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Sample records for california medical association

  1. THE CALIFORNIA MEDICAL MALPRACTICE PICTURE.

    Science.gov (United States)

    RUBSAMEN, D S

    1963-11-01

    The California physician's steadily increasing risk of legal liability poses a basic question: Will he ultimately wind up a guarantor of results, carrying a great burden of malpractice insurance in order to pay for every untoward result of medical treatment? This alarming prospect is the result of many years of judicial (and therefore lay) speculation on the legal significance of the injury which brings the patient into court. Does it look as though this injury probably is associated with medical negligence? If so, let the doctor explain. And the explanation must be very complete. The legal instrument which thus reverses the traditional requirements of proof, permitting the patient-plaintiff to remain silent while the doctor-defendant must exculpate himself, is an evidentiary doctrine called res ipsa loquitur-the thing speaks for itself. The application of the doctrine relieves the patient-plaintiff of the necessity of producing an expert witness to point the finger and say, "The medical conduct that produced this injury was sub-standard." The increased use of the doctrine reflects a judicial conviction that in many parts of California physicians refuse to testify for the patient-plaintiff regardless of the merit to his case.A recent California Supreme Court decision suggests that the Court is not unaware of the adverse social consequences implicit in the irrational expansion of the physician's risk of legal liability. But a reversal of this trend would seem to be contingent on positive conduct from the medical profession in California-conduct demonstrating that no meritorious patient-plaintiff will fail in his malpractice lawsuit for lack of an expert medical witness. PMID:14081771

  2. California's county hospitals and the University of California graduate medical education system. Current issues and future directions.

    OpenAIRE

    Jameson, W J; Pierce, K; Martin, D K

    1998-01-01

    California's county hospitals train 45% of the state's graduate medical residents, including 33% of residents in the University of California system. This paper describes the interrelationships of California's county hospitals and the University of California (UC) graduate medical education (GME) programs, highlighting key challenges facing both systems. The mission of California's county health care systems is to serve all who need health care services regardless of ability to pay. Locating ...

  3. 78 FR 77447 - California Wind Energy Association, First Solar, Inc. v. California Independent System Operator...

    Science.gov (United States)

    2013-12-23

    ... Energy Regulatory Commission California Wind Energy Association, First Solar, Inc. v. California Independent System Operator Corporation, Southern California Edison Company; Notice of Complaint Take notice... Practice and Procedure, 18 CFR 385.206 (2013), California Wind Energy Association and First Solar,...

  4. American Medical Association

    Science.gov (United States)

    ... Medicare & Medicaid Private Payer Reform Claims Processing & Practice Revenue HIPAA Compliance Medical Liability Reform Delivering Care Delivering ... factors to consider before adopting a peer-comparison model designed to guide physicians toward improving the value ...

  5. [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.

  6. Gay and Lesbian Medical Association

    Science.gov (United States)

    ... Click here to learn more. GLMA and Other Associations Speak Out On Religious Freedom Laws As the Governors of and legislators in Arkansas and Indiana work to address the concerns about how religious freedom ... professional associations to join a letter sharing their perspectives as ...

  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. Primary Sources on C. E. Kelsey and the Northern California Indian Association

    OpenAIRE

    Miller, Larisa K.

    2013-01-01

    This article provides a brief history of and identifies primary sources on C. E. Kelsey and the Northern California Indian Association, which brought federal support to the nonreservation Indians of northern California in the early 1900s. Kelsey is a frequently mentioned but largely unknown figure in the unique history of Indian-white relations in California. As an officer of the Northern California Indian Association (NCIA) and special agent for the Indian Office he altered the landscape for...

  9. 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. PMID:24698184

  10. [Croatian Medical Association--Branch Zagreb].

    Science.gov (United States)

    Kaić, Zvonimir; Sain, Snjezana; Gulić, Mirjana; Mahovlić, Vjekoslav; Krznarić, Zeljko

    2014-01-01

    The available literature shows us that "Druztvo ljeciteljah u Zagrebus (the Society of Healers in Zagreb) was founded as far back as the year 1845 by a total of thirteen members. This data allows us to follow the role of doctors and health workers in Zagreb through their everyday profession, research, organizational and social work as well as management through a period of over one hundred to seventy years. The Branch Zagreb was active before the official establishment of subsidiaries of CMA which is evident from the minutes of the regular annual assembly of the Croatian Medical Association on 21 March 1948. Until the end of 1956, there was no clear division of labor, functions and competencies between the Branch and the Main Board. Their actions were instead consolidated and the Branch operated within and under the name of Croatian Medical Association. In that year the Branch became independent. The Branch Zagreb is the largest and one of the most active branches of the Croatian Medical Association. At the moment, the Branch brings together 3621 members, regular members--doctors of medicine (2497), doctors of dental medicine (384), retired physicians (710), and associate members (30 specialists with higher education who are not doctors). The Branch is especially accomplished in its activities in the area of professional development of its members and therefore organizes a series of scientific conferences in the framework of continuous education of physicians, allowing its members to acquire necessary points for the extension of their operating license. The choir "Zagrebacki lijecnici pjevaci" (Zagreb Physicians' Choir) of the Croatian Medical Music Society of the CMA and its activities are inseparable from the Branch Zagreb. The Branch is firmly linked to the parent body, the CMA, and thus has a visible impact on the strategy and the activities of the Association as a whole. Most professional societies of the CMA have their headquarters in Zagreb and this is

  11. The emerging Medical and Geological Association.

    Science.gov (United States)

    Finkelman, R.B.; Centeno, J.A.; Selinus, O.

    2005-01-01

    The impact on human health by natural materials such as water, rocks, and minerals has been known for thousands of years but there have been few systematic, multidisciplinary studies on the relationship between geologic materials and processes and human health (the field of study commonly referred to as medical geology). In the past few years, however, there has been a resurgence of interest in medical geology. Geoscientists working with medical researchers and public health scientists have made important contributions to understanding novel exposure pathways and causes of a wide range of environmental health problems such as: exposure to toxic levels of trace essential and non-essential elements such as arsenic and mercury; trace element deficiencies; exposure to natural dusts and to radioactivity; naturally occurring organic compounds in drinking water; volcanic emissions, etc. By linking with biomedical/public health researchers geoscientists are finally taking advantage of this age-old opportunity to help mitigate environmental health problems. The International Medical Geology Association has recently been formed to support this effort.

  12. 76 FR 46651 - Petition for Rulemaking Submitted by the California Association of Marriage and Family Therapists

    Science.gov (United States)

    2011-08-03

    ... anthony.markley@nrc.gov . SUPPLEMENTARY INFORMATION: On August 24, 2010 (75 FR 51958), the NRC published a... 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...

  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. 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.

  15. 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

  16. Association of sedative-hypnotic medications with suicidality.

    Science.gov (United States)

    Pae, Chi-Un; Koh, Jun Sung; Lee, Soo-Jung; Han, Changsu; Patkar, Ashwin A; Masand, Prakash S

    2011-03-01

    Evaluation of: Brower KJ, McCammon RJ, Wojnar M, Ilgen MA, Wojnar J, Valenstein M. Prescription sleeping pills, insomnia, and suicidality in the National Comorbidity Survey Replication. J. Clin. Psychiatry DOI: 10.4088/JCP.09m05484gry (2010) (Epub ahead of print). Several studies have investigated the association between sedative-hypnotics and suicidality, as such medications not only serve as a method for suicide, but are also involved in the usual options for treating psychiatric and medico-surgical disorders. According to population-based studies in Europe, Asia and the USA, sedative-hypnotic medications were significantly associated with suicide. However, these studies failed to address psychiatric comorbidities, new hypnotic medications, such as zolpidem, and the specific times at which such medications were used. Recently, Brower and colleagues have investigated the association of the prescription of sedative-hypnotic drugs with suicidality, to determine whether such medications were associated with suicidal ideation, suicide plans and suicide attempts in a large-cohort sample. They found that the use of sedative-hypnotic medications was significantly associated with suicidal ideation, suicide plans and suicide attempts. In addition, the use of sedative-hypnotic medications was a stronger predictor than insomnia of both suicidal ideation and suicide attempts. This article will discuss the relationship between prescription of sedative-hypnotic medications and suicide in the context of the potential limitations and significance of this recent research. PMID:21375440

  17. 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

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

    OpenAIRE

    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...

  19. 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.

  20. 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

  1. CONTENT BASED MEDICAL IMAGE RETRIEVAL USING BINARY ASSOCIATION RULES

    OpenAIRE

    Akila; Uma Maheswari

    2013-01-01

    In this study, we propose a content-based medical image retrieval framework based on binary association rules to augment the results of medical image diagnosis, for supporting clinical decision making. Specifically, this work is employed on scanned Magnetic Resonance brain Images (MRI) and the proposed Content Based Image Retrieval (CBIR) process is for enhancing relevancy rate of retrieved images. The pertinent features of a query brain image are extracted by applying third order moment inva...

  2. 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.

  3. Non medical factors associated with psychological disorders in cancer patients

    International Nuclear Information System (INIS)

    Objective: To find out major non-medial factors associated with psychological disorders in cancer patients. Design: An observational study conducted on adult cancer patients. Place and Duration of Study: The study was conducted at Shaukat Khanum Memorial Cancer Hospital and Research Center Lahore Pakistan from January 1999. Patients and Methods: Two hundred and twenty-four newly-diagnosed adult cancer patients were interviewed by the clinical psychologist and data was collected regarding non-medical causal factors, patients age, gender family support system, general home atmosphere and marital status. Collected data was analyzed by utilizing. SPSS for windows version 10.0. Results: Of the 224 patients 142 (63.4%) reported non-medical factors causing psychological distress and 82 (36.6%) reported that medical sources are the most distressing. Ten most common non-medical sources of developing psychological disorders were identified. It was observed that family support system and general home atmosphere were significantly associated with the development of psychological disorders whereas the other variables such as age, gender and marital status had no significant relationship with the non Medical factors. Conclusion: It was concluded that non-medical factors causing psychological problems are significant in cancer patients. The results suggest that we should identify these factors and target psychosocial intervention for those patients most at risk. (author)

  4. Association Between Asthma and Obesity Among Immigrant Asian Americans, California Health Interview Survey, 2001–2011

    OpenAIRE

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

    2014-01-01

    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 a...

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

    Science.gov (United States)

    1995-12-01

    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. PMID:7474278

  6. Medical guidelines for space passengers. Aerospace Medical Association Task Force on Space Travel.

    Science.gov (United States)

    2001-10-01

    In the foreseeable future, private companies will manufacture space vehicles with a capacity of transporting tourists into low Earth orbit. Because of the stresses of spaceflight, the effects of microgravity, and limited medical care capability, a system of medical clearance is highly recommended for these space tourists. It is our purpose to establish guidelines for use by private businesses, medical providers, and those planning on being a space tourist. Consequently, a Task Force was organized by the Aerospace Medical Association (AsMA) for the purpose of facilitating safety of passengers, fellow passengers, crew, and flight operations. The guidelines are meant to serve only as a template with the full expectation that exceptions might be made with appropriate rationale. PMID:11601561

  7. A questionnaire survey of medical cooperation by the Iwaki medical association

    International Nuclear Information System (INIS)

    It has been pointed out that currently, Iwaki City faces an insufficiency of doctors working at hospitals, compared with before. Such an insufficiency became more remarkable after the 2011 Tohoku Earthquake and Fukushima Nuclear Disaster, as about 30,000 people relocated to Iwaki City from the evacuation areas. In this regard, the Iwaki Medical Association conducted a questionnaire survey to investigate the problems of medical cooperation and utilize the data to improve medical cooperation within hospitals and clinics. A total of 159 doctors answered the questionnaires: 64% were community physicians, 36% were doctors working at hospitals, and 42% were physicians. About 60% of the doctors were satisfied with the present medical cooperation. Home health care was performed by 25% of the doctors working at hospitals and 45% of the community physicians. Approximately 80% of the doctors felt the need for additional physicians to perform home health care, although more than half of the doctors answered that they do not perform it. Various problems exist in the context of medical cooperation, but many doctors still hope for its improvement, according to the answers in the questionnaires. Efforts have to be exerted further in order to enhance medical cooperation among the health care team. (author)

  8. Association Between High Ambient Temperature and Risk of Stillbirth in California.

    Science.gov (United States)

    Basu, Rupa; Sarovar, Varada; Malig, Brian J

    2016-05-15

    Recent studies have linked elevated apparent temperatures with adverse birth outcomes, such as preterm delivery, but other birth outcomes have not been well studied. We examined 8,510 fetal deaths (≥20 weeks' gestation) to estimate their association with mean apparent temperature, a combination of temperature and humidity, during the warm season in California (May-October) from 1999 to 2009. Mothers whose residential zip codes were within 10 km of a meteorological monitor were included. Meteorological data were provided by the California Irrigation Management Information System, the US Environmental Protection Agency, and the National Climatic Data Center, while the California Department of Public Health provided stillbirth data. Using a time-stratified case-crossover study design, we found a 10.4% change (95% confidence interval: 4.4, 16.8) in risk of stillbirth for every 10°F (5.6°C) increase in apparent temperature (cumulative average of lags 2-6 days). Risk varied by maternal race/ethnicity and was greater for younger mothers, less educated mothers, and male fetuses. The highest risks were observed during gestational weeks 20-25 and 31-33. No associations were found during the cold season (November-April), and the observed associations were independent of air pollutants. This study adds to the growing body of literature identifying pregnant women and their fetuses as subgroups vulnerable to heat exposure. PMID:27037268

  9. Factors associated with medical orders’ compliance among hyperlipidemic patients

    OpenAIRE

    Dehkordi, Leila Mardanian

    2013-01-01

    Background: Coronary artery diseases are one of the most important issues in health and social problems. One of the amendable risk factors in development of these diseases is high cholesterol which can be modified through correction of lifestyle (diet change, playing sports, and usage of lipid-lowering drugs). Patients’ compliance to therapeutic programs is the most important element to achieve this goal. This study aims to define the factors associated with compliance to medications among hy...

  10. 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).

  11. California Indian Education Association Report on the Fifth Annual State Conference and Workshop (San Diego, California, October 8-10, 1971).

    Science.gov (United States)

    Cooper, Gwen, Ed.; And Others

    The California Indian Education Association has held American Indian education workshops in conjunction with its annual conferences since its inception in 1967. The report of this 5th annual meeting reflected many of the frustrations that Indians face in their contact with society, particularly in the educational system. The frustrations of Indian…

  12. 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.

  13. 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

  14. 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. PMID:22647743

  15. Isolation and Characterization of Borrelia hermsii Associated with Two Foci of Tick-Borne Relapsing Fever in California

    OpenAIRE

    Fritz, Curtis L; Bronson, Lawrence R.; Smith, Charles R.; Schriefer, Martin E.; Tucker, James R.; Schwan, Tom G.

    2004-01-01

    Relapsing fever, caused by the spirochete Borrelia hermsii and transmitted by the soft tick Ornithodoros hermsi, is endemic in many rural mountainous areas of California. Between 1996 and 1998, 12 cases of relapsing fever associated with two exposure sites in northern California were investigated. Follow-up at exposure sites included collection of soft ticks and serum specimens from sylvatic rodents. Attempts to cultivate spirochetes were made through inoculation of patient blood into mice an...

  16. Social Support and Lifestyle vs. Medical Diabetes Self-Management in the Diabetes Study of Northern California (DISTANCE)

    OpenAIRE

    Rosland, AM; Piette, JD; Lyles, CR; Parker, MM; Moffet, HH; Adler, NE; Schillinger, D.; Karter, AJ

    2014-01-01

    © 2014, The Society of Behavioral Medicine (outside the USA). Purpose: Examine social support’s association with seven individual chronic illness self-management behaviors: two healthy “lifestyle” behaviors (physical activity, diet) and five more highly skilled and diabetes-specific (medical) behaviors (checking feet, oral medication adherence, insulin adherence, self-monitored blood glucose, primary care appointment attendance). Background: In chronic illness self-care, social support may in...

  17. Social Support and Lifestyle vs. Medical Diabetes Self-Management in the Diabetes Study of Northern California (DISTANCE)

    OpenAIRE

    Rosland, AM; Piette, JD; Lyles, CR; Parker, MM; Moffet, HH; Adler, NE; Schillinger, D.; Karter, AJ

    2014-01-01

    Background In chronic illness self-care, social support may influence some health behaviors more than others. Purpose Examine social support's association with seven individual chronic illness self-management behaviors: two healthy "lifestyle" behaviors (physical activity, diet) and five more highly skilled and diabetes-specific (medical) behaviors (checking feet, oral medication adherence, insulin adherence, self-monitored blood glucose, primary care appointment attendance). Methods Using cr...

  18. 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

  19. 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.

  20. Prevalence and risk factors associated with Sarcocystis neurona infections in opossums (Didelphis virginiana) from central California.

    Science.gov (United States)

    Rejmanek, Daniel; Vanwormer, Elizabeth; Miller, Melissa A; Mazet, Jonna A K; Nichelason, Amy E; Melli, Ann C; Packham, Andrea E; Jessup, David A; Conrad, Patricia A

    2009-12-01

    Sarcocystis neurona, a protozoal parasite shed by opossums (Didelphis virginiana), has been shown to cause significant morbidity and mortality in horses, sea otters, and other marine mammals. Over the course of 3 years (fall 2005-summer 2008), opossums from central California were tested for infection with S. neurona. Of 288 opossums sampled, 17 (5.9%) were infected with S. neurona based on the molecular characterization of sporocysts from intestinal scrapings or feces. Risk factors evaluated for association with S. neurona infection in opossums included: age, sex, location, season, presence of pouch young in females, concomitant infection, and sampling method (live-trapped or traffic-killed). Multivariate logistic regression analysis identified that opossums in the Central Valley were 9 times more likely to be infected than those near the coast (p=0.009). Similarly, opossum infection was 5 times more likely to be detected during the reproductive season (March-July; p=0.013). This first investigation of S. neurona infection prevalence and associated risk factors in opossums in the western United States can be used to develop management strategies aimed at reducing the incidence of S. neurona infections in susceptible hosts, including horses and threatened California sea otters (Enhydra lutris neries). PMID:19735983

  1. 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.

  2. Community composition, structure, and interrelationships in the marine intertidal Endocladia muricata – Balanus glandula association in Monterey Bay, California

    NARCIS (Netherlands)

    Glynn, Peter W.

    1965-01-01

    Studies of the community composition, structure and species interrelationships of the Endocladia-Balanus association were carried out on the rocky shores at the Hopkins Marine Station, Pacific Grove, California, over the period 1959—1961. The organisms making up this biotic association form a horizo

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

    International Nuclear Information System (INIS)

    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

  4. 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.

  5. 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

  6. 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

  7. 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

  8. 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. PMID:27413658

  9. Patterns of Medicaid Eligibility: A Sample of 408 Medi-Cal Eligibles in San Francisco, California

    OpenAIRE

    Celum, Connie L.; Newacheck, Paul W.; Showstack, Jonathan A.

    1981-01-01

    Medicaid expenditures per recipient have increased substantially in the past decade, even after controlling for medical care price inflation. In response to this Medicaid expenditure growth, various policies to encourage Medicaid enrollment in cost-effective health maintenance organizations (HMOs) are being considered, including guaranteed Medicaid eligibility for Medicaid eligibles enrolled in HMOs. This paper addresses several important questions about Medicaid eligibility that are essentia...

  10. 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....

  11. 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

  12. 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.

  13. 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. PMID:27668523

  14. 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

  15. 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.

  16. 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

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

    OpenAIRE

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

    2012-01-01

    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 (ho...

  18. Environmental characteristics associated with the occurrence of avian botulism in wetlands of a northern California refuge

    Science.gov (United States)

    Rocke, Tonie E.; Euliss, Ned H.; Samuel, Michael D.

    1999-01-01

    Avian botulism is an important disease affecting many species of waterbirds in North America, but the environmental conditions that initiate outbreaks are poorly understood. To determine wetland attributes associated with outbreaks of avian botulism in waterbirds at the Sacramento National Wildlife Refuge (SNWR), California, we compared environmental characteristics between wetlands where outbreaks occurred (outbreak wetlands) and did not occur (nonoutbreak wetlands). In June through October, 1987 89, we monitored the occurrence of avian botulism via observations for sick or dead sentinel mallards (Anas platyrhynchos) placed in 4 wetland enclosures. During this same time period, we collected environmental data from the water column and sediments of each wetland enclosure at 10 14-day sampling intervals. Multivariate analysis was used to reduce 22 environmental variables to 7 factors for inclusion in subsequent statistical analyses. We found that outbreak wetlands had significantly lower redox potential than nonoutbreak wetlands. The probability of botulism in sentinel mallards was associated with increasing temperature, increasing invertebrate abundance or biomass, and decreasing turbidity. However, because these factors were not consistently higher in outbreak wetlands compared to nonoutbreak wetlands, they may have a more proximate effect in initiating an outbreak.

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

    OpenAIRE

    Yusoff, Muhamad S. B.

    2013-01-01

    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 w...

  20. 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).

  1. Systemic adenovirus infection associated with high mortality in mule deer (Odocoileus hemionus) in California

    NARCIS (Netherlands)

    Horzinek, M.C.; Woods, L.W.; Swift, P.K.; Barr, B.C.; Nordhausen, R.W.; Stillian, M.H.; Patton, J.F.; Oliver, M.N.; Jones, K.R.; Maclachlan, N.J.

    1996-01-01

    Seventeen counties in northern California experienced epizootics of high mortality in the mule deer (Odocoileus hemionus) population during the latter half of 1993. Thirteen deer submitted to the California Veterinary Diagnostic Laboratory System as part of this natural die-off had systemic adenovir

  2. 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.

  3. Correlations between root-associated microorganisms and peach replant disease symptoms in a California soil.

    Directory of Open Access Journals (Sweden)

    Jiue-in Yang

    Full Text Available BACKGROUND: Replant disease often occurs when certain crops are "replanted" in a soil that had previously supported the same or similar plant species. This disease typically leads to reductions in plant growth, crop yields, and production duration, and its etiology remains ill-defined. The objective of this study was to identify microorganisms associated with peach replant disease symptoms at a field location in California, USA. Soil samples were subjected to treatments to create various levels of replant disease symptoms. Clonal peach seedlings were grown in the treated soils in greenhouse trials. After 6 weeks, plant growth parameters were measured, and both culture and culture-independent analyses were performed to identify root-associated bacteria, fungi and stramenopiles. RESULTS: A total of 295,785 bacterial operational taxonomic units (OTU were identified by an Illumina-based, high throughput sequence analysis of rRNA genes. Among the 60 most abundant OTUs, 27 showed significant (P<0.05 negative correlation with peach shoot weights while 10 were positively correlated. Most of these OTUs belonged to the bacterial phylum Proteobacteria (96%, including the classes Gammaproteobacteria (44.4%, Betaproteobacteria (33.3% and Alphaproteobacteria (22.2%, and the orders Pseudomonadales, Burkholderiales, Chromatiales, Rhodocyclales, and Sphingomonadales. The most abundant fungi were Trichoderma asperellum, Trichoderma virens, Fusarium oxysporum, Ceratocystis fimbriata and Fusarium solani. The most abundant stramenopiles were Pythium vexans, Pythium violae and an unidentified Aplanochytrium species. Validation experiments using sequence-selective quantitative PCR analyses identified negative and positive associations between P. vexans and Trichoderma spp. and peach shoot weights, respectively. CONCLUSIONS: This study identified numerous microorganisms associated with peach replant symptoms, some of which have been previously identified while others

  4. 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.

  5. 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)

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

    OpenAIRE

    Kalaiselvi Selvaraj; Ganesh Kumar S; Archana Ramalingam

    2014-01-01

    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 tot...

  8. Medication Regimen Complexity and Polypharmacy as Factors Associated With All-Cause Mortality in Older People

    OpenAIRE

    Wimmer, Barbara C.; Bell, J Simon; Fastbom, Johan; Wiese, Michael D; Johnell, Kristina

    2016-01-01

    Objectives: To investigate whether medication regimen complexity and/or polypharmacy are associated with all-cause mortality in older people. Methods: This was a population-based cohort study among community-dwelling and institutionalized people ≥60 years old (n = 3348). Medication regimen complexity was assessed using the 65-item Medication Regimen Complexity Index (MRCI) in 10-unit steps. Polypharmacy was assessed as a continuous variable (number of medications). Mortality data were obtaine...

  9. 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...

  10. 76 FR 55886 - Selection Criteria-Transportation Infrastructure Improvements Associated With Medical Facilities...

    Science.gov (United States)

    2011-09-09

    ... of the Secretary Selection Criteria--Transportation Infrastructure Improvements Associated With... funding from the Office of Economic Adjustment (OEA) for construction of Transportation Infrastructure... Infrastructure Improvements associated with medical facilities related to recommendations of the 2005...

  11. 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.

  12. Association between Lifestyle and School Attendance in Japanese Medical Students: A Pilot Study

    Science.gov (United States)

    Tanaka, Masaaki; Watanabe, Yasuyoshi

    2012-01-01

    Objective: Lifestyle factors are thought to be associated with students' academic performance. Whether lifestyle factors were associated with medical students' school attendance was determined. Design: Cross-sectional design. Setting: The study group consisted of 157 healthy second-year medical students attending Osaka City University Graduate…

  13. 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.

  14. Adverse drug reactions associated with asthma medications in children

    DEFF Research Database (Denmark)

    Aagaard, Lise; Hansen, Ebba Holme

    2014-01-01

    from 1 to 22 months. The most frequently reported ADRs were exacerbation of asthma, respiratory tract infection, cough, fever and headache. Only few ADRs were rated as being serious, however a number of children dropped out of the clinical trials due to serious ADRs, and, therefore, the real number......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...... 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...

  15. 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.

  16. 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.

  17. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects.

    Science.gov (United States)

    2014-01-01

    Published research in English-language journals are increasingly required to carry a statement that the study has been approved and monitored by an Institutional Review Board in conformance with 45 CFR 46 standards if the study was conducted in the United States. Alternative language attesting conformity with the Helsinki Declaration is often included when the research was conducted in Europe or elsewhere. The Helsinki Declaration was created by the World Medical Association in 1964 (ten years before the Belmont Report) and has been amended several times. The Helsinki Declaration differs from its American version in several respects, the most significant of which is that it was developed by and for physicians. The term "patient" appears in many places where we would expect to see "subject." It is stated in several places that physicians must either conduct or have supervisory control of the research. The dual role of the physician-researcher is acknowledged, but it is made clear that the role of healer takes precedence over that of scientist. In the United States, the federal government developed and enforces regulations on researcher; in the rest of the world, the profession, or a significant part of it, took the initiative in defining and promoting good research practice, and governments in many countries have worked to harmonize their standards along these lines. The Helsinki Declaration is based less on key philosophical principles and more on prescriptive statements. Although there is significant overlap between the Belmont and the Helsinki guidelines, the latter extends much further into research design and publication. Elements in a research protocol, use of placebos, and obligation to enroll trials in public registries (to ensure that negative findings are not buried), and requirements to share findings with the research and professional communities are included in the Helsinki Declaration. As a practical matter, these are often part of the work of American

  18. 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.

  19. 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

  20. 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. PMID:9391932

  1. 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.

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

    NARCIS (Netherlands)

    Zwikker, H.E.; Dulmen, S. van; Broeder, A.A. den; Bemt, B.J.F van den; Ende, C.H.M. van den

    2014-01-01

    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

  3. Gender and the Association between Discrimination and Psychological Distress Amongst African Americans in the California Quality of Life Survey

    OpenAIRE

    Glenn, Matthew

    2013-01-01

    Racial discrimination serves as a psychosocial stressor with implications for health, including mental health. Previous research indicates that while African American men report more discrimination events, African American women are at greater risk for some psychiatric conditions. The responses from Black respondents to the California Quality of Life Survey (Cal-QOL) in 2005 and 2007 were analyzed to test the hypothesis that gender moderates the association between discrimination and distres...

  4. The Association of Ambient Air Pollution and Traffic Exposures With Selected Congenital Anomalies in the San Joaquin Valley of California

    OpenAIRE

    Padula, Amy M.; Tager, Ira B.; Carmichael, Suzan L.; Hammond, S. Katharine; Lurmann, Frederick; Shaw, Gary M.

    2013-01-01

    Congenital anomalies are a leading cause of infant mortality and are important contributors to subsequent morbidity. Studies suggest associations between environmental contaminants and some anomalies, although evidence is limited. We aimed to investigate whether ambient air pollutant and traffic exposures in early gestation contribute to the risk of selected congenital anomalies in the San Joaquin Valley of California, 1997–2006. Seven exposures and 5 outcomes were included for a total of 35 ...

  5. 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

  6. 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.

  7. Principles for websites of the American Medical Association

    OpenAIRE

    Winker, Margaret

    2000-01-01

    The Internet has the potential to provide patients and physicians with rapid access to high quality, timely evidence regarding health and medical diagnosis and treatment. However, many barriers must be surmounted before this potential is achieved. Quality of content must be able to be verified, including the accuracy and timeliness of the information, the source of the information, and the objectivity of the source. Advertising and sponsorship must not influence content and should not be juxt...

  8. 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. PMID:25366574

  9. 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...

  10. 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

    OpenAIRE

    Boysen-Osborn, Megan; Anderson, Craig L.; Navarro, Roman; Yanuck, Justin; Strom, Suzanne; McCoy, Christopher E.; Youm, Julie; Ypma-Wong, Mary Frances; Langdorf, Mark I.

    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...

  11. Factors associated with being overweight among Inner Mongolia medical students in China

    OpenAIRE

    Chen, Jie; Yi, He; Liu, Zhiyue; Fan, Yancun; Bian, Jiang; Guo, Wenfang; Chang, Wulantuya; Sun, Juan

    2013-01-01

    Objectives A major goal of our study was to identify the associations between lifestyle factors and obesity in adolescents and young adults at risk by surveying students in Inner Mongolia Medical University. A second goal was to determine these factors differed by gender. Design Cross-sectional study. Setting Students grade 1–3 in Inner Mongolia Medical University. Participants 5471 grade 1–3 medical students, composed of 3891 female and 1580 male students. Students with body mass index (BMI)...

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

    OpenAIRE

    Sun Juan; Yi He; Liu Zhiyue; Wu Yan; Bian Jiang; Wu Yanyan; Eshita Yuki; Li Gaimei; Zhang Qing; Yang Ying

    2013-01-01

    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...

  13. 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...

  14. 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...

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. 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...

  20. 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....

  1. Medication administration error: magnitude and associated factors among nurses in Ethiopia

    OpenAIRE

    Feleke, Senafikish Amsalu; Mulatu, Muluadam Abebe; Yesmaw, Yeshaneh Seyoum

    2015-01-01

    Background The significant impact of medication administration errors affect patients in terms of morbidity, mortality, adverse drug events, and increased length of hospital stay. It also increases costs for clinicians and healthcare systems. Due to this, assessing the magnitude and associated factors of medication administration error has a significant contribution for improving the quality of patient care. The aim of this study was to assess the magnitude and associated factors of medicatio...

  2. 75 FR 51958 - California Association of Marriage and Family Therapists; Notice of Receipt of Petition for...

    Science.gov (United States)

    2010-08-24

    ... Duty Programs,'' published on August 26, 2005; 70 FR 50441), the NRC addressed the question of whether... and Human Services, along with psychiatry, psychology, clinical social work and psychiatric nursing as... on accessing a copy of the petition for rulemaking.) California Business & Professions Code Sec....

  3. Copper tolerance and distribution of epibiotic bacteria associated with giant kelp Macrocystis pyrifera in southern California

    NARCIS (Netherlands)

    Busch, Julia; Nascimento, Juliana Ribeiro; Magalhães, Ana Carolina Rubem; Dutilh, Bas E; Dinsdale, Elizabeth

    2015-01-01

    Kelp forests in southern California are important ecosystems that provide habitat and nutrition to a multitude of species. Macrocystis pyrifera and other brown algae that dominate kelp forests, produce negatively charged polysaccharides on the cell surface, which have the ability to accumulate trans

  4. 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 (pstress and depression 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.

  5. 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...

  6. 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.

  7. 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.

  8. 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.

  9. 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. PMID:25802809

  10. 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.

  11. Cross-validating factors associated with discharges against medical advice.

    Science.gov (United States)

    Dalrymple, A J; Fata, M

    1993-05-01

    Between six percent and 35% of psychiatric patients discharge themselves from hospital against medical advice (AMA). The discharges may prevent patients from deriving the full benefit of hospitalization and may result in rapid rehospitalization. We examined sociodemographic and clinical characteristics of 195 irregular discharges from a 237 bed psychiatric hospital over a five year period and found that AMA discharges increased over the study period to a peak of 25% in 1986. There was a strong negative correlation between AMA discharge rates and the willingness of physicians to commit patients involuntarily. Multiple discriminant analysis revealed a set of nine variables that accurately classified 78% of cases into regular or irregular discharge categories. Further analysis revealed that there are two distinct subgroups of patients who discharge themselves AMA: those who repeatedly left the hospital AMA in a regular "revolving back door" pattern and those who left AMA only once. The repeat group exceeded the one-time group in terms of prior admissions, appearances before review boards, and percentage of Natives. The repeat group also spent twice as long in hospital, and 27% were readmitted within one-week of the index AMA discharge. Less than three percent of the one-time AMA group was readmitted within a week. These results were cross-validated on a new sample of irregular discharges and matched controls. PMID:8518982

  12. 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

  13. 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.

  14. 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…

  15. Prevalence and associated factors of polypharmacy among adult Saudi medical outpatients at a tertiary care center

    Directory of Open Access Journals (Sweden)

    Salih Bin Salih

    2013-01-01

    Full Text Available Objective: The objective of this study was to assess the prevalence of polypharmacy (PP and the associated factors in medical outpatients. Materials and Methods: A cross-sectional, observational, descriptive study was carried out in adult medical outpatients attending internal medicine clinics at King Abdulaziz Medical City, Riyadh, Saudi Arabia from 1 March 2009 to 31 December 2009. PP was defined as the concomitant use of ≥5 medications daily. The number of medications being currently taken by patient was recorded. Effect of patients′ age, gender, educational level, number of prescribers, disease load and disease type on PP was assessed by multivariate analysis using Statistical Package for Social Sciences Incorporated (SPSS Inc Version 18. Results: Out of 766 patients included in the study, 683 (89% had PP. The mean number of prescribed medications, oral pills and doses was 8.8, 9.6 and 12.1, respectively. Factors significantly associated with PP included age (≥61 years, disease load and the number of prescribers. Gender had no impact on PP while education beyond primary education significantly decreased PP. Hypertension, diabetes mellitus and dyslipidemia alone and as a cluster increased PP. Conclusion: We found an extremely high level of PP in medical outpatients at our tertiary care center. The impact of PP on medication compliance and control of underlying diseases in Saudi Arabia is unknown and needs to be studied at different levels of care.

  16. 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.

  17. Prevalence and factors associated with self-medication in rheumatology in Sub-Saharan Africa

    Science.gov (United States)

    Ouédraogo, Dieu-Donné; Zabsonré/Tiendrebeogo, Joelle W; Zongo, Enselme; Kakpovi, Kodjo Geoffroy; Kaboré, Fulgence; Drabo, Joseph Y; Guissou, Innocent Pierre

    2015-01-01

    Objective We sought to determine the prevalence of and factors associated with self-medication in patients with rheumatic diseases. Material and Methods An analytical cross-sectional study was conducted from February to July 2013 in the rheumatology department. We included all patients who consulted for a rheumatic disease during the study period and who gave their consent. Results In total, 203 patients were included; of these, 146 patients (71.92%) had practiced self-medication. Furthermore, 99 patients (48.8%) had practiced self-medication for rheumatologic problems. The mean age of the patients was 45.5 years (range: 18–75 years). State officials accounted for 44.4% of patients. Eighty-one patients were schooled. Low back pain (29.29%) was the main reason for consultation, followed by polyarthralgia (12.12%). Using a visual analogue scale, the level of pain for which patients had used self-medication was rated as >70 out of 100 in 57.6% of patients. Fifty-five patients often self-medicated and 28 patients rarely. Drugs were bought from the pharmacy in 97% of cases. The main channel of self-medication was word of mouth (43.4%). The drugs used were mainly anti-inflammatory drugs (diclofenac: 54.54% and ibuprofen: 57.57%). Ten patients were unaware of the risks of self-medication. In multivariate analysis, sex, education level, and occupation were statistically associated with self-medication. Conclusion Self-medication for a specific rheumatologic symptom appears less common than self-medication in general. The procedures for responsible self-medication should be defined in Burkina Faso in order to minimize the risks.

  18. Associations Between Paternal Responsiveness and Stress Responsiveness in the Biparental California Mouse, Peromyscus californicus

    OpenAIRE

    Chauke, Miyetani

    2012-01-01

    The mechanistic basis of paternal behavior in mammals is poorly understood. Assuming there are parallels between the factors mediating maternal and paternal behavior, it can be expected that the onset of paternal behavior is facilitated by reductions in stress responsiveness, as occurs in females of several mammalian species. This dissertation describes studies investigating the role of stress responsiveness in the expression of paternal behavior in biparental, monogamous California mice (Per...

  19. Ectopic pregnancy with associated gestational choriocarcinoma in a California sea lion (Zalophus californianus).

    Science.gov (United States)

    Fravel, Vanessa A; Lowenstine, Linda J; Koehne, Amanda

    2016-07-01

    A wild-born, captive-reared, 14 yr old, primiparous female California sea lion Zalophus californianus presented for anorexia of 14 d duration and abdominal distention. Routine complete blood cell count revealed leukocytosis with a neutrophilia, and serum chemistry revealed hypoalbumenemia and hyponatremia. Treatment with broad spectrum antibiotics and non-steroidal anti-inflammatories were started, but the animal continued to decline. Abdominal radiographs revealed a mature mineralized fetal skull and spine in the caudal abdomen and abdominal ultrasound revealed ascites but could not confirm the fetus. The patient was taken to surgery where a full term fetus was found outside of the uterus but within the fetal membranes, representing a secondary ectopic pregnancy. The patient passed away during surgery and was taken to necropsy. Gross necropsy revealed a diffuse peritonitis with yellow deposits over the serosal surfaces of the abdominal organs. The uterus appeared intact grossly and the ovaries appeared abnormal. The mesenteric, renal, and sub-lumbar nodes were enlarged and edematous. Histopathology revealed choriocarcinoma in the right uterine horn with evidence of chronic uterine rupture and protrusion of the placental tissue into the abdomen. The choriocarcinoma had metastasized locally as well as to the liver, spleen and lung. Choriocarcinoma is a highly malignant trophoblastic neoplasm that is rare in domestic animals. This case represents, to the authors' knowledge, the first report of gestational choriocarcinoma causing secondary ectopic pregnancy in a California sea lion and presents questions regarding pregnancy monitoring and management in a population of captive, minimally trained California sea lions.

  20. 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.

  1. 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.

  2. 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

  3. 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.

  4. 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...

  5. 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…

  6. 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.

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

    OpenAIRE

    Shindel, AW; Breyer, BN; Smith, JF

    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 asse...

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

    OpenAIRE

    Amanda L. Divin; Zullig, Keith J.

    2014-01-01

    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 deri...

  9. Medical Device-Associated Candida Infections in a Rural Tertiary Care Teaching Hospital of India

    Directory of Open Access Journals (Sweden)

    Sachin C. Deorukhkar

    2016-01-01

    Full Text Available Health care associated infections (HCAIs add incrementally to the morbidity, mortality, and cost expected of the patient’s underlying diseases alone. Approximately, about half all cases of HCAIs are associated with medical devices. As Candida medical device-associated infection is highly drug resistant and can lead to serious life-threatening complications, there is a need of continuous surveillance of these infections to initiate preventive and corrective measures. The present study was conducted at a rural tertiary care hospital of India with an aim to evaluate the rate of medical device-associated Candida infections. Three commonly encountered medical device-associated infections (MDAI, catheter-associated urinary tract infection (CA-UTI, intravascular catheter-related blood stream infections (CR-BSI, and ventilator-associated pneumonia (VAP, were targeted. The overall rate of MDAI in our hospital was 2.1 per 1000 device days. The rate of Candida related CA-UTI and CR-BSI was noted as 1.0 and 0.3, respectively. Untiring efforts taken by team members of Hospital Acquired Infection Control Committee along with maintenance of meticulous hygiene of the hospital and wards may explain the low MDAI rates in our institute. The present surveillance helped us for systematic generation of institutional data regarding MDAI with special reference to role of Candida spp.

  10. 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.

  11. Excess Medical Care Costs Associated with Physical Inactivity among Korean Adults: Retrospective Cohort Study

    Directory of Open Access Journals (Sweden)

    Jin-Young Min

    2016-01-01

    Full Text Available Physical inactivity is a major risk factor for chronic diseases and premature death. The increased health risks associated with physical inactivity may also generate a heavier economic burden to society. We estimated the direct medical costs attributable to physical inactivity among adultsusing data from the 2002–2010 Korean National Health Insurance Service-National Sample Cohort. A total of 68,556 adults whose reported physical activity status did not change during the study period was included for this study. Propensity scores for inactive adults were used to match 23,645 inactive groups with 23,645 active groups who had similar propensity scores. We compared medical expenditures between the two groups using generalized linear models with a gamma distribution and a log link. Direct medical costs were based on the reimbursement records of all medical facilities from 2005 to 2010. The average total medical costs for inactive individuals were $1110.5, which was estimated to be 11.7% higher than the costs for physically active individuals. With respect to specific diseases, the medical costs of inactive people were significantly higher than those of active people, accounting for approximately 8.7% to 25.3% of the excess burden. Physical inactivity is associated with considerable medical care expenditures per capita among Korean adults.

  12. Excess Medical Care Costs Associated with Physical Inactivity among Korean Adults: Retrospective Cohort Study.

    Science.gov (United States)

    Min, Jin-Young; Min, Kyoung-Bok

    2016-01-01

    Physical inactivity is a major risk factor for chronic diseases and premature death. The increased health risks associated with physical inactivity may also generate a heavier economic burden to society. We estimated the direct medical costs attributable to physical inactivity among adults using data from the 2002-2010 Korean National Health Insurance Service-National Sample Cohort. A total of 68,556 adults whose reported physical activity status did not change during the study period was included for this study. Propensity scores for inactive adults were used to match 23,645 inactive groups with 23,645 active groups who had similar propensity scores. We compared medical expenditures between the two groups using generalized linear models with a gamma distribution and a log link. Direct medical costs were based on the reimbursement records of all medical facilities from 2005 to 2010. The average total medical costs for inactive individuals were $1110.5, which was estimated to be 11.7% higher than the costs for physically active individuals. With respect to specific diseases, the medical costs of inactive people were significantly higher than those of active people, accounting for approximately 8.7% to 25.3% of the excess burden. Physical inactivity is associated with considerable medical care expenditures per capita among Korean adults. PMID:26797622

  13. 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.

  14. 2005 Distinguished Academician Lecture: Evolution of postgraduate medical education in Singapore--role of professional associations.

    Science.gov (United States)

    Shanmugaratnam, K

    2005-12-01

    From 1910 to 1945, doctors in Singapore received postgraduate training through apprenticeship. During the early post-war period, some doctors in the public service were given scholarships to study in Britain and to obtain higher professional qualifications from the British Royal Colleges. The events that most influenced subsequent development of postgraduate education in Singapore occurred between 1956 and 1969: the formation of the Academy of Medicine and the Singapore Medical Association (SMA); organisation of courses for candidates preparing for examinations of the Royal Australasian and British Colleges; competition between the Academy and the University over responsibility for postgraduate medical education; the inauguration of the School of Postgraduate Medical Studies (SPMS); and the introduction of Master of Medicine (M Med) degrees in various medical specialties. From 1970 to 1999, there was expansion in several aspects of postgraduate medical education: SPMS awarded more than 2000 M Med degrees; the Singapore Medical Council (SMC) established a Register of Specialists and formed a Specialist Accreditation Board; the Academy formed Chapters in 10 specialties and developed Advanced Specialty Training programmes leading to Fellowship of the Academy of Medicine Singapore (FAMS); the SMA formed Societies in some 20 specialties; and a College of Family Physicians was inaugurated. There have been more developments from 2000 to 2005: the University restructured SPMS as a Division of Graduate Medical Studies within the Faculty of Medicine; the SMC implemented compulsory Continuing Medical Education; and the Academy converted 6 of its 10 Chapters into Colleges. PMID:16453040

  15. 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.

  16. 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.

  17. 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.

  18. Population Structure of Xylella fastidiosa Associated with Almond Leaf Scorch Disease in the San Joaquin Valley of California.

    Science.gov (United States)

    Lin, Hong; Islam, Md Sajedul; Cabrera-La Rosa, Juan C; Civerolo, Edwin L; Groves, Russell L

    2015-06-01

    Xylella fastidiosa causes disease in many commercial crops, including almond leaf scorch (ALS) disease in susceptible almond (Prunus dulcis). In this study, genetic diversity and population structure of X. fastidiosa associated with ALS disease were evaluated. Isolates obtained from two almond orchards in Fresno and Kern County in the San Joaquin Valley of California were analyzed for two successive years. Multilocus simple-sequence repeat (SSR) analysis revealed two major genetic clusters that were associated with two host cultivars, 'Sonora' and 'Nonpareil', respectively, regardless of the year of study or location of the orchard. These relationships suggest that host cultivar selection and adaptation are major driving forces shaping ALS X. fastidiosa population structure in the San Joaquin Valley. This finding will provide insight into understanding pathogen adaptation and host selection in the context of ALS disease dynamics. PMID:25807309

  19. 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.

  20. Medication Persistence Rates and Factors Associated with Persistence in Patients Following Stroke: A Cohort Study

    Directory of Open Access Journals (Sweden)

    Joffres Michel R

    2008-07-01

    Full Text Available Abstract Background Medication nonadherence can be as high as 50% and results in suboptimal patient outcomes. Stroke patients in particular can benefit from pharmacotherapy for thrombosis, hypertension, and dyslipidemia but are at high risk for medication nonpersistence. Methods Patients who were admitted to the Queen Elizabeth II Health Sciences Centre in Halifax, Nova Scotia, with stroke between January 1, 2001 and December 31, 2002 were analyzed. Data collected were pre-stroke function, stroke subtype, stroke severity, patient outcomes, and medication use at discharge, and six and 12 months post discharge. Medication persistence at six and 12 months and the factors associated with nonpersistence at six months were examined using multivariable stepwise logistic regression. Results At discharge, 420 patients (mean age 68.2 years, 55.7% male were prescribed an average of 6.4 medications and mean prescription drug cost was $167 monthly. Antihypertensive (91% and antithrombotic (96% drug use at discharge were frequent, antilipidemic (73% and antihyperglycemic (25% drug use were less common. Self-reported persistence at six and 12 months after stroke was high (> 90% for all categories. In the multivariable model of medication nonpersistence at six months, people aged 65 to 79 years were less likely to be nonpersistent with antihypertensive medications than people aged 80 years or more (Odds ratio (OR 0.11, 95% Confidence Interval (CI 0.03–0.39. Monthly drug costs of Conclusion Patients reported high medication persistence rates six and 12 months after stroke. Identification of factors associated with nonpersistence (such as older age and prior disability will help predict which patients are at higher risk for discontinuing their medications.

  1. 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.

  2. 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

  3. The association between medical education accreditation and the examination performance of internationally educated physicians seeking certification in the United States

    OpenAIRE

    van Zanten, Marta

    2015-01-01

    The purpose of this study was to investigate the performance of graduates of international medical schools who seek Educational Commission for Foreign Medical Graduates certification based on accreditation of their medical education programmes. For the self-selected population who took United States Medical Licensing Examinations during the study period (2006–2010), accreditation was associated with higher first-attempt pass rates on some examinations, especially for international medical gra...

  4. 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.

  5. 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.

  6. 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. PMID:26644345

  7. Exploring the association of ego defense mechanisms with problematic internet use in a Pakistani medical school.

    Science.gov (United States)

    Waqas, Ahmed; Rehman, Abdul; Malik, Aamenah; Aftab, Ramsha; Allah Yar, Aroosa; Allah Yar, Arooj; Rai, Aitzaz Bin Sultan

    2016-09-30

    The present study was designed to analyze association between problematic internet use and use of ego defense mechanisms in medical students. This cross-sectional study was undertaken at CMH Lahore Medical College (CMH LMC) in Lahore, Pakistan from 1st March, 2015 to 30th May, 2015. 522 medical and dental students were included in the study. The questionnaire consisted of three sections: a) demographic characteristics of respondent b) the Defense Style Questionnaire-40 (DSQ-40) and c) the Internet Addiction Test (IAT). All data were analyzed in SPSS v20. Chi square, Independent sample t test and One Way ANOVA were run to analyze association of different variables with scores on IAT. Multiple regression analysis was used to delineate ego defenses as predictors of problematic internet use. A total of 32 (6.1%) students reported severe problems with internet usage. Males had higher scores on IAT i.e had more problematic use of internet. Scores on internet addiction test (IAT) were negatively associated with sublimation and positively associated with projection, denial, autistic fantasy, passive aggression and displacement. There was a high prevalence of problematic use of internet among medical and dental students. It had significant associations with several defense mechanisms. PMID:27504797

  8. 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.

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

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    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

  10. 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.

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

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    ... 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. ...

  12. Association of Arterial Stiffness and Osteoporosis in Healthy Men Undergoing Screening Medical Examination

    OpenAIRE

    Kim, Nam Lee; Jang, Ha Min; Kim, Sul Ki; Ko, Ki Dong; Hwang, In Cheol; Suh, Heuy Sun

    2014-01-01

    Background Association of arterial stiffness and osteoporosis has been previously reported in women. However, this association is still controversial for men. Therefore, we investigated correlation of arterial stiffness and osteoporosis by measuring brachial-ankle (ba) pulse wave velocity (PWV) and bone mineral density (BMD). Methods We reviewed medical charts of 239 people (women: 128, men: 111) who visited the Health Promotion Center, retrospectively. ba-PWV was measured by automatic wave a...

  13. Efficient replication of over 180 genetic associations with self-reported medical data.

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    Joyce Y Tung

    Full Text Available While the cost and speed of generating genomic data have come down dramatically in recent years, the slow pace of collecting medical data for large cohorts continues to hamper genetic research. Here we evaluate a novel online framework for obtaining large amounts of medical information from a recontactable cohort by assessing our ability to replicate genetic associations using these data. Using web-based questionnaires, we gathered self-reported data on 50 medical phenotypes from a generally unselected cohort of over 20,000 genotyped individuals. Of a list of genetic associations curated by NHGRI, we successfully replicated about 75% of the associations that we expected to (based on the number of cases in our cohort and reported odds ratios, and excluding a set of associations with contradictory published evidence. Altogether we replicated over 180 previously reported associations, including many for type 2 diabetes, prostate cancer, cholesterol levels, and multiple sclerosis. We found significant variation across categories of conditions in the percentage of expected associations that we were able to replicate, which may reflect systematic inflation of the effects in some initial reports, or differences across diseases in the likelihood of misdiagnosis or misreport. We also demonstrated that we could improve replication success by taking advantage of our recontactable cohort, offering more in-depth questions to refine self-reported diagnoses. Our data suggest that online collection of self-reported data from a recontactable cohort may be a viable method for both broad and deep phenotyping in large populations.

  14. Factors Associated with Follow-Up Attendance among Rape Victims Seen in Acute Medical Care

    Science.gov (United States)

    Darnell, Doyanne; Peterson, Roselyn; Berliner, Lucy; Stewart, Terri; Russo, Joan; Whiteside, Lauren; Zatzick, Douglas

    2016-01-01

    Objective Rape is associated with Posttraumatic Stress Disorder and related comorbidities. Most victims do not obtain treatment for these conditions. Acute care medical settings are well-positioned to link patients to services; however, difficulty engaging victims and low attendance at provided follow-up appointments is well documented. Identifying factors associated with follow-up can inform engagement and linkage strategies. Method Administrative, patient self-report, and provider observational data from Harborview Medical Center were combined for the analysis. Using logistic regression, we examined factors associated with follow-up health service utilization after seeking services for rape in the emergency department. Results Of the 521 diverse female (n=476) and male (n=45) rape victims, 28% attended the recommended medical/counseling follow-up appointment. In the final (adjusted) logistic regression model, having a developmental or other disability (OR=0.40, 95% CI=0.21-0.77), having a current mental illness (OR=0.25, 95% CI=0.13-0.49), and being assaulted in public (OR=0.50, 95% CI=0.28-0.87) were uniquely associated with reduced odds of attending the follow-up. Having a prior mental health condition (OR= 3.02 95% CI=1.86-4.91), a completed SANE examination (OR=2.97, 95% CI=1.84-4.81), and social support available to help cope with the assault (OR=3.54, 95% CI=1.76-7.11) were associated with an increased odds of attending the follow-up. Conclusions Findings point to relevant characteristics ascertained at the acute care medical visit for rape that may be used to identify victims less likely to obtain posttraumatic medical and mental health services. Efforts to improve service linkage among these patients is warranted and may require alternative models to engage these patients to support posttraumatic recovery. PMID:26168030

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

    Science.gov (United States)

    Wu, Ping; Liu, Naifeng

    2016-01-01

    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 PTPB 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 facilitating control belief, and most of the barrier control beliefs of TPB were related to medication adherence among Chinese type 2 diabetes inpatients. It will be helpful to understand patients’ self-medication and provide methods to develop instruments for identifying factors that influence OAD adherence. PMID:27390519

  16. 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.

  17. 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…

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

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    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.

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

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    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.

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

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    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.

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

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    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.

  2. 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…

  3. 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…

  4. Associations between Self-medication, Health Literacy, and Self-perceived Health Status: A Community-Based Study

    OpenAIRE

    Aziz Kamran; Gholamreza Sharifirad; Yousef Shafaeei; Siamak Mohebi

    2015-01-01

    Background: Although the frequency of self-medication has been well-documented in the public health literature, but no study has examined the relationship between health literacy and self-medication yet. This study was aimed to investigating the relationship between health literacy and self-medication in a community-based study. Methods: This cross-sectional study was conducted on 924 adults to survey association between health literacy and self-medication among peoples in Ardabil city in...

  5. 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.

  6. Epidermal Nevus Syndrome Associated with Brain Malformations and Medulloblastoma

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    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.

  7. 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

  8. 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...

  9. Medical risk factors associated with cholangiocarcinoma in Taiwan: a population-based case-control study.

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    Jeffrey S Chang

    Full Text Available BACKGROUND: Cholangiocarcinoma, including intra- and extrahepatic cholangiocarcinoma, is a rare but highly lethal cancer. Despite effort in finding the risk factors of cholangiocarcinoma, the causes of most cholangiocarcinoma remain unknown. This study utilized a population-based case-control design using data from the National Health Insurance Research Database (NHIRD of Taiwan to assess the medical conditions associated with cholangiocarcinoma. METHODS: 5,157 incident cases of cholangiocarcinoma diagnosed during 2004 to 2008 and 20,628 controls matched to the cases on sex, age, and time of diagnosis (reference date for the controls were identified from the NHIRD. Medical risk factors were ascertained from the NHIRD for each individual. Conditional logistic regression was performed to evaluate the association between cholangiocarcinoma and each medical risk factor. RESULTS: The results showed that factors associated with an increased risk of cholangiocarcinoma included cholangitis, cholelithiasis, cholecystitis, cirrhosis of liver, alcoholic liver disease, chronic non-alcoholic liver disease, hepatitis B, hepatitis C, diabetes, chronic pancreatitis, inflammatory bowel disease, and peptic ulcer. In addition, sex and age differences were observed. CONCLUSIONS: This study confirms the association between cholangiocarcinoma and several less established risk factors, including diabetes, inflammatory bowel disease, hepatitis B, hepatitis C, and peptic ulcer (proxy for the presence of Helicobacter Pylori. Future studies should focus on finding additional environmental and genetic causes of cholangiocarcinoma.

  10. Association between Medication Adherence and Duration of Outpatient Treatment in Patients with Schizophrenia

    Science.gov (United States)

    Kikuyama, Hiroki; Ohta, Munehiro; Kanazawa, Tetsufumi; Okamura, Takehiko; Yoneda, Hiroshi

    2016-01-01

    Objective Medication adherence is important in the treatment of schizophrenia, and critical periods during treatment may be associated with relapse. However, the relationship between adherence and duration of outpatient treatment (DOT) remains unclear. The authors aimed to clarify the relationship between adherence and DOT at a psychiatric hospital in Japan. Methods For outpatients with schizophrenia who regularly visit Shin-Abuyama hospital, the authors conducted a single questionnaire survey (five questions covering gender, age, DOT, medication shortages, and residual medication) over one month period. Participants were divided into two groups whether DOT were from more than one year to within five years or not. Mantel-Haenszel analysis and logistic regression analysis were performed on the data regarding the medication adherence. Results Effective answers were received for 328 patients. The residual medication rate was significantly higher among those receiving outpatient treatment from more than one year to within five years than five years than those receiving outpatient treatment for more than five years or less than one year (p=0.016). Conclusion This survey suggests that there are critical periods during which patients are most prone to poor adherence. Because poor adherence increases the risk of relapse, specific measures must be taken to improve adherence during these periods.

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

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    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.

  12. Temporal association between land-based runoff events and California sea otter (Enhydra lutris nereis) protozoal mortalities.

    Science.gov (United States)

    Shapiro, Karen; Miller, Melissa; Mazet, Jonna

    2012-04-01

    Toxoplasma gondii and Sarcocystis neurona have caused significant morbidity and mortality in threatened Southern sea otters (Enhydra lutris nereis) along the central California coast. Because only terrestrial animals are known to serve as definitive hosts for T. gondii and S. neurona, infections in otters suggest a land to sea flow of these protozoan pathogens. To better characterize the role of overland runoff in delivery of terrestrially derived fecal pathogens to the near shore, we assessed the temporal association between indicators of runoff and the timing of sea otter deaths due to T. gondii and S. neurona. Sea otter stranding records 1998-2004, from Monterey and Estero bays were reviewed and cases identified for which T. gondii or S. neurona were determined to be a primary or contributing cause of death. Precipitation and stream flow data from both study sites were used as indicators of land-based runoff. Logistic regression was applied to determine if a temporal association could be detected between protozoal mortalities and runoff indicators that occur in the 2 mo preceding mortality events. A significant association was found between S. neurona otter deaths at Estero Bay and increased stream flow that occurred 30-60 days prior to mortality events. At this site, the cause of otter mortality following increased river flows was 12 times more likely to be S. neurona infection compared with nonprotozoal causes of death. There were no significant associations between the timing of T. gondii otter deaths and indicators of overland runoff. Our results indicate that the association between overland runoff and otter mortalities is affected by geography as well as parasite type, and highlight the complex mechanisms that influence transmission of terrestrially derived pathogens to marine wildlife. Policy and management practices that aim to mitigate discharges of contaminated overland runoff can aid conservation efforts by reducing pathogen pollution of coastal

  13. 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

  14. 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

    , 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...... with differences in movement-related activation patterns in Parkin-associated compared to sporadic PD. To test this hypothesis, medicated non-dyskinetic patients with either Parkin-associated or sporadic PD underwent functional magnetic resonance imaging (fMRI) while performing externally specified or internally...... 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...

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

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    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.

  16. 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...

  17. 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

  18. Association of Medical Students' Reports of Interactions with the Pharmaceutical and Medical Device Industries and Medical School Policies and Characteristics: A Cross-Sectional Study

    OpenAIRE

    Yeh, James S.; Austad, Kirsten E.; Franklin, Jessica M; Susan Chimonas; Eric G Campbell; Jerry Avorn; Kesselheim, Aaron S.

    2014-01-01

    Editors' Summary Background Making and selling prescription drugs and medical devices is big business. To promote their products, pharmaceutical and medical device companies build relationships with physicians by providing information on new drugs, by organizing educational meetings and sponsored events, and by giving gifts. Financial relationships begin early in physicians' careers, with companies providing textbooks and other gifts to first-year medical students. In medical school settings,...

  19. 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.

  20. 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.

  1. 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.

  2. 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

  3. Adolescent BMI at Northern Israel: From Trends, to Associated Variables and Comorbidities, and to Medical Signatures.

    Science.gov (United States)

    Machluf, Yossy; Fink, Daniel; Farkash, Rivka; Rotkopf, Ron; Pirogovsky, Avinoam; Tal, Orna; Shohat, Tamar; Weisz, Giora; Ringler, Erez; Dagan, David; Chaiter, Yoram

    2016-03-01

    The increasing prevalence of abnormal body mass index (BMI), mainly obesity, is becoming a significant public health problem. This cross-sectional study aimed to provide a comprehensive view of secular trends of BMI, and the associated socio-demographic variables and comorbidities among adolescents with abnormal BMI. Individuals of the study population were born mainly between 1970 and 1993, and were examined at 16 to 19 years of age during the years 1987 to 2010, at 1 conscription center in the northern district of Israel.The study population included 113,694 adolescents. Univariate and multivariable logistic regression models were used to investigate the associations between BMI categories, socio-demographic variables, and medical conditions.A downward trend in the prevalence of normal BMI among both male and female adolescents was obtained, while trends of overweight and obesity (in both genders) and underweight (only among females) rose. Socio-demographic variables such as religion, education, family-related parameters, residential environment, country of birth, and origin were all associated with different risks for abnormal BMI. Obesity was associated with higher risk for hyperlipidemia, endocrine disorders (only in males), knee disorders, and hypertension type I + II (in both genders). Overweight was associated with knee disorders (only in females). Underweight, exclusively in males, was associated with increased risk for endocrine disorders, proteinuria, and cardiac disorders. Hierarchical clustering analysis revealed the intricate relations between gender, BMI, and medical signatures. It brought to light novel clusters of diseases that were abundant among populations having above-normal BMI or underweight males. Furthermore, above-normal BMI was associated with a lower rate of cardiac anomalies and scoliosis/kyphosis, whereas being underweight was associated with a lower risk for hypertension and flat foot.This study provides a reliable and in-depth view

  4. Statistical Trends in the Journal of the American Medical Association and Implications for Training across the Continuum of Medical Education

    OpenAIRE

    Arnold, Lauren D.; Braganza, Melissa; Salih, Rondek; Graham A Colditz

    2013-01-01

    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 implicati...

  5. High mercury seafood consumption associated with fatigue at specialty medical clinics on Long Island, NY

    Directory of Open Access Journals (Sweden)

    Shivam Kothari

    2015-01-01

    Full Text Available We investigated the association between seafood consumption and symptoms related to potential mercury toxicity in patients presenting to specialty medical clinics at Stony Brook Medical Center on Long Island, New York. We surveyed 118 patients from April–August 2012 about their seafood consumption patterns, specifically how frequently they were eating each type of fish, to assess mercury exposure. We also asked about symptoms associated with mercury toxicity including depression, fatigue, balance difficulties, or tingling around the mouth. Of the 118 adults surveyed, 14 consumed high mercury seafood (tuna steak, marlin, swordfish, or shark at least weekly. This group was more likely to suffer from fatigue than other patients (p = 0.02. Logistic regression confirmed this association of fatigue with frequent high mercury fish consumption in both unadjusted analysis (OR = 5.53; 95% CI: 1.40–21.90 and analysis adjusted for age, race, sex, income, and clinic type (OR = 7.89; 95% CI: 1.63–38.15. No associations were observed between fish intake and depression, balance difficulties, or tingling around the mouth. Findings suggest that fatigue may be associated with eating high mercury fish but sample size is small. Larger studies are needed to determine whether fish intake patterns or blood mercury tests warrant consideration as part of the clinical work-up in coastal regions.

  6. 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.

  7. 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.

  8. 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

  9. 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

  10. Substance abuse and batterer programmes in California, USA: factors associated with treatment outcomes.

    Science.gov (United States)

    Timko, Christine; Valenstein, Helen; Stuart, Gregory L; Moos, Rudolf H

    2015-11-01

    The association between substance abuse and intimate partner violence is quite robust. A promising area to improve treatment for the dual problems of substance abuse and violence perpetration is the identification of client characteristics and organisational and programme factors as predictors of health outcomes. Therefore, we examined associations of client, organisational and programme factors with outcomes in community health settings. Directors of 241 substance use disorder programmes (SUDPs) and 235 batterer intervention programmes (BIPs) reported outcomes of programme completion and substance use and violence perpetration rates at discharge; data collection and processing were completed in 2012. SUDPs having more female, non-white, younger, uneducated, unemployed and lower income clients reported lower completion rates. In SUDPs, private, for-profit programmes reported higher completion rates than public or private, non-profit programmes. SUDPs with lower proportions of their budgets from government sources, and higher proportions from client fees, reported better outcomes. Larger SUDPs had poorer programme completion and higher substance use rates. Completion rates in SUDPs were higher when clients could obtain substance- and violence-related help at one location, and programmes integrated violence-prevention contracting into care. In BIPs, few client, organisational and programme factors were associated with outcomes, but the significant factors associated with programme completion were consistent with those for SUDPs. Publicly owned and larger programmes, and SUDPs lacking staff to integrate violence-related treatment, may be at risk of poorer client outcomes, but could learn from programmes that perform well to yield better outcomes. PMID:25470658

  11. 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...

  12. Community Characteristics Associated With Seeking Medical Evaluation for Suspected Child Sexual Abuse in Greater Houston.

    Science.gov (United States)

    Greeley, Christopher Spencer; Chuo, Ching-Yi; Kwak, Min Ji; Henin, Sally S; Donnaruma-Kwoh, Marcella; Ferrell, Jamie; Giardino, Angelo Peter

    2016-06-01

    Child sexual abuse (CSA) affects over 62,000 children annually in the United States. A primary obstacle to the success of a public health prevention strategy is the lack of knowledge around community level risk factors for CSA. We evaluated community level characteristics for children seeking care for suspected CSA in the Greater Houston area for 2009. There was a total incidence rate of medical evaluations for suspected CSA of 5.9/1000 children. We abstracted the medical charts of 1982 (86 %) children who sought a medical evaluation for suspected CSA at three main medical systems in the Greater Houston area for 2009. We evaluated 18 community level variables from the American Community Survey for the 396 zip codes these children lived in. The mean number of cases per Greater Houston zip code was 2.77 (range 0-27), with 62 % of zip codes not having a case at any of the three sites surveyed. Zip codes with a higher than Houston average rate of vacant houses, never married females and unemployed labor force with high family poverty rate, were associated with an increased rate of children seeking care for suspected CSA. We demonstrated zip codes level characteristics which were associated with an increased rate of children seeking care for suspected CSA. Our modelling process and our data have implications for community based strategies aimed at improved surveillance or prevention of CSA. The process of identifying locally specific community level factors suggests target areas which have particular socioeconomic characteristics which are associated with increased rate of seeking CSA evaluations. PMID:26803840

  13. 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. PMID:22634280

  14. 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.

  15. Concentrations and loads of suspended sediment-associated pesticides in the San Joaquin River, California and tributaries during storm events

    Science.gov (United States)

    Hladik, M.L.; Domagalski, J.L.; Kuivila, K.M.

    2009-01-01

    Current-use pesticides associated with suspended sediments were measured in the San Joaquin River, California and its tributaries during two storm events in 2008. Nineteen pesticides were detected: eight herbicides, nine insecticides, one fungicide and one insecticide synergist. Concentrations for the herbicides (0.1 to 3000 ng/g; median of 6.1 ng/g) were generally greater than those for the insecticides (0.2 to 51 ng/g; median of 1.5 ng/g). Concentrations in the tributaries were usually greater than in the mainstem San Joaquin River and the west side tributaries were higher than the east side tributaries. Estimated instantaneous loads ranged from 1.3 to 320 g/day for herbicides and 0.03 to 53 g/day for insecticides. The greatest instantaneous loads came from the Merced River on the east side. Instantaneous loads were greater for the first storm of 2008 than the second storm in the tributaries while the instantaneous loads within the San Joaquin River were greater during the second storm. Pesticide detections generally reflected pesticide application, but other factors such as physical-chemical properties and timing of application were also important to pesticide loads.

  16. 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

  17. 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.

  18. 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.

  19. 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

  20. 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.

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

    OpenAIRE

    Annisa N. Insany; Dika P. Destiani; Anwar Sani; Lilik Sabdaningtyas; Ivan S. Pradipta

    2015-01-01

    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 stu...

  2. Preseismic and coseismic deformation associated with the Coyote Lake, California, earthquake.

    Science.gov (United States)

    King, N.E.; Savage, J.C.; Lisowski, M.; Prescott, W.H.

    1981-01-01

    The Coyote Lake earthquake (ML=5.9; August 6, 1979; epicenter c100 km SE of San Francisco) occurred on the Calaveras fault within a geodetic network that had been surveyed annually since 1972 to monitor strain accumulation. The rupture surface as defined by aftershocks is a vertical rectangle 20 km in length extending from a depth of 4 km to c12 km. The observed deformation of the geodetic network constrains the average slip to be 0.33 + or - 0.05m right lateral. Although the geodetic data furnished an exceptionally detailed picture of the pre-earthquake deformation, no significant premonitory anomaly associated with the Coyote Lake earthquake can be identified.-Authors

  3. 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.

  4. 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

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

    OpenAIRE

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

    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...

  6. Comorbid conditions are associated with healthcare utilization, medical charges and mortality of patients with rheumatoid arthritis.

    Science.gov (United States)

    Han, Guang-Ming; Han, Xiao-Feng

    2016-06-01

    This study aims to examine the associations between comorbid conditions and healthcare utilization, medical charges, or mortality of patients with rheumatoid arthritis (RA). Nebraska state emergency department (ED) discharge, hospital discharge, and death certificate data from 2007 to 2012 were used to study the comorbid conditions of patients with RA. RA was defined using the standard International Classification of Diseases (ICD-9-CM 714 or ICD-10-CM M05, M06, and M08). There were more comorbid conditions in patients with RA than in patients without RA. Comorbid conditions were majorly related to healthcare utilization and mortality of patients with RA. In addition to injury, fracture, sprains, and strains, symptoms of cardiovascular and digestive systems, respiratory infection, and chronic obstructive pulmonary disease (COPD) were common comorbid conditions for ED visits. In addition to joint replacement and fracture, infections, COPD and cardiovascular comorbidities were common comorbid conditions for hospitalizations. Cardiovascular, cerebrovascular, and respiratory comorbidities, dementia, malignant neoplasm, and diabetes mellitus were common comorbid conditions for deaths of patients with RA. In addition, the numbers of comorbid conditions were significantly associated with the length of hospital stay and hospital charges for patients with RA. The findings in this study indicated that comorbid conditions are associated with healthcare utilization, medical charges, and mortality of patients with RA. PMID:27106546

  7. 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

  8. 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.

  9. Raman spectroscopy for rapid discrimination of Staphylococcus epidermidis clones related to medical device-associated infections

    International Nuclear Information System (INIS)

    We report on the potential application of Raman spectroscopy for the fast typing of Staphylococcus epidermidis (S. epidermidis) strains related to medical device-associated infections. In this study bacterial colonies were directly probed on culture plates and Raman spectra were recorded from volumes containing approximately 10 bacteria. The spectra contain information on the molecular composition of the whole bacteria, such as fatty acids, carbohydrates, proteins and nucleic acids, DNA as well as RNA. We demonstrate the potential to discriminate different S. epidermidis clones, even after only short Raman exposure/collection times

  10. 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

  11. The Psychological and Medical Factors Associated With Untreated Binge Eating Disorder

    Science.gov (United States)

    Herman, Barry K.

    2015-01-01

    Objective: Although binge eating disorder (BED) is the most prevalent eating disorder, the impact of untreated BED is underappreciated. This review describes the relationship of BED to physical and mental health, quality of life, and functionality. Data Sources: PubMed searches were conducted on March 21, 2014; searches were limited to English-language research articles, meta-analyses, and reviews published between January 1, 2003 and March 21, 2014. Search terms included (binge eating OR binge-eating OR binge eating disorder) AND (cardiovascular OR metabolic OR metabolic syndrome OR gastrointestinal OR health OR rehabilitation OR recovery OR sleep OR pregnancy OR quality of life OR functional impairment OR activities of daily living OR QoL OR SF-12 OR ED-5D OR SF-36 OR psychosocial OR depressive OR anxiety OR self-esteem OR suicidality OR suicide OR productivity OR family). Study Selection/Data Extraction: Of 326 identified publications, 43 were relevant to the topic and reported on the association of BED with psychiatric and medical comorbidities, quality of life, and functional outcomes. Results: Individuals diagnosed with BED have increased rates of mental health comorbidities (eg, depression and anxiety) and more pronounced medical impairments (eg, cardiovascular disorders) compared with individuals without BED. BED is also associated with functional impairment and reduced quality of life. Conclusions: Binge eating disorder is associated with impairments in physical and mental health, which can decrease quality of life and functionality and lead to increased health care utilization and decreased productivity. However, some caution is warranted in interpreting these findings because it remains unclear whether BED is an antecedent condition, a complication associated with a comorbid psychiatric condition, or an unrelated feature that occurs concurrently with these comorbidities and impairments. Much of the research on BED is based on observational or

  12. The Association Between Antihypertensive Medication and Blood Pressure Control in Patients with Obstructive Sleep Apnea.

    Science.gov (United States)

    Diogo, Lucília N; Pinto, Paula; Bárbara, Cristina; Papoila, Ana L; Monteiro, Emília C

    2015-01-01

    Obstructive sleep apnea and hypertension are closely related diseases. The lowering effect of continuous positive airway pressure (CPAP) on blood pressure (BP) control is modest and concomitant antihypertensive therapy is still required. However, the best antihypertensive regimen for BP control in patients with OSA remains unknown. We aimed to investigate a hypothetical association between ongoing antihypertensive medication and BP control rates in patients with OSA. We conducted a prospective observational study in a cohort of 205 patients with OSA and hypertension who underwent a sleep study and 24-h ambulatory blood pressure monitoring (ABPM). Ongoing antihypertensive medication profile was recorded. Logistic regression models were used to investigate the association between antihypertensive regimen and BP control, before (n = 205) and, when applicable, after CPAP adaptation (n = 90). One hundred and fifty-five patients (155/205) were being treated with 31 different antihypertensive regimens. At baseline, the antihypertensive regimens and the number of antihypertensive drugs were not associated with BP control (p = 0.847; p = 0.991). After CPAP adaptation, a decrease in median night-time systolic and diastolic BP was observed (p = 0.001; p = 0.006). Nevertheless, the lack of association between antihypertensive regimens and the number of antihypertensive drugs and BP control remained (p = 0.864; p = 0.800). Our findings confirm that although CPAP improves nocturnal BP, this improvement is not sufficient to control blood pressure for 24 h. This study shows, for the first time, that in patients with OSA, there is no association between BP control and both the antihypertensive regimen and the number of antihypertensive drugs. PMID:26303482

  13. Cefazolin versus Nafcillin for Methicillin-Sensitive Staphylococcus aureus Bloodstream Infection in a California Tertiary Medical Center.

    Science.gov (United States)

    Pollett, S; Baxi, S M; Rutherford, G W; Doernberg, S B; Bacchetti, P; Chambers, H F

    2016-08-01

    Recent observational studies have suggested possible reductions in mortality in patients receiving cefazolin versus antistaphylococcal penicillins. We examined 90-day mortality in patients receiving cefazolin compared to nafcillin for methicillin-susceptible Staphylococcus aureus (MSSA) bloodstream infection (BSI). We identified persons with MSSA BSI admitted to San Francisco General Hospital from January 2008 to July 2013 through a hospital-wide infection surveillance system and confirmed 90-day mortality using U.S. national vital registries. We included persons receiving cefazolin or nafcillin as the predominant intravenous antimicrobial agent; all participants received inpatient Infectious Diseases service consultation. We estimated the association between receipt of cefazolin and 90-day risk of death by multivariate logistic regression, including a propensity score for receiving cefazolin as the second predictor. Of 230 MSSA BSI cases, 30 received nafcillin and 70 received cefazolin as the predominant antimicrobial; 10 died within 90 days, 5 from each group. Unadjusted analysis showed substantial but not statistically significant reduced odds of death in those receiving cefazolin (odds ratio, 0.38; 95% confidence interval [CI], 0.10 to 1.44). Multivariate analysis with propensity scores found a similar adjusted odds ratio (0.40; 95% CI, 0.09 to 1.74; P = 0.22). We found a large reduction in 90-day mortality in those receiving cefazolin compared to nafcillin for MSSA BSI, but this finding was not statistically significant. The magnitude of effect seen in this and other studies justifies further study. PMID:27216053

  14. 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...

  15. Beyond fatigue: Assessing variables associated with sleep problems and use of sleep medications in multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Alyssa M Bamer

    2010-05-01

    Full Text Available Alyssa M Bamer, Kurt L Johnson, Dagmar A Amtmann, George H KraftDepartment of Rehabilitation Medicine, University of Washington, Seattle, WA, USABackground: Recent research indicates that sleep disturbances are common in persons with multiple sclerosis (MS, though research to date has primarily focused on the relationship between fatigue and sleep. In order to improve treatment of sleep disorders in MS, a better understanding of other factors that contribute to MS sleep disturbance and use of sleep medications in this population is needed.Methods: Individuals with MS (N = 473 involved in an ongoing self-report survey study were asked to report on use of over-the-counter and prescription sleep medications. Participants completed the Medical Outcomes Study Sleep (MOSS scale and other common self-report symptom measures. Multiple regression was used to evaluate factors associated with sleep problems and descriptive statistics were generated to examine use of sleep medications.Results: The mean score on the MOSS scale was 35.9 (standard deviation, 20.2 and 46.8% of the sample had moderate or severe sleep problems. The majority of participants did not use over-the-counter (78% or prescription (70% sleep medications. In a regression model variables statistically significantly associated with sleep problems included depression, nighttime leg cramps, younger age, pain, female sex, fatigue, shorter duration of MS, and nocturia. The model explained 45% of the variance in sleep problems. Of the variance explained, depression accounted for the majority of variance in sleep problems (33%, with other variables explaining significantly less variance.Conclusions: Regression results indicate that fatigue may play a minor role in sleep disturbance in MS and that clinicians should consider the interrelationship between depression and sleep problems when treating either symptom in this population. More research is needed to explore the possibility of under

  16. 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

  17. Factors Associated With High Frequency of Suicidal Ideation in Medically Ill Veterans.

    Science.gov (United States)

    Wendell, Joel; Ratcliff, Chelsea G; Price, Elizabeth; Petersen, Nancy J; Dinapoli, Elizabeth A; Cully, Jeffrey A

    2016-09-01

    Suicide is a leading cause of death, and rates are especially high among medically ill, older individuals. Health-related psychosocial correlates of suicidal ideation (SI) may be particularly important for medically ill older adults as they may clarify who may benefit from interventions to reduce SI. This study examined whether demographic, physical health, and/or health-related psychosocial factors were associated with high frequency of SI in older, medically ill Veterans experiencing elevated anxiety or depression. This cross-sectional study included 302 Veterans with (1) a cardiopulmonary condition and functional impairment and (2) elevated symptoms of depression and/or anxiety. Participants were classified as having either no, low, or high SI, based on self-reported ideation, from the Patient Health Questionnaire-9. SI was reported in 26.8% of the full sample and high SI was reported by 12.6% of participants. Logistic regression analyses predicting high versus no SI found the odds of high SI increased 4.7 times (95% confidence interval, 2.6-8.3) for each 1-unit increase in maladaptive coping and 4.1 times (95% confidence interval, 1.2-14.3) for each 1-unit increase in physical health severity/functional limitations. Older, medically ill Veterans with comorbid depression and/or anxiety frequently reported SI and were at greater risk of experiencing a high frequency of SI if they engaged in maladaptive coping strategies and/or had high levels of functional impairment. Effective interventions to reduce SI for this population should focus on reducing maladaptive coping and minimizing negative behavioral, cognitive, and emotional reactions to functional limitations. PMID:27648503

  18. American Medical Association concepts of nutrition and health. Council on Scientific Affairs.

    Science.gov (United States)

    1979-11-23

    Although human need for various nutrients is well-established, the exact requirements for the different nutrients are not well-known. Nutrient requirements are affected by genetics; environment; nature of the diet; and hemeostatic demands under changing physiological conditions expressed as growth, reproduction and response to the stress of injury or disease. Pregnant and lactating women should be properly nourished if well-nourished infants are desired. Nutrient and energy needs are considerably increased during pregnancy and lactation. The most rapid growth of infants occurs during the 1st 4 to 6 months of life. Because of the many advantages of breast milk over artificial milk, full-term newborn infants should be breastfed, unless there are specific contraindications or breastfeeding is unsuccessful. The American Medical Association (AMA) urges that better efforts be made to educate the public and the medical profession as to the advantages of breastfeeding. The 4th to the 6th months of life constitute the transitional period in infant feeding. The baby should be introduced to single-ingredient foods in small quantities, one at a time, to isolate food sensitivities. Good eating habits can be formed early in life through the proper and gradual introduction of varied and nutritional meal patterns. Energy balance is a nutritional problem in late childhood and once maturity is achieved, while calorically and nutritionally inadequate diets are a growing concern for the elderly. Immoderate eating habits (e.g., overeating) may aggravate or contribute to the development of degenerative diseases and should be discouraged. The AMA recommends that the American public focus on the achievement and maintenance of the most desirable body weight through a proper combination of dietary control and exercise. Specific dietary modifications (sodium restriction, weight control) are necessary in the management of hypertension, diabetes, coronary heart diseases and other medical

  19. Factors associated with self-medication among expatriate high school students: a cross-sectional survey in United Arab Emirates

    OpenAIRE

    Syed Ilyas Shehnaz; Jayadevan Sreedharan; Nelofer Khan; Khaled Jamal Issa; Mohamed Arifulla

    2013-01-01

    The study aimed to assess factors associated with self-medication (SM) among expatriate high school students of United Arab Emirates using a validated questionnaire. Most common reasons for self-medication in 324 participating students were: presence of mild illness and previous experiences. High risk practices like altering the dose, discontinuation of medication and self-medication without adult guidance were observed. The likelihood of SM was 4.9 times (95%C.I.: 2.0-12.2) in students not u...

  20. 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...

  1. Hybrid Medical Image Classification Using Association Rule Mining with Decision Tree Algorithm

    CERN Document Server

    Rajendran, P

    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. The frequent patterns from the CT scan images are generated by frequent pattern tree (FP-Tree) algorithm that mines the association rules. The decision tree method has been used to classify the medical images for diagnosis. This system enhances the classification process to be more accurate. The hybrid method improves the efficiency of the proposed method than the traditional image mining methods. The experimental result on prediagnosed database of brain images showed 97% sensitivity and 95% accuracy respectively. The ph...

  2. 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

  3. Factors Associated with Syringe Sharing Among Users of a Medically Supervised Safer Injecting Facility

    Directory of Open Access Journals (Sweden)

    Evan Wood

    2005-01-01

    Full Text Available Vancouver, Canada recently opened a medically supervised safer injecting facility (SIF in an effort to reduce HIV and overdose risk and public injection drug use. We sought to examine factors associated with syringe sharing among SIF users. SIF users were randomly recruited into a prospective cohort of SIF users known as the Scientific Evaluation of Supervised Injecting (SEOSI cohort. We examined the prevalence and correlates of used syringe borrowing among baseline HIV-negative participants and used syringe lending among baseline HIV-infected participants. Between 22 March 2004 and 22 October 2004, 479 baseline HIV-negative subjects (48 [10%] syringe borrowing events and 103 baseline HIV-infected participants (17 [16.5%] syringe lending events were recruited into the cohort. For baseline HIV negative participants, syringe borrowing was positively associated with public drug use (p<0.001 and requiring help injecting (p=0.001, whereas exclusive SIF use was inversely associated with syringe sharing (p=0.019. For baseline HIV-infected participants, syringe lending was positively associated with daily cocaine injection (p=0.022 and shooting gallery use (p=0.007. Although ongoing injection-related HIV risk behavior was reported among some SIF users, rates of syringe sharing were substantially lower than the rate observed previously in this community and it is noteworthy that exclusive SIF use was associated with reduced syringe sharing.

  4. 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.

  5. 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.

  6. 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. PMID:27379593

  7. Non-compliance to anti-hypertensive medication and its associated factors among hypertensives

    International Nuclear Information System (INIS)

    Non-compliance to anti-hypertensive drugs can have negative impact on cardiovascular outcome. Various studies have been conducted on the issue but the factors are not yet explored properly, particularly in Pakistan. This study was conducted to determine the frequency and factors associated with non-compliance to anti-hypertensive medications in Karachi. Methods: This descriptive cross sectional study was conducted on 113 indoor hypertensive patients included by purposive sampling, aged 30 years and above diagnosed at least 6 months back in public sector tertiary care institutes of Karachi from March to October 2011. Data was collected through a questionnaire in Urdu. Demographic data, hypertension diagnosis, medical co-morbidity, current number of anti-hypertensive medicines, frequency of missing prescribed antihypertensive therapy and other factors affecting compliance pertaining to medicines, patient, physician and health care centre were included in the questionnaire. Results: This study revealed that 68.14% patients were non-compliant. Non-compliance was found to be associated with gender and socioeconomic status. Duration of hypertension, duration between follow up visits to physician, number of drugs, careless attitude, role of physician and limiting access to health care center are found to be important factors in non-compliance. Conclusions: Multiple factors including patients, medicine and health care system related, which can be prevented with simple measures, were found responsible for higher prevalence of non-compliance against anti-hypertensive medicines. (author)

  8. 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

  9. One Year Medical Outcomes and ED Recidivism Following ED Observation for Cocaine-Associated Chest Pain

    Science.gov (United States)

    Cunningham, Rebecca; Walton, Maureen A.; Weber, Jim Edward; O'Broin, Samantha; Tripathi, Shanti P; Maio, Ronald F.; Booth, Brenda M.

    2010-01-01

    Chest pain is the most common complaint among cocaine users who present to the ED seeking care and many hospital resources are applied to stratify cocaine users in regard to future cardiac morbidity and mortality. Little is known about the longitudinal cardiac and non cardiac medical outcomes of cocaine users who have been stratified to an ED observation period following their ED visit. Objectives to examine one-year cardiac outcomes in a low-intermediate risk sample of patients with cocaine- associated chest pain in an urban ED, as well as to examine ED recidivism one year for cardiac and non-cardiac complaints. Methods Prospective consecutive cohort study of patients (18–60 years) who presented to an urban Level 1 ED with cocaine-associated chest pain and were risk stratified to low-intermediate cardiac risk. Exclusion criteria: EKG suggestive of AMI, elevated serum cardiac markers, history of AMI or CABG, hemodynamic instability, unstable angina. Baseline interviews using validated measures of health functioning, and substance use were conducted during CPOU stay, and 3, 6, and 12 months. ED utilization during the study year was abstracted from medical chart. Zero-Inflated Poisson regression analyses were conducted to predict recurrent ED visits. Results 219 participants (73% participation) were enrolled, 65% returned to the ED post index visit; 23% returned for chest pain, of these 66% had a positive cocaine urine screen. No patient had an AMI within the one year follow up period. Patients with continued cocaine use were more likely to have a recurrent ED visit (p<0.001) but these repeat visits were most often related to musculoskeletal pain (21%), and injury (30%) rather than potential cardiac complaints. Conclusions Patients with cocaine-associated chest pain who are low to intermediate cardiac risk and complete a CPOU protocol have less then 1% rate of MI in the subsequent 12-months. PMID:18824277

  10. Exploring the association between parental rearing styles and medical students’ critical thinking disposition in China

    OpenAIRE

    Huang, Lei; WANG, Zhaoxin; Yao, Yuhong; Shan, Chang; Wang, Haojie; Zhu, Mengyi; Lu, Yuan; Sun, Pengfei; ZHAO, Xudong

    2015-01-01

    Background Critical thinking is an essential ability for medical students. However, the relationship between parental rearing styles and medical students’ critical thinking disposition has rarely been considered. The aim of this study was to investigate whether parental rearing styles were significant predictors of critical thinking disposition among Chinese medical students. Methods 1,075 medical students from the first year to the fifth year attending one of three medical schools in China w...

  11. 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.

  12. Pseudoexfoliation: normative data and associations. The Central India Eye and Medical Study.

    Directory of Open Access Journals (Sweden)

    Jost B Jonas

    Full Text Available PURPOSE: To assess the prevalence of pseudoexfoliation (PEX and its associations in a population-based setting. DESIGN: Population-based, cross-sectional study. METHODS: The Central India Eye and Medical Study included 4711 individuals. All study participants underwent a detailed ophthalmological examination. After medical pupil dilation, PEX was assessed by an experienced ophthalmologist using slit-lamp based biomicroscopy. RESULTS: Slit lamp examination results were available for 4646 (98.6% study participants with a mean age of 49.3 ± 13.3 years (range: 30-100 years. PEX was detected in 87 eyes (prevalence: 0.95 ± 0.10% (95%CI: 0.75, 1.15 of 69 subjects (prevalence: 1.49 ± 0.18% (95%CI: 1.14, 1.83. PEX prevalence increased significantly (P<0.001 from 0% in the age group of 30-39 years, to 2.85 ± 0.56% in the age group of 60-69 years, to 6.60 ± 1.21% in the age group of 70-79 years, and to 12.3 ± 4.11% in the age group of 80+ years. In multivariate analysis, PEX prevalence was associated with higher age (P<0.001; regression coefficient B:0.11; odds ratio (OR: 1.11 (95%CI: 1.09, 1.13, lower body mass index (P = 0.001; B: -0.12; OR: 0.88 (95CI: 0.82, 0.95 and higher diastolic blood pressure (P = 0.002; B: 0.02; OR: 1.03 (95%CI: 1.01, 1.04. In the multivariate analysis, PEX was not associated with retinal nerve fiber layer cross section area (P = 0.76 and presence of open-angle glaucoma (P = 0.15. CONCLUSIONS: In a rural Central Indian population aged 30+ years, PEX prevalence (mean: 1.49 ± 0.18% was significantly associated with older age, lower body mass index and higher diastolic blood pressure. It was not significantly associated with optic nerve head measurements, refractive error, any ocular biometric parameter, nuclear cataract, early age-related macular degeneration and retinal vein occlusion, diabetes mellitus, smoking, and dyslipidemia.

  13. [Hygienic risks associated with sanitary installations and medical equipment in hospitals (author's transl)].

    Science.gov (United States)

    Botzenhart, K

    1977-04-01

    The risk of transmission of nosocomial infections associated with technical installations in hospitals probably is not very important. The way of infection (e.g. airborne particles, droplets, fluids, fomites, contact with persons) must be considered and an estimation as to their importance should be tried. Transport systems and air-conditioning plants are discussed as possible transmitters of infectious particles by air and UV-radiation and air-locks in their role as preventive measures. Fluides which can allow a microbial growth are part of many sanitary installations and medical equipment. They may cause transmissions of great numbers of pathogenes to susceptible patients. In this context, ultrasonic inhalators, irrigators, dialysis equipment and faucet aerators are discussed. Concerning transmission by contact, bed-pan washers, endoscopes and anaesthetic tools are mentioned and finally the role of industrial procedures, the extent and function of which can't be supervised by the medical personn,el, must be submitted to adequate microbiological controls. Physicians should pronounce more clearly then before their interest in equipment which can easily be sterilized.

  14. 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. PMID:18593314

  15. 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.

  16. 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.

  17. 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.

  18. 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

  19. 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

  20. The challenges and opportunities of multiskilling in health care. Canadian Association of Medical Radiation Technologists.

    Science.gov (United States)

    1995-08-01

    The pursuit of lower costs and greater efficiency in Canada's health care sector has led some governments and health care institutions to consider multiskilled workers as an option in health care reform and organizational restructuring. Multiskilled practitioners perform more than one main function, often in more than one discipline. This article explores various aspects of multiskilling and how it could affect, or already is affecting, medical radiation technologists and other allied health professionals. It discusses key issues and implications of multiskilling for governments, employers, educational institutions, professional associations, health care professionals, and patients. The article is based on a report released to members for discussion at the 53rd CAMRT Annual General Meeting. Copies of the full report are available on request from: CAMRT, Suite 601, 294 Albert St., Ottawa, ON K1P 6E6. Or, fax your request to: (613) 234-1097. PMID:10145068

  1. Improved Hand Hygiene Compliance is Associated with the Change of Perception toward Hand Hygiene among Medical Personnel

    OpenAIRE

    Lee, Seung Soon; Park, Se Jeong; Chung, Moon Joo; Lee, Ju Hee; Kang, Hyun Joo; Lee, Jeong-a; Kim, Yong Kyun

    2014-01-01

    Background Hand hygiene compliance has improved significantly through hand hygiene promotion programs that have included poster campaign, monitoring and performance feedback, and education with special attentions to perceived subjective norms. We investigated factors associated with improved hand hygiene compliance, focusing on whether the improvement of hand hygiene compliance is associated with changed perception toward hand hygiene among medical personnel. Materials and Methods Hand hygien...

  2. Prevalence and Associated Factors of Smoking Among Final Year Medical Students: A Multicentric Survey From Pakistan

    Science.gov (United States)

    Shahid, Zuhaib Y; Lodhi, Sameed K; Malik, Hamza; Jan, Mohsin M

    2016-01-01

    Introduction Smoking is the leading cause of lung cancer around the world. In a developing country like Pakistan with low levels of literacy and general awareness about adverse effects of smoking, doctors play a pivotal role in educating the masses about its harmful consequences and providing support for smoking cessation. However, their efficacy is affected if they smoke themselves, and oftentimes the habits cultivated during educational recourse are carried into the professional careers. The aim of this study was to document the prevalence of smoking among final year medical students of Lahore, Pakistan, and the factors associated with it. Methodology Study approval was obtained from Combined Military Hospital (CMH) Lahore Medical College, Ethics Review Committee. A cross-sectional survey was carried out in four medical colleges and hospitals of Lahore, Pakistan. A questionnaire consisting of 14 questions related to basic demographics and smoking was used after being pilot tested on 20 students of CMH. The overall response rate was 74.89%. Data was collected from 337 respondents, of which 38 forms were discarded and 299 forms were analyzed by SPSS V21. Results Among the 299 respondents, there were 128 males (42.81%) and 171 females (57.19%) with 32 (10.70%) smokers. Male students reported smoking (n = 27, 21.09%) more than their female counterparts (n = 5, 0.02%). The mean age of participants was 23.01 years. Students having an active smoker at home had statistically significant positive correlations with current smoking status and the number of cigarettes smoked per day. Students with household smoking contacts were also more likely to smoke if they belonged to the male gender. Conclusion Prevalence of smoking in medical students is lower than in the general population but still considerable in the male students. There is a need to target this particular population with interactive counseling sessions, education campaigns, and anti-smoking rules to decrease

  3. Prevalence and Associated Factors of Smoking Among Final Year Medical Students: A Multicentric Survey From Pakistan.

    Science.gov (United States)

    Khubaib, Mohammad U; Shahid, Zuhaib Y; Lodhi, Sameed K; Malik, Hamza; Jan, Mohsin M

    2016-01-01

    Introduction Smoking is the leading cause of lung cancer around the world. In a developing country like Pakistan with low levels of literacy and general awareness about adverse effects of smoking, doctors play a pivotal role in educating the masses about its harmful consequences and providing support for smoking cessation. However, their efficacy is affected if they smoke themselves, and oftentimes the habits cultivated during educational recourse are carried into the professional careers. The aim of this study was to document the prevalence of smoking among final year medical students of Lahore, Pakistan, and the factors associated with it. Methodology Study approval was obtained from Combined Military Hospital (CMH) Lahore Medical College, Ethics Review Committee. A cross-sectional survey was carried out in four medical colleges and hospitals of Lahore, Pakistan. A questionnaire consisting of 14 questions related to basic demographics and smoking was used after being pilot tested on 20 students of CMH. The overall response rate was 74.89%. Data was collected from 337 respondents, of which 38 forms were discarded and 299 forms were analyzed by SPSS V21. Results Among the 299 respondents, there were 128 males (42.81%) and 171 females (57.19%) with 32 (10.70%) smokers. Male students reported smoking (n = 27, 21.09%) more than their female counterparts (n = 5, 0.02%). The mean age of participants was 23.01 years. Students having an active smoker at home had statistically significant positive correlations with current smoking status and the number of cigarettes smoked per day. Students with household smoking contacts were also more likely to smoke if they belonged to the male gender. Conclusion Prevalence of smoking in medical students is lower than in the general population but still considerable in the male students. There is a need to target this particular population with interactive counseling sessions, education campaigns, and anti-smoking rules to decrease

  4. 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.

  5. 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 contrast, Fusobacterium necrophorum, Lactobacillus acidophilus, Staphylococcus aureus and Streptococcus pneumoniae were associated with periodontal health (p < 0.05). Pathogenic species of medical importance may be detected in high prevalence and levels in the 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. PMID:26416306

  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. 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

  8. 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.

  9. 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

  10. 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.

  11. 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?

  12. 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.

  13. MINING MULTIDIMENSIONAL FUZZY ASSOCIATION RULES FROM A DATABASE OF MEDICAL RECORD PATIENTS

    Directory of Open Access Journals (Sweden)

    Rolly Intan

    2008-01-01

    Full Text Available Mining association rules is one of the important tasks in the process of data mining application. In general, the input as used in the process of generating rules is taken from a certain data table by which all the corresponding values of every domain data have correlations one to each others as given in the table. A problem arises when we need to generate the rules expressing the relationship between two or more domains that belong to several different tables in a normalized database. To overcome the problem, before generating rules it is necessary to join the participant tables into a general table by a process called Denormalization Process. This paper shows a process of generating Multidimensional Fuzzy Association Rules mining from a normalized database of medical record patients. The process consists of two sub-processes, namely sub-process of join tables (Denormalization Process and sub-process of generating fuzzy rules. In general, the process of generating the fuzzy rules has been discussed in our previous papers [1, 2, 3, 4]. In addition to the process of generating fuzzy rules, this paper proposes a correlation measure of the rules as an additional consideration for evaluating interestingness of provided rules.

  14. What Medical Oncologist Residents Think about the Italian Speciality Schools: A Survey of the Italian Association of Medical Oncology (AIOM) on Educational, Clinical and Research Activities

    Science.gov (United States)

    Moretti, Anna; De Angelis, Carmine; Lambertini, Matteo; Cremolini, Chiara; Imbimbo, Martina; Berardi, Rossana; Di Maio, Massimo; Cascinu, Stefano; La Verde, Nicla

    2016-01-01

    Background and objectives Relevant heterogeneity exists among Postgraduate Schools in Medical Oncology, also within the same country. In order to provide a comprehensive overview of the landscape of Italian Postgraduate Schools in Medical Oncology, the Italian Association of Medical Oncology (AIOM) undertook an online survey, inviting all the residents to describe their daily activities and to express their overall satisfaction about their programs. Methods A team composed of five residents and three consultants in medical oncology prepared a 38 items questionnaire that was published online in a reserved section, accessible through a link sent by e-mail. Residents were invited to anonymously fill in the questionnaire that included the following sub-sections: quality of teaching, clinical and research activity, overall satisfaction. Results Three-hundred and eleven (57%) out of 547 invited residents filled in the questionnaire. Two-hundred and twenty-three (72%) participants declared that attending lessons was frequently difficult and 153 (49%) declared they did not gain substantial improvement in their knowledge from them. Fifty-five percent stated that they did not receive lessons on palliative care. Their overall judgment about didactic activity was low in 63% of the interviewed. The satisfaction for clinical activity was in 86% of cases good: 84% recognized that, during the training period, they acquired a progressive independence on patients' management. About research activity, the majority (79%) of participants in the survey was actively engaged in managing patients included in clinical trials but the satisfaction level for the involvement in research activities was quite low (54%). Overall, 246 residents (79%) gave a positive global judgment of their Medical Oncology Schools. Conclusions The landscape of Italian Postgraduate Schools in Medical Oncology is quite heterogeneous across the country. Some improvements in the organization of teaching and in the

  15. 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...

  16. 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...

  17. 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.

  18. [A history of Korean medical association's emblem: the caduceus of Asklepios and Hermes].

    Science.gov (United States)

    Shin, Young-Jeon

    2007-06-01

    An emblem represents the identity of an organization. Through the emblem of an organization, they differentiate the members from others and reinforce the membership, homogeneity, and pride. It is also a tool that an organization officially publicizes its mission and values. The symbol designed by Cho, Byungduk was announced as the first emblem of Korean Medical Association (KMA) on October 31st 1947. His design work has the caduceus with the Taeguk sign on the top, the symbol of Korea, and the Red Cross in the background including the name, 'KMA'. Since then, the emblem was revised three times: in 1964, 1973, and 1995. The current symbol is based on the design of the first one. Although Asklepian, the single serpent-entwined staff of Asklepios, is the one known as the symbol of medicine, this emblem takes the caduceus of Hermes who is the patron god of merchants, thieves, and travelers. The mistake comes from the unawareness of the distinction between the caduceus of Asklepios and Hermes. Moreover, it proves that U. S. Army Medical Corps (USAMC) heavily influenced the reconstruction of Korean health care system including KMA. The USAMC has used the symbol of caduceus since 1902. In 1947, the year that the first emblem of KMA was established, Southern part of Korea was governed by the United States Military Government (USMG, 1945-1948). The current emblem of KMA brings up a question whether we should continue to use the symbol that was taken from USMAC in the historical period of USMG governance. Celebrating 100th anniversary year of KMA, KMA needs to re-evaluate the appropriateness of the KMA symbol. PMID:18175460

  19. 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

  20. 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...... the associations between age, gender, systemic diseases, medications and labial and whole salivary flow rates in older people. Methods: Unstimulated labial (LS) and unstimulated (UWS) and chewing-stimulated (SWS) whole salivary flow rates were measured in 389 randomly selected community-dwelling Danish women...

  1. 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.

  2. University of California San Diego's Program in Medical Education-Health Equity (PRIME-HEq): Training Future Physicians to Care for Underserved Communities.

    Science.gov (United States)

    Powell, Tamara; Garcia, Katherine Arias; Lopez, Alexis; Bailey, Jacob; Willies-Jacobo, Lindia

    2016-01-01

    The Program in Medicine-Health Equity (PRIME-HEq) at the University of California, San Diego prepares physicians to clinically serve and publicly advocate for underserved communities. In this article we share some of PRIME-HEq's defining features, such as our admissions process, student-directed service-focused elective courses, active community engagement, and multi-disciplinary Master's training. PMID:27524742

  3. Factors associated with having a medical marijuana card among Veterans with recent substance use in VA outpatient treatment.

    Science.gov (United States)

    Davis, Alan K; Bonar, Erin E; Ilgen, Mark A; Walton, Maureen A; Perron, Brian E; Chermack, Stephen T

    2016-12-01

    Psychiatric symptoms, somatic problems, and co-occurring substance use have been associated with medical marijuana consumption among civilian patients with substance use disorders. It is possible that these factors may impact Veterans' ability to engage in or adhere to mental health and substance use disorder treatment. Therefore, we examined whether psychiatric functioning, substance use, and somatic problems were associated with medical marijuana use among Veterans receiving substance use disorder and/or mental health treatment. Participants (n=841) completed screening measures for a randomized controlled trial and 67 (8%) reported that they had a current medical marijuana card. Most of these participants (78%) reported using marijuana to treat severe/chronic pain. Significant bivariate differences revealed that, compared to participants without a medical marijuana card, those with a card were more likely to be in a middle income bracket, unemployed, and they had a significantly higher number of recent days of marijuana use, synthetic marijuana use, and using sedatives prescribed to them. Additionally, a significantly higher proportion of participants with a medical marijuana card scored above the clinical cutoff for posttraumatic stress disorder (PTSD) symptoms, had significantly higher severity of sleep-related problems, and reported a higher level of pain. These findings highlight the co-occurrence of substance use, PTSD symptoms, sleep-related problems, and chronic pain among Veterans who use medical marijuana. Future research should investigate the inter-relationships among medical marijuana use and other clinical issues (e.g., PTSD symptoms, sleep, pain) over time, and potential implications of medical marijuana use on treatment engagement and response. PMID:27475408

  4. 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.

  5. 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...

  6. 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

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

    OpenAIRE

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

    2016-01-01

    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...

  8. Epiphytic diatoms associated with red mangrove (Rhizophora mangle) prop roots in Bahía Magdalena, Baja California Sur, Mexico.

    Science.gov (United States)

    Siqueiros Beltrones, D A; López Fuerte, F O

    2006-06-01

    The first floristic inventory of benthic diatoms is provided for the Bahia Magdalena-Bahia Almejas lagoon system. Samplings were carried out during November of 1999. The oxydized samples were mounted permanently. Eighty six diatom taxa were identified, out of which 59 are new records for the Bahia Magdalena area, and 12 taxa are new for the Baja California peninsula. Taxa recorded previously as rare in other substrata are common or abundant on the epiphytic macroalgae of mangrove prop roots. Other species are mainly epipelic forms, while 24 are commonly found as tychoplankton in the area. Certain taxa appear to be characteristic of mangrove systems in general. PMID:18494299

  9. 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…

  10. Changes in Study Strategies of Medical Students between Basic Science Courses and Clerkships Are Associated with Performance

    Science.gov (United States)

    Ensminger, David C.; Hoyt, Amy E.; Chandrasekhar, Arcot J.; McNulty, John A.

    2013-01-01

    We tested the hypothesis that medical students change their study strategies when transitioning from basic science courses to clerkships, and that their study practices are associated with performance scores. Factor scores for three approaches to studying (construction, rote, and review) generated from student (n = 150) responses to a…

  11. Role of childhood adversity in the development of medical co-morbidities associated with bipolar disorder

    NARCIS (Netherlands)

    Post, Robert M.; Altshuler, Lori L.; Leverich, Gabriele S.; Frye, Mark A.; Suppes, Trisha; McElroy, Susan L.; Keck, Paul E.; Nolen, Willem A.; Kupka, Ralph W.; Grunze, Heinz; Rowe, Mike

    2013-01-01

    Objective: A role for childhood adversity in the development of numerous medical conditions in adults has been described in the general population, but has not been examined in patients with bipolar disorder who have multiple medical comorbidities which contribute to their premature mortality. Metho

  12. Impacts associated with the recent range shift of the aeolid nudibranch Phidiana hiltoni (Mollusca, Opisthobranchia) in California.

    Science.gov (United States)

    Goddard, Jeffrey H R; Gosliner, Terrence M; Pearse, John S

    2011-01-01

    In 1977, Phidiana hiltoni (O'Donoghue in J. Entomol Zool (Pomona College, Claremont, California) 19:77-119, 1927) began spreading northward from Monterey, California. By 1992, it had reached Duxbury Reef (37° 53' 23″ N, 122° 41' 59″ W), 100 km to the north, where other nudibranchs subsequently appeared to decline. The role of P. hiltoni in this decline was investigated through diet analysis, feeding trials, and comparison of historical and recent abundance data. In the wild, P. hiltoni preyed largely on hydroids, but also showed evidence of predation on nudibranchs. In the laboratory, P. hiltoni attacked most of the dendronotid and aeolid nudibranchs presented to it, ingesting small individuals whole. The pooled abundance of nudibranchs vulnerable to attack by P. hiltoni declined an average of two-thirds at Duxbury Reef since its arrival, compared to (1) no change in the non-vulnerable species and (2) no change in either group at two other sites where P. hiltoni was one to two orders of magnitude less abundant. Phidiana hiltoni therefore appears to have caused this decline, likely through a combination of direct predation and competition for prey. A brief larval period, combined with cyclonic re-circulation in the lee of Point Reyes, may be driving self-recruitment of P. hiltoni at Duxbury Reef, as well as hindering further northward spread. PMID:24391265

  13. Proteomic analysis of cerebrospinal fluid in California sea lions (Zalophus californianus) with domoic acid toxicosis identifies proteins associated with neurodegeneration.

    Science.gov (United States)

    Neely, Benjamin A; Soper, Jennifer L; Gulland, Frances M D; Bell, P Darwin; Kindy, Mark; Arthur, John M; Janech, Michael G

    2015-12-01

    Proteomic studies including marine mammals are rare, largely due to the lack of fully sequenced genomes. This has hampered the application of these techniques toward biomarker discovery efforts for monitoring of health and disease in these animals. We conducted a pilot label-free LC-MS/MS study to profile and compare the cerebrospinal fluid from California sea lions with domoic acid toxicosis (DAT) and without DAT. Across 11 samples, a total of 206 proteins were identified (FDRlions with DAT: complement C3, complement factor B, dickkopf-3, malate dehydrogenase 1, neuron cell adhesion molecule 1, gelsolin, and neuronal cell adhesion molecule. Immunoblot analysis found reelin to be depressed in the cerebrospinal fluid from California sea lions with DAT. Mice administered domoic acid also had lower hippocampal reelin protein levels suggesting that domoic acid depresses reelin similar to kainic acid. In summary, proteomic analysis of cerebrospinal fluid in marine mammals is a useful tool to characterize the underlying molecular pathology of neurodegenerative disease. All MS data have been deposited in the ProteomeXchange with identifier PXD002105 (http://proteomecentral.proteomexchange.org/dataset/PXD002105).

  14. 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.

  15. 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. PMID:24400630

  16. 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.

  17. 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.

  18. 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…

  19. 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…

  20. 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

  1. Self-citation rates among medical imaging journals and a possible association with impact factor

    Energy Technology Data Exchange (ETDEWEB)

    Kurmis, Timothy P. [Department of Orthopaedics and Trauma, Royal Adelaide Hospital, South Australia (Australia)], E-mail: tim.kurmis@health.sa.gov.au; Kurmis, Andrew P. [Department of Orthopaedic Surgery, Royal Melbourne Hospital, Victoria (Australia)

    2010-02-15

    Purpose: Since conceptualisation in 1955, journal impact factors (IFs) have evolved as surrogate markers of perceived 'quality'. However, no previous research has explored the relationship between IF and journal self-citation rate, which may inflate this measure. Given Radiography's ongoing push to achieve Medline and ISI database inclusion, this paper aimed to quantitatively explore the frequency of self-citation and correlate this with ISI-reported IF. Methods: A review of articles published in two peer-reviewed, Medline and ISI-listed, imaging journals (Radiology and Academic Radiology), and Radiography, within in a 12-month period, was performed. The total number of citations and self-citations per article was recorded, and the results compared. Basic statistical and correlation analyses between listed IF ratings and self-citation indices were also performed. Results and Discussion: To our knowledge, this work represents the preliminary investigation exploring the association between ISI-listed IF and self-citation frequency. From the current results it can be suggested that such a relationship does exist, as demonstrated by the strongly positive correlation statistic (Pearson's r{sup 2} = 0.99). Radiology was noted to have a considerably larger mean number of self-citations per article than the other two journals (p < 0.01), despite near-equivalent numbers of references per article. Conclusion: Our findings suggest that there may be relationship between an ISI-listed IFs and journal self-citation rates. It is hoped that this paper will be of interest in academic and research circles, both within medical imaging and more widely, and may provide impetus for discussion relating to self-citation frequency and influence on resultant IF calculations.

  2. 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.

  3. A Lagrangian Physical-Biological Model to Study Water Parcels Associated with Algal Blooms from Southern California Bight to Todos Santos Bay.

    Science.gov (United States)

    Vivas Téllez, I. E.; Rivas, D.

    2015-12-01

    Lagrangian ocean circulation and biological dynamics are numerically studied in Todos Santos Bay during the spring of 2007. This period is particularly interesting after an intense toxic algal bloom occurred in April 2007 in this area, which was associated with the wind-driven upwelling in the region. High resolution, numerical model simulations were carried out to study dynamical features along of the Southern California Bight (SCB), the coast of the northern Baja California (BC), and the interior of Todos Santos Bay (TSB). These simulations are used in a three-dimensional Lagrangian (particle tracking) analysis which provides information about the origin and distribution of the waters present in the Bay during the occurrence of the toxic bloom. After the selection of trajectories of particles showing coherent patterns, a Nitrate-Phytoplankton-Zooplankton-Detritus (NPZD) lower trophic model is implemented to study the influence of the environmental conditions that occur during the particle advection, solving the NPZD equations at every time-varying position of the advected particles. The model is also modified for phytoplankton growth as a function of the environmental temperature to somehow emulate the life cycle of Pseudo-nitzschia. The analysis of the trajectories shows that particles mainly come from two regions: from the north, in the southern portion of SCB and from regions west of the TSB. Knowing the regional circulation patterns and their phytoplankton dynamics can help to understand and even predict the origin and destination of the harmful algal blooms that occur in TSB and its surroundings.

  4. A dietary risk assessment of the pyrethroid insecticide resmethrin associated with its use for West Nile Virus mosquito vector control in California

    Directory of Open Access Journals (Sweden)

    Wesley C. Carr

    2006-01-01

    Full Text Available An outbreak of human illnesses associated with West Nile Virus (WNV occurred in New York City in 1999. Since then, it has gradually spread westwards, reaching northern California for the first time in 2005. WNV is transmitted by several mosquito species and birds serve as the main reservoir. Several control measures have been used, targeting both the aquatic larvae and the adult mosquitoes. In the latter case, roosting birds in trees are sprayed with pyrethroid insecticides because these are highly toxic to mosquitoes, but have low avian toxicity. A request was made to use a resmethrin-containing insecticide during the month of October 2005 in California. Because resmethrin was not registered for use on growing crops, concerns were raised about potential crop contamination. Therefore, an expedited dietary risk assessment was conducted on resmethrin. Developmental toxicity in the rat (NOELs of 25 or 40 mg/kg/day was used as the acute endpoint and dietary exposure was assessed using the DEEM-FCIDTM computer program. Only crops growing above ground during October were considered. Margins of Safety (MOS were found to be above 100, the level generally considered to be sufficient to protect public health when using an animal NOEL.

  5. 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

  6. 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.

  7. Patient and medication-related factors associated with hospital-acquired hyponatremia in patients hospitalized from heart failure.

    Science.gov (United States)

    Saepudin, S; Ball, Patrick A; Morrissey, Hana

    2016-08-01

    Background Hyponatremia has been known as an important predictor of clinical outcomes in patients with heart failure (HF). While information on hyponatremia in patients with HF has been available abundantly, information on factors associated with increased risk of developing hospital-acquired hyponatremia (HAH) is still limited. Objective To identify patients and medication-related factors associated with HAH in patients hospitalized from HF. Setting Fatmawati Hospital in Jakarta, Indonesia. Methods This is a nested case-control study with patients developing HAH served as case group and each patient in case group was matched by age and gender to three patients in control group. Patients included in this study are patients hospitalized from HF, and coded with I.50 according to ICD-10, during 2011-2013 at Fatmawati Hospital in Jakarta, Indonesia. Information retrieved from patients' medical records included demographic profiles, vital signs and symptoms at admission, past medical history, medication during hospitalization and clinical chemistry laboratory records. Multivariable logistic regression analysis was performed to find out patient and treatment-related factors associated with the development of HAH. Main outcome measures Patients and medication related factors having significant association with HAH. Results Four hundreds sixty-four patients were included in this study and 45 of them (9.7 %) met criteria of developing HAH so then, accordingly, 135 patients were selected as controls. 36 patient- and 22 treatment-related factors were analyzed in univariate logistic regression resulted in 20 factors having p value <0.2 and were included in multivariable logistic regression analysis. Final factors showing significant association with HAH are presence of ascites at admission (odds ratio = 4.7; 95 % confidence interval 1.9-11.5) and administration of amiodarone (3.2; 1.3-7.4) and heparin (3.1; 1.2-7.3) during hospital stay. Conclusion Presence of ascites at

  8. 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.

  9. 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

  10. 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

  11. 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

  12. 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.

  13. 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 beliefs and...

  14. 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....

  15. Exploring factors associated with patients' satisfaction with medication change: a questionnaire survey.

    OpenAIRE

    Rodgers, Sarah; Avery, Anthony J; O'Neill, Ciaran

    2002-01-01

    The recent drive to encourage general practitioners (GPs) to rationalise their prescribing has implications for patients who may have their medication changed. A postal survey of such patients was conducted and it wasfound that 65% were at least reasonably satisfied with the way theyfound out about changes in their medication. Logistic analysis showed that patients were more satisfied when they had been told about the change by a GP or a pharmacist or by a letterfrom the practice.

  16. Outbreak of Escherichia coli O157:H7 infections associated with drinking unpasteurized commercial apple juice--British Columbia, California, Colorado, and Washington, October 1996.

    Science.gov (United States)

    1996-11-01

    On October 30, 1996, the Seattle-King County Department of Public Health and the Washington State Department of Health reported an outbreak of Escherichia coli O157:H7 infections epidemiologically associated with drinking Odwalla brand unpasteurized apple juice or Odwalla juice mixtures containing apple juice from a coffee shop chain, grocery stores, or other locations. A case was defined as hemolytic uremic syndrome (HUS) or a stool culture yielding E. coli O157:H7 in a person who became ill after September 30, 1996, and drank Odwalla juice within 10 days before illness onset. As of November 6, British Columbia, California, Colorado, and Washington had reported a total of 45 cases. PMID:8965797

  17. 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

  18. An Analysis of Health Impacts Associated with Pollutant Response to Changes in Emissions In Different Regions of Central California

    Science.gov (United States)

    Tran, C.; Tanrikulu, S.; Beaver, S.; Hilken, H.

    2011-12-01

    Exposure to ozone and particulate matter has been shown to have considerable human health impacts. Currently major air basins of central California such as the San Francisco Bay Area (SFBA), Sacramento area, and the San Joaquin Valley (SJV) are all designated as in nonattainment of the Federal 8-hour ozone and 24-hour PM2.5 standards, despite California's comprehensive emission control programs for the last fifty years. Although these programs were very effective, decreasing anthropogenic emissions 40 to 50 percent in the region from 1990 to 2010 alone, the ambient response of pollutants was mixed and varied among these three interconnected regions. The purpose of this work was to investigate differences in each region's human health impact response to changes in emissions using the US EPA's BenMAP program. Inputs to BenMAP were prepared using the CMAQ model. Ambient concentrations were simulated for 2005. Then, anthropogenic emissions were reduced 10 to 60 percent across the board in 10 percent increments for the purpose of assessing pollutant responses to changes in emissions. BenMAP was run for each emission reduction scenario. The BenMAP results were normalized by county population to enable comparisons among counties that ranged from rural and agricultural to urban and densely populated. In all regions, the benefits of direct PM emission reductions were greater than those of similar precursor reductions. With respect to mortality rates, direct PM reductions produced the largest benefits in Nevada, Stanislaus, Tuolumne, and San Francisco Counties. For a 40 percent reduction in emissions, reductions in annual mortality rates ranged from 120 to 140 per million for these counties. Precursor emission reductions' benefits were maximized at the southern end of SJV, with Tulare showing the maximum reduction of around 83 mortalities per million. Monetized benefits of avoided mortalities as a result of direct PM emission reductions were significantly higher in

  19. 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.

  20. Assessment of Entrepreneurial Skills and Its Association with Social Intelligence in Students of Kermanshah University of Medical Sciences

    OpenAIRE

    Yahya Safari; Fatemeh Tahmasby; Mohammad Javad Karamafrooz

    2013-01-01

    Introduction: Social intelligence and entrepreneurship are among features leading to the academic and career achievements. Due to the importance of this issue, the present study was performed to determine the level of entrepreneurial skills in students of Kermanshah University of Medical Sciences and its association with social intelligence. Methods: In this descriptive cross-sectional study by using systematic random sampling method, we selected 350 students at Kermanshah University of Me...

  1. Executive Functions and Parenting Behaviors in Association With Medical Adherence and Autonomy Among Youth With Spina Bifida

    OpenAIRE

    O’Hara, Lauren K.; Holmbeck, Grayson N.

    2013-01-01

    Objective This study was designed to examine whether executive functions and parenting behaviors (acceptance, behavioral control, and psychological control) are associated with medical adherence and autonomy among preadolescents and adolescents with spina bifida (SB). Methods Questionnaire and observational data were collected from a sample of 8–15 year olds with SB (N = 140) and their mothers, fathers, and teachers. Youth also completed neuropsychological testing. Results Youth with SB demon...

  2. 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.

  3. Associations between the Big Five Personality Traits and the Non-Medical Use of Prescription Drugs for Cognitive Enhancement

    OpenAIRE

    Sebastian eSattler; Reinhard eSchunck

    2016-01-01

    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...

  4. Associations Between the Big Five Personality Traits and the Non-Medical Use of Prescription Drugs for Cognitive Enhancement

    OpenAIRE

    Sattler, Sebastian; Schunck, Reinhard

    2016-01-01

    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 wit...

  5. A Conversation with David Bates, MD, MSc, Chairman of the American Medical Informatics Association

    OpenAIRE

    Raymond, Brian

    2008-01-01

    A world-renowned physician-researcher, David Bates, MD, MSc, is Chief of the Division of General Medicine at the Brigham and Women's Hospital in Boston, MA, and a Professor at Harvard Medical School and the Harvard School of Public Health, where he is codirector of the Program in Clinical Effectiveness. He is the Medical Director of Clinical and Quality Analysis, Information Systems at Partners HealthCare System, Inc. He is also the former Chair of the National Alliance for Primary Care Infor...

  6. 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.

  7. Nationaler Kompetenzbasierter Lernzielkatalog Medizin (NKLM für Deutschland: Zusammenarbeit der Gesellschaft für Medizinische Ausbildung (GMA und des Medizinischen Fakultätentages (MFT [National Competence-Based Learning Objectives for Undergraduate Medical Education (NKLM in Germany: Cooperation of the Association for Medical Education (GMA and the Association of Medical Faculties in Germany (MFT

    Directory of Open Access Journals (Sweden)

    Hahn, Eckhart G.

    2009-08-01

    Full Text Available [english] The Framework for Qualifications of the European Higher Education Area (FQ-EHEA; Bologna Process and the European Qualifications Framework for Lifelong Learning (EQF-LLL; Lisbon Process are competence-driven frameworks for vocational and higher education programmes in need for defined learning objectives. In the field of medical education, The Netherlands and Switzerland have developed national catalogues for undergraduate medical training, which are competence-based and compatible with a two-cycle curriculum comprised of a Bachelor in Medicine and a Master in Medicine. In Germany, virtually all medical organizations, last not least the Association of Medical Faculties (MFT, have voted against the application of the two-cycle (and the three-cycle curriculum to medical undergraduate education. A standstill of the European processes will not be accepted in the political arena, and a proposition was made by the Conference of German Ministers of Higher Education to develop a medical qualification framework for Germany, asking the Association for Medical Education (GMA and the MFT to join forces. This is not possible without consented national learning objectives derived from the professional context of physicians. The GMA has teamed up with the MFT to develop National Competence-Based Learning Objectives for Undergraduate Medical Education (NKLM in Germany (see Figure 1 to fulfill these needs.

  8. The Association between Observed Parental Emotion Socialization and Adolescent Self-Medication

    Science.gov (United States)

    Hersh, Matthew A.; Hussong, Andrea M.

    2009-01-01

    The current study examined the moderating influence of observed parental emotion socialization (PES) on self-medication in adolescents. Strengths of the study include the use of a newly developed observational coding system further extending the study of PES to adolescence, the use of an experience sampling method to assess the daily covariation…

  9. 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.

  10. 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.

  11. The California Hazards Institute

    Science.gov (United States)

    Rundle, J. B.; Kellogg, L. H.; Turcotte, D. L.

    2006-12-01

    leaders, managers, stakeholders, policy makers, educators and the public to effectively and comprehensively combat the problems caused by the natural hazards that threaten California. During this first year of operation, UC faculty involved in the CHI will identify the science and technology research priorities of the Institute, followed by the solicitation of participation by other important stakeholders within California. The CHI is founded upon the idea that the hazards associated with events such as earthquakes and floods need not become great disasters such as the San Francisco earthquake of 1906 and 2005 Hurricane Katrina if these hazards can be anticipated proactively, before they must be dealt with reactively.

  12. 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

    2016-07-01

    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 < 0.05), while improved scores were associated with students who scored highly on the VARK "Aural" modality (P < 0.05). These data support the contention that individual student learning styles contribute little to variation in academic performance in medical students. Anat Sci Educ 9: 391-399. © 2016 American Association of Anatomists. PMID:26845590

  13. Association of Unconscious Race and Social Class Bias With Vignette-Based Clinical Assessments by Medical Students

    Science.gov (United States)

    Haider, Adil H.; Sexton, Janel; Sriram, N.; Cooper, Lisa A.; Efron, David T.; Swoboda, Sandra; Villegas, Cassandra V.; Haut, Elliott R.; Bonds, Morgan; Pronovost, Peter J.; Lipsett, Pamela A.; Freischlag, Julie A.; Cornwell, Edward E.

    2012-01-01

    Context Studies involving physicians suggest that unconscious bias may be related to clinical decision making and may predict poor patient-physician interaction. The presence of unconscious race and social class bias and its association with clinical assessments or decision making among medical students is unknown. Objective To estimate unconscious race and social class bias among first-year medical students and investigate its relationship with assessments made during clinical vignettes. Design, Setting, and Participants A secure Web-based survey was administered to 211 medical students entering classes at Johns Hopkins School of Medicine, Baltimore, Maryland, in August 2009 and August 2010. The survey included the Implicit Association Test (IAT) to assess unconscious preferences, direct questions regarding students’ explicit race and social class preferences, and 8 clinical assessment vignettes focused on pain assessment, informed consent, patient reliability, and patient trust. Adjusting for student demographics, multiple logistic regression was used to determine whether responses to the vignettes were associated with unconscious race or social class preferences. Main Outcome Measures Association of scores on an established IAT for race and a novel IAT for social class with vignette responses. Results Among the 202 students who completed the survey, IAT responses were consistent with an implicit preference toward white persons among 140 students (69%, 95% CI, 61%–75%). Responses were consistent with a preference toward those in the upper class among 174 students (86%, 95% CI, 80%–90%). Assessments generally did not vary by patient race or occupation, and multivariable analyses for all vignettes found no significant relationship between implicit biases and clinical assessments. Regression coefficient for the association between pain assessment and race IAT scores was −0.49 (95% CI, −1.00 to 0.03) and for social class, the coefficient was −0.04 (95% CI

  14. 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.

  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. Factors Associated with Perceived Uncertainty among Parents of Children with Undiagnosed Medical Conditions

    OpenAIRE

    Madeo, Anne C.; O'Brien, Kathleen E.; Bernhardt, Barbara A.; Biesecker, Barbara B.

    2012-01-01

    Uncertainty is a pervasive characteristic of illness. Yet little is known about the individual or situational factors that contribute to perceptions of uncertainty. The present study aims to examine the factors that contribute to perceived uncertainty among parents of a child with an undiagnosed condition. Two hundred sixty-six parents of a child, or children, affected by an undiagnosed medical condition for at least two years completed an electronically administered mixed-methods survey asse...

  17. Identifying key Effective Lifelong Learning Inventory (ELLI) dimensions associated with academic success amongst postgraduate medical students

    OpenAIRE

    Rashid-Doubell, Fiza; Cuculescu-Santana, Mirela

    2012-01-01

    Many elements have been identified as contributors of academic success amongst medical students but to group these components in order to develop guidelines for intervention strategies is atypical. One such tool which could allow this possibility is the Effective Lifelong Learning Inventory (ELLI) developed by the University of Bristol. ELLI is an online self-assessment instrument which identifies and measures the dimensions of learner development. It comprises of 90 key questions used to ...

  18. Drug interactions associated with methadone, buprenorphine, cocaine, and HIV medications: implications for pregnant women

    OpenAIRE

    McCance-Katz, Elinore F.

    2010-01-01

    Pregnancy in substance-abusing women with HIV/AIDS presents a complex clinical challenge. Opioid-dependent women need treatment with opioid therapy during pregnancy to protect the health of mother and developing fetus. However, opioid therapies, methadone and buprenorphine, may have drug interactions with some HIV medications that can have adverse effects leading to suboptimal clinical outcomes. Further, many opioid-dependent individuals have problems with other forms of substance abuse, for ...

  19. Medical Issues Associated with Radiotherapy Accidents: Some Examples and Lessons Learned

    International Nuclear Information System (INIS)

    Over the past one hundred years and longer, since the discovery of ionizing radiations, radiotherapy has made great contributions to controlling human cancer. Clinical practice has improved most dramatically over the past decade as a result of better tools/computers for the identification of clinical cancer target volumes and with more precision delivery of the radiation, with the consequent sparing of normal tissues. Unfortunately, however, radiotherapy accidents, resulting in serious physical, functional and even emotional injury to cancer patients, do occur. It is, therefore, appropriate that this symposium review some of these accidents, as an attempt to better understand how to incorporate better preventive measures and to develop better medical management of the outcomes. Prevention of such accidents is, of course, always the most important way to minimize the complex medical and social issues resulting from such accidents, which always affect the patient, their families and friends, as well as the morale of the caregiver staff. As such accidents are never planned, it is important, when they do occur, to capture and record as much information as possible. The REAC/TS has for the past 40 years maintained a radiation accident registry for this purpose. The REAC/TS registry is far from complete; data from it are used as a basis for this discussion. Our worldwide registry data consist of many types of radiation accident, including industrial, nuclear power plant and medical sources, as is shown. However, it is noteworthy that the most common cause of death listed in this registry in the United States of America is due to the misuse or misadministration of medical sources, as is noted in the ‘circled’ group. A brief review and discussion of several of the more severe radiotherapy accidents listed in the REAC/TS registry (involving both sealed and unsealed radiotherapy sources) are presented and discussed

  20. Computer Man Simulation of Incapacitation: An Automated Approach to Wound Ballistics and Associated Medical Care Assessments

    OpenAIRE

    Clare, V.; Ashman, W.; Broome, P; Jameson, J.; Lewis, J.; Merkler, J.; Mickiewicz, A.; Sacco, W.; Sturdivan, L.

    1981-01-01

    Wound ballistics assessments traditionally have been based on correlations between some quantification of “ballistic dose” and an empirical/subjective medical quantification of human functional degradation. Although complicated by the highly inhomogeneous nature of the human body and by the voluminous data handling requirements these correlation values were obtained by manual methods. The procedure required a substantial commitment of time and resources, thereby restricting the data base from...

  1. Factors associated with adherence to medication among depressed patients from Saudi Arabia: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Al Jumah K

    2014-10-01

    Full Text Available Khalaf Al Jumah,1 Mohamed Azmi Hassali,2 Dalal Al Qhatani,1 Kamal El Tahir3 1Department of Pharmacy, Al Amal Psychiatric Hospital, Riyadh, Saudi Arabia; 2School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia; 3College of Pharmacy, King Saud University, Riyadh, Saudi Arabia Background: Several studies have investigated the factors associated with adherence to antidepressants, with inconsistent conclusions. However, no similar study has investigated this issue among patients diagnosed with major depressive disorder in Saudi Arabia. The aim of this study is to explore patients’ adherence to antidepressant medications, and the factors associated with adherence.Methods: A non-experimental cross-sectional design was used to measure adherence to antidepressants among major depressive disorder patients, and the factors associated with adherence. The patients were recruited from the outpatient clinic at the Al-Amal Complex for Mental Health in Riyadh, Saudi Arabia, between August 2013 and January 2014. Eligible participants met with one of the research coordinators for assessment of their adherence. Adherence was investigated indirectly by use of the Morisky Medication Adherence Scale, and patients’ beliefs were assessed through the Beliefs about Medicine Questionnaire. Information about the severity of their depression, demographics, and other study variables were collected.Results: A total of 403 patients met the inclusion criteria and participated in the study. Of those, 203 (50.37% were females, while the remaining 200 (49.6% were males. There was an average age of 39 years (standard deviation, ±11 years. Half of the patients (52.9% reported low adherence to their antidepressant medication, with statistically significant differences between the low adherence and high adherence scores relating to sex, age, and duration of illness. Conclusion: Low medication adherence is a common problem among major depressive disorder

  2. Medically treated anorexia nervosa is associated with normal P wave parameters.

    Science.gov (United States)

    Nussinovitch, Moshe; Gur, Eitan; Nussinovitch, Naomi; Kaminer, Keren; Volovitz, Benjamin; Nussinovitch, Udi

    2012-07-30

    Anorexia nervosa (AN) is an increasingly common medical condition. Some studies have demonstrated an increased prevalence of atrial premature contractions and anatomical changes in AN patients. Our aim was to investigate P wave parameters and P wave dispersion, an electrocardiographic marker for supraventricular arrhythmias, and its effect on AN. The study group included 48 patients with AN, most hospitalized for a few weeks, and a matched control group. All participants underwent 12-lead electrocardiography (ECG) under strict standards. P wave length and P wave dispersion in each patient were computed from a randomly selected beat and an averaged beat, constructed from 7 to 12 beats, included in a 10-s ECG. There were no statistically significant differences found between the groups for minimal, maximal, average P wave duration and P wave dispersion, calculated either from a random beat or averaged beats. In conclusion, medically treated AN patients who have gained weight have normal P wave parameters, and therefore do not appear to have an increased electrocardiographic risk for atrial fibrillation compared with healthy controls. Further studies are required to evaluate the influence of different disease stages, electrolyte imbalance and other medical complications on P wave parameters and risk for supraventricular arrhythmias in AN patients. PMID:22421068

  3. 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

  4. Associations between Medical Conditions and Breast Cancer Risk in Asians: A Nationwide Population-Based Study in Taiwan.

    Directory of Open Access Journals (Sweden)

    Shu-Chun Chuang

    Full Text Available The breast cancer incidence in Asia is rising. To explore whether the etiology of breast cancer is different from the known risk factors from studies in Western countries, we conducted a nested case-control study using data from the Taiwan National Health Insurance Research Database (NHIRD.All medical conditions based on the first three digits of the ICD-9 and a list of medical conditions based on literature review were retrieved for each case and control. The odds ratios (OR and 95% confidence intervals (CI of the associations between medical conditions and breast cancer risks were estimated using conditional logistic regression and adjusted for occupation, number of breast cancer screening, and the average number of outpatient visits prior the diagnosis. The associations were also estimated for younger (<50 years old and older subjects separately.The analyses included 4,884 breast cancer cases and 19,536 age-matched controls. Prior breast diseases (OR, 95% CI: 2.47, 2.26-2.71, obesity (1.43, 1.04-1.96, endometriosis (1.44, 1.15-1.80, uterine leiomyoma (1.20, 1.03-1.40, hypertensive diseases (1.14, 1.05-1.25, and disorders in lipid metabolism (1.13, 1.04-1.24 were associated with increased breast cancer risk. No heterogeneity was observed between age groups (<50 and ≥50 years old.In addition to benign breast diseases, obesity, endometriosis, uterine leiomyoma, hypertensive diseases, and disorders of lipid metabolism were associated with a subsequent breast cancer risk.Our results suggest that estrogen related factors may play an important role in breast cancer risks in the Taiwanese female population.

  5. 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

  6. 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.

  7. Collaborative Family Healthcare Association commentary on the "joint principles: Integrating behavioral health care into the patient-centered medical home".

    Science.gov (United States)

    Runyan, Christine; Khatri, Parinda

    2014-06-01

    The Collaborative Family Healthcare Association (CFHA) welcomes the opportunity to comment on the complementary set of Joint Principles underscoring the Integration of Behavioral Health Care Into the Patient-Centered Medical Home (The Working Party Group on Integrated Behavioral Healthcare et al., 2014). CFHA is an organization that promotes comprehensive and cost-effective models of health care delivery that integrate mind and body, individual and family, patients, providers, and communities. CFHA appreciates that the Joint Principles do not explicitly endorse any single model of collaboration between behavioral health and medical practice. Rather, they broadly emphasize integration, affirming the only way to have a whole person orientation is to adopt a biopsychosocial-spiritual perspective. This commentary will highlight areas of notable strength within the Joint Principles, as well as challenge the language, if not perspective, on a few critical elements. PMID:24955686

  8. 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.

  9. Incidence of Norovirus-Associated Medical Encounters among Active Duty United States Military Personnel and Their Dependents.

    Directory of Open Access Journals (Sweden)

    Brian Rha

    Full Text Available Norovirus is a leading cause of gastroenteritis episodes and outbreaks in US military deployments, but estimates of endemic disease burden among military personnel in garrison are lacking.Diagnostic codes from gastroenteritis-associated medical encounters of active duty military personnel and their beneficiaries from July 1998-June 2011 were obtained from the Armed Forces Health Surveillance Center. Using time-series regression models, cause-unspecified encounters were modeled as a function of encounters for specific enteropathogens. Model residuals (representing unexplained encounters were used to estimate norovirus-attributable medical encounters. Incidence rates were calculated using population data for both active duty and beneficiary populations.The estimated annual mean rate of norovirus-associated medically-attended visits among active duty personnel and their beneficiaries was 292 (95% CI: 258 to 326 and 93 (95% CI: 80 to 105 encounters per 10,000 persons, respectively. Rates were highest among beneficiaries <5 years of age with a median annual rate of 435 (range: 318 to 646 encounters per 10,000 children. Norovirus was estimated to cause 31% and 27% of all-cause gastroenteritis encounters in the active duty and beneficiary populations, respectively, with over 60% occurring between November and April. There was no evidence of any lag effect where norovirus disease occurred in one population before the other, or in one beneficiary age group before the others.Norovirus is a major cause of medically-attended gastroenteritis among non-deployed US military active duty members as well as in their beneficiaries.

  10. Association between neighbourhood air pollution concentrations and dispensed medication for psychiatric disorders in a large longitudinal cohort of Swedish children and adolescents

    OpenAIRE

    Oudin, Anna; Bråbäck, Lennart; Åström, Daniel Oudin; Strömgren, Magnus; Forsberg, Bertil

    2016-01-01

    Objective To investigate associations between exposure to air pollution and child and adolescent mental health. Design Observational study. Setting Swedish National Register data on dispensed medications for a broad range of psychiatric disorders, including sedative medications, sleeping pills and antipsychotic medications, together with socioeconomic and demographic data and a national land use regression model for air pollution concentrations for NO2, PM10 and PM2.5. Participants The entire...

  11. Factors Associated With Medical and Nursing Students' Willingness to Donate Organs.

    Science.gov (United States)

    Tumin, Makmor; Tafran, Khaled; Tang, Li Yoong; Chong, Mei Chan; Mohd Jaafar, Noor Ismawati; Mohd Satar, NurulHuda; Abdullah, Nurhidayah

    2016-03-01

    Malaysia suffers from a chronic shortage of human organs for transplantation. Medical and nursing students (MaNS) are future health professionals and thus their attitude toward organ donation is vital for driving national donation rates. This study investigates MaNS' willingness to donate organs upon death and the factors influencing their willingness. A cross-sectional design was used with a sample of 500 students (264 medical and 236 nursing) at the University of Malaya. A self-administrated questionnaire was used. The responses were analyzed by using descriptive statistics and multiple logistic regression. Of all respondents, 278 (55.6%) were willing to donate organs upon death, while the remaining 222 (44.4%) were unwilling to donate. Only 44 (8.8%) had donor cards. The multiple logistic regression revealed that the minorities ethnic group was more willing to donate organs than Malay respondents (adjusted odds ratio [aOR] = 1.98, P = 0.010). In addition, medical students were more willing to donate than nursing students (aOR = 2.53, P = 0.000). Respondents who have a family member with a donor card were more willing to donate than respondents who do not (aOR = 3.48, P = 0.006). MaNS who believed that their religion permits deceased donation were more willing to donate than their counterparts (aOR = 4.96, P = 0.000). Household income and sex were not significant predictors of MaNS' willingness to donate organs upon death. MaNS have moderate willingness, but low commitment toward deceased organ donation. Strategies for improving MaNS' attitude should better educate them on organ donation, targeting the most the Malay and nursing students, and should consider the influence of family attitude and religious permissibility on MaNS' willingness. PMID:27015207

  12. 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. PMID:27103910

  13. 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.

  14. [Factors associated with academic success of medical students at Buenos Aires University].

    Science.gov (United States)

    Borracci, Raúl A; Pittaluga, Roberto D; Álvarez Rodríguez, Juan E; Arribalzaga, Eduardo B; Poveda Camargo, Ricardo L; Couto, Juan L; Provenzano, Sergio L

    2014-01-01

    The aim of this study was to identify common factors relating to the academic success of medical students who were distinguished with honors at the Buenos Aires University. In 2011, 142 graduates were surveyed; the questionnaire included 59 questions on their sociodemographic environment, living conditions and social integration, motivation to study, learning capacity and health quality during their career. Compared to other students, these distinguished students more often lived in the city, far from their families; had been educated at private or universitary high schools, their economic needs were financed by their parents, who were on the whole professionals. Most of them were single and childless. The possibility of future employment oportunities (work) did not influence their choice of a medical career, academic success was important to them and they believed that success depended largely on personal effort; they knew how to handle anxiety, were sociable but independent and preferred solid experience to abstract conceptuality in order to obtain information. Our conclusion, within the current system of candidate selection, these results serve to calculate the covert self-selection mechanisms during the career, or in a more restrictive regime, to select those likely to reach academic success due to their privileged ambience. The analysis of demographic factors indicates some degree of inequality for socially disadvantaged students. Perhaps, a selection system based only on intellectual abilities would help identify and support the best candidates regardless of their social context. PMID:25555005

  15. 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...

  16. Adherence and Associated Factors towards Antidiabetic Medication among Type II Diabetic Patients on Follow-Up at University of Gondar Hospital, Northwest Ethiopia

    Directory of Open Access Journals (Sweden)

    Mastewal Abebaw

    2016-01-01

    Full Text Available Background. The prevalence of diabetes mellitus (DM is rising worldwide and is more in the developing countries which unfortunately are already suffering from communicable diseases. The aim of this study was to assess adherence and associated factors towards antidiabetic medication among type II diabetic patients in University of Gondar Hospital, Diabetic Clinic, Gondar, Northwest Ethiopia. Methods. Institutional based cross-sectional study was conducted. Systematic sampling technique was used. Morisky Medication Adherence Scale (MMAS scores were used for labeling patients as adherent or nonadherent. Data were entered and analyzed using SPSS version 20. To see the association of variables logistic regression with OR and 95% CI was done. Results. A total of 288 study participants were interviewed with response rate of 100%. The level of adherence was found to be 85.1%. Factors found to be significantly associated with antidiabetic medication adherence were level of education (AOR = 14.27, 95% CI = 3.0, 67.82, duration of diabetes (AOR = 6.10, 95% CI = 2.03, 18.34, and knowledge about DM and its medications (AOR = 28.05, 95% CI = 8.96, 87.8. Conclusions and Recommendations. Large proportion of respondents in this study were found to be adherent to their antidiabetic medications. Level of education, duration of diabetes, and knowledge about DM and its medication were significantly associated with antidiabetic medication adherence of patients. Health education including adherence counseling to create awareness towards DM and its medications is mandatory.

  17. Non-medical prescription drug and illicit street drug use among young Swiss men and associated mental health issues.

    Science.gov (United States)

    Baggio, Stéphanie; Studer, Joseph; Mohler-Kuo, Meichun; Daeppen, Jean-Bernard; Gmel, Gerhard

    2014-01-01

    Non-medical use of prescription drugs (NMUPD) is increasing among the general population, particularly among teenagers and young adults. Although prescription drugs are considered safer than illicit street drugs, NMUPD can lead to detrimental consequences. The aim of the present study was to investigate the relationship between drug use (NMUPD on the one side, illicit street drugs on the other side) with mental health issues and then compare these associations. A representative sample of 5719 young Swiss men aged around 20 years filled in a questionnaire as part of the ongoing baseline Cohort Study on Substance Use Risk Factors (C-SURF). Drug use (16 illicit street drugs and 5 NMUPDs, including sleeping pills, sedatives, pain killers, antidepressants, stimulants) and mental health issues (depression, SF12) were assessed. Simple and multiple linear regressions were employed. In simple regressions, all illicit and prescription drugs were associated with poorer mental health. In multiple regressions, most of the NMUPDs, except for stimulants, were significantly associated with poorer mental health and with depression. On the contrary, the only associations that remained significant between illicit street drugs and mental health involved cannabis. NMUPD is of growing concern not only because of its increasing occurrence, but also because of its association with depression and mental health problems, which is stronger than the association observed between these problems and illicit street drug use, excepted for cannabis. Therefore, NMUPD must be considered in screening for substance use prevention purposes. PMID:24447983

  18. 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.

  19. Pitfalls associated with the therapeutic reference pricing practice of asthma medication

    Directory of Open Access Journals (Sweden)

    Kalo Zoltan

    2012-07-01

    Full Text Available Abstract Background Therapeutic reference pricing (TRP based on the WHO daily defined dose (DDD is a method frequently employed for the cost-containment of pharmaceuticals. Our objective was to compare average drug use in the real world with DDD and to evaluate whether TRP based on DDD could result in cost savings on maintenance medication and the total direct health expenditures for asthma patients treated with Symbicort Turbuhaler (SYT and Seretide Diskus (SED in Hungary. Methods Real-world data were derived from the Hungarian National Health Insurance Fund database. Average doses and costs were compared between the high-dose and medium-dose SYT and SED groups. Multiple linear regressions were employed to adjust the data for differences in the gender and age distribution of patients. Results 27,779 patients with asthma were included in the analysis. Average drug use was lower than DDD in all groups, 1.38-1.95 inhalations in both SED groups, 1.28-1.97 and 1.74-2.49 inhalations in the medium and high-dose SYT groups, respectively. Although the cost of SED based on the DDD would be much lower than the cost of SYT in the medium-dose groups, no difference was found in the actual cost of the maintenance therapy. No significant differences were found between the groups in terms of total medical costs. Conclusions Cost-containment initiatives by payers may influence clinical decisions. TRP for inhalation asthma drugs raises special concern, because of differences in the therapeutic profile of pharmaceuticals and the lack of proven financial benefits after exclusion of the effect of generic price erosion. Our findings indicate that the presented TRP approach of asthma medications based on the daily therapeutic costs according to the WHO DDD does not result in reduced public healthcare spending in Hungary. Further analysis is required to show whether TRP generates additional expenditures by inducing switching costs and reducing patient compliance

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

    OpenAIRE

    Jesús Rodríguez-Romero; Laura del Carmen López-González; Felipe Galván-Magaña; Francisco J. Sánchez-Gutiérrez; Roxana B Inohuye-Rivera; Juan C. Pérez-Urbiola

    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...

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

    OpenAIRE

    Bowie, Janice V.; Juon, Hee-Soon; Rodriguez, Elisa M.; Cho, Juhee

    2006-01-01

    Introduction Hispanics 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. Methods To estimate the prevalence of overweight and obesity among Mexican and Central Americans li...

  2. Fluvoxamine-associated oscillopsia and a role for personalized medication dosing.

    Science.gov (United States)

    Singman, Eric L; Hocum, Brian; Yohannan, Jithin; Pearson, Virginia

    2015-12-01

    A 60-year-old woman reported horizontal "shimmering" movement while reading crossword puzzles when using fluvoxamine, bupropion, quetiapine, lithium, and levothyroxine. This visual disturbance, likely oscillopsia, started after the fluvoxamine was added and waned as the fluvoxamine was tapered, disappearing after the drug was discontinued. Genetic testing to explore how the patient metabolizes these medications combined with YouScript® interaction analysis suggest that she may have had abnormally high plasma concentrations of fluvoxamine during this time. Oscillopsia may be a novel dose-dependent side effect of fluvoxamine. Genetic testing combined with YouScript has the potential to discover novel drug side effects, elucidate drug interactions and guide future prescribing decisions. PMID:26351962

  3. Risk factors associated with subclinical mastitis as detected by California Mastitis Test in smallholder dairy farms in Jimma, Ethiopia using multilevel modelling.

    Science.gov (United States)

    Tolosa, T; Verbeke, J; Piepers, S; Supré, K; De Vliegher, S

    2013-10-01

    The prevalence of subclinical mastitis and associated risk factors at the herd, cow and quarter level were studied using multilevel modelling in smallholder dairy farms in Jimma, Ethiopia. Forty-two herds, out of the 55 dairy farms located in Jimma (76%), were visited, a questionnaire was performed, and 635 quarters belonging to 176 lactating cows were screened to detect the presence of subclinical mastitis using the California Mastitis Test (CMT). Sixty-two percent of the cows and 51% of the quarters were subclinically infected. Quarters from cows in later stage of lactation (>180 DIM) [opposed to early lactation (mastitis in smallholder dairy farms in Jimma and a lack of awareness of the existence of the disease among dairy farmers. Implementation of a mastitis prevention program adapted to the local needs, including a focus on milking technique, application of appropriate tick control measurements as well as fertility management, allowing cows to be dried-off at a more appropriate moment, are needed. To conclude, milking by squeezing instead of stripping, but not of cows with tick-infested udders, as well as fertility management could reduce the subclinical mastitis prevalence (and incidence) on the short term. PMID:23910496

  4. 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.

  5. ‘A Matter of Conscience’: The Moral Authority of the World Medical Association and the Readmission of the South Africans, 1976–1994

    OpenAIRE

    Mbali, Mandisa

    2014-01-01

    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 whit...

  6. A systematic review of the factors associated with delays in medical and psychological help-seeking among men.

    Science.gov (United States)

    Yousaf, Omar; Grunfeld, Elizabeth A; Hunter, Myra S

    2015-01-01

    Despite a growing literature on the factors associated with men's low rates of medical and psychological help-seeking, a systematic review of these is missing. Such an overview can help to inform health psychologists of the barriers to the performance of adaptive health behaviours, such as prompt help-seeking, and could inform theoretical advancements and the development of targeted interventions to facilitate prompt help-seeking among men. We systematically reviewed quantitative and qualitative empirical papers on factors associated with delays in men's medical and psychological help-seeking. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and we used the databases PsycINFO, Medline, Embase and PsycARTICLES (with keywords: men/male*/gender*, help*/seek* and health*/service*/utili*[sation]) for papers in English. 41 citations (amounting to 21,787 participants aged 15-80 + ) met the inclusion criteria. Approximately half of these used qualitative methodologies (i.e., semi-structured interviews and focus groups), while half used quantitative methodologies (i.e., questionnaires). We identify a number of recurring cognitive, emotional, health-service related and socio-demographic help-seeking factors/predictors from the 41 papers. Of these, the most prominent barriers to help-seeking were disinclination to express emotions/concerns about health, embarrassment, anxiety and fear, and poor communication with health-care professionals. PMID:26209212

  7. Assessment of Entrepreneurial Skills and Its Association with Social Intelligence in Students of Kermanshah University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Yahya Safari

    2013-12-01

    Full Text Available Introduction: Social intelligence and entrepreneurship are among features leading to the academic and career achievements. Due to the importance of this issue, the present study was performed to determine the level of entrepreneurial skills in students of Kermanshah University of Medical Sciences and its association with social intelligence. Methods: In this descriptive cross-sectional study by using systematic random sampling method, we selected 350 students at Kermanshah University of Medical Sciences. Data were collected using entrepreneurial skills standard and social intelligence questionnaires. Reliability and validity of two questionnaires have been already assessed in previous studies. Results analyzed by descriptive statistics and Pearson correlation coefficient test. Results: Students’ entrepreneurial skill was totally 255.69 which is assessed at poor scores range. Research findings also indicated the presence of a statistically significantly positive association between social intelligence and risk-taking (r=0.14 P=0.035, locus of control (r=0.72, P=0.019, need to achievement (r=0.54, P=0.012, mental health (r=0.53, P=0.033, pragmatism (r=0.45, P=0.04, ambiguity toleration (r=0.58, P=0.029, positive thinking (r=0.72, P=0.019, and challenging (r=0.29, P=0.016. Conclusion: Given the students’ poor entrepreneurial skills and the correlation between social intelligence and entrepreneurial components, it is recommended to strengthen social intelligence and consequently promote entrepreneurial skills.

  8. Association between LEP and LEPR gene polymorphisms and dyslipidemia in patients using atypical antipsychotic medication

    NARCIS (Netherlands)

    Gregoor, Jochem G.; van der Weide, Jan; Loovers, Harriet M.; van Megen, Harold J.; Egberts, Toine C.; Heerdink, Eibert R.

    2010-01-01

    Background Treatment with atypical antipsychotic agents is often complicated by dyslipidemia, which is a risk factor for cardiovascular disease. Objectives To determine whether the LEPR Q223R, the LEP -2548G/A, and the HTR2C -759C/T polymorphisms are associated with dyslipidemia in patients using at

  9. 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.

  10. Capital expenditure trends in California hospitals: 2002-2007.

    Science.gov (United States)

    McCue, Michael J

    2011-01-01

    From 1997 to 2001, hospitals expanded their capital expenditures by only 1% while future capital investment was expected to grow by 14% (Healthcare Financial Management Association 2004). Analyzing California hospital data from 2002 to 2004 to 2005 to 2007, the author identified and classified capital expenditures into 4 major types. Between the 2 study periods, growth in capital purchases exceeded 23% for medical equipment, expansion, and maintenance types of projects. Large nonprofit hospitals capturing a greater share of the market and serving fewer uninsured and government payers had a greater number of these types of capital purchases.

  11. Accountable care organization formation is associated with integrated systems but not high medical spending.

    Science.gov (United States)

    Auerbach, David I; Liu, Hangsheng; Hussey, Peter S; Lau, Christopher; Mehrotra, Ateev

    2013-10-01

    Medicare's approximately 250 accountable care organizations (ACOs) care for a growing portion of all fee-for-service beneficiaries across the United States. We examined where ACOs have formed and what regional factors are predictive of ACO formation. Understanding these factors could help policy makers foster growth in areas with limited ACO development. We found wide variation in ACO formation, with large areas, such as the Northwest, essentially empty of ACOs, and others, such as the Northeast and Midwest, dense with the organizations. Key regional factors associated with ACO formation include a greater fraction of hospital risk sharing (capitation), larger integrated hospital systems, and primary care physicians practicing in large groups. Area income, Medicare per capita spending, Medicare Advantage enrollment rates, and physician density were not associated with ACO formation. Together, these results imply that underlying provider integration in a region may help drive the formation of ACOs.

  12. Antiretroviral regimen and suboptimal medication adherence are associated with low-level human immunodeficiency virus viremia.

    Science.gov (United States)

    Konstantopoulos, Christina; Ribaudo, Heather; Ragland, Kathleen; Bangsberg, David R; Li, Jonathan Z

    2015-01-01

    Episodes of human immunodeficiency virus low-level viremia (LLV) are common in the clinical setting, but its association with antiretroviral therapy (ART) regimen and adherence remains unclear. Antiretroviral therapy adherence was evaluated in participants of the Research on Access to Care in the Homeless cohort by unannounced pill counts. Factors associated with increased risk of LLV include treatment with a protease inhibitor (PI)-based regimen (ritonavir-boosted PI vs nonnucleoside reverse-transcriptase inhibitor: adjusted hazard ratio [HR], 3.1; P = .01) and lower ART adherence over the past 3 months (HR, 1.1 per 5% decreased adherence, adjusted; P = .050). Patients with LLV may benefit from ART adherence counseling and potentially regimen modification. PMID:25884007

  13. 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.

  14. 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.

  15. 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. PMID:23228146

  16. 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).

  17. Displaced rocks, strong motion, and the mechanics of shallow faulting associated with the 1999 Hector Mine, California, earthquake

    Science.gov (United States)

    Michael, A.J.; Ross, S.L.; Stenner, H.D.

    2002-01-01

    The paucity of strong-motion stations near the 1999 Hector Mine earthquake makes it impossible to make instrumental studies of key questions about near-fault strong-motion patterns associated with this event. However, observations of displaced rocks allow a qualitative investigation of these problems. By observing the slope of the desert surface and the frictional coefficient between these rocks and the desert surface, we estimate the minimum horizontal acceleration needed to displace the rocks. Combining this information with observations of how many rocks were displaced in different areas near the fault, we infer the level of shaking. Given current empirical shaking attenuation relationships, the number of rocks that moved is slightly lower than expected; this implies that slightly lower than expected shaking occurred during the Hector Mine earthquake. Perhaps more importantly, stretches of the fault with 4 m of total displacement at the surface displaced few nearby rocks on 15?? slopes, suggesting that the horizontal accelerations were below 0.2g within meters of the fault scarp. This low level of shaking suggests that the shallow parts of this rupture did not produce strong accelerations. Finally, we did not observe an increased incidence of displaced rocks along the fault zone itself. This suggests that, despite observations of fault-zone-trapped waves generated by aftershocks of the Hector Mine earthquake, such waves were not an important factor in controlling peak ground acceleration during the mainshock.

  18. 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

  19. Associations between the Big Five Personality Traits and the Non-Medical Use of Prescription Drugs for Cognitive Enhancement

    Directory of Open Access Journals (Sweden)

    Sebastian eSattler

    2016-01-01

    Full Text Available 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= 6,454, 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 (reuse 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 (reuse 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

  20. 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

  1. 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.

  2. 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....

  3. 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. PMID:9382409

  4. 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.

  5. 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.

  6. Conference scene: Summary of the 6th Conference of the Romanian Association of Medical Laboratories with international participation.

    Science.gov (United States)

    Carasevici, Eugen

    2011-10-01

    The Romanian Association of Medical Laboratories (RAML) conferences have acquired a reputation for standing out as the most prominent and efficient meetings in the national community of laboratory medicine, being a landmark of the development in this field in Romania and an active affiliation to international forums. This year, the conference setting was Piatra Neamt, in the northeast part of Romania, which produced a friendly and stimulating professional environment. As in previous years, leading experts in the fields of laboratory medicine attended the event. This year, we enjoyed the opportunity to have such distinguished guests as the members of the executive board of International Federation of Clinical Chemistry and Laboratory Medicine (IFCC); Graham Beastall, IFCC President; Päivi Hannele Laitinen, IFCC secretary; and Grazyna Sypniewska, IFCC Communication and Publication Division, and editor of the electronic journal of the IFCC. As usual, the conference program included all aspects of clinical laboratory activity, with a special focus on technology development, instrumentation and laboratory management. Fully aware of the fact that the complexity and depth of laboratory practice have undergone an impressive and rapid evolution, the specific goals of the event were to increase knowledge in the fundamentals of new molecular investigation, areas which show the tendency to become routine in our daily activity. In addition, laboratory management and the place of medical laboratories in the process of translational medicine were subjects of focus. The 6th Conference of the Romanian Association of Medical Laboratories was held from Wednesday 1st to Saturday 4th of June 2011. A total of 273 participants from all local branches of the Association attended. The scientific program included seven plenary sessions where 22 lectures and 18 short communications were delivered, and three poster sessions with 44 poster presentations. Session topics covered issues of

  7. 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...

  8. 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

  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 medication adherence in school-aged children with asthma

    Directory of Open Access Journals (Sweden)

    Amy H.Y. Chan

    2016-03-01

    Full Text Available Adherence to preventive asthma treatment is poor, particularly in children, yet the factors associated with adherence in this age group are not well understood. Adherence was monitored electronically over 6 months in school-aged children who attended a regional emergency department in New Zealand for an asthma exacerbation and were prescribed twice-daily inhaled corticosteroids. Participants completed questionnaires including assessment of family demographics, asthma responsibility and learning style. Multivariable analysis of factors associated with adherence was conducted. 101 children (mean (range age 8.9 (6–15 years, 51% male participated. Median (interquartile range preventer adherence was 30% (17–48% of prescribed. Four explanatory factors were identified: female sex (+12% adherence, Asian ethnicity (+19% adherence, living in a smaller household (−3.0% adherence per person in the household, and younger age at diagnosis (+2.7% for every younger year of diagnosis (all p<0.02. In school-aged children attending the emergency department for asthma, males and non-Asian ethnic groups were at high risk for poor inhaled corticosteroid adherence and may benefit most from intervention. Four factors explained a small proportion of adherence behaviour indicating the difficulty in identifying adherence barriers. Further research is recommended in other similar populations.

  11. 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.

  12. 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.

  13. 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

  14. Medical image of the week: healthcare-associated pneumonia secondary to aspiration

    Directory of Open Access Journals (Sweden)

    Nissim L

    2015-07-01

    Full Text Available A 57 year-old bedbound paraplegic man developed a worsening productive cough after being hospitalized for several days. He was brought to the radiology suite for a CT scan of the chest, revealing a soft tissue density within his right main-stem bronchus, with volume loss of his right lung (Figure 1. Bronchoscopy was performed, yielding a 2 cm piece of broccoli, successfully removed with forceps (Figure 2. Culture from the bronchial aspirate was positive for Pseudomonas aeruginosa. The patient’s respiratory status dramatically improved after removal of the foreign body and commencement of pathogen-directed antibiotics. This study illustrates a dramatic example of healthcare-associated pneumonia (HCAP secondary to aspiration, as described by the American Thoracic Society / Infectious Diseases Society of America (1.

  15. Medical diagnoses associated with substance dependence among inpatients at a large urban hospital.

    Directory of Open Access Journals (Sweden)

    Humberto Choi

    Full Text Available There are limited data on reasons for hospital admission among patients dependent on substances other than alcohol. We compared primary discharge diagnoses for heroin- or cocaine-dependent patients to non-dependent patients.We evaluated a cohort of patients admitted to a general medicine service at a public teaching hospital during July 2005-June 2008. Through bedside interviews, we identified patients who had substance-use disorders. We categorized patients by substance used, route of administration, and dependent or non-dependent use. We grouped diagnostic codes (i.e., ICD-9 using Healthcare Utilization Project categories. We excluded HIV-infected patients.Of 11,397 patients, 341 (3.0% were dependent on inhalational heroin, 260 (2.3% on non-injection cocaine, and 106 (0.9% on injection heroin. Compared to non-dependent patients, inhalational heroin-dependent patients were over three-fold more likely to have been admitted for respiratory diseases (28% vs. 8%, p<0.01; this association was strongest for asthma exacerbation (OR=7.0; 95% CI, 4.7 to 70.4, p<0.01. Of the 225 admissions for an asthma exacerbation, 44 (19.6% had co-occurrent heroin-dependence. The most frequent diagnostic category among cocaine-dependent patients was circulatory, which was similar to non-dependent patients (22% vs. 21%, p=0.92.There is a strong association between heroin dependence and hospital admission for an asthma exacerbation. Provision of specialized substance-use treatment for inhalational heroin users will be necessary to reduce the frequency of exacerbations and repeat hospital admissions.

  16. 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

  17. 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.

  18. Medications: Myths Versus Facts

    Science.gov (United States)

    ... High Blood Pressure Tools & Resources Stroke More Medications: Myths Versus Facts Updated:Aug 30,2016 Taking medication ... Association volunteer. Here are some of the top myths about taking cardiovascular medication: I feel OK, so ...

  19. 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

  20. 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

    Abstract – Objective: To investigate the associations between age, gender, systemic diseases, medications, labial and whole salivary flow rates and oral and ocular dryness in older people. Methods: Symptoms of oral and ocular dryness, systemic diseases, medications (coded according to the Anatomi......Abstract – Objective: To investigate the associations between age, gender, systemic diseases, medications, labial and whole salivary flow rates and oral and ocular dryness in older people. Methods: Symptoms of oral and ocular dryness, systemic diseases, medications (coded according...... 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...

  1. '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.

  2. 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

    Science.gov (United States)

    Kiesewetter, Jan; Gutmann, Johanna; Drossard, Sabine; Gurrea Salas, David; Prodinger, Wolfgang; Mc Dermott, Fiona; Urban, Bert; Staender, Sven; Baschnegger, Heiko; Hoffmann, Gordon; Hübsch, Grit; Scholz, Christoph; Meier, Anke; Wegscheider, Mirko; Hoffmann, Nicolas; Ohlenbusch-Harke, Theda; Keil, Stephanie; Schirlo, Christian; Kühne-Eversmann, Lisa; Heitzmann, Nicole; Busemann, Alexandra; Koechel, Ansgar; Manser, Tanja; Welbergen, Lena; Kiesewetter, Isabel

    2016-01-01

    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: Basics, Recognize Causes as Foundation for Proactive Behavior, and Approaches for Solutions. 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

  3. 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

  4. Plasma suPAR levels are associated with mortality, admission time, and Charlson Comorbidity Index in the acutely admitted medical patient

    DEFF Research Database (Denmark)

    Haupt, Thomas Huneck; Petersen, Janne; Ellekilde, Gertrude;

    2012-01-01

    . METHODS: We included 543 patients with various diseases from a Danish Acute Medical Unit during a two month period. A triage unit ensured that only medical patients were admitted to the Acute Medical Unit. SuPAR was measured on plasma samples drawn upon admission. Patients were followed-up for three...... with these endpoints. RESULTS: Increased suPAR was significantly associated with 90-day mortality (4.87 ng/ml in survivors versus 7.29 ng/ml in non-survivors, P

  5. Medication possession ratio associated with short-term virologic response in individuals initiating antiretroviral therapy in Namibia.

    Science.gov (United States)

    Hong, Steven Y; Jerger, Logan; Jonas, Anna; Badi, Alfons; Cohen, Steven; Nachega, Jean B; Parienti, Jean-Jacques; Tang, Alice M; Wanke, Christine; Terrin, Norma; Pereko, Dawn; Blom, Abraham; Trotter, Andrew B; Jordan, Michael R

    2013-01-01

    The visual-analogue scale (VAS), Likert item (rating scale), pills identification test (PIT), and medication possession ratio (MPR) provide estimates of antiretroviral therapy (ART) adherence which correlate with HIV viral suppression. These simple adherence measures are inexpensive and easy to administer; however, require validation and adjustment prior to implementation. The objective of this study was to define the optimal adherence assessment measure in Namibia to identify patients at risk for sub-optimal adherence and poor virologic response 6 months after ART initiation. We conducted a cross-sectional survey in HIV-infected adults receiving ART for 6-12 months prior to the adherence assessment. Adherence measures included 30-day VAS, 30-day Likert item, self-reported treatment interruptions, PIT, and MPR. Association of adherence measures with 6-month HIV-1 RNA level was assessed using two thresholds (1000 copies/mL and 5000 copies/mL). Adherence was assessed in 236 patients, mean age 37.3 years, 54% female. Mean adherence was 98.1% by 30-day VAS, 84.7% by 30-day Likert item, 97.0% by self-reported treatment interruptions, 90.6% by PIT, and 98.8% by MPR. Agreement between adherence measures was poor using kappa statistic. 76% had HIV-1 RNA <1000 copies/ml, and 88% had HIV-1 RNA <5000 copies/ml. MPR (continuous) was associated with viral suppression <5000 copies/ml (p = 0.036). MPR <75% was associated with virologic failure at ≥5000 copies/ml with OR 3.89 (1.24, 12.21), p = 0.013. Adherence was high with all measures. Only MPR, was associated with short-term virologic response, suggesting its cross-culturally utility for early identification of patients at high risk for virologic failure.

  6. 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.

  7. Associations between self-medication, health literacy, and self-perceived health status: A community-based study

    Directory of Open Access Journals (Sweden)

    Aziz Kamran

    2015-01-01

    Conclusions: Self-medication had a significant relationship with health literacy and health status. Therefore, the design and implementation of training programs are necessary to increase the perception on the risk of self-medication.

  8. Medically unexplained physical symptoms and work functioning over 2 years: their association and the influence of depressive and anxiety disorders and job characteristics

    OpenAIRE

    den Boeft, Madelon; Twisk, Jos W R; Hoekstra, Trynke; Terluin, Berend; Penninx, Brenda W. J. H.; van der Wouden, Johannes C.; Numans, Mattijs E.; van der Horst, Henriette E

    2016-01-01

    Background Medically unexplained physical symptoms (MUPS) are highly prevalent and may affect work functioning. In this study we aimed to assess the longitudinal association between MUPS and work functioning over 2 years and the influence of job characteristics and depressive and anxiety disorders on this association. Methods We assessed the longitudinal association between MUPS and work functioning, operationalized in terms of absenteeism and disability at work, in 1887 working participants ...

  9. [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.

  10. [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. PMID:23008956

  11. 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.

  12. 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.

  13. American Veterinary Medical Association

    Science.gov (United States)

    ... understand and manage their pets' health. Workplace Wellness Workplace Wellness Tools Workplace wellness is good for both ... Ethics that include a broad-based statement on diversity, including gender identity. Wellness & economics take center stage ...

  14. Medical Library Association

    Science.gov (United States)

    ... www.mlanet.org/blog/scanning-the-horizon-emerging-technology-at-your-library-and-in-the-classroom Go ... 9:57AM CDT, Wed Sep 28th, 2016 Miami, Florida Health Sciences Librarian Updated 9:45AM CDT, Wed Sep 28th, ...

  15. 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

  16. 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

  17. 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. PMID:15138246

  18. 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

  19. 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%.

  20. 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

  1. 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

    OpenAIRE

    Mika, Kathryn

    2012-01-01

    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. ...

  2. 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

  3. The Association Between Potentially Inappropriate Prescribing and Medication-Related Hospital Admissions in Older Patients: A Nested Case Control Study

    NARCIS (Netherlands)

    van der Stelt, C.A.K.; Vermeulen Windsant-van den Tweel, A.M.A.; Egberts, A.C.G.; van den Bemt, P.M.L.A.; Leendertse, A.J.; Hermens, W.A.J.J.; van Marum, R.J.; Derijks, Jeroen

    2016-01-01

    Introduction: Medication-related problems can cause serious adverse drug events (ADEs) that may lead to hospitalization of the patient. There are multiple screening methods to detect and reduce potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs). Whether this will

  4. Retrospective study of cattle poisonings in California: recognition, diagnosis, and treatment

    OpenAIRE

    Puschner B; Varga A

    2012-01-01

    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 Laborator...

  5. Teale California shoreline

    Data.gov (United States)

    California Department of Resources — California Spatial Information System (CaSIL) is a project designed to improve access to geo-spatial and geo-spatial related data information throughout the state...

  6. 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...

  7. Connecting the dots: examining transgender women's utilization of transition-related medical care and associations with mental health, substance use, and HIV.

    Science.gov (United States)

    Wilson, Erin C; Chen, Yea-Hung; Arayasirikul, Sean; Wenzel, Conrad; Raymond, H Fisher

    2015-02-01

    Findings on access to general healthcare for transgender people have emerged, but little is known about access to transition-related medical care for transwomen (i.e., hormones, breast augmentation, and genital surgery). Transgender women have low access to general medical care and are disproportionately at risk for substance use, mental illness, and HIV. We conducted an analysis to determine if utilization of transition-related medical care is a protective factor for health risks to transgender women and to investigate if care differs by important demographic factors and HIV status. A secondary analysis was conducted using data from a 2010 HIV surveillance study using respondent-driven sampling to recruit 314 transwomen in San Francisco. Survey-corrected logistic regression models were used to estimate odds ratios for six psychosocial health problems-binge drinking, injection drug use, anxiety, depression, suicidal ideation, and high-risk intercourse-comparing various levels of utilization of transition-related medical care. Odds ratios were also calculated to determine if utilization of transition-related medical care was related to less overlap of risk domains. We found that Latina and African American transwomen had significantly lower estimated utilization of breast augmentation and genital surgery, as did transwomen who identified as transgender rather than female. Overall, utilization of transition-related medical care was associated with significantly lower estimated odds of suicidal ideation, binge drinking, and non-injection drug use. Findings suggest that utilization of transition-related medical care may reduce risk for mental health problems, especially suicidal ideation, and substance use among transwomen. Yet, important racial/ethnic and gender identity disparities in utilization of transition-related medical care need to be addressed. PMID:25476958

  8. Beyond medications and diet: alternative approaches to lowering blood pressure: a scientific statement from the american heart association.

    Science.gov (United States)

    Brook, Robert D; Appel, Lawrence J; Rubenfire, Melvyn; Ogedegbe, Gbenga; Bisognano, John D; Elliott, William J; Fuchs, Flavio D; Hughes, Joel W; Lackland, Daniel T; Staffileno, Beth A; Townsend, Raymond R; Rajagopalan, Sanjay

    2013-06-01

    Many antihypertensive medications and lifestyle changes are proven to reduce blood pressure. Over the past few decades, numerous additional modalities have been evaluated in regard to their potential blood pressure-lowering abilities. However, these nondietary, nondrug treatments, collectively called alternative approaches, have generally undergone fewer and less rigorous trials. This American Heart Association scientific statement aims to summarize the blood pressure-lowering efficacy of several alternative approaches and to provide a class of recommendation for their implementation in clinical practice based on the available level of evidence from the published literature. Among behavioral therapies, Transcendental Meditation (Class IIB, Level of Evidence B), other meditation techniques (Class III, Level of Evidence C), yoga (Class III, Level of Evidence C), other relaxation therapies (Class III, Level of Evidence B), and biofeedback approaches (Class IIB, Level of Evidence B) generally had modest, mixed, or no consistent evidence demonstrating their efficacy. Between the noninvasive procedures and devices evaluated, device-guided breathing (Class IIA, Level of Evidence B) had greater support than acupuncture (Class III, Level of Evidence B). Exercise-based regimens, including aerobic (Class I, Level of Evidence A), dynamic resistance (Class IIA, Level of Evidence B), and isometric handgrip (Class IIB, Level of Evidence C) modalities, had relatively stronger supporting evidence. It is the consensus of the writing group that it is reasonable for all individuals with blood pressure levels >120/80 mm Hg to consider trials of alternative approaches as adjuvant methods to help lower blood pressure when clinically appropriate. A suggested management algorithm is provided, along with recommendations for prioritizing the use of the individual approaches in clinical practice based on their level of evidence for blood pressure lowering, risk-to-benefit ratio, potential

  9. Patients' Beliefs About Medications are Associated with Stated Preference for Methadone, Buprenorphine, Naltrexone, or no Medication-Assisted Therapy Following Inpatient Opioid Detoxification.

    Science.gov (United States)

    Uebelacker, Lisa A; Bailey, Genie; Herman, Debra; Anderson, Bradley; Stein, Michael

    2016-07-01

    Subsequent to initial opioid detoxification, people with opioid use disorder are typically advised to engage in follow-up treatment to prevent relapse. Medication-assisted treatments (MATs) - i.e., the opioid agonist methadone (MMT) or partial agonist/antagonist, buprenorphine/naltrexone (BUP) -- are the maintenance treatment options with the best research support for positive outcomes. A third MAT, injectable extended-release naltrexone (XR-NTX), was approved by the FDA for opioid dependence in 2010 and shows promise. However, relatively few eligible patients choose to initiate one of these MATs following initial detoxification treatment. Consistent with the health belief model, we hypothesized that beliefs about 1) efficacy of each MAT; 2) safety of each MAT; and 3) perceived consistency with being drug-free would predict stated patient preferences for a particular MAT or for no MAT. We also hypothesized that perceived structural barriers (e.g., time, transportation) would decrease the likelihood of stating a preference for a given MAT. To assess these hypotheses, we surveyed 372 people undergoing inpatient opioid detoxification treatment. Results supported hypotheses for all 3 sets of patient beliefs, with the patient group stating that they preferred a particular MAT having significantly more positive beliefs about that MAT relative to other groups (p<.001). The group that preferred "no MAT" had the most negative beliefs about all MATs. Perceived structural barriers were not related to stated preferences, except that people who preferred BUP were more likely to endorse barriers to MMT than any of the other 3 groups. Notably, a relatively high proportion (32%) of participants were most interested in XR-NTX despite a lack of prior experience with this medication. These results suggest that efforts to increase MAT enrollment following detoxification might benefit from including patient beliefs as one set of factors to assess and target for change. PMID:27211996

  10. Elements of the patient-centered medical home associated with health outcomes among veterans: the role of primary care continuity, expanded access, and care coordination.

    Science.gov (United States)

    Nelson, Karin; Sun, Haili; Dolan, Emily; Maynard, Charles; Beste, Laruen; Bryson, Christopher; Schectman, Gordon; Fihn, Stephan D

    2014-01-01

    Care continuity, access, and coordination are important features of the patient-centered medical home model and have been emphasized in the Veterans Health Administration patient-centered medical home implementation, called the Patient Aligned Care Team. Data from more than 4.3 million Veterans were used to assess the relationship between these attributes of Patient Aligned Care Team and Veterans Health Administration hospitalization and mortality. Controlling for demographics and comorbidity, we found that continuity with a primary care provider was associated with a lower likelihood of hospitalization and mortality among a large population of Veterans receiving VA primary care. PMID:25180648

  11. Measurement of treatment compliance using a medical device for glaucoma patients associated with intraocular pressure control: a survey

    Directory of Open Access Journals (Sweden)

    Jean-Philippe Nordmann

    2010-07-01

    Full Text Available Jean-Philippe Nordmann1, Christophe Baudouin1, Jean-Paul Renard2, Philippe Denis3, Antoine Lafuma4, Caroline Laurendeau4, Viviane Jeanbat4, Gilles Berdeaux5,61Hôpital des Quinzes-Vingt, Paris, France; 2Hôpital du Val de Grâce, Paris, France; 3Hôpital Edouard Herriot, Lyon, France; 4Cemka, Bourg-la-Reine, France; 5Alcon France, Rueil-Malmaison, France; 6Conservatoire National des Arts et Métiers, Paris, FranceObjective: To identify and characterize treatment compliance profiles of glaucoma patients and evaluate the association with intraocular pressure (IOP.Methods: A computerized device (Travalert® that recorded daily instillation times and eye-drop counts was given for 3 months. Patients were declared compliant when at least 2 drops were instilled per day. Compliance rates were calculated for weekdays and weekends, separately, over 8 consecutive weeks. A principal components analysis (PCA was followed by an ascendant hierarchical classification (AHC to identify compliance groups.Results: 140 patients were recruited (mean age 65.5 years; 51.8% female of whom 83.6% had primary open-angle glaucoma with mean IOP 23.9 mmHg before Travalert® use. 60.7% were treated with DuoTrav® (travoprost timolol fixed combination and 39.3% with ­travoprost. The PCA identified two axes (compliance and treatment weeks. The AHC identified 3 ­compliance groups: ‘high’ (56.6%, approx. 80% compliance, ‘medium’ (21.2%, approx. 50% compliance, and ‘low’ (22.1%, approx. 20% compliance. Demographics and glaucoma parameters did not predict low compliance. Final mean IOP was 16.1 mmHg, but higher in the low compliance group (17.7 mmHg, P = 0.02.Conclusions: Compliance measurement by a medical device showed compliance rates <80% by 50% (approx. of patients, significantly impacting IOP control. No demographic or glaucoma variable was associated with low compliance.Keywords: glaucoma, compliance, efficacy, intraocular pressure control

  12. 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

  13. Greater striatal responses to medication in Parkinsons disease are associated with better task-switching but worse reward performance

    NARCIS (Netherlands)

    Aarts, E.; Nusselein, A.A.; Smittenaar, P.; Helmich, R.C.G.; Bloem, B.R.; Cools, R.

    2014-01-01

    Dopaminergic medication in Parkinsons 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 hypothes

  14. Associations between Medical Conditions and Breast Cancer Risk in Asians: A Nationwide Population-Based Study in Taiwan

    OpenAIRE

    Shu-Chun Chuang; Guo-Jie Wu; Yen-Shen Lu; Ching-Hung Lin; Chao Agnes Hsiung

    2015-01-01

    Background The breast cancer incidence in Asia is rising. To explore whether the etiology of breast cancer is different from the known risk factors from studies in Western countries, we conducted a nested case-control study using data from the Taiwan National Health Insurance Research Database (NHIRD). Methods All medical conditions based on the first three digits of the ICD-9 and a list of medical conditions based on literature review were retrieved for each case and control. The odds ratios...

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

    OpenAIRE

    WU, Ping

    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...

  16. Which medical interview skills are associated with patients’ verbal indications of undisclosed feelings of anxiety and depressive feelings?

    OpenAIRE

    Goto, Michiko; Takemura, Yousuke C.

    2016-01-01

    Background In medical practice, obtaining information regarding patients’ undisclosed “feelings of anxiety” or “depressive feelings” is important. The purpose of this study was to determine which interview skills are best suited for eliciting verbal indications of undisclosed feelings, for example anxiety or depressive feelings in patients. Methods Our group videotaped 159 medical interviews at an outpatient department of the Department of Family Medicine, Mie University Hospital (Mie, Japan)...

  17. Factors influencing medical students′ choice of future specialization in medical sciences: A cross-sectional questionnaire survey from medical schools in china, malaysia and regions of south asian association for regional cooperation

    Directory of Open Access Journals (Sweden)

    Arun Kumar

    2014-01-01

    Full Text Available Background: In future, increase in the number of healthcare professionals is dependent on the career interest among present undergraduate medical students. Based on their interest to pursue their specialty, the availability of medical doctors in each specialty could be done. Aims: This study was to find out future career interest and factors that influence undergraduate medical students to choose their future specialization. Materials and Methods: The study was carried out among first-year medical students from five countries. The students were asked to complete an 8-item questionnaire. Two thousand one hundred fifty three participants were enrolled in the study. Data were analyzed in Microsoft-Excel and Statistical Package for the Social Sciences. Results: Of the 2153 participants, only 1470 responded. Among the 1470 participants, 169 participants were excluded due to the ambiguity in responses, finally making it to 1301participants. Among them, Anatomy (49.3% followed by Biochemistry (26.7% and Physiology (24% were the most preferred subjects. Conclusions: Anatomy was the most preferred basic science subject among the other subjects and the students were interested to pursuing surgery in future. Furthermore, the most preferred future specialties were surgery, internal medicine and pediatrics with gender variations; males preferring surgery and females in obstetrics and gynecology.

  18. 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

  19. Is there an association between immunosuppressant therapy medication adherence and depression, quality of life, and personality traits in the kidney and liver transplant population?

    OpenAIRE

    Gorevski E; Succop P; Sachdeva J; Cavanaugh TM; Volek P; Heaton P; Chisholm-Burns M; Martin-Boone JE

    2013-01-01

    Elizabeth Gorevski,1 Paul Succop,1 Jyoti Sachdeva,1 Teresa M Cavanaugh,1 Paul Volek,1 Pamela Heaton,1 Marie Chisholm-Burns,2 Jill E Martin-Boone1 1University of Cincinnati, Cincinnati, OH, USA, 2University of Tennessee College of Pharmacy, Memphis, TN, USA Objectives: To measure the association of transplant patients' personality, depression, and quality of life with medication adherence in kidney and liver transplant recipients. Methods: A cross-sectional study of liver and kidney t...

  20. 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".

  1. 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.

  2. 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…

  3. 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

  4. 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

  5. Medical and household characteristics associated with methicillin resistant Staphylococcus aureus nasal carriage among patients admitted to a rural tertiary care hospital.

    Directory of Open Access Journals (Sweden)

    Leah Schinasi

    Full Text Available BACKGROUND: Methicillin resistant Staphylococcus aureus (MRSA poses a threat to patient safety and public health. Understanding how MRSA is acquired is important for prevention efforts. This study investigates risk factors for MRSA nasal carriage among patients at an eastern North Carolina hospital in 2011. METHODS: Using a case-control design, hospitalized patients ages 18 - 65 years were enrolled between July 25, 2011 and December 15, 2011 at Vidant Medical Center, a tertiary care hospital that screens all admitted patients for nasal MRSA carriage. Cases, defined as MRSA nasal carriers, were age and gender matched to controls, non-MRSA carriers. In-hospital interviews were conducted, and medical records were reviewed to obtain information on medical and household exposures. Multivariable conditional logistic regression was used to derive odds ratio (OR estimates of association between MRSA carriage and medical and household exposures. RESULTS: In total, 117 cases and 119 controls were recruited to participate. Risk factors for MRSA carriage included having household members who took antibiotics or were hospitalized (OR: 3.27; 95% Confidence Interval (CI: 1.24-8.57 and prior hospitalization with a positive MRSA screen (OR: 3.21; 95% CI: 1.12-9.23. A lower proportion of cases than controls were previously hospitalized without a past positive MRSA screen (OR: 0.40; 95% CI: 0.19-0.87. CONCLUSION: These findings suggest that household exposures are important determinants of MRSA nasal carriage in hospitalized patients screened at admission.

  6. Depressive symptoms are associated with higher rates of readmission or mortality after medical hospitalization: A systematic review and meta-analysis.

    Science.gov (United States)

    Pederson, Jenelle L; Warkentin, Lindsey M; Majumdar, Sumit R; McAlister, Finlay A

    2016-05-01

    Depressive symptoms during a medical hospitalization may be an overlooked prognostic factor for adverse events postdischarge. Our aim was to evaluate whether depressive symptoms predict 30-day readmission or death after medical hospitalization. We conducted a systematic review of studies that compared postdischarge outcomes by in-hospital depressive status. We assessed study quality and pooled published and unpublished data using random effects models. Overall, one-third of 6104 patients discharged from medical wards were depressed (interquartile range, 27%-40%). Compared to inpatients without depression, those discharged with depressive symptoms were more likely to be readmitted (20.4% vs 13.7%, risk ratio [RR]: 1.73, 95% confidence interval [CI]: 1.16-2.58) or die (2.8% vs 1.5%, RR: 2.13, 95% CI: 1.31-3.44) within 30 days. Depressive symptoms were common in medical inpatients and are associated with an increased risk of adverse events postdischarge. Journal of Hospital Medicine 2016;11:373-380. © 2016 The Authors Journal of Hospital Medicine published by Wiley Periodicals, Inc. on behalf of Society of Hospital Medicine. PMID:26824220

  7. 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.

  8. Genomic Characterization of Burkholderia pseudomallei Isolates Selected for Medical Countermeasures Testing: Comparative Genomics Associated with Differential Virulence

    OpenAIRE

    Sahl, Jason W.; Allender, Christopher J.; Colman, Rebecca E.; Califf, Katy J.; Schupp, James M.; Currie, Bart J.; Van Zandt, Kristopher E.; H Carl Gelhaus; Paul Keim; Apichai Tuanyok

    2015-01-01

    Burkholderia pseudomallei is the causative agent of melioidosis and a potential bioterrorism agent. In the development of medical countermeasures against B. pseudomallei infection, the US Food and Drug Administration (FDA) animal Rule recommends using well-characterized strains in animal challenge studies. In this study, whole genome sequence data were generated for 6 B. pseudomallei isolates previously identified as candidates for animal challenge studies; an additional 5 isolates were seque...

  9. Older Age and Steroid Use Are Associated with Increasing Polypharmacy and Potential Medication Interactions Among Patients with Inflammatory Bowel Disease

    OpenAIRE

    Parian, Alyssa; Ha, Christina Y.

    2015-01-01

    Background: Comorbidity and polypharmacy, more prevalent among older persons, may impact the treatment of patients with inflammatory bowel disease (IBD). The aims of this study were to assess the frequency of polypharmacy and medication interactions within a cohort of older patients with IBD and describe IBD treatment patterns. Methods: Cohort study of 190 patients with IBD 65 years or older followed at a tertiary IBD referral center from 2006 to 2012. Data collected included demographics, IB...

  10. Associations between respiratory illnesses and secondhand smoke exposure in flight attendants: A cross-sectional analysis of the Flight Attendant Medical Research Institute Survey

    Directory of Open Access Journals (Sweden)

    Redberg Rita F

    2011-09-01

    Full Text Available Abstract Background Secondhand tobacco smoke (SHS is associated with increased risk of respiratory illness, cancer, and cardiovascular disease. Prior to smoking bans on airlines in the late 1980s, flight attendants were exposed to a significant amount of SHS. In the present study, we examine associations between flight attendant SHS exposure and development of respiratory illnesses and cardiovascular disease. Methods Between December 2006 and October 2010, three hundred sixty-two flight attendants completed an online questionnaire with information regarding experience as a flight attendant, medical history, smoking history, and SHS exposure. Rates of illnesses in flight attendants were compared with an age and smoking history matched population sample from NHANES 2005-2006. Logistic regression analysis was used to examine the association of reported medical conditions and pre-ban years of exposure. Results Compared with the sample from NHANES 2005-2006, flight attendants had increased prevalence of chronic bronchitis (11.7% vs. 7.2%, p Conclusions Flight attendants experience increased rates of respiratory illnesses compared to a population sample. The frequency of symptoms of nasal congestion, throat or eye irritation is associated with occupational SHS exposure in the pre-smoking ban era.

  11. According to current situation of Local Medical Association Medical Research Management Special Committee, tentative discussion on academic organizations to promote medical research management team construction%地方医学会医学科学研究管理学专委会现状与学术组织促进医学科研管理队伍建设

    Institute of Scientific and Technical Information of China (English)

    吕亚雯; 方伟岗; 樊建军; 刘俊立

    2013-01-01

    中华医学会医学科学研究管理学分会已成立28年,为更好发挥医学科学研究管理学分会作用,加强沟通与指导,笔者对地方医学会医学科学研究管理学专委会情况进行了调研分析.随着国家对科研投入力度不断加大,高效的科研产出更加需要科研人才和具有较高综合素质的科研管理人才.建立健全各地医学科研管理学专委会,通过积极的组织建设、丰富的学术交流、专业的能力培训,促进医学科研管理队伍建设.%Chinese Society of Medical Science Research Administration Association has been established for 28 years.In order to make Chinese Society of Medical Science Research Administration Association better play the role,strengthen communication and guidance,the author made an investigation and analysis on Local Medical Association Medical Research Management special committee of current situation.With the increasing research investment from government,efficient research outputs need science research personnel and higher comprehensive quality of research and management personnel.Establish and improve local medical science research management special committee by means of positive organizational building and rich academic exchange and professional training to promote medical research management team construction.

  12. Lag Times in Reporting Injuries, Receiving Medical Care, and Missing Work: Associations With the Length of Work Disability in Occupational Back Injuries

    Science.gov (United States)

    Besen, Elyssa; Harrell, Mason; Pransky, Glenn

    2016-01-01

    Objective: The aim of this study is to examine the associations between lag times following occupational low back injury and the length of work disability. Methods: In a retrospective cohort study using workers’ compensation claims, random effects Tobit models were used to explore how disability length relates to three lag times: the number of days from the date of injury to reporting the injury, the number of days from the date of injury to medical care, and the number of days from the date of injury to initiating work disability. Results: In general, shorter lag times for each of the different lags were related to shorter lengths of disability. Conclusions: Decreasing the length of the lag times in reporting injuries, receiving medical care, and missing work may help to decrease the length of work disability for workers after low back injury. PMID:26445030

  13. Moving toward a United States strategic plan in primary care informatics: a White Paper of the Primary Care Informatics Working Group, American Medical Informatics Association

    Directory of Open Access Journals (Sweden)

    David Little

    2003-06-01

    Full Text Available The Primary Care Informatics Working Group (PCIWG of the American Medical Informatics Association (AMIA has identified the absence of a national strategy for primary care informatics. Under PCIWG leadership, major national and international societies have come together to create the National Alliance for Primary Care Informatics (NAPCI, to promote a connection between the informatics community and the organisations that support primary care. The PCIWG clinical practice subcommittee has recognised the necessity of a global needs assessment, and proposed work in point-of-care technology, clinical vocabularies, and ambulatory electronic medical record development. Educational needs include a consensus statement on informatics competencies, recommendations for curriculum and teaching methods, and methodologies to evaluate their effectiveness. The research subcommittee seeks to define a primary care informatics research agenda, and to support and disseminate informatics research throughout the primary care community. The AMIA board of directors has enthusiastically endorsed the conceptual basis for this White Paper.

  14. 探索实施医联体的有效途径%A Discussion on the Effective Way to Medical Association

    Institute of Scientific and Technical Information of China (English)

    李茜; 李凤如; 史培娜; 刘建

    2014-01-01

    At present, a big problem is that health resources in China feature insufficient supply, uneven distribution structure, and partly waste. In order to rationally use health resources and satisfy people’s health needs, some regions began to explore the model of Medical Association. This article focuses on the description of present situation and problems of health resources in China, and proposes the model of Medical Association as a good way to resolving these problems, so as to gradually standardize medical procedures for patients to see a doctor, and to improve the efficiency of medical services and provide people with a high-quality health life.%目前,我国卫生资源总量不足,结构分布不均,部分医疗卫生资源被浪费等仍是卫生领域中的一大症结,为了达到合理利用卫生资源,满足人们健康需求的目的,部分地区开始探索并运行医疗联合体的医疗模式。本文主要介绍我国卫生资源现状及存在的问题并提出“医联体”这一医疗模式可以作为解决这些问题的一个途径,以逐步规范我国就医秩序,提高效率,使居民享受高水平健康生活。

  15. 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

  16. Pycnogonids associated with the giant lion´s-paw scallop Nodipecten subnodosus (Sowerby) in Ojo de Liebre Bay, Guerrero Negro, Baja California Sur, Mexico.

    Science.gov (United States)

    de León-Espinosa, Angel; de León-González, Jesus A

    2015-01-01

    Five species of epibenthic pycnogonids collected on the giant lion´s-paw scallop Nodipecten subnodosus are recorded. A new species of Eurycyde, Eurycyde bamberi, is described. Of the 19 species known in this genus; the new species is closest to Eurycyde hispida Kroyer, 1844 but differs from it in the absence of plumose spines and the shapes of the lateral process, first coxa, and ocular tubercle. The new species represents the third member of Eurycyde from the eastern Pacific in addition to Eurycyde spinosa Hilton, 1916 and Eurycyde clitellaria Stock, 1955. Besides Eurycyde bamberi, the following species were collected: Nymphopsis duodorsospinosa Hilton, 1942c; Callipallene californiensis (Hall, 1913); Nymphon lituus Child, 1979; and Pycnogonum rickettsi Schmitt, 1934. Pycnogonum rickettsi is recorded for first time from Mexican waters, as is Nymphon lituus from the western coast of Baja California Peninsula. Each of these four species are re-described and re-illustrated in order to fill in existing gaps in the literature of the region. PMID:26692802

  17. 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

  18. Persistent recurring wheezing in the fifth year of life after laboratory-confirmed, medically attended respiratory syncytial virus infection in infancy

    OpenAIRE

    Escobar, Gabriel J; Masaquel, Anthony S; Li, Sherian X; Walsh, Eileen M.; Kipnis, Patricia

    2013-01-01

    Background Respiratory syncytial virus (RSV) infection in infancy is associated with subsequent recurrent wheezing. Methods A retrospective cohort study examined children born at ≥32 weeks gestation between 1996–2004. All children were enrolled in an integrated health care delivery system in Northern California and were followed through the fifth year of life. The primary endpoint was recurrent wheezing in the fifth year of life and its association with laboratory-confirmed, medically-attende...

  19. A Bifactor Model of the Beck Depression Inventory and Its Association With Medical Prognosis After Myocardial Infarction

    NARCIS (Netherlands)

    de Miranda Azevedo, Ricardo; Roest, Annelieke M.; Carney, Robert M.; Denollet, Johan; Freedland, Kenneth E.; Grace, Sherry L.; Hosseini, Seyed H.; Lane, Deirdre A.; Parakh, Kapil; Pilote, Louise; de Jonge, Peter

    2016-01-01

    Objectives: Evidence suggests that depression is associated with adverse outcomes in patients with myocardial infarction (MI). Some of the symptoms of depression may also be symptoms of somatic illness and these may confound the association between depression and prognosis. We investigated whether d

  20. 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…

  1. California's English Learner Students

    Science.gov (United States)

    Hill, Laura E.

    2012-01-01

    English Learner (EL) students in California's schools are numerous and diverse, and they lag behind their native-English-speaking peers. Closing the achievement gap for EL students has been a long-standing goal for California educators, and there are some signs of success. Now that EL funding and curriculum issues are receiving a fresh level of…

  2. 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.

  3. 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

  4. Lag Times in Reporting Injuries, Receiving Medical Care, and Missing Work: Associations With the Length of Work Disability in Occupational Back Injuries

    OpenAIRE

    Besen, Elyssa; Harrell, Mason; Pransky, Glenn

    2015-01-01

    Objective: The aim of this study is to examine the associations between lag times following occupational low back injury and the length of work disability. Methods: In a retrospective cohort study using workers’ compensation claims, random effects Tobit models were used to explore how disability length relates to three lag times: the number of days from the date of injury to reporting the injury, the number of days from the date of injury to medical care, and the number of days from the date ...

  5. Examining rare and low-frequency genetic variants previously associated with lone or familial forms of atrial fibrillation in an electronic medical record system

    DEFF Research Database (Denmark)

    Weeke, Peter; Denny, Joshua C; Basterache, Lisa;

    2015-01-01

    BACKGROUND: Studies in individuals or small kindreds have implicated rare variants in 25 different genes in lone and familial atrial fibrillation (AF) using linkage and segregation analysis, functional characterization, and rarity in public databases. Here, we used a cohort of 20 204 patients...... medical record-linked DNA repository, BioVU. Known correlations between AF and common variants at 4q25 were replicated. None of the 19 variants previously associated with AF were over-represented among AF cases (P>0.1 for all), and the frequency of variant carriers among non-AF controls was >0.1% for 14...

  6. The diagnostic suitability of a xerostomia questionnaire and the association between xerostomia, hyposalivation and medication use in a group of nursing home residents

    OpenAIRE

    van der Putten, Gert-Jan; Brand, Henk S; Schols, Jos M. G. A.; de Baat, Cees

    2010-01-01

    The study objective was to explore the diagnostic suitability of the Xerostomia Inventory and the association between xerostomia, hyposalivation and medication use in a group of nursing home residents. A cross-sectional study was carried out in 50 physically impaired nursing home residents (20 men) with a mean age of 78.1 years (range, 53–98) in The Netherlands. The Xerostomia Inventory-Dutch version was completed for all residents and the data were subjected to exploratory factor analysis to...

  7. 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.

  8. The California-Arizona Minority Partnership for Astronomy Research and Education (CAMPARE): an Educational Experience for Undergraduates at the University of Arizona Alumni Association's Astronomy Camp.

    Science.gov (United States)

    Lemon, Courtney; McCarthy, D.; Rudolph, A.

    2011-01-01

    The California-Arizona Minority Partnership for Astronomy Research and Education (CAMPARE) is an NSF-funded partnership between the Astronomy Program at Cal Poly Pomona (CPP) and the University of Arizona Steward Observatory designed to promote participation of underrepresented minorities (including women) in astronomy research and education. As part of the education component of the program, CPP undergraduate physics majors and minors are eligible to work as a counselor at the University of Arizona's Astronomy Camp, one of the premier astronomy outreach opportunities in the world. CAMPARE students have the opportunity to work in this learn-by-doing environment with a wide range of students to gain first hand experience of teaching astronomy to students of a wide variety of ages in highly structured educational setting. Cal Poly Pomona students who are interested in education, both formal and informal, work in a variety of camps, from Girl Scout camps to camps for advanced high school students, to further their understanding of what it means to be a professional in the field of education. The CAMPARE student who participated in this program during summer 2010 had the opportunity to work under Dr. Don McCarthy, camp director of University of Arizona's Astronomy Camps for 20 years, and observe the interpersonal relations between campers and staff that is so vital to the learning the students receive. Through these observations, the CAMPARE student was able to learn to gauge students' interest in the material, and experience real life teaching and learning scenarios in the informal education realm.

  9. [Medical leadership competency].

    Science.gov (United States)

    Barth, Sonja; Jonitz, Günther

    2009-01-01

    With all these changes in health care systems the physicians' professional duties are about to undergo changes as well. Especially economic, administrative and legal aspects are becoming more and more important in medical care. In order to take responsibility with respect to leadership aspects a profound professionalisation is required. The Curriculum Medical Leadership edited by the German Medical Association provides an extensive example of a framework for continuing professional development (CPD) courses in medical leadership.

  10. 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.

  11. Media Coverage, Journal Press Releases and Editorials Associated with Randomized and Observational Studies in High-Impact Medical Journals: A Cohort Study

    Science.gov (United States)

    Wang, Michael T. M.; Bolland, Mark J.; Gamble, Greg; Grey, Andrew

    2015-01-01

    Background 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. Methods and Findings 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). Conclusions 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. PMID:26701758

  12. 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

  13. Disability, anxiety and depression associated with medication-overuse headache can be considerably reduced by detoxification and prophylactic treatment

    DEFF Research Database (Denmark)

    Bendtsen, L; Munksgaard, Sb; Tassorelli, C;

    2014-01-01

    OBJECTIVE: The objective of this article is to investigate whether headache-related disability, depression and anxiety can be reduced by detoxification and prophylactic treatment in patients with medication-overuse headache (MOH). METHODS: Patients with MOH were included from six centres in Europe...... and Latin America in a seven-month cohort study. Before and six months after treatment, the degree of disability was measured by the Migraine Disability Assessment (MIDAS) questionnaire, while anxiety and depression were measured by the Hospital Anxiety and Depression Scale (HADS). RESULTS: A total of.......7% from 195 to 96 and number of those with anxiety was reduced by 27.1% from 284 to 207 (both P < 0.001). CONCLUSIONS: Disability, depression and anxiety were considerably reduced in patients with MOH by detoxification and prophylactic treatment. This emphasises the urgent need for increased awareness...

  14. 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

  15. 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

  16. 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.

  17. 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.

  18. Recent Tobacco Smoking is Associated with Poor HIV Medical Outcomes Among HIV-Infected Individuals in New York.

    Science.gov (United States)

    Hile, Stephen J; Feldman, Matthew B; Alexy, Emily R; Irvine, Mary K

    2016-08-01

    Tobacco smoking is associated with adverse health effects among people living with HIV (PLWH), including a higher risk of cancer and cardiovascular problems. Further, there is evidence that PLWH are two to three times more likely to smoke than the general population. The aim of this study was to examine the association between tobacco smoking and biomarkers of HIV disease progression, including unsuppressed viral load (viral load >200 copies/mL) and low CD4 cell count (New York City metropolitan area. In multivariate analyses controlling for sociodemographic and clinical characteristics, recent tobacco smoking was independently associated with unsuppressed viral load (AOR = 1.38, CI 1.26-1.50) and low CD4 cell count (AOR = 1.12, CI 1.01-1.24). Findings suggest the importance of routine assessments of tobacco use in clinical care settings for PLWH. PMID:26837623

  19. 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

  20. Historical events associated with fallout from Bravo Shot-Operation castle and 25 y of medical findings

    Energy Technology Data Exchange (ETDEWEB)

    Cronkite, E.P.; Conard, R.A.; Bond, V.P. [Brookhaven National Labs., Upton, NY (United States)

    1997-07-01

    The events prior to Bravo Shot-Operation Castle that led to a decision not to evacuate the Marshallese prior to testing the thermonuclear bombs are presented as are the actions taken after the fallout incident in evacuating the exposed Marshallese and the military personnel. The initial medical effects (findings during first 6 wk after exposure) are briefly described and are followed by description of long term effects, namely, induction of one case or fatal acute myeloid leukemia and a large number of thyroid tumors (benign and malignant) in addition to hypothyroidism in adults and children and two cases of cretinism. The hypothyroidism and cretinism responded well to administration of oral thyroxine. During the first 25 y, there was also much unrest and political agitation initiated by exposed and unexposed Marshallese who were very unhappy as a result of relocation and inability to return to their homelands and feeling that all illness and deaths were due to the mysterious radiation, which they understandably did not understand. The difficulties in part were ameliorated by financial aid from the U.S. Congress. In view of one of us (EPC), no one agency or person in the U.S. Government was willing to take the responsibility for care of the Marshallese and its financing. The exposed and non-exposed Marshallese had their lifestyle changed, some of their homelands made uninhabitable for several years and could aptly be called {open_quotes}nuclear nomads,{close_quotes} an expression coined by others. 14 refs., 3 tabs.

  1. 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. PMID:26030167

  2. 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

  3. Adverse Event Burden, Resource Use, and Costs Associated with Immunosuppressant Medications for the Treatment of Systemic Lupus Erythematosus: A Systematic Literature Review

    Directory of Open Access Journals (Sweden)

    A. Oglesby

    2013-01-01

    Full Text Available This paper assessed the burden of adverse events (AEs associated with azathioprine (AZA, cyclophosphamide (CYC, mycophenolate mofetil (MMF, methotrexate (MTX, and cyclosporine (CsA in patients with systemic lupus erythematosus (SLE. Thirty-eight publications were included. Incidence of AEs ranged from 42.8% to 97.3%. Common AEs included infections (2.4–77%, gastrointestinal AEs (3.2–66.7%, and amenorrhea and/or ovarian complications (0–71%. More hematological cytopenias were associated with AZA (14 episodes than MMF (2 episodes. CYC was associated with more infections than MMF (40–77% versus 12.5–32%, resp. or AZA (17–77% versus 11–29%, resp.. Rates of hospitalized infections were similar between MMF and AZA patients, but higher for those taking CYC. There were more gynecological toxicities with CYC than MMF (32–36% versus 3.6–6%, resp. or AZA (32–71% versus 8–18%, resp.. Discontinuation rates due to AEs were 0–44.4% across these medications. In summary, the incidence of AEs associated with SLE immunosuppressants was consistently high as reported in the literature; discontinuations due to these AEs were similar across treatments. Studies on the economic impact of these AEs were sparse and warrant further study. This paper highlights the need for more treatment options with better safety profiles.

  4. Association between reduced white matter integrity in the corpus callosum and serotonin transporter gene DNA methylation in medication-naive patients with major depressive disorder.

    Science.gov (United States)

    Won, E; Choi, S; Kang, J; Kim, A; Han, K-M; Chang, H S; Tae, W S; Son, K R; Joe, S-H; Lee, M-S; Ham, B-J

    2016-01-01

    Previous evidence suggests that the serotonin transporter gene (SLC6A4) is associated with the structure of brain regions that are critically involved in dysfunctional limbic-cortical network activity associated with major depressive disorder (MDD). Diffusion tensor imaging (DTI) and tract-based spatial statistics were used to investigate changes in white matter integrity in patients with MDD compared with healthy controls. A possible association between structural alterations in white matter tracts and DNA methylation of the SLC6A4 promoter region was also assessed. Thirty-five medication-naive patients with MDD (mean age: 40.34, male/female: 10/25) and age, gender and education level matched 49 healthy controls (mean age: 41.12, male/female: 15/34) underwent DTI. SLC6A4 DNA methylation was also measured at five CpG sites of the promoter region, and the cell type used was whole-blood DNA. Patients with MDD had significantly lower fractional anisotropy (FA) values for the genu of the corpus callosum and body of the corpus callosum than that in healthy controls (family-wise error corrected, Pbody of the corpus callosum in patients with MDD. These results contribute to evidence indicating an association between epigenetic gene regulation and structural brain alterations in depression. Moreover, we believe this is the first report of a correlation between DNA methylation of the SLC6A4 promoter region and white matter integrity in patients with MDD. PMID:27505229

  5. SLA 2002: Putting Knowledge to Work. Papers Presented at the Special Libraries Association Conference (Los Angeles, California, June 9-12, 2002).

    Science.gov (United States)

    Special Libraries Association, Washington, DC.

    This document contains the following papers from the 2002 Special Libraries Association Conference: (1) "Competencies for the 21st Century Information Professional: Translating the SLA Competencies into Business Competencies" (Sue Henczel); (2) "Compromises along the Way: Balancing Speed to Market with Sustainability While Delivering Knowledge…

  6. 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...

  7. 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...

  8. 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,...

  9. 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...

  10. 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...

  11. The Oxbow School, California.

    Science.gov (United States)

    Pearson, Clifford A.

    2003-01-01

    Describes the design of the Oxbow School, an art- and design-oriented high school in Napa, California, including the educational context and design goals. Includes information on the architects, as well as floor plans and photographs. (EV)

  12. 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 ...

  13. Literature based drug interaction prediction with clinical assessment using electronic medical records: novel myopathy associated drug interactions.

    Directory of Open Access Journals (Sweden)

    Jon D Duke

    Full Text Available Drug-drug interactions (DDIs are a common cause of adverse drug events. In this paper, we combined a literature discovery approach with analysis of a large electronic medical record database method to predict and evaluate novel DDIs. We predicted an initial set of 13197 potential DDIs based on substrates and inhibitors of cytochrome P450 (CYP metabolism enzymes identified from published in vitro pharmacology experiments. Using a clinical repository of over 800,000 patients, we narrowed this theoretical set of DDIs to 3670 drug pairs actually taken by patients. Finally, we sought to identify novel combinations that synergistically increased the risk of myopathy. Five pairs were identified with their p-values less than 1E-06: loratadine and simvastatin (relative risk or RR = 1.69; loratadine and alprazolam (RR = 1.86; loratadine and duloxetine (RR = 1.94; loratadine and ropinirole (RR = 3.21; and promethazine and tegaserod (RR = 3.00. When taken together, each drug pair showed a significantly increased risk of myopathy when compared to the expected additive myopathy risk from taking either of the drugs alone. Based on additional literature data on in vitro drug metabolism and inhibition potency, loratadine and simvastatin and tegaserod and promethazine were predicted to have a strong DDI through the CYP3A4 and CYP2D6 enzymes, respectively. This new translational biomedical informatics approach supports not only detection of new clinically significant DDI signals, but also evaluation of their potential molecular mechanisms.

  14. Association between Organizational Citizenship Behavior and Educational Performance of Faculty Members in Tabriz University of Medical Sciences- 2014

    Directory of Open Access Journals (Sweden)

    Hazratian Teimour

    2015-07-01

    Full Text Available Introduction: Regarding the educational goals of university and academic performance, it seems that organizational citizenship behavior (OCB is one of the effective variables in increasing the educational performance of university faculty members. The present study aims to investigate the relationship between organizational citizenship behavior (OCB and educational performance of the faculty members of Tabriz University of Medical Sciences in 2013-14. Methods: Researchers selected 127 faculty members and 1,120 students from different grades in order to investigate the relationship between altruism, conscientiousness, sportsmanship, civic virtue and respect and the educational performance of faculty members. Generalized estimating equations (GEE were used in this method. Data were analyzed using SPSS 21 software and the significance level of 0.05. Results: There was a significant relationship between altruism and educational performance (P =0.043. There was a significant relationship between conscientiousness and educational performance (p=0.046. A significant relationship was observed between sportsmanship and educational performance (p=0.004. There was no significant relationship between civic virtue and educational performance (p=0.98. A significant relationship was observed between respect and educational performance (P>0.001. There was no relationship between citizenship behavior and gender of the faculty members (P> 0.05.Conclusion: The results of this study showed that the more faculty members have the spirit of cooperation and assistance to colleagues and students and try to understand the specific situations that students face, the more effective they are in increasing the educational performance at the university level.

  15. Factors associated with intern noncompliance with the 2003 Accreditation Council for Graduate Medical Education’s 30-hour duty period requirement

    Directory of Open Access Journals (Sweden)

    Maloney Christopher G

    2012-07-01

    Full Text Available Abstract Background In 2003 the Accreditation Council for Graduate Medical Education mandated work hour restrictions. Violations can results in a residency program being cited or placed on probation. Recurrent violations could results in loss of accreditation. We wanted to determine specific intern and workload factors associated with violation of a specific mandate, the 30-hour duty period requirement. Methods Retrospective review of interns’ performance against the 30-hour duty period requirement during inpatient ward rotations at a pediatric residency program between June 24, 2008 and June 23, 2009. The analytical plan included both univariate and multivariable logistic regression analyses. Results Twenty of the 26 (77% interns had 80 self-reported episodes of continuous work hours greater than 30 hours. In multivariable analysis, noncompliance was inversely associated with the number of prior inpatient rotations (odds ratio: 0.49, 95% confidence interval (0.38, 0.64 per rotation but directly associated with the total number of patients (odds ratio: 1.30 (1.10, 1.53 per additional patient. The number of admissions on-call, number of admissions after midnight and number of discharges post-call were not significantly associated with noncompliance. The level of noncompliance also varied significantly between interns after accounting for intern experience and workload factors. Subject to limitations in statistical power, we were unable to identify specific intern characteristics, such as demographic variables or examination scores, which account for the variation in noncompliance between interns. Conclusions Both intern and workload factors were associated with pediatric intern noncompliance with the 30-hour duty period requirement during inpatient ward rotations. Residency programs must develop information systems to understand the individual and experience factors associated with noncompliance and implement appropriate interventions to

  16. Ventilator associated pneumonia in a medical intensive care unit: Microbial aetiology, susceptibility patterns of isolated microorganisms and outcome

    Directory of Open Access Journals (Sweden)

    Varun Goel

    2012-01-01

    Full Text Available Background: Ventilator-associated pneumonia (VAP is a common complication of ventilatory support for patients with acute respiratory failure and is associated with increased morbidity and mortality. Aim of the Study: The present study was undertaken to do quantitative cultures of aerobic bacteria, perform the antibiotic susceptibility testing from the endotracheal aspirates and clinical outcome of the clinically suspected patients of VAP. Methods: A prospective study was performed over a period of one year in a tertiary care hospital, enrolling patients on mechanical ventilation (MV for ≥48 hr. Endotracheal aspirates (ETA were collected from patients with suspected VAP, and direct gram′s stain criteria was used to accept the sample. Quantitative cultures of ETA were performed with the threshold for microbiological diagnosis of VAP was taken as ≥10 5 colony forming units (cfu/ml. Results: Out of 53 cases, 2 (3.77% were polymicrobial. Multidrug resistant bacteria, mainly Acinetobacter baumannii 49.09% (27/55 and Pseudomonas aeruginosa 30.91% (17/55 were the most common pathogens isolated. Metallo-beta lactamases (MBLs was produced by 47.06% (8/17 of Pseudomonas aeruginosa and 62.96% (17/27 of Acinetobacter baumannii. Conclusion: The bacteriological approach for the management of VAP helps the clinicians in choosing the appropriate antibiotics. This study showed that quantitative cultures of endotracheal aspirate at a cutoff point of 10 5 cfu/ml is one of the alternative to bronchoscopy in the diagnosis of clinically suspected ventilator associated pneumonia.

  17. Is medical perspective on clinical governance practices associated with clinical units’ performance and mortality? A cross-sectional study through a record-linkage procedure

    Science.gov (United States)

    Sarchielli, Guido; De Plato, Giovanni; Cavalli, Mario; Albertini, Stefano; Nonni, Ilaria; Bencivenni, Lucia; Montali, Arianna; Ventura, Antonio; Montali, Francesca

    2016-01-01

    Objective: Assessment of the knowledge and application as well as perceived utility by doctors of clinical governance tools in order to explore their impact on clinical units’ performance measured through mortality rates and efficiency indicators. Methods: This research is a cross-sectional study with a deterministic record-linkage procedure. The sample includes n = 1250 doctors (n = 249 chiefs of clinical units; n = 1001 physicians) working in six public hospitals located in the Emilia-Romagna Region in Italy. Survey instruments include a checklist and a research-made questionnaire which were used for data collection about doctors’ knowledge and application as well as perceived utility of clinical governance tools. The analysis was based on clinical units’ performance indicators which include patients’ mortality, extra-region active mobility rate, average hospital stay, bed occupancy, rotation and turnover rates, and the comparative performance index as efficiency indicators. Results: The clinical governance tools are known and applied differently in all the considered clinical units. Significant differences emerged between roles and organizational levels at which the medical leadership is carried out. The levels of knowledge and application of clinical governance practices are correlated with the clinical units’ efficiency indicators (bed occupancy rate, bed turnover interval, and extra-region mobility). These multiple linear regression analyses highlighted that the clinical governance knowledge and application is correlated with clinical units’ mortality rates (odds ratio, −8.677; 95% confidence interval, −16.654, −0.700). Conclusion: The knowledge and application, as well as perceived utility by medical professionals of clinical governance tools, are associated with the mortality rates of their units and with some efficiency indicators. However, the medical frontline staff seems to not consider homogeneously useful the clinical

  18. The use of medication and associated factors among adults living in Campinas, São Paulo, Brazil: differences between men and women

    Directory of Open Access Journals (Sweden)

    Priscila Maria Stolses Bergamo Francisco

    2014-12-01

    Full Text Available The objective of this study was to verify factors associated with the use of medication by adults, with emphasis on the differences between men and women. It was a population-based, cross-sectional study with cluster sampling conducted in two stages in Campinas in the state of São Paulo in 2008. Among the 2,413 individuals aged 20 or older, the prevalence of use of at least one drug in the three days before the research was 45.4% (95% CI: 41.3 - 49.4 in men and 64.6% (95% CI: 59.8 - 69.2 in women. For adult men over 40 years old who were not working, former smokers, with one or more chronic diseases, with two or more health problems and who sought health care or a health professional in the two weeks preceding the research showed higher prevalence of medication use. Among women, a higher prevalence of use was observed in females over 40, obese, former smokers, who reported a short sleep pattern, with one or more chronic diseases and two or more health problems, and who reported seeking a health care service or professional in the past 15 days. The findings showed some differences in the determinants of drug use in relation to gender, revealing the greater importance of health-related behavior among women.

  19. [Standardization of measurement of catalytic activity concentration of enzymes--current situation regarding the external quality assessment program provided by the Japan Medical Association].

    Science.gov (United States)

    Maekawa, Masato

    2010-01-01

    Measurement of the catalytic activity concentration of enzymes has been standardized using a traceability chain, consisting a reference measurement system for enzyme catalytic activity and reference standard-JSCC enzyme. The Japan Medical Association (JMA) has provided an external quality assessment (EQA) survey program for clinical laboratory testing. More than 3,100 clinical laboratories participated in 2008. The EQA program indicated that standardization of the measurement of the catalytic activity concentration of enzymes has been completed for AST, ALT, LD, ALP, gammaGT, and CK in more than 90% laboratories, and for Amy and ChE in nearly 80% of laboratories. Because such a large survey program must use artificial specimens, a matrix effect cannot be avoided, especially in dry chemistry. However, the bias produced by a matrix effect usually has a predictable tendency: it can be corrected. Next, after standardization of the measurement of the catalytic activity concentration of enzymes, we should develop and use common reference intervals. On completing the standardization, we can make standard medical decisions using reference measurement systems and rules.

  20. Nonadherence to anti-HIV medication is associated with higher level of anxiety: Experience from a tertiary care hospital of Odisha

    Directory of Open Access Journals (Sweden)

    Mousumee Panigrahi

    2015-01-01

    Full Text Available Aim: To correlate the level of anxiety with nonadherence to antiretroviral medication. Materials and Methods: This observational, cross-sectional, hospital-based study was conducted in 78 patients attending antiretroviral therapy (ART center of a tertiary care hospital of Odisha. The study duration was 6 months. Patients were designated as nonadherent by referring to the white card. Utilization of ART drugs and adverse drug reactions were included in a predesigned format. The anxiety level of all included patients was scored as per Hamilton Anxiety Rating Scale. Mean anxiety score of the adherent group was compared with that of the nonadherent group. Possible causes of nonadherence leading to high anxiety level were evaluated. Results: 46% of patients in the nonadherent group had very severe, 17% had moderate to severe, 28% had mild to moderate and 9% had a mild level of anxiety. In the adherent group, however, mild to moderate level of anxiety was observed only in 10% patients. Conclusions: Anxiety is associated with sub-optimal medication adherence in HIV infected patients.

  1. Clinical Study of Obesity and associated morbidities in patients admitted to College of Medical Sciences Teaching-Hospital, Bharatpur

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    Manohar Pradhan

    2015-12-01

    Full Text Available Background and Objectives: The present study was conducted with objective to study the incidence of obesity and associated co-morbidities in patients admitted to CMS-TH, Bharatpur.Materials and Methods: One hundred and fifty consecutive overweight patients from the January 2009 to December 2012 with Basal metabolic index (BMI>25 and obese patients (BMI>30 were included in this hospital based prospective study. Detailed evaluation of risk factors and family history of other diseases were taken, other obesity related indicators like WPRO, 2000 for BMI, waist circumference (NCEP ATP III and NCEP for South Asian ethnicity NCEP– National Cholesterol Education Program and waist hip ratio (WHO criteria were measured and comparison done in order to detect best method for application. These cases were evaluated for associated co-morbid condition and metabolic syndrome which were diagnosed using NCEP ATP III criteria.Results: The mean age of patients was 52.7 years. Commonest co-existing risk factors were alcohol consumption, smoking, hypertension and type 2 diabetes mellitus. Evaluation based on WHO criteria revealed that 56.7% patients were overweight, 38.7 % were obese class II and 4.6 % were class II. While 45.1% male and 69.1% female patients had central obesity. The figure was 81.7 % for males and 94.1% for females with WHO criteria using waist hip ratio. Risk factors like alcohol consumption (52.7%, smoking (52.7% and fatty liver disease (22.66% were the commonest co-morbid conditions.Conclusion: In the present study, risk factors of alcohol, smoking and hypertension and co-morbid conditions diabetes mellitus, dyslipidemia, ischemic heart disease, stroke and fatty liver were noted. Waist hip ratio was the best indicator to detect central obesity and co-morbid conditions and recommended to be used for Nepali population.JCMS Nepal. 2015;11(3:16-19

  2. Modifications in dietary fat quality are associated with changes in serum lipids of older adults independently of lipid medication.

    Science.gov (United States)

    Buyken, Anette E; Flood, Victoria; Rochtchina, Elena; Nestel, Paul; Brand-Miller, Jennie; Mitchell, Paul

    2010-01-01

    Prospective evidence on the extent to which serum lipid concentrations in older persons respond to dietary modification is scarce. It is not clear whether such behavioral changes are relevant in the context of more commonly initiated treatments with lipid-lowering drugs. We therefore examined whether individual changes in the consumption of dietary fatty acids or main food sources were associated with changes in the serum lipid profile of older Australians. A total of 903 participants (> or =49 y) in the Blue Mountains Eye Study had complete data on fasting lipids and dietary intake from a validated FFQ at baseline (1992-1994) and 5- and 10-y follow-up examinations. Decreasing consumption of SFA and butter during the 10-y period were associated with moderate decreases in serum total cholesterol independently of initiation of lipid-lowering drug treatment [adjusted estimates were 0.018 +/- 0.007 mmol/(L x % energy (%en) from SFA (P = 0.01) and 0.055 +/- 0.015 mmol/(L x 5 g butter) (P = 0.0003), respectively]. Increased consumption of (n-3) fatty acids and fish was independently related to modest increases in serum HDL-cholesterol [0.067 +/- 0.026 mmol/(L x %en from (n-3) fatty acids) (P = 0.01) and 0.010 +/- 0.004 mmol/(L x 20 g fish) (P = 0.02)] and decreases in log-transformed serum triglyceride concentrations [P = 0.02 for (n-3) fatty acids and P = 0.02 for fish intake]. Hence, 10-y changes in the intake of dietary fatty acids and their food sources appear to have contributed to concurrent improvements in the serum lipid profile of older Australians, independent of concomitantly initiated lipid-lowering drug treatment. PMID:19923396

  3. Assessing local patients' knowledge and awareness of radiation dose and risks associated with medical imaging: a questionnaire study

    International Nuclear Information System (INIS)

    To assess the awareness of radiation dose and associated risks caused by radiological procedures among local patients. All subjects were recruited by randomly sampling the patients receiving radiological examinations. These subjects were stratified on age, sex and education. The questionnaire was in Chinese and consisted of 28 questions mostly in multiple choice/true-or-false format, divided into three sections examining demographic data, radiation knowledge/awareness and expectations. A total of 173 questionnaires were returned (83 females and 84 females; mean age of 53). Of these, 32.6% had attended college, 32.6% had completed matriculation and 24.4% secondary school. Most subjects underwent CT (75), MRI (70) and PET-CT (18). Education significantly affected the radiation knowledge (P=0.013). 60.7% and 32.7% were not aware of the radiation-free nature of MRI and USG, respectively. Respectively, 45.4% and 43.5% were of the misconception that Barium enema and Barium swallow studies do not involve radiation. Moreover, 77.6% and 87.9% were aware of the radiation-laden nature of CT and plain X-rays, respectively. Furthermore, 34% and 50%, respectively, think that they are not exposed to radiation at home and on a plane. Regarding the fatal cancer risk from CT, 17.8% chose the correct answer and 62% underestimated the risk. 32.2% correctly estimated the equivalent dose of CT in terms of number of conventional X-rays and 43.2% underestimated the dose. Most (98.2%) were told of the indication, and 42.7% were told the associated radiation dose. Patient radiation awareness is unsatisfactory. There is need to increase patient radiation awareness, and to provide them with the necessary information.

  4. Ototoxic Medications (Medication Effects)

    Science.gov (United States)

    ... effects of the medications on your hearing and balance systems. The team will discuss with you how these side effects will affect your quality of life. What are the effects I may notice from ... speech is affected. Balance problems can also occur as a result of ...

  5. Factors associated with satisfaction with community-based non-medicalized counseling and testing using HIV rapid tests among MSM in France.

    Science.gov (United States)

    Préau, Marie; Lorente, Nicolas; Sagaon-Teyssier, Luis; Champenois, Karen; Gall, Jean Marie Le; Mabire, Xavier; Spire, Bruno; Mora, Marion; Yazdanpanah, Yazdan; Suzan, Marie

    2016-10-01

    The aims of the study were to determine the level of satisfaction of men who have sex with men (MSM) participating in two community-based non-medicalized counseling and testing programs (ANRS-DRAG and ANRS-COM'TEST) offering HIV rapid tests (hereafter CBOffer), and to identify factors associated with satisfaction. Between 2009 and 2011, 436 participants voluntarily benefited from a CBOffer in the two programs. They completed self-administered questionnaires before and after testing. Psychosocial scores were constructed using principal component analyses to reflect the following dimensions: post-test satisfaction, avoidance of at-risk situations as a HIV risk-reduction strategy, and attitudes towards condom use. Logarithmic regression of the post-test satisfaction score was performed on these scores and on other selected explanatory variables, including the variable "self-identification as homosexual or bisexual". Post-test satisfaction ranged between 90-99 and below 90 for 50% and 25% of the participants, respectively. Post-test satisfaction with the CBOffer was independently associated with self-defined sexuality, meeting place for sexual partners, participants' attitudes about being HIV-positive, and condom use. The very high level of satisfaction was associated with both personal and socio-behavioral factors. Vulnerable MSM could be targeted better and, accordingly, could use this offer more frequently as a combined prevention tool. PMID:27088324

  6. Clinical profile and factors associated with mortality in hospitalized patients with HIV/AIDS: a retrospective analysis from Tripoli Medical Centre, Libya, 2013.

    Science.gov (United States)

    Shalaka, N S; Garred, N A; Zeglam, H T; Awasi, S A; Abukathir, L A; Altagdi, M E; Rayes, A A

    2015-09-01

    In Libya, little is known about HIV-related hospitalizations and in-hospital mortality. This was a retrospective analysis of HIV-related hospitalizations at Tripoli Medical Centre in 2013. Of 227 cases analysed, 82.4% were males who were significantly older (40.0 versus 36.5 years), reported injection drug use (58.3% versus 0%) and were hepatitis C virus co-infected (65.8% versus 0%) compared with females. Severe immunosuppression was prevalent (median CD4 count = 42 cell/μL). Candidiasis was the most common diagnosis (26.0%); Pneumocystis pneumonia was the most common respiratory disease (8.8%), while cerebral toxoplasmosis was diagnosed in 8.4% of patients. Current HAART use was independently associated with low risk of in-hospital mortality (OR 0.33), while central nervous system symptoms (OR 4.12), sepsis (OR 6.98) and low total lymphocyte counts (OR 3.60) were associated with increased risk. In this study, late presentation with severe immunosuppression was common, and was associated with significant in-hospital mortality. PMID:26450860

  7. Prevalence and associated factors of behavioral intention for risk compensation following voluntary medical male circumcision among male sexually transmitted diseases patients in China.

    Science.gov (United States)

    Wang, Zixin; Feng, Tiejian; Lau, Joseph T F

    2016-10-01

    Risk compensation was an important concern of voluntary medical male circumcision (VMMC) promotion campaigns. No study investigated risk compensation following VMMC among male sexually transmitted diseases patients (MSTDP). A cross-sectional survey interviewed 308 uncircumcised MSTDP in Shenzhen, China. 26.9% of them intended to perform at least one of the five types of risk compensation behaviors following VMMC. In the summary stepwise model, provision of incorrect response to HIV/sexually transmitted diseases knowledge items (multivariate odds ratios (ORm) = 2.30), genital herpes infection (ORm = 3.19), Risk Reduction Score for Unprotected Sex, and Negative Condom Attitudes Scale (ORm = 1.13) were significantly associated with behavioral intention to perform at least one type of risk compensation behavior following VMMC. The results provided a framework for developing related interventions. Prevention of risk compensation should be an essential component of VMMC promotion for all MSTDP, irrespective of their intention for VMMC.

  8. Allergic rhinitis and its associated co-morbidities at Bugando Medical Centre in Northwestern Tanzania; A prospective review of 190 cases

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    Said Said A

    2012-11-01

    Full Text Available Abstract Background Allergic rhinitis is one of the commonest atopic diseases which contribute to significant morbidity world wide while its epidemiology in Tanzania remains sparse. There was paucity of information regarding allergic rhinitis in our setting; therefore it was important to conduct this study to describe our experience on allergic rhinitis, associated co-morbidities and treatment outcome in patients attending Bugando Medical Centre. Methods This was descriptive cross-sectional study involving all patients with a clinical diagnosis of allergic rhinitis at Bugando Medical Centre over a three-month period between June 2011 and August 2011. Data was collected using a pre-tested coded questionnaire and analyzed using SPSS statistical computer software version 17.0. Results A total of 190 patients were studied giving the prevalence of allergic rhinitis 14.7%. The median age of the patients was 8.5 years. The male to female ratio was 1:1. Adenoid hypertrophy, tonsillitis, hypertrophy of inferior turbinate, nasal polyps, otitis media and sinusitis were the most common co-morbidities affecting 92.6% of cases and were the major reason for attending hospital services. Sleep disturbance was common in children with adenoids hypertrophy (χ2 = 28.691, P = 0.000. Allergic conjunctivitis was found in 51.9%. The most common identified triggers were dust, strong perfume odors and cold weather (P χ2 = 4.583, P = 0.032. In this study family history of allergic rhinitis was not a significant risk factor (P =0.423. The majority of patients (68.8% were treated surgically for allergic rhinitis co morbidities. Post operative complication and mortality rates were 2.9% and 1.6% respectively. The overall median duration of hospital stay of in-patients was 3 days (2 – 28 days. Most patients (98.4% had satisfactory results at discharge. Conclusion The study shows that allergic rhinitis is common in our settings representing 14.7% of all

  9. Association between medication possession ratio, virologic failure and drug resistance in HIV-1 infected adults on antiretroviral therapy in Côte d’Ivoire

    Science.gov (United States)

    Messou, Eugène; Chaix, Marie-Laure; Gabillard, Delphine; Minga, Albert; Losina, Elena; Yapo, Vincent; Kouakou, Martial; Danel, Christine; Sloan, Caroline; Rouzioux, Christine; Freedberg, Kenneth A.; Anglaret, Xavier

    2011-01-01

    Background Adherence is a strong determinant of viral suppression with antiretroviral therapy (ART), but measuring it is challenging. Medication delivery can be measured accurately in settings with computerized prescription databases. We studied the association between Medication Possession Ratio (MPR), virologic suppression, and resistance to ART in Côte d’Ivoire. Methods We conducted a prospective cohort study of HIV-1 infected adults initiating ART in three clinics using computerized monitoring systems. Patients had viral load (VL) tests at month 6 (M6) and month 12 (M12) after ART initiation, and genotype tests if VL was detectable (≥300 copies/ml). MPR was defined as the number of daily doses of antiretroviral drug actually provided divided by the total number of follow-up days since ART initiation. Results Overall, 1,573 patients started ART with stavudine/zidovudine plus lamivudine plus nevirapine/efavirenz. At M6 and M12, 996 and 942 patients were in active follow-up; 20% (M6) and 25% (M12) of patients had detectable VL, including 7% (M6) and 11% (M12) with ≥1 resistance mutation. Among patients with MPR ≥95%, 80–94%, 65–79%, 50–64% and <50% at M12, the proportion with detectable VL [resistance] was 9% [4%], 17% [7%], 45% [24%], 67% [31%], and 85% [37%]. Among patients with ≥1 mutation at M12, 86% were resistant to lamivudine/emtricitabine and/or nevirapine/efavirenz but not to other drugs. Conclusion MPR was strongly associated with virologic outcomes. Half of those with detectable VL at M12 had no resistance mutations. MPR should be used at M6 to identify patients who might benefit from early interventions to reinforce adherence. PMID:21191309

  10. Rapid Assessment of Logging-Associated Sediment-Delivery Pathways in an Intensively-Managed Forested Watershed in the Southern Cascades, Northern California

    Science.gov (United States)

    Coe, D. B.; Wopat, M. A.; Lindsay, D.; Stanish, S.; Boone, M.; Beck, B.; Wyman, A.; Bull, J.

    2012-12-01

    The potential for water-quality impacts in intensively-managed forested watersheds depends partly upon the frequency of overland flow paths linking logging-related hillslope sediment sources to the channel network, as well as the volume of sediment delivered along these flow paths. In response to public concerns over perceived water-quality impacts from clearcut timber harvesting, the Battle Creek Task Force, composed of subject-matter experts from 4 different state agencies, performed a rapid assessment for visible evidence of sediment delivery pathways from multiple logging-associated features in the upper Battle Creek watershed - an area underlain predominantly by Holocene- and Late Pleistocene-aged volcanic rock types, with highly permeable soils, and relatively few streams. Logging-associated features were selected for assessment based on erosion potential and proximity to stream channels. Identified sediment-delivery pathways were then characterized by dominant erosion process and the relative magnitude of sediment delivery (i.e., low, moderate, and high) was estimated. Approximately 26 km of stream buffers adjacent to 55 clearcut harvest units were assessed, and the single detected instance of sediment delivery was found to be of low magnitude and the result of illegal encroachment by logging equipment into a 5-m wide stream-adjacent equipment-limitation zone. The proportion of sampled sites delivering sediment was found to be highest for tractor-stream crossings, followed by road-stream crossings, stream-adjacent road segments, stream-adjacent landings, and clearcut harvest units, respectively. All 5 tractor-stream crossings delivered sediment, but were generally delivering a low magnitude of sediment derived from sheetwash and rilling. Road-stream crossings (n=39) and stream-adjacent road segments (n=24) delivered observable sediment 69 and 67 percent of the time, respectively. The highest magnitudes of sediment delivery from roads were associated with

  11. Abortion - medical

    Science.gov (United States)

    Therapeutic medical abortion; Elective medical abortion; Induced abortion; Nonsurgical abortion ... A medical, or nonsurgical, abortion can be done within 7 weeks from the first day of the woman's last ...

  12. A UK general practice population cohort study investigating the association between lipid lowering drugs and 30-day mortality following medically attended acute respiratory illness.

    Science.gov (United States)

    Joshi, Roshni; Venkatesan, Sudhir; Myles, Puja R

    2016-01-01

    Background. Cholesterol lowering drugs HMG-CoA reductase inhibitors (statins) and PPARα activators (fibrates) have been shown to reduce host inflammation via non-disease specific immunomodulatory mechanisms. Recent studies suggest that commonly prescribed drugs in general practice, statins and fibrates, may be beneficial in influenza-like illness related mortality. This retrospective cohort study examines the association between two lipid lowering drugs, statins and fibrates, and all-cause 30-day mortality following a medically attended acute respiratory illness (MAARI). Methods. Primary care patient data were retrospectively extracted from the UK Clinical Practice Research Datalink (CPRD) database. The sample comprised 201,179 adults aged 30 years or older experiencing a MAARI episode. Patient exposure to statins or fibrates was coded as separate dichotomous variables and deemed current if the most recent GP prescription was issued in the 30 days prior to MAARI diagnosis. Multivariable logistic regression and Cox regression were used for analyses. Adjustment was carried out for chronic lung disease, heart failure, metformin and glitazones, comorbidity burden, socio-demographic and lifestyle variables such as smoking status and body mass index (BMI). Statistical interaction tests were carried out to check for effect modification by gender, body mass index, smoking status and comorbidity. Results. A total of 1,096 (5%) patients died within the 30-day follow up period. Of this group, 213 (19.4%) were statin users and 4 (0.4%) were fibrate users. After adjustment, a significant 35% reduction in odds [adj OR; 0.65 (95% CI [0.52-0.80])] and a 33% reduction in the hazard [adj HR: 0.67 (95% CI [0.55-0.83])] of all-cause 30-day mortality following MAARI was observed in statin users. A significant effect modification by comorbidity burden was observed for the association between statin use and MAARI-related mortality. Fibrate use was associated with a non

  13. A UK general practice population cohort study investigating the association between lipid lowering drugs and 30-day mortality following medically attended acute respiratory illness.

    Science.gov (United States)

    Joshi, Roshni; Venkatesan, Sudhir; Myles, Puja R

    2016-01-01

    Background. Cholesterol lowering drugs HMG-CoA reductase inhibitors (statins) and PPARα activators (fibrates) have been shown to reduce host inflammation via non-disease specific immunomodulatory mechanisms. Recent studies suggest that commonly prescribed drugs in general practice, statins and fibrates, may be beneficial in influenza-like illness related mortality. This retrospective cohort study examines the association between two lipid lowering drugs, statins and fibrates, and all-cause 30-day mortality following a medically attended acute respiratory illness (MAARI). Methods. Primary care patient data were retrospectively extracted from the UK Clinical Practice Research Datalink (CPRD) database. The sample comprised 201,179 adults aged 30 years or older experiencing a MAARI episode. Patient exposure to statins or fibrates was coded as separate dichotomous variables and deemed current if the most recent GP prescription was issued in the 30 days prior to MAARI diagnosis. Multivariable logistic regression and Cox regression were used for analyses. Adjustment was carried out for chronic lung disease, heart failure, metformin and glitazones, comorbidity burden, socio-demographic and lifestyle variables such as smoking status and body mass index (BMI). Statistical interaction tests were carried out to check for effect modification by gender, body mass index, smoking status and comorbidity. Results. A total of 1,096 (5%) patients died within the 30-day follow up period. Of this group, 213 (19.4%) were statin users and 4 (0.4%) were fibrate users. After adjustment, a significant 35% reduction in odds [adj OR; 0.65 (95% CI [0.52-0.80])] and a 33% reduction in the hazard [adj HR: 0.67 (95% CI [0.55-0.83])] of all-cause 30-day mortality following MAARI was observed in statin users. A significant effect modification by comorbidity burden was observed for the association between statin use and MAARI-related mortality. Fibrate use was associated with a non

  14. Trends in California's Water Footprint, 1992-2012

    Science.gov (United States)

    Cooley, H.; Fulton, J.

    2015-12-01

    Water and other natural resource uses are increasingly affected by globalized trade and consumption patterns. We examine how California's water footprint has changed over two decades (1992 to 2012). Four findings emerge: first, California's water footprint (WF) has grown faster than population, indicating an increased per-capita WF; second, while California's WF is primarily associated with food products, energy products are becoming more important; third, the state's internal water resources are increasingly used for products consumed outside of the state; and fourth, external water resources have provided for all of California's expanded WF and are predominately "green water," or non-managed water sources. In light of climate change and mounting pressures on water resources, California policymaking must examine these trends in order to mitigate water-related risk.

  15. Primer registro de la asociación del jurelillo negro Hemicaranx zelotes Gilbert (Pisces: Carangidae con la medusa bala de cañón Stomolophus meleagris Agassiz (Scyphozoa: Rhizostomatidae en Bahía de Kino, Golfo de California First record of association of the Blackfin Jack Hemicaranx zelotes Gilbert (Pisces: Carangidae with the cannonball jellyfish Stomolophus meleagris Agassiz (Scyphozoa: Rhizostomatidae in Kino Bay, Gulf of California

    Directory of Open Access Journals (Sweden)

    Juana López Martínez

    2008-08-01

    Full Text Available Se detectó la asociación de juveniles del jurelillo negro Hemicaranx zelotes (Gilbert 1898 con medusas de la especie Stomolophus meleagris (Agassiz 1860 en Bahía de Kino, Golfo de California, México. Los peces fueron observados acompañando a la medusa entre la subumbrela y los brazos orales, manifestándose una simbiosis, comportamiento usualmente utilizado por los peces juveniles para protegerse de sus depredadores e incrementar su tasa de sobrevivencia. Hasta la fecha no se había documentado ningún caso de asociación entre el jurelillo negro y la medusa bala de cañón, por lo que este es el primer registro de tal simbiosis.Juvenile Blacking Jack Hemicaranx zelotes (Gilbert 1898 associated with cannonball jellies Stomolophus meleagris (Agassiz 1860 in Kino Bay, Gulf of California, Mexico was observed. The fish accompany the jellies, swim between the umbrella and the oral arms, showing a symbiotic behavior that the fish use for protection from predators. This is the first record of a symbiotic association of Blacking Jack with can-nonball jellies.

  16. WIC: A Door to Health Care for California's Children.

    Science.gov (United States)

    Barillas, Roxana; Horner, Dawn

    About 1.5 million uninsured children in California are eligible for Medi-Cal or Healthy Families, the state's primary public health insurance programs for children. The Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides a natural entry point for reaching these eligible families. This briefing report was written for WIC…

  17. The Story of California = La Historia de California.

    Science.gov (United States)

    Bartel, Nick

    "The Story of California" is a history and geography of the state of California, intended for classroom use by limited-English-proficient, native Spanish-speaking students in California's urban middle schools. The book is designed with the left page in English and the right page in Spanish to facilitate student transition into comfortable use of…

  18. A Comparative Study of Medical Ethics Formulated by Professional Associations between China and U.S.: A Case Study of the Code of Medical Ethics of the CMA and the Code of Medical Ethics of the AMA%医师行业组织医德规范比较研究——以《医师条诫》和《医德守则》为例

    Institute of Scientific and Technical Information of China (English)

    张骞; 甄橙

    2013-01-01

    The Code of Medical Ethics of the Chinese Medical Association and the Code of Medical Ethics of the American Medical Association are the first documents on medical ethics formulated by the two organizations. They both discussed the requirements of medical profession to physicians, doctor-patient relationship, doctor-doctor relationship and the duty of physicians to the public. Meanwhile, their differences due to the different social conditions and cultures of the two countries. Social conditions should be taken into account when formulating medical ethics and necessary institution and effective supervision should be established.%《医师条诫》和《医德守则》分别是中美两国医学会颁布的伦理准则,均探讨了医学职业对医师的要求,医患关系、医际关系、医师的社会责任等内容,由于中美两国社会文化的差异,两部规范存在不同,反映出医德规范的制定,要结合社会实际情况,医德规范的实施需要多层次的制度保障,并且需要有效的监督的特点.

  19. Efecto del blanqueamiento del coral por baja temperatura en los crustáceos decápodos asociados a arrecifes del suroeste del golfo de California Effect of coral bleaching induced by low temperature on reef-associated decapod crustaceans of the southwestern Gulf of California

    Directory of Open Access Journals (Sweden)

    Luis Hernández

    2010-10-01

    Full Text Available El blanqueamiento del coral es consecuencia de un estrés natural o antropogénico sobre los arrecifes. En la región del Pacífico tropical este, el blanqueamiento del coral se asocia comúnmente con el incremento de la temperatura superficial del mar, pero también se puede presentar por temperaturas bajas. A principio de 2008 se registró una anomalía de temperatura extraordinariamente baja, de hasta 1.8 °C menor al promedio registrado en los últimos 25 años, que se manifestó con un severo blanqueamiento de corales en varias localidades al sur del golfo de California, alcanzando cifras de hasta el 90% del coral blanqueado. El objetivo del presente trabajo fue describir los cambios en el ensamblaje de decápodos asociados a los arrecifes en la región afectada. Las bahías de La Paz (24° N y Loreto (26° N fueron visitadas antes, durante y después del evento, realizándose censos visuales en 6 sitios de cada bahía. Los resultados muestran que la riqueza y dominancia de decápodos cambió por efecto del blanqueamiento. La afectación fue diferencial entre ambas localidades: la fauna coralina de la región de Loreto fue más afectada que la de bahía de La Paz y los cambios en los ensamblajes de decápodos fueron diferentes.Coral reef bleaching is a common stress response to natural or anthropogenic events. In the Tropical East Pacific, coral reef bleaching has been commonly associated to temperature increase of the sea surface, but it can also occur with low temperatures. In early 2008, an abnormality of very low temperature was recorded, up to 1.8 °C lower than the average temperature in the last 25 years, and a severe coral bleaching was observed in numerous localities in the southern part of the Gulf of California, which rose up to 90% of coral bleaching in some places. The aim of this work was to describe changes in decapod assemblages associated to coral reefs in the affected region. La Paz (24°N and Loreto (26°N bays were

  20. Medication adherence among transgender women living with HIV.

    Science.gov (United States)

    Baguso, Glenda N; Gay, Caryl L; Lee, Kathryn A

    2016-08-01

    Medication adherence is linked to health outcomes among adults with HIV infection. Transgender women living with HIV (TWLWH) in the US report suboptimal adherence to medications and are found to have difficulty integrating HIV medication into their daily routine, but few studies explore the factors associated with medication adherence among transgender women. Thus, the purpose of this paper is to examine demographic and clinical factors related to self-reported medication adherence among transgender women. This secondary analysis is based on data collected from the Symptom and Genetic Study that included a convenience sample of 22 self-identified transgender women, 201 non-transgender men, and 72 non-transgender women recruited in northern California. Self-reported medication adherence was assessed using the AIDS Clinical Trials Group Adherence Questionnaire. Gender differences in demographic and clinical variables were assessed, as were differences between transgender women reporting high and low adherence. Transgender women had lower adherence to medications compared to non-transgender males and non-transgender females (p = .028) and were less likely to achieve viral suppression (p = .039). Within the transgender group, Black/African-Americans reported better adherence than participants who were Whites/Caucasian or other races (p = .009). Adherence among transgender women was unrelated to medication count and estrogen therapy, but consistent with other reports on the HIV population as a whole; transgender women with high adherence were more likely to achieve viral suppression compared to the transgender women with low adherence. Despite the high incidence of HIV infection in the transgender population, few studies focus on TWLWH, either in regard to their adherence to antiretroviral therapies or to their healthcare in general. To address ongoing health disparities, more studies are needed focusing on the transgender population's continuum of care in