in animal studies, but they have not yet been tested in clinical studies.

  20. Medical Treatments for Endometriosis-Associated Pelvic Pain

    Directory of Open Access Journals (Sweden)

    Gabriella Zito

    2014-01-01

    Full Text Available The main sequelae of endometriosis are represented by infertility and chronic pelvic pain. Chronic pelvic pain causes disability and distress with a very high economic impact. In the last decades, an impressive amount of pharmacological agents have been tested for the treatment of endometriosis-associated pelvic pain. However, only a few of these have been introduced into clinical practice. Following the results of the controlled studies available, to date, the first-line treatment for endometriosis associated pain is still represented by oral contraceptives used continuously. Progestins represent an acceptable alternative. In women with rectovaginal lesions or colorectal endometriosis, norethisterone acetate at low dosage should be preferred. GnRH analogues may be used as second-line treatment, but significant side effects should be taken into account. Nonsteroidal anti-inflammatory drugs are widely used, but there is inconclusive evidence for their efficacy in relieving endometriosis-associated pelvic pain. Other agents such as GnRH antagonist, aromatase inhibitors, immunomodulators, selective progesterone receptor modulators, and histone deacetylase inhibitors seem to be very promising, but there is not enough evidence to support their introduction into routine clinical practice. Some other agents, such as peroxisome proliferator activated receptors-γ ligands, antiangiogenic agents, and melatonin have been proven to be efficacious in animal studies, but they have not yet been tested in clinical studies.

  1. Standards for the academic veterinary medical library.

    Science.gov (United States)

    Murphy, Sarah Anne; Bedard, Martha A; Crawley-Low, Jill; Fagen, Diane; Jette, Jean-Paul

    2005-01-01

    The Standards Committee of the Veterinary Medical Libraries Section was appointed in May 2000 and charged to create standards for the ideal academic veterinary medical library, written from the perspective of veterinary medical librarians. The resulting Standards for the Academic Veterinary Medical Library were approved by members of the Veterinary Medical Libraries Section during MLA '03 in San Diego, California. The standards were approved by Section Council in April 2005 and received final approval from the Board of Directors of the Medical Library Association during MLA '04 in Washington, DC.

  2. Associations between empathy and big five personality traits among Chinese undergraduate medical students

    Science.gov (United States)

    Song, Yang; Shi, Meng

    2017-01-01

    Background Empathy promotes positive physician-patient communication and is associated with improved patient satisfaction, treatment adherence and clinical outcomes. It has been suggested that personality traits should be taken into consideration in programs designed to enhance empathy in medical education due to the association found between personality and empathy among medical students. However, the associations between empathy and big five personality traits in medical education are still underrepresented in the existing literature and relevant studies have not been conducted among medical students in China, where tensions in the physician-patient relationship have been reported as outstanding problems in the context of China’s current medical reform. Thus, the main objective of this study was to examine the associations between empathy and big five personality traits among Chinese medical students. Methods A cross-sectional study was conducted in a medical university in Northeast China in June 2016. Self-reported questionnaires including the Interpersonal Reactivity Index (IRI) and Big Five Inventory (BFI) and demographic characteristics were distributed. A total of 530 clinical medical students became our final subjects. Hierarchical regression analysis was performed to explore the effects of big five personality traits on empathy. Results Results of this study showed that big five personality traits accounted for 19.4%, 18.1%, 30.2% of the variance in three dimensions of empathy, namely, perspective taking, empathic concern and personal distress, respectively. Specifically, agreeableness had a strong positive association with empathic concern (β = 0.477, PNeuroticism was strongly associated with personal distress (β = 0.526, P<0.01) and modestly associated with perspective taking (β = 0.149, P<0.01). Openness to experience had modest associations with perspective taking (β = 0.150, P<0.01) and personal distress (β = -0.160, P<0.01). Conscientiousness

  3. [Vilnius Medical Association: the first half-century (1805-1850)].

    Science.gov (United States)

    Bojczuk, H

    2000-01-01

    Vilnius Medical Association, oldest scientific medical association in Poland and in the Russian Empire, was founded for the purposes of self-development in 1805 on the initiative of an Austrian professor of pathology and detailed therapy, Józef Frank (1771-1842). From its beginnings, the association acted for the good of society and science, independently of political conditions and with varying intensity. Apart from doctors, it also included pharmacists who contributed towards raising the standard of pharmacy in Lithuania. The first half-century of its existence constitutes the most fruitful period of activity as it was supported by professors of the then Medical Department of Vilnius University. At that time the Association established its regulations, founded the Library, and published "Pamietnik Wileńskiego Towarzystwa Lekarskiego" (Journal of Vilnius Medical Association, 1818 and 1821), "Pamietnik Farmaceutyczny" (Pharmaceutical Journal, 1820 and 1821), "Dziennik Medycyny Chirurgii i Farmacji" (Journal of Medicine, Surgery and Pharmacy, 1820, 1823, and 1830), as well as "Collectanea Medico Chirurgica", 1838. It also began gathering and analysing data for medical statistics, as well as developing Polish medical and chemical nomenclature. The Association re-organised shipments of medicines from pharmacies. It endeavoured to raise the standard of medical knowledge in the Vilnius area, combated epidemics of plague, cholera, scarlet fever, smallpox, typhus, diphteria, dysentery and monitored occurrences of plica. It also established the first Institute of Vaccination against Smallpox in Vilnius (1809); carried out scientific research on health resorts at Druskienniki, Birsztany and Stokliszki; promoted hygiene and examined the health of the inhabitants of Vilnius and the surrounding area as well as endorsed authority decisions related to the location of temporary military hospitals. At its meetings, members of the Association discussed their own medical cases as

  4. The Association of Antidepressant Medication and Body Weight Gain.

    Directory of Open Access Journals (Sweden)

    Sara Ranjbar

    2013-04-01

    Full Text Available Objective: To review the literature and discover which antidepressants are responsible for weight gain and then to discuss the areas with lack of adequate knowledge. Method: An electronic search was conducted through Medline, Pubmed, Cochrane library, and ScienceDirect. Forty nine empirical researches were identified and reviewed. Results: Amitriptyline, clomipramine, and mirtazapine have been associated with more weight gain induction in clinical studies, but not in animal-based studies. All TCAs have been reported to cause weight gain except protriptyline. MAOIs have been associated with weight gain. In SSRI group, citalopram and ecitalopram induce weight, yet mixed results exist for paroxetine and fluoxetine. Researches unanimously reported weight loss effect for bupropion. Some studies suggest contributing factors in the relationship of antidepressants with body weight changes including age, gender, base-line weights and treatment duration. Various results of different treatment durations have been reported in some cases but there are not continuous time-dependent studies for the influences of antidepressants on body weight changes. Conclusion: More studies are required to discover underlying mechanisms and the time-dependent effects of antidepressants on body weight changes.

  5. Development of a new diabetes medication self-efficacy scale and its association with both reported problems in using diabetes medications and self-reported adherence

    Science.gov (United States)

    Sleath, Betsy; Carpenter, Delesha M; Blalock, Susan J; Davis, Scott A; Hickson, Ryan P; Lee, Charles; Ferreri, Stefanie P; Scott, Jennifer E; Rodebaugh, Lisa B; Cummings, Doyle M

    2016-01-01

    Background Although there are several different general diabetes self-efficacy scales, there is a need to develop a self-efficacy scale that providers can use to assess patient’s self-efficacy regarding medication use. The purpose of this study was to: 1) develop a new diabetes medication self-efficacy scale and 2) examine how diabetes medication self-efficacy is associated with patient-reported problems in using diabetes medications and self-reported adherence. Patients and methods Adult English-speaking patients with type 2 diabetes were recruited from a family medicine clinic and a pharmacy in Eastern North Carolina, USA. The patients were eligible if they reported being nonadherent to their diabetes medicines on a visual analog scale. Multivariable regression was used to examine the relationship between self-efficacy and the number of reported diabetes medication problems and adherence. Results The diabetes medication self-efficacy scale had strong reliability (Cronbach’s alpha =0.86). Among a sample (N=51) of mostly African-American female patients, diabetes medication problems were common (6.1±3.1) and a greater number of diabetes medications were associated with lower medication adherence (odds ratio: 0.35; 95% confidence interval: 0.13, 0.89). Higher medication self-efficacy was significantly related to medication adherence (odds ratio: 1.17; 95% confidence interval: 1.05, 1.30) and inversely related to the number of self-reported medication problems (β=−0.13; P=0.006). Conclusion Higher diabetes medication self-efficacy was associated with fewer patient-reported medication problems and better medication adherence. Assessing medication-specific self-efficacy may help to identify medication-related problems that providers can help the patients address, potentially improving adherence and patient outcomes. PMID:27354769

  6. Survey of teaching/learning of healthcare-associated infections in UK and Irish medical schools.

    LENUS (Irish Health Repository)

    O'Brien, D

    2009-10-01

    All medical doctors have an important role to play in the diagnosis, management and prevention of healthcare-associated infection (HCAI). Strengthening the contribution of medical doctors and medical students to HCAI prevention programmes should include measures that enhance knowledge, improve practice and develop appropriate attitudes to the safety and quality of patient care. The Hospital Infection Society (HIS) funded a review of medical education on HCAI throughout medical schools in the UK and the Republic of Ireland. A questionnaire was drafted and circulated to all medical schools and 31 of 38 (82%) responded. The prevalence and transmission of HCAI were taught by 97% and 100% of medical schools, respectively, but the importance of HCAI as a quality and safety issue was covered in only 60% of medical schools. Multiple choice questions (MCQs) and objective structure clinical examinations (OSCEs) were the most popular methods of assessment. Lectures, discussion of cases and practical demonstrations were considered useful by >90% of respondents and online material and log books by 67% and 60%, respectively. More than 80% were willing to share a common pool of educational resources. An agreed curriculum should be developed for educating medical students in HCAI prevention and control, to outline optimum methods for assessment and develop a shared pool of educational resources.

  7. Rapid Post-Miocene tectonic rotation associated with the San Gregorio Fault Zone in central California

    Science.gov (United States)

    Holm, Eric J.; Horns, Daniel M.; Verosub, Kenneth L.

    1991-12-01

    Paleomagnetic measurements of samples from the Mio-Pliocene Purisima Formation demonstrate that the Pomponio tectonic block of central coastal California has rotated clockwise by approximately 35° to 55° within the last 2.5 million years. The most likely interpretation of this data is that the Pomponio block is broken into several small blocks which have rotated by various amounts. The data suggest that rotations contribute to vertical deformation and secondary faulting within the central San Andreas Fault System, and that they play an important role in the accommodation of shear along the fault system.

  8. Evaluation of medical research performance – position paper of the Association of the Scientific Medical Societies in Germany (AWMF

    Directory of Open Access Journals (Sweden)

    Herrmann-Lingen, Christoph

    2014-06-01

    Full Text Available [english] Objective: The evaluation of medical research performance is a key prerequisite for the systematic advancement of medical faculties, research foci, academic departments, and individual scientists’ careers. However, it is often based on vaguely defined aims and questionable methods and can thereby lead to unwanted regulatory effects. The current paper aims at defining the position of German academic medicine toward the aims, methods, and consequences of its evaluation. Methods: During the Berlin Forum of the Association of the Scientific Societies in Germany (AWMF held on 18 October 2013, international experts presented data on methods for evaluating medical research performance. Subsequent discussions among representatives of relevant scientific organizations and within three ad-hoc writing groups led to a first draft of this article. Further discussions within the AWMF Committee for Evaluation of Performance in Research and Teaching and the AWMF Executive Board resulted in the final consented version presented here.Results: The AWMF recommends modifications to the current system of evaluating medical research performance. Evaluations should follow clearly defined and communicated aims and consist of both summative and formative components. Informed peer reviews are valuable but feasible in longer time intervals only. They can be complemented by objective indicators. However, the Journal Impact Factor is not an appropriate measure for evaluating individual publications or their authors. The scientific “impact” rather requires multidimensional evaluation. Indicators of potential relevance in this context may include, e.g., normalized citation rates of scientific publications, other forms of reception by the scientific community and the public, and activities in scientific organizations, research synthesis and science communication. In addition, differentiated recommendations are made for evaluating the acquisition of third

  9. The association between medication adherence and treatment intensification with blood pressure control in resistant hypertension.

    Science.gov (United States)

    Daugherty, Stacie L; Powers, J David; Magid, David J; Masoudi, Frederick A; Margolis, Karen L; O'Connor, Patrick J; Schmittdiel, Julie A; Ho, P Michael

    2012-08-01

    Patients with resistant hypertension are at risk for poor outcomes. Medication adherence and intensification improve blood pressure (BP) control; however, little is known about these processes or their association with outcomes in resistant hypertension. This retrospective study included patients from 2002 to 2006 with incident hypertension from 2 health systems who developed resistant hypertension or uncontrolled BP despite adherence to ≥3 antihypertensive medications. Patterns of hypertension treatment, medication adherence (percentage of days covered), and treatment intensification (increase in medication class or dose) were described in the year after resistant hypertension identification. Then, the association between medication adherence and intensification with 1-year BP control was assessed controlling for patient characteristics. Of the 3550 patients with resistant hypertension, 49% were male, and mean age was 60 years. One year after resistance hypertension determination, fewer patients were taking diuretics (77.7% versus 92.2%; PTreatment was intensified in 21.6% of visits with elevated BP. Increasing treatment intensity was associated with 1-year BP control (adjusted odds ratio, 1.64 [95% CI, 1.58-1.71]). In this cohort of patients with resistant hypertension, treatment intensification but not medication adherence was significantly associated with 1-year BP control. These findings highlight the need to investigate why patients with uncontrolled BP do not receive treatment intensification.

  10. Demographic factors associated with perceptions about water safety and tap water consumption among adults in Santa Clara County, California, 2011.

    Science.gov (United States)

    van Erp, Brianna; Webber, Whitney L; Stoddard, Pamela; Shah, Roshni; Martin, Lori; Broderick, Bonnie; Induni, Marta

    2014-06-12

    The objective of this study was to examine differences in tap water consumption and perceptions of bottle versus tap water safety for Hispanics and non-Hispanic whites, as well as associations with other demographic characteristics. Data are from the Santa Clara County, California, Dietary Practices Survey (2011; N = 306). We used logistic regression to examine associations between demographic characteristics and 1) perceptions that bottled water is safer than tap and 2) primarily consuming tap water. Hispanics were less likely than non-Hispanic whites to primarily drink tap water (OR = 0.33; 95% CI, 0.11-0.99), although there was no significant difference in perceptions that bottled water is safer between these groups (OR = 0.50; 95% CI, 0.11-2.27). Hispanics may be an important population for interventions promoting tap water consumption.

  11. Evaluation of seasonal patterns of Kawasaki Syndrome- and rotavirus-associated hospitalizations in California and New York, 2000-2005

    Directory of Open Access Journals (Sweden)

    Parashar Umesh D

    2009-10-01

    Full Text Available Abstract Background Kawasaki Syndrome (KS is an uncommon childhood disease with unknown etiology. It has been suggested that rotavirus infection may play a causative role in the development of KS. Methods To examine potential temporal associations between KS and rotavirus infection, seasonal patterns of KS- and rotavirus-associated hospitalizations among children in California and New York during 2000-2005 were compared. Results Rotavirus hospital admissions were markedly winter seasonal, with very few summer hospitalizations. KS hospitalizations occurred year-round but also peaked slightly during winter and spring. Conclusion The strong winter seasonal pattern of rotavirus clearly differed from the year-round pattern of KS hospitalizations. While the present study cannot completely rule out rotavirus as having a role in the development of KS, other agents must be involved in the etiology of KS.

  12. 78 FR 17679 - Implementation of the Updated American Veterinary Medical Association Guidelines for the...

    Science.gov (United States)

    2013-03-22

    ... Association Guidelines for the Euthanasia of Animals: 2013 Edition SUMMARY: The National Institutes of Health... the American Veterinary Medical Association (AVMA) Guidelines for the Euthanasia of Animals: 2013... updated Guidelines. DATES: Public concerns regarding the updated AVMA Guidelines for the Euthanasia...

  13. Factors Associated with the Medical Severity of Suicide Attempts in Youths and Young Adults.

    Science.gov (United States)

    Swahn, Monica H.; Potter, Lloyd B.

    2002-01-01

    This study examined factors associated with the medical severity of suicide attempts focusing on demographic characteristics, and circumstances of the suicide attempt. Results show that young age was significantly associated with a nearly lethal suicide attempt. Prior attempts, hopelessness, depression, and help-seeking were significantly and…

  14. Association between cigarette smoking and depressive symptoms among military medical students in Turkey.

    Science.gov (United States)

    Güleç, Mahir; Bakir, Bilal; Ozer, Mustafa; Uçar, Muharrem; Kiliç, Selim; Hasde, Metin

    2005-04-30

    An association has been documented between two important health concerns, smoking and depression. A cross-sectional study was carried out to explore whether this relationship exists in a sample of Turkish military medical undergraduates. Of a total of 779 military medical undergraduates, 690 agreed to participate in the study. The students completed a self-administered questionnaire including the Turkish adaptation of the Beck Depression Inventory (BDI) and gave a smoking history. It was determined that the smokers among medical students were 2.2 times more likely to have depressive symptoms than nonsmokers. This result extends the significant association between smoking and depressive symptoms in the literature to a sample of Turkish military medical undergraduates.

  15. Associations of desire for change in sexual life amongst female medical students in North America

    OpenAIRE

    Shindel, AW; Breyer, BN; Smith, JF

    2013-01-01

    We analyzed associations of dissatisfaction with sexual life and desire for change in female medical students. Students enrolled in medical schools in North America between February and July 2008 were invited to participate in an internet-based survey of sexual function. The principle outcome measure was a single item question on sexual life satisfaction and desire for change. Women who reported dissatisfaction and desire for change were classified as 'sexually bothered'. The survey also asse...

  16. The Japan Medical Association's disaster preparedness: lessons from the Great East Japan Earthquake and Tsunami.

    Science.gov (United States)

    Ishii, Masami; Nagata, Takashi

    2013-10-01

    A complex disaster, the Great East Japan Earthquake of March 11, 2011, consisted of a large-scale earthquake, tsunami, and nuclear accident, resulting in more than 15 000 fatalities, injuries, and missing persons and damage over a 500-km area. The entire Japanese public was profoundly affected by "3/11." The risk of radiation exposure initially delayed the medical response, prolonging the recovery efforts. Japan's representative medical organization, the Japan Medical Association (JMA), began dispatching Japan Medical Association Teams (JMATs) to affected areas beginning March 15, 2011. About 1400 JMATs comprising nearly 5500 health workers were launched. The JMA coordinated JMAT operations and cooperated in conducting postmortem examination, transporting large quantities of medical supplies, and establishing a multiorganizational council to provide health assistance to disaster survivors. Importantly, these response efforts contributed to the complete recovery of the health care system in affected areas within 3 months, and by July 15, 2011, JMATs were withdrawn. Subsequently, JMATs II have been providing long-term continuing medical support to disaster-affected areas. However, Japan is at great risk for future natural disasters because of its Pacific Rim location. Also, its rapidly aging population, uneven distribution of and shortage of medical resources in regional communities, and an overburdened public health insurance system highlight the need for a highly prepared and effective disaster response system.

  17. The Frequency of Medication-related Osteonecrosis of the Jaw and its Associated Risk Factors.

    Science.gov (United States)

    Dodson, Thomas B

    2015-11-01

    This article provides the best current frequency estimate of medication-related osteonecrosis of the jaws (MRONJ), and identifies factors associated with the risk of developing osteonecrosis of the jaw (ONJ) among patients exposed to relevant medications (ie, antiresorptive or antiangiogenic agents). MRONJ is a rare but serious complication of cancer treatment or osteoporosis management. This review confirms that antiresorptive medications such as oral or intravenous bisphosphonates and denosumab are the most common risk factors for developing ONJ. The risk of MRONJ is greater in patients with cancer than in those receiving antiresorptive treatments for osteoporosis by a factor of 10.

  18. Pleuritis and suppurative pneumonia associated with a hypermucoviscosity phenotype of Klebsiella pneumoniae in California sea lions (Zalophus californianus).

    Science.gov (United States)

    Jang, Spencer; Wheeler, Liz; Carey, Roberta B; Jensen, Bette; Crandall, Claudia M; Schrader, Kimmi N; Jessup, David; Colegrove, Kathleen; Gulland, Frances M D

    2010-02-24

    The aim of this study is to document the isolation of a hypermucoviscosity (HMV) phenotype of Klebsiella pneumoniae from 25 cases of suppurative pneumonia and pleuritis and two cases of abscesses in California sea lions (Zalophus californianus) from the central California coast, representing the first report of this zoonotic pathogen from the marine environment and only the second report in non-humans. Animals died 2h to 4 days after first being observed sick on beaches. Clinical signs varied from dyspnoea to coma. Gross post-mortem examination of 25 cases revealed fibrinous pleuritis, copious pus in the pleural cavity and suppurative bronchopneumonia. K. pneumoniae isolates obtained from lung and pleural swabs and the hepatic and subcuticular abscesses were highly mucoid on blood agar culture media and were positive to the "string test". Twenty-one of the 27 isolates were examined by PCR and all were positive for rmpA and K2wyz and negative for K1magA genes. Although pneumonia and pleuritis have previously commonly been observed in marine mammals, their association with pure cultures of a zoonotic bacteria, K. pneumoniae HMV phenotype, has not. This report provides further evidence of the role marine mammals play as sentinels of health risks to humans from coastal waters.

  19. The association of needlestick injury with depressive symptoms among first-year medical residents in Japan.

    Science.gov (United States)

    Wada, Koji; Sakata, Yumi; Fujino, Yoshihisa; Yoshikawa, Toru; Tanaka, Katsutoshi; Miyajima, Eriko; Watanabe, Mitsuyasu; Aizawa, Yoshiharu

    2007-12-01

    Depressive symptoms among medical residents are common. The objective of this study was to determine the association of depressive symptoms with needlestick injury among first-year medical residents (so-called "intern"). We conducted a prospective cohort study among 107 medical residents in 14 training hospitals. The baseline survey was conducted in August 2005 and the follow-up survey was conducted in March 2006. Depressive symptoms were based on the Center for Epidemiological Study of Depression. Factors associated with depressive symptoms were examined using logistic regression analysis. For medical residents without depressive symptoms at the baseline survey, needlestick injury events were associated with depressive symptoms at the follow-up survey (corrected odds ratio [cOR]=2.98; 95% confidence interval [CI], 1.16-3.70). Because it was not possible to determine when the medical residents developed depressive symptoms, it is not possible to definitely determine causality between needlestick injury and depressive symptoms, although these findings are suggestive. Therefore, it would seem prudent to suggest the provision of mental health services to medical residents sustaining a needlestick injury since this may be helpful in identifying and treating depression.

  20. The association of medical comorbidity in schizophrenia with poor physical and mental health.

    Science.gov (United States)

    Dixon, L; Postrado, L; Delahanty, J; Fischer, P J; Lehman, A

    1999-08-01

    This study determined the prevalence of medical comorbidities in a cohort of persons receiving treatment for schizophrenia and the association of medical comorbidity with physical and mental health status. A total of 719 persons with schizophrenia sampled from a variety of community and treatment settings as part of the schizophrenia Patient Outcomes Research Team (PORT) participated in a survey interview. Multiple regression analyses were used to assess sociodemographic factors associated with the number of current medical comorbidities and the association of medical comorbidity count with patient ratings of physical health, mental health, symptoms, and quality of life. The majority of patients reported at least one medical problem. Problems with eyesight, teeth, and high blood pressure were most common. A greater number of current medical problems independently contributed to worse perceived physical health status, more severe psychosis and depression, and greater likelihood of a history of a suicide attempt. This study underscores the need to attend to somatic health care for persons with schizophrenia as well as the linkage of physical and mental health status.

  1. The Association between Charlson Comorbidity Index and the Medical Care Cost of Cancer: A Retrospective Study

    Directory of Open Access Journals (Sweden)

    Seok-Jun Yoon

    2015-01-01

    Full Text Available Background. This study compared comorbidity-related medical care cost associated with different types of cancer, by examining breast (N=287, colon (N=272, stomach (N=614, and lung (N=391 cancer patients undergoing surgery. Methods. Using medical benefits claims data, we calculated Charlson Comorbidity Index (CCI and total medical cost. The effect of comorbidity on the medical care cost was investigated using multiple regression and logistic regression models and controlling for demographic characteristics and cancer stage. Results. The treatment costs incurred by stomach and colon cancer patients were 1.05- and 1.01-fold higher, respectively, in patients with higher CCI determined. For breast cancer, the highest costs were seen in those with chronic obstructive pulmonary disease (COPD, but the increase in cost reduced as CCI increased. Colon cancer patients with diabetes mellitus and a CCI = 1 score had the highest medical costs. The lowest medical costs were incurred by lung cancer patients with COPD and a CCI = 2 score. Conclusion. The comorbidities had a major impact on the use of medical resources, with chronic comorbidities incurring the highest medical costs. The results indicate that comorbidities affect cancer outcomes and that they must be considered strategies mitigating cancer’s economic and social impact.

  2. Medication details documented on hospital discharge: cross-sectional observational study of factors associated with medication non-reconciliation.

    LENUS (Irish Health Repository)

    Grimes, Tamasine C

    2011-03-01

    Movement into or out of hospital is a vulnerable period for medication safety. Reconciling the medication a patient is using before admission with the medication prescribed on discharge, and documenting any changes (medication reconciliation) is recommended to improve safety. The aims of the study were to investigate the factors contributing to medication reconciliation on discharge, and identify the prevalence of non-reconciliation.

  3. Description of novel Babesia species and associated lesions from common murres (Uria aalge) from California.

    Science.gov (United States)

    Yabsley, Michael J; Greiner, Ellis; Tseng, Florina S; Garner, Michael M; Nordhausen, Robert W; Ziccardi, Michael H; Borjesson, Dori L; Zabolotzky, Shanon

    2009-10-01

    A novel Babesia species is described from blood collected from 3 common murres (also known as common guillemots) (Uria aalge) from California. This is the first report of a Babesia species from the Alcidae and the second from the Charadriiformes. Babesia uriae n. sp. is morphologically similar to several other avian Babesia species but can be differentiated from Babesia bennetti, the only other species from a host in the Charadriiformes, by size of round and amoeboid forms. Phylogenetic analysis of near-full length 18S rRNA, ITS-1, 5.8S rRNA, and ITS-2 sequences indicated that the Babesia sp. from the common murre is closely related to Babesia poelea, a parasite of brown boobies (Sula leucogaster).

  4. The underexamined association between posttraumatic stress disorder, medical illness and suicidal behavior.

    Science.gov (United States)

    Dobry, Yuriy; Sher, Leo

    2013-01-01

    Posttraumatic stress disorder (PTSD) is concerning not only because of the severity and chronicity of its symptoms - including distressing nightmares, flashbacks, anxiety attacks and maladaptive patterns of avoidant and nearly paranoid behavior - but also because of the wide spectrum of clinical and social impairments it is tightly associated with. The most striking example of clinical morbidity associated with PTSD is the well-known increase in the risk of suicidal behavior. Given that PTSD and medical illnesses increase the likelihood of suicide separately and independently, it is reasonable to suggest that the risk of suicidal behavior differs between patients suffering from PTSD comorbid with medical illnesses and patients having either condition alone. The available data point toward a novel clinical notion, an altered risk of suicidal behavior in patients suffering from comorbid PTSD and medical illnesses. This area of overlap between medicine and psychiatry is still in its infancy, with many unanswered questions about the rate, patterns and psychobiological mechanisms of suicidal behavior in this patient population. The positive association between PTSD, medical illness and suicidal behavior that appears to exist in the adult population, most likely affects the pediatric population as well. Closer investigation into the significance of the association between chronic medical illnesses, PTSD and suicidality in children, adolescents and adults is necessary.

  5. Phylogenetic, Morphological, and Pathogenic Characterization of Alternaria Species Associated with Fruit Rot of Blueberry in California.

    Science.gov (United States)

    Zhu, X Q; Xiao, C L

    2015-12-01

    Fruit rot caused by Alternaria spp. is one of the most important factors affecting the postharvest quality and shelf life of blueberry fruit. The aims of this study were to characterize Alternaria isolates using morphological and molecular approaches and test their pathogenicity to blueberry fruit. Alternaria spp. isolates were collected from decayed blueberry fruit in the Central Valley of California during 2012 and 2013. In total, 283 isolates were obtained and five species of Alternaria, including Alternaria alternata, A. tenuissima, A. arborescens, A. infectoria, and A. rosae, were identified based on DNA sequences of the plasma membrane ATPase, Alt a1 and Calmodulin gene regions in combination with morphological characters of the culture and sporulation. Of the 283 isolates, 61.5% were identified as A. alternata, 32.9% were A. arborescens, 5.0% were A. tenuissima, and only one isolate of A. infectoria and one isolate of A. rosae were found. These fungi were able to grow at temperatures from 0 to 35°C, and mycelial growth was arrested at 40°C. Optimal radial growth occurred between 20 to 30°C. Pathogenicity tests showed that all five Alternaria spp. were pathogenic on blueberry fruit at 0, 4, and 20°C, with A. alternata, A. arborescens, and A. tenuissima being the most virulent species, followed by A. infectoria and A. rosae. Previously A. tenuissima has been reported to be the primary cause of Alternaria fruit rot of blueberry worldwide. Our results indicated that the species composition of Alternaria responsible for Alternaria fruit rot in blueberry can be dependent on geographical region. A. alternata, A. arborescens, A. infectoria, and A. rosae are reported for the first time on blueberry in California. This is also the first report of A. infectoria and A. rosae infecting blueberry fruit.

  6. Injuries and Traumatic Psychological Exposures Associated with the South Napa Earthquake - California, 2014.

    Science.gov (United States)

    Attfield, Kathleen R; Dobson, Christine B; Henn, Jennifer B; Acosta, Meileen; Smorodinsky, Svetlana; Wilken, Jason A; Barreau, Tracy; Schreiber, Merritt; Windham, Gayle C; Materna, Barbara L; Roisman, Rachel

    2015-09-11

    On August 24, 2014, at 3:20 a.m., a magnitude 6.0 earthquake struck California, with its epicenter in Napa County (1). The earthquake was the largest to affect the San Francisco Bay area in 25 years and caused significant damage in Napa and Solano counties, including widespread power outages, five residential fires, and damage to roadways, waterlines, and 1,600 buildings (2). Two deaths resulted (2). On August 25, Napa County Public Health asked the California Department of Public Health (CDPH) for assistance in assessing postdisaster health effects, including earthquake-related injuries and effects on mental health. On September 23, Solano County Public Health requested similar assistance. A household-level Community Assessment for Public Health Emergency Response (CASPER) was conducted for these counties in two cities (Napa, 3 weeks after the earthquake, and Vallejo, 6 weeks after the earthquake). Among households reporting injuries, a substantial proportion (48% in Napa and 37% in western Vallejo) reported that the injuries occurred during the cleanup period, suggesting that increased messaging on safety precautions after a disaster might be needed. One fifth of respondents overall (27% in Napa and 9% in western Vallejo) reported one or more traumatic psychological exposures in their households. These findings were used by Napa County Mental Health to guide immediate-term mental health resource allocations and to conduct public training sessions and education campaigns to support persons with mental health risks following the earthquake. In addition, to promote community resilience and future earthquake preparedness, Napa County Public Health subsequently conducted community events on the earthquake anniversary and provided outreach workers with psychological first aid training.

  7. Number of medications is associated with outcomes in the elderly patient with metabolic syndrome

    Institute of Scientific and Technical Information of China (English)

    Akshar Y. Patel; Pratik Shah; Joseph H. Flaherty

    2012-01-01

    Background The diagnosis of metabolic syndrome indicates a clustering of metabolic imbalances which in sum have been recognized as a major predictor of cardiovascular and all-cause mortality. The aim of this study was to assess the level of under-pharmacy and poly-pharmacy and its prognostic impact in elderly patients with metabolic syndrome. Methods Retrospective chart-review at a tertiary medical center, of 324 patients greater than 65 years of age who met the International Diabetes Foundation criteria for metabolic syndrome diagnosis [Body Mass Index (BMI) > 30 kg/m2, diagnosis of type 2 diabetes, hypertension, and dyslipidemia]. Results There were 60 (18.5%) patients in the low (≤ 5) medication burden group, 159 (49.1%) in the medium (> 5 and ≤ 10) medication burden group, and 105(32.4%) in the high (> 10) medication burden group. At baseline, the groups differed only by systolic blood pressure. At two years follow-up,the medium group had significantly better improvement in high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), HbA1c, and systolic blood pressure compared to the low medication burden group and significantly better improvement in triglycerides, Haemoglobin A1c (HbA1c) and systolic blood pressure compared to the high medication group. Decrease in HDL-C was the only variable associated with strokes. High medication burden predicted hospitalization burden. The number of anti-hypertensives, history of tobacco use, low and high medication burdens and decrease in HDL-C were all associated with death. Conclusions Both poly-pharmacy and under-pharmacy are associated with a decreased therapeutic benefit among patients with metabolic syndrome in terms of important laboratory measurements as well as clinical outcomes such as myocardial infarctions, hospitalization, and death.

  8. Associations of anemia persistency with medical expenditures in Medicare ESRD patients on dialysis

    Directory of Open Access Journals (Sweden)

    Jiannong Liu

    2009-04-01

    Full Text Available Jiannong Liu1, Haifeng Guo1, David Gilbertson1, Robert Foley1,2, Allan Collins1,21Chronic Disease Research Group, Minneapolis Medical Research Foundation, Minneapolis, MN, USA; 2Department of Medicine, University of Minnesota, Minneapolis, MN, USAAbstract: Most end-stage renal disease (ESRD patients begin renal replacement therapy with hemoglobin levels below the recommended US National Kidney Foundation Dialysis Outcomes Quality Initiative Guidelines lower level of 110 g/L. Although most patients eventually reach this target, the time required varies substantially. This study aimed to determine whether length of time with below-target hemoglobin levels after dialysis initiation is associated with medical costs, and if so, whether intermediate factors underlie the associations. US patients initiating dialysis in 2002 were studied using the Centers for Medicare and Medicaid Services ESRD database. Anemia persistence (time in months with hemoglobin below 110 g/L was determined in a six-month entry period, and outcomes were assessed in the subsequent six-month follow-up period. The structural equation modeling technique was used to evaluate associations between persistent anemia and medical costs and to determine intermediate factors for these associations. The study included 28,985 patients. Mean per-patient-per-month medical cost was $6267 (standard deviation $5713 in the six-month follow-up period. Each additional month with hemoglobin below 110 g/L was associated with an 8.9% increment in medical cost. The increased cost was associated with increased erythropoietin use and blood transfusions, and increased rates of hospitalization and vascular access procedures in the follow-up period. Keywords: anemia persistency, end-stage renal disease, medical costs, structural equation modeling

  9. Factors associated with skipping breakfast among Inner Mongolia Medical students in China

    Directory of Open Access Journals (Sweden)

    Sun Juan

    2013-01-01

    Full Text Available Abstract Background Few studies on the breakfast consumption habits of medical students in China have been carried out. The aim of the present study was to determine the prevalence of skipping breakfast and factors associated with skipping breakfast among medical students in Inner Mongolia of China, and to assist in the design of interventions to improve breakfast consumption habits of medical college students in this region. Methods From December 2010 to January 2011 a cross-sectional survey was conducted among medical students in the Inner Mongolia Medical College using a self-administered questionnaire. The prevalence of skipping breakfast in relation to lifestyle habits was described and factors associated with breakfast consumption were identified using multiple logistic regression analysis. Results The overall prevalence of skipping breakfast was 41.7% and 23.5% for males and females, respectively. The Faculty of Medicine Information Management had the highest breakfast skipping prevalence. Logistic regression models found that the main factors associated with breakfast consumption habits among medical students were gender, class years of education, monthly expenses, faculty, appetite, sleeping quality, and the learning process; monthly expenses, sleeping quality, and the learning process showed a dose-dependent relationship. Conclusions Breakfast consumption was associated with many factors, most importantly monthly expenses, sleeping quality and the learning process. The prevalence of skipping breakfast is significantly higher compared recently reported figures for medical students in western countries and other areas of China. Improvement of breakfast education should be considered for students in which higher monthly expenses, poor sleeping quality, or a laborious learning process have been identified.

  10. Extracurricular activities associated with stress and burnout in preclinical medical students.

    Science.gov (United States)

    Fares, Jawad; Saadeddin, Zein; Al Tabosh, Hayat; Aridi, Hussam; El Mouhayyar, Christopher; Koleilat, Mohamad Karim; Chaaya, Monique; El Asmar, Khalil

    2016-09-01

    This study aims to assess the prevalence of stress and burnout among preclinical medical students in a private university in Beirut, Lebanon, and evaluate the association between extracurricular involvement and stress and burnout relief in preclinical medical students. A cross-sectional survey was conducted on a random sample of 165 preclinical medical students. Distress level was measured using the 12-item General Health Questionnaire (GHQ-12) while that of burnout was measured through the Maslach Burnout Inventory-Student Survey (MBI-SS). The MBI-SS assesses three interrelated dimensions: emotional exhaustion, cynicism, and academic efficacy. Extracurricular activities were divided into four categories: physical exercise, music, reading, and social activities. All selected participants responded. A substantial proportion of preclinical medical students suffered from stress (62%) and burnout (75%). Bivariate and multivariate regression analyses revealed that being a female or a 1st year medical student correlated with higher stress and burnout. Music-related activities were correlated with lower burnout. Social activities or living with parents were associated with lower academic efficacy. The high stress and burnout levels call for action. Addressing the studying conditions and attending to the psychological wellbeing of preclinical medical students are recommendations made in the study.

  11. California Bioregions

    Data.gov (United States)

    California Department of Resources — California regions developed by the Inter-agency Natural Areas Coordinating Committee (INACC) were digitized from a 1:1,200,000 California Department of Fish and...

  12. Coping styles and its association with sources of stress in undergraduate medical students

    Directory of Open Access Journals (Sweden)

    Sandhya Cherkil

    2013-01-01

    Full Text Available Context: The two ubiquitous factors that have been identified in medical courses to underlie mental health are stress and different coping styles adopted to combat stress. Aim: To find the association between coping styles and stress in undergraduate medical students. Settings and Design: A medical college in Central Kerala. A cross-sectional study design was adopted. Materials and Methods: Source and Severity of Stress Scale, Medical Student Version, was used to assess the source and nature of stress. Brief Cope was used to find out the coping styles adopted. Statistical Analysis: The statistical analysis was done using Statistical Package for Social Sciences version 20 and SAS. Chi-square analysis was used to find the association between coping styles and stress domains and with the overall stress score. Results: There is a significant positive association between overall stress score and coping styles ( P=0.001 of ′Negative cope′, ′Blame′, and ′Humor′. ′Positive cope′ and ′Religion′ has significant positive association with ′Academics′ ( P=0.047 and ′Self Expectations′ ( P=0.009. ′Blame′ ( P<0.001 has very high significant positive association with ′Academics′, ′Self expectation′, and ′Relationships′. Very high significant positive association is further found between ′Humor′ ( P<0.001 and ′Self expectations′, ′Living conditions′, and ′Health and Value conflict′. ′Substance Use′ is positively associated in high significance to ′Health and Value conflict′ ( P<0.001. Conclusions: The outcome of the study emphasizes the need for stress management techniques in the medical school.

  13. Association between addressing antiseizure drug side effects and patient-reported medication adherence in epilepsy

    Directory of Open Access Journals (Sweden)

    Moura LMVR

    2016-10-01

    Full Text Available Lidia M V R Moura,1 Thiago S Carneiro,1 Andrew J Cole,1 John Hsu,2,3 Barbara G Vickrey,4 Daniel B Hoch1 1Department of Neurology, 2Mongan Institute for Health Policy, Department of Medicine, Massachusetts General Hospital, 3Department of Health Care Policy, Harvard Medical School, Boston, MA, 4Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA Background and aim: Adherence to treatment is a critical component of epilepsy management. This study examines whether addressing antiepileptic drug (AED side effects at every visit is associated with increased patient-reported medication adherence.Patients and methods: This study identified 243 adults with epilepsy who were seen at two academic outpatient neurology settings and had at least two visits over a 3-year period. Demographic and clinical characteristics were abstracted. Evidence that AED side effects were addressed was measured through 1 phone interview (patient-reported and 2 medical records abstraction (physician-documented. Medication adherence was assessed using the validated Morisky Medication Adherence Scale-4. Complete adherence was determined as answering “no” to all questions.Results: Sixty-two (25% patients completed the interviews. Participants and nonparticipants were comparable with respect to demographic and clinical characteristics; however, a smaller proportion of participants had a history of drug-resistant epilepsy than nonparticipants (17.7% vs 30.9%, P=0.04. Among the participants, evidence that AED side effects were addressed was present in 48 (77% medical records and reported by 51 (82% patients. Twenty-eight (45% patients reported complete medication adherence. The most common reason for incomplete adherence was missed medication due to forgetfulness (n=31, 91%. There was no association between addressing AED side effects (neither physician-documented nor patient-reported and complete medication adherence (P=0.22 and 0.20.Discussion and

  14. Personality and Medical Specialty Choice: A Literature Review and Integration.

    Science.gov (United States)

    Borges, Nicole J.; Savickas, Mark L.

    2002-01-01

    Synthesizes studies categorized by medical specialties and using the following instruments into the Five Factor Model of personality: Adjective Check List, California Psychological Inventory, 16 Personality Factor Questionnaire, and Myers-Briggs Type Indicator. Suggests a loose association between personalty factors and medical specialties and…

  15. Associations between medical student empathy and personality: a multi-institutional study.

    Directory of Open Access Journals (Sweden)

    Patrício Costa

    Full Text Available BACKGROUND: More empathetic physicians are more likely to achieve higher patient satisfaction, adherence to treatments, and health outcomes. In the context of medical education, it is thus important to understand how personality might condition the empathetic development of medical students. Single institutional evidence shows associations between students' personality and empathy. This multi-institutional study aimed to assess such associations across institutions, looking for personality differences between students with high empathy and low empathy levels. METHODS: Participants were 472 students from three medical schools in Portugal. They completed validated adaptations to Portuguese of self-report measures of the NEO-Five Factor Inventory(NEO-FFI and the Jefferson Scale of Physician Empathy(JSPE-spv. Students were categorized into two groups: "Bottom" (low empathy, N = 165 and "Top" (high empathy, N = 169 according to their empathy JSPE-spv total score terciles. Correlation analysis, binary logistic regression analysis and ROC curve analysis were conducted. RESULTS: A regression model with gender, age and university had a predictive power (pseudo R2 for belonging to the top or bottom group of 6.4%. The addition of personality dimensions improved the predictive power to 16.8%. Openness to experience and Agreeableness were important to predict top or bottom empathy scores when gender, age and university were considered." Based on the considered predictors the model correctly classified 69.3% of all students. CONCLUSIONS: The present multi-institutional cross-sectional study in Portugal revealed across-school associations between the Big5 dimensions Agreeableness and Openness to experience and the empathy of medical students and that personality made a significant contribution to identify the more empathic students. Therefore, medical schools may need to pay attention to the personality of medical students to understand how to enhance

  16. Annual Proceedings of Selected Research and Development Papers Presented at the Annual Convention of the Association for Educational Communications and Technology (36th, Anaheim, California, 2013). Volume 2

    Science.gov (United States)

    Simonson, Michael, Ed.

    2013-01-01

    For the thirty-sixth year, the Research and Theory Division of the Association for Educational Communications and Technology (AECT) is sponsoring the publication of these Proceedings. Papers published in this volume were presented at the annual AECT Convention in Anaheim, California. The Proceedings of AECT's Convention are published in two…

  17. Annual Proceedings of Selected Research and Development Papers Presented at the Annual Convention of the Association for Educational Communications and Technology (36th, Anaheim, California, 2013). Volume 1

    Science.gov (United States)

    Simonson, Michael, Ed.

    2013-01-01

    For the thirty-sixth year, the Research and Theory Division of the Association for Educational Communications and Technology (AECT) is sponsoring the publication of these Proceedings. Papers published in this volume were presented at the annual AECT Convention in Anaheim, California. The Proceedings of AECT's Convention are published in two…

  18. Epidermal Nevus Syndrome Associated with Brain Malformations and Medulloblastoma

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2013-01-01

    Full Text Available Researchers at Juntendo University and Tokyo Women’s Medical University, Japan; and University of California, San Francisco, Ca, report a male infant with epidermal nevus syndrome associated with brainstem and cerebellar malformations and neonatal medulloblastoma.

  19. The Unauthorized Residency Status Myth: Health Insurance Coverage and Medical Care Use among Mexican Immigrants in California

    Directory of Open Access Journals (Sweden)

    Enrico A. Marcelli

    2004-01-01

    Full Text Available Tomando en cuenta los avances recientes en el modelo conductual del uso de asistencia médica y la epidemiología social, este artículo utiliza datos de encuestas para estimar si el estatus de residencia no autorizada entre los mexicanos que todavía no llegan a la vejez y otros inmigrantes latinos en California influyó en la probabilidad de que tuvieran seguro de salud y recibieran asistencia médica. Se estima que el estatus de residencia no autorizada ha disminuido la probabilidad de que estuvieran asegurados y, a su vez, ha aumentado la de que recurrieran al seguro de salud pública. Sin embargo, después de controlar otras características individuales, el contexto de vecindad y el capital social, ni el seguro ni el estatus de residencia parecen haber influido en que una persona obtuviera la asistencia médica necesaria. Finalmente, el contexto de vecindad, la dificultad para encontrar un lugar de asistencia médica y el compromiso cívico parecieran ser más importantes para comprender el uso de los servicios médicos.

  20. For Distinguished Public Service: Medical Library Association Honors FNLM and NIH MedlinePlus Magazine | NIH ...

    Science.gov (United States)

    ... this page please turn Javascript on. For Distinguished Public Service: Medical Library Association Honors FNLM and NIH MedlinePlus Magazine Past Issues / Summer 2011 Table of Contents MLA President Ruth Holst presented FNLM ... Service Award at the MLA’s recent national conference. ...

  1. Periocular necrotizing fasciitis associated with kerato-conjunctivitis and treated with medical management: A case report

    Directory of Open Access Journals (Sweden)

    Shome Debraj

    2008-01-01

    Full Text Available We report a 25-year-old systemically healthy male who presented with periocular necrotizing fasciitis (NF in the left eyelid. This was associated with the presence of immunologically mediated marginal kerato-conjunctivitis, in the same eye. This potentially dangerous lid infection and the associated ocular surface infection resolved successfully, with medical management. We report this case to highlight the successful conservative management of periocular NF and the hitherto unreported anterior segment involvement.

  2. Water use in California

    Science.gov (United States)

    Brandt, Justin; Sneed, Michelle; Rogers, Laurel Lynn; Metzger, Loren F.; Rewis, Diane; House, Sally F.

    2014-01-01

    As part of the USGS National Water Use Compilation, the California Water Science Center works in cooperation with local, State, and Federal agencies as well as academic and private organizations to collect and report total water withdrawals for California. The 2010 California water use data are aggregated here, in this website, for the first time. The California Water Science Center released these data ahead of the online USGS National Water Use Compilation circular report, in response to increased interest associated with current drought conditions. The national report is expected to be released late in 2014. The data on this website represents the most current California water use data available in the USGS National Water Use Compilation. It contains a section on water use in California for 2010. Water-use estimates are compiled by withdrawal source type, use category, and county. Withdrawal source types include groundwater, both fresh and saline,

  3. The Development of a Total Quality Management Plan for David Grant USAF Medical Center Travis Air Force Base, California

    Science.gov (United States)

    1991-12-01

    Ralston, F. (Summer, 1984). Total quality management: A revolutionary management philosophy. S.A.M. Advanced Management Journal , 24-33. Ryan, M. 3...Care" that appeared in the 5 January 1989 edition of The New England Journal of Medicine. In this article he lists six steps that lead to continuous...pathology, endodontics, pediatrics, periodontics, and prosthodontics . In addition to the basic allied specialties, David Grant USAF Medical Center

  4. Association between Acculturation and Binge Drinking among Asian-Americans: Results from the California Health Interview Survey

    Directory of Open Access Journals (Sweden)

    Monideepa B. Becerra

    2013-01-01

    Full Text Available Objective. Evaluate the association between acculturation and binge drinking among six Asian-American subgroups. Methods. A cross-sectional analysis of public access adult portion of 2007, 2009, and 2011/2012 California Health Interview Survey data was conducted. Univariate and multivariable logistic regression analyses were utilized with any binge drinking in the past year as the outcome variable and language spoken at home and time in USA as proxy measures of acculturation. Results. A total of 1,631 Asian-Americans (N=665,195 were identified as binge drinkers. Binge drinking was positively associated with being first generation South Asian (OR=3.05, 95% CI=1.55, 5.98 and monolingual (English only Vietnamese (OR=3.00; 95% CI=1.58, 5.70, especially among females. Other factors associated with increased binge drinking were being female (Chinese only, not being current married (South Asian only, and being an ever smoker (all subgroups except South Asians. Conclusion. First generation South Asians and linguistically acculturated Vietnamese, especially females, are at an increased risk of binge drinking. Future studies and preventive measures should address the cultural basis of such health risk behaviors among Asian-American adults.

  5. An analysis of lecture video utilization in undergraduate medical education: associations with performance in the courses

    Directory of Open Access Journals (Sweden)

    Chandrasekhar Arcot

    2009-01-01

    Full Text Available Abstract Background Increasing numbers of medical schools are providing videos of lectures to their students. This study sought to analyze utilization of lecture videos by medical students in their basic science courses and to determine if student utilization was associated with performance on exams. Methods Streaming videos of lectures (n = 149 to first year and second year medical students (n = 284 were made available through a password-protected server. Server logs were analyzed over a 10-week period for both classes. For each lecture, the logs recorded time and location from which students accessed the file. A survey was administered at the end of the courses to obtain additional information about student use of the videos. Results There was a wide disparity in the level of use of lecture videos by medical students with the majority of students accessing the lecture videos sparingly (60% of the students viewed less than 10% of the available videos. The anonymous student survey revealed that students tended to view the videos by themselves from home during weekends and prior to exams. Students who accessed lecture videos more frequently had significantly (p Conclusion We conclude that videos of lectures are used by relatively few medical students and that individual use of videos is associated with the degree to which students are having difficulty with the subject matter.

  6. Factors associated with a patient-centered medical home among children with behavioral health conditions.

    Science.gov (United States)

    Knapp, Caprice; Woodworth, Lindsey; Fernandez-Baca, Daniel; Baron-Lee, Jacqueline; Thompson, Lindsay; Hinojosa, Melanie

    2013-11-01

    At some point in their lives, nearly one-half of all American children will have a behavioral health condition. Many will not receive the care they need from a fragmented health delivery system. The patient-centered medical home is a promising model to improve their care; however, little evidence exists. Our study aim was to examine the association between several behavioral health indicators and having a patient-centered medical home. 91,642 children's parents or guardians completed the 2007 National Survey of Children's Health. An indicator for patient-centered medical home was included in the dataset. Descriptive statistics, bivariate tests, and multivariate regression models were used in the analyses. Children in the sample were mostly Male (52 %), White (78 %), non-Hispanic (87 %), and did not have a special health care need (80 %). 6.2 % of the sample had at least one behavioral health condition. Conditions ranged from ADHD (6 %) to Autism Spectrum Disorder (ASD) (1 %). Frequency of having a patient-centered medical home also varied for children with a behavioral health condition (49 % of children with ADHD and 33 % of children with ASD). Frequency of having a patient-centered medical home decreased with multiple behavioral health conditions. Higher severity of depression, anxiety, and conduct disorder were associated with a decreased likelihood of a patient-centered medical home. Results from our study can be used to target patient-centered medical home interventions toward children with one or more behavioral health conditions and consider that children with depression, anxiety, and conduct disorder are more vulnerable to these disparities.

  7. The Association between Medical Education Accreditation and Examination Performance of Internationally Educated Physicians Seeking Certification in the United States

    Science.gov (United States)

    van Zanten, Marta; Boulet, John R.

    2013-01-01

    The purposes of this research were to examine medical education accreditation practices around the world, with special focus on the Caribbean, and to explore the association between medical school accreditation and graduates' examination performance. In addition to other requirements, graduates of international medical schools seeking to…

  8. Association between routine laboratory tests and long-term mortality among acutely admitted older medical patients

    DEFF Research Database (Denmark)

    Klausen, Henrik Hedegaard; Petersen, Janne; Bandholm, Thomas

    2017-01-01

    BACKGROUND: Older people have the highest incidence of acute medical admissions. Old age and acute hospital admissions are associated with a high risk of adverse health outcomes after discharge, such as reduced physical performance, readmissions and mortality. Hospitalisations in this population...... are often by acute admission and through the emergency department. This, along with the rapidly increasing proportion of older people, warrants the need for clinically feasible tools that can systematically assess vulnerability in older medical patients upon acute hospital admission. These are essential...

  9. Premenstrual dysphoric disorder in medical students residing in hostel and its association with lifestyle factors

    Directory of Open Access Journals (Sweden)

    Amrita Mishra

    2015-01-01

    Full Text Available Context: There is scant research on premenstrual syndrome (PMS and its more severe counterpart, premenstrual dysphoric disorder (PMDD in Indian females. This study aimed to evaluate symptoms of PMS in medical students and to find the association of sociodemographic variables and lifestyle factors with PMDD. Subjects and Methods: A total of 179 medical students residing in the hostel of an Indian medical college and its affiliated teaching hospital were approached, of which 100 (55.8% returned the completed questionnaires. Data related to lifestyle factors was collected. Self-screening quiz for Diagnostic and Statistical Manual of Mental Disorders-IV-Text Revision PMDD and Shortened Premenstrual Assessment Form were used for diagnosis of PMDD and detection of symptomatology, respectively. Results: PMDD was present in 37% of the respondents. It was found at a higher rate in older and postgraduate students. PMDD was significantly associated with lifestyle factors, namely, sleep, physical activity, total tea/coffee intake, and change in tea/coffee and food intake under stress. The most common physical and psychological symptoms were body ache/joint pain and feeling depressed/blue, respectively. Conclusions: PMDD is fairly common in Indian medical students residing in hostel although cultural factors may influence symptom expression. This study suggests that PMDD is associated with lifestyle factors in young, professional, urban women. Modification in lifestyle may thus be an important approach for management of PMS/PMDD. Prospective studies with larger representative samples are needed to validate these findings.

  10. Factors Associated with Medication Nonadherence among Hypertensives in Ghana and Nigeria

    Directory of Open Access Journals (Sweden)

    Vincent Boima

    2015-01-01

    Full Text Available Background. Blood pressure (BP control is poor among hypertensives in many parts of sub-Saharan Africa. A potentially modifiable factor for control of BP is medication nonadherence (MNA; our study therefore aimed to determine factors associated with MNA among hypertensives in Ghana and Nigeria. Methodology. We conducted a multicenter cross-sectional study. Patients were recruited from Korle-Bu Hospital (n=120, Ghana; and University of Port Harcourt Teaching Hospital, (n=73 Apapa General Hospital Lagos (n=79 and University College Hospital Ibadan (n=85, Nigeria. Results. 357 hypertensive patients (42.6% males participated. MNA was found in 66.7%. Adherence showed correlation with depression (r=-0.208, P<0.001, concern about medications (r=-0.0347, P=0.002, and knowledge of hypertension (r=0.14, P=0.006. MNA was associated with formal education (P=0.001 and use of herbal preparation (P=0.014. MNA was found in 61.7% of uninsured participants versus 73.1% of insured participants (P=0.032. Poor BP control was observed in 69.7% and there was significant association between MNA and poor BP control (P=0.006. Conclusion. MNA is high among hypertensives in Ghana and Nigeria and is associated with depression, concern about hypertensive medications, formal education, and use of herbal preparations. The negative association between health insurance and MNA suggests interplay of other factors and needs further investigation.

  11. Brazilian Medical Association guidelines for the diagnosis and differential diagnosis of panic disorder

    Directory of Open Access Journals (Sweden)

    Michelle Nigri Levitan

    2013-12-01

    Full Text Available Objective: To present the most relevant findings regarding the Brazilian Medical Association guidelines for the diagnosis and differential diagnosis of panic disorder. Methods: We used the methodology proposed by the Brazilian Medical Association for the Diretrizes Project. The MEDLINE (PubMed, Scopus, Web of Science, and LILACS online databases were queried for articles published from 1980 to 2012. Searchable questions were structured using the PICO format (acronym for “patient” [or population], “intervention” [or exposure], “comparison” [or control], and “outcome”. Results: We present data on clinical manifestations and implications of panic disorder and its association with depression, drug abuse, dependence and anxiety disorders. In addition, discussions were held on the main psychiatric and clinical differential diagnoses. Conclusions: The guidelines are proposed to serve as a reference for the general practitioner and specialist to assist in and facilitate the diagnosis of panic disorder.

  12. Poor asthma education and medication compliance are associated with increased emergency department visits by asthmatic children

    Directory of Open Access Journals (Sweden)

    Saleh Al-Muhsen

    2015-01-01

    Full Text Available BACKGROUND: Acute exacerbations of bronchial asthma remain a major cause of frequent Emergency Department (ED visits by pediatric patients. However, other factors including psychosocial, behavioural and educational, are also reportedly associated with repetitive ED visits. Therefore, it is necessary to determine whether such visits are justifiable. OBJECTIVE: The objective of this cross-sectional study was to identify risk factors associated with visits to ED by asthmatic children. METHODS: Asthmatic children (n = 297 between 1-17 years old were recruited and information collected at the time of visiting an ED facility at two major hospitals. RESULTS: Asthmatic patients visited the ED 3.9 ΁ 3.2 times-per-year, on average. Inadequately controlled asthma was perceived in 60.3% of patients. The majority of patients (56.4% reported not receiving education about asthma. Patients reflected misconceptions about the ED department, including the belief that more effective treatments are available (40.9%, or that the ED staff is better qualified (27.8%. About half of patients (48.2% visited the ED because of the convenience of being open 24 hours, or because they are received immediately (38.4%. Uncontrolled asthma was associated with poor education about asthma and/or medication use. Patients educated about asthma, were less likely to stop corticosteroid therapy when their symptoms get better (OR:0.55; 95% CI:0.3-0.9; P = 0.04. CONCLUSION: This study reports that most patients had poor knowledge about asthma and were using medications improperly, thus suggesting inefficient application of management action plan. Unnecessary and frequent visits to the ED for asthma care was associated with poor education about asthma and medication use. Potential deficiencies of the health system at directing patients to the proper medical facility were uncovered and underline the necessity to improve education about the disease and medication compliance of patients and

  13. Hazard-evaluation and technical-assistance report HETA 90-122-l2073, technical assistance to San Francisco General Hospital and Medical Center, San Francisco, California

    Energy Technology Data Exchange (ETDEWEB)

    Moss, C.E.; Seitz, T.

    1990-10-01

    In response to a request from the Director of the Environmental Health and Safety Department of the San Francisco General Hospital and Medical Center, located in San Francisco, California, an evaluation was undertaken of possible hazardous working conditions at that site. Concern existed about exposures to hazards while operating the germicidal lamp at the facility. Germicidal lamps were used to disinfect the air in tuberculosis and aerosolized pentamidine clinics. The workers wore no protective eye wear. All rooms used a 30 watt germicidal lamp. Lower wattage bulbs in the smaller rooms would have reduced occupational ultraviolet (UV) exposure. Reflectance levels of UV radiation were quite high and varied. Worker exposure to germicidal lamp UV levels was dependent on many factors, some of the most important ones being the position of the bulb in the room, age of the bulb, obstruction of the UV radiation by objects near the bulb, and the height of the worker. While there are no consensus guidelines available on ventilation systems designed for areas where germicidal lamps are used, the provision of good room air distribution and mixing is recommended to prevent stagnant air conditions or short circuiting of supply air within the room. Bulb changers need to be aware of the need for protective clothing and gloves for protection from both the UV radiation levels as well as possible glass breakage.

  14. Association between patients' beliefs and oral antidiabetic medication adherence in a Chinese type 2 diabetic population

    Directory of Open Access Journals (Sweden)

    Wu P

    2016-06-01

    Full Text Available Ping Wu,1 Naifeng Liu2 1Department of Clinical Pharmacy, School of Basic Medical Sciences and Clinical Pharmacy, China Pharmaceutical University, 2Institute of Cardiovascular Disease, Southeast University Medical School, Nanjing, People’s Republic of China Purpose: The objective of this study was to identify, using the theory of planned behavior (TPB, patients’ beliefs about taking oral antidiabetic drugs (OADs as prescribed, and to measure the correlations between beliefs and medication adherence.Patients and methods: We performed a cross-sectional study of type 2 diabetic patients using structured questionnaires in a Chinese tertiary hospital. A total of 130 patients were enrolled to be interviewed about TPB variables (behavioral, normative, and control beliefs relevant to medication adherence. Medication adherence was assessed using the eight-item Morisky Medication Adherence Scale (MMAS-8. Spearman’s rank correlation was used to assess the association between TPB and MMAS-8. Logistic regression analysis was performed to examine the relationship between different variables and MMAS-8, with statistical significance determined at P<0.05.Results: From 130 eligible Chinese patients with an average age of 60.6 years and a male proportion of 50.8%, a nonsignificant relationship between behavioral, normative, and the most facilitating control beliefs and OAD adherence was found in our study. Having the OADs on hand (P=0.037 was the only facilitating control belief associated with adherence behavior. Being away from home or eating out (P=0.000, not accepting the disease (P=0.000, ignorance of life-long drug adherence (P=0.038, being busy (P=0.001, or poor memory (P=0.008 were control belief barriers found to be correlated with poor adherence. TPB is the only important determinant influencing OAD adherence among all the factors (P=0.011.Conclusion: The results indicate that the TPB model could be used to examine adherence to OADs. One

  15. Ethical orientation, functional linguistics, and the codes of ethics of the Canadian Nurses Association and the Canadian Medical Association.

    Science.gov (United States)

    Hadjistavropoulos, Thomas; Malloy, David C; Douaud, Patrick; Smythe, William E

    2002-09-01

    The literature on codes of ethics suggests that grammatical and linguistic structures as well as the theoretical ethical orientation conveyed in codes of ethics have implications for the manner in which such codes are received by those bound by them. Certain grammatical and linguistic structures, for example, tend to have an authoritarian and disempowering impact while others can be empowering. The authors analyze and compare the codes of ethics of the Canadian Nurses Association (CNA) and the Canadian Medical Association (CMA) in terms of their ethical orientation and grammatical/linguistic structures. The results suggest that the two codes differ substantially along these two dimensions. The CNA code contains proportionally more statements that provide a rationale for ethical behaviour; the statements of the CMA code tend to be more dogmatic. Functional grammar analysis suggests that both codes convey a strong deontological tone that does not enhance the addressee's ability to engage in discretionary decision-making. The nurses' code nonetheless implies a collaborative relationship with the client, whereas the medical code implies that the patient is the recipient of medical wisdom. The implications of these findings are discussed.

  16. Relative Prevalence of Grapevine Leafroll-Associated Virus Species in Wine Grape-Growing Regions of California.

    Directory of Open Access Journals (Sweden)

    Abhineet M Sharma

    Full Text Available Some diseases manifest as one characteristic set of symptoms to the host, but can be caused by multiple pathogens. Control treatments based on plant symptoms can make it difficult to effectively manage such diseases, as the biology of the underlying pathogens can vary. Grapevine leafroll disease affects grapes worldwide, and is associated with several viral species in the family Closteroviridae. Whereas some of the viruses associated with this disease are transmitted by insect vectors, others are only graft-transmissible. In three regions of California, we surveyed vineyards containing diseased vines and screened symptomatic plants for all known viral species associated with grapevine leafroll disease. Relative incidence of each virus species differed among the three regions regions, particularly in relation to species with known vectors compared with those only known to be graft-transmitted. In one region, the pathogen population was dominated by species not known to have an insect vector. In contrast, populations in the other surveyed regions were dominated by virus species that are vector-transmissible. Our survey did not detect viruses associated with grapevine leafroll disease at some sites with characteristic disease symptoms. This could be explained either by undescribed genetic diversity among these viruses that prevented detection with available molecular tools at the time the survey was performed, or a misidentification of visual symptoms that may have had other underlying causes. Based on the differences in relative prevalence of each virus species among regions and among vineyards within regions, we expect that region and site-specific management strategies are needed for effective disease control.

  17. Identifying risk factors for healthcare-associated infections from electronic medical record home address data

    Directory of Open Access Journals (Sweden)

    Rosenman Marc B

    2010-09-01

    Full Text Available Abstract Background Residential address is a common element in patient electronic medical records. Guidelines from the U.S. Centers for Disease Control and Prevention specify that residence in a nursing home, skilled nursing facility, or hospice within a year prior to a positive culture date is among the criteria for differentiating healthcare-acquired from community-acquired methicillin-resistant Staphylococcus aureus (MRSA infections. Residential addresses may be useful for identifying patients residing in healthcare-associated settings, but methods for categorizing residence type based on electronic medical records have not been widely documented. The aim of this study was to develop a process to assist in differentiating healthcare-associated from community-associated MRSA infections by analyzing patient addresses to determine if residence reported at the time of positive culture was associated with a healthcare facility or other institutional location. Results We identified 1,232 of the patients (8.24% of the sample with positive cultures as probable cases of healthcare-associated MRSA based on residential addresses contained in electronic medical records. Combining manual review with linking to institutional address databases improved geocoding rates from 11,870 records (79.37% to 12,549 records (83.91%. Standardization of patient home address through geocoding increased the number of matches to institutional facilities from 545 (3.64% to 1,379 (9.22%. Conclusions Linking patient home address data from electronic medical records to institutional residential databases provides useful information for epidemiologic researchers, infection control practitioners, and clinicians. This information, coupled with other clinical and laboratory data, can be used to inform differentiation of healthcare-acquired from community-acquired infections. The process presented should be extensible with little or no added data costs.

  18. An examination of the bleeding complications associated with herbal supplements, antiplatelet and anticoagulant medications.

    Science.gov (United States)

    Spolarich, A E; Andrews, L

    2007-01-01

    Dental professionals routinely treat patients taking prescription, nonprescription, and herbal medications that are known or have the potential to alter bleeding. Prescription anticoagulant and antiplatelet medications, as well as over-the-counter drugs such as aspirin, are typically taken to reduce the risk of thromboembolic events, including stroke. Herbal supplements are widely used for a variety of indications, and both patients and health care practitioners are often unaware of the anticoagulant and antiplatelet effects that occur as either predictable pharmacologic effects or adverse side effects of herbal medicines. In addition, patient use of these herbal supplements is usually undisclosed to health care providers. The purpose of this literature review is to examine the mechanisms of action of drugs and herbs that alter bleeding, and to educate dental professionals as to the proper care and management of patients using these medications. Decision-making strategies, including interpretation of laboratory tests, and when to discontinue the use of these medications are discussed. Patients undergoing routine dental and dental hygiene procedures do not need to discontinue the use of anticoagulant and antiplatelet medications. However, alterations in drug use may be required for those patients undergoing invasive surgical procedures. It is recommended that herbal supplements must be discontinued 2 weeks prior to receiving invasive surgical procedures. Dental practitioners must learn to weigh the risks of discontinuing drug therapy against the potential risks to patients, and implement risk reduction strategies to minimize adverse bleeding complications associated with dental treatment.

  19. Report on the American Association of Medical Physics Undergraduate Fellowship Programs.

    Science.gov (United States)

    Smilowitz, Jennifer B; Avery, Stephen; Gueye, Paul; Sandison, George A

    2013-01-07

    The American Association of Physicists in Medicine (AAPM) sponsors two summer undergraduate research programs to attract top performing undergraduate students into graduate studies in medical physics: the Summer Undergraduate Fellowship Program (SUFP) and the Minority Undergraduate Summer Experience (MUSE). Undergraduate research experience (URE) is an effective tool to encourage students to pursue graduate degrees. The SUFP and MUSE are the only medical physics URE programs. From 2001 to 2012, 148 fellowships have been awarded and a total of $608,000 has been dispersed to fellows. This paper reports on the history, participation, and status of the programs. A review of surveys of past fellows is presented. Overall, the fellows and mentors are very satisfied with the program. The efficacy of the programs is assessed by four metrics: entry into a medical physics graduate program, board certification, publications, and AAPM involvement. Sixty-five percent of past fellow respondents decided to pursue a graduate degree in medical physics as a result of their participation in the program. Seventy percent of respondents are currently involved in some educational or professional aspect of medical physics. Suggestions for future enhancements to better track and maintain contact with past fellows, expand funding sources, and potentially combine the programs are presented.

  20. Stress among Medical Students and Its Association with Substance Use and Academic Performance

    Directory of Open Access Journals (Sweden)

    Leta Melaku

    2015-01-01

    Full Text Available Background. Chronic stress among medical students affects academic performance of students and leads to depression, substance use, and suicide. There is, however, a shortage of such research evidence in Ethiopia. Objective. We aimed to estimate the prevalence and severity of stress and its association with substance use and academic performance among medical students. Methods. A cross-sectional survey was conducted on a sample of 329 medical students at Jimma University. Data were collected using the General Health Questionnaire (GHQ-12, Medical Students Stress Questionnaire (MSSQ-20, and Drug Abuse Surveillance Test (DAST. Data were analyzed using SPSS version 20.0. Logistic regression analysis and Student’s t-test were applied. Results. The mean age of the respondents was 23.02 (SD = 2.074 years. The current prevalence of stress was 52.4%. Academic related stressor domain was the main source of stress among 281 (88.6% students. Stress was significantly associated with khat chewing [AOR = 3.03, 95% CI (1.17, 7.85], smoking [AOR = 4.55, 95% CI (1.05, 19.77], and alcohol intake [AOR = 1.93, 95% CI (1.03, 3.60]. The prevalence of stress was high during the initial three years of study. Stress was significantly (p=0.001 but negatively (r=-0.273 correlated with academic achievement. Conclusion. Stress was a significant problem among medical students and had a negative impact on their academic performance. Year of study, income, and substance use were associated with stress. Counseling and awareness creation are recommended.

  1. Policing the social boundaries of the American Medical Association, 1847-70.

    Science.gov (United States)

    Haynes, Douglas M

    2005-04-01

    In May 1870 the American Medical Association (AMA) voted to deny the admission of black delegates and their white colleagues to the national meeting in Washington, D.C. Historians of race and medicine have customarily viewed this decision as marking a crucial milestone in the formation of the nexus between racism and the development of the American medical profession in the era after the Civil War (1861-64). This study recasts this narrative by locating the 1870 decision in relation to the antebellum practices of the association and their social consequences for American medicine. It argues that the viability of the AMA as the national voice of the profession was critically dependent on rejecting racial equality. Indeed, at a moment when the question of the abolition of slavery polarized the nation, the AMA was founded in 1847 to create a voluntary professional organization, national in scope, dedicated to raising the standards of medical training and practice. To this end, the AMA elected presidents and selected host cities for annual meetings in the North, South, and West. Seven out of the fourteen meetings and six out of fourteen presidents were from slave and/or border states. These institutional practices together with the representation of blacks as different and enjoying an appropriate status as slaves grounded the national identity of the profession in black subordination. Similarly, the gendered discourses about healing and practices of female exclusion privileged medical authority as male by drawing on and reinforcing patriarchy. In the wake of the war, leaders hoped to restore the national character of the organization by resuming antebellum practices. In response to the new possibilities for blacks in medicine--as represented by the biracial National Medical Society--the AMA took steps to vigorously police the racial boundaries of the national profession. As this study will show, the 1870 decision reflected the logic of the racial politics at the heart

  2. Review of Seismic Hazard Issues Associated with Auburn Dam Project, Sierra Nevada Foothills, California

    Science.gov (United States)

    Schwartz, D.P.; Joyner, W.B.; Stein, R.S.; Brown, R.D.; McGarr, A.F.; Hickman, S.H.; Bakun, W.H.

    1996-01-01

    Summary -- The U.S. Geological Survey was requested by the U.S. Department of the Interior to review the design values and the issue of reservoir-induced seismicity for a concrete gravity dam near the site of the previously-proposed Auburn Dam in the western foothills of the Sierra Nevada, central California. The dam is being planned as a flood-control-only dam with the possibility of conversion to a permanent water-storage facility. As a basis for planning studies the U.S. Army Corps of Engineers is using the same design values approved by the Secretary of the Interior in 1979 for the original Auburn Dam. These values were a maximum displacement of 9 inches on a fault intersecting the dam foundation, a maximum earthquake at the site of magnitude 6.5, a peak horizontal acceleration of 0.64 g, and a peak vertical acceleration of 0.39 g. In light of geological and seismological investigations conducted in the western Sierran foothills since 1979 and advances in the understanding of how earthquakes are caused and how faults behave, we have developed the following conclusions and recommendations: Maximum Displacement. Neither the pre-1979 nor the recent observations of faults in the Sierran foothills precisely define the maximum displacement per event on a fault intersecting the dam foundation. Available field data and our current understanding of surface faulting indicate a range of values for the maximum displacement. This may require the consideration of a design value larger than 9 inches. We recommend reevaluation of the design displacement using current seismic hazard methods that incorporate uncertainty into the estimate of this design value. Maximum Earthquake Magnitude. There are no data to indicate that a significant change is necessary in the use of an M 6.5 maximum earthquake to estimate design ground motions at the dam site. However, there is a basis for estimating a range of maximum magnitudes using recent field information and new statistical fault

  3. Healdsburgite - a New Tektite and Associated Tektite Strewnfield in North Central California

    Science.gov (United States)

    Erickson, R. C.; Deino, A. L.; Norwick, S. A.; Byrd, C.

    2012-12-01

    Erickson, Rolfe; Norwick, Steven; and Byrd, Caitlin, Sonoma State University; Deino, Alan, Berkeley Geochronology Center. I A Distinctive Glass Clast Population In numerous locations in Sonoma and Solano Counties in north central California, over an area of ~ 200 km2, distinctive ~ 1-5 cm dominantly ovoid glass clasts are found as part of the pebble population in young sediments. They are composed of black massive aphyric nonvesicular glass whose surfaces are totally covered with a texture of adjoining small deep pits and grooves. The pits are hemispherical, 1-10 mm across, and join at sharp edges composed of straight segments. The grooves, where present, are the width and depth of the pits and may be up to several cm long and vermicular. Some clasts have internal layering resembling flow textures. These glass objects were brought to our attention by a local resident, Ms. Diane Moore, about 20 years ago. Four of these glass clasts from widely separated locations in the exposure area have been dated by the laser incremental-heating Ar39/Ar40 method at the Berkeley Geochronology Center, with an age of ~ 2.81 Ma (upper Pliocene). The four samples have mutually overlapping ages at one sigma. Chemical analyses of the 10 major and 50 minor elements, of four widely separated clasts, were obtained at commercial laboratories. The clasts are all rhyolites and cluster tightly on the TAS diagram of Le Maitre et al (2002). All available data show that all these pitted and grooved clasts are part of a single population. II. The Clasts are Tektites We believe these distinctive glass clasts to be tektites for the following reasons: 1. Pits are always present and wholly cover the clast surface. Perhaps half the clasts also have distinctive irregular vermicular grooves superimposed on the pitted surface. This surface pattern is like those on other long-recognized 'classic' tektites, like indochinites. The clasts look like tektites; compare McCall (2001, Figure 2.30) for example. 2

  4. Symptom experience associated with immunosuppressive drugs after liver transplantation in adults : possible relationship with medication non-compliance?

    NARCIS (Netherlands)

    Drent, Gerda; Moons, P.; De Geest, S.; Kleibeuker, J. H.; Haagsma, E. B.

    2008-01-01

    Symptom experience (occurrence and perceived distress) associated with side effects of immunosuppressive medications in organ transplant patients may well be associated with poorer quality of life and medication non-compliance. The aims of this study were: first, to assess symptom experience in clin

  5. Spring-time distributions of migratory marine birds in the southern California Current: Oceanic eddy associations and coastal habitat hotspots over 17 years

    Science.gov (United States)

    Yen, P. P. W.; Sydeman, W. J.; Bograd, S. J.; Hyrenbach, K. D.

    2006-02-01

    We used a 17-year time series of shipboard observations to address the hypothesis that marine birds associate with persistent hydrographic features in the southern California Current System (CCS). Overall, approximately 27,000 km of ocean habitat were surveyed, averaging 1600 km per cruise. We identified mesoscale features (eddy centers and the core of the California Current), based on dynamic height anomalies, and considered habitat associations for seven migratory seabird species: black-footed albatross ( Phoebastria nigripes), Cook's petrel ( Pterodroma cookii), Leach's storm-petrel ( Oceanodroma leucorhoa), dark shearwaters (mainly sooty shearwater Puffinus griseus, with a few short-tailed shearwaters Puffinus tenuirostris), northern fulmar ( Fulmarus glacialis), red phalarope ( Phalaropus fulicaria), and red-necked phalarope ( Phalaropus lobatus). We explored associations (presence/absence and density relationships) of marine birds with mesoscale features (eddies, current jet) and metrics of primary productivity (chlorophyll a and nitrate concentrations). Mesoscale eddies were consistently identified in the study region, but were spatially and temporally variable. The resolved eddies were large-scale features associated with meanders of the equatorward-flowing California Current. Cook's petrel was found offshore with no specific habitat affinities. Black-footed albatross, red phalarope, and Leach's storm petrel were found in association with offshore eddies and/or the core of the California Current, but the functional relationship for these species varied, possibly reflecting differences in flight capabilities. The more coastal species, including the shearwaters, fulmar, and red-necked phalarope, were positively associated with proxies of primary productivity. Of the hydrographic habitats considered, the upwelling region of Point Conception appears to be an important "hotspot" of sustained primary production and marine bird concentrations. Point Conception and

  6. The Association between Non-Medical Prescription Drug Use and Suicidal Behavior among United States Adolescents

    Directory of Open Access Journals (Sweden)

    Amanda L. Divin

    2014-11-01

    Full Text Available Adolescence represents a vulnerable time for the development of both drug use/abuse and mental illness. Although previous research has substantiated a relationship between drug use and suicidal behavior, little research has examined this relationship with non-medical prescription drug use. Given the growing prevalence of non-medical prescription drug use (NMPDU among adolescents, this study explored the association between NMPDU and suicidal behavior. Nationally representative data were derived from 16, 410 adolescents who completed the 2009 National Youth Risk Behavior Survey. Approximately 19.8% of participants reported lifetime NMPDU. NMPDU was associated with significantly increased odds of suicidal behavior (P < 0.01, with seriously considering attempting suicide and making a plan about attempting suicide representing the strongest correlates for males and females. Results suggest the importance of 1 continued reinforcement of drug education programs in high school begun at earlier ages and 2 mental health care and screenings among adolescents.

  7. Rhizopus oryzae associated with Melanagromyza splendida and stem disease of sunflowers (Helianthus annuus) in California

    Science.gov (United States)

    In September 2012, a female parental line in a Yolo, CA in sunflower seed-production field began displaying external stem symptoms that could not be attributed to any known disease. Symptoms appeared to be associated with tunneling caused by an un-identified insect. Stems were collected and Rhizopu...

  8. Paternal responsiveness is associated with, but not mediated by reduced neophobia in male California mice (Peromyscus californicus).

    Science.gov (United States)

    Chauke, Miyetani; de Jong, Trynke R; Garland, Theodore; Saltzman, Wendy

    2012-08-20

    Hormones associated with pregnancy and parturition have been implicated in facilitating the onset of maternal behavior via reductions in neophobia, anxiety, and stress responsiveness. To determine whether the onset of paternal behavior has similar associations in biparental male California mice (Peromyscus californicus), we compared paternal responsiveness, neophobia (novel-object test), and anxiety-like behavior (elevated plus maze, EPM) in isolated virgins (housed alone), paired virgins (housed with another male), expectant fathers (housed with pregnant pairmate), and new fathers (housed with pairmate and pups). Corticotropin-releasing hormone (CRH) and Fos immunoreactivity (IR) were quantified in brain tissues following exposure to a predator-odor stressor or under baseline conditions. New fathers showed lower anxiety-like behavior than expectant fathers and isolated virgins in EPM tests. In all housing conditions, stress elevated Fos-IR in the hypothalamic paraventricular nucleus (PVN). Social isolation reduced overall (baseline and stress-induced) Fos- and colocalized Fos/CRH-IR, and increased overall CRH-IR, in the PVN. In the central nucleus of the amygdala, social isolation increased stress-induced CRH-IR and decreased stress-induced activation of CRH neurons. Across all housing conditions, paternally behaving males displayed more anxiety-related behavior than nonpaternal males in the EPM, but showed no differences in CRH- or Fos-IR. Finally, the latency to engage in paternal behavior was positively correlated with the latency to approach a novel object. These results suggest that being a new father does not reduce anxiety, neophobia, or neural stress responsiveness. Low levels of neophobia, however, were associated with, but not necessary for paternal responsiveness.

  9. Disorders of fuel metabolism: medical complications associated with starvation, eating disorders, dietary fads, and supplements.

    Science.gov (United States)

    Judge, Bryan S; Eisenga, Bernard H

    2005-08-01

    Disorders of fuel metabolism as they relate to abnormal fuel intake,abnormal fuel expenditure, and dietary supplements are the focus of this article. The emergency physician should be aware of the medical complications that can occur as a result of starvation states,eating disorders, fad diets, hypermetabolic states, and ergogenic aids. Knowledge and understanding of the complications associated with these disorders will facilitate the diagnosis and management of patients who present to the emergency department with any of the disorders reviewed.

  10. Midbrain infarction: associations and aetiologies in the New England Medical Center Posterior Circulation Registry

    OpenAIRE

    Martin, P.; Chang, H.; Wityk, R; CAPLAN, L.

    1998-01-01

    Most reports of midbrain infarction have described clinicoanatomical correlations rather than associations and aetiologies. Thirty nine patients with midbrain infarction (9.4%) are described out of a series of 415 patients with vertebrobasilar ischaemic lesions in the New England Medical Center Posterior Circulation Registry. Patients were categorised according to the rostral-caudal extent of infarction. The "proximal" vertebrobasilar territory includes the medulla and po...

  11. Development of an Integrated Psychosocial Treatment to Address the Medical Burden Associated with Bipolar Disorder

    OpenAIRE

    Sylvia, Louisa G; Nierenberg, Andrew A.; Stange, Jonathan P.; Peckham, Andrew D.; Deckersbach, Thilo

    2011-01-01

    We developed an integrated psychosocial treatment for bipolar disorder to decrease the disproportionate medical burden associated with this illness. Three treatment modules, Nutrition/weight loss, Exercise, and Wellness Treatment (NEW Tx) were administered in twelve 60-minute group sessions over 14 weeks. After the first group (N = 4) had completed the treatment, it was revised, and then a second group (N = 6) completed the revised treatment. Participants completed all of the study assessment...

  12. Nonadherence to antihypertensive medications and associated factors in general medicine clinics

    Directory of Open Access Journals (Sweden)

    Al Ghobain M

    2016-08-01

    Full Text Available Mohammed Al Ghobain,1,2 H Alhashemi,1,2 A Aljama,3 S Bin Salih,1,2 Z Assiri,4 A Alsomali,4 Gamal Mohamed5 1Department of Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, 2King Abdullah International Medical Research Centre, 3Department of Medicine, King Abdulaziz Medical City, 4College of Nursing, 5College of Public Health, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia Objectives: Nonadherence to antihypertensive medications has not been assessed in the Saudi population. The aim of this study was to address and evaluate the magnitude of nonadherence among hypertensive patients and the risk factors associated with it. Methods: A cross-sectional survey was conducted on hypertensive patients who attended the general internal medicine clinics at King Abdulaziz Medical City, Riyadh, Saudi Arabia, using a questionnaire that was modified after reviewing the literature. Hypertensive patients were labeled as nonadherent if they missed their medications for a total of 7 days during the previous month. Results: A total of 302 patients participated in the study, of whom 63% were females with a mean age of 64 years, and 64% were illiterate. The prevalence of nonadherence to medications among hypertensive patients was found to be 12.3%. Poor disease knowledge was reported in 80% of patients, while 66% of the patients had poor monitoring of their disease. Younger age (≤65 years, poor monitoring, and uncontrolled blood pressure (BP ≥140/90 mmHg were the predictor factors associated with nonadherence (odds ratio [OR] =2.04, P=0.025; OR=2.39, P=0.004; and OR=2.86, P=0.003, respectively. Conclusion: Nonadherence to antihypertensive medications is lower than that previously reported in the literature. Younger age, uncontrolled BP, and poor monitoring are the main risk factors associated with nonadherence. Keywords: nonadherence, hypertension, Saudi Arabia, uncontrolled blood

  13. Factors associated with stress of conscience among emergency medical technicians in China.

    Science.gov (United States)

    Zhang, Hong; Wang, Kang; Liu, Yu; Chan, Darius K-S

    2013-09-01

    The current study was designed to investigate factors related to stress of conscience among emergency medical technicians in China. One hundred and seventy-five doctors and nurses from emergency departments completed questionnaires measuring demographic information, two personality traits (i.e. responsibility and logical-affective orientation), stress of conscience and colleagues' stress of conscience. Important findings include the following: (i) Stress of conscience varied as a function of age, years of work, and marital status; (ii) Participants' stress of conscience was highly associated with colleagues' stress of conscience; and (iii) Both responsibility and a logical orientation were negatively associated with stress of conscience.

  14. Position of the American Dietetic Association: integration of medical nutrition therapy and pharmacotherapy.

    Science.gov (United States)

    2003-10-01

    It is the position of the American Dietetic Association that the application of medical nutrition therapy (MNT) and lifestyle counseling as a part of the Nutrition Care Process is an integral component of the medical treatment for management of specific disease states and conditions and should be the initial step in the management of these situations. If optimal control cannot be achieved with MNT alone and concurrent pharmacotherapy is required, then The Association promotes a team approach to care for clients receiving concurrent MNT and pharmacotherapy and encourages active collaboration among dietetics professionals and other members of the health care team. There are a number of medical conditions, many of them chronic, that will respond to MNT and, therefore, MNT should be the first intervention for these conditions. In addition to being a vital element of the optimal management and control of these conditions, MNT is also a cost-effective method of management. However, because of the long-term nature of these conditions, concurrent pharmacotherapy may become necessary to achieve or maintain optimal control. In cases where this is necessary, MNT should continue to be an integral component of the therapy because it may complement or enhance the therapeutic effectiveness of pharmacotherapy, thereby reducing or eliminating the need for multiple medications. The utilization of a coordinated multidisciplinary team approach is critical to the success of the concurrent use of MNT and pharmacotherapy because of the long-term duration of the treatments, the necessity of monitoring compliance and effectiveness, and the likelihood of multiple medication-nutrient interactions.

  15. Outcomes associated with prescribed medications in older adults with multimorbidity: protocol for a scoping review

    Science.gov (United States)

    Tricco, Andrea C; Vyas, Manav; Kohli, Kapil; Soin, Sarthak; Abaeian, Mitra; Watt, Stephanie; Straus, Sharon E

    2017-01-01

    Introduction Multimorbidity becomes increasingly prevalent with ageing. Polypharmacy is often associated with multimorbidity because patients accrue medications to treat each individual disease; however, there is uncertainty around the generalisability of disease-specific guidelines. Namely, the extrapolation of results from studies conducted in younger patients to older adults with multimorbidity. The main objective of this scoping review is to explore our current knowledge of the outcomes that older adults with multimorbidity experience from taking prescribed medications. Methods and analysis A scoping review will be conducted to explore what is known about the outcomes experienced by older adults with multimorbidity who are taking guideline-recommended medications and to identify areas for future research. In addition to searching the grey literature, the following databases will be searched from 1990 onward: MEDLINE, EMBASE, PsycINFO and the Cochrane Library. Experimental, quasi-experimental and non-experimental studies consisting of patients ≥65 years old who have two or more comorbid conditions (explicitly grouped together for the purpose of analysis) and who are being prescribed a guideline-recommended prescription medication for a chronic condition will be considered for inclusion in our scoping review. We will describe patient (eg, mortality, morbidity, quality of life) and health system (eg, number of emergency department visits or hospitalisations, cost to third-party payer) outcomes associated with the prescription of medications for older adults who have two or more chronic comorbid conditions. Two reviewers will complete all screening and data abstraction independently. Data will be synthesised with descriptive statistics. Ethics and dissemination Ethics approval is not required because this is a scoping review of published literature. Results will be disseminated through conference presentations and publication in a peer-reviewed journal. PMID

  16. Antihypertension medication adherence and associated factors at Dessie Hospital, North East Ethiopia, Ethiopia

    Directory of Open Access Journals (Sweden)

    Legese Chelkeba

    2013-06-01

    Full Text Available Hypertension is an overwhelming global challenge. Despite the development of many effective anti hypertensive drugs, target to reduce morbidity and mortality due to high blood pressures are reached in only a minor of patients in clinical practice. Poor adherence is one of the biggest obstacles in therapeutic control of blood pressures. There are complaints from patients and physicians that the poor result of actual antihypertensive drug therapies. Many people with age indifference are attacked by this “silent killer” or which results in target organ damage as a complication. The aim of this study was to assess the magnitude of adherence and the factors associated with non-adherence to anti-hypertensive medication. Cross sectional exclusively convenient study was conducted by using structured questionnaires consisting of open and closed-ended questions on patients diagnosed for hypertension and have already been on anti hypertensive medications at least for three months at Dessie Referral hospital from 20/01/2012 to 29/01/2012. A total of hundred hypertensive patients were screened from hundred six cases by the exclusive criteria and the overall incidence of anti-hypertensive medication non adherence was 26%. The study identifies reasons why patients don’t adherent with the drug regiments. Among Factors associated with non adherence were health system and health care provider poor interaction with patient and therapy factors like frustration and unwanted effect of the medication in the long run. There was indication of non adherence from the study area. Great emphasis should be placed on intervention strategies such as patient counseling and increasing awareness of the physicians, all other prescribers and health care providers at large about the non adherence of anti hypertensive drugs as well as the complication what comes due to this medication non adherence. [Int J Res Med Sci 2013; 1(3.000: 191-197

  17. Association between mental health screening by self-report questionnaire and insomnia in medical students

    Directory of Open Access Journals (Sweden)

    Loayza H. Maria Paz

    2001-01-01

    Full Text Available Epidemiological research points to the high prevalence of psychiatric disorders among insomniacs. We carried out a cross-sectional study with medical students with the aim of evaluating the association between insomnia and suspicion of psychiatric disorder; 302 medical students were included (184 males and 118 females; mean age = 20.47±1.89 years. The main association was tested by logistic regression analysis. The overall prevalence of positivity in a screening test for psychiatric disorder was 22.19%; and of insomnia, 28.15%. Difficulty initiating sleep (OR=3.45, difficulty maintaining sleep (OR=7.61, falling asleep later (OR=1.99 and waking up earlier (OR=1.91 were associated with suspicion of psychiatric disorder. As a group, the variables difficulty initiating sleep, difficulty maintaining sleep, falling asleep after 11 pm, and waking up before 6 am presented an odds ratio of 5.96 for positivity in the screening for psychiatric disorder. Furthermore, difficulty maintaining sleep (OR=2.24 was associated with "being female," and falling asleep later (OR=0.43 was associated with "being male". These results underscore the importance of determining in what cases difficulty sleeping may have severe clinical repercussions or affect performance.

  18. Discovering disease associations by integrating electronic clinical data and medical literature.

    Directory of Open Access Journals (Sweden)

    Antony B Holmes

    Full Text Available Electronic health record (EHR systems offer an exceptional opportunity for studying many diseases and their associated medical conditions within a population. The increasing number of clinical record entries that have become available electronically provides access to rich, large sets of patients' longitudinal medical information. By integrating and comparing relations found in the EHRs with those already reported in the literature, we are able to verify existing and to identify rare or novel associations. Of particular interest is the identification of rare disease co-morbidities, where the small numbers of diagnosed patients make robust statistical analysis difficult. Here, we introduce ADAMS, an Application for Discovering Disease Associations using Multiple Sources, which contains various statistical and language processing operations. We apply ADAMS to the New York-Presbyterian Hospital's EHR to combine the information from the relational diagnosis tables and textual discharge summaries with those from PubMed and Wikipedia in order to investigate the co-morbidities of the rare diseases Kaposi sarcoma, toxoplasmosis, and Kawasaki disease. In addition to finding well-known characteristics of diseases, ADAMS can identify rare or previously unreported associations. In particular, we report a statistically significant association between Kawasaki disease and diagnosis of autistic disorder.

  19. Cultural values associated with substance use among Hispanic adolescents in southern California.

    Science.gov (United States)

    Soto, Claradina; Unger, Jennifer B; Ritt-Olson, Anamara; Soto, Daniel W; Black, David Scott; Baezconde-Garbanati, Lourdes

    2011-01-01

    Cultural values can shape people's attitudes toward substance use and influence their risk of experimentation with drugs. This article examines the relationships between cultural values (familism, respeto, and machismo), fatalism (a culturally encouraged personality disposition), and substance use among Hispanic adolescents. In 2005, cross-sectional data were collected from 1,616 Hispanic ninth grade students in Los Angeles. Each cultural value was associated with lifetime substance use; however, these relationships depended on the type of substance and gender. Our findings suggest that it might be useful to incorporate the cultural values and address the personality trait of fatalism in prevention programs for Hispanic adolescents. The study's limitations are noted.

  20. Submarine-fan facies associations of the Eocene Butano Sandstone, Santa Cruz mountains, California

    Science.gov (United States)

    Nilsen, Tor H.

    1984-06-01

    The Eocene Butano Sandstone was deposited as a submarine fan in a relatively small, partly restricted basin in a borderland setting. It is possibly as thick as 3000 m and was derived from erosion of nearly Mesozoic granitic and older metamorphic rocks located to the south. Deposition was at lower bathyal to abyssal water depths. The original fan may have been 120-to 160-km long and 80-km wide. Outcrops of submarine-canyon, innerfan, middle-fan, and outer-fan facies associations indicate that the depositional model of Mutti and Ricci Lucchi can be used to describe the Butano Sandstone.

  1. The association between chronotype and perceived academic stress to depression in medical students.

    Science.gov (United States)

    Romo-Nava, Francisco; Tafoya, Silvia A; Gutiérrez-Soriano, Joaquín; Osorio, Yanik; Carriedo, Pilar; Ocampo, Bárbara; Bobadilla, Rosa I; Heinze, Gerhard

    2016-01-01

    Depression is a multifactorial illness that is highly prevalent among medical students (MS). Chronotypes, which reflect circadian preference in humans, as well as academic stress have been associated with depression in different populations. However, it is not known how chronotype and stress might alone or in combination, associate with depression in MS. Thus, we aimed to evaluate the association between stress, chronotype and depression in MS. In a cross-sectional study, we evaluated a total of 1068 medical students from a public Medical School in Mexico City. The Patient Health Questionnaire-9 (PHQ-9) was used to evaluate depressive symptom severity and the presence of a current depressive episode with a cutoff score of 10 or higher. The Morning-Evening Questionnaire (MEQ) was used to establish chronotype and the Academic Stress Inventory was used to measure perceived academic stress (PAS). We observed that depressive symptom severity was higher in non-morning chronotypes and moderate/severe PAS groups. A factorial ANOVA showed an association between PAS groups and depressive symptom severity. Linear regression showed an association between depressive symptom severity and variables such as PAS scores (p = 0.001), family history of depression (p = 0.001), gender (p = 0.001) and academic year (p = 0.029). Logistic regression analysis showed that evening chronotype (OR: 2.3, 95% CI: 1.2-4.3, p = 0.01) and severe PAS (OR: 4.4, 95% CI: 2.8-7.0, p = 0.0001) were associated with depression. Further, MS with the combination of severe PAS and morning (OR: 5.9, 95% CI: 1.6-22.2, p = 0.01), intermediate (OR: 7.5, 95% CI: 2.3-24.4, p = 0.001) or evening (OR: 10.6, 95% CI: 2.8-40.0, p = 0.001) chronotypes showed a greater association with depression than any PAS or chronotype group alone. Being female, perceiving restricted or limited economic resources, having severe scores of academic stress, and evening chronotype were associated with an increased probability to suffer a

  2. Aquatic macroinvertebrates associated with Schoenoplectus litter in a constructed wetland in California (USA)

    Science.gov (United States)

    Nelson, S.M.; Thullen, J.S.

    2008-01-01

    Culm processing characteristics were associated with differences in invertebrate density in a study of invertebrates and senesced culm packs in a constructed treatment wetland. Invertebrate abundance differed by location within the wetland and there were differences between the two study years that appeared to be related to water quality and condition of culm material. Open areas in the wetland appeared to be critical in providing dissolved oxygen (DO) and food (plankton) to the important invertebrate culm processor, Glyptotendipes. As culm packs aged, invertebrate assemblages became less diverse and eventually supported mostly tubificid worms and leeches. It appears from this study that wetland design is vital to processing of plant material and that designs that encourage production and maintenance of high DO's will encourage microbial and invertebrate processing of material.

  3. Factors associated with medical student test anxiety in objective structured clinical examinations: a preliminary study

    Science.gov (United States)

    2016-01-01

    Objectives To investigate attributes of medical students associated with their test anxiety on Objective Structured Clinical Examinations (OSCEs). Methods A cross-sectional study using a self-administered questionnaire was conducted of all Year 3 and 4 students at a private medical school in South Korea in 2014. This 53-item questionnaire consisted of factors pertaining to test anxiety on the OSCE identified from a review of relevant literature, which included students’ motivational beliefs and achievement emotions, perceived values of the OSCE, and attitude and orientation towards patients. Participants’ test anxiety levels were measured using the Korean Achievement Emotions Questionnaire. Participants rated their responses using a five-point Likert-type scale. Univariate analysis was performed to examine relationships between the variables. Results A total of 94 students completed the questionnaire (a 93% response rate). No differences in the participants’ test anxiety scores were observed across genders, entry-levels, or years in medical school. Participants’ test anxiety on the OSCE showed moderate association with their class-related achievement emotions (i.e., anxiety and boredom), where r = 0.46 and 0.32, p OSCE (r = -0.21, p OSCE. These findings have implications for developing effective educational interventions for helping students cope with such a stress by enhancing our understanding of the various factors that influence their test anxiety in OSCEs. PMID:28035056

  4. Gain ratio based fuzzy weighted association rule mining classifier for medical diagnostic interface

    Indian Academy of Sciences (India)

    N S Nithya; K Duraiswamy

    2014-02-01

    The health care environment still needs knowledge based discovery for handling wealth of data. Extraction of the potential causes of the diseases is the most important factor for medical data mining. Fuzzy association rule mining is wellperformed better than traditional classifiers but it suffers from the exponential growth of the rules produced. In the past, we have proposed an information gain based fuzzy association rule mining algorithm for extracting both association rules and membership functions of medical data to reduce the rules. It used a ranking based weight value to identify the potential attribute. When we take a large number of distinct values, the computation of information gain value is not feasible. In this paper, an enhanced approach, called gain ratio based fuzzy weighted association rule mining, is thus proposed for distinct diseases and also increase the learning time of the previous one. Experimental results show that there is a marginal improvement in the attribute selection process and also improvement in the classifier accuracy. The system has been implemented in Java platform and verified by using benchmark data from the UCI machine learning repository.

  5. Risk factors associated with uncomplicated peptic ulcer and changes in medication use after diagnosis.

    Directory of Open Access Journals (Sweden)

    Antonio González-Pérez

    Full Text Available BACKGROUND: Few epidemiologic studies have investigated predictors of uncomplicated peptic ulcer disease (PUD separately from predictors of complicated PUD. OBJECTIVE: To analyze risk factors associated with uncomplicated PUD and medication use after diagnosis. METHODS: Patients diagnosed with uncomplicated PUD (n = 3,914 were identified from The Health Improvement Network database among individuals aged 40-84 years during 1997-2005, with no previous history of PUD. Prescription records for the year after the date of diagnosis were reviewed and a nested case-control analysis was performed to calculate the odds ratios for the association of potential risk factors with PUD. RESULTS: Medications associated with developing uncomplicated PUD included current use of acetylsalicylic acid (ASA, nonsteroidal anti-inflammatory drugs (NSAIDs, paracetamol, selective serotonin reuptake inhibitors, antidepressants, antihypertensives or acid suppressants. Uncomplicated PUD was significantly associated with being a current or former smoker and having had a score of at least 3 on the Townsend deprivation index. Approximately 50% of patients who were users of ASA (19% of patients or chronic users of NSAIDs (7% of patients at diagnosis did not receive another prescription of the medication in the 60 days after diagnosis, and 30% were not represcribed therapy within a year. Among patients who were current users of ASA or chronic NSAIDs at the time of the PUD diagnosis and received a subsequent prescription for their ASA or NSAID during the following year, the vast majority (80-90% also received a proton pump inhibitor coprescription. CONCLUSIONS: Our results indicate that several risk factors for upper gastrointestinal bleeding are also predictors of uncomplicated PUD, and that some patients do not restart therapy with ASA or NSAIDs after a diagnosis of uncomplicated PUD. Further investigation is needed regarding the consequences for these patients in terms of

  6. Association of American Veterinary Medical Colleges (AAVMC): 50 Years of History and Service.

    Science.gov (United States)

    Maccabe, Andrew T; Crawford, Lester; Heider, Lawrence E; Hooper, Billy; Mann, Curt J; Pappaioanou, Marguerite

    2015-01-01

    The mission of the Association of American Veterinary Medical Colleges (AAVMC) is to advance the quality of academic veterinary medicine. Founded in 1966 by the 18 US colleges of veterinary medicine and 3 Canadian colleges of veterinary medicine then in existence, the AAVMC is celebrating 50 years of public service. Initially, the AAVMC comprised the Council of Deans, the Council of Educators, and the Council of Chairs. In 1984, the tri-cameral structure was abandoned and a new governing structure with a board of directors was created. In 1997, the AAVMC was incorporated in Washington, DC and a common application service was created. Matters such as workforce issues and the cost of veterinary medical education have persisted for decades. The AAVMC is a champion of diversity in the veterinary profession and a strong advocate for One Health. The AAVMC has adopted a global perspective as more international colleges of veterinary medicine have earned COE accreditation and become members.

  7. Introducing DVM: DiVersity Matters (an Association of American Veterinary Medical Colleges Initiative).

    Science.gov (United States)

    Greenhill, Lisa M

    2007-01-01

    Now more than ever, colleges of veterinary medicine (CVMs) are challenged to improve the educational experience, build environments that support long-term student and faculty success, and create a diverse and competitive workforce. Additionally, the nation's fast-evolving racial and ethnic demographics demand that the veterinary medical profession be responsive to the emerging needs of this changing population. In March 2005, during the 15th Iverson Bell Symposium, the Association of American Veterinary Medical Colleges (AAVMC) unveiled its DiVersity Matters (DVM) initiative, designed to bring the CVMs closer to achieving these goals. Several key objectives of the initiative and their possible long-term significance to success of the DiVersity Matters initiative are explored here, and CVMs are encouraged to expand efforts to increase racial and ethnic diversity in academic veterinary medicine.

  8. Development of an integrated psychosocial treatment to address the medical burden associated with bipolar disorder.

    Science.gov (United States)

    Sylvia, Louisa G; Nierenberg, Andrew A; Stange, Jonathan P; Peckham, Andrew D; Deckersbach, Thilo

    2011-05-01

    We developed an integrated psychosocial treatment for bipolar disorder to decrease the disproportionate medical burden associated with this illness. Three treatment modules, Nutrition/weight loss, Exercise, and Wellness Treatment (NEW Tx) were administered in twelve 60-minute group sessions over 14 weeks. After the first group (N=4) had completed the treatment, it was revised, and then a second group (N=6) completed the revised treatment. Participants completed all of the study assessments and attended 82% of the sessions. Both groups added over 100 minutes of weekly exercise to their baseline duration. Participants in the second group showed improvements in their quality of life, depressive symptoms, and weight. It appears that NEW Tx may be a feasible intervention with promising pilot data for reducing the medical burden in bipolar disorder, but future research is needed to further evaluate the efficacy of NEW Tx.

  9. Medical societies in modern China-China Medical Missionary Association%中国近代医学社团——博医会

    Institute of Scientific and Technical Information of China (English)

    刘远明

    2011-01-01

    In modern times, the development and exchange of scientific research were promoted greatly by establishments of scientific societies in the west. In the second half of the 17th century, medical societies such as the Berlin Royal Society of Medicine, the Paris Surgical Society, the Edinburgh Medical Society and the London Medical Society appeared in sequence, which promoted the progress of European medicine greatly by means of medical conferences and journals. At the end of the 19th century, in order to promote medical missions and education, western missionaries drew lessons from the medical society system and founded the China Medical Missionary Association (CMMA). The association was dedicated to work in four fields: terminology standardization, missionary hospitals, medical education and study on endemic disease. CMMA accelerated the development of medical missions and the spread of western medicine. As members of CMMA must be of religious orders, many scholars were not qualified to join in, which resulted in limitation of academic research and exchange. With the return of overseas students, Chinese scholars majoring in western medicine enhanced the awareness of medical knowledge. As a result, western medical societies were established one by one, including the Shanghai Medical Association, the Chinese Pharmaceutical Association, the Chinese Medical Association and the Society of Chinese Medicines of the Republic of China. Established in 1915, the Chinese Medical Association had members who also belonged to the CMMA,so the Chinese Medical Association made reference to the CMMA for its organization, function, operating mechanism, journals, etc..%从17世纪下半叶起,西欧相继出现了柏林皇家医学会、巴黎外科学会、爱丁堡和伦敦医学会等医学团体,它们通过举办会议,编辑期刊,极大地推动了当时欧洲医学的进步.19世纪末期,西方在华医学传教士为了更好地进行医学传教及医学教育工作,借鉴

  10. A genome-wide association study of heparin-induced thrombocytopenia using an electronic medical record

    DEFF Research Database (Denmark)

    Karnes, Jason H; Cronin, Robert M; Rollin, Jerome

    2015-01-01

    . Here, we performed a genome-wide association study (GWAS) and candidate gene study using HIT cases and controls identified using electronic medical records (EMRs) coupled to a DNA biobank and attempted to replicate GWAS associations in an independent cohort. We subsequently investigated influences......-heparin treated patients (OR 3.09; 1.14-8.13; p=0.02). In the candidate gene study, SNPs at HLA-DRA were nominally associated with HIT (OR 0.25; 0.15-0.44; p=2.06×10(-6)). Further study of TDAG8 and HLA-DRA SNPs is warranted to assess their influence on the risk of developing HIT....

  11. Associations of planting date, drought stress, and insects with Fusarium ear rot and fumonisin B1 contamination in California maize.

    Science.gov (United States)

    Parsons, M W; Munkvold, G P

    2010-05-01

    Fusarium ear rot, caused by Fusarium verticillioides, is one of the most common diseases of maize, causing yield and quality reductions and contamination of grain by fumonisins and other mycotoxins. Drought stress and various insects have been implicated as factors affecting disease severity. Field studies were conducted to evaluate the interactions and relative influences of drought stress, insect infestation, and planting date upon Fusarium ear rot severity and fumonisin B1 contamination. Three hybrids varying in partial resistance to Fusarium ear rot were sown on three planting dates and subjected to four irrigation regimes to induce differing levels of drought stress. A foliar-spray insecticide treatment was imposed to induce differing levels of insect injury. Populations of thrips (Frankliniella spp.), damage by corn earworm (Helicoverpa zeae), Fusarium ear rot symptoms, and fumonisin B1 levels were assessed. There were significant effects of hybrid, planting date, insecticide treatment, and drought stress on Fusarium ear rot symptoms and fumonisin B1 contamination, and these factors also had significant interacting effects. The most influential factors were hybrid and insecticide treatment, but their effects were influenced by planting date and drought stress. The more resistant hybrids and the insecticide-treated plots consistently had lower Fusarium ear rot severity and fumonisin B1 contamination. Later planting dates typically had higher thrips populations, more Fusarium ear rot, and higher levels of fumonisin B1. Insect activity was significantly correlated with disease severity and fumonisin contamination, and the correlations were strongest for thrips. The results of this study confirm the influence of thrips on Fusarium ear rot severity in California, USA, and also establish a strong association between thrips and fumonisin B1 levels.

  12. Borrelia burgdorferi sensu lato spirochetes in wild birds in northwestern California: associations with ecological factors, bird behavior and tick infestation.

    Science.gov (United States)

    Newman, Erica A; Eisen, Lars; Eisen, Rebecca J; Fedorova, Natalia; Hasty, Jeomhee M; Vaughn, Charles; Lane, Robert S

    2015-01-01

    Although Borrelia burgdorferi sensu lato (s.l.) are found in a great diversity of vertebrates, most studies in North America have focused on the role of mammals as spirochete reservoir hosts. We investigated the roles of birds as hosts for subadult Ixodes pacificus ticks and potential reservoirs of the Lyme disease spirochete B. burgdorferi sensu stricto (s.s.) in northwestern California. Overall, 623 birds representing 53 species yielded 284 I. pacificus larvae and nymphs. We used generalized linear models and zero-inflated negative binomial models to determine associations of bird behaviors, taxonomic relationships and infestation by I. pacificus with borrelial infection in the birds. Infection status in birds was best explained by taxonomic order, number of infesting nymphs, sampling year, and log-transformed average body weight. Presence and counts of larvae and nymphs could be predicted by ground- or bark-foraging behavior and contact with dense oak woodland. Molecular analysis yielded the first reported detection of Borrelia bissettii in birds. Moreover, our data suggest that the Golden-crowned Sparrow (Zonotrichia atricapilla), a non-resident species, could be an important reservoir for B. burgdorferi s.s. Of 12 individual birds (9 species) that carried B. burgdorferi s.l.-infected larvae, no birds carried the same genospecies of B. burgdorferi s.l. in their blood as were present in the infected larvae removed from them. Possible reasons for this discrepancy are discussed. Our study is the first to explicitly incorporate both taxonomic relationships and behaviors as predictor variables to identify putative avian reservoirs of B. burgdorferi s.l. Our findings underscore the importance of bird behavior to explain local tick infestation and Borrelia infection in these animals, and suggest the potential for bird-mediated geographic spread of vector ticks and spirochetes in the far-western United States.

  13. Borrelia burgdorferi sensu lato spirochetes in wild birds in northwestern California: associations with ecological factors, bird behavior and tick infestation.

    Directory of Open Access Journals (Sweden)

    Erica A Newman

    Full Text Available Although Borrelia burgdorferi sensu lato (s.l. are found in a great diversity of vertebrates, most studies in North America have focused on the role of mammals as spirochete reservoir hosts. We investigated the roles of birds as hosts for subadult Ixodes pacificus ticks and potential reservoirs of the Lyme disease spirochete B. burgdorferi sensu stricto (s.s. in northwestern California. Overall, 623 birds representing 53 species yielded 284 I. pacificus larvae and nymphs. We used generalized linear models and zero-inflated negative binomial models to determine associations of bird behaviors, taxonomic relationships and infestation by I. pacificus with borrelial infection in the birds. Infection status in birds was best explained by taxonomic order, number of infesting nymphs, sampling year, and log-transformed average body weight. Presence and counts of larvae and nymphs could be predicted by ground- or bark-foraging behavior and contact with dense oak woodland. Molecular analysis yielded the first reported detection of Borrelia bissettii in birds. Moreover, our data suggest that the Golden-crowned Sparrow (Zonotrichia atricapilla, a non-resident species, could be an important reservoir for B. burgdorferi s.s. Of 12 individual birds (9 species that carried B. burgdorferi s.l.-infected larvae, no birds carried the same genospecies of B. burgdorferi s.l. in their blood as were present in the infected larvae removed from them. Possible reasons for this discrepancy are discussed. Our study is the first to explicitly incorporate both taxonomic relationships and behaviors as predictor variables to identify putative avian reservoirs of B. burgdorferi s.l. Our findings underscore the importance of bird behavior to explain local tick infestation and Borrelia infection in these animals, and suggest the potential for bird-mediated geographic spread of vector ticks and spirochetes in the far-western United States.

  14. The Association of Academic Health Sciences Libraries' legislative activities and the Joint Medical Library Association/Association of Academic Health Sciences Libraries Legislative Task Force.

    Science.gov (United States)

    Zenan, Joan S

    2003-04-01

    The Association of Academic Health Sciences Libraries' (AAHSL's) involvement in national legislative activities and other advocacy initiatives has evolved and matured over the last twenty-five years. Some activities conducted by the Medical Library Association's (MLA's) Legislative Committee from 1976 to 1984 are highlighted to show the evolution of MLA's and AAHSL's interests in collaborating on national legislative issues, which resulted in an agreement to form a joint legislative task force. The history, work, challenges, and accomplishments of the Joint MLA/AAHSL Legislative Task Force, formed in 1985, are discussed.

  15. Statistical trends in the Journal of the American Medical Association and implications for training across the continuum of medical education.

    Directory of Open Access Journals (Sweden)

    Lauren D Arnold

    Full Text Available BACKGROUND: Statistical training across the continuum of medical education may not have advanced at the pace of statistical reporting in the medical literature, yet a comprehensive understanding of statistical concepts most commonly presented in current research is critical to the effective practice of Evidence Based Medicine. The objective of this content analysis was to describe statistical techniques used in a leading medical journal, JAMA, across a 20-year period, with a focus on implications for medical education. METHODS AND FINDINGS: Two issues of JAMA published each month in 1990, 2000, and 2010 were randomly selected; from these, 361 articles were reviewed. Primary focus, study design, and statistical components were abstracted and examined by year of publication. The number of published RCTs and cohort studies differed significantly across years of interest, with an increasing trend of publication. The most commonly reported statistics over the 20-year period of interest included measures of morbidity and mortality, descriptive statistics, and epidemiologic outcomes. However, between 1990 and 2010, there was an increase in reporting of more advanced methods, such as multivariable regression, multilevel modeling, survival analysis, and sensitivity analysis. While this study is limited by a focus on one specific journal, a strength is that the journal examined is widely read by a range of clinical specialties and is considered a leading journal in the medical field, setting standards for published research. CONCLUSIONS: The increases in frequency and complexity of statistical reporting in the literature over the past two decades may suggest that moving beyond basic statistical concepts to a more comprehensive understanding of statistical methods is an important component of clinicians' ability to effectively read and use the medical research. These findings provide information to consider as medical schools and graduate medical education

  16. Attitudes to Medication after Kidney Transplantation and Their Association with Medication Adherence and Graft Survival: A 2-Year Follow-Up Study

    Directory of Open Access Journals (Sweden)

    Mirjam Tielen

    2014-01-01

    Full Text Available Background. Nonadherence to medication is a common problem after kidney transplantation. The aim of this study was to explore attitudes towards medication, adherence, and the relationship with clinical outcomes. Method. Kidney recipients participated in a Q-methodological study 6 weeks after transplantation. As a measure of medication adherence, respondents completed the Basel Assessment of Adherence to Immunosuppressive Medications Scale (BAASIS©-interview. Moreover, the intrapatient variability in the pharmacokinetics of tacrolimus was calculated, which measures stability of drug intake. Data on graft survival was retrieved from patient records up to 2 years after transplantation. Results. 113 renal transplant recipients (19–75 years old participated in the study. Results revealed three attitudes towards medication adherence—attitude 1: “confident and accurate,” attitude 2: “concerned and vigilant,” and attitude 3: “appearance oriented and assertive.” We found association of attitudes with intrapatient variability in pharmacokinetics of tacrolimus, but not with self-reported nonadherence or graft survival. However, self-reported nonadherence immediately after transplantation was associated with lower two-year graft survival. Conclusion. These preliminary findings suggest that nonadherence shortly after kidney transplantation may be a risk factor for lower graft survival in the years to follow. The attitudes to medication were not a risk factor.

  17. EUROmediCAT signal detection: an evaluation of selected congenital anomaly‐medication associations

    Science.gov (United States)

    Given, Joanne E.; Loane, Maria; Luteijn, Johannes M.; Morris, Joan K.; de Jong van den Berg, Lolkje T.W.; Garne, Ester; Addor, Marie‐Claude; Barisic, Ingeborg; de Walle, Hermien; Gatt, Miriam; Klungsoyr, Kari; Khoshnood, Babak; Latos‐Bielenska, Anna; Nelen, Vera; Neville, Amanda J.; O'Mahony, Mary; Pierini, Anna; Tucker, David; Wiesel, Awi

    2016-01-01

    Aims To evaluate congenital anomaly (CA)‐medication exposure associations produced by the new EUROmediCAT signal detection system and determine which require further investigation. Methods Data from 15 EUROCAT registries (1995–2011) with medication exposures at the chemical substance (5th level of Anatomic Therapeutic Chemical classification) and chemical subgroup (4th level) were analysed using a 50% false detection rate. After excluding antiepileptics, antidiabetics, antiasthmatics and SSRIs/psycholeptics already under investigation, 27 associations were evaluated. If evidence for a signal persisted after data validation, a literature review was conducted for prior evidence of human teratogenicity. Results Thirteen out of 27 CA‐medication exposure signals, based on 389 exposed cases, passed data validation. There was some prior evidence in the literature to support six signals (gastroschisis and levonorgestrel/ethinylestradiol (OR 4.10, 95% CI 1.70–8.53; congenital heart disease/pulmonary valve stenosis and nucleoside/tide reverse transcriptase inhibitors (OR 5.01, 95% CI 1.99–14.20/OR 28.20, 95% CI 4.63–122.24); complete absence of a limb and pregnen (4) derivatives (OR 6.60, 95% CI 1.70–22.93); hypospadias and pregnadien derivatives (OR 1.40, 95% CI 1.10–1.76); hypospadias and synthetic ovulation stimulants (OR 1.89, 95% CI 1.28–2.70). Antipropulsives produced a signal for syndactyly while the literature revealed a signal for hypospadias. There was no prior evidence to support the remaining six signals involving the ordinary salt combinations, propulsives, bulk‐forming laxatives, hydrazinophthalazine derivatives, gonadotropin releasing hormone analogues and selective serotonin agonists. Conclusion Signals which strengthened prior evidence should be prioritized for further investigation, and independent evidence sought to confirm the remaining signals. Some chance associations are expected and confounding by indication is possible. PMID

  18. Health inequalities, physician citizens and professional medical associations: an Australian case study

    Directory of Open Access Journals (Sweden)

    Naccarella Lucio

    2007-08-01

    Full Text Available Abstract Background As socioeconomic health inequalities persist and widen, the health effects of adversity are a constant presence in the daily work of physicians. Gruen and colleagues suggest that, in responding to important population health issues such as this, defining those areas of professional obligation in contrast to professional aspiration should be on the basis of evidence and feasibility. Drawing this line between obligation and aspiration is a part of the work of professional medical colleges and associations, and in doing so they must respond to members as well as a range of other interest groups. Our aim was to explore the usefulness of Gruen's model of physician responsibility in defining how professional medical colleges and associations should lead the profession in responding to socioeconomic health inequalities. Methods We report a case study of how the Royal Australian College of General Practitioners is responding to the issue of health inequalities through its work. We undertook a consultation (80 interviews with stakeholders internal and external to the College and two focus groups with general practitioners and program and policy review of core programs of College interest and responsibility: general practitioner training and setting of practice standards, as well as its work in public advocacy. Results Some strategies within each of these College program areas were seen as legitimate professional obligations in responding to socioeconomic health inequality. However, other strategies, while potentially professional obligations within Gruen's model, were nevertheless contested. The key difference between these lay in different moral orientations. Actions where agreement existed were based on an ethos of care and compassion. Actions that were contested were based on an ethos of justice and human rights. Conclusion Colleges and professional medical associations have a role in explicitly leading a debate about values

  19. Guideline-recommended use of asthma medication by children is associated with parental information and knowledge : the PIAMA birth cohort

    NARCIS (Netherlands)

    Wijga, Alet H.; Zuidgeest, Mira G. P.; Kerkhof, Marjan; Koppelman, Gerard H.; Smit, Henriette A.; de Jongste, Johan C.

    2014-01-01

    PurposeWe investigated the use of asthma medication by children and the association of use as recommended by guidelines with modifiable risk factors: parental attitudes, knowledge of asthma medication and information provided by health care providers. MethodsQuestionnaire data were obtained from par

  20. Development of a new diabetes medication self-efficacy scale and its association with both reported problems in using diabetes medications and self-reported adherence

    Directory of Open Access Journals (Sweden)

    Sleath B

    2016-06-01

    Full Text Available Betsy Sleath,1,2 Delesha M Carpenter,1 Susan J Blalock,1 Scott A Davis,1 Ryan P Hickson,1 Charles Lee,3 Stefanie P Ferreri,4 Jennifer E Scott,5 Lisa B Rodebaugh,6 Doyle M Cummings6,7 1Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, The University of North Carolina at Chapel Hill, Chapel Hill, 2Cecil G. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill, Chapel Hill, 3Polyglot Systems, Inc., Morrisville, 4Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, 5Consortium for Implementation Science, Department of Health Policy and Management, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, 6Department of Family Medicine, Brody School of Medicine, East Carolina University, Greenville, 7Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC, USA Background: Although there are several different general diabetes self-efficacy scales, there is a need to develop a self-efficacy scale that providers can use to assess patient’s self-efficacy regarding medication use. The purpose of this study was to: 1 develop a new diabetes medication self-efficacy scale and 2 examine how diabetes medication self-efficacy is associated with patient-reported problems in using diabetes medications and self-reported adherence. Patients and methods: Adult English-speaking patients with type 2 diabetes were recruited from a family medicine clinic and a pharmacy in Eastern North Carolina, USA. The patients were eligible if they reported being nonadherent to their diabetes medicines on a visual analog scale. Multivariable regression was used to examine the relationship between self-efficacy and the number of reported diabetes medication problems and adherence. Results: The diabetes medication self-efficacy scale had strong reliability (Cronbach’s alpha =0.86. Among a sample

  1. The Rashomon effect: another view of medicine, religion, and the American Medical Association.

    Science.gov (United States)

    Crigger, B J

    2014-12-01

    What is the story of medicine and religion at the American Medical Association (AMA)? Where did the Department of Medicine and Religion originate? What did the program accomplish? Why was it all but completely discontinued after scarcely a decade? The surviving records support more than one interpretation. Exploring the broader organizational context helps tell a richer story.In this issue of Academic Medicine, Daniel Kim and colleagues open a window on a fascinating bit of history: that of the AMA's formal experience with religion and medicine during the 1960s and early 1970s; however, reconstructing the story of a program from documentary records is always something of an uncertain proposition. Equally important is taking account of such factors as the role of the AMA's House of Delegates in policy making, of state and county medical societies in carrying out program activities, and of the influence of charismatic individuals on decisions regarding programs and activities. Before the medical community decides what lesson(s) to draw from the story of the AMA's Department of Medicine and Religion, it should try to understand that story as completely as possible.As Kim et al note, the available materials leave out much that historians might wish to know. Records preserve the substance of decisions taken, but are largely silent about the reasoning behind those decisions. Relevant information is scattered through multiple record systems, making it difficult to find. Inevitably, historians have to read between the lines.

  2. Role of a medical students' association in improving the curriculum at a faculty of health sciences.

    Science.gov (United States)

    Toker, Asaf; Urkin, Jacob; Bloch, Yuval

    2002-11-01

    The Joyce and Irving Goldman School of Medicine, Faculty of Health Sciences at the Ben Gurion University of the Negev encourages students to take part in the development and evaluation of the teaching experience. These special relations between the school and the students contribute not only to changes in the curriculum but also to increased involvement of faculty and students in the community. This article reviews the special relationship between the Faculty of Health Sciences and its medical students through the Medical Students Association (ASRN). During the last decade, BGU medical students have initiated innovative programmes some of which have recently become integrated into the curriculum. These include: prevention of sexual violence among youth, decreasing white-coat fear in small children ('Teddy Bear hospital') and participation in home-hospice activities. By encouraging students to become equal partners in faculty development and rejecting the traditional paternalistic mode of teacher-student relationships, the faculty has created an improved learning experience, and increased student motivation and levels of communication between the teachers and the future clinicians.

  3. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules

    DEFF Research Database (Denmark)

    Gharib, H; Papini, E; Paschke, R;

    2010-01-01

    American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules are systematically developed statements to assist health care professionals in medical...... decision making for specific clinical conditions. Most of the content herein is based on literature reviews. In areas of uncertainty, professional judgment was applied. These guidelines are a working document that reflects the state of the field at the time of publication. Because rapid changes...

  4. Restless legs syndrome: associated non-motor symptoms and medical comorbidities: a controlled study

    Directory of Open Access Journals (Sweden)

    Sanghera MK

    2015-10-01

    risk factors manifested 5 and 10 years prior, respectively, to their diagnosis. Conclusion: Primary RLS develops earlier in those patients who only have RLS compared to those who later also develop PD. Mood and sleep impairment can be present years prior to the diagnosis of RLS. Other medical comorbidities associated with RLS included hypertension, hyperlipidemia, arthritis, chronic pain, and diabetes. Keywords: restless legs syndrome, non-motor symptoms, medical comorbidities, risk factors for RLS

  5. Prevalence of depression and its associated factors using Beck Depression Inventory among students of a medical college in Karnataka

    OpenAIRE

    Kumar, Ganesh S; Jain, Animesh; Hegde, Supriya

    2012-01-01

    Background and Objective: Depression among medical students is an area of increasing concern worldwide. This study aimed to assess the prevalence of depression and its associated factors among medical students. Materials and Methods: A stratified random sample of 400 students was assessed using Beck Depression Inventory by investigators. Associations between depression and class of studying, social factors like alcohol use, drug addiction, family problems, family history of depression, and st...

  6. Medication Errors in Vietnamese Hospitals : Prevalence, Potential Outcome and Associated Factors

    NARCIS (Netherlands)

    Huong-Thao Nguyen, [Unknown; Tuan-Dung Nguyen, [No Value; van den Heuvel, Edwin R.; Haaijer-Ruskamp, Flora M.; Taxis, Katja

    2015-01-01

    Background Evidence from developed countries showed that medication errors are common and harmful. Little is known about medication errors in resource-restricted settings, including Vietnam. Objectives To determine the prevalence and potential clinical outcome of medication preparation and administr

  7. Association of medications for lifestyle-related diseases with reflux esophagitis

    Science.gov (United States)

    Asaoka, Daisuke; Nagahara, Akihito; Hojo, Mariko; Matsumoto, Kenshi; Ueyama, Hiroya; Matsumoto, Kohei; Izumi, Kentaro; Takeda, Tsutomu; Komori, Hiroyuki; Akazawa, Yoichi; Shimada, Yuji; Osada, Taro; Watanabe, Sumio

    2016-01-01

    Background Because of a change in lifestyle, especially adoption of westernized eating habits, lifestyle-related diseases have become increasingly prevalent. The aim of this study was to investigate the association of medications for lifestyle-related diseases with reflux esophagitis (RE). Methods We conducted a hospital-based, cross-sectional retrospective study of consecutive outpatients who received an upper gastrointestinal endoscopy in our department from February 2008 to November 2014, which was performed by one specialist who was a member of the Japan Gastroenterological Endoscopy Society. We investigated the patient profile, Helicobacter pylori (H. pylori) infection status, medications for lifestyle-related diseases (including calcium channel blockers, statins, and bisphosphonates), and upper gastrointestinal endoscopic findings (RE, hiatal hernia, Barrett’s mucosa, and endoscopic gastric mucosal atrophy [EGA]). Patients with gastrectomy, peptic ulcer disease, gastric or esophageal malignant disease, and those who used proton pump inhibitors or histamine-2 receptor antagonists were excluded. We divided the subjects into a group without RE (RE(−)) and a RE (RE(+)) group as judged by endoscopy, and investigated the risk factors for RE. Results Of 1,744 consecutive cases, 590 cases (300 males and 290 females; mean age 60.5±13.2 years) were eligible. RE(−) and RE(+) cases numbered 507 and 83, respectively. Bivariate analysis showed significant positive associations of RE with male sex, body mass index (BMI), calcium channel blockers, Barrett’s mucosa, hiatal hernia and negative associations of RE with H. pylori positivity, EGA. Multivariate analysis showed significant positive associations of RE with BMI (odds ratio [OR]: 1.20, 95% confidence interval [95% CI]: 1.10–1.29), use of calcium channel blockers (OR: 2.12, 95% CI: 1.16–3.87), Barrett’s mucosa (OR: 2.97, 95% CI: 01.64–5.38), hiatal hernia (OR: 3.13, 95% CI: 1.79–5.47) and negative

  8. Impaired Fasting Glucose and Associated Anthropometry among Students of a Medical College in Coastal Kerala, India

    Directory of Open Access Journals (Sweden)

    Saritha S. Vargese

    2015-10-01

    Full Text Available Background: India being the diabetic capital need to emphasize on preventive strategies to reduce the incidence of diabetes and thus reduce the burden on health services and resources of the country. The identification of high risk group like those with impaired fasting glucose stresses the need for simple interventional measures to bring down the diabetic community in the country. Aim and Objectives: Medical students have a busy schedule for their studies due to huge syllabus and they generally do not have much physical exercise which emphasizes the need to identify the risk factors for diabetes and also to sensitize them on the need to identify the prediabetics in the community. So the study was carried out to determine the prevalence of impaired fasting glucose and the associated anthropometric measurements among medical students in a rural area in Kerala, India. Material and Methods: A cross sectional study was done to assess the fasting blood glucose using a glucometer and anthropometric measurements like waist circumference ,waist hip ratio and body mass index among the students of a medical school in coastal Kerala India. A pretested questionnaire was used to collect the data after obtaining informed consent. Results: The prevalence of impaired fasting glucose was found to be very high 55(21.6% among the study group, significantly higher among males 43(51.8% (p=0.000 and body mass index was significantly associated (p=0.044 with impaired fasting glucose which was consistent with many other studies. Conclusion: The study throws light on the fact that the prevalence of prediabetes and anthropometric risk factors are high among youth and highlights the need for immediate measures to identify the risk group right from the young age and initiate simple interventional measures to reduce the diabetic load in the community.

  9. The association between diabetes related medical costs and glycemic control: A retrospective analysis

    Directory of Open Access Journals (Sweden)

    Barron John

    2006-01-01

    Full Text Available Abstract Background The objective of this research is to quantify the association between direct medical costs attributable to type 2 diabetes and level of glycemic control. Methods A longitudinal analysis using a large health plan administrative database was performed. The index date was defined as the first date of diabetes diagnosis and individuals had to have at least two HbA1c values post index date in order to be included in the analyses. A total of 10,780 individuals were included in the analyses. Individuals were stratified into groups of good (N = 6,069, fair (N = 3,586, and poor (N = 1,125 glycemic control based upon mean HbA1c values across the study period. Differences between HbA1c groups were analyzed using a generalized linear model (GLM, with differences between groups tested by utilizing z-statistics. The analyses allowed a wide range of factors to affect costs. Results 42.1% of those treated only with oral agents, 66.1% of those treated with oral agents and insulin, and 57.2% of those treated with insulin alone were found to have suboptimal control (defined as fair or poor throughout the study period (average duration of follow-up was 2.95 years. Results show that direct medical costs attributable to type 2 diabetes were 16% lower for individuals with good glycemic control than for those with fair control ($1,505 vs. $1,801, p Conclusion Almost half (44% of all patients diagnosed with type 2 diabetes are at sub-optimal glycemic control. Evidence from this analysis indicates that the direct medical costs of treating type 2 diabetes are significantly higher for individuals who have fair or poor glycemic control than for those who have good glycemic control. Patients under fair control account for a greater proportion of the cost burden associated with antidiabetic prescription drugs.

  10. [Proposal for improving EQA programs in clinical microbiology by the Japanese Association of Medical Technologists].

    Science.gov (United States)

    Inuzuka, Kazuhisa

    2005-04-01

    External quality assessment (EQA) programs have been conducted by the Japanese Association of Medical Technologists (JAMT) since 1989. The nationwide EQA programs have provided feedback for improving clinical tests quality in individual laboratories. The participating laboratories have been expected to process the survey samples according to their usual practice for patient specimens. However, many problems relating to the EQA programs in clinical microbiology have been raised. Dishonesty in the responses, survey samples being handled in a manner that improves assessment results, surveys depending on volunteers because of time and cost limitations were some of the initial problems. In addition, the criteria used to evaluate the results were poorly understood, so that neither examiners not participants were clear as to how the evaluation worked. And finally, the nationwide EQA programs can detect only gross errors and use invalid methods for evaluating routine performances. They have been measuring only a few steps in specimens processing. To assess overall laboratory competence, other methods are needed. It is time to reform the JAMT nationwide EQA program to initiate real proficiency testing and to this end it is necessary to increase collaboration between JAMT and the regional associations of medical technologists, so that the improved testing program can be properly administered.

  11. Extracting Primary Open-Angle Glaucoma from Electronic Medical Records for Genetic Association Studies.

    Directory of Open Access Journals (Sweden)

    Nicole A Restrepo

    Full Text Available Electronic medical records (EMRs are being widely implemented for use in genetic and genomic studies. As a phenotypic rich resource, EMRs provide researchers with the opportunity to identify disease cohorts and perform genotype-phenotype association studies. The Epidemiologic Architecture for Genes Linked to Environment (EAGLE study, as part of the Population Architecture using Genomics and Epidemiology (PAGE I study, has genotyped more than 15,000 individuals of diverse genetic ancestry in BioVU, the Vanderbilt University Medical Center's biorepository linked to a de-identified version of the EMR (EAGLE BioVU. Here we develop and deploy an algorithm utilizing data mining techniques to identify primary open-angle glaucoma (POAG in African Americans from EAGLE BioVU for genetic association studies. The algorithm described here was designed using a combination of diagnostic codes, current procedural terminology billing codes, and free text searches to identify POAG status in situations where gold-standard digital photography cannot be accessed. The case algorithm identified 267 potential POAG subjects but underperformed after manual review with a positive predictive value of 51.6% and an accuracy of 76.3%. The control algorithm identified controls with a negative predictive value of 98.3%. Although the case algorithm requires more downstream manual review for use in large-scale studies, it provides a basis by which to extract a specific clinical subtype of glaucoma from EMRs in the absence of digital photographs.

  12. The Association of Shelter Veterinarians' 2016 Veterinary Medical Care Guidelines for Spay-Neuter Programs.

    Science.gov (United States)

    Griffin, Brenda; Bushby, Philip A; McCobb, Emily; White, Sara C; Rigdon-Brestle, Y Karla; Appel, Leslie D; Makolinski, Kathleen V; Wilford, Christine L; Bohling, Mark W; Eddlestone, Susan M; Farrell, Kelly A; Ferguson, Nancy; Harrison, Kelly; Howe, Lisa M; Isaza, Natalie M; Levy, Julie K; Looney, Andrea; Moyer, Michael R; Robertson, Sheilah Ann; Tyson, Kathy

    2016-07-15

    As community efforts to reduce the overpopulation and euthanasia of unwanted and unowned cats and dogs have increased, many veterinarians have increasingly focused their clinical efforts on the provision of spay-neuter services. Because of the wide range of geographic and demographic needs, a wide variety of spay-neuter programs have been developed to increase delivery of services to targeted populations of animals, including stationary and mobile clinics, MASH-style operations, shelter services, community cat programs, and services provided through private practitioners. In an effort to promote consistent, high-quality care across the broad range of these programs, the Association of Shelter Veterinarians convened a task force of veterinarians to develop veterinary medical care guidelines for spay-neuter programs. These guidelines consist of recommendations for general patient care and clinical procedures, preoperative care, anesthetic management, surgical procedures, postoperative care, and operations management. They were based on current principles of anesthesiology, critical care medicine, infection control, and surgical practice, as determined from published evidence and expert opinion. They represent acceptable practices that are attainable in spay-neuter programs regardless of location, facility, or type of program. The Association of Shelter Veterinarians envisions that these guidelines will be used by the profession to maintain consistent veterinary medical care in all settings where spay-neuter services are provided and to promote these services as a means of reducing sheltering and euthanasia of cats and dogs.

  13. Flipping the advanced cardiac life support classroom with team-based learning: comparison of cognitive testing performance for medical students at the University of California, Irvine, United States

    Directory of Open Access Journals (Sweden)

    Megan Boysen-Osborn

    2016-02-01

    Full Text Available Purpose: It aimed to find if written test results improved for advanced cardiac life support (ACLS taught in flipped classroom/team-based Learning (FC/TBL vs. lecture-based (LB control in University of California-Irvine School of Medicine, USA. Methods: Medical students took 2010 ACLS with FC/TBL (2015, compared to 3 classes in LB (2012-14 format. There were 27.5 hours of instruction for FC/TBL model (TBL 10.5, podcasts 9, small-group simulation 8 hours, and 20 (12 lecture, simulation 8 hours in LB. TBL covered 13 cardiac cases; LB had none. Seven simulation cases and didactic content were the same by lecture (2012-14 or podcast (2015 as was testing: 50 multiple-choice questions (MCQ, 20 rhythm matchings, and 7 fill-in clinical cases. Results: 354 students took the course (259 [73.1%] in LB in 2012-14, and 95 [26.9%] in FC/TBL in 2015. Two of 3 tests (MCQ and fill-in improved for FC/TBL. Overall, median scores increased from 93.5% (IQR 90.6, 95.4 to 95.1% (92.8, 96.7, P=0.0001. For the fill-in test: 94.1% for LB (89.6, 97.2 to 96.6% for FC/TBL (92.4, 99.20 P=0.0001. For MC: 88% for LB (84, 92 to 90% for FC/TBL (86, 94, P=0.0002. For the rhythm test: median 100% for both formats. More students failed 1 of 3 tests with LB vs. FC/TBL (24.7% vs. 14.7%, and 2 or 3 components (8.1% vs. 3.2%, P=0.006. Conversely, 82.1% passed all 3 with FC/TBL vs. 67.2% with LB (difference 14.9%, 95% CI 4.8-24.0%. Conclusion: A FC/TBL format for ACLS marginally improved written test results.

  14. Flipping the advanced cardiac life support classroom with team-based learning: comparison of cognitive testing performance for medical students at the University of California, Irvine, United State

    Science.gov (United States)

    2016-01-01

    Purpose: It aimed to find if written test results improved for advanced cardiac life support (ACLS) taught in flipped classroom/team-based Learning (FC/TBL) vs. lecture-based (LB) control in University of California-Irvine School of Medicine, USA. Methods: Medical students took 2010 ACLS with FC/TBL (2015), compared to 3 classes in LB (2012-14) format. There were 27.5 hours of instruction for FC/TBL model (TBL 10.5, podcasts 9, small-group simulation 8 hours), and 20 (12 lecture, simulation 8 hours) in LB. TBL covered 13 cardiac cases; LB had none. Seven simulation cases and didactic content were the same by lecture (2012-14) or podcast (2015) as was testing: 50 multiple-choice questions (MCQ), 20 rhythm matchings, and 7 fill-in clinical cases. Results: 354 students took the course (259 [73.1%] in LB in 2012-14, and 95 [26.9%] in FC/TBL in 2015). Two of 3 tests (MCQ and fill-in) improved for FC/TBL. Overall, median scores increased from 93.5% (IQR 90.6, 95.4) to 95.1% (92.8, 96.7, P=0.0001). For the fill-in test: 94.1% for LB (89.6, 97.2) to 96.6% for FC/TBL (92.4, 99.20 P=0.0001). For MC: 88% for LB (84, 92) to 90% for FC/TBL (86, 94, P=0.0002). For the rhythm test: median 100% for both formats. More students failed 1 of 3 tests with LB vs. FC/TBL (24.7% vs. 14.7%), and 2 or 3 components (8.1% vs. 3.2%, P=0.006). Conversely, 82.1% passed all 3 with FC/TBL vs. 67.2% with LB (difference 14.9%, 95% CI 4.8-24.0%). Conclusion: A FC/TBL format for ACLS marginally improved written test results. PMID:26893399

  15. Across-shore variability in plankton layering and abundance associated with physical forcing in Monterey Bay, California

    Science.gov (United States)

    Sevadjian, J. C.; McManus, M. A.; Ryan, J.; Greer, A. T.; Cowen, R. K.; Woodson, C. B.

    2014-01-01

    The purpose of this study was to further our understanding of the role of the coastal physical oceanographic environment as a dynamic and constantly evolving habitat for plankton. Over a 3-week period in the summer of 2010, an array of moorings were deployed and shipboard and autonomous underwater vehicle (AUV) surveys were conducted to investigate the association between physical processes and plankton distributions over the Monterey Bay, California inner shelf. Acoustic backscatter, chlorophyll-a fluorescence, and high-resolution zooplankton imagery data collected during the shipboard surveys were used to map the distributions of phytoplankton and zooplankton; and profiles of temperature, salinity, oxygen, and nitrate from the AUV characterized the physical and chemical environment. A synthesis of underway and moored time series data provided insight into the histories of water masses in the area, and facilitated tracking of internal wave groups as they propagated towards shore. A near-bottom intrusion of recently-upwelled water was found to be strongly influenced by the diurnal tide, resulting in daily across-shelf excursions past the mooring array at the 20-m isobath. Behind the leading edge of the intrusion, the water column was highly stratified in temperature, salinity, oxygen, and nitrate; and thin layers of phytoplankton and zooplankton persisted at the upper boundary of the intrusion. In ambient waters shoreward of the intrusion, stratification was weak; copepod, appendicularian, and gelatinous zooplankton abundances were relatively low; and phytoplankton and acoustic backscatter were broadly distributed throughout the lower half of the water column. The arrival of two shoreward-propagating internal wave groups observed during the shipboard survey corresponded with disparate responses in plankton distribution. In the wake of the first wave group, phytoplankton and zooplankton layers thinned or converged; in the wake of the second wave group, an eight

  16. Associations of major and trace components in time-series settling particle samples from Cuenca Alfonso, SW Gulf of California

    Science.gov (United States)

    Rodríguez-Castañeda, A. P.; Shumilin, E.; Silverberg, N.; Morton-Bermea, O.; Hernandez-Alvarez, E.; Aguirre-Bahena, F.

    2007-12-01

    Cuenca Alfonso is a natural sedimentation basin in Bahía de La Paz, southern Baja California Peninsula, an arid subtropical region characterized by limited land runoff with a productive surface layer overlying a well-developed Oxygen Minimum Zone. A time-series sediment trap program was initiated in 2002 to help understand the processes controlling variations in the biogeochemistry of this environment. INAA, ICP-MS and ICP-OES analyses, as well as flame AAS were made for major and trace elements in 105 subsamples of material collected at 350 m depth during 2002-2005. Principal component analysis, including data for organic and inorganic carbon, biogenic silica and the lithogenic fraction, yielded four factors. Factor 1 (25% of the total variance) showed high eigenvalues for the classical terrigenous aluminosilicate elements: Al, Fe, Mn Sc. High loadings also occurred for the group of light to medium REEs (except for Eu). The latter are frequently associated with acid source rocks, such the granites and rhyolitic volcanics exposed on the margin of the bay. Factor 2 (18%) grouped mainly REEs, with high loading on the heavier members of the series that are more typical of basic rocks (thick sequences of andesitic volcanics occur to the NW), as well as Ni and Rb. Factor 3 (12%) appears to represent carbonate organism production, with high loadings for Cinorg, Ca and moderate levels for Corg and Cu, while %litho is moderately negative, as is biogenic silica. The fourth factor (9%) is characterized by high negative loadings for Cd, Co, Se and moderately negative values for Corg. Moderate positive loadings occur only for Sr and, at lower levels, for U, Sb and %lithogenic. This suggests that this grouping is related to particles that have been partially transformed within the Oxygen Minimum Zone. The results will be examined for distinctive periods within the time-series, such as the hurricane-influenced months of August-September 2003, the generally very low fluxes

  17. The Association of Health Literacy with Illness and Medication Beliefs Among Older Adults with Asthma

    Science.gov (United States)

    Federman, Alex D.; Wolf, Michael; Sofianou, Anastasia; Wilson, Elizabeth A.H.; Martynenko, Melissa; Halm, Ethan A.; Leventhal, Howard; Wisnivesky, Juan P.

    2013-01-01

    Background Suboptimal health literacy (HL) and asthma beliefs are associated with poor asthma self-management and outcomes. We tested the hypothesis that low HL is associated with inaccurate beliefs. Methods Asthmatics ≥ 60 were recruited from hospital and community practices in New York, NY and Chicago, IL (n=420). HL was measured with the Short Test of Functional Health Literacy in Adults; validated instruments derived from the Self Regulation model were used to assess beliefs. The association of beliefs with HL was evaluated with multivariate models. Results Thirty-six percent of patients had low HL; 54% believed they only have asthma when symptoms are present, 29% believed they will not always have asthma and 20% believed that their doctor can cure asthma. HL was associated with beliefs of not having asthma all the time and that asthma can be cured (OR: 1.84, 95% CI: 1.2 to 2.82; OR: 2.22, 95% CI: 1.29 to 3.82, respectively). Patients with low HL were also more likely to be concerned about medication use (β = 0.92, p = .05), despite recognizing their necessity (β = -1.36, p = .01). Conclusions Older asthmatics with low HL endorse erroneous asthma beliefs. Practice implications Health communications for improving self-management behaviors in asthma should employ both health literacy-appropriate strategies and messages to counter illness-related misconceptions. PMID:23523196

  18. Associations of desire for change in sexual life amongst female medical students in North America

    Science.gov (United States)

    Shindel, Alan W.; Breyer, Benjamin N.; Smith, James F.

    2012-01-01

    We analyzed associations of dissatisfaction with sexual life and desire for change in female medical students. Students enrolled in medical schools in North America between February and July 2008 were invited to participate in an internet based survey of sexual function. The principle outcome measure was a single item question on sexual life satisfaction and desire for change. Women who reported dissatisfaction and desire for change were classified as “sexually bothered”. The survey also assessed ethnodemographic factors, student status, sexual history, and depressive symptoms. Respondents completed the Female Sexual Function Index (FSFI) and the Index of Sex Life (ISL). Descriptive statistics, ANOVA, and multivariable logistic regression were utilized to analyze responses. There were 661 non-virgin female subjects with data adequate for analysis. Whereas 281 (43%) of these met criteria for High Risk of Female Sexual Dysfunction (HRFSD) based on FSFI scoring, just 173 (26%) reported sexual bother. Among women with HRFSD, 126 (45%) reported sexual bother; in women without HRFSD, 362 (95%) were not sexually bothered. Interference in sexual life from tiredness and stress were associated with sexual bother. Progressively better scores on the FSFI-desire, orgasm, and satisfaction domains were significantly associated with lower odds of sexual bother. Few women in this cohort with FSFI score >26.55 reported sexual bother. Women with FSFI less than 26.55 had greater odds of sexual bother but this criterion alone was not pathognomonic for sexual concerns. Issues of sexual desire and orgasm appear to play a more important role than lubrication, arousal, and sexual pain issues in this population. PMID:22971616

  19. Learning Scientific and Medical Terminology with a Mnemonic Strategy Using an Illogical Association Technique

    Science.gov (United States)

    Brahler, C. Jayne; Walker, Diane

    2008-01-01

    For students pursuing careers in medical fields, knowledge of technical and medical terminology is prerequisite to being able to solve problems in their respective disciplines and professions. The Dean Vaughn Medical Terminology 350 Total Retention System, also known as Medical Terminology 350 (25), is a mnemonic instructional and learning…

  20. Incidence and factors associated with medication nonadherence in patients with mental illness: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    J M Lucca

    2015-01-01

    Full Text Available Background: In spite of the progress made in the treatment of psychiatric disorders during the last few decades, nonadherence continues to be a frequent phenomenon, often associated with potentially severe clinical consequences and increased health-care costs. There are numerous factors associated with medication nonadherence in patients with mental illness. The aim of the study was to determine the incidence and factors associated with medication nonadherence among psychiatric outpatients. Materials and Methods: A cross-sectional study was carried out in the outpatient psychiatric department of an Indian tertiary care private hospital over a period of 1 year. Patients aged 18 years and above who presented with mental illness as diagnosed by the International Classification of Diseases (ICD-10 and who were receiving at least one psychotropic medication for at least 1 month were included in the study. Medication adherence was assessed using the Medication Adherence Rating Scale (MARS. Results: Of the 400 patients, 172 (43% were nonadherent to their prescribed medications. There is a statistically significant association between the education (P = 0.001, number of drugs (P = 0.002, family income (P = 0.013, and nonadherence. Among the 172 patients, 33.5 % were nonadherent to their therapy due to patient-related factors followed by drug-related factors (32% and disease-related factors (31%. Conclusion: The overall incidence of medication nonadherence in patients with mental illness was 43%. Numerous factors contributed to medication nonadherence. Strategies need to be developed and implemented to enhance medication adherence, and thereby achieve a better therapeutic outcome in patients with mental illness.

  1. The medical antigravity suit for management of surgically uncontrollable bleeding associated with abdominal pregnancy.

    Science.gov (United States)

    Sandberg, E C; Pelligra, R

    1983-07-01

    Three patients with abdominal pregnancy have been treated at Stanford University Hospital in recent years. Common to each was surgically uncontrolled hemorrhage for which circumferential pneumatic compression (supplied by a medical antigravity suit) was used to stop the bleeding. In each patient, the hemostatic effect of treatment was dramatic. In published accounts of the use of the garment in other severely hemorrhaging patients, the effects have been similarly dramatic and equally successful. These observations lead to a compelling consideration in regard to optimum management of patients with abdominal pregnancy. If our experience is confirmed by others, optimum management in abdominal pregnancy hereafter should regularly and routinely include removal of the placenta at the primary operation. This approach would anticipate use of the medical antigravity suit to provide hemostasis if surgically uncontrollable bleeding is encountered. Theoretically, the complications and long-term morbidity associated with retention of the placenta would be eliminated by this means while the previous disadvantage of placental removal, the potential for exsanguinating hemorrhage, would be circumvented.

  2. Effects of medications and laser on induced tooth movement and associated root resorption: four key points

    Directory of Open Access Journals (Sweden)

    Alberto Consolaro

    2013-04-01

    Full Text Available The following four fundamental points on the use of experimental models will be described to ensure an accurate evaluation of the effects of medication and laser therapy on induced tooth movement and associated root resorption: (1 If the objective is to check the effect on root resorption, the forces experimentally applied must produce a lesion on the cementoblast layer in all specimens; (2 If the objective is to optimize induced tooth movement and reduce treatment time without side effects, the forces experimentally applied should not produce a lesion in the cementoblast layer in any specimen; (3 The laser therapy operator, the person administering medication and the person that places appliances should not know which animals will effectively receive the test treatment, and the control groups should receive placebo treatments; (4 CT and microscopic analysis of the specimens should be random, and the group to which the specimen belongs should not be identified to ensure that the person reading images and the pathologists are not influenced in their evaluation of phenomena. These measures will ensure that results are more reliable and easier to extrapolate to orthodontic clinical practice.

  3. The Association of Shelter Veterinarians veterinary medical care guidelines for spay-neuter programs.

    Science.gov (United States)

    Looney, Andrea L; Bohling, Mark W; Bushby, Philip A; Howe, Lisa M; Griffin, Brenda; Levy, Julie K; Eddlestone, Susan M; Weedon, James R; Appel, Leslie D; Rigdon-Brestle, Y Karla; Ferguson, Nancy J; Sweeney, David J; Tyson, Kathy A; Voors, Adriana H; White, Sara C; Wilford, Christine L; Farrell, Kelly A; Jefferson, Ellen P; Moyer, Michael R; Newbury, Sandra P; Saxton, Melissa A; Scarlett, Janet M

    2008-07-01

    As efforts to reduce the overpopulation and euthanasia of unwanted and unowned dogs and cats have increased, greater attention has been focused on spay-neuter programs throughout the United States. Because of the wide range of geographic and demographic needs, a wide variety of programs have been developed to increase delivery of spay-neuter services to targeted populations of animals, including stationary and mobile clinics, MASH-style operations, shelter services, feral cat programs, and services provided through private practitioners. In an effort to ensure a consistent level of care, the Association of Shelter Veterinarians convened a task force of veterinarians to develop veterinary medical care guidelines for spay-neuter programs. The guidelines consist of recommendations for preoperative care (eg, patient transport and housing, patient selection, client communication, record keeping, and medical considerations), anesthetic management (eg, equipment, monitoring, perioperative considerations, anesthetic protocols, and emergency preparedness), surgical care (eg, operating-area environment; surgical-pack preparation; patient preparation; surgeon preparation; surgical procedures for pediatric, juvenile, and adult patients; and identification of neutered animals), and postoperative care (eg, analgesia, recovery, and release). These guidelines are based on current principles of anesthesiology, critical care medicine, microbiology, and surgical practice, as determined from published evidence and expert opinion. They represent acceptable practices that are attainable in spay-neuter programs.

  4. California Air Basins

    Data.gov (United States)

    California Department of Resources — Air ResourcesCalifornia Air Resources BoardThe following datasets are from the California Air Resources Board: * arb_california_airbasins - California Air BasinsThe...

  5. Medical management of levodopa-associated motor complications in patients with Parkinson's disease.

    Science.gov (United States)

    Jankovic, Joseph; Stacy, Mark

    2007-01-01

    Parkinson's disease is a neurodegenerative disorder that affects approximately 1% of people over the age of 60 years. Levodopa is standard, and often initial, therapy for patients with this condition; however, with continued treatment and as the disease progresses, up to 80% of patients experience 'wearing-off' symptoms, dyskinesias and other motor complications. These levodopa-associated problems may become disabling and profoundly affect quality of life. Medications commonly used to manage these symptoms include monoamine oxidase type B (MAO-B) inhibitors, catechol-O-methyltransferase (COMT) inhibitors, the NMDA receptor antagonist amantadine and dopamine receptor agonists. Agents that block MAO-B, such as rasagiline and selegiline, are used as both initial and adjunctive therapy in patients with Parkinson's disease. These medications increase concentrations of dopamine in the brain by blocking its reuptake from the synaptic cleft, a mechanism that can slow motor decline, increase 'on' time and improve symptoms of Parkinson's disease. Adverse events with these agents can include confusion, hallucination and orthostatic hypotension. MAO-B inhibition may elicit drug-drug interactions if administered with TCAs, SSRIs or SNRIs. Conventional oral selegiline is associated with potentially harmful plasma concentrations of three major amphetamine metabolites, although metabolite concentrations are significantly lower with a new orally disintegrating tablet (ODT) selegiline formulation. Selegiline ODT is also absorbed more efficiently and shows less pharmacokinetic variability than conventional oral selegiline.COMT mediates peripheral catabolism of levodopa. Therefore, agents that block COMT, such as tolcapone and entacapone, increase the elimination half-life of levodopa. Given adjunctively with levodopa, COMT inhibitors can decrease 'off' time and increase 'on' time, as well as lower the daily levodopa dose. Although more potent than entacapone, tolcapone requires

  6. Gender Associated with the Intention to Choose a Medical Specialty in Medical Students: A Cross-Sectional Study in 11 Countries in Latin America

    Science.gov (United States)

    Mayta-Tristán, Percy; Pereyra-Elías, Reneé; Montenegro-Idrogo, Juan José; Inga-Berrospi, Fiorella; Ancalli, Felix; Bonilla-Escobar, Francisco; Diaz-Velez, Cristian; Gutierrez-Quezada, Erick; Gomez-Alhach, Jennifer; Muñoz-Medina, Carlos E.; Sanchez-Pozo, Adriana; Vidal, Milisen

    2016-01-01

    Introduction The selection of a medical specialty has been associated with multiple factors, such as personal preferences, academic exposure, motivational factors and sociodemographic factors, such as gender. The number of women in the medical field has increased in recent years. In Latin America, we have not found any studies that explore this relationship. Objective To determine whether there is an association between gender and the intention to choose a medical specialty in medical students from 11 countries in Latin America. Methods Secondary analysis of the Collaborative Working Group for the Research of Human Resources for Health (Red-LIRHUS) data; a multi-country project of students in their first year and fifth year of study, from 63 medical schools in 11 Latin American countries. All students who referred intention to choose a certain medical specialty were considered as participants. Results Of the 11073 surveyed students, 9235 indicated the name of a specific specialty. The specialties chosen most often in the fifth year were General Surgery (13.0%), Pediatrics (11.0%), Internal Medicine (10.3%) and Obstetrics/Gynecology (9.0%). For women, the top choices were Pediatrics (15.8%), Obstetrics/Gynecology (11.0%), Cardiology (8.7%), General Surgery (8.6%), and Oncology (6.4%). In the adjusted analysis, the female gender was associated with the choice of Obstetrics/Gynecology (RP: 2.75; IC95%: 2.24–3.39); Pediatric Surgery (RP: 2.19; IC95%: 1.19–4.00), Dermatology (RP: 1.91; IC95%:1.24–2.93), Pediatrics (RP: 1.83; IC95%: 1.56–2.17), and Oncology (RP: 1.37; IC95%: 1.10–1.71). Conclusions There is an association between the female gender and the intention to choose Obstetrics/Gynecology, Pediatrics, Pediatric Surgery, Dermatology, and Oncology. We recommend conducting studies that consider other factors that can influence the choice of a medical specialty. PMID:27519055

  7. Identifying Early Childhood Personality Dimensions Using the California Child Q-Set and Prospective Associations With Behavioral and Psychosocial Development

    OpenAIRE

    Wilson, Sylia; Schalet, Benjamin D.; Hicks, Brian M.; Zucker, Robert A.

    2013-01-01

    The present study used an empirical, “bottom-up” approach to delineate the structure of the California Child Q-Set (CCQ), a comprehensive set of personality descriptors, in a sample of 373 preschool-aged children. This approach yielded two broad trait dimensions, Adaptive Socialization (emotional stability, compliance, intelligence) and Anxious Inhibition (emotional/behavioral introversion). Results demonstrate the value of using empirical derivation to investigate the structure of personalit...

  8. GPS Time Series Analysis of Southern California Associated with the 2010 M7.2 El Mayor/Cucapah Earthquake

    Science.gov (United States)

    Granat, Robert; Donnellan, Andrea

    2011-01-01

    The Magnitude 7.2 El-Mayor/Cucapah earthquake the occurred in Mexico on April 4, 2012 was well instrumented with continuous GPS stations in California. Large Offsets were observed at the GPS stations as a result of deformation from the earthquake providing information about the co-seismic fault slip as well as fault slip from large aftershocks. Information can also be obtained from the position time series at each station.

  9. Chronic Medical Conditions and Negative Affect; Racial Variation in Reciprocal Associations

    Directory of Open Access Journals (Sweden)

    Shervin Assari

    2016-08-01

    Full Text Available Background: Black-White health paradox can be defined as a lower frequency of depression despite a higher prevalence of economic and social adversities as well as chronic medical conditions (CMC among American Blacks compared to American Whites. Based on this paradox, the CMC - depressive symptoms link is expected to be weaker among Blacks and Whites. We conducted a 10 year longitudinal study to compare Blacks and Whites for bidirectional associations between number of CMC and negative affect.Methods: We used data from the MIDUS (Midlife in the United States, a nationally representative longitudinal study of American adults. A total number of 7,108 individuals with age range 25 to 75 (N = 7,108 were followed for 10 years from 1995 to 2004. Age, gender, and socioeconomic status (education and income measured at baseline were controls. Negative affect and chronic medical conditions were measured at baseline and end of follow up. Race was the moderator. Linear regression analysis was used to test the moderating effect of race on the reciprocal associations between CMC and negative affect, net of covariates.Results: In the pooled sample, while baseline CMC was predictive of an increase in negative affect over time, baseline negative affect was also predictive of an increase in CMC. We found interactions between race and baseline CMC on change in depressive symptoms, as well as race with negative affect on CMC change. Conclusion: Blacks and Whites differ in reciprocal links between CMC and negative affect over time. This finding replicates recent studies on differential links between psychosocial outcomes and physical health based on race. Findings may help us better understand how Black - White health paradox develops across mid and later life.

  10. Associations between teaching effectiveness and participant self-reflection in continuing medical education.

    Science.gov (United States)

    Ratelle, John T; Bonnes, Sara L; Wang, Amy T; Mahapatra, Saswati; Schleck, Cathy D; Mandrekar, Jayawant N; Mauck, Karen F; Beckman, Thomas J; Wittich, Christopher M

    2017-03-16

    Effective medical educators can engage learners through self-reflection. However, little is known about the relationships between teaching effectiveness and self-reflection in continuing medical education (CME). We aimed to determine associations between presenter teaching effectiveness and participant self-reflection in conference-based CME. This cross-sectional study evaluated presenters and participants at a national CME course. Participants provided CME teaching effectiveness (CMETE) ratings and self-reflection scores for each presentation. Overall CMETE and CME self-reflection scores (five-point Likert scale with one as strongly disagree and five as strongly agree) were averaged for each presentation. Correlations were measured among self-reflection, CMETE, and presentation characteristics. In total, 624 participants returned 430 evaluations (response, 68.9%) for the 38 presentations. Correlation between CMETE and self-reflection was medium (Pearson correlation, 0.3-0.5) or large (0.5-1.0) for most presentations (n = 33, 86.9%). Higher mean (SD) CME reflection scores were associated with clinical cases (3.66 [0.12] vs. 3.48 [0.14]; p = 0.003) and audience response (3.66 [0.12] vs. 3.51 [0.14]; p = 0.005). To our knowledge, this is the first study to show a relationship between teaching effectiveness and participant self-reflection in conference-based CME. Presenters should consider using clinical cases and audience response systems to increase teaching effectiveness and promote self-reflection among CME learners.

  11. The non-medical workforce and its role in surgical training: Consensus recommendations by the Association of Surgeons in Training.

    Science.gov (United States)

    Gokani, Vimal J; Peckham-Cooper, Adam; Bunting, David; Beamish, Andrew J; Williams, Adam; Harries, Rhiannon L

    2016-11-01

    Changes in the delivery of the healthcare structure have led to the expansion of the non-medical workforce (NMW). The non-medical practitioner in surgery (a healthcare professional without a medical degree who undertakes specialist training) is a valuable addition to a surgical firm. However, there are a number of challenges regarding the successful widespread implementation of this role. This paper outlines a number of these concerns, and makes recommendations to aid the realisation of the non-medical practitioner as a normal part of the surgical team. In summary, the Association of Surgeons in Training welcomes the development of the non-medical workforce as part of the surgical team in order to promote enhanced patient care and improved surgical training opportunities. However, establishing a workforce of independent/semi-independent practitioners who compete for the same training opportunities as surgeons in training may threaten the UK surgical training system, and therefore the care of our future patients.

  12. Asthma and asthma medication use among 4-year-old offspring of subfertile couples--association with IVF?

    Science.gov (United States)

    Kuiper, Derk B; Seggers, Jorien; Schendelaar, Pamela; Haadsma, Maaike L; Roseboom, Tessa J; Heineman, Maas J; Hadders-Algra, Mijna

    2015-11-01

    This study evaluated the prevalence of asthma and asthma medication use in 213 4-year-old singletons followed from birth onwards, including three groups of children born following: (i) controlled ovarian hyperstimulation IVF/intracytoplasmic sperm injection (ICSI); (ii) modified natural cycle IVF/ICSI; and (iii) natural conception in subfertile couples. The rate of asthma medication was higher in the ovarian hyperstimulation-IVF/ICSI than in the subfertile group (adjusted odds ratios [aOR]: 1.96 [1.00-3.84]). Time to pregnancy, a proxy for the severity of subfertility, was not associated with asthma and asthma medication. In conclusion, controlled ovarian hyperstimulation-IVF/ICSI is associated with the use of asthma medication in 4-year-old offspring of subfertile couples.

  13. Evaluation of self-reported medication adherence and its associated factors among epilepsy patients in Hospital Kuala Lumpur

    Science.gov (United States)

    Molugulu, Nagashekhara; Gubbiyappa, Kumar Shiva; Vasudeva Murthy, C. R.; Lumae, Lim; Mruthyunjaya, Anil Tumkur

    2016-01-01

    Introduction: Reports on medication adherence and its associated factors in patients with epilepsy in South East Asian countries are lacking. The primary purpose of this study was to assess the degree of medication adherence and its relationship with patient's satisfaction, psychosocial factors, quality of life and mental health in a sample of Malaysian epilepsy patients. Methodology: It is a cross-sectional study and was carried out in the outpatient Neurology Department of Hospital Kuala Lumpur, Malaysia (n=272). Data was collected by administering the structured questionnaire. Results and Discussion: Results showed that 49.3% of the epilepsy patients were non-adherent to their prescribed regimen. Univariate analysis showed significant associations between medication adherence and the following factors: race, seizure frequency, overall patient satisfaction, medication taste and smell, medication cost and physical appearance, medication effectiveness, complexity of medication regimen, patient barrier, patient understanding, patient role functioning, patient positivity, vitality and general interest. Multiple regression analysis indicated that factors that are influencing medication adherence are seizure frequency (P = 0.048), overall patient satisfaction (P = 0.043) and patient understanding about their illness (P = 0.001). The model chosen for testing the relationship between medication adherence and its associated factors give an R2 value of 25.2% with an adjusted R2 of 21.4%. The F value was also significant (P = 0.000). Based on the research findings, the researchers recommends that clinicians need to play a vital role in educating the patients on their disease conditions. By educating the patients on nature of epilepsy, different modalities of treatment and benefits of adherence to treatment will help in the better adherence and management. PMID:27999469

  14. Data for calculating population, collision and displacement vulnerability among marine birds of the California Current System associated with offshore wind energy infrastructure

    Science.gov (United States)

    Adams, Josh; Kelsey, Emily; Felis, Jonathan J.; Pereksta, David M.

    2016-01-01

    The U.S. Geological Survey, Western Ecological Research Center (USGS-WERC) was requested by the Bureau of Ocean Energy Management (BOEM) to create a database for marine birds of the California Current System (CCS) that would allow quantification and species ranking regarding vulnerability to offshore wind energy infrastructure (OWEI). This was needed so that resource managers could evaluate potential impacts associated with siting and construction of OWEI within the California Current System section of the Pacific Offshore Continental Shelf, including California, Oregon, and Washington. Along with its accompanying Open File Report (OFR), this comprehensive database can be used (and modified or updated) to quantify marine bird vulnerability to OWEIs in the CCS at the population level. For 81 marine bird species present in the CCS, we generated numeric scores to represent three vulnerability indices associated with potential OWEI: population vulnerability, collision vulnerability, and displacement vulnerability. The metrics used to produce these scores includes global population size, proportion of the population in the CCS, threat status, adult survival, breeding score, annual occurrence in the CCS, nocturnal and diurnal flight activity, macro-avoidance behavior, flight height, and habitat flexibility; values for these metrics can be updated and adjusted as new data become available. The scoring methodology was peer-reviewed to evaluate if the metrics identified and the values generated were appropriate for each species considered. The numeric vulnerability scores in this database can readily be applied to areas in the CCS with known species distributions and where offshore renewable energy development is being considered. We hope that this information can be used to assist meaningful planning decisions that will impact seabird conservation. These data support the following publication: Adams, J., Kelsey, E.C., Felis J.J., and Pereksta, D.M., 2016

  15. Association of medications for lifestyle-related diseases with reflux esophagitis

    Directory of Open Access Journals (Sweden)

    Asaoka D

    2016-10-01

    Full Text Available Daisuke Asaoka,1 Akihito Nagahara,2 Mariko Hojo,1 Kenshi Matsumoto,1 Hiroya Ueyama,1 Kohei Matsumoto,1 Kentaro Izumi,1 Tsutomu Takeda,1 Hiroyuki Komori,1 Yoichi Akazawa,1 Yuji Shimada,2 Taro Osada,1 Sumio Watanabe1 1Department of Gastroenterology, University of Juntendo, School of Medicine, Tokyo, 2Department of Gastroenterology, Juntendo University Shizuoka Hospital, Shizuoka, Japan Background: Because of a change in lifestyle, especially adoption of westernized eating habits, lifestyle-related diseases have become increasingly prevalent. The aim of this study was to investigate the association of medications for lifestyle-related diseases with reflux esophagitis (RE.Methods: We conducted a hospital-based, cross-sectional retrospective study of consecutive outpatients who received an upper gastrointestinal endoscopy in our department from February 2008 to November 2014, which was performed by one specialist who was a member of the Japan Gastroenterological Endoscopy Society. We investigated the patient profile, Helicobacter pylori (H. pylori infection status, medications for lifestyle-related diseases (including calcium channel blockers, statins, and bisphosphonates, and upper gastrointestinal endoscopic findings (RE, hiatal hernia, Barrett’s mucosa, and endoscopic gastric mucosal atrophy [EGA]. Patients with gastrectomy, peptic ulcer disease, gastric or esophageal malignant disease, and those who used proton pump inhibitors or histamine-2 receptor antagonists were excluded. We divided the subjects into a group without RE (RE(– and a RE (RE(+ group as judged by endoscopy, and investigated the risk factors for RE.Results: Of 1,744 consecutive cases, 590 cases (300 males and 290 females; mean age 60.5±13.2 years were eligible. RE(– and RE(+ cases numbered 507 and 83, respectively. Bivariate analysis showed significant positive associations of RE with male sex, body mass index (BMI, calcium channel blockers, Barrett’s mucosa, hiatal

  16. Posthospital Discharge Medical Care Costs and Family Burden Associated with Osteoporotic Fracture Patients in China from 2011 to 2013

    Directory of Open Access Journals (Sweden)

    Zhao Xie

    2015-01-01

    Full Text Available Objectives. This study collected and evaluated data on the costs of outpatient medical care and family burden associated with osteoporosis-related fracture rehabilitation following hospital discharge in China. Materials and Methods. Data were collected using a patient questionnaire from osteoporosis-related fracture patients (N = 123 who aged 50 years and older who were discharged between January 2011 and January 2013 from 3 large hospitals in China. The survey captured posthospital discharge direct medical costs, indirect medical costs, lost work time for caregivers, and patient ambulatory status. Results. Hip fracture was the most frequent fracture site (62.6%, followed by vertebral fracture (34.2%. The mean direct medical care costs per patient totaled 3,910¥, while mean indirect medical costs totaled 743¥. Lost work time for unpaid family caregivers was 16.4 days, resulting in an average lost income of 3,233¥. The average posthospital direct medical cost, indirect medical cost, and caregiver lost income associated with a fracture patient totaled 7,886¥. Patients’ ambulatory status was negatively impacted following fracture. Conclusions. Significant time and cost of care are placed on patients and caregivers during rehabilitation after discharge for osteoporotic fracture. It is important to evaluate the role and responsibility for creating the growing and inequitable burden placed on patients and caregivers following osteoporotic fracture.

  17. Attention deficit hyperactivity disorder in elementary school children in Rhode Island: associated psychosocial factors and medications used.

    Science.gov (United States)

    Harel, Ephat H; Brown, William D

    2003-01-01

    This study was undertaken to explore psychosocial factors associated with referral for attention deficit hyperactivity disorder (ADHD) evaluation or ADHD diagnosis among elementary school children in Rhode Island, as well as to examine the extent of drug therapy among this population. A survey was distributed to parents/guardians of 2,800 3rd- to 5th-grade public school students in 4 Rhode Island school districts. The average age of the children was 9.0 +/- 1.0 years with 52% girls. Approximately 12% of the students had been referred for ADHD evaluation (RFE). Of these, 52% (6% of all children in the survey) were receiving psychoactive prescription medications daily. While the male:female ratio in the non-RFE group was almost 1:1, there were more boys than girls in the RFE group (male/female ratio of 3:1, p medicated group (male/female ratio 4:1, p children and medicated children were older than classroom peers (p children and medicated children were significantly less likely to have parents who completed college (p children (p medicated children) followed by methylphenidate (43%). Nearly 18% of the medicated children were receiving 1 to 3 additional psychoactive prescription medications on a daily basis. In conclusion, RFE children and children medicated for ADHD were more likely to have a stepparent, have no siblings, and have parents that had not completed college. Amphetamine rather than methylphenidate accounted for the majority of medications used in this study, and simultaneous use of multiple psychoactive medications was reported in 18% of the medicated children.

  18. A Tangible Bridge-An interview with Mr.Sun Ciyi,Secretary General of Shanghai Pudong Medical Device Trade Association

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    @@ Q:As the Secretary General of Shanghai Pudong Medical Device Trade Association (referred as "the Association").you have worked in the medical industry for many years.Could you tell us your opinion about the current situation of medical device market in China?

  19. Medical and Surgical Treatment in Pediatric Orbital Myositis Associated with Coxsackie Virus

    Directory of Open Access Journals (Sweden)

    Pedro Gil

    2015-01-01

    Full Text Available Purpose. To report a case of orbital myositis associated with Coxsackie virus and its medical and surgical approach. Methods. Complete ophthalmological examination and imaging and analytical investigation were performed. Results. A 6-year-old male presented with subacute painless binocular horizontal diplopia. Examination revealed bilateral best-corrected visual acuity (BCVA of 20/20 and right eye 45-prism-dioptre (PD esotropia in near and distance fixations, with no motility restrictions. Serologic screening was positive for Coxsackie virus acute infection and computerized tomography (CT suggested right eye medial rectus orbital myositis. An oral corticosteroid 1.0 mg/kg/day regimen was started. A new CT after two months showed symmetrical lesions in both medial rectus muscles. Corticosteroids were increased to 1.5 mg/kg/day. After imagiological resolution on the 4th month, alternating 45 PD esotropia persisted. Bilateral 7 mm medial rectus recession was performed after 1 year without spontaneous recovery. At 1-year follow-up, the patient is orthophoric with 200′′ stereopsis and bilateral 20/20 BCVA. Conclusions. To our knowledge, this is the first reported case of orbital myositis associated with Coxsackie virus. This is also the first reported case of isolated strabismus surgery after orbital myositis in pediatric age, highlighting the favourable aesthetic and functional outcomes even in cases of late ocular motility disorders.

  20. Medication Use Associated with Exposure to Manganese in Two Ohio Towns

    Science.gov (United States)

    This report describes the use of medications as a proxy when medical record reviews are unavailable, to study the health effects of residents environmentally exposed to airmanganese (n = 185) compared to unexposed residents (n = 90). Participants' current medication lists and med...

  1. Trends, productivity losses, and associated medical conditions among toxoplasmosis deaths in the United States, 2000-2010.

    Science.gov (United States)

    Cummings, Patricia L; Kuo, Tony; Javanbakht, Marjan; Sorvillo, Frank

    2014-11-01

    Few studies have quantified toxoplasmosis mortality, associated medical conditions, and productivity losses in the United States. We examined national multiple cause of death data and estimated productivity losses caused by toxoplasmosis during 2000-2010. A matched case-control analysis examined associations between comorbid medical conditions and toxoplasmosis deaths. In total, 789 toxoplasmosis deaths were identified during the 11-year study period. Blacks and Hispanics had the highest toxoplasmosis mortality compared with whites. Several medical conditions were associated with toxoplasmosis deaths, including human immunodeficiency virus (HIV), lymphoma, leukemia, and connective tissue disorders. The number of toxoplasmosis deaths with an HIV codiagnosis declined from 2000 to 2010; the numbers without such a codiagnosis remained static. Cumulative disease-related productivity losses for the 11-year period were nearly $815 million. Although toxoplasmosis mortality has declined in the last decade, the infection remains costly and is an important cause of preventable death among non-HIV subgroups.

  2. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association Medical guidelines for clinical practice for the diagnosis and management of thyroid nodules

    DEFF Research Database (Denmark)

    Gharib, Hossein; Papini, Enrico; Paschke, Ralf;

    2010-01-01

    American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules are systematically developed statements to assist health care professionals in medical...... decision making for specific clinical conditions. Most of the content herein is based on literature reviews. In areas of uncertainty, professional judgment was applied.These guidelines are a working document that reflects the state of the field at the time of publication. Because rapid changes in this area...

  3. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association Medical Guidelines for Clinical Practice for the Diagnosis and Management of thyroid Nodules

    DEFF Research Database (Denmark)

    Gharib, Hossein; Papini, Enrico; Paschke, Ralf;

    2010-01-01

    American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules are systematically developed statements to assist health care professionals in medical...... decision making for specific clinical conditions. Most of the content herein is based on literature reviews. In areas of uncertainty, professional judgment was applied.These guidelines are a working document that reflects the state of the field at the time of publication. Because rapid changes in this area...

  4. Association between Perceived Value and Self-Medication with Antibiotics: An Observational Study Based on Health Belief Model Theory

    Directory of Open Access Journals (Sweden)

    Annisa N. Insany

    2015-06-01

    Full Text Available High prevalence of self medication with antibiotics can increase the probability of irrational use of antibiotics which may lead antibiotics resistance. Thus, shifting of behavior is required to minimize the irrational use of antibiotics. This study was aimed to determine the association between public perceived value and self-medication with antibiotics which can be used to develop an intervention model in order to reduce the practice of self-medication with antibiotics. An observational study was conducted during the period of November–December 2014.The subjects were patients who visit primary health care facilities in Bandung. A structured-interview that has been validated was used to investigate the association between perceived value and self-medication behavior based on the Health Belief Model theory (perceived susceptibility, benefits, barrier, and cues to action. Approximately 506 respondents were drawn randomly from 43 community healthcare centers and 8 pharmacies. Data was analyzed by using descriptive statistics and logistic regression (CI 95%, α = 5%. Validity and reliability of the questionnaire were shown with a correlation coefficient of >0.3 and a cronbach-alpha value of 0.719, respectively. We found that 29.45% of respondents practiced self-medication with antibiotics over the last six months. Additionally, there was no significant association between the perceived susceptibility, benefits, barrier, and cues to action with self-medication behavior (p>0.05. Easiness to access antibiotics without prescription was presumed as a factor that contribute to self-medication with antibiotics, therefore strict regulation in antibiotics use is very needed as a basic intervention to decrease self-medication with antibiotic.

  5. Associations between medication use and homocysteine levels in an older population, and potential mediation by vitamin B12 and folate: data from the B-PROOF study

    NARCIS (Netherlands)

    Ham, A.C.; Enneman, A.W.; Dijk, van S.C.; Wijngaarden, van J.P.; Zwaluw, van der N.L.; Brouwer, E.M.; Dhonukshe-Rutten, R.A.M.; Groot, de C.P.G.M.; Witkamp, R.F.

    2014-01-01

    Background Elevated homocysteine levels are a risk indicator for cardiovascular disease, fractures and cognitive decline. Previous studies indicated associations between homocysteine levels and medication use, including antihypertensive, lipid-lowering and antidiabetic medication. However, results w

  6. Risk of recurrent overdose associated with prescribing patterns of psychotropic medications after nonfatal overdose

    Science.gov (United States)

    Okumura, Yasuyuki; Nishi, Daisuke

    2017-01-01

    Objective We aimed to estimate risk of recurrent overdose associated with psychosocial assessment by psychiatrists during hospitalization for nonfatal overdose and prescribing patterns of psychotropic medications after discharge. Methods A retrospective cohort study was conducted using a nationwide claims database in Japan. We classified patients aged 19–64 years hospitalized for nonfatal overdose between October 2012 and September 2013 into two cohorts: 1) those who had consulted a psychiatrist prior to overdose (n=6,790) and 2) those who had not (n=4,950). All patients were followed up from 90 days before overdose until 365 days after discharge. Results Overall, 15.3% of patients with recent psychiatric treatment had a recurrent overdose within 365 days, compared with 6.0% of those without psychiatric treatment. Psychosocial assessment during hospital admission had no significant effect on subsequent overdose, irrespective of treatment by psychiatrists before overdose. There was a dose–response relationship for the association of benzodiazepine prescription after overdose with subsequent overdose in either cohort, even after accounting for average daily dosage of benzodiazepines before overdose and other confounders. In patients with recent psychiatric treatment, the cumulative proportion of recurrent overdose at 365 days was 27.7% for patients receiving excessive dosages of benzodiazepines, 22.0% for those receiving high dosages, 15.3% for those receiving normal dosages, and 7.6% for those receiving no benzodiazepines. In patients without psychiatric treatment, the cumulative proportion of recurrent overdose at 365 days was 24.3% for patients receiving excessive dosages of benzodiazepines, 18.0% for those receiving high dosages, 9.0% for those receiving normal dosages, and 4.1% for those receiving no benzodiazepines. Conclusion Lower dose of benzodiazepines after overdose is associated with lower risk of subsequent overdose. PMID:28293108

  7. Multisite geriatrics clerkship for fourth-year medical students: a successful model for teaching the Association of American Medical Colleges' core competencies.

    Science.gov (United States)

    Oates, Daniel J; Norton, Lisa E; Russell, Matthew L; Chao, Serena H; Hardt, Eric J; Brett, Belle; Kimball, Patricia; Levine, Sharon A

    2009-10-01

    As the population ages, it is important that graduating medical students be properly prepared to treat older adults, regardless of their chosen specialty. To this end, the Association of American Medical Colleges (AAMC) and the John A. Hartford Foundation convened a consensus conference to establish core competencies in geriatrics for all graduating medical students. An ambulatory geriatric clerkship for fourth-year medical students that successfully teaches 24 of the 26 AAMC core competencies using an interdisciplinary, team-based approach is reported here. Graduating students (N=158) reported that the clerkship was successful at teaching the core competencies, as evidenced by positive responses on the AAMC Graduation Questionnaire (GQ). More than three-quarters (80-93%) of students agreed or strongly agreed that they learned the seven geriatrics concepts asked about on the GQ, which cover 14 of the 26 core competencies. This successful model for a geriatrics clerkship can be used in many institutions to teach the core competencies and in any constellation of geriatric ambulatory care sites that are already available to the faculty.

  8. The association between Colombian medical students' healthy personal habits and a positive attitude toward preventive counseling: cross-sectional analyses

    Directory of Open Access Journals (Sweden)

    Sarmiento Francisco

    2009-07-01

    Full Text Available Abstract Background Physician-delivered preventive counseling is important for the prevention and management of chronic diseases. Data from the U.S. indicates that medical students with healthy personal habits have a better attitude towards preventive counseling. However, this association and its correlates have not been addressed in rapidly urbanized settings where chronic disease prevention strategies constitute a top public health priority. This study examines the association between personal health practices and attitudes toward preventive counseling among first and fifth-year students from 8 medical schools in Bogotá, Colombia. Methods During 2006, a total of 661 first- and fifth-year medical students completed a culturally adapted Spanish version of the "Healthy Doctor = Healthy Patient" survey (response rate = 78%. Logistic regression analyses were used to assess the association between overall personal practices on physical activity, nutrition, weight control, smoking, alcohol use (main exposure variable and student attitudes toward preventive counseling on these issues (main outcome variable, stratified by year of training and adjusting by gender and medical training-related factors (basic knowledge, perceived adequacy of training and perception of the school's promotion on each healthy habit. Results The median age and percentage of females for the first- and fifth-year students were 21 years and 59.5% and 25 years and 65%, respectively. After controlling for gender and medical training-related factors, consumption of ≥ 5 daily servings of fruits and/or vegetables, not being a smoker or binge drinker were associated with a positive attitude toward counseling on nutrition (OR = 4.71; CI = 1.6–14.1; p = 0.006 smoking (OR = 2.62; CI = 1.1–5.9; p = 0.022, and alcohol consumption (OR = 2.61; CI = 1.3–5.4; p = 0.009, respectively. Conclusion As for U.S. physician and medical students, a positive association was found between the

  9. Detection of domoic acid in northern anchovies and California sea lions associated with an unusual mortality event.

    Science.gov (United States)

    Lefebvre, K A; Powell, C L; Busman, M; Doucette, G J; Moeller, P D; Silver, J B; Miller, P E; Hughes, M P; Singaram, S; Silver, M W; Tjeerdema, R S

    1999-01-01

    The occurrence of an unusual mortality event involving California sea lions (Zalophus californianus) along the central California coast in May 1998 was recently reported. The potent neurotoxin domoic acid (DA), produced naturally by the diatom Pseudo-nitzschia australis and transmitted to the sea lions via planktivorous northern anchovies (Engraulis mordax), was identified as the probable causative agent. Details of DA analyses for anchovy tissues and sea lion feces are described. Domoic acid levels were estimated in anchovy samples by HPLC-UV, and in sea lion feces using the same method as well as a microplate receptor binding assay, with absolute confirmation by tandem mass spectrometry. The highest DA concentrations in anchovies occurred in the viscera (223 +/- 5 microg DA g(-1)), exceeding values in the body tissues by seven-fold and suggesting minimal bioaccumulation of DA in anchovy tissue. HPLC values for DA in sea lion fecal material (ranging from 152 to 136.5 microg DA g(-1)) required correction for interference from an unidentified compound. Inter-laboratory comparisons of HPLC data showed close quantitative agreement. Fecal DA activity determined using the receptor binding assay corresponded with HPLC values to within a factor of two. Finally, our detection of P. australis frustules, via scanning electron microscopy, in both anchovy viscera and fecal material from sea lions exhibiting seizures provides corroborating evidence that this toxic algal species was involved in this unusual sea lion mortality event.

  10. Mercury exposure associated with altered plasma thyroid hormones in the declining western pond turtle (Emys marmorata) from California mountain streams

    Science.gov (United States)

    Meyer, Erik; Eagles-Smith, Collin A.; Sparling, Donald; Blumenshine, Steve

    2014-01-01

    Mercury (Hg) is a global threat to wildlife health that can impair many physiological processes. Mercury has well-documented endocrine activity; however, little work on the effects of Hg on the thyroid hormones triiodothyronine (T3) and thyroxine (T4) in aquatic wildlife exists despite the fact that it is a sensitive endpoint of contaminant exposure. An emerging body of evidence points to the toxicological susceptibility of aquatic reptiles to Hg exposure. We examined the endocrine disrupting potential of Hg in the western pond turtle (Emys marmorata), a long-lived reptile that is in decline throughout California and the Pacific Northwest. We measured total Hg (THg) concentrations in red blood cells (RBCs) and plasma T3 and T4 of turtles from several locations in California that have been impacted by historic gold mining. Across all turtles from all sites, the geometric mean and standard error THg concentration was 0.805 ± 0.025 μg/g dry weight. Sampling region and mass were the strongest determinants of RBC THg. Relationships between RBC THg and T3 and T4 were consistent with Hg-induced disruption of T4 deiodination, a mechanism of toxicity that may cause excess T4 levels and depressed concentrations of biologically active T3.

  11. Mental Health Trainings in California's K-12 System Are Associated with Increased Confidence and Likelihood to Intervene with and Refer Students

    Science.gov (United States)

    Osilla, Karen Chan; Goldweber, Asha; Seelam, Rachana; Kase, Courtney Ann; Roth, Elizabeth; Stein, Bradley D.

    2015-01-01

    California's Statewide Prevention and Early Intervention (PEI) activities funded by the California Mental Health Services Authority (CalMHSA) under Proposition 63 included PEI training in mental health for staff from K-12 schools in California. RAND evaluated a subset of these PEI trainings using an anonymous survey that asked participants to…

  12. Mental Health Trainings in California's Higher Education System Are Associated with Increased Confidence and Likelihood to Intervene with and Refer Students

    Science.gov (United States)

    Osilla, Karen Chan; Woodbridge, Michelle W.; Seelam, Rachana; Kase, Courtney Ann; Roth, Elizabeth; Stein, Bradley D.

    2015-01-01

    California's Statewide Prevention and Early Intervention (PEI) activities funded by the California Mental Health Services Authority (CalMHSA) under Proposition 63 included PEI training in mental health for staff from K-12 schools in California. RAND evaluated a subset of these PEI trainings using an anonymous survey that asked participants to…

  13. Investigating crustal deformation associated with the North America-Pacific plate boundary in southern California with GPS geodesy

    Science.gov (United States)

    Spinler, Joshua C.

    The three largest earthquakes in the last 25 years in southern California occurred on faults located adjacent to the southern San Andreas fault, with the M7.3 1992 Landers and M7.1 1999 Hector Mine earthquakes occurring in the eastern California shear zone (ECSZ) in the Mojave Desert, and the M7.2 2010 El Mayor-Cucapah earthquake occurring along the Laguna Salada fault in northern Baja California, Mexico. The locations of these events near to but not along the southern San Andreas fault (SSAF) is unusual in that the last major event on the SSAF occurred more than 300 years ago, with an estimated recurrence interval of 215 +/- 25 years. The focus of this dissertation is to address the present-day deformation field along the North America-Pacific plate boundary in southern California and northern Baja California, through the analysis of GPS data, and elastic block and viscoelastic earthquake models to determine fault slip rates and rheological properties of the lithosphere in the plate boundary zone. We accomplish this in three separate studies. The first study looks at how strain is partitioned northwards along-strike from the southern San Andreas fault near the Salton Sea. We find that estimates for slip-rates on the southern San Andreas decrease from ~23 mm/yr in the south to ~8 mm/yr as the fault passes through San Gorgonio Pass to the northwest, while ~13-18 mm/yr of slip is partitioned onto NW-SE trending faults of the ECSZ where the Landers and Hector Mine earthquakes occurred. This speaks directly to San Andreas earthquake hazards, as a reduction in the slip rate would require greater time between events to build up enough slip deficit in order to generate a large magnitude earthquake. The second study focuses on inferring the rheological structure beneath the Salton Trough region. This is accomplished through analysis of postseismic deformation observed using a set of the GPS data collected before and after the 2010 El Mayor-Cucapah earthquake. By

  14. Medical muddle.

    Science.gov (United States)

    Gartrell, Nanette

    2014-01-01

    Nanette Gartrell, MD, is a psychiatrist and researcher whose investigations have documented the mental health and psychological well-being of lesbian, gay, bisexual, and transgender (LGBT) people over the past four decades. Nanette is the principal investigator of an ongoing longitudinal study of lesbian families in which the children were conceived by donor insemination. Now in its 27th year, this project has been cited internationally in the debates over equality in marriage, foster care, and adoption. Previously on the faculty at Harvard Medical School and the University of California, San Francisco, Nanette is currently a Visiting Distinguished Scholar at the Williams Institute, UCLA School of Law. In 2013, Nanette received the Association of Women Psychiatrists Presidential Commendation Award for "selfless and enduring vision, leadership, wisdom, and mentorship in the fields of women's mental health, ethics, and gender research." At the age of 63, Nanette experienced a 3 ½ month period of intractable, incapacitating dizziness for which there was never a clear diagnosis.

  15. In-hospital medical complications associated with patient dependency after acute ischemic stroke: data from the China National Stroke Registry

    Institute of Scientific and Technical Information of China (English)

    WANG Peng-lian; ZHAO Xing-quan; DU Wan-liang; WANG An-xin; JI Rui-jun; YANG Zhong-hua; WANG Chun-xue

    2013-01-01

    Background The mortality of stroke patients is strongly affected by medical complications.However,there are limited data investigating the effect of in-hospital medical complications on the dependency of stroke patients worldwide.We prospectively and systematically investigated the effect of medical complications on dependency of patients at 3,6 and 12 months after stroke using the China National Stroke Registry (CNSR).Methods This prospective cohort study collected data of patients age >18 years with acute ischemic stroke in 132 clinical centers distributed across 32 provinces and four municipalities (including Hong Kong region) of China,from September 2007 to August 2008.Data on medical complications,dependency and other information were obtained from paper-based registry forms.Medical complications associated with stroke outcomes were assessed using multivariable Logistic regression.Results Of 11 560 patients with acute ischemic stroke,1826 (15.80%) presented with in-hospital medical complications.In-hospital medical complications were independent risk factors for dependency of patients at 3 months (adjusted odds ratio (OR) 2.367,95% confidence interval (CI) 2.021-2.771),6 months (adjusted OR 2.257,95% CI 1.922-2.650),and 12 months (adjusted OR 1.820,95% CI 1.538-2.154) after acute ischemic stroke.Conclusion The results demonstrated that the short-term and long-term dependency of acute ischemic stroke patients is significantly associated with in-hospital medical complications in China.

  16. Variability in medication taking is associated with cognitive performance in nondemented older adults.

    Science.gov (United States)

    Austin, Johanna; Klein, Krystal; Mattek, Nora; Kaye, Jeffrey

    2017-01-01

    Interventions to slow cognitive decline typically can do little to reverse decline. Thus, early detection methods are critical. However, tools like cognitive testing are time consuming and require costly expertise. Changes in activities of daily living such as medication adherence may herald the onset of cognitive decline before clinical standards. Here, we determine the relationship between medication adherence and cognitive function in preclinical older adults. We objectively assessed medication adherence in 38 older adults (mean age 86.7 ± 6.9 years). Our results demonstrate that individuals with lower cognitive function have more spread in the timing of taking their medications (P = .014) and increase the spread in the timing of taking their medications over time (P = .012). These results demonstrate that continuous monitoring of medication adherence may provide the opportunity to identify patients experiencing slow cognitive decline in the earliest stages when pharmacologic or behavioral interventions may be most effective.

  17. Association between self-efficacy, career interest and rural career intent in Australian medical students with rural clinical school experience

    Science.gov (United States)

    Isaac, Vivian; Walters, Lucie; McLachlan, Craig S

    2015-01-01

    Objectives To investigate medical student's self-efficacy at the time of finishing their rural clinical school (RCS) placement and factors associated with self-efficacy. Secondary aims are to explore whether interest levels or self-efficacy are associated with rural or remote career intentions. Design, setting and participants A cross-sectional study of medical students who had completed their RCS term in 17 Australian universities. Data were derived from the 2013 Federation of Rural Australian Medical Educators (FRAME) evaluation survey. Questionnaire responses were analysed from 653 medical students from regional Australia. All 732 students who completed their RCS term in 2013 were invited to participate. Primary and secondary outcome measures Rural self-efficacy: Six questions to measure self-efficacy beliefs in rural medical practice, based on the sources of self-efficacy described by Bandura. Rural career intention: Students were asked to identify their preferred location for future practice. The options were, Capital or Major City; Inner regional city or large town; Smaller town and very remote area. Results Questionnaire responses were analysed from 653 medical students from regional Australia (response rate 89.2%). 83.8% of all students recalled an increase in their interest levels for rural medicine as a result of their RCS experience. Actual career intention to work in a regional area or rural area was 60.2%. Bivariate analyses showed female gender (p=0.003), rural background (prural medicine (OR 1.4 (95% CI 1.3 to 1.5)) and rural career intent (OR 1.2 (95% CI 1.1 to 1.3)). (Model included gender, rural background, preference for RCS, generalist intent, rural practice interest and self-efficacy). Conclusions Self-efficacy is associated with increased interest levels for rural medicine and rural medical career intent. PMID:26671960

  18. Periodontal-disease-associated biofilm: A reservoir for pathogens of medical importance.

    Science.gov (United States)

    Vieira Colombo, Ana Paula; Magalhães, Clarissa Bichara; Hartenbach, Fátima Aparecida Rocha Resende; Martins do Souto, Renata; Maciel da Silva-Boghossian, Carina

    2016-05-01

    The ecological diversity of the periodontal microenvironment may provide suitable conditions for the colonization of species not usually considered members of the oral microbiota. In this investigation, we aimed to determine the prevalence and levels of pathogenic species of medical relevance in the microbiota of individuals with distinct periodontal clinical status. Subgingival biofilm was obtained from patients with periodontal health (H, n = 81), gingivitis (G, n = 55), generalized aggressive (AgP, n = 36) or chronic periodontitis (CP, n = 98), and analyzed for 39 microbial taxa using a checkerboard DNA-DNA hybridization technique. Microbial differences among groups, as well as associations between clinical and microbiological parameters were sought by non-parametric and univariate correlation tests. Neisseria spp., Peptostreptococus anaerobius, Candida albicans, enterobacteria, Pseudomonas aeruginosa, Eubacterium saphenum, Clostridium difficile and Olsenella uli were detected in high mean prevalence and counts in the subgingival microbiota of the study population. Species that were more related to periodontal inflammation and tissue destruction at the patient and site levels included enterobacteria, C. albicans, Neisseria spp., P. aeruginosa, O. uli, Hafnia alvei, Serratia marcescens and Filifactor alocis (p periodontal health (p periodontal microbiota. Regardless of their role in periodontal health or disease, the periodontal biofilm may be a source for dissemination and development of systemic infections by these pathogenic microorganisms.

  19. The Incidence of Nosocomial Toxigenic Clostridium difficile Associated Diarrhea in Tehran Tertiary Medical Centers

    Directory of Open Access Journals (Sweden)

    Norakhoda Sadeghifard

    2010-10-01

    Full Text Available Clostridium difficile is the most common cause of nosocomial diarrhea. It is usually a consequence of antibiotic treatment, But sporadic cases can occur. This study was aimed to determine the frequency of the nosocomial Clostridium difficile (C. difficile associated diarrhea in Tehran University of Medical Sciences hospitals and study of antibacterial susceptibility of isolates. In this study a total of 942 stool samples from patients with nosocomial diarrhea that were hospitalized in Imam Khomeini hospital, Shariati hospital and Children clinical center were collected. The samples were cultured on a selective cycloserine cefoxitin fructose agar (CCFA and incubated in anaerobic conditions, at 37°C for 5 days. Isolates were characterized to species level by conventional biochemical tests. Bacterial cytotoxicity was assayed on tissue culture (vero. Antimicrobial sensitivity of isolated toxigenic C. difficile were investigated by kirby Beuer method (disk diffusion. Our findings show that, of the total patients, 57 toxigenic C. difficile (6.1% were isolated. Results of statistical analysis show significant differences between the rate of isolated toxigenic C. difficile and age group of patients (P

  20. Nephrogenic systemic fibrosis associated with gadolinium based contrast agents: A summary of the medical literature reporting

    Energy Technology Data Exchange (ETDEWEB)

    Broome, Dale R. [Department of Radiology, Loma Loma University Medical Center, 11234 Anderson Street, Room 2606, Loma Linda, CA 92354 (United States)], E-mail: dbroome@ahs.llumc.edu

    2008-05-15

    Nephrogenic systemic fibrosis (NSF) is a systemic fibrosing disorder that principally affects the skin, but can involve virtually any tissue in the human body and result in significant disability and even death. Since 2006 numerous retrospective case reports and case series have reported a very strong association of this disease with exposure to gadolinium-based contrast agents (Gd-CA) for MR imaging in the setting of severe or end-stage renal disease. The purpose of this report is to summarize the medical literature reporting of biopsy-proven NSF cases in which the authors specifically investigated patient exposure to Gd-CA. A Pub Med MEDLINE search was performed using the key words-nephrogenic systemic fibrosis and nephrogenic fibrosing dermopathy. All case reports and case series of NSF were reviewed to determine if patients had a preceding exposure to Gd-CA and which specific Gd-CA was involved. If the original reports did not clarify the specific Gd-CA, I reviewed follow-up letters to the editors or contacted the authors to clarify which specific Gd-CA were linked to the NSF cases. If several reports originated from the same institution, clarification was also obtained to avoid redundant reporting. As of February 1, 2008 there have been 190 biopsy-proven cases of NSF published in the peer-reviewed literature with the following associations: 157 gadodiamide (Omniscan, GE Healthcare), 8 gadopentetate (Magnevist, Bayer Healthcare), 3 gadoversetamide (OptiMARK, Covidien), and 18 unspecified Gd-CA, and 4 confounded cases with more than one Gd-CA. Five cases of NSF were unassociated with Gd-CA.

  1. Variables Associated with Utilization of a Centralized Medical Post in the Andean Community of Pampas Grande, Peru

    Science.gov (United States)

    Merry, Stephen P.; Rohrer, James E.; Thacher, Thomas D.; Summers, Matthew R.; Alpern, Jonathan D.; Contino, Robert W.

    2012-01-01

    Context: Integral to the location of health resources is the distance decay of utilization observed in a population. In rural Peru, a nongovernmental organization planning to increase the availability of health services needed this information. Purpose: To determine variables associated with utilization of a central medical clinic and determine…

  2. The American Medical Association Older Driver Curriculum for Health Professionals: Changes in Trainee Confidence, Attitudes, and Practice Behavior

    Science.gov (United States)

    Meuser, Thomas M.; Carr, David B.; Irmiter, Cheryl; Schwartzberg, Joanne G.; Ulfarsson, Gudmundur F.

    2010-01-01

    Few gerontology and geriatrics professionals receive training in driver fitness evaluation, state reporting of unfit drivers, or transportation mobility planning yet are often asked to address these concerns in the provision of care to older adults. The American Medical Association (AMA) developed an evidence-based, multi-media Curriculum to…

  3. Relationship of depression and catastrophizing to pain, disability, and medication adherence in patients with HIV-associated sensory neuropathy.

    Science.gov (United States)

    Lucey, Brendan P; Clifford, David B; Creighton, Jason; Edwards, Robert R; McArthur, Justin C; Haythornthwaite, Jennifer

    2011-08-01

    Few studies have examined how patients with chronic HIV infection cope with pain and how pain relates to medication adherence. Pain coping strategies such as catastrophizing are often associated with increased pain and disability and may also influence adherence to medications. The goal of our study is to assess the relationship of catastrophizing and depression to pain, disability, and medication adherence through questionnaires administered to a cross-section of patients with HIV-associated sensory neuropathy. In our study, 46 HIV-seropositive subjects completed questionnaires evaluating neuropathic pain severity, pain catastrophizing, pain-related disability, depressive symptoms, severity of antiretroviral therapy (ART) side effects, and common reasons for medication nonadherence. Hierarchical regression analysis indicated that pain catastrophizing correlated with severity of neuropathic pain independent of depressive symptoms. Furthermore, depressive symptoms were not associated with multiple factors independent of pain catastrophizing such as severity of neuropathic pain and pain-related disability. Pain catastrophizing, but not depressive symptoms, correlated with increased pain disability even after controlling for the effects of age and neuropathic pain. We also found that poor adherence attributed to fear of side effects or forgetfulness was associated with increased severity of neuropathic pain, while depressive symptoms but not catastrophizing correlated with ART side effects. These findings suggest that both catastrophizing and depressive symptoms are important factors to consider in the management of pain from HIV neuropathy and adherence to ART.

  4. Associations between labial and whole salivary flow rates, systemic diseases and medications in a sample of older people

    DEFF Research Database (Denmark)

    Smidt, Dorte; Torpet, Lis Andersen; Nauntofte, Birgitte;

    2010-01-01

    Smidt D, Torpet LA, Nauntofte B, Heegaard KM, Pedersen AML. Associations between labial and whole salivary flow rates, systemic diseases and medications in a sample of older people. Community Dent Oral Epidemiol 2010; 38: 422-435. © 2010 John Wiley & Sons A/S Abstract - Objective: To investigate ...

  5. Identifying Early Childhood Personality Dimensions Using the California Child Q-Set and Prospective Associations With Behavioral and Psychosocial Development.

    Science.gov (United States)

    Wilson, Sylia; Schalet, Benjamin D; Hicks, Brian M; Zucker, Robert A

    2013-08-01

    The present study used an empirical, "bottom-up" approach to delineate the structure of the California Child Q-Set (CCQ), a comprehensive set of personality descriptors, in a sample of 373 preschool-aged children. This approach yielded two broad trait dimensions, Adaptive Socialization (emotional stability, compliance, intelligence) and Anxious Inhibition (emotional/behavioral introversion). Results demonstrate the value of using empirical derivation to investigate the structure of personality in young children, speak to the importance of early-evident personality traits for adaptive development, and are consistent with a growing body of evidence indicating that personality structure in young children is similar, but not identical to, that in adults, suggesting a model of broad personality dimensions in childhood that evolve into narrower traits in adulthood.

  6. Emergency repair of inguinal hernia in the premature infant is associated with high direct medical costs

    NARCIS (Netherlands)

    J. Verhelst (Joost); B. de Goede (Barry); B.J.H. van Kempen (Bob); H.R. Langeveld-Benders (Hester); M.J. Poley (Marten); G. Kazemier (Geert); J. Jeekel (Hans); R.M.H. Wijnen (René); J.F. Lange (Johan)

    2015-01-01

    textabstractPurpose: Inguinal hernia repair is frequently performed in premature infants. Evidence on optimal management and timing of repair, as well as related medical costs is still lacking. The objective of this study was to determine the direct medical costs of inguinal hernia, distinguishing b

  7. Learning scientific and medical terminology with a mnemonic strategy using an illogical association technique.

    Science.gov (United States)

    Brahler, C Jayne; Walker, Diane

    2008-09-01

    For students pursuing careers in medical fields, knowledge of technical and medical terminology is prerequisite to being able to solve problems in their respective disciplines and professions. The Dean Vaughn Medical Terminology 350 Total Retention System, also known as Medical Terminology 350 (25), is a mnemonic instructional and learning strategy that combines mental imagery and keyword mnemonic elaboration processes to help students recall the scientific meaning of Greek and Latin word parts. High school students in Anatomy and Physiology classes at a career technology center were divided into experimental (Medical Terminology 350), control (rote memorization), or combination (Medical Terminology 350 and rote memorization) groups and completed pre- and posttests of standardized word recall tests. Students in the Dean Vaughn Medical Terminology 350 Total Retention System group achieved significantly greater pre- to posttest word recall improvement compared with students in both the rote memorization (P Medical Terminology 350 (P

  8. Antimicrobial activity of sodium hypochlorite associated with intracanal medication for Candida albicans and Enterococcus faecalis inoculated in root canals

    Directory of Open Access Journals (Sweden)

    Marcia Carneiro Valera

    2009-12-01

    Full Text Available OBJECTIVE: The purpose of this study was to evaluate the action of sodium hypochlorite (NaOCl associated with an intracanal medication against Candida albicans and Enterococcus faecalis inoculated in root canals. MATERIAL AND METHODS: Thirty-six human single-rooted teeth with single root canals were used. The canals were contaminated with C. albicans and E. faecalis for 21 days and were then instrumented with 1% NaOCl. The roots were divided into 3 groups (n=12 according to the intracanal medication applied: calcium hydroxide paste, 2% chlorhexidine (CHX gel, and 2% CHX gel associated with calcium hydroxide. The following collections were made from the root canals: a initial sample (IS: 21 days after contamination (control, b S1: after instrumentation, c S2: 14 days after intracanal medication placement; S3: 7 days after intracanal medication removal. The results were analyzed statistically by the Kruskal-Wallis test at 5% significance level. RESULTS AND CONCLUSIONS: Both 1% NaOCl irrigation and the intracanal medications were effective in eliminating E. faecalis and C. albicans inoculated in root canals.

  9. Falls are associated with stroke, arthritis and multiple medications among community-dwelling elderly persons in Japan.

    Science.gov (United States)

    Mizukami, Satoshi; Arima, Kazuhiko; Abe, Yasuyo; Kanagae, Mitsuo; Kusano, Yosuke; Niino, Naoakira; Aoyagi, Kiyoshi

    2013-01-01

    Falls are a major public health problem and the second leading cause of death due to unintentional accidental injury after road traffic accidents. Inactive, older individuals with several chronic illnesses fall more frequently than older individuals who are active and healthy. No population-based study has addressed the association of stroke, arthritis, hypnotic and other prescription medications with falls among the elderly simultaneously in a single population in Japan. We examined the prevalence of falls among community-dwelling elderly Japanese individuals, whom we randomly selected from a list of inhabitants aged ≥ 65 years compiled from the resident registration, and the associations between falls and each of stroke, arthritis, and hypnotic and other prescription medications. We interviewed 295 men and 307 women, and collected information about the number of falls during the latest one year, hemiplegia due to stroke, arthritis in the legs, and the number of hypnotic and other medications. We found that 46 men (16%) and 67 women (22%) had fallen at least once during the latest one year. Logistic regression analysis adjusted for age showed that hemiplegia due to stroke (p falls in men. Arthritis in the legs (p = 0.05) and taking at least four daily prescription medications (p falls in women. Treatment of fall-related diseases and medication management are important strategies for reducing falls among elderly persons.

  10. Assessing the effect of treatment duration on the association between anti-diabetic medication and cancer risk.

    Directory of Open Access Journals (Sweden)

    Anna But

    Full Text Available Most studies that have evaluated the association between anti-diabetic medication and cancer risk have suffered from methodological drawbacks. To avoid time-related biases, we evaluated the effect of treatment duration on the cancer risk among naive users of anti-diabetic medication as compared to non-users. In addition, we addressed the influence of common risk factors such as smoking and BMI. The study population comprised 23,394 participants of FINRISK surveys. Data on cancer and anti-diabetic medication were linked with the study cohorts. We applied Lexis tabulation to the data and analyzed split records by using Poisson regression. Changes in cancer incidence in relation to treatment duration were examined by modeling the rate ratio (RR. After a median follow-up of 9 years, 53 cancer cases among users of anti-diabetic medication and 1,028 among non-users were diagnosed. No significant difference in cancer risk between users and non-users was observed after adjustment. The RR for all medication regardless of its duration was 1.01 [95% CI 0.75-1.33], and 1.37 [0.94-1.94] for period of 1-4 years. The results were similar for metformin, sulfonylurea, and insulin. This study demonstrates that evaluation of the variation in cancer risk in relation to treatment duration is of particular importance for enhancing the accuracy of conclusions on the link between exposure to anti-diabetic medication and cancer risk.

  11. Isozyme markers associated with O(3) tolerance indicate shift in genetic structure of ponderosa and Jeffrey pine in Sequoia National Park, California.

    Science.gov (United States)

    Staszak, J; Grulke, N E; Marrett, M J; Prus-Glowacki, W

    2007-10-01

    Effects of canopy ozone (O(3)) exposure and signatures of genetic structure using isozyme markers associated with O(3) tolerance were analyzed in approximately 20-, approximately 80-, and >200-yr-old ponderosa (Pinus ponderosa Dougl. ex Laws.) and Jeffrey pine (Pinus jeffreyi Grev. & Balf.) in Sequoia National Park, California. For both species, the number of alleles and genotypes per loci was higher in parental trees relative to saplings. In ponderosa pine, the heterozygosity value increased, and the fixation index indicated reduction of homozygosity with increasing tree age class. The opposite tendencies were observed for Jeffrey pine. Utilizing canopy attributes known to be responsive to O(3) exposure, ponderosa pine was more symptomatic than Jeffrey pine, and saplings were more symptomatic than old growth trees. We suggest that these trends are related to differing sensitivity of the two species to O(3) exposure, and to higher O(3) exposures and drought stress that younger trees may have experienced during germination and establishment.

  12. Direct medical resource utilization associated with osteoporosis-related nonvertebral fractures in postmenopausal women.

    Science.gov (United States)

    Jean, Sonia; Bessette, Louis; Belzile, Etienne L; Davison, K Shawn; Candas, Bernard; Morin, Suzanne; Dodin, Sylvie; Brown, Jacques P

    2013-02-01

    The purposes of this study were to assess direct medical resource utilization related to the treatment of nonvertebral osteoporotic fractures within 1 year postfracture and to evaluate whether age impacts resource utilization. A previously-validated algorithm for physician claims databases identified 15,327 women aged 50 years or older with incident fracture at nonvertebral osteoporotic sites between January 1, 2004 and December 31, 2005. Administrative databases of the health services available to all residents in Quebec served to study fracture-related health resource utilization in the year after fracture. Data were linked by a unique personal identifier, creating a longitudinal cohort of all fracture cases for health resource utilization. The proportions of fractures treated by open reduction, closed reduction, immobilization or follow-up by an orthopedic surgeon (OS) were evaluated. The mean number of claims for consultation with an OS or other clinicians in inpatient and outpatient visits, the hospitalization rate and length of stay (LOS) were assessed. Hip/femur fractures represented the highest rate of resource utilization because the majority of them required surgery (91.1%) and hospitalization (94.5%) with a mean (median) LOS of 39.2 (31) days. However, other nonvertebral fracture types needed significant clinical care related to surgery (27.9%), follow-up consultation with an OS (77.6%), and hospitalization (27.3% of total LOS). Even pelvic fractures, which often do not require surgical treatment, commanded high resource utilization due to the high hospitalization rate (67.4%) with mean (median) LOS of 34.2 (26) days. Moreover, age was an important determinant of health resource utilization, being associated with an increased number of visits to other physicians, hospitalization, and length of hospitalization (LOS), admissions to long term care (LTC), and death. Osteoporosis-related fractures accounted for substantial healthcare resource utilization

  13. Assessment of Obesity, Overweight and Its Association with the Fast Food Consumption in Medical Students

    Science.gov (United States)

    Purohit, Geetanjali; Nair, Sandhya Pillai; Patel, Bhavita; Rawal, Yash; Shah, R. M.

    2014-01-01

    Introduction: Obesity is a condition in which excess body fat accumulates, which leads to various adverse effects on health, particularly cardiovascular diseases (CVDs), which reduce life expectancy and/or increase health problems. Fast food consumption is one of the factors which have been reported as a cause of obesity. Body mass index (BMI) is used to assess obesity and overweight, which can be calculated by using the formula, weight in kg, divided by square of height in metres. Aim: This study focused on the relationship of body mass index with fast food consumption, associated soft drink consumption and physical activity. Methods: Descriptive cross-sectional study was conducted in Department of Biochemistry, SBKS MI and RC, and Sumandeep Vidyapeeth. This study was approved by the ethical review board .One hundred and forty seven medical students from 1st year MBBS course were included in this study. Self-structured questionnaire was used, which contained several data like information on age, height, weight, education level. The formula used for calculating BMI was, weight in kg, divided by square of height in metres (Kg/m2). Results: In our study, out of 147 students, a total of 138 students (more than 90%) used to have fast food. Among these, a total of 47 students (34.05%) were pre-obese and obese. Out of 147 students, 87 students (59.18%) were in normal weight range, while 13 (8.84%) students were underweight. Statistical Analysis: Data was compiled in an Excel worksheet and it was analyzed for percentages and proportions. Chi-square and Pearson’s correlation test were also applied wherever they were applicable and Alpha error was set at a 5% level. Conclusion: In our study, a significant relationship was found between BMI and fast food consumption, less physical activity, and intake of soft drinks. PMID:24995170

  14. Factors associated with mental health status of medical residents: a model-guided study.

    Science.gov (United States)

    Anagnostopoulos, Fotios; Demerouti, Evangelia; Sykioti, Panagiota; Niakas, Dimitris; Zis, Panagiotis

    2015-03-01

    Residency is a stressful period in a physician's development, characterized by long work hours, time pressure, and excessive work load, that can exert negative effects on residents' mental health. Job burnout and negative work-home interference may play a major role in residents' mental health problems. The present study used the job demands-resources model as a theoretical framework to examine the way in which job demands (e.g., workload, emotional demands) and job resources (e.g., supervisor support, job autonomy) were associated with residents' mental health. From a pool of 290 medical residents, 264 (91 %) completed the questionnaires. Applying structural equation modeling techniques, the results showed that greater emotional exhaustion (β = -.65, SE = .09, p < .001) and more work-home interference (β = -.26, SE = .10, p < .05) were related to poor mental health. Specific job demands (i.e., high workload) and particular job resources (i.e., low opportunities for professional development and low supervisor support) were related to poor mental health not directly but only indirectly, via emotional exhaustion or work-home interference. Thus, through work-related emotional exhaustion, the impact of work conditions might be transmitted to and interfere with non-work related domains such as family life, as well as with domain-unspecific aspects of well-being, such as mental health and psychological distress. Implications of the results and suggestions for future research and practice are outlined.

  15. Korean association of medical journal editors at the forefront of improving the quality and indexing chances of its member journals.

    Science.gov (United States)

    Suh, Chang-Ok; Oh, Se Jeong; Hong, Sung-Tae

    2013-05-01

    The article overviews some achievements and problems of Korean medical journals published in the highly competitive journal environment. Activities of Korean Association of Medical Journal Editors (KAMJE) are viewed as instrumental for improving the quality of Korean articles, indexing large number of local journals in prestigious bibliographic databases and launching new abstract and citation tracking databases or platforms (eg KoreaMed, KoreaMed Synapse, the Western Pacific Regional Index Medicus [WPRIM]). KAMJE encourages its member journals to upgrade science editing standards and to legitimately increase citation rates, primarily by publishing more great articles with global influence. Experience gained by KAMJE and problems faced by Korean editors may have global implications.

  16. Enterococcus and Streptococcus spp. associated with chronic and self-medicated urinary tract infections in Vietnam

    Directory of Open Access Journals (Sweden)

    Poulsen Louise

    2012-11-01

    Full Text Available Abstract Background Urinary tract infections (UTI are one of the most common infections among women worldwide. E. coli often causes more than 75% of acute uncomplicated UTI, however, little is known about how recurrent UTIs and indiscriminate use of antimicrobials affect the aetiology of UTIs. This study aimed to establish the aetiology of UTI in a population of recurrent and self-medicated patients referred from pharmacies to a hospital in Hanoi, Vietnam and to describe genotypes and antimicrobial susceptibility of the associated bacterial pathogens. The aetiology of bacterial pathogens associated with UTI (defined as ≥ 104 CFU/ml urine was established by phenotypic and molecular methods. Enterococcus faecalis isolates were typed by Multi Locus Sequence Typing (MLST, Pulsed-Field Gel Electrophoresis (PFGE and antimicrobial susceptibility testing. Methods Urine samples from 276 patients suffering symptoms of urinary tract infection were collected and cultured on Flexicult agar® allowing for detection of the most common urine pathogens. Patients were interviewed about underlying diseases, duration of symptoms, earlier episodes of UTI, number of episodes diagnosed by doctors and treatment in relation to UTI. All tentative E. faecalis and E. faecium isolates were identified to species level by PCR, 16S rRNA and partial sequencing of the groEL gene. E. faecalis isolates were further characterized by Multi Locus Sequence Typing and antimicrobial susceptibility testing. Results Mean age of 49 patients was 48 yrs (range was 11–86 yrs and included 94% women. On average, patients reported to have suffered from UTI for 348 days (range 3 days-10 years, and experienced 2.7 UTIs during the previous year. Cephalosporins were reported the second drug of choice in treatment of UTI at the hospital. E. faecalis (55.1%, E. coli (12.2% and Streptococcus gallolyticus subsp. pasteurianus (8.2% were main bacterial pathogens. MIC testing of E. faecalis showed

  17. Factors associated with positive attitude towards blood donation among medical students.

    Science.gov (United States)

    Gazibara, Tatjana; Kovacevic, Nikolina; Maric, Gorica; Kurtagic, Ilma; Nurkovic, Selmina; Kisic-Tepavcevic, Darija; Pekmezovic, Tatjana

    2015-12-01

    The aim of this study was to assess attitudes and practice of blood donation among medical students. Medical students were recruited at Medical Faculty, University of Belgrade, Serbia. Of 973 students, 38.4% of freshmen and 41.4% of final year students have donated blood (χ(2) = 0.918, p = 0.186). Blood donors had significantly more positive attitude towards some aspects of blood donation. Being female, residing in a city other than the capital and previous blood donation experience were independent predictors of positive attitude towards being a blood donor to an unknown person. Efforts are required to augment blood donor pool among future physicians.

  18. Factors associated with anti-tuberculosis medication adverse effects: a case-control study in Lima, Peru.

    Directory of Open Access Journals (Sweden)

    Kocfa Chung-Delgado

    Full Text Available BACKGROUND: Long-term exposure to anti-tuberculosis medication increases risk of adverse drug reactions and toxicity. The objective of this investigation was to determine factors associated with anti-tuberculosis adverse drug reactions in Lima, Peru, with special emphasis on MDR-TB medication, HIV infection, diabetes, age and tobacco use. METHODOLOGY AND RESULTS: A case-control study was performed using information from Peruvian TB Programme. A case was defined as having reported an anti-TB adverse drug reaction during 2005-2010 with appropriate notification on clinical records. Controls were defined as not having reported a side effect, receiving anti-TB therapy during the same time that the case had appeared. Crude, and age- and sex-adjusted models were calculated using odds ratios (OR and 95% confidence intervals (95%CI. A multivariable model was created to look for independent factors associated with side effect from anti-TB therapy. A total of 720 patients (144 cases and 576 controls were analyzed. In our multivariable model, age, especially those over 40 years (OR = 3.93; 95%CI: 1.65-9.35, overweight/obesity (OR = 2.13; 95%CI: 1.17-3.89, anemia (OR = 2.10; IC95%: 1.13-3.92, MDR-TB medication (OR = 11.1; 95%CI: 6.29-19.6, and smoking (OR = 2.00; 95%CI: 1.03-3.87 were independently associated with adverse drug reactions. CONCLUSIONS: Old age, anemia, MDR-TB medication, overweight/obesity status, and smoking history are independent risk factors associated with anti-tuberculosis adverse drug reactions. Patients with these risk factors should be monitored during the anti-TB therapy. A comprehensive clinical history and additional medical exams, including hematocrit and HIV-ELISA, might be useful to identify these patients.

  19. The Association of Health Literacy with Illness and Medication Beliefs among Patients with Chronic Obstructive Pulmonary Disease.

    Directory of Open Access Journals (Sweden)

    Minal S Kale

    Full Text Available Low health literacy is associated with low adherence to self-management in many chronic diseases. Additionally, health beliefs are thought to be determinants of self-management behaviors. In this study we sought to determine the association, if any, of health literacy and health beliefs among elderly individuals with COPD.We enrolled a cohort of patients with COPD from two academic urban settings in New York, NY and Chicago, IL. Health literacy was measured using the Short Test of Functional Health Literacy in Adults. Using the framework of the Self-Regulation Model, illness and medication beliefs were measured with the Brief Illness Perception Questionnaire (B-IPQ and Beliefs about Medications Questionnaire (BMQ. Unadjusted analyses, with corresponding Cohen's d effect sizes, and multiple logistic regression were used to assess the relationships between HL and illness and medication beliefs.We enrolled 235 participants, 29% of whom had low health literacy. Patients with low health literacy were more likely to belong to a racial minority group (p<0.001, not be married (p = 0.006, and to have lower income (p<0.001 or education (p<0.001. In unadjusted analyses, patients with low health literacy were less likely to believe they will always have COPD (p = 0.003, Cohen's d = 0.42, and were more likely to be concerned about their illness ((p = 0.04, Cohen's d = 0.17. In analyses adjusted for sociodemographic factors and other health beliefs, patients with low health literacy were less likely to believe that they will always have COPD (odds ratio [OR]: 0.78, 95% confidence interval [CI]: 0.65-0.94. In addition, the association of low health literacy with expressed concern about medications remained significant (OR: 1.20, 95% CI: 1.05-1.37 though the association of low health literacy with belief in the necessity of medications was no longer significant (OR: 0.92, 95% CI: 0.82-1.04.In this cohort of urban individuals with COPD, low health literacy was

  20. The Association of Health Literacy with Illness and Medication Beliefs among Patients with Chronic Obstructive Pulmonary Disease

    Science.gov (United States)

    Kale, Minal S.; Federman, Alex D.; Krauskopf, Katherine; Wolf, Michael; O’Conor, Rachel; Martynenko, Melissa; Leventhal, Howard; Wisnivesky, Juan P.

    2015-01-01

    Background Low health literacy is associated with low adherence to self-management in many chronic diseases. Additionally, health beliefs are thought to be determinants of self-management behaviors. In this study we sought to determine the association, if any, of health literacy and health beliefs among elderly individuals with COPD. Methods We enrolled a cohort of patients with COPD from two academic urban settings in New York, NY and Chicago, IL. Health literacy was measured using the Short Test of Functional Health Literacy in Adults. Using the framework of the Self-Regulation Model, illness and medication beliefs were measured with the Brief Illness Perception Questionnaire (B-IPQ) and Beliefs about Medications Questionnaire (BMQ). Unadjusted analyses, with corresponding Cohen’s d effect sizes, and multiple logistic regression were used to assess the relationships between HL and illness and medication beliefs. Results We enrolled 235 participants, 29% of whom had low health literacy. Patients with low health literacy were more likely to belong to a racial minority group (p<0.001), not be married (p = 0.006), and to have lower income (p<0.001) or education (p<0.001). In unadjusted analyses, patients with low health literacy were less likely to believe they will always have COPD (p = 0.003, Cohen’s d = 0.42), and were more likely to be concerned about their illness ((p = 0.04, Cohen’s d = 0.17). In analyses adjusted for sociodemographic factors and other health beliefs, patients with low health literacy were less likely to believe that they will always have COPD (odds ratio [OR]: 0.78, 95% confidence interval [CI]: 0.65–0.94). In addition, the association of low health literacy with expressed concern about medications remained significant (OR: 1.20, 95% CI: 1.05–1.37) though the association of low health literacy with belief in the necessity of medications was no longer significant (OR: 0.92, 95% CI: 0.82–1.04). Conclusions In this cohort of urban

  1. Brown v. Plata: prison overcrowding in California.

    Science.gov (United States)

    Newman, William J; Scott, Charles L

    2012-01-01

    California's prisons are currently designed to house approximately 85,000 inmates. At the time of the U.S. Supreme Court's 2011 decision in Brown v. Plata, the California prison system housed nearly twice that many (approximately 156,000 inmates). The Supreme Court held that California's prison system violated inmates' Eighth Amendment rights. The Court upheld a three-judge panel's order to decrease the population of California's prisons by an estimated 46,000 inmates. They determined that overcrowding was the primary cause of the inmates' inadequate medical and mental health care. As a result, the California Department of Corrections and Rehabilitation (CDCR) has been working to redistribute inmates and parolees safely and decrease the overall population to the mandated levels. These large-scale adjustments to California's penal system create potential opportunities to study the long-term effects on affected inmates.

  2. Epidemiological Investigation of Lifestyle Associated Modifiable Risk Factors among Medical Students

    Directory of Open Access Journals (Sweden)

    Anurag Srivastava

    2013-06-01

    Conclusion: The study shows a high prevalence of NCD related risk factors in medical students. Primary prevention may be one way to lower the risk burden of NCDs. [Natl J Med Res 2013; 3(3.000: 210-215

  3. Novelty-seeking and avoidant coping strategies are associated with academic stress in Korean medical students.

    Science.gov (United States)

    An, Hoyoung; Chung, Seockhoon; Park, Jangho; Kim, Seong-Yoon; Kim, Kyung Mo; Kim, Ki-Soo

    2012-12-30

    High levels of stress and depression in medical students is raising concern. In this study, we sought to identify coping strategies and other factors influencing academic stress in medical students. We enrolled 157 students from the University of Ulsan College of Medicine, Korea, in November, 2010. We used the Medical Stress Scale, Temperament and Character Inventory, Hamilton Depression Scale, Beck Depression Inventory, and Coping Response Inventory to assess psychological parameters. We used Pearson's correlation and linear regression analyses to analyze the data. Novelty-seeking, self-directedness, cooperativeness, coping strategy, and depression scale scores all correlated significantly with stress level. Linear regression analysis indicated that students who are novelty-seeking, likely to use avoidant coping strategies, and unlikely to use active-cognitive and active-behavioral strategies tend to have higher stress levels. Reduction of stress in medical students may be achieved through evaluation of coping strategies and personality features and use of interventions to promote active coping strategies.

  4. Association of Maternal Self-Medication and Over-the-Counter Analgesics for Children

    DEFF Research Database (Denmark)

    Jensen, Janne Fangel; Gottschau, Mathilde; Siersma, Volkert Dirk;

    2014-01-01

    Self-medication with over-the-counter (OTC) analgesics, such as paracetamol (PCM), among children and adolescents is increasing and constitutes an important public health issue internationally. Reasons for this development are unclear; parental influence is suggested. Our objective was to examine...... whether self-medication with OTC analgesics among school-aged children is influenced by maternal self-reported health and medicine use, taking the child's frequency of pain into account....

  5. The association of smoking with medical treatment adherence in the workforce of a large employer

    Directory of Open Access Journals (Sweden)

    Sherman BW

    2014-04-01

    Full Text Available Bruce W Sherman,1–3 Wendy D Lynch4,5 1Employers Health Coalition, Inc., Canton, OH, USA; 2Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, USA; 3Sherman Consulting Services, LLC, Burlington, MA, USA; 4Lynch Consulting, Ltd, Steamboat Springs, CO, USA; 5Altarum Institute, Ann Arbor, MI, USA Purpose: Prior descriptive epidemiology studies have shown that smokers have lower compliance rates with preventive care services and lower chronic medication adherence rates for preventive care services in separate studies. The goal of this study was to perform a more detailed analysis to validate both of these findings for current smokers versus nonsmokers within the benefit-covered population of a large US employer. Patients and methods: This study involved the analysis of incurred medical and pharmacy claims for employee and spouse health plan enrollees of a single US-based employer during 2010. Multivariate regression models were used to compare data by active or never-smoker status for preventive care services and medication adherence for chronic conditions. Analysis controlled for demographic variables, chronic condition prevalence, and depression. Results: Controlling for demographic variables and comorbid conditions, smokers had significantly lower cancer screening rates, with absolute reductions of 6%–13%. Adherence to chronic medication use for hypertension was also significantly lower among smokers, with nearly 7% fewer smokers having a medication possession ratio of ≥80%. Smokers were less adherent to depression medications (relative risk =0.79 than nonsmokers (P=0.10. While not statistically significant, smokers were consistently less adherent to all other medications than nonsmokers. Conclusion: Current smokers are less compliant with recommended preventive care and medication use than nonsmokers, likely contributing to smoking-related employer costs. Awareness of these care gaps among smokers and

  6. Association between preterm delivery and pre-pregnancy body mass (BMI), exercise and sleep during pregnancy among working women in Southern California.

    Science.gov (United States)

    Guendelman, Sylvia; Pearl, Michelle; Kosa, Jessica L; Graham, Steve; Abrams, Barbara; Kharrazi, Martin

    2013-05-01

    Little is known about modifiable lifestyle factors beyond quitting smoking that could prevent preterm delivery (PTD, pregnancy BMI, second trimester exercise and sleep on PTD. We conducted a nested, population-based case-control study interviewing postpartum 344 cases delivering at pregnancy, and delivered a singleton birth in Southern California in 2002-2003. Modeled separately, moderate (odds ratio [OR] = 0.90; 95% confidence interval [CI] = 0.84-0.96--per hour/week) and vigorous (OR = 0.67; 95% CI = 0.46-0.98 for yes vs. no) exercise during the second trimester were associated with a reduced odds of PTD, and sleep duration was not (OR = 1.09, 95% CI = 0.80-1.48 for 8 h vs. 7-8 h). When sleep and exercise variables were modeled together along with pre-pregnancy BMI, only moderate exercise (OR = 0.91; 95% CI 0.85-0.98) continued to be associated with reduced odds of PTD. The benefits of moderate exercise appeared strongest for women with BMI greater than 24 kg/m(2) (OR = 0.85; 95% CI = 0.79-0.93) and weakened with decreasing BMI. No other interactions were found. Moderate exercise is associated with reduced PTD, particularly for women with BMI above the normal range. The results are of public health relevance given that these risk factors are potentially modifiable both pre-conceptionally and during pregnancy and rates of PTD are still high in the United States.

  7. Association between learning style preferences and anatomy assessment outcomes in graduate-entry and undergraduate medical students.

    Science.gov (United States)

    O'Mahony, Siobhain M; Sbayeh, Amgad; Horgan, Mary; O'Flynn, Siun; O'Tuathaigh, Colm M P

    2016-07-08

    An improved understanding of the relationship between anatomy learning performance and approaches to learning can lead to the development of a more tailored approach to delivering anatomy teaching to medical students. This study investigated the relationship between learning style preferences, as measured by Visual, Aural, Read/write, and Kinesthetic (VARK) inventory style questionnaire and Honey and Mumford's learning style questionnaire (LSQ), and anatomy and clinical skills assessment performance at an Irish medical school. Additionally, mode of entry to medical school [undergraduate/direct-entry (DEM) vs. graduate-entry (GEM)], was examined in relation to individual learning style, and assessment results. The VARK and LSQ were distributed to first and second year DEM, and first year GEM students. DEM students achieved higher clinical skills marks than GEM students, but anatomy marks did not differ between each group. Several LSQ style preferences were shown to be weakly correlated with anatomy assessment performance in a program- and year-specific manner. Specifically, the "Activist" style was negatively correlated with anatomy scores in DEM Year 2 students (rs = -0.45, P = 0.002). The "Theorist" style demonstrated a weak correlation with anatomy performance in DEM Year 2 (rs = 0.18, P = 0.003). Regression analysis revealed that, among the LSQ styles, the "Activist" was associated with poorer anatomy assessment performance (P learning styles contribute little to variation in academic performance in medical students. Anat Sci Educ 9: 391-399. © 2016 American Association of Anatomists.

  8. Self-Medication Practice among Amateur Runners: Prevalence and Associated Factors

    Directory of Open Access Journals (Sweden)

    Médéa Locquet, Charlotte Beaudart, Robert Larbuisson, Fanny Buckinx, Jean-François Kaux, Jean-Yves Reginster, Olivier Bruyère

    2016-06-01

    Full Text Available The term “self-medication” involves consumption, without any physician’s advice, of over-the-counter drugs but also of formerly prescribed drugs. Amateur athletes could resort frequently to self-medication for different reasons. Indeed, they may use self-medication products because they are regularly exposed to pain, tiredness, injuries and difficulties with recovery. Sometimes, they can also deliberately use medications in order to enhance their physical performance (Conrad et al., 2004. In 2015, we wanted to identify and better understand self-medication practices in an amateur sports population in the Province of Liège, Belgium. We focused especially on amateur runners because of the growing interest in this population. We went to 8 running events in order to interview amateur runners about their self-medication behaviors exclusively aiming at being better prepared for this specific race. Approval was granted by the Ethics Committee of the University Teaching Hospital of Liège. Data regarding consumption of self-medication drugs just before the running event (i.e. intake maximum last 24 hours before the race was collected through an anonymous self-administrated questionnaire. The level and intensity of usual sports practice, the membership to a sports club and the length of the race on that specific day (10 or 21km were also recorded. A total of 358 amateur runners, mainly composed of men (62.0% with a median age of 39 years (IQR: 29-49 have volunteered. Among the 358 respondents, 112 runners (31.3% had taken self-medication drugs during the period immediately preceding the running event (i.e. maximum last 24 hours, with the aim of being better prepared for this specific race. Athletes declared consuming self-medication drugs before the race mainly to reduce pain (36.1% and headaches (16.6% but also in order to improve their physical performance (9.9% (Table 1. The two therapeutic classes most often reported were analgesics and

  9. Characterization of Multi-Scale Atmospheric Conditions Associated with Extreme Precipitation in the Transverse Ranges of Southern California

    Science.gov (United States)

    Oakley, N.; Kaplan, M.; Ralph, F. M.

    2015-12-01

    The east-west oriented Transverse Ranges of Southern California have historically experienced shallow landslides and debris flows that threaten life and property. Steep topography, soil composition, and frequent wildfires make this area susceptible to mass wasting. Extreme rainfall often acts as a trigger for these events. This work characterizes atmospheric conditions at multiple scales during extreme (>99th percentile) 1-day precipitation events in the major sub-ranges of the Transverse Ranges. Totals from these 1-day events generally exceed the established sub-daily intensity-duration thresholds for shallow landslides and debris flows in this region. Daily extreme precipitation values are derived from both gridded and station-based datasets over the period 1958-2014. For each major sub-range, extreme events are clustered by atmospheric feature and direction of moisture transport. A composite analysis of synoptic conditions is produced for each cluster to create a conceptual model of atmospheric conditions favoring extreme precipitation. The vertical structure of the atmosphere during these extreme events is also examined using observed and modeled soundings. Preliminary results show two atmospheric features to be of importance: 1) closed and cutoff low-pressure systems, areas of counter-clockwise circulation that can produce southerly flow orthogonal to the Transverse Range ridge axes; and 2) atmospheric rivers that transport large quantities of water vapor into the region. In some cases, the closed lows and atmospheric rivers work in concert with each other to produce extreme precipitation. Additionally, there is a notable east-west dipole of precipitation totals during some extreme events between the San Gabriel and Santa Ynez Mountains where extreme values are observed in one range and not the other. The cause of this relationship is explored. The results of this work can help forecasters and emergency responders determine the likelihood that an event will

  10. Factors associated with self-medication among medicine sellers in urban Vietnam.

    Science.gov (United States)

    Nguyen, Huy Van; Nguyen, Thi Hong Ngoc

    2015-01-01

    In Vietnam, many medicine sellers serving pharmacies and retail outlets do not have adequate professional qualifications, and there has been a limited institutional control. The objective of this cross-sectional study was to examine the prevalence and determinants of self-medication among medicine sellers in Hanoi, Vietnam. Although 96.55% of medicine sellers had relatively serious health problems, only 61.21% visited a healthcare facility, though self-medication was moderately high (approximately 39%). Adopting Andersen's conceptual model, it was identified that medicine sellers who reported higher professional education, had low confidence in healthcare services, had not received any professional in-service during the prior year, had less serious health problems and who perceived the current costs of healthcare as too high were more likely to report self-medication. The findings have public health policy implications for these healthcare providers in urban Vietnam and other similar developing countries.

  11. Adverse drug reactions associated with asthma medications in children: systematic review of clinical trials

    DEFF Research Database (Denmark)

    Aagaard, Lise; Hansen, Ebba Holme

    2014-01-01

    Background Respiratory medications are frequently prescribed for use in children. Several studies have reported information on the safety of asthma medications in clinical studies in adults, but information about safety in children is scarce. Objective To review published clinical trials......, age and gender, type and seriousness of ADRs, design, setting, observation period, type of assessors, and funding sources was extracted from the articles. Results Literature searches resulted in 162 potential relevant articles. However only 12 of these studies were included in this review...... on the occurrence and characteristics of adverse drug reactions (ADRs) in children, reported for asthma medications licensed for paediatric use. Methods We systematically reviewed the literature following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines. PubMed, Embase...

  12. A Code of Professional Ethical Conduct for the American Medical Informatics Association: An AMIA Board of Directors Approved White Paper

    OpenAIRE

    Hurdle, John F.; Adams, Samantha; Brokel, Jane; Chang, Betty; Embi, Peter; Petersen, Carolyn; Terrazas, Enrique; Winkelstein, Peter

    2007-01-01

    The AMIA Board of Directors has decided to periodically publish AMIA’s Code of Professional Ethical Conduct for its members in the Journal of the American Medical Informatics Association. The Code also will be available on the AMIA Web site at www.amia.org as it continues to evolve in response to feedback from the AMIA membership. The AMIA Board acknowledges the continuing work and dedication of the AMIA Ethics Committee. AMIA is the copyright holder of this work.

  13. Moderating effects of salivary testosterone levels on associations between job demand and psychological stress response in Japanese medical workers.

    Science.gov (United States)

    Hirokawa, Kumi; Miwa, Machiko; Taniguchi, Toshiyo; Tsuchiya, Masao; Kawakami, Norito

    2016-06-10

    Levels of job stress have been shown to be inversely associated with testosterone levels, but some inconsistent results have been documented. We investigated the moderating effects of testosterone levels on associations between job stress-factors and psychological stress responses in Japanese medical workers. The participants were 63 medical staff (20 males and 43 women; mean age: 30.6 years; SD=7.3) in Okayama, Japan. Their job-stress levels and psychological stress responses were evaluated using self-administered questionnaires, and their salivary testosterone collected. Multiple regression analyses showed that job demand was positively associated with stress responses in men and women. An interaction between testosterone and support from colleagues had a significant effect on depression and anxiety for women. In women with lower testosterone levels, a reducing effect of support from colleagues on depression and anxiety was intensified. In women with higher testosterone levels, depression and anxiety levels were identical regardless of support from colleagues. Testosterone may function as a moderator between perceived work environment and psychological stress responses for female medical workers.

  14. Regular Tooth Brushing is Associated with a Decreased Risk of Metabolic Syndrome According to a Medical Check-Up Database.

    Science.gov (United States)

    Tsutsumi, Chiyo; Kakuma, Tatsuyuki

    2015-01-01

    Associations have been reported between periodontal disease and increased cardiovascular disease risk, as well as between healthy self-reported tooth brushing behavior and reduced cardiovascular disease risk. We examined the association between self-reported tooth brushing behavior and the risk of metabolic syndrome (MetS) using a large medical check-up database. A total of 12,548 medical checkup records from a medical screening center in a city in southwest Japan were assessed. Subjects were aged 30 to 59 years. As lifestyle is associated with both tooth brushing and MetS, many lifestyle variables were considered as potential confounders. Logistic regression model were employed with a list of 127 lifestyle variables. Twenty variables associated with both tooth brushing and MetS were selected for both males and females. Furthermore, final confounding variables were selected by principal component analysis to avoid collinearity problems. The association of tooth brushing and MetS was evaluated for males and females separately by calculating adjusted odds ratios (ORs) with selected confounders plus age. The association between daily tooth brushing frequency and MetS risk for both genders was significant after adjusting for confounders, with the risk of MetS decreasing with increased frequency of daily tooth brushing (adjusted OR = 0.57 (95%Cl:0.48-0.81), 0.50 (95%Cl:0.35-0.71), 0.42 (95%Cl: 0.29-0.61) for males and adjusted OR = 0.65 (95%Cl:0.48-0.87), 0.44 (95%Cl:0.32-0.62) for females). Therefore, oral hygiene, including the frequency of tooth brushing as a significant component, may be an important factor in preventing MetS.

  15. School-Level Factors Associated with Increased Fruit and Vegetable Consumption among Students in California Middle and High Schools

    Science.gov (United States)

    Gosliner, Wendi

    2014-01-01

    Background: This study assessed associations between selective school-level factors and students' consumption of fruits and vegetables at school. Better understanding of school factors associated with increased produce consumption is especially important, as students are served more produce items at school. Methods: This cross-sectional study…

  16. Patient centered primary care is associated with patient hypertension medication adherence.

    Science.gov (United States)

    Roumie, Christianne L; Greevy, Robert; Wallston, Kenneth A; Elasy, Tom A; Kaltenbach, Lisa; Kotter, Kristen; Dittus, Robert S; Speroff, Theodore

    2011-08-01

    There is increasing evidence that patient centered care, including communication skills, is an essential component to chronic illness care. Our aim was to evaluate patient centered primary care as a determinant of medication adherence. We mailed 1,341 veterans with hypertension the Short Form Primary Care Assessment Survey (PCAS) which measures elements of patient centered primary care. We prospectively collected each patient's antihypertensive medication adherence for 6 months. Patients were characterized as adherent if they had medication for >80%. 654 surveys were returned (50.7%); and 499 patients with complete data were analyzed. Antihypertensive adherence increased as scores in patient centered care increased [RR 3.18 (95% CI 1.44, 16.23) bootstrap 5000 resamples] for PCAS score of 4.5 (highest quartile) versus 1.5 (lowest quartile). Future research is needed to determine if improving patient centered care, particularly communication skills, could lead to improvements in health related behaviors such as medication adherence and health outcomes.

  17. Association of Classroom Participation and Examination Performance in a First-Year Medical School Course

    Science.gov (United States)

    Millis, Richard M.; Dyson, Sharon; Cannon, Dawn

    2009-01-01

    The advent of internet-based delivery of basic medical science lectures may unintentionally lead to decreased classroom attendance and participation, thereby creating a distance learning paradigm. In this study, we tested the hypothesis that classroom attendance/participation may be positively correlated with performance on a written examination…

  18. Academic and Family Conditions Associated with Intrinsic Academic Motivation in Japanese Medical Students: A Pilot Study

    Science.gov (United States)

    Tanaka, Masaaki; Watanabea, Yasuyoshi

    2012-01-01

    Objective: Intrinsic academic motivation is one of the most important psychological concepts in education, and it is related to academic outcomes in medical students. This study examined the relationships between academic and family conditions and intrinsic academic motivation. Design: Cross-sectional design. Setting: The study group consisted of…

  19. Implementing the Association of Teachers of Preventive Medicine's Recommendations into the Undergraduate Medical School Curriculum.

    Science.gov (United States)

    Altekruse, Joan; And Others

    1991-01-01

    Ideas for integrating preventive medicine into the undergraduate medical curriculum include options for curricula in quantitative skills, clinical preventive medicine, primary care rotation, community health services, and independent continuing education. Recommendations are based on a guide assessing the effectiveness of 169 types of preventive…

  20. A Qualitative Study of Factors Associated with Medical Students' Academic Success

    Directory of Open Access Journals (Sweden)

    Gholamreza S. Ardekain

    2008-01-01

    Full Text Available Problem statement: The aim of the present study was to determine the successful medical students' viewpoints on factors significant to their academic success assessed according to the students' grade point average. In this research the students with the grade point average (GPA A (17-20 were considered academically successful. Approach: The participants were 30 fifth year successful students (i.e. students with GPA, A from Shiraz Medical School. The instrument used for the qualitative data gathering was interview. The subjects were arranged into 6 groups of 5 students followed by a discussion on reasons of their success. Five educated tutors coordinated the groups. Results: Categorizing of focus group data was done and 4 general factors including "personal abilities" "attitude, beliefs and motivation", "effort and perseverance" and "supportive factors" were found to be critical to the students' success. It is clear that all factors mentioned by students play an important role in their success in general. The similarities between the results of this study and those of others support the idea that all successful medical students share some common characteristics. Conclusion/Recommendations: The results of this study would help both medical school authorities and instructors to design strategies for more effective education. The results can also help other students to find out what might lead them to more success.

  1. The Association between the Availability of Sugar-Sweetened Beverage in School Vending Machines and Its Consumption among Adolescents in California: A Propensity Score Matching Approach

    Directory of Open Access Journals (Sweden)

    Lu Shi

    2010-01-01

    Full Text Available There is controversy over to what degree banning sugar-sweetened beverage (SSB sales at schools could decrease the SSB intake. This paper uses the adolescent sample of 2005 California Health Interview Survey to estimate the association between the availability of SSB from school vending machines and the amount of SSB consumption. Propensity score stratification and kernel-based propensity score matching are used to address the selection bias issue in cross-sectional data. Propensity score stratification shows that adolescents who had access to SSB through their school vending machines consumed 0.170 more drinks of SSB than those who did not (<.05. Kernel-based propensity score matching shows the SSB consumption difference to be 0.158 on the prior day (<.05. This paper strengthens the evidence for the association between SSB availability via school vending machines and the actual SSB consumption, while future studies are needed to explore changes in other beverages after SSB becomes less available.

  2. Collision and displacement vulnerability among marine birds of the California Current System associated with offshore wind energy infrastructure

    Science.gov (United States)

    Adams, Josh; Kelsey, Emily C.; Felis, Jonathan J.; Pereksta, David M.

    2016-10-27

    With growing climate change concerns and energy constraints, there is an increasing need for renewable energy sources within the United States and globally. Looking forward, offshore wind-energy infrastructure (OWEI) has the potential to produce a significant proportion of the power needed to reach our Nation’s renewable energy goal. Offshore wind-energy sites can capitalize open areas within Federal waters that have persistent, high winds with large energy production potential. Although there are few locations in the California Current System (CCS) where it would be acceptable to build pilemounted wind turbines in waters less than 50 m deep, the development of technology able to support deep-water OWEI (>200 m depth) could enable wind-energy production in the CCS. As with all humanuse of the marine environment, understanding the potential impacts of wind-energy infrastructure on the marine ecosystem is an integral part of offshore wind-energy research and planning. Herein, we present a comprehensive database to quantify marine bird vulnerability to potential OWEI in the CCS (see http://dx.doi.org/10.5066/F79C6VJ0). These data were used to quantify marine bird vulnerabilities at the population level. For 81 marine bird species present in the CCS, we created three vulnerability indices: Population Vulnerability, Collision Vulnerability, and Displacement Vulnerability. Population Vulnerability was used as a scaling factor to generate two comprehensive indicies: Population Collision Vulnerability (PCV) and Population Displacement Vulnerability (PDV). Within the CCS, pelicans, terns (Forster’s [Sterna forsteri], Caspian [Hydroprogne caspia], Elegant [Thalasseus elegans], and Least Tern [Sternula antillarum]), gulls (Western [Larus occidentalis] and Bonaparte’s Gull [Chroicocephalus philadelphia]), South Polar Skua (Stercorarius maccormicki), and Brandt’s Cormorant (Phalacrocorax penicillatus) had the greatest PCV scores. Brown Pelican (Pelicanus occidentalis

  3. Incidence of medication error associated with the use of beta-blockers in Pakistan.

    Science.gov (United States)

    Nesar, Shagufta; Shoaib, Muhammad Harris; Yousuf, Rabia Ismail; Rahim, Najia; Muhammad, Iyad Naeem

    2014-05-01

    Medication errors (ME) are human errors, which are very frequent in cardiovascular patients and result in patient morbidity and mortality. This study was focused to evaluate the quality of prescriptions and to emphasize the placement of clinical pharmacist in health care team. This study was carried out in different outpatient settings of (in) Karachi, Pakistan. The study period was June 2011 till June 2012. Retrospective data was analyzed for the outpatients' prescription of beta blocker drugs. During the study, prescriptions (n=450) were collected from different outpatient settings of (in) Karachi, Pakistan. Prescription containing beta-blockers were analyzed for the essential elements to be mentioned in prescription. Drug-drug interactions were identified by the Micromedex.2.0 Drug-Reax database and severity of medication error was determined by NCCMERP Index. A total of 1627 medication errors were identified in 450 prescriptions. The most frequent error was not mentioning the patient's weight (95%), followed by missing diagnosis (79.4%) and drug-drug interactions (69.5%). Twenty-two prescriptions were placed in the most severe category I (4.88%). Average number of drugs per prescription was 4.76. Significant difference was observed (χ(2)=52.418, p<0.05) using SPSS 19 for those prescription orders having more than 5 drugs with Beta-blockers. This indicates that the errors in prescription such as drug-drug interactions, wrong dose etc. was significantly increased with the number of drugs per prescription. Results showed that medication errors are very frequent in prescription written in outpatient setting of various hospitals and clinics in Karachi. This shows that the irrational prescribing is a common practice in developing countries. Placement of skilled pharmacist in the health care system is the only solution for avoidance of these medication related problems.

  4. Electronic medical record data to identify variables associated with a fibromyalgia diagnosis: importance of health care resource utilization

    Directory of Open Access Journals (Sweden)

    Masters ET

    2015-03-01

    Full Text Available Elizabeth T Masters,1 Jack Mardekian,1 Birol Emir,1 Andrew Clair,1 Max Kuhn,2 Stuart L Silverman,31Pfizer, Inc., New York, NY, 2Pfizer, Inc., Groton, CT, 3Cedars-Sinai Medical Center, Los Angeles, CA, USABackground: Diagnosis of fibromyalgia (FM is often challenging. Identifying factors associated with an FM diagnosis may guide health care providers in implementing appropriate diagnostic and management strategies.Methods: This retrospective study used the de-identified Humedica electronic medical record (EMR database to identify variables associated with an FM diagnosis. Cases (n=4,296 were subjects ≥18 years old with ≥2 International Classification of Diseases, Ninth Revision (ICD-9 codes for FM (729.1 ≥30 days apart during 2012, associated with an integrated delivery network, with ≥1 encounter with a health care provider in 2011 and 2012. Controls without FM (no-FM; n=583,665 did not have the ICD-9 codes for FM. Demographic, clinical, and health care resource utilization variables were extracted from structured EMR data. Univariate analysis identified variables showing significant differences between the cohorts based on odds ratios (ORs.Results: Consistent with FM epidemiology, FM subjects were predominantly female (78.7% vs 64.5%; P<0.0001 and slightly older (mean age 53.3 vs 52.7 years; P=0.0318. Relative to the no-FM cohort, the FM cohort was characterized by a higher prevalence of nearly all evaluated comorbidities; the ORs suggested a higher likelihood of an FM diagnosis (P<0.0001, especially for musculoskeletal and neuropathic pain conditions (OR 3.1 for each condition. Variables potentially associated with an FM diagnosis included higher levels of use of specific health care resources including emergency-room visits, outpatient visits, hospitalizations, and medications. Units used per subject for emergency-room visits, outpatient visits, hospitalizations, and medications were also significantly higher in the FM cohort (P<0

  5. AIDS-associated diarrhea and wasting in northeast Brazil is associated with subtherapeutic plasma levels of antiretroviral medications and with both bovine and human subtypes of Cryptosporidium parvum

    Directory of Open Access Journals (Sweden)

    Richard K. Brantley

    2003-02-01

    Full Text Available Advanced HIV infection is frequently complicated by diarrhea, disruption of bowel structure and function, and malnutrition. Resulting malabsorption of or pharmacokinetic changes in antiretroviral agents might lead to subtherapeutic drug dosing and treatment failure in individual patients, and could require dose adjustment and/or dietary supplements during periods of diarrheal illness. We determined the plasma levels of antiretroviral medications in patients that had already been started on medication by their physicians in an urban infectious diseases hospital in northeast Brazil. We also obtained blood samples from patients hospitalized for diarrhea or AIDS-associated wasting, and we found reduced stavudine and didanosine levels in comparison with outpatients without diarrhea or wasting who had been treated at the same hospital clinic. There was a predominance of the protozoal pathogens Cryptosporidium and Isospora belli, typical opportunistic pathogens of AIDS-infected humans, in the stool samples of inpatients with diarrhea. We conclude that severe diarrhea and wasting in this population is associated with both protozoal pathogens and subtherapeutic levels of antiretroviral medications.

  6. Factors associated with attitude and hypothetical behaviour regarding brain death and organ transplantation: comparison between medical and other university students.

    Science.gov (United States)

    Ohwaki, Kazuhiro; Yano, Eiji; Shirouzu, Makiko; Kobayashi, Aya; Nakagomi, Tadayoshi; Tamura, Akira

    2006-01-01

    The aim of this study was to investigate the factors, including knowledge, that determine an individual's attitudes and behaviours regarding brain death and organ transplantation using questionnaires among medical and other university students. A total of 522 students (388 medical and 134 other) answered a questionnaire. The survey included the individual's knowledge about brain death, attitudes towards brain death and organ transplantation, and hypothetical behaviours assuming their willingness to donate their own or their family's organs. Medical students were more likely to have knowledge about brain death and to accept brain death and organ transplantation compared with other students, while there was no difference in their willingness to donate their own or their family's organs. Logistic regression analysis was used to assess the effects of various factors on the attitudes and behaviours. In both medical and other students, confidence in brain-death diagnosis by doctors was independently associated with their willingness to donate their own organs after the adjustment for other factors, including knowledge (odds ratio [OR], 1.85; 95% confidence interval [CI], 1.15 to 2.97 and OR, 4.97; 95% CI, 1.01 to 24.39, respectively). An increase in knowledge may cause positive attitudes towards brain death and organ transplant. Meanwhile, reducing uncertainty about the brain-death diagnostic process might have a beneficial effect on the willingness to donate organs.

  7. Medical waste management plan.

    Energy Technology Data Exchange (ETDEWEB)

    Lane, Todd W.; VanderNoot, Victoria A.

    2004-12-01

    This plan describes the process for managing research generated medical waste at Sandia National Laboratories/California. It applies to operations at the Chemical and Radiation Detection Laboratory (CRDL), Building 968, and other biosafety level 1 or 2 activities at the site. It addresses the accumulation, storage, treatment and disposal of medical waste and sharps waste. It also describes the procedures to comply with regulatory requirements and SNL policies applicable to medical waste.

  8. Trends in health sciences library and information science research: an analysis of research publications in the Bulletin of the Medical Library Association and Journal of the Medical Library Association from 1991 to 2007*

    Science.gov (United States)

    Gore, Sally A.; Nordberg, Judith M.; Palmer, Lisa A.

    2009-01-01

    Objective: This study analyzed trends in research activity as represented in the published research in the leading peer-reviewed professional journal for health sciences librarianship. Methodology: Research articles were identified from the Bulletin of the Medical Library Association and Journal of the Medical Library Association (1991–2007). Using content analysis and bibliometric techniques, data were collected for each article on the (1) subject, (2) research method, (3) analytical technique used, (4) number of authors, (5) number of citations, (6) first author affiliation, and (7) funding source. The results were compared to a previous study, covering the period 1966 to 1990, to identify changes over time. Results: Of the 930 articles examined, 474 (51%) were identified as research articles. Survey (n = 174, 37.1%) was the most common methodology employed, quantitative descriptive statistics (n = 298, 63.5%) the most used analytical technique, and applied topics (n = 332, 70%) the most common type of subject studied. The majority of first authors were associated with an academic health sciences library (n = 264, 55.7%). Only 27.4% (n = 130) of studies identified a funding source. Conclusion: This study's findings demonstrate that progress is being made in health sciences librarianship research. There is, however, room for improvement in terms of research methodologies used, proportion of applied versus theoretical research, and elimination of barriers to conducting research for practicing librarians. PMID:19626146

  9. PubMed search strategies for the identification of etiologic associations between hypothalamic-pituitary disorders and other medical conditions.

    Science.gov (United States)

    Guaraldi, Federica; Grottoli, Silvia; Arvat, Emanuela; Mattioli, Stefano; Ghigo, Ezio; Gori, Davide

    2013-12-01

    Biomedical literature has enormously grown in the last decades and become broadly available through online databases. Ad-hoc search methods, created on the basis of research field and goals, are required to enhance the quality of searching. Aim of this study was to formulate efficient, evidence-based PubMed search strategies to retrieve articles assessing etiologic associations between a condition of interest and hypothalamic-pituitary disorders (HPD). Based on expert knowledge, 17 MeSH (Medical Subjects Headings) and 79 free terms related to HPD were identified to search PubMed. Using random samples of abstracts retrieved by each term, we estimated the proportion of articles containing pertinent information and formulated two strings (one more specific, one more sensitive) for the detection of articles focusing on the etiology of HPD, that were then applied to retrieve articles identifying possible etiologic associations between HPD and three diseases (malaria, LHON and celiac disease) considered not associated to HPD, and define the number of abstracts needed to read (NNR) to find one potentially pertinent article. We propose two strings: one sensitive string derived from the combination of articles providing the largest literature coverage in the field and one specific including combined terms retrieving ≥40% of potentially pertinent articles. NNR were 2.1 and 1.6 for malaria, 3.36 and 2.29 for celiac disease, 2.8 and 2.2 for LHON, respectively. For the first time, two reliable, readily applicable strings are proposed for the retrieval of medical literature assessing putative etiologic associations between HPD and other medical conditions of interest.

  10. The Association of HIV-Related Stigma to HIV Medication Adherence: A Systematic Review and Synthesis of the Literature.

    Science.gov (United States)

    Sweeney, Shannon M; Vanable, Peter A

    2016-01-01

    This paper provides a review of the quantitative literature on HIV-related stigma and medication adherence, including: (1) synthesis of the empirical evidence linking stigma to adherence, (2) examination of proposed causal mechanisms of the stigma and adherence relationship, and (3) methodological critique and guidance for future research. We reviewed 38 studies reporting either cross-sectional or prospective analyses of the association of HIV-related stigma to medication adherence since the introduction of antiretroviral therapies (ART). Although there is substantial empirical evidence linking stigma to adherence difficulties, few studies provided data on psychosocial mechanisms that may account for this relationship. Proposed mechanisms include: (a) enhanced vulnerability to mental health difficulties, (b) reduction in self-efficacy, and (c) concerns about inadvertent disclosure of HIV status. Future research should strive to assess the multiple domains of stigma, use standardized measures of adherence, and include prospective analyses to test mediating variables.

  11. Writing an article for a geriatrics journal: guidelines from the Journal of the American Medical Directors Association.

    Science.gov (United States)

    Messinger-Rapport, Barbara J; Gammack, Julie; Thomas, David R

    2008-01-01

    The ability to translate clinical research findings or a critical analysis into a publication is essential to disseminate new knowledge, advance the field, and influence patient care. Complete coverage of article preparation and style can be found in texts such as the AMA Manual of Style. Additionally, all major publications provide organizational and content instruction in a "Guideline for Authors" document. This article provides structured information regarding editorial expectations for a medical publication, focusing on the geriatric submission. For the Journal of the American Medical Directors Association (JAMDA), manuscripts should be applicable to, if not focused on, issues related to long-term care. The editors of JAMDA are committed to assisting authors in developing ideas for manuscripts, structuring the article and providing thoughtful reviewer comment to assist in revising the document.

  12. Oligocene tectonics and sedimentation, California

    Science.gov (United States)

    Nilsen, T.H.

    1984-01-01

    During the Oligocene epoch, California was marked by extensive nonmarine sedimentation, in contrast to its pre-Oligocene and post-Oligocene depositional history. The Oligocene continental deposits are especially widespread in southern California and fill a number of small and generally partly restricted basins. Fluvial facies in many basins prograded over previously deposited lower Tertiary turbidites. Volcanism, from widespread centers, was associated with the nonmarine sedimentation. However, some basins remained marine and a few contain Oligocene turbidites and pelagic sediments deposited at bathyal depths. The Oligocene redbeds of California do not form a post-orogenic molasse sequence comparable to the Old Red Sandstone or Alpine molasse. They are synorogenic and record local uplift of basins and surrounding source areas. Late Cretaceous to contemporary orogenesis in California has been generally characterized by the formation of small restricted basins of variable depth adjacent to small upland areas in response to strike-slip faulting. Deposition of Oligocene redbeds was associated with climatic change from warm and humid to cold and semiarid, and a global lowering of sea level. Oligocene tectonism occurred during the transition from subduction of the Farallon Plate to initiation of the modern San Andreas transform system. However, the major influence that caused uplift, formation of fault-bounded basins, and extensive redbed deposition, especially in southern California, was the approach of the Pacific-Farallon spreading ridge to the western margin of California. ?? 1984.

  13. California Political Districts

    Data.gov (United States)

    California Department of Resources — This is a series of district layers pertaining to California'spolitical districts, that are derived from the California State Senateand State Assembly information....

  14. Association among active seafloor deformation, mound formation, and gas hydrate growth and accumulation within the seafloor of the Santa Monica Basin, offshore California

    Science.gov (United States)

    Paull, C.K.; Normark, W.R.; Ussler, W.; Caress, D.W.; Keaten, R.

    2008-01-01

    Seafloor blister-like mounds, methane migration and gas hydrate formation were investigated through detailed seafloor surveys in Santa Monica Basin, offshore of Los Angeles, California. Two distinct deep-water (??? 800??m water depth) topographic mounds were surveyed using an autonomous underwater vehicle (carrying a multibeam sonar and a chirp sub-bottom profiler) and one of these was explored with the remotely operated vehicle Tiburon. The mounds are > 10??m high and > 100??m wide dome-shaped bathymetric features. These mounds protrude from crests of broad anticlines (~ 20??m high and 1 to 3??km long) formed within latest Quaternary-aged seafloor sediment associated with compression between lateral offsets in regional faults. No allochthonous sediments were observed on the mounds, except slumped material off the steep slopes of the mounds. Continuous streams of methane gas bubbles emanate from the crest of the northeastern mound, and extensive methane-derived authigenic carbonate pavements and chemosynthetic communities mantle the mound surface. The large local vertical displacements needed to produce these mounds suggests a corresponding net mass accumulation has occurred within the immediate subsurface. Formation and accumulation of pure gas hydrate lenses in the subsurface is proposed as a mechanism to blister the seafloor and form these mounds. ?? 2008 Elsevier B.V. All rights reserved.

  15. Seasonal changes in a fish assemblage associated with mangroves in a coastal lagoon of Baja California Sur, Mexico

    OpenAIRE

    2011-01-01

    The fish assemblage in a coastal lagoon with mangroves known as Rancho Bueno was determined and associated with environmental parameters. We used an experimental otter trawl net to catch the fish, and 62 fish species were identified from 48 genera and 30 families. The most abundant species were: Etropus crossotus, Eucinostomus gracilis, Paralabrax maculatofasciatus, Sphoeroides annulatus, and Eucinostomus dowii. The water temperature changed seasonally, being warm from July through December...

  16. Medical Identity

    DEFF Research Database (Denmark)

    Musaeus, Peter

    2015-01-01

    Purpose: To examine philosophical stances underpinning medical identity and assess the conceptual relationship between physician, medical practice and culture. Argument: Medical identity is about the ideals and moral positions that physicians take when justifying themselves. Medical identity...... hedonistic versus sentimentalist approaches to medical identity. The sociocultural philosophical analysis of medical identity can shed light on what it means conceptually for a physician to harbor beliefs associated with him/her being taken to be an autonomous professional. It is important because it touches...... on the meaning of being a compassionate, good and skilled physician, making its relevance to person-centered medicine self-evident. Conclusion: Medical identity should be analyzed with reference to literature, philosophy and medical practice in order for the physician to exercise a reflective position...

  17. Humanitarismo, redención y ciencia médica en Nueva España: El expediente de salud pública para frenar la extinción de indios en la Baja California (1797-1805 Humanitarianism, Redemption and Medical Science in New Spain: The Public Health Plan to Halt the Extinction of Indians in Baja California (1797-1805

    Directory of Open Access Journals (Sweden)

    Francisco Altable

    2011-08-01

    Full Text Available A partir de la descripción de los diversos momentos de la puesta en marcha de un programa médico diseñado para revertir el largo proceso de decadencia poblacional de los indios de la península de California, se pone a la vista lo que podría denominarse el humanitarismo político de la corona española, proyectado en el debate habido entre las perspectivas religiosa y científica en torno a la extinción de los indios. El artículo explica las causas de lo que se denomina aquí la utopía de la sanación de los californios y ofrece una interpretación que varía de las concepciones relativas a la consabida incapacidad génica de los indios para sobrevivir a los contagios, a los errores e imposiciones del proceso de aculturación y a otros factores adversos a la existencia indígena. Se concluye que el fracaso del programa médico en cuestión contribuyó a la frustración de las expectativas colonizadoras, humanitarias, religiosas y modernizadoras del régimen borbónico.On the basis of a description of various moments in the implementation of a medical program to reverse the long population decline of Indians in the California península, what could be called the political humanitarianism of the Spanish Crown emerged, projected onto the debate between the religious and scientific perspectives regarding the extinction of the Indians. The árdele explains the causes of what is called the Utopia of the Californians' healing, offering an interpretation that ranges from relative conceptions to the Indians' well-known genetic capacity to survive the infections, errors and impositions of the acculturation process and other factors that adversely affect indigenous existence. It concludes that the failure of the medical program in question contributed to the frustration of the colonizing, humanitarian, religious and modernizing expectations of the Bourbon regime.

  18. Periodontal Systemic Connections-Novel Associations-A Review of the Evidence with Implications for Medical Practitioners.

    Science.gov (United States)

    Kalakonda, Butchibabu; Koppolu, Pradeep; Baroudi, Kusai; Mishra, Ashank

    2016-04-01

    Periodontal diseases, considered as inflammatory diseases have proved to have a spectrum of systemic implications. Earliest research has associated periodontal disease with common systemic aliments such as hypertension, diabetes, osteoporosis, rheumatoid arthritis to name a few. The evolution of advanced diagnostic aids let researchers make vast inroads in linking periodontal diseases to systemic diseases like Alzheimer's disease (AD) and even Schizophrenia. Our aim was to review and critically evaluate comprehensive literature and provide knowledge to medical practitioners on these associations so as to pave way for closer interactions between medical and dental practitioners in implementing better health care. Electronic databases such as PubMed, Google Scholar and Cochrane databases were used as source of the data for relevant studies published from 2005 up to 2015 with the following keywords, "'Periodontal disease", "systemic conditions", "periodontal disease and Alzheimer's", "Periodontal disease and Schizophrenia", "Periodontal disease and Psoriasis" and "Periodontal disease and erectile dysfunction". The evidence presented ascertains that a reasonable and modest association does exist between Periodontal disease and Alzheimer's, Schizophrenia, Erectile dysfunction, as well as Psoriasis and thus establishes periodontal disease as a potential risk factor.

  19. Corpus-based associations provide additional morphological variants to medical terminologies.

    Science.gov (United States)

    Zweigenbaum, Pierre; Grabar, Natalia

    2003-01-01

    Knowledge of morphologically derived words, as provided for medical English by the UMLS Specialist Lexicon, is useful to detect term variants for automated coding and indexing. For most other languages though, no comparable morphological knowledge base is available. We therefore endeavored to design general methods to help collect such knowledge for a given language. We propose here a method for discovering derived words in text corpora and apply it to a French medical corpus. To evaluate this method, we study its ability to suggest derived adjectives for 2,297 nouns found in the SNOMED nomenclature, which itself specifies adjectival equivalents for some of its terms. 74% of the proposed adjectives are judged correct (precision) and cover 16% of these nouns (recall), a larger amount than what SNOMED already specifies. Furthermore, the corpus suggests additional adjectives which can increase SNOMED's by 76%. We conclude that such a method can help speed up the construction of a morphological knowledge base which can increase the number of term variants in an existing controlled vocabulary.

  20. Association of L-DOPA with recovery following Ayurveda medication in Parkinson's disease.

    Science.gov (United States)

    Nagashayana, N; Sankarankutty, P; Nampoothiri, M R; Mohan, P K; Mohanakumar, K P

    2000-06-15

    Ayurveda, the Indian system of traditional medicine, uses a concoction of several spices, herbs and minerals for the treatment of diseases. In a clinical prospective study we have evaluated the efficacy of Ayurveda treatment (a concoction in cow's milk of powdered Mucuna pruriens and Hyoscyamus reticulatus seeds and Withania somnifera and Sida cordifolia roots) in 18 clinically diagnosed (with a mean Hoen and Yahr value of 2.22) parkinsonian patients. As per Ayurveda principles, 13 patients underwent both cleansing (for 28 days) and palliative therapy (56 days), 5 patients underwent palliative therapy alone (84 days). Only the former group showed significant improvement in activities of daily living (ADL) and on motor examination as per UPDRS rating. Symptomatically, they exhibited better response in tremor, bradykinesia, stiffness and cramps as compared to the latter group. Excessive salivation worsened in both the groups. Analyses of powdered samples in milk, as administered in patients, revealed about 200 mg of L-DOPA per dose. The study establishes the necessity of cleansing therapy in Ayurveda medication prior to palliative therapy. It also reveals contribution of L-DOPA in the recovery as observed in Parkinson' disease following Ayurveda medication.

  1. [Despite medication, overdrive pacing is required to stabilize the electrical storm associated with acute coronary syndrome: a case report].

    Science.gov (United States)

    Umeda, Masanobu; Morimoto, Atsushi; Yokoyama, Kaori; Tateishi, Emi; Makino, Kanako; Yamamoto, Kazuo; Nakagawa, Yoko; Fukuhara, Shinya; Takase, Eiji

    2007-10-01

    A 75-year-old female complained of severe chest pain and was emergently admitted to our hospital because of anterior acute myocardial infarction. Emergent coronary angiography was performed and revealed occlusion in segment 7, so a stent was implanted. Lidocaine, carvedilol, amiodarone, magnesium, and nifekalant were administered successively because non-sustained ventricular tachycardia (NSVT) frequently appeared like an electrical storm. After nifekalant administration, QTc was significantly prolonged and torsades de pointes was induced. Overdrive pacing was performed and finally the NSVT was completely controlled. If fatal arrhythmias such as NSVT show resistance to medication, overdrive pacing should be considered to stabilize the arrhythmia associated with acute coronary syndrome.

  2. Psychosocial factors associated with migraine and tension-type headache in medical students

    DEFF Research Database (Denmark)

    Lebedeva, Elena R; Kobzeva, Natalia R; Gilev, Denis V

    2017-01-01

    , not enough sleep, insomnia, depressed mood, anxiety, irritability, tendency towards conflicts and not being married. We report psychosocial factors associated with headache according to diagnosis and sex using univariate and multivariate logistic regression analyses. RESULTS: Several factors were...... significantly associated with migraine and TTH in the univariate analysis. In the multivariate analysis, two psychosocial factors were statistically significantly associated with migraine in all students: irritability (OR 2.2, 95% CI 1.4-3.6) and overwork (OR 2.2, 95% CI 1.4-3.5). Insomnia (2.7, 95% CI 1...

  3. Forensic medicine in South Africa: associations between medical practice and legal case progression and outcomes in female murders.

    Directory of Open Access Journals (Sweden)

    Naeemah Abrahams

    Full Text Available BACKGROUND: Forensic medicine has been largely by-passed by the tide of health systems research and evidence based medicine. Murder victims form a central part of forensic medical examiners' case load, and women murdered by intimate partners are an important subgroup, representing the most severe form and consequence of intimate partner violence. Our aim was to describe the epidemiology of female murder in South Africa (by intimate and non-intimate partners; and to describe and compare autopsy findings, forensic medical management of cases and the contribution of these to legal outcomes. METHODS: We did a retrospective national study in a proportionate random sample of 25 medico-legal laboratories to identify all homicides in 1999 of women aged 14 years and over. Data were abstracted from the mortuary file and autopsy report, and collected from a police interview. FINDINGS: In 21.5% of cases the perpetrator was convicted. Factors associated with a conviction for the female murders included having a history of intimate partner violence 1.18 (95%CI: 0.16-2.20, weapon recovered 1.36 (95% CI:0.58-2.15 and a detective visiting the crime scene 1.57 (95% CI:0.14-3.00. None of the forensic medical activities increased the likelihood of a conviction. CONCLUSION: The findings raise important questions about the role of forensic medicine in these cases.

  4. Population genetic structure of Phytophthora cinnamomi associated with avocado in California and the discovery of a potentially recent introduction of a new clonal lineage.

    Science.gov (United States)

    Pagliaccia, D; Pond, E; McKee, B; Douhan, G W

    2013-01-01

    Phytophthora root rot (PRR) of avocado (Persea americana), caused by Phytophthora cinnamomi, is the most serious disease of avocado worldwide. Previous studies have determined that this pathogen exhibits a primarily clonal reproductive mode but no population level studies have been conducted in the avocado-growing regions of California. Therefore, we used amplified fragment length polymorphism based on 22 polymorphic loci and mating type to investigate pathogen diversity from 138 isolates collected in 2009 to 2010 from 15 groves from the Northern and Southern avocado-growing regions. Additional isolates collected from avocado from 1966 to 2007 as well as isolates from other countries and hosts were also used for comparative purposes. Two distinct clades of A2 mating-type isolates from avocado were found based on neighbor joining analysis; one clade contained both newer and older collections from Northern and Southern California, whereas the other clade only contained isolates collected in 2009 and 2010 from Southern California. A third clade was also found that only contained A1 isolates from various hosts. Within the California population, a total of 16 genotypes were found with only one to four genotypes identified from any one location. The results indicate significant population structure in the California avocado P. cinnamomi population, low genotypic diversity consistent with asexual reproduction, potential evidence for the movement of clonal genotypes between the two growing regions, and a potential introduction of a new clonal lineage into Southern California.

  5. Imaging movement-related activity in medicated Parkin-associated and sporadic Parkinson's disease

    DEFF Research Database (Denmark)

    van Eimeren, Thilo; Binkofski, Ferdinand; Buhmann, Carsten

    2010-01-01

    Treatment-related motor complications such as dyskinesias are a major problem in the long-term management of Parkinson's disease (PD). In sporadic PD, a relatively early onset of the disease is known to be associated with an early development of dyskinesias. Although linked with early onset......, patients with Parkin-associated PD often show a stable long-term response to dopaminergic therapy without developing treatment-induced motor complications. Therefore, we reasoned that this difference in vulnerability to develop dyskinesias under long-term dopaminergic therapy may be associated...... selected movements. Patients with Parkin-associated and sporadic PD showed no difference in movement-related activation patterns. Moreover, the covariates 'age' and 'disease duration' similarly influenced brain activation in both patient groups. The present finding suggests that a stable long-term motor...

  6. Congenital Microtia Treated at Sapporo Medical University Hospital: Clinical Characteristics and Associated Anomalies.

    Science.gov (United States)

    Ogasawara, Noriko; Jitsukawa, Sumito; Takahashi, Nozomi; Takano, Kenichi; Himi, Tetsuo

    2016-01-01

    Seventy-three children who underwent plastic surgery for their external ear malformations between December 2010 and May 2013 at the Sapporo Medical University Hospital were evaluated. The predominance of right-sided malformation (62%) in males (71%) was similar to that reported previously, but the number of bilateral cases (9.3%) was lower than that in previous reports. We classified patients' ears using Marx's classification. The pure-tone average (average air conduction thresholds measured at 500, 1,000 and 2,000 Hz) was used as the representative value for the hearing level, which was compared with a patient's Marx classification. We evaluated the facial nerve position using high-resolution computed tomography scans. A thorough understanding of anatomical variations and complications, as well as performing appropriate treatments, is required for otolaryngologists to effectively manage congenital microtia.

  7. Medical management of urethral and colonic perforation associated with urinary catheterization in a kitten.

    Science.gov (United States)

    Whittemore, Jacqueline C; Zucca, Lynda

    2003-09-15

    A 6-week-old male kitten was evaluated because of stranguria and possible urethral blockage; a urinary catheter placed during general anesthesia penetrated the urethral and colonic walls and entered the colon. Treatment was conservative, with fluids administered i.v., administration of piperacillin, and supportive care. The kitten never became febrile or clinically ill and continued to thrive. There was no development of clinical signs consistent with stricture, diverticulum, or fistula formation. Complications from urethral perforation include infection and urethral stricture. Reconstructive surgery is considered the treatment of choice for traumatic urethral-colonic perforation. However, surgery may not be feasible or may be cost-prohibitive in certain situations. In such instances, medical management may provide a reasonable alternative to euthanasia.

  8. Multiple deformation mechanisms operating at seismogenic depths: Tectonic pseudotachylyte and associated deformation from the central Sierra Nevada, California

    Science.gov (United States)

    Prante, M. R.; Evans, J. P.

    2012-12-01

    Description and identification of fault-related deformation products that are diagnostic of seismic slip have implications for the energy budget of earthquakes, fault strength, and fault-rock assemblages. We describe tectonic pseduotachylyte, cataclastic rocks, crystal-plastic deformation, and hydrothermal alteration form faults exhumed from seismogenic depths in the Volcanic Lakes area, in northern Sequoia and Kings Canyon National Park, CA, USA. Fault rock protoliths include Mesozoic granite and granodiorite plutonic and limited metasedimentary and metavolcanic rocks. These plutonic and metamorphic rocks are cross-cut by the E-W striking, steeply dipping, left-lateral strike-slip Granite Pass (GPF) and Glacier Lakes faults (GLF). Cross-cutting relationships and microstructural data suggest that the GPF is the oldest fault in the area and preserves evidence for coeval brittle and plastic crystal deformation, and hydrothermal fluid-flow. Tectonic pseudotachylyte from the area has been dated using the 40Ar/39Ar method at 76.6 ± 0.3 Ma; when placed into a thermochronologic framework for the plutonic host rock it can be inferred that the pseudotachylyte formed at depths between 2.4-6.0 km with ambient temperatures between 110-160°C. Exceptionally well preserved tectonic pseudotachylyte from the GLF and GPF contain evidence for a frictional melt origin including: 1) plagioclase spherulites and microlites, 2) injection vein morphology, 3) amygdules, 4) viscous flow banding and folds, and 5) embayed and corroded clasts. Pseudotachylyte from the GPF and GLF is associated with brittle and plastic deformation in the damage zone of the faults. Evidence for plastic deformation includes undulose extinction, deformation lamellae, subgrain development, and grain boundary bulging in quartz; and limited undulose extinction in feldspar. Additionally, abundant hydrothermal alteration and mineralization has been documented in the GPF and GLF fault zones, including, chlorite

  9. Fumigation success for California facility.

    Science.gov (United States)

    Hacker, Robert

    2010-02-01

    As Robert Hacker, at the time director of facilities management at the St John's Regional Medical Center in Oxnard, California, explains, the hospital, one of the area's largest, recently successfully utilised a new technology to eliminate mould, selecting a cost and time-saving fumigation process in place of the traditional "rip and tear" method. Although hospital managers knew the technology had been used extremely effectively in other US buildings, this was reportedly among the first ever healthcare applications.

  10. Clonal distribution and associated characteristics of Escherichia coli clinical and surveillance isolates from a military medical center.

    Science.gov (United States)

    Manges, Amee R; Mende, Katrin; Murray, Clinton K; Johnston, Brian D; Sokurenko, Evgeni V; Tchesnokova, Veronika; Johnson, James R

    2017-04-01

    Antimicrobial-resistant Escherichia coli are a concern for military health services. We studied 100 extended-spectrum beta-lactamase (ESBL)-producing and non-producing E. coli clinical and surveillance isolates from military personnel and civilians at Brooke Army Medical Center (2007-2011). Major E. coli lineages, most prominently ST10 (24%), ST131 (16%), and ST648 (8%), were distributed much as reported for other North American populations. ST131, represented mainly by its resistance-associated ST131-H30 clonal subset, was uniquely associated with a clinical origin, regardless of ESBL status. Thus, clonal background predicted resistance phenotype and clinical versus surveillance origin, and these findings could assist military clinicians and epidemiologists.

  11. Awareness of the association between periodontal disease and pre-term births among general dentists, general medical practitioners and gynecologists

    Directory of Open Access Journals (Sweden)

    Fouzia Tarannum

    2013-01-01

    Full Text Available In the recent decades, periodontal disease has been identified as a risk factor for pre-term deliveries. Hence, it is important to evaluate the awareness of health-care providers of the association between periodontal diseases and pre-term birth. A self-administered questionnaire was distributed to random samples representing general medical practitioners (GMPs, general dental practitioners (GDPs and Gynecologists for this study. A knowledge score was calculated for correct answers to 11 survey questions related to oral health effects during pregnancy and compared among the three groups. In this study, 133 physicians, 135 dentists and 100 Gynecologists completed the questionnaire. More GDPs (67.4% than GMPs (56.4% and Gynecologists (63% reported there was an association between periodontal disease and pre-term low birth weight. Efforts to increase this awareness may prove valuable in improving preventive care during pregnancy.

  12. Persistent organic pollutants associated to water fluxes and sedimentary processes in the Colorado River delta, Baja California, México.

    Science.gov (United States)

    Lugo-Ibarra, K C; Daesslé, L W; Macías-Zamora, J V; Ramírez-Álvarez, N

    2011-09-01

    Polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCPs) were studied in sediment cores from two distinctive modern channels of the Colorado River (CR) delta. Their abundance and temporal changes are associated with flood-flows from the CR across the USA-Mexico border. The CR channel is directly exposed to river flood-flows while the Hardy River (HR) is a local channel derived mainly from agricultural runoff, geothermal effluents, and treated urban wastewater. Different headwater compositions and degrees of exposure to flood-flows appear to be the factors controlling the composition of persistent organic pollutants (POPs). Enrichment of OCPs (46 ng g(-1) dwt in HR and 4.37 ng g(-1) dwt in CR) occurred during or a few years after flooding. PCB-138 (4.2 ng g(-1)dwt) is enriched in HR suggesting its origin in dielectric oils from the geothermal power plant. PCB-28 (2.1 ng g(-1)dwt) in CR may be related with atmospheric input and/or re-deposition of upstream sediments. In surficial sediments (0-3 cm), only HR exceeds international sediment quality guidelines (4,4'-DDE=8.16 ng g(-1)dwt and ΣDDT=8.34 ng g(-1)dwt).

  13. Recreational use of erectile dysfunction medications in undergraduate men in the United States: characteristics and associated risk factors.

    Science.gov (United States)

    Harte, Christopher B; Meston, Cindy M

    2011-06-01

    Mounting evidence indicates that erectile dysfunction medications (EDMs) have become increasingly used as a sexual enhancement aid among men without a medical indication. Recreational EDM use has been associated with increased sexual risk behaviors, an increased risk for STIs, including incident HIV infection, and high rates of concomitant illicit drug use. The aim of the present study was to investigate the characteristics and associated risk factors for recreational EDM use among young, healthy, undergraduate men. A cross-sectional sample of 1,944 men were recruited from 497 undergraduate institutions within the Unites States between January 2006 and May 2007. The survey assessed patterns of EDM use, as well as demographic, substance use, and sexual behavior characteristics. Four percent of participants had recreationally used an EDM at some point in their lives, with 1.4% reporting current use. The majority of recreational EDM users reported mixing EDMs with illicit drugs and particularly during risky sexual behaviors. Recreational EDM use was independently associated with increased age, gay, or bisexual sexual orientation, drug abuse, lifetime number of sex partners, and lifetime number of "one-night stands." Recreational EDM users also reported a 2.5-fold rate of erectile difficulties compared to nonusers. Overall, recreational use of EDMs was associated with sexual risk behaviors and substance abuse; however, a relatively small proportion of undergraduates reported using EDMs. Results also suggest that a sizable portion of recreational EDM users are heterosexual men, and that use does not solely occur within the environments of venues that cater to men having sex with men.

  14. Treatment of Whiplash-Associated Disorders - Part II: Medical and Surgical Interventions

    Directory of Open Access Journals (Sweden)

    Anne Conlin

    2005-01-01

    Full Text Available BACKGROUND: Whiplash-associated disorder (WAD is a term used to describe injury due to an acceleration-deceleration mechanism at the neck. In 1995, the Quebec Task Force published a report that contained evidence-based recommendations regarding the treatment of WAD based on studies completed before 1993 and consensus-based recommendations.

  15. Association between medication prescription for atopic diseases and attention-deficit/hyperactivity disorder

    NARCIS (Netherlands)

    van der Schans, Jurjen; Pleiter, Janine C.; de Vries, Tjalling W; Schuiling-Veninga, Catharina C M; Bos, Jens H.J.; Hoekstra, Pieter J.; Hak, Eelko

    2016-01-01

    BACKGROUND: Data on the association between atopic diseases and attention-deficit/hyperactivity disorder (ADHD) have been inconclusive. OBJECTIVES: To assess whether children with drug-treated ADHD are more likely to receive treatment for asthma, allergic rhinitis, or eczema before the start of ADHD

  16. Association between Benzodiazepine Use and Dementia: Data Mining of Different Medical Databases.

    Science.gov (United States)

    Takada, Mitsutaka; Fujimoto, Mai; Hosomi, Kouichi

    2016-01-01

    Purpose: Some studies have suggested that the use of benzodiazepines in the elderly is associated with an increased risk of dementia. However, this association might be due to confounding by indication and reverse causation. To examine the association between benzodiazepine anxiolytic drug use and the risk of dementia, we conducted data mining of a spontaneous reporting database and a large organized database of prescriptions. Methods: Data from the US Food and Drug Administration Adverse Event Reporting System (FAERS) from the first quarter of 2004 through the end of 2013 and data from the Canada Vigilance Adverse Reaction Online Database from the first quarter of 1965 through the end of 2013 were used for the analyses. The reporting odds ratio (ROR) and information component (IC) were calculated. In addition, prescription sequence symmetry analysis (PSSA) was performed to identify the risk of dementia after using benzodiazepine anxiolytic drugs over the period of January 2006 to May 2014. Results: Benzodiazepine use was found to be associated with dementia in analyses using the FAERS database (ROR: 1.63, 95% CI: 1.61-1.64; IC: 0.66, 95% CI: 0.65-0.67) and the Canada Vigilance Adverse Reaction Online Database (ROR: 1.88, 95% CI: 1.83-1.94; IC: 0.85, 95% CI: 0.80-0.89). ROR and IC values increased with the duration of action of benzodiazepines. In the PSSA, a significant association was found, with adjusted sequence ratios of 1.24 (1.05-1.45), 1.20 (1.06-1.37), 1.23 (1.11-1.37), 1.34 (1.23-1.47), 1.41 (1.29-1.53), and 1.44 (1.33-1.56) at intervals of 3, 6, 12, 24, 36, and 48 months, respectively. Furthermore, the additional PSSA, in which patients who initiated a new treatment with benzodiazepines and anti-dementia drugs within 12- and 24-month periods were excluded from the analysis, demonstrated significant associations of benzodiazepine use with dementia risk. Conclusion: Multi-methodological approaches using different methods, algorithms, and databases suggest

  17. Association between Benzodiazepine Use and Dementia: Data Mining of Different Medical Databases

    Science.gov (United States)

    Takada, Mitsutaka; Fujimoto, Mai; Hosomi, Kouichi

    2016-01-01

    Purpose: Some studies have suggested that the use of benzodiazepines in the elderly is associated with an increased risk of dementia. However, this association might be due to confounding by indication and reverse causation. To examine the association between benzodiazepine anxiolytic drug use and the risk of dementia, we conducted data mining of a spontaneous reporting database and a large organized database of prescriptions. Methods: Data from the US Food and Drug Administration Adverse Event Reporting System (FAERS) from the first quarter of 2004 through the end of 2013 and data from the Canada Vigilance Adverse Reaction Online Database from the first quarter of 1965 through the end of 2013 were used for the analyses. The reporting odds ratio (ROR) and information component (IC) were calculated. In addition, prescription sequence symmetry analysis (PSSA) was performed to identify the risk of dementia after using benzodiazepine anxiolytic drugs over the period of January 2006 to May 2014. Results: Benzodiazepine use was found to be associated with dementia in analyses using the FAERS database (ROR: 1.63, 95% CI: 1.61-1.64; IC: 0.66, 95% CI: 0.65-0.67) and the Canada Vigilance Adverse Reaction Online Database (ROR: 1.88, 95% CI: 1.83-1.94; IC: 0.85, 95% CI: 0.80-0.89). ROR and IC values increased with the duration of action of benzodiazepines. In the PSSA, a significant association was found, with adjusted sequence ratios of 1.24 (1.05-1.45), 1.20 (1.06-1.37), 1.23 (1.11-1.37), 1.34 (1.23-1.47), 1.41 (1.29-1.53), and 1.44 (1.33-1.56) at intervals of 3, 6, 12, 24, 36, and 48 months, respectively. Furthermore, the additional PSSA, in which patients who initiated a new treatment with benzodiazepines and anti-dementia drugs within 12- and 24-month periods were excluded from the analysis, demonstrated significant associations of benzodiazepine use with dementia risk. Conclusion: Multi-methodological approaches using different methods, algorithms, and databases suggest

  18. Environmental Assessment for Conversion of the Existing Aero Club Runway to Emergency Helipad for David Grant Medical Center Travis Air Force Base, Fairfield, California

    Science.gov (United States)

    2010-07-01

    7 miles northeast of central Fairfield. The Proposed Action is located in the west portion of the Base, with the Base boundary to the north and...shallow pools that fill with water during the winter rainy season. Vernal pools begin drying out during the spring and are completely dry during...associated with agricultural practices, along with occurrences of non-native and native wildflowers and weedy forbs. The annual grasses germinate

  19. Hot Spots and Hot Moments of Methylmercury Production Associated With Agricultural and Non-agricultural Wetlands of the Yolo Bypass Wildlife Area, California

    Science.gov (United States)

    Marvin-Dipasquale, M.; Windham-Myers, L.; Agee, J. L.; Kakouros, E.; Cox, M. H.; Fleck, J.; Alpers, C. N.; Stephenson, M.

    2008-12-01

    The Yolo Bypass Wildlife Area (YBWA) is part of the larger Yolo Bypass floodwater protection zone associated with the Sacramento River and the Sacramento-San Joaquin Delta, in California. While mercury contamination is widespread throughout the region due to historic mining practices, the Yolo Bypass is responsible for a high proportion of the aqueous methylmercury (MeHg) entering the Delta, and biota from the Yolo Bypass are particularly elevated in toxic MeHg. Land use in the YBWA includes seasonally flooded agricultural fields (white rice, wild rice, fallow fields), and permanently and seasonally flooded non-agricultural wetlands used for resident and migratory waterfowl. Mercury biogeochemistry was examined in 0-2 cm surface sediment, as a function of habitat type, wetland management, and agricultural practices during the 2007-08 crop year. In permanently flooded wetlands, MeHg concentrations varied within a narrow range (ca. 0.5-1.5 ng/g dry wt) throughout the study period. In contrast, the three types of agricultural fields had higher MeHg concentrations throughout the rice-growing season (June-Sept; ca. 1.5-3.5 ng/g), and exhibited the highest levels (ca. 3.3-6.3 ng/g) in the post-harvest winter period (Dec-Feb). Further, naturally dried sediment, sampled during July '08 from post-harvest drained fallow agricultural fields (prior to reflooding) had MeHg concentrations that were also quite elevated (3.1 +/- 1.5 ng/g). This suggests that the initial elevated concentrations of overlying water MeHg, sometimes measured soon after flooding previously dried fields, may be related to the release of MeHg formed during the previous wet season and trapped in dried sediment, as opposed to being MeHg newly produced by bacteria upon soil rewetting. These results indicate that the 'hot spots and hot moments' associated with MeHg production in this system are linked to hydrologic manipulations (wetting and drying) in the agricultural fields, and that the practice of post

  20. Hybrid Medical Image Classification Using Association Rule Mining with Decision Tree Algorithm

    OpenAIRE

    Rajendran, P.; M.Madheswaran

    2010-01-01

    The main focus of image mining in the proposed method is concerned with the classification of brain tumor in the CT scan brain images. The major steps involved in the system are: pre-processing, feature extraction, association rule mining and hybrid classifier. The pre-processing step has been done using the median filtering process and edge features have been extracted using canny edge detection technique. The two image mining approaches with a hybrid manner have been proposed in this paper....

  1. Association between chronotype, food intake and physical activity in medical residents.

    Science.gov (United States)

    Mota, Maria Carliana; Waterhouse, Jim; De-Souza, Daurea Abadia; Rossato, Luana Thomazetto; Silva, Catarina Mendes; Araújo, Maria Bernadete Jeha; Tufik, Sérgio; de Mello, Marco Túlio; Crispim, Cibele Aparecida

    2016-01-01

    An individual's chronotype is a trait which reflects his/her diurnal preferences for the times of rest and activities, and displays a continuum from morningness to eveningness. Studies have shown that eveningness tends to be associated with a less healthy lifestyle, including increased likelihood of developing obesity. In this study, we examined the relationship between chronotype and food intake, physical sleep and activity in 72 resident physicians (52 women and 20 men). Assessments included chronotype evaluation by the Horne and Ostberg Morningness-Eveningness questionnaire (MEQ); food intake pattern through a self-administered food diary that was kept over the course of 3 non-successive days; physical activity level, using the Baecke questionnaire (BQ); sleep quality and quantity using the Pittsburgh Sleep Quality Index (PSQI); and sleepiness, Epworth Sleepiness Scale (ESS). Linear regression analyses, after adjustments for age, sex, body mass index (BMI), hours of additional work per week ESS and total physical activity score, showed that the chronotype score was negatively associated with cholesterol (coefficient = -0.24; p = 0.04), sweets (coefficient = -0.27, p = 0.03) and vegetables (coefficient = -0.26; p = 0.04) intakes. Following the same statistical adjustments, the chronotype score was positivity associated with leisure-time index (coefficient = 0.26, p = 0.03) and BQ total score (coefficient = 0.27, p = 0.03). We concluded that most issues related to nutrition problems and unhealthy lifestyle were associated with scores indicative of eveningness. These findings emphasize the importance of assessing an individual's chronotype when examining feeding behavior.

  2. [Epstein-Barr virus and associated diseases. Course of Medical Virology, Institut Pasteur, 1995/1996].

    Science.gov (United States)

    de Thé, G

    1997-01-01

    The Epstein-Barr virus (EBV) is an ubiquitous virus infecting nearly the entire adult human population. The EBV is closely associated with rhinopharyngeal cancer in Southern China and Northern Africa. Three geographic subtypes of EBV have been identified to date. They differ by their nuclear antigene EBNA2. The EBNA2 AC strains predominate in Asia; EBNA2 AD strains predominate in the United States; EBNA2 B strains have all been identified in black Africa. Burkitt's lymphoma is the most frequent tumor in children aged 5 to 9 years in equatorial Africa. A prospective study in 42,000 children in Ouganda demonstrated that children who develop Burkitt's lymphoma have severe EBV infection during the first months of life. Very early EBV infection observed in North or equatorial Africa increases the risk of Burkitt's lymphoma by 20-times that in Europe. Hyperendemic malaria observed in the equatorial zone increases the incidence of tumors by a factor of 20. An association between EBV and rhinopharyngeal cancer is a constant feature only in South China, in North and East Africa, as well as in arctic regions as cases of carcinoma not associated with EBV infection have been reported in Greece. Surveys in the Democratic Republic of China concerning several hundred thousand persons have shown that serum IgA/VCA allows early diagnosis of cancer. It is estimated that the risk of rhinopharyngeal cancer is 20% in Chinese with high levels of IgA/VCA.

  3. Is single room hospital accommodation associated with differences in healthcare-associated infection, falls, pressure ulcers or medication errors? A natural experiment with non-equivalent controls

    Science.gov (United States)

    Maben, Jill; Murrells, Trevor; Griffiths, Peter

    2016-01-01

    Objectives A wide range of patient benefits have been attributed to single room hospital accommodation including a reduction in adverse patient safety events. However, studies have been limited to the US with limited evidence from elsewhere. The aim of this study was to assess the impact on safety outcomes of the move to a newly built all single room acute hospital. Methods A natural experiment investigating the move to 100% single room accommodation in acute assessment, surgical and older people’s wards. Move to 100% single room accommodation compared to ‘steady state’ and ‘new build’ control hospitals. Falls, pressure ulcer, medication error, meticillin-resistant Staphylococcus aureus and Clostridium difficile rates from routine data sources were measured over 36 months. Results Five of 15 time series in the wards that moved to single room accommodation revealed changes that coincided with the move to the new all single room hospital: specifically, increased fall, pressure ulcer and Clostridium difficile rates in the older people’s ward, and temporary increases in falls and medication errors in the acute assessment unit. However, because the case mix of the older people’s ward changed, and because the increase in falls and medication errors on the acute assessment ward did not last longer than six months, no clear effect of single rooms on the safety outcomes was demonstrated. There were no changes to safety events coinciding with the move at the new build control site. Conclusion For all changes in patient safety events that coincided with the move to single rooms, we found plausible alternative explanations such as case-mix change or disruption as a result of the re-organization of services after the move. The results provide no evidence of either benefit or harm from all single room accommodation in terms of safety-related outcomes, although there may be short-term risks associated with a move to single rooms. PMID:26811373

  4. Association between eating disorders and body image in athletes and non-athlete students in Qazvin University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    M. Miri

    2016-06-01

    Full Text Available Background: Body image dissatisfaction and eating disorders are of common problems in adolescence and adulthood especially among athletes. Objective: The aim of this study was to determine the association of eating disorders and body image in athletes and non-athlete students in Qazvin University of Medical Sciences. Methods: This cross-sectional study was conducted on 226 athlete students and 350 non-athlete students of Qazvin University of Medical Sciences during 2013-2014. Students who followed a specific sport field and had participated in at least one sport event were considered as athlete students. All athlete students were entered the study by census method. Non-athlete students were selected among students who had not any exercise activity and by random sampling method. Data were collected through demographic questionnaire, Eating Attitudes Test (EAT-26, and Multidimensional Body-Self Relations Questionnaire (MBSRQ. Data were analyzed using T-test and Chi-square test. Results: Mean age was 21.92±3.19 years and mean body mass index (BMI was 22.24±3.18 kg/m2. The frequency of eating disorders was 11.5% among the athlete students and 11.2% among the non-athlete students. Anorexia nervosa was found to be more prevalent than bulimia nervosa in both groups. The students with normal BMI had better body image perception and less eating disorders symptoms than other students. The association of age, educational level, and gender with eating disorders and body image was not statistically significant. The association of eating disorders and body image was not statistically significant. Eating disorders were more prevalent in males than females but the difference was not statistically significant. Conclusion: With regards to the results, it seems that eating disorders and body image dissatisfaction are relatively prevalent among both athletes and non-athlete students and BMI is predictor of eating disorders.

  5. Associations Between the Big Five Personality Traits and the Non-Medical Use of Prescription Drugs for Cognitive Enhancement.

    Science.gov (United States)

    Sattler, Sebastian; Schunck, Reinhard

    2015-01-01

    While the number of studies of the non-medical use of prescription drugs to augment cognitive functions is growing steadily, psychological factors that can potentially help explain variance in such pharmaceutical cognitive enhancement (CE) behavior are often neglected in research. This study investigates the association between the Big Five personality traits and a retrospective (prior CE-drug use) as well as a prospective (willingness to use CE drugs) measure of taking prescription drugs with the purpose of augmenting one's cognitive functions (e.g., concentration, memory, or vigilance) without medical necessity. We use data from a large representative survey of German employees (N = 6454, response rate = 29.8%). The Five Factor Model (FFM) of Personality was measured with a short version of the Big Five Personality Traits Inventory (BFI-S), which includes: openness to experience, conscientiousness, extraversion, agreeableness, and neuroticism. Together with this, demographic variables such as gender, age, education, and income were used as potential confounders in multiple logistic regression models. Our results show a 2.96% lifetime prevalence of CE-drug use and a 10.45% willingness to (re)use such drugs in the future. We found that less conscientious and more neurotic respondents have a higher probability of prior CE-drug use and a greater willingness to use CE drugs in the future. No significant effects were found for openness, extraversion, or agreeableness. Prior CE-drug use was strongly associated with a greater willingness to take such drugs in the future. This study shows that specific personality traits are not only associated with prior enhancement behavior, but also affect the willingness to (re)use such drugs. It helps increase understanding of the risk factors of CE-drug use, which is a health-related behavior that can entail severe side-effects for consumers. The knowledge gathered can thus help improve interventions aimed at minimizing health

  6. Summary recommendations for responsible monitoring and regulation of clinical software systems. American Medical Informatics Association, The Computer-based Patient Record Institute, The Medical Library Association, The Association of Academic Health Science Libraries, The American Health Information Management Association, and The American Nurses Association.

    Science.gov (United States)

    Miller, R A; Gardner, R M

    1997-11-01

    Clinical software systems are becoming ubiquitous. A growing literature documents how these systems can improve health care delivery, but concerns about patient safety must now be formally addressed. In 1996, the U.S. Food and Drug Administration (FDA) called for discussions on regulation of software programs as medical devices. In response, a consortium of organizations dedicated to improving health care through information technology developed recommendations for the responsible regulation and monitoring of clinical software systems by users, vendors, and regulatory agencies. These recommendations were revised and approved by the American Medical informatics Association Public Policy Committee and Board. Other organizations reviewed, modified, and approved the recommendations, and the Boards of Directors of most of the organizations in the consortium endorsed the guidelines. The consortium proposes four categories of clinical system risk and four classes of monitoring and regulatory action that can be applied on the basis of the risk level. The consortium recommends that most clinical software systems be supervised locally and that developers of health care information systems adopt a code of good business practices. Budgetary and other constraints limit the type and number of systems that the FDA can regulate effectively; therefore, the FDA should exempt most clinical software systems and focus on systems that pose high clinical risk and provide limited opportunity for competent human intervention.

  7. Risk factors associated with children learning disorders at school: a socio-medical problem.

    Directory of Open Access Journals (Sweden)

    Beatriz Sabina Roméu

    2010-08-01

    Full Text Available Background: At the polyclinic ´´Area I´´ in Cienfuegos there are no previous studies on learning disorders in children and no epidemiological or exploratory research on personal, family and school issues related to this problem has been conducted. Objective: To determine the differences between children with and without learning disorders in second and third grade in the schools in the area of the "Dr. José Luis Chaviano" polyclinic in Cienfuegos in order to determine the risk factors depending on the child, the school and the family. Method: A non-coupled case-control study was conducted from September 2008 to June 2009. Study group: 42 children presenting learning difficulties as to their teacher´s opinion. Control group: 40 children with normal learning selected by simple random sampling. Interviews were conducted with parents, teachers and children as well as observations of school activities. Standardized questionnaires were applied and the information obtained was processed by using the SPSS statistical program. The chi-square statistic was used and the relative risks were estimated. Results: The identified disorders were associated with mood changes, unattendance to school and poor muscle control for writing, among others mentioned by teachers. The frequent change of teachers was also an associated condition. Among the risk factors related to family issues were: parents´ low educational level, cohabitation, family history of neurotic disorders, inconsistent educational management, family violence, marginalization and understimulation at home. Conclusion: Learning disorders were associated with risk factors depending on the child, school and, in a relevant way, on the family environment factors.

  8. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules: Executive Summary of recommendations

    DEFF Research Database (Denmark)

    Gharib, H; Papini, E; Paschke, R;

    2010-01-01

    American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules are systematically developed statements to assist health care professionals in medical...... decision making for specific clinical conditions. Most of the content herein is based on literature reviews. In areas of uncertainty, professional judgment was applied. These guidelines are a working document that reflects the state of the field at the time of publication. Because rapid changes...

  9. Associated Roles of Perioperative Medical Directors and Anesthesia: Hospital Agreements for Operating Room Management.

    Science.gov (United States)

    Dexter, Franklin; Epstein, Richard H

    2015-12-01

    As reviewed previously, decision making can be made systematically shortly before the day of surgery based on reducing the hours of overutilized operating room (OR) time and tardiness of case starts (i.e., patient waiting). We subsequently considered in 2008 that such decision making depends on rational anesthesia-hospital agreements specifying anesthesia staffing. Since that prior study, there has been a substantial increase in understanding of the timing of decision making to reduce overutilized OR time. Most decisions substantively influencing overutilized OR time are those made within 1 workday before the day of surgery and on the day of surgery, because only then are ORs sufficiently full that case scheduling and staff assignment decisions affect overutilized OR time. Consequently, anesthesiologists can easily be engaged in such decisions, because generally they must be involved to ensure that the corresponding anesthesia staff assignments are appropriate. Despite this, at hospitals with >8 hours of OR time used daily in each OR, computerized recommendations are superior to intuition because of cognitive biases. Decisions need to be made by a Perioperative Medical Director who has knowledge of the principles of perioperative managerial decision making published in the scientific literature rather than by a committee lacking this competency. Education in the scientific literature, and when different analytical methods should be used, is important. The addition that we make in this article is to show that an agreement between an anesthesia group and a hospital can both reduce overutilized OR time and patient waiting: The anesthesia group and hospital will ensure, hourly, that, when there are case(s) waiting to start, the number of ORs in use for each service will be at least the number that maximizes the efficiency of use of OR time. Neither the anesthesia group nor the hospital will be expected to run more than that number of ORs without mutual agreement

  10. Factors associated with overcrowded emergency rooms in Thailand: a medical school setting.

    Science.gov (United States)

    Wibulpolprasert, Arrug; Sittichanbuncha, Yuwares; Sricharoen, Pungkava; Borwornsrisuk, Somporn; Sawanyawisuth, Kittisak

    2014-01-01

    Background. Overcrowding in the emergency department (ED) is a significant public health problem in the US, Europe, and Asia. Factors associated with prolonged length of stay in Thailand are still limited. Methods. This study was conducted at the ED, Ramathibodi Hospital, Mahidol University, Thailand, during July 2011. We selected 300 patients (5.77%) from a total of 5,202 who visited the ED during the study period by simple random sampling. Charts were retrospectively reviewed baseline characteristics, clinical factors, and duration of ED stay. Multivariate logistic regression analyses were performed to identify independent factors for an ED stay more than or equal to 8 hours. Results. We excluded 33 patients (11%) due to incomplete data or stroke fast track enrollment. In total, 267 patients were in the analysis and 53 patients (19.85%) had an ED visit time more than or equal to 8 hours. The number of rounds of blood testing and the type of insurance were associated with prolonged ED stay of more than or equal to 8 hours. Conclusion. ED physicians may need to consider appropriate investigations to shorten the length of stay in the ED.

  11. Factors Associated with Overcrowded Emergency Rooms in Thailand: A Medical School Setting

    Directory of Open Access Journals (Sweden)

    Arrug Wibulpolprasert

    2014-01-01

    Full Text Available Background. Overcrowding in the emergency department (ED is a significant public health problem in the US, Europe, and Asia. Factors associated with prolonged length of stay in Thailand are still limited. Methods. This study was conducted at the ED, Ramathibodi Hospital, Mahidol University, Thailand, during July 2011. We selected 300 patients (5.77% from a total of 5,202 who visited the ED during the study period by simple random sampling. Charts were retrospectively reviewed baseline characteristics, clinical factors, and duration of ED stay. Multivariate logistic regression analyses were performed to identify independent factors for an ED stay more than or equal to 8 hours. Results. We excluded 33 patients (11% due to incomplete data or stroke fast track enrollment. In total, 267 patients were in the analysis and 53 patients (19.85% had an ED visit time more than or equal to 8 hours. The number of rounds of blood testing and the type of insurance were associated with prolonged ED stay of more than or equal to 8 hours. Conclusion. ED physicians may need to consider appropriate investigations to shorten the length of stay in the ED.

  12. Large vertical motions and basin evolution in the Outer Continental Borderland off Southern California associated with plate boundary development and continental rifting

    Science.gov (United States)

    Nicholson, C.; Sorlien, C. C.; Schindler, C. S.; De Hoogh, G.

    2011-12-01

    The Continental Borderland offshore southern California occupies a strategic position along the continental margin. It was the locus of ~75% of Pacific-North America displacement history, it helped accommodate the large-scale (>90°) tectonic rotation of the Western Transverse Ranges province, and is still accommodating potentially 20% of PAC-NAM plate motion today. As such, it represents an ideal natural laboratory to investigate plate boundary evolution and basin development associated with transform initiation, oblique continental rifting, transrotation and transpression. We have been using newly released grids of high-quality industry multichannel seismic (MCS) reflection data, combined with multibeam bathymetry and offshore well data to map and construct digital 3D fault surfaces and stratigraphic reference horizons over large parts of the Outer Continental Borderland. These 3D surfaces of structure and stratigraphy can be used to better understand and evaluate regional patterns of uplift, subsidence, fault interaction and other aspects of plate boundary deformation. In the northern Outer Borderland, mapping in Santa Cruz basin, and across both Santa Rosa and Santa Cruz-Catalina ridges reveals a pattern of interacting high-and low-angle faults, fault reactivation, basin subsidence, folding, and basin inversion. Subsidence since early-Miocene time is significant (up to 4 km) and is much larger than predicted by simple thermal cooling models of continental rifting. This requires additional tectonic components to drive this regional subsidence and subsequent basin inversion. Farther south, a more en echelon pattern of ridges and basins suggests a distributed component of right-lateral shear also contributed to much of the modern Borderland seafloor topography, including major Borderland basins. Vertical motions of uplift and subsidence can be estimated from a prominent early-Miocene unconformity that likely represents a regional, paleo-horizontal, near

  13. The definition of healthcare-associated pneumonia (HCAP) is insufficient for the medical environment in Japan: a comparison of HCAP and nursing and healthcare-associated pneumonia (NHCAP).

    Science.gov (United States)

    Kaku, Norihito; Yanagihara, Katsunori; Morinaga, Yoshitomo; Izumikawa, Koichi; Nagashima, Seiji; Kakeya, Hiroshi; Yamamoto, Yoshihiro; Fukuda, Minoru; Takatani, Hiroshi; Fukuda, Masaaki; Hashiguchi, Kohji; Kohno, Shigeru

    2013-02-01

    Healthcare-associated pneumonia (HCAP) is a new concept of pneumonia, which was proposed in the ATS/IDSA guidelines. The guidelines explain that HCAP patients should be treated with broad-spectrum antimicrobial drugs directed at multidrug-resistant pathogens. However, in Japan, there are many elderly people who received in-home care service. These patients seemed to be consistent with the concept of HCAP, but they did not meet the definition of HCAP. Therefore, the Japanese Respiratory Society modified the definition of HCAP according to the medical environmental in Japan. We retrospectively observed HCAP patients and nursing home and healthcare-associated pneumonia (NHCAP) patients who were hospitalized during 24 months at the Japanese Red Cross Nagasaki Genbaku Hospital (Nagasaki, Japan). Patient background, disease severity, identified pathogens, initial antibiotic regimens, and outcomes were compared. A total of 108 patients (77 HCAP and 31 NHCAP except HCAP patients) were evaluated. Of NHCAP except HCAP patients, 27 (87.1 %) were above 3 in the ECOG PS score. There were almost no significant differences between the two groups in characteristics, pneumonia severity, identified bacteria, initial antibiotic regimens, and response rate of initial antibiotic therapy. Although the in-hospital mortality of HCAP patients and NHCAP except HCAP patients was 9.1 % and 19.4 %, respectively, this difference did not reach statistical significance (P > 0.05). Our study suggested that, in the criteria of HCAP, some Japanese patients, who were consistent with the concept of HCAP, were classified as community-acquired pneumonia (CAP). Therefore, there is a need to change the definition of HCAP according to the medical environment in Japan.

  14. First-episode medication-naive major depressive disorder is associated with altered resting brain function in the affective network.

    Directory of Open Access Journals (Sweden)

    Xiaocui Zhang

    Full Text Available BACKGROUND: Major depressive disorder (MDD has been associated with abnormal structure and function of the brain's affective network, including the amygdala and orbitofrontal cortex (OFC. However, it is unclear if alterations of resting-state function in this affective network are present at the initial onset of MDD. AIMS: To examine resting-state function of the brain's affective network in first-episode, medication-naive patients with MDD compared to healthy controls (HCs. METHODS: Resting-state functional magnetic resonance imaging (rs-fMRI was performed on 32 first-episode, medication-naive young adult patients with MDD and 35 matched HCs. The amplitude of low-frequency fluctuations (ALFF of the blood oxygen level-dependent (BOLD signal and amygdala-seeded functional connectivity (FC were investigated. RESULTS: Compared to HC, MDD patients showed reduced ALFF in the bilateral OFC and increased ALFF in the bilateral temporal lobe extending to the insular and left fusiform cortices. Enhanced anti-correlation of activity between the left amygdala seed and the left OFC was found in MDD patients but not in HCs. CONCLUSIONS: Reduced ALFF in the OFC suggests hypo-functioning of emotion regulation in the affective network. Enhanced anti-correlation of activity between the amygdala and OFC may reflect dysfunction of the amygdala-OFC network and additionally represent a pathological process of MDD.

  15. [Consideration of Rehabilitation within High Class Quality Guidelines, Registered by the German Association of the Scientific Medical Professional Societies (AWMF)].

    Science.gov (United States)

    Jäckel, W H; Beindorf, G; Glattacker, M

    2013-10-01

    Clinical practice guidelines are systematically developed documents aiming at guiding decisions in specific areas of health care. Therefore, incorporating rehabilitation in guidelines adressing chronic diseases is of major importance. As information regarding consideration of rehabilitation in guidelines is lacking, the intention of our study was to analyse to what degree rehabilitation experts participated in guideline development and whether guidelines for chronic diseases include relevant information and recommendations concerning rehabilitation.In order to answer these questions we investigated 97 guidelines of high class quality, registered by the German Association of the Scientific Medical Professional Societies (AWMF). 36 out of these guidelines addressed chronic health conditions in which rehabilitation may be of relevance. Guidelines identified were analysed using a set of defined criteria.In 11 out of the 36 guidelines one or more medical rehabilitation societies participated in the development process, 17 include a chapter on rehabilitation issues, and 20 information concerning indication for rehabilitation processes. 24 guidelines consider rehabilitation in their recommendations.There is substantial variance concerning inclusion of rehabilitation in German guidelines on chronic diseases. Rehabilitation societies are encouraged to strive for stronger integration of rehabilitation into guidelines of other societies.

  16. ASSOCIATION OF THYROID DYSFUNCTION AMONG INFERTILE WOMEN VISITING NEPALGUNJ MEDICAL COLLEGE HOSPITAL, KOHALPUR-NEPAL

    Directory of Open Access Journals (Sweden)

    M Shrewastwa

    2013-09-01

    Full Text Available Background: Infertility is one of the medial, social, and psychological burdens in this part of world. Thyroid dysfunction can lead to menstrual disturbance, anovulatory cycles, and decreased fecundity. Proper management of thyroid dysfunction can result in restoration of normal fertility. Therefore it is very important to screen thyroid abnormalities among women with infertility. This study aimed to determine association of thyroid dysfunction among infertile women. This study comprises total of 735 primary infertile women with age ranging from 20 to 35 years. Blood samples were collected and subjected for estimation of thyroid hormones. Out of 635 cases 447 (74.4% were thyroid. A numberof 56 (7.6% have primary hypothyroidism, 31 (4.2% have primary hyperthyroidism, 87 (11.8% have subclinical hypothyroidism, and 8 (1.1% have subclinical hyperthyroidism.

  17. Association of psycho-wellness with various blood types in young medical students

    Directory of Open Access Journals (Sweden)

    Anuradha Yadav

    2016-08-01

    Results: In the present study it was observed that majority of students belong to blood group B (39.38%, followed by blood group O (27.88%, A (27.66% and AB (7.08% respectively. Blood type A was more in red zone and more prone to PTSD (post traumatic syndrome disorders. Whereas blood type B was more prone to suicidal tendency. Proportion of psychomorbidity was found more in Rh+ than Rh (28.16% verse 15%. But these variations were statistically insignificant. Conclusions: Blood type A and Rh+ were more prone to psycho morbidity and and lsquo;B' for suicidal tendency, while O had least suicidal tendency but this variation was not found significant. So it can be concluded that there is no association between blood type and psycho wellness of individual. [Int J Res Med Sci 2016; 4(8.000: 3468-3472

  18. American Association of Oral and Maxillofacial Surgeons position paper on medication-related osteonecrosis of the jaw--2014 update.

    Science.gov (United States)

    Ruggiero, Salvatore L; Dodson, Thomas B; Fantasia, John; Goodday, Reginald; Aghaloo, Tara; Mehrotra, Bhoomi; O'Ryan, Felice

    2014-10-01

    Strategies for management of patients with, or at risk for, medication-related osteonecrosis of the jaw (MRONJ) were set forth in the American Association of Oral and Maxillofacial Surgeons (AAOMS) position papers in 2007 and 2009. The position papers were developed by a special committee appointed by the board and composed of clinicians with extensive experience in caring for these patients and basic science researchers. The knowledge base and experience in addressing MRONJ has expanded, necessitating modifications and refinements to the previous position paper. This special committee met in September 2013 to appraise the current literature and revise the guidelines as indicated to reflect current knowledge in this field. This update contains revisions to diagnosis, staging, and management strategies and highlights current research status. The AAOMS considers it vitally important that this information be disseminated to other relevant health care professionals and organizations.

  19. [Croatian Medical Association, Andrija Stampar and public health politics in the Kingdom of Serbs, Croats and Slovenians (Kingdom of Yugoslavia)].

    Science.gov (United States)

    Dugac, Zeljko

    2005-01-01

    The research on work of doctor Andrija Stampar (1888-1958) as the head of the Hygienic division of The Ministry of Public Health of the Kingdom of Serbs, Croats and Slovenians from 1919 till 1929-1931 is presented, as well as the influence of the Health Section of the League of Nations and Rockefeller Foundation. Special attention is also given to the resistance of practicing physicians around the Croatian Medical Association in Zagreb to Stampar's project of socialization of medicine. In addition, I will elaborate on the changing of the official public health politics after Stampar's dismissal from the Ministry in 1931, as well as the new changes connected with the founding of politically more independent province - Banovina Hrvatska in 1939. The article is mostly based on unpublished archival sources about the life and work of A. Stampar, as well as the documentation of Rockefeller Foundation.

  20. Levels of patient activation among adults with schizophrenia: associations with hope, symptoms, medication adherence, and recovery attitudes.

    Science.gov (United States)

    Kukla, Marina; Salyers, Michelle P; Lysaker, Paul H

    2013-04-01

    Patient activation, defined as one's attitudes and confidence toward managing illness, has been not been thoroughly studied in consumers with schizophrenia. The current study sought to understand the relationship between patient activation and symptoms, medication adherence, recovery attitudes, and hope in a sample of 119 adults with schizophrenia. The participants were enrolled in an 18-month randomized controlled study of the Illness Management and Recovery program. Data were collected at baseline; correlations and stepwise multiple regressions were used to examine the relationships and determine the unique contribution of variables. Higher patient activation was most strongly associated with positive recovery attitudes, higher levels of hope, and fewer emotional discomfort symptoms. Patient activation was significantly related to a broad measure of illness self-management, providing evidence for the construct validity of the patient activation measure. Our findings emphasize the importance of recovery-based mental health services that recognize level of patient activation as a potential factor in consumer outcomes.

  1. [Four and a half decades since Gynecologic-Obstretician Department was established as a part of Vojvodinian and Serbian Medical Association].

    Science.gov (United States)

    Draca, Petar

    2008-01-01

    Gynecologic-Obstetrician Section of Vojvodinian Medical Association was founded in 1961. One of its first assignments was to organize gynecologic-obstetrician service in the Province of Vojvodina, form general documentation register, modernize medical knowledge of doctors and improve proficiency and quality level of contemporary midwives. The expertise of gynecologists was in the second plan of importance because it had been, was and is still being developed through Gynecologic-Obstetrician Section of Serbian Medical Association. Special attention was given to general medical practitioners and midwives who used to work in delivery rooms out of hospitals, as well as to midwives who used to work at mother and child care institutions. The main idea was to decrease the level of morbidity and mortality in Province by increasing the level of knowledge. For contribution in the development of mother and child health care on the territory of the whole former Yugoslavia, in 1987 Croatian Medical Association gave acknowledgement diploma to Gynecologic-Obstetrician Department of Vojvodinian Medical Association. Some gynecologic-obstetrician departments started to organize meetings of gynecologic-obstetricians of Serbian Medical Association, which have grown into traditional assembly. Intersectional meetings were also held in Vojvodina, and several of them hosted famous national and international experts. The traditional assembly of Vojvodinian gynecologists is held every October in Novi Sad, regularly at the main auditorium of Matica Srpska Library. The most important expert event for Vojvodinian gynecologists was the first National Congress of Yugoslavian Gynecologist and Obstetricians that was held on the territory of Vojvodina. The organizer of 10th Yugoslavian Gynecologic-Obstetrician Congress was Gynecologic-Obstetrician Section of Vojvodinian Medical Association assigned by Yugoslavian Gynecologic-Obstetrician Association. The Congress was held from 4th to 7th of October

  2. Urological management (medical and surgical of BK-virus associated haemorrhagic cystitis in children following haematopoietic stem cell transplantation

    Directory of Open Access Journals (Sweden)

    Nikhil Vasdev

    2013-10-01

    Full Text Available Aim: Haemorrhagic cystitis (HC is uncommon and in its severe form potentially life threatening complication of Haematopoietic stem cell transplantation (HSCT in children. We present our single centre experience in the urological management of this clinically challenging condition. Patients and Methods: Fourteen patients were diagnosed with BK-Virus HC in our centre. The mean age at diagnosis was 8.8 years (range, 3.2-18.4 years. The mean number of days post-BMT until onset of HC was 20.8 (range, 1 – 51. While all patients tested urine positive for BKV at the clinical onset of HC, only four patients had viral quantification, with viral loads ranging from 97,000 to >1 billion/ml. 8 patients had clinical HC. Ten patients experienced acute GVHD (grade I: 6 patients, grade II: 3 patients, grade 4: 1 patient.Results: Four patients received medical management for their HC. Treatments included hyperhydration, MESNA, blood and platelet transfusion, premarin and oxybutynin (Table 6.  Two patients received both medical and surgical management which included cystoscopy with clot evacuation, bladder irrigation and supra-pubic catheter insertion. One patient received exclusive surgical management. Seven patients were treated conservatively. Conclusion: There is limited available evidence for other potential therapeutic strategies highlighting the need for more research into the pathophysiology of HSCT-associated HC. Commonly used interventions with possible clinical benefit (e.g. cidofovir, ciprofloxacin still require to be evaluated in multi-centre, high-quality studies. Potential future preventative and therapeutic options, such as modulation of conditioning, immunosuppression and engraftment, new antiviral and anti-inflammatory and less nephrotoxic agents need to be assessed.---------------------------Cite this article as:Vasdev N, Davidson A, Harkensee C, Slatter M, Gennery A, Willetts I, Thorpe A.Urological management (medical and surgical of BK

  3. Prevalence of unrecognized depression and associated factors among patients attending medical outpatient department in Adare Hospital, Hawassa, Ethiopia

    Directory of Open Access Journals (Sweden)

    Tilahune AB

    2016-10-01

    Full Text Available Asres Bedaso Tilahune,1 Gezahegn Bekele,1 Nibretie Mekonnen,2 Eyerusalem Tamiru2 1School of Nursing and Midwifery, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia; 2Department of Medical Case Team, Hawassa University Comprehensive Specialized Hospital, Hawassa, Ethiopia Abstract: Depression is an illness that involves the body, mood, and thoughts and that affects the way a person eats, sleeps, feels about him or herself and thinks about things. Depression is one of the most common mental disorders affecting 121 million people in the world, and it frequently goes unrecognized among patients. It is estimated that 5%–10% of the population at any given time is suffering from identifiable depression needing psychiatric or psychosocial intervention. An institution-based cross-sectional study design was implemented to determine the magnitude and associated factors of unrecognized depression among patients attending the adult medical outpatient department in Adare Hospital, Hawassa, Southern Nations, Nationalities, and Peoples’ Region, Ethiopia, among 326 patients selected using systematic random sampling technique. Data were collected using the interviewer-administered technique. A structured questionnaire was used to collect data on sociodemographic characteristics and other independent variables. Depression was assessed using the Patient Health Questionnaire 9. Data were entered and analyzed using SPSS 20. The level of significance was determined at P<0.05. About 326 patients were interviewed, of whom 186 (57.1% were males. The mean age of participant was 34 with standard deviation of ±13.1 years. Current substance users accounted for 106 (32.5% of the total participants. Of 326 respondents, 80 (24.5% had significant depressive symptoms, while the detection rate of depression by the clinician was 0%. Depression was associated with female sex (adjusted odds ratio [AOR] =1.63 [1.14–2.34], age >60 years (AOR =4

  4. Proceedings of the Annual Conference of the Military Testing Association (27th) Held in San Diego, California on 21-25 October 1985. Volume 1

    Science.gov (United States)

    1985-10-25

    and Development Center (NPRDC). The Conference was held at the Bahia Hotel in San Diego, California, 21 through 25 October 1985. A total of 169 paper...different xuthds of ensurrng job performance yield quite different results." Campbell at.o narris 1escro-be the results of attempting to interpret

  5. Digital Compilation of "Preliminary Map of Landslide Deposits in Santa Cruz County, California, By Cooper-Clark and Associates, 1975": A Digital Map Database

    Science.gov (United States)

    Report by Roberts, Sebastian; Barron, Andrew D.; Preface by Brabb, Earl E.; Pike, Richard J.

    1998-01-01

    A 1:62,500-scale black-and-white map identifying some 2,000 landslides of various types in Santa Cruz County, California, has been converted to a digital-map database that can be acquired from the U.S. Geological Survey over the Internet or on magnetic tape.

  6. Isolation of Campylobacter from feral swine (Sus scrofa) on the ranch associated with the 2006 Escherichia coli O157:H7 spinach outbreak investigation in California

    Science.gov (United States)

    We report the isolation of Campylobacter species from the same population of feral swine that was investigated in San Benito County, California during the 2006 spinach-related Escherichia coli O157:H7 outbreak. This is the first survey of Campylobacter in a free-ranging feral swine population in the...

  7. The Learning Objective Catalogue for Patient Safety in Undergraduate Medical Education – A Position Statement of the Committee for Patient Safety and Error Management of the German Association for Medical Education

    Directory of Open Access Journals (Sweden)

    Kiesewetter, Jan

    2016-02-01

    Full Text Available Background: Since the report “To err is human” was published by the Institute of Medicine in the year 2000, topics regarding patient safety and error management are in the focal point of interest of science and politics. Despite international attention, a structured and comprehensive medical education regarding these topics remains to be missing.Goals: The Learning Objective Catalogue for Patient Safety described below the Committee for Patient Safety and Error Management of the German Association for Medical Education (GMA has aimed to establish a common foundation for the structured implementation of patient safety curricula at the medical faculties in German-speaking countries. Methods: The development the Learning Objective Catalogue resulted via the participation of 13 faculties in two committee meetings, two multi-day workshops, and additional judgments of external specialists.Results: The Committee of Patient Safety and Error Management of GMA developed the present Learning Objective Catalogue for Patient Safety in Undergraduate Medical Education, structured in three chapters: , and . The learning objectives within the chapters are organized on three levels with a hierarchical organization of the topics. Overall, the Learning Objective Catalogue consists of 38 learning objectives. All learning objectives are referenced with the National Competency-based Catalogue of Learning Objectives for Undergraduate Medical Education.Discussion: The Learning Objective Catalogue for Patient Safety in Undergraduate Medical Education is a product that was developed through collaboration of members from 13 medical faculties. In the German-speaking countries, the Learning Objective Catalogue should advance discussion regarding the topics of patient safety and error management and help develop subsequent educational structures. The Learning Objective Catalogue for Patient Safety can serve as a common ground for an intensified, constructive, subject

  8. 'A matter of conscience': the moral authority of the World Medical Association and the readmission of the South Africans, 1976-1994.

    Science.gov (United States)

    Mbali, Mandisa

    2014-04-01

    This article describes the role of transnational anti-apartheid activism in South Africa, Britain and the United States in generating international moral outrage over the readmission of the Medical Association of South Africa (MASA) to the World Medical Association (WMA), which had taken place in 1981 after it had withdrawn from that body in 1976. It discusses an example of a controversy where an international health organisation (IHO) lost moral authority as a result of being accused of white supremacy and a pro-American engagement in Cold War politics. At the time of its readmission to the WMA, the MASA was controversial because of its failure to strike off its membership roll one of the doctors implicated the death in detention of Black Consciousness leader Steve Biko in 1977. It details how these activists viewed the American Medical Association as having campaigned for the MASA's readmission. The WMA's readmission of the MASA cost the former its relationships with the World Health Organisation (WHO) and the British Medical Association - a dispute which continued until South Africa's democratic transition of 1994. With its focus on transnational activism in relation to the WMA and the effects of activists' allegations of racism on its internal politics, this article contributes to the literature on the history of IHOs. Ultimately, this controversy shows the deficiency of international medical professional associations as ethical arbitrators of last resort.

  9. Reporting of financial conflicts of interest in clinical practice guidelines: a case study analysis of guidelines from the Canadian Medical Association Infobase

    OpenAIRE

    Shnier, Adrienne; Lexchin, Joel; Romero, Mirna; Brown, Kevin

    2016-01-01

    Background Clinical practice guidelines are widely distributed by medical associations and relied upon by physicians for the best available clinical evidence. International findings report that financial conflicts of interest (FCOI) with drug companies may influence drug recommendations and are common among guideline authors. There is no comparable study on exclusively Canadian guidelines; therefore, we provide a case study of authors’ FCOI declarations in guidelines from the Canadian Medical...

  10. National Assessment of Shoreline Change Part 3: Historical Shoreline Change and Associated Coastal Land Loss Along Sandy Shorelines of the California Coast

    Science.gov (United States)

    Hapke, Cheryl J.; Reid, David; Richmond, Bruce M.; Ruggiero, Peter; List, Jeff

    2006-01-01

    Beach erosion is a chronic problem along many open-ocean shores of the United States. As coastal populations continue to grow and community infrastructures are threatened by erosion, there is increased demand for accurate information regarding past and present trends and rates of shoreline movement. There is also a need for a comprehensive analysis of shoreline movement that is consistent from one coastal region to another. To meet these national needs, the U.S. Geological Survey is conducting an analysis of historical shoreline changes along open-ocean sandy shores of the conterminous United States and parts of Hawaii and Alaska. One purpose of this work is to develop standard repeatable methods for mapping and analyzing shoreline movement so that periodic updates regarding coastal erosion and land loss can be made nationally that are systematic and internally consistent. In the case of this study, the shoreline being measured is the boundary between the ocean water surface and the sandy beach. This report on the California Coast represents the first of two reports on long-term sandy shoreline change for the western U.S., the second of which will include the coast of the Pacific NW, including Oregon and Washington. A report for the Gulf of Mexico shoreline was completed in 2004 and is available at: http://pubs.usgs.gov/of/2004/1043/. This report summarizes the methods of analysis, interprets the results, provides explanations regarding long-term and short-term trends and rates of change, and describes how different coastal communities are responding to coastal erosion. Shoreline change evaluations are based on comparing three historical shorelines digitized from maps, with a recent shoreline derived from lidar (Light Detection and Ranging) topographic surveys. The historical shorelines generally represent the following periods: 1800s, 1920s-1930s, and 1950s-1970s, whereas the lidar shoreline is from 1998-2002. Long-term rates of change are calculated using all

  11. Ecoregions of California

    Science.gov (United States)

    Griffith, Glenn E.; Omernik, James M.; Smith, David W.; Cook, Terry D.; Tallyn, Ed; Moseley, Kendra; Johnson, Colleen B.

    2016-02-23

    (2000), and Omernik and Griffith (2014).California has great ecological and biological diversity. The State contains offshore islands and coastal lowlands, large alluvial valleys, forested mountain ranges, deserts, and various aquatic habitats. There are 13 level III ecoregions and 177 level IV ecoregions in California and most continue into ecologically similar parts of adjacent States of the United States or Mexico (Bryce and others, 2003; Thorson and others, 2003; Griffith and others, 2014).The California ecoregion map was compiled at a scale of 1:250,000. It revises and subdivides an earlier national ecoregion map that was originally compiled at a smaller scale (Omernik, 1987; U.S. Environmental Protection Agency, 2013). This poster is the result of a collaborative project primarily between U.S. Environmental Protection Agency (USEPA) Region IX, USEPA National Health and Environmental Effects Research Laboratory (Corvallis, Oregon), California Department of Fish and Wildlife (DFW), U.S. Department of Agriculture (USDA)–Natural Resources Conservation Service (NRCS), U.S. Department of the Interior–Geological Survey (USGS), and other State of California agencies and universities.The project is associated with interagency efforts to develop a common framework of ecological regions (McMahon and others, 2001). Reaching that objective requires recognition of the differences in the conceptual approaches and mapping methodologies applied to develop the most common ecoregion-type frameworks, including those developed by the USDA–Forest Service (Bailey and others, 1994; Miles and Goudy, 1997; Cleland and others, 2007), the USEPA (Omernik 1987, 1995), and the NRCS (U.S. Department of Agriculture–Soil Conservation Service, 1981; U.S. Department of Agriculture–Natural Resources Conservation Service, 2006). As each of these frameworks is further refined, their differences are becoming less discernible. Regional collaborative projects such as this one in California

  12. The ATXN2-SH2B3 locus is associated with peripheral arterial disease: an electronic medical record-based genome-wide association study

    Directory of Open Access Journals (Sweden)

    Iftikhar eKullo

    2014-06-01

    Full Text Available Objectives: In contrast to coronary heart disease, genetic variants that influence susceptibility to peripheral arterial disease (PAD remain unknown. Background: We performed a two-stage genomic association study leveraging an electronic medical record linked-biorepository to identify genetic variants that mediate susceptibility to PAD.Methods: PAD was defined as a resting/post-exercise ankle-brachial index (ABI ≤0.9 or ≥1.4 and/or history of lower extremity revascularization. Controls were patients without history of PAD. In Stage I we performed a genome-wide association analysis adjusting for age and sex, of 561,490 SNPs in 1641 PAD cases (66±11 y, 64% men and 1604 control subjects (61±7 y, 60% men of European ancestry. In Stage II we genotyped the top 48 SNPs that were associated with PAD in Stage I, in a replication cohort of 740 PAD cases (70±11 y, 63% men and 1051 controls (70±12 y, 61% men. Results: The SNP rs653178 in the ATXN2-SH2B3 locus was significantly associated with PAD in the discovery cohort (OR: 1.23; P=5.59x10-5, in the replication cohort (OR=1.22; 8.9x10-4 and in the combined cohort (OR=1.22; P-value: P=6.46x10-7. In the combined cohort this SNP remained associated with PAD after additional adjustment for cardiovascular risk factors including smoking (OR: 1.22; P=2.15x10-6 and after excluding patients with ABI >1.4 (OR: 1.237; P=3.98x10-7. The SNP is in near-complete linkage disequilibrium (r2=0.99 with a missense SNP (rs3184504 in SH2B3, a gene encoding an adapter protein that plays a key role in immune and inflammatory response pathways and vascular homeostasis. The SNP has pleiotropic effects and has been previously associated with multiple phenotypes including myocardial infarction. Conclusions: Our findings suggest that the ATXN2-SH2B3 locus influences susceptibility to PAD.

  13. Analysis of Medical Domain Using CMARM: Confabulation Mapreduce Association Rule Mining Algorithm for Frequent and Rare Itemsets

    Directory of Open Access Journals (Sweden)

    Dr. Jyoti Gautam

    2015-11-01

    Full Text Available In Human Life span, disease is a major cause of illness and death in the modern society. There are various factors that are responsible for diseases like work environment, living and working conditions, agriculture and food production, housing, unemployment, individual life style etc. The early diagnosis of any disease that frequently and rarely occurs with the growing age can be helpful in curing the disease completely or to some extent. The long-term prognosis of patient records might be useful to find out the causes that are responsible for particular diseases. Therefore, human being can take early preventive measures to minimize the risk of diseases that may supervene with the growing age and hence increase the life expectancy chances. In this paper, a new CMARM: Confabulation-MapReduce based association rule mining algorithm is proposed for the analysis of medical data repository for both rare and frequent itemsets using an iterative MapReduce based framework inspired by cogency. Cogency is the probability of the assumed facts being true if the conclusion is true, means it is based on pairwise item conditional probability, so the proposed algorithm mine association rules by only one pass through the file. The proposed algorithm is also valuable for dealing with infrequent items due to its cogency inspired approach.

  14. [On the problem of traumatic shock associated with a combined injury (based on the materials of one forensic medical expertise)].

    Science.gov (United States)

    Volkov, V P

    2012-01-01

    The author presents the results of the critical analysis of the materials of forensic medical expertise of a case of the serious harm to health that has led to involunry manslaughter. According to the expert opinion, the death resulted from the traumatic shock associated with the combined head and the chest injury. Such conclusion levels out the difference between the two accused persons and their "contribution" to the extent and severity of the inflicted damage to the victim's body; thereby, it equalizes the degree of their guilt and criminal responsibility. The present study showed that such interpretation of tanatogenesis associated with the combined injury is erroneous. The death of the injured person resulted from cerebral coma that developed following a severe craniocerebral injury as a constituent component of the combined trauma. It is emphasized that the thorough investigation of tanatogenesis based on the reliable elucidation of the immediate cause of death makes it possible to avoid poorly substantiated expert conclusions and their potential dire legal consequences.

  15. Suicidal Behavior Among People Living with HIV (PLHIV) in Medical Care in Estonia and Factors Associated with Receiving Psychological Treatment.

    Science.gov (United States)

    Lemsalu, Liis; Rüütel, Kristi; Laisaar, Kaja-Triin; Lõhmus, Liilia; Raidvee, Aire; Uusküla, Anneli

    2016-09-24

    People living with HIV (PLHIV) have higher rates of suicidal behavior than the general population. This study assessed suicidal behavior (ideation and/or attempts, ever and in the past 12 months) among PLHIV receiving outpatient HIV medical care in Estonia and associations between suicidal behavior and psychological treatment. The cross-sectional study collected data from January to November 2013 using a self-report questionnaire. Eight hundred PLHIV participated, 39 % (n = 306) of whom had been suicidal. Lifetime prevalence was 36 % for suicidal ideation and 20 % for attempts. Younger age, incarceration, having ever abused alcohol and also injected drugs, having lived with HIV for more than 10 years, and being depressed were associated with lifetime suicidal behavior. Suicidal behavior within the past 12 months was reported by 20 % (n = 156) of respondents. Of these, 27 % received psychological treatment (counseling and/or psychotherapy), 20 % had taken antidepressants, and 49 % sedatives. Individuals perceiving a need for treatment were significantly more likely to receive psychological treatment when experiencing suicidal behavior (OR 25.65, 95 % CI 2.92-225.47). In conclusion, suicidal behavior is frequent among PLHIV but psychological treatment is not often received. One of the barriers to treatment is patients' lack of perceived need for help.

  16. Identification, pathogenicity and abundance of Paracremonium pembeum sp. nov. and Graphium euwallaceae sp. nov.--two newly discovered mycangial associates of the polyphagous shot hole borer (Euwallacea sp.) in California.

    Science.gov (United States)

    Lynch, Shannon Colleen; Twizeyimana, Mathias; Mayorquin, Joey Sal; Wang, Danny Ho; Na, Francis; Kayim, Mukaddes; Kasson, Matthew T; Thu, Pham Quang; Bateman, Craig; Rugman-Jones, Paul; Hulcr, Jiri; Stouthamer, Richard; Eskalen, Akif

    2016-01-01

    Fusarium euwallaceae is a well-characterized fungal symbiont of the exotic ambrosia beetle Euwallacea sp. (polyphagous shot hole borer [PSHB]), together inciting Fusarium dieback on many host plants in Israel and California. Recent discoveries of additional fungal symbionts within ambrosia beetle mycangia suggest these fungi occur as communities. Colony-forming units of Graphium euwallaceae sp. nov. and Paracremonium pembeum sp. nov., two novel fungal associates of PSHB from California, grew from 36 macerated female heads and 36 gallery walls collected from Platanus racemosa, Acer negundo, Persea americana and Ricinus communis. Fungi were identified based on micromorphology and phylogenetic analyses of the combined internal transcribed spacer region (nuc rDNA ITS1-5.8S-ITS2 [ITS barcode]), elongation factor (EF 1-α), small subunit (18S rDNA) sequences for Graphium spp., ITS, EF 1-α, calmodulin (cmdA), large subunit of the ATP citrate lyase (acl1), β-tubulin (tub2), RNA polymerase II second largest subunit (rpb2) and large subunit (28S rDNA) sequences for Paracremonium spp. Other Graphium spp. recovered from PSHB in Vietnam, Euwallacea fornicatus in Thailand, E. validus in Pennsylvania and Paracremonium sp. recovered from PSHB in Vietnam were identified. F. euwallaceae was recovered from mycangia at higher frequencies and abundances in all hosts except R. communis, in which those of F. euwallaceae and P. pembeum were equal. P. pembeum was relatively more abundant within gallery walls of A. negundo and R. communis. In all hosts combined F. euwallaceae was relatively more abundant within PSHB heads than gallery walls. All three fungi grew at different rates and colonized inoculated excised stems of P. americana and A. negundo. P. pembeum produced longer lesions than F. euwallaceae and G. euwallaceae on inoculated avocado shoots. Results indicate PSHB is associated with a dynamic assemblage of mycangial fungal associates that pose additional risk to native and

  17. Estimates of Maternal Mortality Ratio and the associated medical causes in Orissa and Rajasthan States - A cross sectional study

    Directory of Open Access Journals (Sweden)

    Abha Rani Aggarwal

    2015-03-01

    Full Text Available Background: Maternal Mortality Ratio (MMR is an important indicator of reproductive health and its reduction remains a challenge in India. Aims &Objective: This study was conducted with the aim of estimating MMR in two states Orissa and Rajasthan having high MMR as well as to identify the associated medical causes of maternal mortality. Material Methods: This survey was conducted from October 2010-June 2012 on a sample of 13 Primary Health Centres (PHCs in Orissa and 15 PHCs in Rajasthan. These numbers have been derived after estimating the total number of live births using MMR and birth rate from Sample Registration System. 1997-2003.An adapted snowball technique was adopted wherein maternal deaths were captured by snowball technique and the numbers of live births were taken from the available records from the various health facilities in the study.  Results: The overall birth rate in Orissa was found to be 19 per 1000 population while in Rajasthan it was 24 per 1000 population. The study revealed that 17% additional maternal deaths could be captured by snowball technique as against the official record. The overall weighted estimate of MMR was 252 per one lakh live births (95% CI: 246-259 per 1,00,000 live births in Orissa and 209 per one lakh live births (95% CI: 207-211 per one lakh live births in Rajasthan. The main causes of maternal deaths were post-partum haemorrhage, anaemia and septicaemia. More than 25% maternal deaths could be attributed to indirect causes including suicide, accident and infectious diseases. Conclusion: There appears to be a positive trend towards reduction of maternal mortality in Orissa and Rajasthan. Greater care is essential to reduce medical as well as incidental causes of death during pregnancy.

  18. Traditional and Host-Associated Fecal Indicator Bacterial Patterns in Southern California Watersheds: Field Source Identification Studies and Laboratory Microcosms Investigating Presence and Persistence in Water and Sediments

    Science.gov (United States)

    Mika, Kathryn Beth

    Overall, recreational beach water quality remains an issue of concern in Southern California and across the globe. Many factors come into play when determining water quality, including physical issues such as the myriad sources that contribute pollution to the site and financial and political issues that control the way water quality is monitored and determined. Current national regulations require the monitoring of fecal indicator bacteria in order to determine recreational water quality. However, it is also important to identify biological and geographical sources of pollution to consistently impaired locations. A commonly applied approach to meet the goals of source identification is to sample sites that have been high in FIB for further study. A tiered approach such as this, however, assumes a correlation between FIB and the sources of interest in the watershed. The research described in this dissertation tests this assumption in two Southern California watersheds, Santa Monica Canyon and Ventura Harbor. In both cases, a tiered approach to sampling using FIB as a first tier to guide sampling would have failed to identify sources of human fecal pollution (as identified by the presence of the human-associated Bacteroides marker HF183). Every watershed is a distinct environment that has different potential sources of bacteria and many factors contributing to the persistence of the bacteria. Rather than attempting to apply an indicator that has worked as a first tier in other watersheds, it would be better to have as a first tier an in-depth study of the watershed using historical data or local experts to provide information on the most likely sources of pollution in the watershed. Using this information it would be possible to design a study using FIB and one or more source-associated parameters to identify specific sources of pollution in the watershed. In addition, sampling FIB and other parameters such as HF183 allow the application of other microbial source

  19. California Condor Critical Habitat

    Data.gov (United States)

    California Department of Resources — These Data identify (in general) the areas where critical habitat for the California Condor occur. Critical habitat for the species consists of the following 10...

  20. Environmental Assessment for the Demolition Associated with and the Construction of the Logistics Operations Resource Center, Los Angeles Air Force Base, California

    Science.gov (United States)

    2006-02-13

    Exchange Services AQMP Air Quality Management Plan ASHRAE American Society of Heating, Refrigerating, arrl Air Conditioning Engineers AT-FP Anti...in the SCAQMD’s California Environmental Quality Act (CEQA) Air Quality Handbook , April 1993 (Table 3.l.2). They include significant emissions...Section 3: Affected Environment in sound above the baseline levels below will be used as our threshold of sign_ifi.cance ( Handbook of Environmental

  1. Greater striatal responses to medication in Parkinson׳s disease are associated with better task-switching but worse reward performance.

    Science.gov (United States)

    Aarts, Esther; Nusselein, Abraham A M; Smittenaar, Peter; Helmich, Rick C; Bloem, Bastiaan R; Cools, Roshan

    2014-09-01

    Dopaminergic medication in Parkinson's disease has been proposed to improve cognitive processing by modulating the severely depleted dorsal striatum, while impairing reward processing by modulating the relatively intact ventral striatum. However, there is no direct (neural) evidence for this hypothesis. Here we fill this gap by scanning Parkinson's disease patients (n=15) ON and relatively OFF their dopaminergic medication using functional magnetic resonance imaging. During scanning, patients performed a task that enabled the simultaneous measurement of task-switching and reward-related processing. Brain-behavior correlations revealed that medication-related increases (ON-OFF) in switch-related BOLD signal (switch-repeat) in the dorsomedial striatum were associated, on an individual basis, with improvements in task-switching (i.e. a decreased switch cost). Conversely, medication-related increases (ON-OFF) in reward-related BOLD signal (high-low) in the ventromedial striatum were associated, on an individual basis, with impairments in performance in anticipation of reward (i.e. an increased reward cost). Linear regression analyses demonstrated that the positive relationship between medication-related changes in BOLD and the reward cost was unique to the ventromedial striatum, whereas the negative relationship between medication-related changes in BOLD and the switch cost was not unique to the dorsomedial striatum. These findings extend the dopamine overdose hypothesis, according to which dopamine-induced changes in dorsal and ventral striatal processing lead to cognitive improvement and impairment respectively.

  2. Medical Library Association

    Science.gov (United States)

    ... Speed Ahead and Other News Librarians without Borders® HINARI and Internet Resources Workshop Report Bhutan: September 5- ... 2016 September 5-6 and 7-8, 2016 HINARI and Internet Resources Workshop conducted at Keysar Gyalpo ...

  3. National Medical Association

    Science.gov (United States)

    ... Regional Meetings CME Fall Workshop Approved CME Activities Journal CME Quiz Online CME Submit an Abstract Faculty and Invited Speakers Policies and Procedures CME Resource Links Contact CME Resources Journal of the NMA Programs Overview Programmatic Initiatives National ...

  4. American Veterinary Medical Association

    Science.gov (United States)

    ... safe for both people and pets. Education Standards Veterinary Education Standards The AVMA Council on Education is ... comments on proposed changes to several of its veterinary college accreditation standards. Comments are due Dec. 1. ​ ...

  5. Three types of self-efficacy associated with medication adherence in patients with co-occurring HIV and substance use disorders, but only when mood disorders are present

    Directory of Open Access Journals (Sweden)

    Reif S

    2013-06-01

    Full Text Available Susan Reif,1 Rae Jean Proeschold-Bell,1,2 Jia Yao,1 Sara LeGrand,1,2 Anna Uehara,2 Edgar Asiimwe,2 Evelyn Byrd Quinlivan31Duke Center for Health Policy and Inequalities Research, 2Duke Global Health Institute, Duke University, Durham, NC, 3Center for Infectious Diseases, University of North Carolina Chapel Hill, Chapel Hill, NC, USABackground: Adherence with medication regimens for human immunodeficiency virus (HIV is a life-saving behavior for people with HIV infection, yet adherence is challenging for many individuals with co-occurring substance use and/or mood disorders. Medication-taking self-efficacy, which is the confidence that one can take one's medication as prescribed, is associated with better adherence with HIV medication. However, little is known about the influence that other kinds of self-efficacy have on adherence with HIV medication, especially among HIV-infected individuals with co-occurring substance use and/or mood disorders. We sought to examine the relationship between adherence with HIV medication among substance users and three specific kinds of self-efficacy, ie, one's confidence that one can communicate with medical providers, get support, and manage one's mood. We further sought to examine whether symptoms of depression and anxiety moderate these relationships.Methods: Patients were recruited from three HIV clinics in the southeastern United States as part of an integrated study of treatment for HIV and substance use.Results: We interviewed 154 patients with HIV and substance use who reported taking HIV medications. Based on symptoms of depression and anxiety using the Patient Health Questionnaire-9 and the Hospital Anxiety and Depression Scale-Anxiety, 63% had probable depression and/or anxiety. Higher levels of self-efficacy in provider communication (β = 3.86, P < 0.01, getting needed support (β = 2.82, P < 0.01, and mood management (β = 2.29, P < 0.05 were related to better self-reported adherence with HIV

  6. Medical expenditures associated with major depressive disorder among privately insured working-age adults with diagnosed diabetes in the United States, 2008

    Science.gov (United States)

    Shrestha, Sundar S.; Zhang, Ping; Li, Rui; Thompson, Theodore J.; Chapman, Daniel P.; Barker, Lawrence

    2017-01-01

    Aim We aimed at estimating excess medical expenditures associated with major depressive disorder (MDD) among working-age adults diagnosed with diabetes, disaggregated by treatment mode: insulin-treated diabetes (ITDM) or non-insulin-treated diabetes (NITDM). Methods We analyzed data for over 500,000 individuals with diagnosed diabetes from the 2008 U.S. MarketScan claims database. We grouped diabetic patients first by treatment mode (ITDM or NITDM), then by MDD status (with or without MDD), and finally by whether those with MDD used antidepressant medication. We estimated annual mean excess outpatient, inpatient, prescription drug, and total expenditures using regression models, controlling for demographics, types of health coverage, and comorbidities. Results Among persons having ITDM, the estimated annual total mean expenditure for those with no MDD (the comparison group) was $19,625. For those with MDD, the expenditures were $12,406 (63%) larger if using antidepressant medication and $7322 (37%) larger if not using antidepressant medication. Among persons having NITDM, the corresponding estimated expenditure for the comparison group was $10,746, the excess expenditures were $10,432 (97%) larger if using antidepressant medication and $5579 (52%) larger if not using antidepressant medication, respectively. Inpatient excess expenditures were the largest of total excess expenditure for those with ITDM and MDD treated with antidepressant medication; for all others with diabetes and MDD, outpatient expenditures were the largest excess expenditure. Conclusions Among working-age adults with diabetes, MDD was associated with substantial excess medical expenditures. Implementing the effective interventions demonstrated in clinical trials and treatment guidelines recommended by professional organizations might reduce the economic burden of MDD in this population. PMID:23490596

  7. Ototoxic Medications (Medication Effects)

    Science.gov (United States)

    ... Information for the Public / Hearing and Balance Ototoxic Medications (Medication Effects) By Barbara Cone, Patricia Dorn, Dawn Konrad- ... Audiology Information Series [PDF]. What Is Ototoxicity? Certain medications can damage the ear, resulting in hearing loss, ...

  8. Expanding insurance coverage through tax credits, consumer choice, and market enhancements: the American Medical Association proposal for health insurance reform.

    Science.gov (United States)

    Palmisano, Donald J; Emmons, David W; Wozniak, Gregory D

    2004-05-12

    Recent reports showing an increase in the number of uninsured individuals in the United States have given heightened attention to increasing health insurance coverage. The American Medical Association (AMA) has proposed a system of tax credits for the purchase of individually owned health insurance and enhancements to individual and group health insurance markets as a means of expanding coverage. Individually owned insurance would enable people to maintain coverage without disruption to existing patient-physician relationships, regardless of changes in employers or in work status. The AMA's plan would empower individuals to choose their health plan and give patients and their physicians more control over health care choices. Employers could continue to offer employment-based coverage, but employees would not be limited to the health plans offered by their employer. With a tax credit large enough to make coverage affordable and the ability to choose their own coverage, consumers would dramatically transform the individual and group health insurance markets. Health insurers would respond to the demands of individual consumers and be more cautious about increasing premiums. Insurers would also tailor benefit packages and develop new forms of coverage to better match the preferences of individuals and families. The AMA supports the development of new health insurance markets through legislative and regulatory changes to foster a wider array of high-quality, affordable plans.

  9. A Survey of eye discomfort and headache associated with computer use among dormitory students of Tehran University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    2012-12-01

    Full Text Available Introduction: Eye discomforts and headache are prevalent among computer users. The aim of present study was to determine eye discomforts and headache associated with computer use among dormitory students of Tehran University of Medical Sciences. .Material and Method: In this cross – sectional study, data were collected using MIRTH (Musculo skeletal Injury Reduction Tools for Health and Safety questionnaire. The results were Analyzed using SPSS Software and with descriptive statistical indexes as well as correlation test. .Result: of the 744 distributed questionnaires, 631 students completed the questionnaire (84.4%. The mean age for the studied population was 22.72± 3.6 years. The relative frequency of eye discomforts for the female and male student was 76.38% and 70.11% respectively. The correlation test showed significant relationship between eye discomforts as well as headache with gender, work hours’ with a computer per day and glass use (P-V < 0.05. Also, the correlation between eye discomforts and headache was statistically significant (P-V < 0.01. .Conclusion: Eye discomforts and headache relating to the computer uses are prevalent among students. The condition is more prevalent among females and prolonged computer users. Interventional and training programs should be considered to prevent and reduction of related problems.

  10. A CROSS-SECTIONAL STUDY ON THE PREVALENCE OF SELF-MEDICATION PRACTICES AND ITS ASSOCIATED FACTORS AMONG HOUSEWIVES IN RURAL AREAS OF ERNAKULAM DISTRICT

    Directory of Open Access Journals (Sweden)

    Kesley Elsa

    2016-06-01

    Full Text Available BACKGROUND Self-medication can be defined as obtaining and consuming drugs without the advice of a physician. There is a lot of public and professional concern about the irrational use of drugs in Self Medication. Even if self-medication helps in reducing the burden on the health care system to a certain extent, it can lead to severe problems like antimicrobial resistance and addictions. This study will provide useful insight on the reasons for which patients resort to this practice and might help the policy makers and regulatory authorities to streamline the process of drug regulations and safety issues of over-the-counter drugs. This study also focuses on the attitude of people, who follow the practice of self-medication. Self-medication in modern pharmaceuticals seems to be a field in which information is scarce and to the best of our knowledge there is limited research conducted to reveal the extent of this problem in our community. OBJECTIVE To find out the prevalence of self-medication among housewives and to study the associated factors in rural areas of Ernakulum district. METHODOLOGY The rural areas selected for the study was the field areas of MOSC Medical College, Kolencherry; 163 subjects were studied (With P=71% from a study conducted on self-medication practices in coastal regions of South India. 1 . Cluster sampling was used to select subjects and data was collected using pretested interviewer administered questionnaire from those who signed the informed written consent. Data was entered using EPI INFO software and analysis was done using appropriate statistical tools. (Prevalence, probabilities, confidence limits were calculated. RESULTS AND CONCLUSIONS The prevalence of self-medication among housewives was 57.67% and included analgesics (81.9%, antacids (31.91% and antibiotics were only used by 4.26%.

  11. Associated Clinical Disorders Diagnosed by Medical Specialists in 188 FMR1 Premutation Carriers Found in the Last 25 Years in the Spanish Basque Country: A Retrospective Study

    Science.gov (United States)

    Merino, Sonia; Ibarluzea, Nekane; Maortua, Hiart; Prieto, Begoña; Rouco, Idoia; López-Aríztegui, Maria-Asunción; Tejada, Maria-Isabel

    2016-01-01

    Fragile X-associated tremor/ataxia syndrome (FXTAS) and fragile X-associated primary ovarian insufficiency (FXPOI) are definitely related to the fragile X mental retardation 1 (FMR1) premutation (PM). Additional medical problems have also been associated with the PM, such as fibromyalgia, endocrine, and psychiatric disorders. To improve our understanding in the field, we reviewed all PM carriers and their reasons for any medical referrals from 104 fragile X families molecularly diagnosed in our laboratory and living in the Spanish Basque Country. After signing the written informed consent, we studied their electronic medical records in order to identify the disorders associated with the PM and their frequencies. We obtained clinical data in 188 PM carriers (147 women and 41 men). In women, the frequency of FXPOI (22.61%) was similar to that previously reported in PM carriers. In men, the frequency of definite FXTAS (28.57%) was lower than reported elsewhere. Furthermore, thyroid pathology was associated with the PM, the frequency of hypothyroidism being much higher in the studied region than in the general population (8.84% vs. 0.93%). Finally, we found no association with fibromyalgia or psychiatric problems. These findings represent another population contribution in this field and may be useful for the clinical management of PM carriers. PMID:27775646

  12. COPD exacerbations associated with the modified Medical Research Council scale and COPD assessment test among Humana Medicare members

    Directory of Open Access Journals (Sweden)

    Pasquale MK

    2016-01-01

    Full Text Available Margaret K Pasquale,1 Yihua Xu,1 Christine L Baker,2 Kelly H Zou,3 John G Teeter,4 Andrew M Renda,5 Cralen C Davis,1 Theodore C Lee,6 Joel Bobula2 1Comprehensive Health Insights, Inc., Humana Inc., Louisville, KY, 2Outcomes and Evidence, Global Health & Value, Pfizer Inc., 3Statistical Center for Outcomes, Real-World and Aggregate Data, Global Innovative Pharma Business, Pfizer Inc., New York, NY, 4Global Medical Development, Global Innovative Pharma Business, Pfizer Inc., Groton, CT, 5Retail Strategy & Execution, Humana Inc., Louisville, KY, 6Global Medical Affairs, Global Innovative Pharma Business, Pfizer Inc., New York, NY, USA Background: The Global initiative for chronic Obstructive Lung Disease guidelines recommend assessment of COPD severity, which includes symptomatology using the modified Medical Research Council (mMRC or COPD assessment test (CAT score in addition to the degree of airflow obstruction and exacerbation history. While there is great interest in incorporating symptomatology, little is known about how patient reported symptoms are associated with future exacerbations and exacerbation-related costs.Methods: The mMRC and CAT were mailed to a randomly selected sample of 4,000 Medicare members aged >40 years, diagnosed with COPD (≥2 encounters with International Classification of Dis­eases-9th Edition Clinical Modification: 491.xx, 492.xx, 496.xx, ≥30 days apart. The exacerbations and exacerbation-related costs were collected from claims data during 365-day post-survey after exclusion of members lost to follow-up or with cancer, organ transplant, or pregnancy. A logistic regression model estimated the predictive value of exacerbation history and symptomatology on exacerbations during follow-up, and a generalized linear model with log link and gamma distribution estimated the predictive value of exacerbation history and symptomatology on exacerbation-related costs.Results: Among a total of 1,159 members who returned the

  13. Associations between oral and ocular dryness, labial and whole salivary flow rates, systemic diseases and medications in a sample of older people

    DEFF Research Database (Denmark)

    Smidt, Dorte; Torpet, Lis Andersen; Nauntofte, Birgitte

    2011-01-01

    to the Anatomical therapeutic chemical (ATC) classification system), tobacco and alcohol consumption were registered, and unstimulated labial (LS) and unstimulated (UWS) and chewing-stimulated (SWS) whole salivary flow rates were measured in 668 randomly selected community-dwelling elderly aged 65–95. Results...... number of diseases and medications, but neither with age and gender per se nor with tobacco and alcohol consumption. New detailed information concerning associations between medications and oral and ocular dryness has been obtained using the ATC classification system....

  14. Effects of antihistamine and anti-inflammatory medication use on risk of specific glioma histologies

    OpenAIRE

    Scheurer, Michael E.; Amirian, E. Susan; Davlin, Stacy L.; Rice, Terri; Wrensch, Margaret; Melissa L. Bondy

    2011-01-01

    Several studies have shown a decrease in glioma risk associated with a personal history of allergic conditions and the medications used to treat the symptoms. However, few studies have been able to examine risk within histological subgroups of glioma. Case-control data from M. D. Anderson Cancer Center and University of California, San Francisco were pooled to conduct the analysis stratified by histological subtype. A risk prediction model considering inflammation-related variables and antihi...

  15. Associations of Undergoing a Routine Medical Examination or Not with Prevalence Rates of Hypertension and Diabetes Mellitus: A Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Lin Zhang

    2016-06-01

    Full Text Available Background: Undergoing a routine medical examination may be associated with the prevalence rate of chronic diseases from a population-based household interview survey. However, this important issue has not been examined so far. Methods: Data came from the first health service household interview of Hunan province, China, in 2013. A Rao–Scott chi-square test was performed to examine the difference in prevalence rates between subgroups. Adjusted odds ratio (OR was calculated using the PROC SURVEYLOGISTIC procedure of SAS9.1 statistical software. Results: In total, 24,282 residents of 8400 households were surveyed. A higher proportion of elderly adults had undergone a medical examination within the prior 12 months compared with young adults (≥65 years, 60%; 45–64 years, 46%; 18–44 years, 37%. After controlling for location, sex, and household income per capita, undergoing a medical examination was significantly associated with high prevalence rates of hypertension (adjusted OR: 2.0, 95% CI: 1.1–3.5 and of diabetes mellitus (adjusted OR: 3.3, 95% CI: 1.7–6.5 for young adults aged 18–44 years. The associations were not statistically significant for age groups 45–64 years and 65 years or older. Conclusion: The prevalence rates of hypertension and diabetes mellitus may be seriously underestimated for young adults not undergoing a routine medical examination in a health household interview survey.

  16. 摒除利益保护藩篱,回归法律公正本位*--医学会医疗损害鉴定职能的反思与重构%Remove Hedge of Interests Protection,Return to Justice of Judicial Law:Reflection and Reconstruction on Function of Medical Damage Appraisal of Medical Association

    Institute of Scientific and Technical Information of China (English)

    曾恩泉; 陈伯礼; 邓振华; 陈红

    2015-01-01

    医学会属于医疗行业协会,其职责是促进医学科学发展、维护医疗机构和医务人员利益,而医疗损害鉴定具有司法性质,应保障鉴定的中立和公正。医学会从事医疗损害鉴定的法律依据不足,中立性无法保证,医疗损害鉴定与医疗事故鉴定法律属性各异,且医疗损害鉴定的目的与医学会之宗旨相冲突。因此,医学会从事医疗损害鉴定只是权宜之计,在《侵权责任法》实施后应放弃医疗损害鉴定职能,回归本职,以新的方式在医疗损害鉴定体系中发挥作用。%Medical associations belonging to the medical industry consortia have duties to promote the development of medical science and protect interests of medical institutions and medical staffs .With the juridical nature ,the medical damage appraisal should ensure its neutrality and justice .However ,medical associations are struggling with insufficient legal evidence ,uncertain neutrality ,different legal attributes of medical damage and medical malpractice appraisals and conflict between goals of the medical damage appraisal and aims of the medical associations .Therefore ,it is expedient for medical associations to perform medical damage appraisal .With the implementation of Tort Liability Act ,medical associations should shift the appraisal function of medical damage to its original duties and responsibilities position ,and play a new role in medical damage appraisal system .

  17. Factors associated with medication information in diabetes care: differences in perceptions between patients and health care professionals

    Directory of Open Access Journals (Sweden)

    Längst G

    2015-10-01

    Full Text Available Gerda Längst,1 Hanna Marita Seidling,2,3 Marion Stützle,2,3 Dominik Ose,1 Ines Baudendistel,1 Joachim Szecsenyi,1 Michel Wensing,1,4 Cornelia Mahler1 1Department of General Practice and Health Services Research, University Hospital of Heidelberg, Heidelberg, Germany; 2Cooperation Unit Clinical Pharmacy, University of Heidelberg, Heidelberg, Germany; 3Department of Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Heidelberg, Germany; 4Radboud University Nijmegen Medical Centre, Scientific Institute for Quality of Healthcare, Nijmegen, the Netherlands Purpose: This qualitative study in patients with type 2 diabetes and health care professionals (HCPs aimed to investigate which factors they perceive to enhance or impede medication information provision in primary care. Similarities and differences in perspectives were explored.Methods: Eight semistructured focus groups were conducted, four with type 2 diabetes patients (n=25 and four with both general practitioners (n=13 and health care assistants (n=10. Sessions were audio and video recorded, transcribed verbatim, and subjected to computer-aided qualitative content analysis.Results: Diabetes patients and HCPs broadly highlighted similar factors as enablers for satisfactory medication information delivery. Perceptions substantially differed regarding impeding factors. Both patients and HCPs perceived it to be essential to deliver tailored information, to have a trustful and continuous patient–provider relationship, to regularly reconcile medications, and to provide tools for medication management. However, substantial differences in perceptions related to impeding factors included the causes of inadequate information, the detail required for risk-related information, and barriers to medication reconciliation. Medication self-management was a prevalent topic among patients, whereas HCPs’ focus was on fulfilling therapy and medication management responsibilities

  18. Association between patients' beliefs and oral antidiabetic medication adherence in a Chinese type 2 diabetic population

    OpenAIRE

    Wu P; Liu N

    2016-01-01

    Ping Wu,1 Naifeng Liu2 1Department of Clinical Pharmacy, School of Basic Medical Sciences and Clinical Pharmacy, China Pharmaceutical University, 2Institute of Cardiovascular Disease, Southeast University Medical School, Nanjing, People’s Republic of China Purpose: The objective of this study was to identify, using the theory of planned behavior (TPB), patients’ beliefs about taking oral antidiabetic drugs (OADs) as prescribed, and to measure the correlations between bel...

  19. Evaluation of Exam Anxiety Level among Kermanshah University of Medical Sciences Students and its Association with Demographic Characteristics in 2014

    OpenAIRE

    MM Mohammadi; Sh Parandin

    2015-01-01

    Introduction: Test -anxiety is one of the most common mental health problems among the students that can impair performance and leads to failure of the exam. So, this study aimed to determine the rate of exam-anxiety among Kermanshah University of Medical Sciences' students. Methods: This cross sectional-analytic study was conducted on 510 students of Kermanshah University of Medical Sciences by convenience sampling method in 2014. In this study, data collection tool was Test-Anxiety que...

  20. Turkish Medical Information System and Medical Librarianship

    Directory of Open Access Journals (Sweden)

    Huriye Çolaklar

    2010-01-01

    Full Text Available In Turkey, medical information is supported at state level according to national policies. However, although the history of medical libraries in Turkey goes back to the 13th century in Anatolia, modern medical library applications adopted since the 1950s have not received much state support. In the past thirteen years a few medical libraries joined forces under ÜNAK (the Association of University and Research Librarians to contribute to the organization and development of Turkish Medical Information through the establishment of a "Medical Working Group" in 2000.

  1. Surface Deformation Associated with Geothermal Fluids Extraction at the Cerro Prieto Geothermal Field, Baja California, Mexico Revealed by DInSAR Technique

    Science.gov (United States)

    Sarychikhina, O.; Glowacka, E.; Mojarro, J.

    2016-08-01

    The Differential Synthetic Aperture Radar Interferometry (DInSAR) is widely used for surface deformation detection and monitoring.In this paper, ERS-1/2, ENVISAT and RADARSAT-2 synthetic aperture radar (SAR) images acquired between 1993 and 2014 were processed to investigate the evolution of surface deformation at the Cerro Prieto geothermal field, Baja California, Mexico. The conventional DInSAR together with the interferogram stacking method was applied. Average LOS (line of sight) displacement velocity maps were generated for different periods: 1993 - 1997, 1998 - 2000, 2004, 2005, 2007, 2009, and 2012 - 2014, revealing that the area corresponding to Cerro Prieto basin presented the important surface deformation (mainly subsidence) during the entire time of investigation. The changes in the surface deformation pattern and rate were identified. These changes have a good correlation in time with the changes of production in the Cerro Prieto geothermal field.

  2. Is social capital as perceived by the medical director associated with coordination among hospital staff? A nationwide survey in German hospitals.

    Science.gov (United States)

    Gloede, Tristan D; Hammer, Antje; Ommen, Oliver; Ernstmann, Nicole; Pfaff, Holger

    2013-03-01

    Effective coordination among all members of hospital staff has been shown to be associated with better quality of care. The literature indicates that social capital, a form of organizational resource, may facilitate the task of coordination. However, to the best of our knowledge, no study has yet examined this link within a healthcare setting. Thus, the objective of this study was to analyze the relationship between social capital and coordination among hospital staff, as perceived by the medical director being a key informant of the hospital. In 2008, we surveyed the medical directors of 1224 German hospitals by the use of a standardized questionnaire. We conducted stepwise multivariate linear regression and controlled for hospital size, ownership and teaching status. In total, 551 medical directors (45%) responded to the survey. We found social capital to be a significant predictor of coordination (β = 0.444, p social capital can be associated with better coordination among members of hospital staff, as perceived by the medical director. Therefore, investment in social capital may facilitate better organization of work processes in hospitals and may therefore help to improve patient outcomes. However, longitudinal studies are needed in order to explain the causal relationship between social capital and coordination among hospital staff.

  3. [20th anniversary of Association Doctors of Hope. Experience resulting from the cooperation with Polish medical communities in the Polish Borderlands (Kresy)].

    Science.gov (United States)

    Chłap, Zbigniew

    2011-01-01

    20th Anniversary of Association Doctors of Hope (ADH) is an opportunity for presentation of the conclusions resulting from the realization of our tasks, especially those related to the Polish medical communities in the Borderlands. Maintaining the contacts with the Polish minorities in Lithuania, Latria, Byelorussia, Ukraine, Romania, Moldavia and Georgia are the priority tasks of ADH. Those communities differ in the extent of their needs and the relations with the local authorities in the context of the aid provided by our Association and the cooperation with us. The programme of our medical missions in the Borderlands included: a) rendering immediate aid by supplying medicines, medical materials; b) physical examination of groups of Poles (including the youths); c) organizing joint medical and pedagogical conferences concerning heath problems and healthy lifestyle. The article refers to the need for coordination of the cooperation among Polish organizations, the organizations in the Borderlands and consulates, in order to facilitate studying of the Poles in Poland, as well as to arrange for specialization residencies in Poland for doctor of Polish descent. Perfecting of the professional qualifications is a vital factor in strengthening the respect for the Polish communities, which, as minorities, are continuously expose to breaking the law by the local authorities.

  4. HIV-Related Stress and Life Chaos Mediate the Association Between Poverty and Medication Adherence Among People Living with HIV/AIDS.

    Science.gov (United States)

    Kalichman, Seth C; Kalichman, Moira O

    2016-12-01

    HIV treatment depends on high-levels of antiretroviral therapy (ART) adherence, which is severely impeded by poverty. Men and women living with HIV infection (N = 92) completed computerized interviews of demographic and health characteristics, poverty markers, stressful life events, and life chaos, as well as unannounced pill counts to determine prospective medication adherence and medical record chart abstractions for HIV viral load. Poverty markers were associated with both stressors and chaos, and the direct effects of all three factors predicted ART non-adherence. The multiple mediation model showed that accounting for stressors and chaos resulted in a non-significant association between poverty markers and ART adherence. The indirect effect of poverty markers on adherence through life chaos was significant, whereas the indirect effect of poverty markers on adherence through stressors was not significant. Factors that render HIV-related stress and create chaos offer intervention targets that are more amenable to change than poverty itself.

  5. California State Waters Map Series: offshore of San Gregorio, California

    Science.gov (United States)

    Cochrane, Guy R.; Dartnell, Peter; Greene, H. Gary; Watt, Janet T.; Golden, Nadine E.; Endris, Charles A.; Phillips, Eleyne L.; Hartwell, Stephen R.; Johnson, Samuel Y.; Kvitek, Rikk G.; Erdey, Mercedes D.; Bretz, Carrie K.; Manson, Michael W.; Sliter, Ray W.; Ross, Stephanie L.; Dieter, Bryan E.; Chin, John L.; Cochran, Susan A.; Cochrane, Guy R.; Cochran, Susan A.

    2014-01-01

    the northern and southern parts of the map area are the result of right-lateral motion on strands of the San Gregorio Fault system. In the south, headlands near Pescadero Point have been uplifted by motion along the west strand of the San Gregorio Fault (also called the Frijoles Fault), which separates rocks of the Pigeon Point Formation south of the fault from rocks of the Purisima Formation north of the fault. The regional uplift in this map area has caused relatively shallow water depths within California's State Waters and, thus, little accommodation space for sediment accumulation. Sediment is observed offshore in the central part of the map area, in the shelter of the headlands north of the east strand of the San Gregorio Fault (also called the Coastways Fault) around Miramontes Point (about 5 km north of the map area) and also on the outer half of the California's State Waters shelf in the south where depths exceed 40 m. Sediment in the outer shelf of California's State Waters is rippled, indicating some mobility. The Offshore of San Gregorio map area lies within the cold-temperate biogeographic zone that is called either the "Oregonian province" or the "northern California ecoregion." This biogeographic province is maintained by the long-term stability of the southward-flowing California Current, an eastern limb of the North Pacific subtropical gyre that flows from Oregon to Baja California. At its midpoint off central California, the California Current transports subarctic surface (0–500 m deep) waters southward, about 150 to 1,300 km from shore. Seasonal northwesterly winds that are, in part, responsible for the California Current, generate coastal upwelling. The south end of the Oregonian province is at Point Conception (about 350 km south of the map area), although its associated phylogeographic group of marine fauna may extend beyond to the area offshore of Los Angeles in southern California. The ocean off of central California has experienced a warming

  6. Development and Use of a Medication History Service Associated with a Health Information Exchange: Architecture and Preliminary Findings

    Science.gov (United States)

    Frisse, Mark E.; Tang, Lianhong; Belsito, Anne; Overhage, J. Marc

    2010-01-01

    We describe our early experience with use in emergency department settings of a standards-based medication history service integrated into a health information exchange (HIE). The service sends queries from one Exchange’s emergency department interface both to a local ambulatory care system and to the medication hub services provided by a second HIE. This second HIE in turn sends requests to SureScripts and returns histories for incorporation into the first Exchange’s clinical interface. The service caches all requests to avoid costly duplicate query charges and maintains an account of queries, registered users, charges, and results obtained. Usage may be increasing as additional retail pharmacy data become available. Early results suggest that research and development emphasis requirements will of necessity shift from obtaining prescription medication history to finding new means to ensuring effective use. PMID:21346977

  7. Co-occurring amphetamine use and associated medical and psychiatric comorbidity among opioid-dependent adults: results from the Clinical Trials Network

    Directory of Open Access Journals (Sweden)

    Blazer DG

    2011-07-01

    Full Text Available Daniel J Pilowsky1, Li-Tzy Wu2, Bruce Burchett2, Dan G Blazer2, George E Woody3, Walter Ling41Departments of Epidemiology and Psychiatry, Columbia University, and the New York State Psychiatric Institute, New York City, NY; 2Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke University Medical Center, Durham, NC; 3Department of Psychiatry, School of Medicine, University of Pennsylvania and Treatment Research Institute, Philadelphia, PA; 4David Geffen School of Medicine, NPI/Integrated Substance Abuse Programs, University of California, Los Angeles, CA, USABackground: In response to the rising rate of treatment admissions related to illicit use of amphetamines (eg, methamphetamine, we examined the prevalence of amphetamine use among treatment-seeking, opioid-dependent adults, explored whether amphetamine users were as likely as nonamphetamine users to enroll in opioid-dependence treatment trials, and determined whether amphetamine users manifested greater levels of medical and psychiatric comorbidity than nonusers.Methods: The sample included 1257 opioid-dependent adults screened for participation in threemultisite studies of the National Drug Abuse Treatment Clinical Trials Network (CTN001-003, which studied the effectiveness of buprenorphine for opioid detoxification under varying treatment conditions. Patients were recruited from 23 addiction treatment programs across the US. Medical and psychiatric comorbidity were examined by past-month amphetamine use (current vs former and route of administration. Five mutually exclusive groups were examined, ie, nonusers, current amphetamine injectors, current amphetamine noninjectors, former amphetamine injectors, and former amphetamine noninjectors.Results: Of the sample (n = 1257, 22.3% had a history of regular amphetamine use. Of the 280 amphetamine users, 30.3% reported injection as their primary route. Amphetamine users were more likely than nonusers to be white and use more

  8. Medical Identity

    DEFF Research Database (Denmark)

    Musaeus, Peter

    2015-01-01

    is the study of the sociocultural paragons that conceptually underlie the phenomenology of physician’s coming to take themselves as autonomous social agents. The paper relies on Hegel’s Phenomenology of Spirit and investigates dilemmas pertaining to first objectivist versus subjectivist views and second...... hedonistic versus sentimentalist approaches to medical identity. The sociocultural philosophical analysis of medical identity can shed light on what it means conceptually for a physician to harbor beliefs associated with him/her being taken to be an autonomous professional. It is important because it touches...

  9. Association between education about organ transplantation aimed at medical students and the acquisition of the organ donor card. A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Xiomara Benavides-López

    2014-10-01

    Full Text Available Background. The transplantation group of the National University of Colombia considers that education about transplants is important to raise the donation rate in this country. Objective. To find a statistical association between education about transplantation aimed at medical students and the number of students and their families bearing the organ donor card. Materials and methods. Cross-sectional analytical study. Two surveys were designed and sent to two different student populations. The first group had taken the course "Human Organ and Tissue Transplantation", and the second group was composed of students from the fifth semester of medical education. The statistical test used was difference of proportions, sample size of 50 people, statistical power of 80%, difference in proportions 20%, alpha 0.05, p <0.05. Results. The surveys were answered by 29 students from first group and 74 students from second group. First question: "Do you carry the organ donor card?", p-value of 0.03 found. Second question: "Do your family members carry the organ donor card?", p-value of 0.732 found. Affirmative answer to the first question, p=0.10 and answer to second question, p=0.0005. Conclusion. An association was found between education about transplantation focused on medical students and bearing the organ donor card and communicating their wishes to their families. Likewise, an association between education and a positive attitude toward donation was found in the families of students that participated on the course "Human Organ and Tissue Transplantation".

  10. Authentic Assessment in California.

    Science.gov (United States)

    Educational Leadership, 1989

    1989-01-01

    Describes the teacher-developed California Assessment Program (CAP) writing measure, designed to support California's reform curriculum and based on matrix sampling techniques. This program will be supplemented by literature and mathematics assessments. The greatest challenge is designing an assessment to match the state's new history and social…

  11. Factors associated with medication information in diabetes care: differences in perceptions between patients and health care professionals

    NARCIS (Netherlands)

    Langst, G.; Seidling, H.M.; Stutzle, M.; Ose, D.; Baudendistel, I.; Szecsenyi, J.; Wensing, M.; Mahler, C.

    2015-01-01

    PURPOSE: This qualitative study in patients with type 2 diabetes and health care professionals (HCPs) aimed to investigate which factors they perceive to enhance or impede medication information provision in primary care. Similarities and differences in perspectives were explored. METHODS: Eight sem

  12. Asthma and asthma medication use among 4-year-old offspring of subfertile couples - association with IVF?

    NARCIS (Netherlands)

    Kuiper, Derk B.; Seggers, Jorien; Schendelaar, Pamela; Haadsma, Maaike L.; Roseboom, Tessa J.; Heineman, Maas J.; Hadders-Algra, Mijna

    2015-01-01

    This study evaluated the prevalence of asthma and asthma medication use in 213 4-year-old singletons followed from birth onwards, including three groups of children born following: (i) controlled ovarian hyperstimulation IVF/intracytoplasmic sperm injection (ICSI); (ii) modified natural cycle IVF/IC

  13. Association of Research Self-Efficacy with Medical Student Career Interests, Specialization, and Scholarship: A Case Study

    Science.gov (United States)

    Bierer, S. Beth; Prayson, Richard A.; Dannefer, Elaine F.

    2015-01-01

    This study used variables proposed in social cognitive career theory (SCCT) to focus the evaluation of a research curriculum at the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University (CCLCM). Eight cohorts of CCLCM medical students completed a web-based version of the six-scale Clinical Research Appraisal…

  14. Use of e-learning to enhance medical students' understanding and knowledge of healthcare-associated infection prevention and control.

    LENUS (Irish Health Repository)

    O'Neill, E

    2011-12-01

    An online infection prevention and control programme for medical students was developed and assessed. There was a statistically significant improvement (P<0.0001) in the knowledge base among 517 students after completing two modules. The majority of students who completed the evaluation were positive about the learning experience.

  15. Retrospective study of cattle poisonings in California: recognition, diagnosis, and treatment

    Directory of Open Access Journals (Sweden)

    Puschner B

    2012-11-01

    Full Text Available Anita Varga,1 Birgit Puschner21William R Pritchard Veterinary Medical Teaching Hospital, Large Animal Clinic, School of Veterinary Medicine, University of California, Davis, CA, USA; 2Department of Molecular Biosciences and the California Animal Health and Food Safety Laboratory System, School of Veterinary Medicine, University of California, Davis, CA, USAAbstract: In this retrospective study all suspect bovine intoxications submitted to the California Animal Health and Food Safety Laboratory between January 1, 2000 and December 31, 2011 were reviewed. A total of 1199 cases were submitted, but a diagnosis of intoxication was only established in 13.5% of cases. In these cases, overexposures to minerals, metals, and poisonous plants were determined as the most commonly diagnosed poisonings in cattle in California. Nitrate/nitrite poisoning was the most commonly diagnosed plant-associated intoxication, followed by gossypol and oleander. This study details the diagnostic challenges and treatment options for the most commonly diagnosed intoxications. To ensure proper treatment and prevention of new cases, accurate diagnosis is necessary, and therefore this review provides an essential tool for the food animal practitioner. Available toxicological analyses are offered at select laboratories, which can be time consuming and expensive, yet the potential for residues in consumed animal products and implications for human health necessitate testing and consultation. Any potential exposure to a toxicant in cattle should be reviewed to determine whether a residue hazard exists. Therapy focuses on immediate removal of the toxicant from the environment and from the gastrointestinal tract. With few antidotes available, most are cost prohibitive to treat numerous affected cattle. In addition, most antidotes will require extra-label drug use and establishment of meat and milk withdrawal times.Keywords: toxins, toxicology, poisonous plants, bovine

  16. Prescription factors associated with medication non-adherence in Japan assessed from leftover drugs in the SETSUYAKU-BAG campaign: Focus on oral antidiabetic drugs

    Directory of Open Access Journals (Sweden)

    Kaori Koyanagi

    2016-07-01

    Full Text Available Background: Medication adherence has an important influence on health outcomes in patients with chronic diseases. However, few studies have been performed in Japan to determine factors related to medication non-adherence. Objective: The aim of this study was to identify prescription factors related to medication non-adherence by investigating patient characteristics, all prescriptions, and prescriptions for oral antidiabetic drugs (OADs.Methods: A retrospective cross-sectional survey of prescription data about implementation of dosing regimen was performed at community pharmacies engaged in appropriate use of leftover drugs. We evaluated the amount of drugs originally prescribed and the reduced amount after use of leftover drugs, and then calculated prescription reduction ratio (PRR. We analyzed prescription factors contributing to non-adherence based on the PRR.Results: Prescription information for 1,207 patients was reviewed, revealing that patients were non-adherent to 58% of prescriptions. Lack of a drug copayment, fewer concurrent drugs, and drugs not in single-dose packaging were associated with non-adherence. Among the 1,207 patients, 234 prescriptions for diabetes and 452 OAD formulations were included. Forty-seven percent of prescriptions and 29% of the formulations were non-adherent. A higher dosing frequency and preprandial administration were associated with non-adherence. Among the OADs, adherence was lower for α-glucosidase inhibitors and biguanides than for sulfonylureas. Conclusions: Several factors related to patient characteristics, general drug prescriptions, and OAD prescriptions were associated with non-adherence. Further consideration will be needed to improve adherence to medication in Japan. Health care providers should perform more careful monitoring of adherence in patients with the factors identified by this study.

  17. Spirometry, questionnaire and electronic medical record based COPD in a population survey: Comparing prevalence, level of agreement and associations with potential risk factors

    Science.gov (United States)

    Yzermans, C. Joris; Krop, Esmeralda; Aalders, Bernadette; Rooijackers, Jos; Zock, Jan-Paul; van Dijk, Christel E.; Maassen, Catharina B. M.; Schellevis, François; Heederik, Dick; Smit, Lidwien A. M.

    2017-01-01

    Background COPD-diagnosis is confirmed by post-bronchodilator (BD) spirometry. However, epidemiological studies often rely on pre-BD spirometry, self-reports, or medical records. This population-based study aims to determine COPD-prevalence based on four different operational definitions and their level of agreement, and to compare associations between COPD-definitions and risk factors. Methods COPD-prevalence in 1,793 adults from the general Dutch population (aged 18–70 years) was assessed based on self-reported data, Electronic Medical Records (EMR), and post-BD spirometry: using the FEV1/FVC below the lower limit of normal (LLN) and GOLD fixed cut-off (FEV1/FVC <0.70). Using spirometry as a reference, sensitivity was calculated for self-reported and EMR-based COPD. Associations between COPD and known risk factors were assessed with logistic regression. Data were collected as part of the cross-sectional VGO study (Livestock Farming and Neighboring Residents’ Health Study). Results The highest prevalence was found based on spirometry (GOLD: 10.9%, LLN: 5.9%), followed by self-report (4.6%) and EMR (2.9%). Self-reported or EMR-based COPD identified less than 30% of all COPD-cases based on spirometry. The direction of association between known risk factors and COPD was similar across the four definitions, however, magnitude and significance varied. Especially indicators of allergy were more strongly associated with self-reported COPD compared to the other definitions. Conclusions COPD-prevalence varied depending on the used definition. A substantial number of subjects with spirometry-based COPD cannot be identified with questionnaires or medical records which can cause underestimation of COPD-prevalence. The influence of the different COPD-definitions on associations with known risk factors was limited. PMID:28273094

  18. The Association Between Antihypertensive Medication Nonadherence and Visit-to-Visit Variability of Blood Pressure: Findings From the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial.

    Science.gov (United States)

    Kronish, Ian M; Lynch, Amy I; Oparil, Suzanne; Whittle, Jeff; Davis, Barry R; Simpson, Lara M; Krousel-Wood, Marie; Cushman, William C; Chang, Tara I; Muntner, Paul

    2016-07-01

    Low adherence to antihypertensive medication has been hypothesized to increase visit-to-visit variability (VVV) of blood pressure (BP). We assessed the association between antihypertensive medication adherence and VVV of BP in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). VVV of BP was calculated using SD independent of mean, SD, and average real variability across study visits conducted 6 to 28 months after randomization. Participants who reported taking heart disease or nonfatal myocardial infarction, stroke, heart failure, or mortality risk. In conclusion, improving medication adherence may lower VVV of BP. However, VVV of BP is associated with cardiovascular outcomes independent of medication adherence.

  19. Glaucoma medications.

    Science.gov (United States)

    Chae, Bora; Cakiner-Egilmez, Tulay; Desai, Manishi

    2013-01-01

    Glaucoma is a common eye condition that affects millions of individuals worldwide, making it the second-leading cause of blindness. Because glaucoma is associated with increased IOP level, the primary goal in treatment of glaucoma includes lowering IOP to prevent further progression of the disease. While various surgical interventions exist, medical therapy is currently the first line of treatment. Medical treatment of glaucoma includes topical beta-blockers, alpha-2 agonists, prostaglandins, parasympathomimetics and CAIs. Anti-glaucoma agents help reduce IOP by affecting the production of aqueous humor or increasing the outflow of aqueous through the trabecular or uveoscleral pathway. Choosing an appropriate medical regimen can be challenging and various factors such as efficacy, safety, cost and patient compliance must be considered. First-line treatment is often topical beta-blockers or prostaglandin analogs. However, beta-blocking agents can be associated with systemic side effects and need to be used cautiously in patients with serious concomitant cardiopulmonary disease. Alpha-2 agonists and parasympathomimetics are often considered second- or third-line treatment options but good adjunctive agents. Oral CAIs are often indicated for patients with elevated IOP in an acute setting or for patients resistant to other glaucoma medications and patients who are not good surgical candidates.

  20. NLP techniques associated with the OpenGALEN ontology for semi-automatic textual extraction of medical knowledge: abstracting and mapping equivalent linguistic and logical constructs.

    Science.gov (United States)

    do Amaral, M B; Roberts, A; Rector, A L

    2000-01-01

    This research project presents methodological and theoretical issues related to the inter-relationship between linguistic and conceptual semantics, analysing the results obtained by the application of a NLP parser to a set of radiology reports. Our objective is to define a technique for associating linguistic methods with domain specific ontologies for semi-automatic extraction of intermediate representation (IR) information formats and medical ontological knowledge from clinical texts. We have applied the Edinburgh LTG natural language parser to 2810 clinical narratives describing radiology procedures. In a second step, we have used medical expertise and ontology formalism for identification of semantic structures and abstraction of IR schemas related to the processed texts. These IR schemas are an association of linguistic and conceptual knowledge, based on their semantic contents. This methodology aims to contribute to the elaboration of models relating linguistic and logical constructs based on empirical data analysis. Advance in this field might lead to the development of computational techniques for automatic enrichment of medical ontologies from real clinical environments, using descriptive knowledge implicit in large text corpora sources.

  1. Infection-Associated Clinical Outcomes in Hospitalized Medical Evacuees After Traumatic Injury: Trauma Infectious Disease Outcome Study

    Science.gov (United States)

    2011-07-01

    Pneumonia : both must be present- ( New or progressive infiltrate seen on radiology film and evidence of infection (Temp 38°C or 36°C or WBC 12,000 or...provide a timely assessment of performance improvement interven- tions.5,10,11 Efforts to prevent infection include the develop- ment of guidelines for...in Table 1, available through medical record review, applying standardized definitions for nosocomial infections used by the National Healthcare Safety

  2. Medical Certification System -

    Data.gov (United States)

    Department of Transportation — Provides automated risk-based decision making capability in support of medical certification and clearances processing associated fees and supporting surveillance of...

  3. 6Associate Professor, Department of ENT, Amrita Institute of Medical Sciences, Kochi, Kerala, India. Amrita Vishwa Vidyapeetham University

    Directory of Open Access Journals (Sweden)

    Alexander John

    2016-09-01

    Full Text Available Background: Teacher education curricula should enable teachers to facilitate learners’ acquiring knowledge, attitudes, behavior and skills that they will need in their profession. Though there are faculty development programmes that are being conducted in India, there are only a few published reports of the same.  Aims & Objectives: To assess the “Effectiveness of a Short training in Teaching Methodology for entry level Medical Teachers.” Settings and Design: A quasi-experimental study with pre-test post-test design and an educational intervention was carried out on 30 consenting Senior Residents at a Medical College in Kochi. Material & Methods: The intervention was eight-hour training in teaching methodology using a curriculum designed by the researcher in consultation with experts. Data analysis was done using SPSS software to compare the pre and post - test scores of the residents. Results: Overall feedback was positive. The participants reported that “they had learned a lot” and were of the view that “the course would help them to put forward better performances” when assigned teaching-learning tasks. The pre-test and post-test scores were compared and significant improvement was found with regard to knowledge, motivation to teach (reflecting attitude change and practice. Conclusion: A short training in teaching methodology has helped entry level medical teachers to become more effective in their teaching.

  4. Comparison of Three Supply Distribution Systems for Medical and Surgical Supplies in the Veterans Administration Sierra Pacific Network

    Science.gov (United States)

    2011-12-01

    rehabilitation , women’s health, surgery and social work services. Northern California has two divisions, each with an associate director. The Sacramento Valley...24 medical- surgical beds, 16 TCU beds, 10 ICU beds, 10 PICU, and a four-room operating suite, also houses a cardiac catheterization lab, a...medicine, surgery, psychiatry, 21 rehabilitation , neurology, oncology, dentistry, geriatrics, and extended care. With nearly 900 beds, including

  5. Attributes Associated with Adherence to Glaucoma Medical Therapy and its Effects on Glaucoma Outcomes: An Evidence-Based Review and Potential Strategies to Improve Adherence.

    Science.gov (United States)

    Joseph, Arun; Pasquale, Louis R

    2017-01-01

    The treatment paradigm in glaucoma classically starts with exhausting all medical therapy prior to proceeding with laser or incisional surgery, although laser-first and surgery-first strategies have been explored in randomized clinical trials. Although glaucoma drops are proven to work well to lower intraocular pressure, slow the conversion from ocular hypertension, and slow the progression of disease in early open angle glaucoma, adherence to treatment is likely optimum in the randomized clinical trials that support these claims. In real-world scenarios, medical therapy often fails and practitioners are forced to proceed with more invasive treatment modalities to slow the progression of this blinding disease. This review aims to take an evidence-based approach to study the risk factors for poor adherence in glaucoma patients, to determine whether poor adherence is, in fact, associated with worse outcomes, and to seek potential strategies to improve adherence in these patients.

  6. Medical Physics Data Book,

    Science.gov (United States)

    The Medical Physics Data Book is a collection of physical and chemical data useful in medical physics . The information has been extracted from other...ionizing Radiation. Carried out by the Medical Physics Data Group of the American Association of Physicists in Medicine, this compilation is meant to

  7. How to evaluate health-related quality of life and its association with medication adherence in pulmonary tuberculosis – designing a prospective observational study in South Africa

    Directory of Open Access Journals (Sweden)

    Tanja Kastien-Hilka

    2016-05-01

    Full Text Available Introduction: Health-related quality of life (HRQOL has become an important measure to identify and shape effective and patient-relevant healthcare interventions innovations through outcomes. Adherence to tuberculosis (TB treatment is a public health concern. The main objective of this research is to develop a study design for evaluation of HRQOL and its association with medication adherence in TB in South Africa. Methodology: A conceptual framework for HRQOL in TB has been developed to identify patient-reported outcome (PRO measures for HRQOL and adherence and to generate an endpoint model. Two generic (SF-12 and EQ-5D-5L, one disease-specific (St. George´s Respiratory Questionnaire (SGRQ and one condition-specific (Hospital Anxiety and Depression Scale (HADS measure for HRQOL and Morisky Medication Adherence Scale (MMAS for adherence assessment were identified. All measures are applied in a longitudinal multicentre study at five data collection time points during standard TB treatment. Statistical analysis includes multivariable analysis. Change over time in the physical component score (PCS of SF-12 is defined as primary endpoint. Sample size estimation based thereupon has led to a recruitment target of 96 patients. This study is on-going. Discussion: This is the first longitudinal study in South Africa which evaluates HRQOL and its association with medication adherence in TB in a comprehensive manner. Results will help to improve current treatment programmes and medication adherence and will support the identification of sustainable health innovations in TB, determining the value of new products, and supporting decision making with regard to health policy and pricing.

  8. Association between patients’ beliefs and oral antidiabetic medication adherence in a Chinese type 2 diabetic population [Corrigendum

    Directory of Open Access Journals (Sweden)

    Wu P

    2016-09-01

    Full Text Available Wu P, Liu N. Patient Prefer Adherence. 2016;10:1161–1167. On page 1163, Table 1, the copyright statement “Use of the MMAS-8 is protected by US copyright laws. A license agreement to use the scale is available from: Donald E. Morisky, ScD, ScM, MSPH, Professor, Department of Community Health Sciences, UCLA School of Public Health, 650 Charles E. Young Drive South, Los Angeles, CA 90095-1772, dmorisky@gmail.com” was not included in the Note section. On page 1166, Acknowledgment section, the acknowledgment was “The authors thank the staff at the Department of Endocrinology, the First People’s Hospital of Changzhou, for their assistance and cooperation with the studies. We thank Doctor Honghong Yao, Department of Pharmacology, Medical School of Southeast University, Nanjing, Jiangsu, People’s Republic of China, for her assistance.” however it should have been “The authors thank the staff at the Department of Endocrinology, the First People’s Hospital of Changzhou, for their assistance and cooperation with the studies. We thank Doctor Honghong Yao, Department of Pharmacology, Medical School of Southeast University, Nanjing, Jiangsu, People’s Republic of China, for her assistance. The authors thank Professor Donald E. Morisky, Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, United States, for granting them to use the copyrighted MMAS-8. Professor Donald E. Morisky has worked his entire career in developing the very important instrument for medication-taking behavior measure. Permission to use the MMAS scales is required.33–35 Reproduction and distribution of the MMAS is protected by US copyright laws. A license agreement to use the scale is available from: Donald E. Morisky, ScD, ScM, MSPH, Professor, Department of Community Health Sciences, UCLA School of Public Health, 650 Charles E. Young Drive South, Los Angeles, CA 90095-1772, dmorisky@gmail.com.” On page 1167, References

  9. Medical complications of anorexia nervosa.

    Science.gov (United States)

    Shuttleworth, E; Sharma, S; Lal, S; Allan, P J

    2016-05-01

    Anorexia nervosa is a psychiatric disorder with potential life-threatening medical sequelae. This article reviews the principal medical complications associated with anorexia nervosa, highlights associated diagnostic pitfalls and emphasizes the importance of a multidisciplinary approach to management.

  10. Association of research self-efficacy with medical student career interests, specialization, and scholarship: a case study.

    Science.gov (United States)

    Bierer, S Beth; Prayson, Richard A; Dannefer, Elaine F

    2015-05-01

    This study used variables proposed in social cognitive career theory (SCCT) to focus the evaluation of a research curriculum at the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University (CCLCM). Eight cohorts of CCLCM medical students completed a web-based version of the six-scale Clinical Research Appraisal Inventory-Short Form (CRAI-SF) items at matriculation (n = 128) or graduation (n = 111) during 2009-2013. Parametric statistics were used to compare CRAI-SF scales to domains proposed in SCCT: trainees' characteristics (gender, training level, advanced degree), career interests, career intentions (medical specialty), and performance (peer-reviewed publications and required thesis topic). A number of lessons emerged in using theory to frame the evaluation of a complex educational program. Graduates rated their research self-efficacy significantly higher on all six CRAI-SF scales with large effect sizes (>.90) on five scales (Conceptualizing a Study, Study Design and Analysis, Responsible Research Conduct, Collaborating with Others, and Reporting a Study). Women and men did not have significantly different scores on CRAI-SF scales (p > .05), suggesting that the research program provides adequate supports for women students. Most thesis projects addressed clinical (36.9 %, n = 41) or translational (34.2 %, n = 38) research topics. The CRAI-SF discriminated between medical school matriculates and graduates, suggesting that research self-efficacy increases with mastery experiences. No significant relationships occurred between CRAI-SF scores and graduates' thesis topics or chosen clinical specialty. Correlations demonstrated significant relationships between graduates' perceptions of research self-efficacy and their interest in clinical research careers.

  11. Factors associated with physicians' choice of a career in research: a retrospective report 15 years after medical school graduation.

    Science.gov (United States)

    Krupat, Edward; Camargo, Carlos A; Strewler, Gordon J; Espinola, Janice A; Fleenor, Thomas J; Dienstag, Jules L

    2017-03-01

    Relatively little is known regarding factors associated with the choice of a research career among practicing physicians, and most investigations of this issue have been conducted in the absence of a theoretical/conceptual model. Therefore we designed a survey to identify the determinants of decisions to pursue a biomedical research career based upon the Theory of Planned Behavior and the concept of stereotype threat. From October 2012 through January 2014 electronic surveys were sent to four consecutive Harvard Medical School graduating classes, 1996-1999. Respondents provided demographic information, indicated their current research involvement, and provided retrospective reports of their experiences and attitudes when they were making career choices as they completed medical school. Multivariable ordinal regression was used to identify factors independently associated with current research involvement. Completed questionnaires were received from 358 respondents (response rate 65 %). In unadjusted analyses, variables associated with more extensive research involvement included non-minority status, male gender, lower debt at graduation, strong attitudes toward research at time of graduation, and greater social pressures to pursue research (all P career for women (OR 2.53, 95 % CI 1.00-6.40; P = 0.05). Most of the factors predicting research career choice involve factors that are potentially modifiable, suggesting that appropriately designed behavioral interventions may help to expand the size and diversity of the biomedical research community.

  12. Factors associated with delayed entry into HIV medical care after HIV diagnosis in a resource-limited setting: Data from a cohort study in India

    Directory of Open Access Journals (Sweden)

    Gerardo Alvarez-Uria

    2013-06-01

    Full Text Available Studies from sub-Saharan Africa have shown that a substantial proportion of patients diagnosed with HIV enter into HIV medical care late. However, data from low or middle-income countries outside Africa are scarce. In this study, we investigated risk factors associated with delayed entry into care stratified by gender in a large cohort study in India. 7701 patients were diagnosed with HIV and 5410 entered into care within three months of HIV diagnosis. Nearly 80% entered into care within a year, but most patients who did not enter into care within a year remained lost to follow up or died. Patient with risk factors related to having a low socio-economic status (poverty, being homeless, belonging to a disadvantaged community and illiteracy were more likely to enter into care late. In addition, male gender and being asymptomatic at the moment of HIV infection were factors associated with delayed entry into care. Substantial gender differences were found. Younger age was found to be associated with delayed entry in men, but not in women. Widows and unmarried men were more likely to enter into care within three months. Women belonging to disadvantaged communities or living far from a town were more likely to enter into care late. The results of this study highlight the need to improve the linkage between HIV diagnosis and HIV treatment in India. HIV programmes should monitor patients diagnosed with HIV until they engage in HIV medical care, especially those at increased risk of attrition.

  13. California Harpoon Fishery

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains vessel logbook and landings data from harpoon vessels that fish within 200 miles of the California coast, from 1974 to present. The harpoon...

  14. Coastal California Digital Imagery

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This digital ortho-imagery dataset is a survey of coastal California. The project area consists of approximately 3774 square miles. The project design of the digital...

  15. California Ocean Uses Atlas

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This dataset is a result of the California Ocean Uses Atlas Project: a collaboration between NOAA's National Marine Protected Areas Center and Marine Conservation...

  16. California Data Exchange Center

    Science.gov (United States)

    ... to make July &28;Water Smart Month.&29; &28;Conserving ... Remote sensors today indicate that statewide, snowpack water content is 54 percent of ... California ranked first, along with Texas, on ...

  17. University of Southern California

    Data.gov (United States)

    Federal Laboratory Consortium — The focus of the University of Southern California (USC) Children''s Environmental Health Center is to develop a better understanding of how host susceptibility and...

  18. Earthquakes in Southern California

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — There have been many earthquake occurrences in Southern California. This set of slides shows earthquake damage from the following events: Imperial Valley, 1979,...

  19. California Watershed Hydrologic Units

    Data.gov (United States)

    California Department of Resources — This dataset is intended to be used as a tool for water-resource management and planning activities, particularly for site-specific and localized studies requiring a...

  20. The Pulse Azimuth effect as seen in induction coil magnetometers located in California and Peru 2007–2010, and its possible association with earthquakes

    Directory of Open Access Journals (Sweden)

    J. C. Dunson

    2011-07-01

    Full Text Available The QuakeFinder network of magnetometers has recorded geomagnetic field activity in California since 2000. Established as an effort to follow up observations of ULF activity reported from before and after the M = 7.1 Loma Prieta earthquake in 1989 by Stanford University, the QuakeFinder network has over 50 sites, fifteen of which are high-resolution QF1005 and QF1007 systems. Pairs of high-resolution sites have also been installed in Peru and Taiwan.

    Increases in pulse activity preceding nearby seismic events are followed by decreases in activity afterwards in the three cases that are discussed here. In addition, longer term data is shown, revealing a rich signal structure not previously known in QuakeFinder data, or by many other authors who have reported on pre-seismic ULF phenomena. These pulses occur as separate ensembles, with demonstrable repeatability and uniqueness across a number of properties such as waveform, angle of arrival, amplitude, and duration. Yet they appear to arrive with exponentially distributed inter-arrival times, which indicates a Poisson process rather than a periodic, i.e., stationary process.

    These pulses were observed using three-axis induction coil magnetometers that are buried 1–2 m under the surface of the Earth. Our sites use a Nyquist frequency of 16 Hertz (25 Hertz for the new QF1007 units, and they record these pulses at amplitudes from 0.1 to 20 nano-Tesla with durations of 0.1 to 12 s. They are predominantly unipolar pulses, which may imply charge migration, and they are stronger in the two horizontal (north-south and east-west channels than they are in the vertical channels. Pulses have been seen to occur in bursts lasting many hours. The pulses have large amplitudes and study of the three-axis data shows that the amplitude ratios of the pulses taken from pairs of orthogonal coils is stable across the bursts, suggesting a similar source.

    This paper presents three

  1. The Pulse Azimuth effect as seen in induction coil magnetometers located in California and Peru 2007-2010, and its possible association with earthquakes

    Science.gov (United States)

    Dunson, J. C.; Bleier, T. E.; Roth, S.; Heraud, J.; Alvarez, C. H.; Lira, A.

    2011-07-01

    The QuakeFinder network of magnetometers has recorded geomagnetic field activity in California since 2000. Established as an effort to follow up observations of ULF activity reported from before and after the M = 7.1 Loma Prieta earthquake in 1989 by Stanford University, the QuakeFinder network has over 50 sites, fifteen of which are high-resolution QF1005 and QF1007 systems. Pairs of high-resolution sites have also been installed in Peru and Taiwan. Increases in pulse activity preceding nearby seismic events are followed by decreases in activity afterwards in the three cases that are discussed here. In addition, longer term data is shown, revealing a rich signal structure not previously known in QuakeFinder data, or by many other authors who have reported on pre-seismic ULF phenomena. These pulses occur as separate ensembles, with demonstrable repeatability and uniqueness across a number of properties such as waveform, angle of arrival, amplitude, and duration. Yet they appear to arrive with exponentially distributed inter-arrival times, which indicates a Poisson process rather than a periodic, i.e., stationary process. These pulses were observed using three-axis induction coil magnetometers that are buried 1-2 m under the surface of the Earth. Our sites use a Nyquist frequency of 16 Hertz (25 Hertz for the new QF1007 units), and they record these pulses at amplitudes from 0.1 to 20 nano-Tesla with durations of 0.1 to 12 s. They are predominantly unipolar pulses, which may imply charge migration, and they are stronger in the two horizontal (north-south and east-west) channels than they are in the vertical channels. Pulses have been seen to occur in bursts lasting many hours. The pulses have large amplitudes and study of the three-axis data shows that the amplitude ratios of the pulses taken from pairs of orthogonal coils is stable across the bursts, suggesting a similar source. This paper presents three instances of increases in pulse activity in the 30 days prior

  2. Evolution of the Rodgers Creek–Maacama right-lateral fault system and associated basins east of the northward-migrating Mendocino Triple Junction, northern California

    Science.gov (United States)

    McLaughlin, Robert J.; Sarna-Wojcicki, Andrei M.; Wagner, David L.; Fleck, Robert J.; Langenheim, V.E.; Jachens, Robert C.; Clahan, Kevin; Allen, James R.

    2012-01-01

    The Rodgers Creek–Maacama fault system in the northern California Coast Ranges (United States) takes up substantial right-lateral motion within the wide transform boundary between the Pacific and North American plates, over a slab window that has opened northward beneath the Coast Ranges. The fault system evolved in several right steps and splays preceded and accompanied by extension, volcanism, and strike-slip basin development. Fault and basin geometries have changed with time, in places with younger basins and faults overprinting older structures. Along-strike and successional changes in fault and basin geometry at the southern end of the fault system probably are adjustments to frequent fault zone reorganizations in response to Mendocino Triple Junction migration and northward transit of a major releasing bend in the northern San Andreas fault. The earliest Rodgers Creek fault zone displacement is interpreted to have occurred ca. 7 Ma along extensional basin-forming faults that splayed northwest from a west-northwest proto-Hayward fault zone, opening a transtensional basin west of Santa Rosa. After ca. 5 Ma, the early transtensional basin was compressed and extensional faults were reactivated as thrusts that uplifted the northeast side of the basin. After ca. 2.78 Ma, the Rodgers Creek fault zone again splayed from the earlier extensional and thrust faults to steeper dipping faults with more north-northwest orientations. In conjunction with the changes in orientation and slip mode, the Rodgers Creek fault zone dextral slip rate increased from ∼2–4 mm/yr 7–3 Ma, to 5–8 mm/yr after 3 Ma. The Maacama fault zone is shown from several data sets to have initiated ca. 3.2 Ma and has slipped right-laterally at ∼5–8 mm/yr since its initiation. The initial Maacama fault zone splayed northeastward from the south end of the Rodgers Creek fault zone, accompanied by the opening of several strike-slip basins, some of which were later uplifted and compressed

  3. Refined Views of Strike-slip Fault Zones, Seismicity, and State of Stress Associated With the Pacific-North America Plate Boundary in Southern California

    Science.gov (United States)

    Hauksson, E.; Nicholson, C.; Shaw, J. H.; Plesch, A.; Shearer, P. M.; Sandwell, D. T.; Yang, W.

    2013-12-01

    The mostly strike-slip plate boundary in southern California is expressed as a system of late Quaternary faults or principal slip zones (PSZs), with numerous adjacent smaller slip surfaces. It is complex, even after large cumulative displacements, and consists of major fault systems with multi-stranded, non-planar fault geometry, including some in close proximity to each other. There are also secondary cross faults and low-angle detachments that interact with the PSZs accommodating main plate boundary motion. The loading of plate-tectonic strain causes the largest earthquakes along PSZs, moderate-sized events in their immediate vicinity, and small earthquakes across the whole region. We apply relocated earthquake and refined focal mechanism (1981-2013) catalogs, as well as other geophysical datasets to provide refined views of the 3D fault geometry of these active fault systems. To determine properties of individual fault zones, we measure the Euclidian distance from every hypocenter to the nearest PSZ. In addition, we assign crustal geophysical parameters such as heat flow value and shear or dilatation strain rates to each epicenter. We investigate seismogenic thickness and fault zone width as well as earthquake source processes. We find that the seismicity rate is a function of location, with the rate dying off exponentially with distance from the PSZ. About 80% of small earthquakes are located within 5 km of a PSZ. For small earthquakes, stress drops increase in size with distance away from the PSZs. The magnitude distribution near the PSZs suggests that large earthquakes are more common close to PSZs, and they are more likely to occur at greater depth than small earthquakes. In contrast, small quakes can occur at any geographical location. An optimal combination of heat flow and strain rate is required to concentrate the strain along rheologically weak fault zones, which accommodate the crustal deformation processes, causing seismicity. The regional trend of

  4. Special medical conditions associated with catatonia in the internal medicine setting: hyponatremia-inducing psychosis and subsequent catatonia.

    Science.gov (United States)

    Novac, Andrei A; Bota, Daniela; Witkowski, Joanne; Lipiz, Jorge; Bota, Robert G

    2014-01-01

    Diagnosis and treatment of catatonia in the psychiatry consultation service is not infrequent. Usually, the patient either presents to the Emergency Department or develops catatonia on the medical floor. This condition manifests with significant behavioral changes (from mildly decreased speech output to complete mutism) that interfere with the ability to communicate. After structural brain disorders are excluded, one of the diagnoses that always should be considered is catatonia. However, the causes of catatonia are numerous, ranging from psychiatric causes to a plethora of medical illnesses. Therefore, it is not surprising that there are many proposed underlying mechanisms of catatonia and that controversy persists about the etiology of specific cases.There are only 6 reports of hyponatremia-induced catatonia and psychosis in the literature. Here, we present the case of a 30-year-old woman with catatonia and psychosis induced by hyponatremia, and we use this report to exemplify the multitude of biologic causes of catatonia and to propose a new way to look at the neuroanatomical basis of processing, particularly the vertical processing systems we believe are involved in catatonia.

  5. A Study to Evaluate Internet Addiction Disorder among Students of a Medical College and Associated Hospital of Central India

    Directory of Open Access Journals (Sweden)

    Amit Malviya, Sanjay Dixit, Harish Shukla, Ankita Mishra, Abhineet Jain, Amrita Tripathi

    2014-01-01

    Full Text Available Background: Internet Addiction is an addiction like any other: it is defined as a compulsive loss of impulse control resulting in damage to the user and his or her relationships, schoolwork, or employment. Online gaming, compulsive use of social networking, and marathon Internet surfing sessions are all included in this powerful addition. Objective: To study Internet dependence among undergraduate students of MGM Medical College Indore and to determine prevalence of Internet addiction disorder among these students. Materials and Methods: A cross sectional study was carried out from Sept.2011 to January 2012 among 242 undergraduates of MGM Medical College of Indore city selected by simple random sampling. The data was collected by inter personal interviews using a standardized ‘Internet Addiction Test’ questionnaire developed by Dr. Kimberly S. Young in 1998. Results: Among 242 study subjects, 164 (67.8% were males and 78 (32.2% were females. Overall analysis to find out proportion of study subjects falling in the category of internet addicts on the basis of scoring system adapted for the study reveals that 23 (9.5% subjects have been found to be internet addicts i.e. have scores 80-100. Among 23 (9.5% internet addicts found in the study, 15 (6.1% were males and 8 (3.3% were females. (n=242. Conclusion: The data is indicative of Internet addiction to be an emerging problem of the modern era

  6. Feasibility of ensuring confidentiality and security of computer-based patient records. Council on Scientific Affairs, American Medical Association.

    Science.gov (United States)

    1993-05-01

    Legal and ethical precepts that apply to paper-based medical records, including requirements that patient records be kept confidential, accurate and legible, secure, and free from unauthorized access, should also apply to computer-based patient records. Sources of these precepts include federal regulations, state medical practice acts, licensing statutes and the regulations that implement them, accreditation standards, and professional codes of ethics. While the legal and ethical principles may not change, the risks to confidentiality and security of patient records appear to differ between paper- and computer-based records. Breaches of system security, the potential for faulty performance that may result in inaccessibility or loss of records, the increased technical ability to collect, store, and retrieve large quantities of data, and the ability to access records from multiple and (sometimes) remote locations are among the risk factors unique to computer-based record systems. Managing these risks will require a combination of reliable technological measures, appropriate institutional policies and governmental regulations, and adequate penalties to serve as a dependable deterrent against the infringement of these precepts.

  7. Lead Poisoning and Anemia Associated with Use of Ayurvedic Medications Purchased on the Internet--Wisconsin, 2015.

    Science.gov (United States)

    Meiman, Jon; Thiboldeaux, Robert; Anderson, Henry

    2015-08-21

    On April 30, 2015, the Wisconsin Division of Public Health (WDPH) was notified by a local health department of an elevated blood lead level (BLL) in a female patient aged 64 years. All Wisconsin laboratories are required to provide BLL testing results performed on any state resident to WDPH, and WDPH and local health departments are statutorily mandated to investigate any single BLL ≥20 µg/dL or BLLs that are persistently ≥15 µg/dL. Review of medical records revealed that the patient had developed progressive fatigue and shortness of breath during a period of multiple weeks that prompted inpatient medical evaluation. Hemoglobin level was 8.3 g/dL (normal range for age and sex of patient = 12.5-15.0 g/dL), and peripheral blood smear showed normochromic, normocytic red blood cells with basophilic stippling. A BLL was obtained and found to be 85.8 µg/dL. Urine toxic metals tests revealed mercury and aluminum levels in the normal range. Combined methylated and inorganic urine arsenic levels were slightly elevated at 53.3 µg/L (normal = lead chelation therapy with oral meso-2,3-dimercaptosuccinic acid.

  8. The role of interdisciplinary team approach in the management of the diabetic foot: a joint statement from the Society for Vascular Surgery and the American Podiatric Medical Association.

    Science.gov (United States)

    Sumpio, Bauer E; Armstrong, David G; Lavery, Lawrence A; Andros, George

    2010-01-01

    The Society for Vascular Surgery (SVS) and the American Podiatric Medical Association (APMA) recognize the beneficial impact of a multidisciplinary team approach on the care of patients with critical limb ischemia, especially in the diabetic population. As a first step in identifying clinical issues and questions important to both memberships, and to work together to find solutions that will benefit the shared patient, the two organizations appointed a representative group to write a joint statement on the importance of multidisciplinary team approach to the care of the diabetic foot.

  9. The Association between Antidepressant Medications and Coronary Heart Disease in Brazil: A Cross-sectional Analysis on the Brazilian Longitudinal Study of Adult Health (ELSA-Brazil

    Directory of Open Access Journals (Sweden)

    Andrew eKemp

    2015-01-01

    Full Text Available Background: Recent studies have highlighted associations between use of antidepressant medications and coronary heart disease (CHD. Tricyclic antidepressants are not recommended in patients with CHD as they may increase morbidity and mortality. However, this class of antidepressants are freely prescribed in public health pharmacies, while access to other classes of antidepressants is restricted in Brazil. Here we examine the associations between antidepressant use and prevalent CHD in a large cohort from Brazil. Methods: Participants included 14,994 civil servants aged 35 to 74 from the baseline assessment of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil. CHD (n=710 included stable angina, myocardial infarction and coronary revascularization. Univariate (unadjusted and multivariate (adjusted logistic regression analyses were conducted to estimate odds ratios and confidence intervals. Results: After full adjustment for covariates, tricyclic antidepressants (TCA use (n=156 was associated with a 2-fold increase in prevalent CHD, relative to non-use (n=14,076. Additional sensitivity analysis revealed a three-fold association for myocardial infarction (OR: 2.962, 95% CI: 1.413-6.210 and coronary revascularization (OR: 2.915, 95% CI: 1.275-6.662. There were no significant associations between antidepressant use and stable angina pectoris. Conclusions: Findings highlight a strong association between TCA use and prevalent CHD. While the cross-sectional design is an important limitation of the present study, findings have important implications for the treatment of cardiac patients in Brazil.

  10. Family physicians' ability to perform population management is associated with adoption of other aspects of the patient-centered medical home.

    Science.gov (United States)

    Ottmar, Jessica; Blackburn, Brenna; Phillips, Robert L; Peterson, Lars E; Jaén, Carlos Roberto

    2015-04-01

    The patient-centered medical home (PCMH) model is considered a promising approach to improving population health, but how elements of these advanced practice models relate to population health capability is unknown. To measure associations between family physicians' performance of population management with PCMH components, a cross-sectional survey was conducted with physicians accessing the American Board of Family Medicine Web site in 2011. Bivariate analysis and logistic regression tested associations between physician and practice demographics and specific PCMH features. The primary outcome was performance of population management. The final sample included 3855 physicians, 37.3% of whom reported performing population management. Demographic characteristics significantly associated with greater use of population management were female sex and graduation from an international medical school. PCMH components that remained associated with population management after adjustment were access to clinical case managers (odds ratio [OR]=2.01, 95% confidence interval [95% CI]: 1.69, 2.39), behavioral health collaboration (OR=1.49, 95% CI: 1.26, 1.77), having an electronic health record that supports meaningful use (OR=1.47, 95% CI: 1.25, 1.74), recent participation in a quality improvement project (OR=2.47, 95% CI: 2.12, 2.89), and routine measurement of patient difficulty securing an appointment (OR=2.87, 95% CI: 2.45, 3.37). Performance of population management was associated with several PCMH elements and resources not present in traditional primary care offices. Attention to these elements likely will enhance delivery of population management services in primary care.

  11. The association between psychological stress and recurrent aphthous stomatitis among medical and dental student cohorts in an educational setup in India

    Directory of Open Access Journals (Sweden)

    A Kaleswara Rao

    2015-01-01

    Full Text Available Introduction: Aphthous stomatitis is very common, affecting about 20-60% of the normal individuals to some degree. Although its etiology is not well-understood, it is multifactorial, and stress could be one possible triggering factor. Aims: The aim was to assess the prevalence of aphthous stomatitis and its association with psychological stress in both medical and dental graduate students. Materials and Methods: A cross-sectional study was conducted in 275 medical and dental student cohorts of an educational setup in India. Data were collected using a self-administered questionnaire, information regarding psychological stress, and 1-year period prevalence of aphthous stomatitis was collected. Data analysis was done with SPSS software version 20 (Chicago Inc., IL, USA. Categorical variables were compared using Chi-square test and comparison between mean stress scores and aphthous stomatitis was done with ANOVA and binary logistic regression was done. P ≤0.05 was considered as statistically significant. Results: The prevalence of aphthous stomatitis in the study population was 78.1% and males were more commonly affected than females. Among the student cohorts, final year MBBS and final year BDS students were highly affected than others, which is statistically significant. Conclusions: Stress increases the risk of aphthous stomatitis. Stress management strategies are necessary for medical and dental graduate students.

  12. Media Coverage, Journal Press Releases and Editorials Associated with Randomized and Observational Studies in High-Impact Medical Journals: A Cohort Study.

    Directory of Open Access Journals (Sweden)

    Michael T M Wang

    Full Text Available Publication of clinical research findings in prominent journals influences health beliefs and medical practice, in part by engendering news coverage. Randomized controlled trials (RCTs should be most influential in guiding clinical practice. We determined whether study design of clinical research published in high-impact journals influences media coverage.We compared the incidence and amount of media coverage of RCTs with that of observational studies published in the top 7 medical journals between 1 January 2013 and 31 March 2013. We specifically assessed media coverage of the most rigorous RCTs, those with >1000 participants that reported 'hard' outcomes. There was no difference between RCTs and observational studies in coverage by major newspapers or news agencies, or in total number of news stories generated (all P>0.63. Large RCTs reporting 'hard' outcomes did not generate more news coverage than small RCTs that reported surrogate outcomes and observational studies (all P>0.32. RCTs were more likely than observational studies to attract a journal editorial (70% vs 46%, P = 0.003, but less likely to be the subject of a journal press release (17% vs 50%, P0.99, nor were they more likely to be the subject of a journal press release (14% vs 38%, P = 0.14.The design of clinical studies whose results are published in high-impact medical journals is not associated with the likelihood or amount of ensuing news coverage.

  13. A Cross-Sectional Study of the Association between Overnight Call and Irritable Bowel Syndrome in Medical Students

    Directory of Open Access Journals (Sweden)

    Malcolm Wells

    2012-01-01

    Full Text Available BACKGROUND: Shift work has been associated with irritable bowel syndrome (IBS, which includes gastrointestinal symptoms such as abdominal pain, constipation and diarrhea. Overnight call shifts also lead to a disruption of the endogenous circadian rhythm.

  14. Gateway to curiosity: Medical marijuana ads and intention and use during middle school.

    Science.gov (United States)

    D'Amico, Elizabeth J; Miles, Jeremy N V; Tucker, Joan S

    2015-09-01

    Over the past several years, medical marijuana has received increased attention in the media, and marijuana use has increased across the United States. Studies suggest that as marijuana has become more accessible and adults have become more tolerant regarding marijuana use, adolescents perceive marijuana as more beneficial and are more likely to use if they are living in an environment that is more tolerant of marijuana use. One factor that may influence adolescents' perceptions about marijuana and marijuana use is their exposure to advertising of this product. We surveyed sixth- to eighth-grade youth in 2010 and 2011 in 16 middle schools in Southern California (n = 8,214; 50% male; 52% Hispanic; mean age = 13 years) and assessed exposure to advertising for medical marijuana, marijuana intentions, and marijuana use. Cross-lagged regressions showed a reciprocal association of advertising exposure with marijuana use and intentions during middle school. Greater initial medical marijuana advertising exposure was significantly associated with a higher probability of marijuana use and stronger intentions to use 1 year later, and initial marijuana use and stronger intentions to use were associated with greater medical marijuana advertising exposure 1 year later. Prevention programs need to better explain medical marijuana to youth, providing information on the context for proper medical use of this drug and the potential harms from use during this developmental period. Furthermore, as this is a new frontier, it is important to consider regulating medical marijuana advertisements, as is currently done for alcohol and tobacco products.

  15. Association of long-term PM2.5 exposure with mortality using different air pollution exposure models: impacts in rural and urban California.

    Science.gov (United States)

    Garcia, Cynthia A; Yap, Poh-Sin; Park, Hye-Youn; Weller, Barbara L

    2016-01-01

    Most PM2.5-associated mortality studies are not conducted in rural areas where mortality rates may differ when population characteristics, health care access, and PM2.5 composition differ. PM2.5-associated mortality was investigated in the elderly residing in rural-urban zip codes. Exposure (2000-2006) was estimated using different models and Poisson regression was performed using 2006 mortality data. PM2.5 models estimated comparable exposures, although subtle differences were observed in rate ratios (RR) within areas by health outcomes. Cardiovascular disease (CVD), ischemic heart disease (IHD), and cardiopulmonary disease (CPD), mortality was significantly associated with rural, urban, and statewide chronic PM2.5 exposures. We observed larger effect sizes in RRs for CVD, CPD, and all-cause (AC) with similar sizes for IHD mortality in rural areas compared to urban areas. PM2.5 was significantly associated with AC mortality in rural areas and statewide; however, in urban areas, only the most restrictive exposure model showed an association. Given the results seen, future mortality studies should consider adjusting for differences with rural-urban variables.

  16. California State Waters Map Series Data Catalog

    Science.gov (United States)

    Golden, Nadine E.

    2013-01-01

    In 2007, the California Ocean Protection Council initiated the California Seafloor Mapping Program (CSMP), designed to create a comprehensive seafloor map of high-resolution bathymetry, marine benthic habitats, and geology within the 3-nautical-mile limit of California's State Waters. The CSMP approach is to create highly detailed seafloor maps and associated data layers through the collection, integration, interpretation, and visualization of swath sonar data, acoustic backscatter, seafloor video, seafloor photography, high-resolution seismic-reflection profiles, and bottom-sediment sampling data. CSMP has divided coastal California into 110 map blocks (fig. 1), each to be published individually as USGS Scientific Investigations Maps (SIMs) at a scale of 1:24,000. The map products display seafloor morphology and character, identify potential marine benthic habitats, and illustrate both the seafloor geology and shallow (to about 100 m) subsurface geology. This CSMP data catalog contains much of the data used to prepare the SIMs in the California State Waters Map Series. Other data that were used to prepare the maps were compiled from previously published sources (for example, onshore geology) and, thus, are not included herein.

  17. Evaluation of Exam Anxiety Level among Kermanshah University of Medical Sciences Students and its Association with Demographic Characteristics in 2014

    Directory of Open Access Journals (Sweden)

    MM Mohammadi

    2015-12-01

    Full Text Available Introduction: Test -anxiety is one of the most common mental health problems among the students that can impair performance and leads to failure of the exam. So, this study aimed to determine the rate of exam-anxiety among Kermanshah University of Medical Sciences' students. Methods: This cross sectional-analytic study was conducted on 510 students of Kermanshah University of Medical Sciences by convenience sampling method in 2014. In this study, data collection tool was Test-Anxiety questionnaire includes 25 questions. Data were analyzed with the Pearson correlation and t-test using SPSS 16 software. Results: 198 students (38. 8% had mild exam-anxiety, 140 students (27. 5% moderate exam-anxiety and 172 students (33. 7% had severe exam-anxiety. The difference between the mean of anxiety scores was significant at various fields of study (P <0. 05.  Midwifery students experienced more stress in comparison with the students of other fields. There was a significant relationship between exam anxiety level, and the variables of gender, location, age and total grades average of students (P<0/05. There was not a significant relationship between exam anxiety level and marital status, parental occupation, semester entrance and employment of students. Conclusion: Due to the high level of exam anxiety among the different fields of medicine as well as the negative effect of this type of anxiety on academic performance of students, the necessity of the use of psychological services, counseling, identification of causes of anxiety, and planning for decreasing this problem was recommended. Obviously, in this regard, more attention should be paid to the highest-risk groups such as female midwifery students.

  18. Processes Affecting the Trihalomethane Concentrations Associated with the Third Injection, Storage, and Recovery Test at Lancaster, Antelope Valley, California, March 1998 through April 1999

    Science.gov (United States)

    Fram, Miranda S.; Bergamaschi, Brian A.; Goodwin, Kelly D.; Fujii, Roger; Clark, Jordan F.

    2003-01-01

    The formation and fate of trihalomethanes (THM) during the third injection, storage, and recovery test at Lancaster, Antelope Valley, California, were investigated as part of a program to assess the long-term feasibility of using injection, storage, and recovery as a water-supply method and as a way to reduce water-level declines and land-subsidence in the Antelope Valley. The program was conducted by the U.S. Geological Survey in cooperation with the Los Angeles County Department of Public Works and the Antelope Valley-East Kern Water Agency. The water used for injection, storage, and recovery must be disinfected before injection and thus contains THMs and other disinfection by-products. THMs (chloroform, CHCl3, bromodichloromethane, CHCl2Br, dibromochloromethane, CHClBr2, and bromoform, CHBr3) are formed by reaction between natural dissolved organic carbon that is present in water and chlorine that is added during the disinfection step of the drinking water treatment process. THMs are carcinogenic compounds, and their concentrations in drinking water are regulated by the U.S. Environmental Protection Agency. During previous cycles of the Lancaster program, extracted water still contained measurable concentrations of THMs long after continuous pumping had extracted a greater volume of water than had been injected. This raised concerns about the potential long-term effect of injection, storage, and recovery cycles on ground-water quality in Antelope Valley aquifers. The primary objectives of this investigation were to determine (1) what controlled continued THM formation in the aquifer after injection, (2) what caused of the persistence of THMs in the extracted water, even after long periods of pumping, (3) what controlled the decrease of THM concentrations during the extraction period, and (4) the potential for natural attenuation of THMs in the aquifer. Laboratory experiments on biodegradation of THMs in microcosms of aquifer materials indicate that aquifer

  19. Severe hypoglycemia symptoms, antecedent behaviors, immediate consequences and association with glycemia medication usage: Secondary analysis of the ACCORD clinical trial data

    Directory of Open Access Journals (Sweden)

    Bonds Denise E

    2012-05-01

    Full Text Available Abstract Background Hypoglycemia is a common complication of diabetes treatment. This paper describes symptoms, predecessors, consequences and medications associated with the first episode of severe hypoglycemia among ACCORD participants with type 2 diabetes, and compares these between intensive (Int: goal A1C Methods Information about symptoms, antecedents, and consequences was collected at the time participants reported an episode of severe hypoglycemia. Data on medications prescribed during the clinical trial was used to determine the association of particular diabetes drug classes and severe hypoglycemia. Results The most frequently reported symptoms in both glycemia group were weakness/fatigue (Int 29%; Std 30% and sweating (Int 26%; Std 27%, followed by confusion/disorientation (Int 22%; Std 29% and shakiness (Int 21%; Std 19%. Approximately half of all events were preceded by a variation in food intake (Int 48%; Std 58%. The most common consequences were confusion (Int 37%; Std 34%, loss of consciousness (Int 25%; Std 25%, and hospitalization (Int 18%; Std 24%. The highest rates of hypoglycemia were found among those participants treated with insulin only (Int 6.09/100 person yrs; Std 2.64/100 person yrs while the lowest were among those prescribed oral agents only (Int 1.93/100 person yrs; Std 0.20/100 person yrs. Conclusions Severe hypoglycemia episodes were frequently preceded by a change in food intake, making many episodes potentially preventable. Symptoms of confusion/disorientation and loss of consciousness were frequently seen. The highest rates of hypoglycemia were seen with prescription of insulin, either alone or in combination with other medications. Clinical Trial Registration Number: NCT00000620

  20. Rhinovirus wheezing illness in infancy is associated with medically attended third year wheezing in low risk infants: results of a healthy birth cohort study.

    Science.gov (United States)

    de Winter, Janneke J H; Bont, Louis; Wilbrink, Berry; van der Ent, Cornelis K; Smit, Henriette A; Houben, Michiel L

    2015-12-01

    Rhinoviruses may be pathogens contributing to the development of childhood wheezing. However, their role in low risk infants without an asthmatic predisposition is unknown. Knowing which healthy, low risk children are at increased risk for childhood wheezing after rhinovirus wheezing illness (RV-WI) in infancy, might help in developing prevention and treatment strategies for childhood wheezing. The aim of this study was to determine the association of medically attended wheezing at the age of three with RV-WI in the first year of life in low risk children without parental asthma. In a low risk, prospective birth cohort study, we followed 181 healthy born children from birth through the third year of life. We considered children 'low risk' if neither parent had a doctor's diagnosis of asthma. We determined infant RV-WI by parent-reported wheezing (based on daily logs) and simultaneous molecular rhinovirus detection in the first year of life. Respiratory function and blood eosinophil count were both measured in the first month of life. The primary outcome, third year wheezing, was defined as the use of prescribed inhaled asthma medications together with a doctor's visit for respiratory symptoms in the third year of life. We calculated the association of RV-WI with medically attended third year wheezing and other known possible risk factors for wheezing at the age of three. Among low risk children, third year wheezing was observed in 7 out of 18 (39%) children with versus 10 out of 163 (6%) children without infant RV-WI (OR 9.7, 95% CI 3.1-33.5, P third year wheezing was unchanged after adjustment for potential confounders such as eosinophilia and atopic eczema. RV-WI is a robust and independent risk factor for third year wheezing in low risk children without parental asthma. Future research will identify and protect those children at increased risk for RV-WI.

  1. Prevalence, awareness, medication, control, and risk factors associated with hypertension in Bai ethnic group in rural China: the Yunnan Minority Eye Study.

    Directory of Open Access Journals (Sweden)

    Jinman Zhang

    Full Text Available PURPOSE: This study aimed to assess the prevalence, awareness, treatment, and control of hypertension and their associated factors among Bai ethnic population in the rural China. METHODS: A population-based survey was conducted in 2010 with a randomly cluster sampling in rural communities in Dali, southwest China. A total of 2133 adults aged 50 or above were interviewed, and their blood pressure, height, weight and waist circumference were measured. Hypertension was defined as a mean SBP≥140 mmHg and/or DBP≥90 mmHg, and/or current use of antihypertensive medications. RESULTS: The prevalence of hypertension was 42.1% (899/2133, and the age- and gender-adjusted prevalence was 40.0%. Among the hypertensive participants, 28.4% (255/899were aware of their condition, while 24.6% (221/899 took antihypertensive medications, with only 7.5% (67/899 of those achieving blood pressure control (<140/90 mmHg. Risk factors for hypertension were older age, smoking, alcohol drinking, family history of HBP, overweight, and obesity, while protective factors included being lean, and having finished senior high school or above. CONCLUSIONS: Hypertension prevalence is high among the population of Bai ethnic group in China, while the associated risk factors of hypertension include overweight/obesity, cigarette smoking, history of hypertension, and older age. The percentages of hypertensive participants aware of their hypertension and those taking antihypertensive medications were low with an incredibly low proportion of hypertensive patients who kept their hypertension under control. It is suggested that health education and hypertension screening programs be carried out in the area for the high blood pressure prevention and control.

  2. Poor medication adherence in type 2 diabetes: recognizing the scope of the problem and its key contributors

    OpenAIRE

    Polonsky WH; Henry RR

    2016-01-01

    William H Polonsky,1,2 Robert R Henry2,3 1Behavioral Diabetes Institute, San Diego, 2University of California, San Diego, 3Center for Metabolic Research, VA San Diego Healthcare System, San Diego, CA, USA Abstract: At least 45% of patients with type 2 diabetes (T2D) fail to achieve adequate glycemic control (HbA1c <7%). One of the major contributing factors is poor medication adherence. Poor medication adherence in T2D is well documented to be very common and is associated w...

  3. Janis Huston Audin, MSc, DVM,1950-2009. Dynamic editor-in-chief of the Journal of the American Veterinary Medical Association and strong One Health advocate dies

    Directory of Open Access Journals (Sweden)

    Bruce Kaplan, DVM

    2009-09-01

    Full Text Available Dr Janis H. Audin (MSc Illinois 1975, DVM Illinois 1979, a champion of progressive veterinary medical journalism and ‘One Health’ died on 22 April 2009 following a long, courageous and difficult battle with pancreatic cancer. The world has lost a truly significant One Health leader and advocate. Under her guidance, the Journal of the American Veterinary Medical Association (JAVMA implemented a ‘one-health wonders’ column that recognised and highlighted prominent One Health individuals among the medical and veterinary medical professions in the United States. The American Veterinary Medical Association (AVMA has lost a dedicated and gifted editor-in-chief.Dr Audin joined the editorial staff of the AVMA in 1985, as an assistant editor and was promoted to associate editor in 1989 and editor in 1994. She became the editor-in-chief of both the JAVMA and the American Journal of Veterinary Research in 1995. Prior to that, Dr Audin practised as an associate veterinarian in Calumet City, Illinois, for four years.During her tenure, Dr Audin was noted for implementing procedural and technological changes in the journal to reduce costs, improve timeliness of publications and promote readership interest and awareness. New features in the News section introduced under her leadership have made the journals more practical and public health-relevant. For instance, Dr Audin fostered the United States Department of Agriculture’s Food Safety and Inspection Service (USDA-FSIS ‘Inspection Insights’ - a public health-oriented food safety monthly column related to meat, poultry and egg products - from 1996 through 1998. She also increased international manuscript submissions.On 23 March 2009 AVMA Executive Vice President Dr W. Ron DeHaven named Dr Audin as editor-in-chief emeritus of the Publications Division. Wisely, it also meant that Dr Audin could continue contributing to the staff effort to ensure the high quality of the AVMA scientific journals

  4. The Association of Medication-Use and Frailty-Related Factors with Gait Performance in Older Patients

    NARCIS (Netherlands)

    de Groot, Maartje H; van Campen, Jos P C M; Kosse, Nienke M; de Vries, Oscar J; Beijnen, Jos H; Lamoth, Claudine J C

    2016-01-01

    The increased fall risk associated with the use of psychotropic drugs might be caused by underlying problems in postural control that are induced by sedative side-effects of these drugs. The current literature on the effects of psychotropics on postural control only examined acute single-drug effect

  5. Molecular pathology curriculum for medical laboratory scientists: A report of the association for molecular pathology training and education committee.

    Science.gov (United States)

    Taylor, Sara; Bennett, Katie M; Deignan, Joshua L; Hendrix, Ericka C; Orton, Susan M; Verma, Shalini; Schutzbank, Ted E

    2014-05-01

    Molecular diagnostics is a rapidly growing specialty in the clinical laboratory assessment of pathology. Educational programs in medical laboratory science and specialized programs in molecular diagnostics must address the training of clinical scientists in molecular diagnostics, but the educational curriculum for this field is not well defined. Moreover, our understanding of underlying genetic contributions to specific diseases and the technologies used in molecular diagnostics laboratories change rapidly, challenging providers of training programs in molecular diagnostics to keep their curriculum current and relevant. In this article, we provide curriculum recommendations to molecular diagnostics training providers at both the baccalaureate and master's level of education. We base our recommendations on several factors. First, we considered National Accrediting Agency for Clinical Laboratory Sciences guidelines for accreditation of molecular diagnostics programs, because educational programs in clinical laboratory science should obtain its accreditation. Second, the guidelines of several of the best known certifying agencies for clinical laboratory scientists were incorporated into our recommendations. Finally, we relied on feedback from current employers of molecular diagnostics scientists, regarding the skills and knowledge that they believe are essential for clinical scientists who will be performing molecular testing in their laboratories. We have compiled these data into recommendations for a molecular diagnostics curriculum at both the baccalaureate and master's level of education.

  6. Immune status, antibiotic medication and pH are associated with changes in the stomach fluid microbiota.

    Science.gov (United States)

    von Rosenvinge, Erik C; Song, Yang; White, James R; Maddox, Cynthia; Blanchard, Thomas; Fricke, W Florian

    2013-07-01

    The stomach acts as a barrier to ingested microbes, thereby influencing the microbial ecology of the entire gastrointestinal (GI) tract. The stomach microbiota and the role of human host and environmental factors, such as health status or medications, in shaping its composition remain largely unknown. We sought to characterize the bacterial and fungal microbiota in the stomach fluid in order to gain insights into the role of the stomach in GI homeostasis. Gastric fluid was collected from 25 patients undergoing clinically indicated upper endoscopy. DNA isolates were used for PCR amplification of bacterial 16S ribosomal RNA (rRNA) genes and fungal i