The effect of hand hygiene on illness rate among students in university residence halls.

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White, Cindy; Kolble, Robin; Carlson, Rebecca; Lipson, Natasha; Dolan, Mike; Ali, Yusuf; Cline, Mojee

2003-10-01

Several studies have indicated a connection between hand sanitization and infection control in numerous settings such as extended care facilities, schools, and hospitals. The purpose of this study was to assess the effectiveness of both a hand-hygiene message campaign and the use of an alcohol gel hand sanitizer in decreasing the incidence of upper-respiratory illness among students living in university residence halls. This study involved a total of 430 students recruited from 4 residence halls during the fall semester at the University of Colorado at the Boulder campus. Dormitories were paired into control and product groups. In the product groups, alcohol gel hand-sanitizer dispensers were installed in every room, bathroom, and dining hall. The data were statistically analyzed for the differences between product and control groups in reported symptoms, illness rates, and absenteeism from classes. The overall increase in hand-hygiene behavior and reduction in symptoms, illness rates, and absenteeism between the product group and control group was statistically significant. Reductions in upper respiratory-illness symptoms ranged from 14.8% to 39.9%. Total improvement in illness rate was 20%. The product group had 43% less missed school/work days. Hand-hygiene practices were improved with increased frequency of handwashing through increasing awareness of the importance of hand hygiene, and the use of alcohol gel hand sanitizer in university dormitories. This resulted in fewer upper respiratory-illness symptoms, lower illness rates, and lower absenteeism.

Comparison of Boer, Kiko, and Spanish meat goat does for stayability and cumulative reproductive output in the humid subtropical southeastern United States

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Pellerin Ashley N

2012-08-01

Full Text Available Abstract Background Longevity is the amount of time breeding females stay active in a herd by avoiding death or culling because of illness or reproductive failure. This is a trait of economic relevance in commercial small ruminant breeding herds as it affects lifetime reproductive output. The purpose of this study was to determine if breed of meat goat influences breeding doe survival rates and cumulative reproductive performance under semi-intensive management. Results Boer (n = 132, Kiko (n = 92 and Spanish (n = 79 does were evaluated for longevity trends and cumulative kid production. The herd was managed on humid subtropical pasture. Does had the chance to complete 2 to 6 production years. Survival curves were analyzed for 2 culling methods. The actual culling practice removed does after two failures to wean a kid. An alternative culling protocol removed doe records after the first failure to wean a kid. Kid production traits analyzed across herd life were the total number of kids weaned and cumulative kid weight weaned to the 2-, 3-, and 5-year stayability endpoints. Most (82% doe exits were illness-related under the actual culling method. Reproductive failure represented 51% of doe exits under the alternative culling protocol. Boer does had greater survival declines (P P P  Conclusion Boer does had low stayability and cumulative kid production rates compared with Kiko and Spanish does. Poor health was the primary driver of does exiting the herd. Kiko and Spanish does did not differ for longevity and lifetime performance indicators.

Change in self-rated general health is associated with perceived illness burden

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Nielsen, Anni Brit Sternhagen; Jensen, Per; Gannik, Dorte Effersøe

2015-01-01

Background: iabetic patients’ lifestyle adaptations to improve glycaemic control are not always followed by improvements in self-rated general health (SRH). The perceived impact of diabetes on patients’ daily lives may influence changes in their SRH. This paper examines the association of illness...... diabetes-related symptoms, and cardiovascular disease were related to lower SRH ratings. On average SRH improved by 0.46 (95% CI: 0.37; 0.55) during the first year after diagnosis without inclusion of covariates. Mental and practical illness burden was the only factor associated with change in SRH...

Work-related ill health in doctors working in Great Britain: incidence rates and trends.

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Zhou, Anli Yue; Carder, Melanie; Gittins, Matthew; Agius, Raymond

2017-11-01

Background Doctors have a higher prevalence of mental ill health compared with other professional occupations but incidence rates are poorly studied. Aims To determine incidence rates and trends of work-related ill health (WRIH) and work-related mental ill health (WRMIH) in doctors compared with other professions in Great Britain. Method Incidence rates were calculated using an occupational physician reporting scheme from 2005-2010. Multilevel regression was use to study incidence rates from 2001 to 2014. Results Annual incidence rates for WRIH and WRIMH in doctors were 515 and 431 per 100 000 people employed, respectively. Higher incidence rates for WRIH and WRMIH were observed for ambulance staff and nurses, respectively. Doctors demonstrated an annual average incidence rates increase for WRIH and WRMIH, especially in women, whereas the other occupations demonstrated a decreasing or static trend. The difference in trends between the occupations was statistically significant. Conclusions WRIH and WRMIH incidence rate are increasing in doctors, especially in women, warranting further research. © The Royal College of Psychiatrists 2017.

Psychometric properties of the Cumulated Ambulation Score

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Ferriero, Giorgio; Kristensen, Morten T; Invernizzi, Marco

2018-01-01

INTRODUCTION: In the geriatric population, independent mobility is a key factor in determining readiness for discharge following acute hospitalization. The Cumulated Ambulation Score (CAS) is a potentially valuable score that allows day-to-day measurements of basic mobility. The CAS was developed...... and validated in older patients with hip fracture as an early postoperative predictor of short-term outcome, but it is also used to assess geriatric in-patients with acute medical illness. Despite the fast- accumulating literature on the CAS, to date no systematic review synthesizing its psychometric properties....... Of 49 studies identified, 17 examined the psychometric properties of the CAS. EVIDENCE SYNTHESIS: Most papers dealt with patients after hip fracture surgery, and only 4 studies assessed the CAS psychometric characteristics also in geriatric in-patients with acute medical illness. Two versions of CAS...

An epidemiological study of rates of illness in passengers and crew at a busy Caribbean cruise port.

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Marshall, Cathy Ann; Morris, Euclid; Unwin, Nigel

2016-04-12

The Caribbean has one of the largest cruise ship industries in the world, with close to 20 million visitors per year. The potential for communicable disease outbreaks on vessels and the transmission by ship between countries is high. Barbados has one of the busiest ports in the Caribbean. Our aim was to describe and analyse the epidemiology of illnesses experienced by passengers and crew arriving at the Bridgetown Port, Barbados between 2009 and 2013. Data on the illnesses recorded were extracted from the passenger and crew arrival registers and passenger and crew illness logs for all ships and maritime vessels arriving at Barbados' Ports and passing through its territorial waters between January 2009 and December 2013. Data were entered into an Epi Info database and most of the analysis undertaken using Epi Info Version 7. Rates per 100,000 visits were calculated, and confidence intervals on these were derived using the software Openepi. There were 1031 cases of illness from over 3 million passenger visits and 1 million crew visits during this period. The overall event rate for communicable illnesses was 15.7 (95 % CI 14.4-17.1) per 100,000 passengers, and for crew was 24.0 (21.6-26.6) per 100, 000 crew. Gastroenteritis was the predominant illness experienced by passengers and crew followed by influenza. The event rate for gastroenteritis among passengers was 13.7 (12.5-15.0) per 100,000 and 14.4 (12.6, 16.5) for crew. The event rate for non-communicable illnesses was 3.4 per 100,000 passengers with myocardial infarction being the main diagnosis. The event rate for non-communicable illnesses among crew was 2.1 per 100,000, the leading cause being injuries. The predominant illnesses reported were gastroenteritis and influenza similar to previous published reports from around the world. This study is the first of its type in the Caribbean and the data provide a baseline for future surveillance and for comparison with other countries and regions.

Children's experiences of parental mental illness: a literature review.

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Gladstone, Brenda M; Boydell, Katherine M; Seeman, Mary V; McKeever, Patricia D

2011-11-01

This paper provides a review of published qualitative research on children's experiences of parental mental illness. We undertook a comprehensive search of Medical Literature Analysis and Retrieval System Online, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Sociological Abstracts and Applied Social Sciences Index and Abstracts databases, as well as citation searches in Web of Science and manual searches of other relevant journals and reference lists of primary papers. Although 20 studies met the search criteria, only 10 focused exclusively on children's descriptions of their experience--the remainder elicited adults' perspectives on children's experiences of parental mental illnesses. Findings are organized under three themes: the impact of illness on children's daily life, how children cope with their experiences and how children understand mental illness. Despite references to pervasive knowledge gaps in the literature, significant information has been accumulated about children's experiences of parental mental illness. Considerable variability in research findings and tensions remain unresolved. For example, evidence is mixed as to children's knowledge and understanding of mental illnesses and how best to deploy resources to help them acquire optimal information. Furthermore, children's desire to be recognized as important to their parents' well-being conflicted with adults' perceptions that children should be protected from too much responsibility. Nevertheless, the cumulative evidence remains a key reason for advocating for psychoeducation and peer-support group interventions for children, which are endorsed by child and adult study participants alike. © 2011 Blackwell Publishing Asia Pty Ltd.

An epidemiological study of rates of illness in passengers and crew at a busy Caribbean cruise port

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Cathy Ann Marshall

2016-04-01

Full Text Available Abstract Background The Caribbean has one of the largest cruise ship industries in the world, with close to 20 million visitors per year. The potential for communicable disease outbreaks on vessels and the transmission by ship between countries is high. Barbados has one of the busiest ports in the Caribbean. Our aim was to describe and analyse the epidemiology of illnesses experienced by passengers and crew arriving at the Bridgetown Port, Barbados between 2009 and 2013. Methods Data on the illnesses recorded were extracted from the passenger and crew arrival registers and passenger and crew illness logs for all ships and maritime vessels arriving at Barbados’ Ports and passing through its territorial waters between January 2009 and December 2013. Data were entered into an Epi Info database and most of the analysis undertaken using Epi Info Version 7. Rates per 100,000 visits were calculated, and confidence intervals on these were derived using the software Openepi. Results There were 1031 cases of illness from over 3 million passenger visits and 1 million crew visits during this period. The overall event rate for communicable illnesses was 15.7 (95 % CI 14.4–17.1 per 100,000 passengers, and for crew was 24.0 (21.6–26.6 per 100, 000 crew. Gastroenteritis was the predominant illness experienced by passengers and crew followed by influenza. The event rate for gastroenteritis among passengers was 13.7 (12.5–15.0 per 100,000 and 14.4 (12.6, 16.5 for crew. The event rate for non-communicable illnesses was 3.4 per 100,000 passengers with myocardial infarction being the main diagnosis. The event rate for non-communicable illnesses among crew was 2.1 per 100,000, the leading cause being injuries. Conclusions The predominant illnesses reported were gastroenteritis and influenza similar to previous published reports from around the world. This study is the first of its type in the Caribbean and the data provide a baseline for future surveillance

Physical Activity in Individuals with Severe Mental Illness: Client versus Case Manager Ratings

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Bezyak, Jill L.; Chan, Fong; Lee, Eun-Jeong; Catalano, Denise; Chiu, Chung-Yi

2012-01-01

The "Physical Activity Scale for Individuals With Physical Disabilities" was examined as a physical activity measure for people with severe mental illness. Case manager ratings were more closely related to body mass index than clients' ratings, challenging the accuracy of self-report physical activity measures for individuals with severe mental…

Illness severity, trait anxiety, cognitive impairment and heart rate variability in bipolar disorder.

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Levy, Boaz

2014-12-30

Numerous studies have documented a significant association between symptom severity and cognitive functioning in bipolar disorder (BD). These findings advanced speculations about a potential link between the physiological stress associated with illness severity and cognitive dysfunction. To explore this hypothesis, the current study employed heart rate variability (HRV) as a physiological measure that is sensitive to the effects of chronic stress, and a scale of trait anxiety for assessing a psychological condition that is correlated with hyper sympathetic arousal. Analyses indicated that BD patients with High Illness Severity reported more symptoms of trait-anxiety (i.e., State Trait Anxiety Inventory), performed more poorly on a computerized neuropsychological battery (i.e., CNS Vital Signs), and exhibited a more constricted HRV profile (i.e., lower SDNN with elevated LF/HF ratio) than patients with Low Illness Severity. Illness severity was determined by a history of psychosis, illness duration, and number of mood episodes. A third group of healthy controls (n=22) performed better on the neuropsychological battery and exhibited a healthier HRV profile than the BD groups. This study provides preliminary evidence that illness severity and cognitive impairment in BD may be associated with state anxiety and neuro-cardiac alterations that are sensitive to physiological stress. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Complication rates of open surgical versus percutaneous tracheostomy in critically ill patients.

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Johnson-Obaseki, Stephanie; Veljkovic, Andrea; Javidnia, Hedyeh

2016-11-01

In the setting of critical care, the most common indications for tracheostomy include: prolonged intubation, to facilitate weaning from mechanical ventilation, and for pulmonary toileting. In this setting, tracheostomy can be performed either via open surgical or percutaneous technique. Advantages for percutaneous dilatational tracheostomy (PDT) include: simplicity, smaller incision, less tissue trauma, lower incidence of wound infection, lower incidence of peristomal bleeding, decreased morbidity from patient transfer, and cost-effectiveness. Despite many studies comparing surgical tracheostomy (ST) versus PDT, there remains no consensus on which of these techniques minimizes complications in critically ill patients. To provide an updated meta-analysis to answer the following question: Is there a difference in complication rates between ST and PDT in the setting of critically ill patients? Our secondary outcome of interest was to examine the difference in procedure time in the ST versus PDT groups. We conducted a literature search using the following databases: Ovid MEDLINE, Embase, Google Scholar, and Cochrane Database of Systematic Reviews. Studies from 1985 until October 2014 published in French or English languages in peer-reviewed journals were included. With regard to rates of mortality, intraoperative hemorrhage, and postoperative hemorrhage, there was no statistically significant difference between the two techniques. Evaluation of infections rates and operative time, however, revealed a statistically significant difference, favoring PDT over ST. In critically ill patients, PDT appears to be a safe and efficient alternative to open ST. NA Laryngoscope, 126:2459-2467, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Thirty-Day Mortality After Infection Among Persons With Severe Mental Illness: A Population-Based Cohort Study in Denmark.

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Ribe, Anette Riisgaard; Vestergaard, Mogens; Katon, Wayne; Charles, Morten; Benros, Michael Eriksen; Vanderlip, Erik; Nordentoft, Merete; Laursen, Thomas Munk

2015-08-01

Persons with severe mental illness die 15-20 years earlier on average than persons without severe mental illness. Although infection is one of the leading overall causes of death, no studies have evaluated whether persons with severe mental illness have a higher mortality after infection than those without. The authors studied mortality rate ratios and cumulative mortality proportions after an admission for infection for persons with severe mental illness compared with persons without severe mental illness by linking data from Danish national registries. The cohort consisted of all persons hospitalized for infection during the period 1995-2011 in Denmark (N=806,835), of whom 11,343 persons had severe mental illness. Within 30 days after an infection, 1,052 (9.3%) persons with a history of severe mental illness and 58,683 (7.4%) persons without a history of severe mental illness died. Thirty-day mortality after any infection was 52% higher in persons with severe mental illness than in persons without (mortality rate ratio=1.52, 95% CI=1.43-1.61). Mortality was increased for all infections, and the mortality rate ratios ranged from 1.27 (95% CI=1.15-1.39) for persons hospitalized for sepsis to 2.61 (95% CI=1.69-4.02) for persons hospitalized for CNS infections. Depending on age, 1.7 (95% CI=1.2-2.2) to 2.9 (95% CI=2.0-3.7) more deaths were observed within 30 days after an infection per 100 persons with a history of severe mental illness compared with 100 persons without such a history. Persons with severe mental illness have a markedly elevated 30-day mortality after infection. Some of these excess deaths may be prevented by offering individualized and targeted interventions.

Cumulative query method for influenza surveillance using search engine data.

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Seo, Dong-Woo; Jo, Min-Woo; Sohn, Chang Hwan; Shin, Soo-Yong; Lee, JaeHo; Yu, Maengsoo; Kim, Won Young; Lim, Kyoung Soo; Lee, Sang-Il

2014-12-16

Internet search queries have become an important data source in syndromic surveillance system. However, there is currently no syndromic surveillance system using Internet search query data in South Korea. The objective of this study was to examine correlations between our cumulative query method and national influenza surveillance data. Our study was based on the local search engine, Daum (approximately 25% market share), and influenza-like illness (ILI) data from the Korea Centers for Disease Control and Prevention. A quota sampling survey was conducted with 200 participants to obtain popular queries. We divided the study period into two sets: Set 1 (the 2009/10 epidemiological year for development set 1 and 2010/11 for validation set 1) and Set 2 (2010/11 for development Set 2 and 2011/12 for validation Set 2). Pearson's correlation coefficients were calculated between the Daum data and the ILI data for the development set. We selected the combined queries for which the correlation coefficients were .7 or higher and listed them in descending order. Then, we created a cumulative query method n representing the number of cumulative combined queries in descending order of the correlation coefficient. In validation set 1, 13 cumulative query methods were applied, and 8 had higher correlation coefficients (min=.916, max=.943) than that of the highest single combined query. Further, 11 of 13 cumulative query methods had an r value of ≥.7, but 4 of 13 combined queries had an r value of ≥.7. In validation set 2, 8 of 15 cumulative query methods showed higher correlation coefficients (min=.975, max=.987) than that of the highest single combined query. All 15 cumulative query methods had an r value of ≥.7, but 6 of 15 combined queries had an r value of ≥.7. Cumulative query method showed relatively higher correlation with national influenza surveillance data than combined queries in the development and validation set.

Rates of Mental Illness and Associated Academic Impacts in Ontario's College Students

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Holmes, Alana; Silvestri, Robert

2016-01-01

Staff at campus-based counselling and disability centres in 15 of Ontario's 24 community colleges completed 3,536 surveys on 1,964 individual students querying the presence of mental illness and academic challenges as reported by students accessing these services. Survey data were analyzed to determine prevalence rates of mental disorders and…

Ovarian response and cumulative live birth rate of women undergoing in-vitro fertilisation who had discordant anti-Mullerian hormone and antral follicle count measurements: a retrospective study.

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Hang Wun Raymond Li

Full Text Available OBJECTIVE: To evaluate ovarian response and cumulative live birth rate of women undergoing in-vitro fertilization (IVF treatment who had discordant baseline serum anti-Mullerian hormone (AMH level and antral follicle count (AFC. METHODS: This is a retrospective cohort study on 1,046 women undergoing the first IVF cycle in Queen Mary Hospital, Hong Kong. Subjects receiving standard IVF treatment with the GnRH agonist long protocol were classified according to their quartiles of baseline AMH and AFC measurements after GnRH agonist down-regulation and before commencing ovarian stimulation. The number of retrieved oocytes, ovarian sensitivity index (OSI and cumulative live-birth rate for each classification category were compared. RESULTS: Among our studied subjects, 32.2% were discordant in their AMH and AFC quartiles. Among them, those having higher AMH within the same AFC quartile had higher number of retrieved oocytes and cumulative live-birth rate. Subjects discordant in AMH and AFC had intermediate OSI which differed significantly compared to those concordant in AMH and AFC on either end. OSI of those discordant in AMH and AFC did not differ significantly whether either AMH or AFC quartile was higher than the other. CONCLUSIONS: When AMH and AFC are discordant, the ovarian responsiveness is intermediate between that when both are concordant on either end. Women having higher AMH within the same AFC quartile had higher number of retrieved oocytes and cumulative live-birth rate.

The association of the original OSHA chemical hazard communication standard with reductions in acute work injuries/illnesses in private industry and the industrial releases of chemical carcinogens.

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Oleinick, Arthur

2014-02-01

OSHA predicted the original chemical Hazard Communication Standard (HCS) would cumulatively reduce the lost workday acute injury/illness rate for exposure events by 20% over 20 years and reduce exposure to chemical carcinogens. JoinPoint trend software identified changes in the rate of change of BLS rates for days away from work for acute injuries/illnesses during 1992-2009 for manufacturing and nonmanufacturing industries for both chemical, noxious or allergenic injury exposure events and All other exposure events. The annual percent change in the rates was used to adjust observed numbers of cases to estimate their association with the standard. A case-control study of EPA's Toxic Release Inventory 1988-2009 data compared carcinogen and non-carcinogens' releases. The study estimates that the HCS was associated with a reduction in the number of acute injuries/illnesses due to chemical injury exposure events over the background rate in the range 107,569-459,395 (Hudson method/modified BIC model) depending on whether the HCS is treated as a marginal or sole factor in the decrease. Carcinogen releases have declined at a substantially faster rate than control non-carcinogens. The previous HCS standard was associated with significant reductions in chemical event acute injuries/illnesses and chemical carcinogen exposures. © 2013 Wiley Periodicals, Inc.

The impact of transport of critically ill pediatric patients on rural emergency departments in Manitoba.

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Hansen, Gregory; Beer, Darcy L; Vallance, Jeff K

2017-01-01

Although the interfacility transport (IFT) of critically ill pediatric patients from rural to tertiary health centres may improve outcomes, the impact of IFTs on the rural referring centre is not known. The purpose of this study was to investigate how the IFT of critically ill children affects staffing and functionality of rural emergency departments (EDs) in Manitoba. In 2015, surveys were emailed to the medical directors of all 15 regional EDs within 2 hours' travel time from a tertiary pediatric hospital. The survey consisted of 9 questions that addressed baseline characteristics of the regional EDs and duration of ED staffing changes or closures due to IFT of critically ill pediatric patients. Ten surveys were received (67% response rate); a regional ED catchment population of about 130 000 people was represented. Interfacility transport caused most EDs (60%, with an average catchment population of 15 000) to close or to alter their staffing to a registered nurse only. These temporary changes lasted a cumulative total of 115 hours. Interfacility transport of critically ill pediatric patients resulted in ED closures and staffing changes in rural Manitoba. These findings suggest that long-term sustainable solutions are required to improve access to emergency care.

Ventilator associated pneumonia: perspectives on the burden of illness.

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Cook, D

2000-01-01

The objective of this narrative review is to summarize selected current concepts and clinical evidence regarding the burden of illness of VAP, including its epidemiology, diagnosis, attributable mortality and risk factors. Studies were identified through MEDLINE, EMBASE, bibliographies of primary and review articles and personal files. While cross sectional studies inform us about VAP prevalence, longitudinal studies inform us of the cumulative risk and conditional risk of developing VAP. Reported VAP rates are modulated by factors related to case mix, causative microorganisms, interventions that influence risk over time, and VAP definitions employed. Population-specific and organism-specific VAP rates are needed to avoid misleading benchmarking between different ICUs, and to minimize inappropriate between-study comparisons. Observational studies have shown that invasive sampling techniques versus non-invasive approaches to diagnose VAP facilitates more targeted antibiotic treatment; however, the influence of the diagnostic method on endpoints such as mortality is less clear. VAP is associated with approximately a 4 day increase in length of ICU stay and an attributable mortality of approximately 20-30%. Fixed VAP risk factors include underlying cardiorespiratory disease, neurologic injury and trauma. Modifiable VAP risk factors include supine body position, witnessed aspiration, paralytic agents and antibiotic exposure. If modifiable risk factors tested in randomized trials lower VAP rates, such as semirecumbency versus supine positioning, these represent effective VAP prevention strategies. Ventilator-associated pneumonia is a major morbid outcome among critically ill patients. Studies evaluating more effective prevention and treatment strategies are needed.

Understanding Response Rates to Surveys About Family Members' Psychological Symptoms After Patients' Critical Illness.

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Long, Ann C; Downey, Lois; Engelberg, Ruth A; Nielsen, Elizabeth; Ciechanowski, Paul; Curtis, J Randall

2017-07-01

Achieving adequate response rates from family members of critically ill patients can be challenging, especially when assessing psychological symptoms. To identify factors associated with completion of surveys about psychological symptoms among family members of critically ill patients. Using data from a randomized trial of an intervention to improve communication between clinicians and families of critically ill patients, we examined patient-level and family-level predictors of the return of usable surveys at baseline, three months, and six months (n = 181, 171, and 155, respectively). Family-level predictors included baseline symptoms of psychological distress, decisional independence preference, and attachment style. We hypothesized that family with fewer symptoms of psychological distress, a preference for less decisional independence, and secure attachment style would be more likely to return questionnaires. We identified several predictors of the return of usable questionnaires. Better self-assessed family member health status was associated with a higher likelihood and stronger agreement with a support-seeking attachment style with a lower likelihood, of obtaining usable baseline surveys. At three months, family-level predictors of return of usable surveys included having usable baseline surveys, status as the patient's legal next of kin, and stronger agreement with a secure attachment style. The only predictor of receipt of surveys at six months was the presence of usable surveys at three months. We identified several predictors of the receipt of surveys assessing psychological symptoms in family of critically ill patients, including family member health status and attachment style. Using these characteristics to inform follow-up mailings and reminders may enhance response rates. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Origin of path independence between cumulative CO2 emissions and global warming

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Seshadri, Ashwin K.

2017-11-01

Observations and GCMs exhibit approximate proportionality between cumulative carbon dioxide (CO2) emissions and global warming. Here we identify sufficient conditions for the relationship between cumulative CO2 emissions and global warming to be independent of the path of CO2 emissions; referred to as "path independence". Our starting point is a closed form expression for global warming in a two-box energy balance model (EBM), which depends explicitly on cumulative emissions, airborne fraction and time. Path independence requires that this function can be approximated as depending on cumulative emissions alone. We show that path independence arises from weak constraints, occurring if the timescale for changes in cumulative emissions (equal to ratio between cumulative emissions and emissions rate) is small compared to the timescale for changes in airborne fraction (which depends on CO2 uptake), and also small relative to a derived climate model parameter called the damping-timescale, which is related to the rate at which deep-ocean warming affects global warming. Effects of uncertainties in the climate model and carbon cycle are examined. Large deep-ocean heat capacity in the Earth system is not necessary for path independence, which appears resilient to climate modeling uncertainties. However long time-constants in the Earth system carbon cycle are essential, ensuring that airborne fraction changes slowly with timescale much longer than the timescale for changes in cumulative emissions. Therefore path independence between cumulative emissions and warming cannot arise for short-lived greenhouse gases.

Childhood trauma and chronic illness in adulthood: mental health and socioeconomic status as explanatory factors and buffers.

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Mock, Steven E; Arai, Susan M

2010-01-01

Experiences of traumatic events in childhood have been shown to have long-term consequences for health in adulthood. With data from the 2005 Canadian Community Health Survey we take a life course perspective of cumulative disadvantage and examine the potential role of mental health and socioeconomic status in adulthood as multiple mediators of the link between childhood trauma and chronic illness in adulthood. Mental health and socioeconomic status are also tested as buffers against the typically adverse consequences of childhood trauma. The results suggest mental health and socioeconomic status partially explain the association of childhood trauma with chronic illness in adulthood, with mental health showing a stronger effect. In addition, an analysis of the interactions suggested higher socioeconomic status is a potential protective factor for those with a history of trauma. Results also suggest cumulative disadvantage following trauma may lead to chronic illness and suggest the need for public health expenditures on resources such as counseling and income supports to prevent or reduce psychological harm and chronic illness resulting from traumatic events.

Childhood trauma and chronic illness in adulthood: mental health and socioeconomic status as explanatory factors and buffers

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Steven E Mock

2011-01-01

Full Text Available Experiences of traumatic events in childhood have been shown to have long-term consequences for health in adulthood. With data from the 2005 Canadian Community Health Survey we take a life course perspective of cumulative disadvantage and examine the potential role of mental health and socioeconomic status in adulthood as multiple mediators of the link between childhood trauma and chronic illness in adulthood. Mental health and socioeconomic status are also tested as buffers against the typically adverse consequences of childhood trauma. The results suggest mental health and socioeconomic status partially explain the association of childhood trauma with chronic illness in adulthood, with mental health showing a stronger effect. In addition, an analysis of the interactions suggested higher socioeconomic status is a potential protective factor for those with a history of trauma. Results also suggest cumulative disadvantage following trauma may lead to chronic illness and suggest the need for public health expenditures on resources such as counseling and income supports to prevent or reduce psychological harm and chronic illness resulting from traumatic events.

Cumulative stress and autonomic dysregulation in a community sample.

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Lampert, Rachel; Tuit, Keri; Hong, Kwang-Ik; Donovan, Theresa; Lee, Forrester; Sinha, Rajita

2016-05-01

Whether cumulative stress, including both chronic stress and adverse life events, is associated with decreased heart rate variability (HRV), a non-invasive measure of autonomic status which predicts poor cardiovascular outcomes, is unknown. Healthy community dwelling volunteers (N = 157, mean age 29 years) participated in the Cumulative Stress/Adversity Interview (CAI), a 140-item event interview measuring cumulative adversity including major life events, life trauma, recent life events and chronic stressors, and underwent 24-h ambulatory ECG monitoring. HRV was analyzed in the frequency domain and standard deviation of NN intervals (SDNN) calculated. Initial simple regression analyses revealed that total cumulative stress score, chronic stressors and cumulative adverse life events (CALE) were all inversely associated with ultra low-frequency (ULF), very low-frequency (VLF) and low-frequency (LF) power and SDNN (all p accounting for additional appreciable variance. For VLF and LF, both total cumulative stress and chronic stress significantly contributed to the variance alone but were not longer significant after adjusting for race and health behaviors. In summary, total cumulative stress, and its components of adverse life events and chronic stress were associated with decreased cardiac autonomic function as measured by HRV. Findings suggest one potential mechanism by which stress may exert adverse effects on mortality in healthy individuals. Primary preventive strategies including stress management may prove beneficial.

Cumulative live birth rates after IVF in patients with polycystic ovaries: phenotype matters.

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De Vos, Michel; Pareyn, Stéphanie; Drakopoulos, Panagiotis; Raimundo, José M; Anckaert, Ellen; Santos-Ribeiro, Samuel; Polyzos, Nikolaos P; Tournaye, Herman; Blockeel, Christophe

2018-05-07

Do cumulative live birth rates (CLBR) vary among women with different polycystic ovary syndrome (PCOS) phenotypes who undergo IVF/intracytoplasmic sperm injection (ICSI) treatment? In this retrospective cohort study, data from 567 patients undergoing an assisted reproductive technology (ART) cycle between January 2010 and December 2015 were collected. Demographical traits, cycle characteristics and clinical and laboratory data were analysed. After conventional ovarian stimulation using a gonadotrophin-releasing hormone antagonist protocol, the median number of oocytes retrieved ranged between 11 and 13.5 and did not differ significantly among the studied groups. Live birth rate (LBR) after fresh embryo transfer and CLBR after transfer of all fresh and vitrified embryos were significantly lower in women with hyperandrogenic PCOS phenotypes A (LBR 16.7%, CLBR 25.8%) and C (LBR 18.5%, CLBR 27.8%) compared with women with normoandrogenic PCOS phenotype D (LBR 33.7%, CLBR 48%) (P-value for LBR 0.01 and 0.03, respectively; P-value for CLBR 0.002 and 0.01, respectively) and controls with a polycystic ovarian morphology (LBR 37.1%, CLBR 53.3%) (P-value for LBR 0.002 and 0.01, respectively; P-value for CLBR counselling and tailored approaches when treating PCOS patients with hyperandrogenism who require ART. Copyright © 2018 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

A Prospective Study of Ventilation Rates and Illness Absence in California Office Buildings

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Eliseeva, Ekaterina A. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Spears, Michael [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Chan, Wanyu R. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Cohn, Sebastian [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Sullivan, Douglas P. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Fisk, William J. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

2014-10-07

Background – This study investigated the associations of ventilation rates (VRs), estimated from indoor CO2 concentrations, in offices with the amount of respiratory infections, illness absences, and building-related health symptoms in occupants. Methods – Office buildings were recruited from three California climate zones. In one or more study spaces within each building, real-time logging sensors measured carbon dioxide, temperature, and relative humidity for one year. Ventilation rates were estimated using daily peak CO2 levels, and also using an alternative metric. Data on occupants and health outcomes were collected through web-based surveys every three months. Multivariate models were used to assess relationships between metrics of ventilation rate or CO2 and occupant outcomes. For all outcomes, negative associations were hypothesized with VR metrics, and positive associations with CO2 metrics. Results – Difficulty recruiting buildings and low survey response limited sample size and study power. In 16 studied spaces within 9 office buildings, VRs were uniformly high over the year, from twice to over nine times the California office VR standard (7 L/s or 15 cfm per person). VR and CO2 metrics had no statistically significant relationships with occupant outcomes, except for a small significantly positive association of the alternative VR metric with respiratory illness-related absence, contrary to hypotheses. Conclusions– The very high time-averaged VRs in the California office buildings studied presumably resulted from “economizer cycles” bringing in large volumes of outdoor air; however, in almost all buildings even the estimated minimum VRs supplied (without the economizer) substantially exceeded the minimum required VR. These high VRs may explain the absence of hypothesized relationships with occupant outcomes. Among uniformly high VRs, little variation in contaminant concentration and occupant effects would be expected. These findings may

Do illness rating systems predict discharge location, length of stay, and cost after total hip arthroplasty?

Directory of Open Access Journals (Sweden)

Sarah E. Rudasill, BA

2018-06-01

Conclusions: These findings suggest that although ASA classifications predict discharge location and SOI scores predict length of stay and total costs, other factors beyond illness rating systems remain stronger predictors of discharge for THA patients.

Cumulative dosages of antipsychotic drugs are associated with increased mortality rate in patients with Alzheimer's dementia

DEFF Research Database (Denmark)

Nielsen, R E; Lolk, A; Valentin, J B

2016-01-01

OBJECTIVE: We wished to investigate the effects of cumulative dosages of antipsychotic drug in Alzheimer's dementia, when controlling for known risk factors, including current antipsychotic exposure, on all-cause mortality. METHOD: We utilized a nationwide, population-based, retrospective cohort...... study design with mortality as outcome in individual patients diagnosed with Alzheimer's dementia. RESULTS: We included a total of 45 894 patients and followed them for 3 803 996 person-years in total, presenting 27 894 deaths in the study population. Cumulative antipsychotic exposure increased...... or equal to 730 DDDs: HR 1.06, 95% CI (0.95-1.18), P = 0.322, when controlling for proxy markers of severity, somatic and mental comorbid disorders. CONCLUSION: In this nationwide cohort study of 45 894 patients diagnosed with Alzheimer's dementia, we found that cumulative dosages of antipsychotic drugs...

Cumulative Poisson Distribution Program

Science.gov (United States)

Bowerman, Paul N.; Scheuer, Ernest M.; Nolty, Robert

1990-01-01

Overflow and underflow in sums prevented. Cumulative Poisson Distribution Program, CUMPOIS, one of two computer programs that make calculations involving cumulative Poisson distributions. Both programs, CUMPOIS (NPO-17714) and NEWTPOIS (NPO-17715), used independently of one another. CUMPOIS determines cumulative Poisson distribution, used to evaluate cumulative distribution function (cdf) for gamma distributions with integer shape parameters and cdf for X (sup2) distributions with even degrees of freedom. Used by statisticians and others concerned with probabilities of independent events occurring over specific units of time, area, or volume. Written in C.

Cumulative carbon as a policy framework for achieving climate stabilization

Science.gov (United States)

Matthews, H. Damon; Solomon, Susan; Pierrehumbert, Raymond

2012-01-01

The primary objective of the United Nations Framework Convention on Climate Change is to stabilize greenhouse gas concentrations at a level that will avoid dangerous climate impacts. However, greenhouse gas concentration stabilization is an awkward framework within which to assess dangerous climate change on account of the significant lag between a given concentration level and the eventual equilibrium temperature change. By contrast, recent research has shown that global temperature change can be well described by a given cumulative carbon emissions budget. Here, we propose that cumulative carbon emissions represent an alternative framework that is applicable both as a tool for climate mitigation as well as for the assessment of potential climate impacts. We show first that both atmospheric CO2 concentration at a given year and the associated temperature change are generally associated with a unique cumulative carbon emissions budget that is largely independent of the emissions scenario. The rate of global temperature change can therefore be related to first order to the rate of increase of cumulative carbon emissions. However, transient warming over the next century will also be strongly affected by emissions of shorter lived forcing agents such as aerosols and methane. Non-CO2 emissions therefore contribute to uncertainty in the cumulative carbon budget associated with near-term temperature targets, and may suggest the need for a mitigation approach that considers separately short- and long-lived gas emissions. By contrast, long-term temperature change remains primarily associated with total cumulative carbon emissions owing to the much longer atmospheric residence time of CO2 relative to other major climate forcing agents. PMID:22869803

Cumulative incidence, distribution, and determinants of catastrophic health expenditure in Nepal: results from the living standards survey.

Science.gov (United States)

Ghimire, Mamata; Ayer, Rakesh; Kondo, Masahide

2018-02-14

Nepal has committed to the global community to achieve universal health coverage by 2030. Nevertheless, Nepal still has a high proportion of out-of-pocket health payment and a limited risk-pooling mechanism. Out-of-pocket payment for the healthcare services could result in catastrophic health expenditure (CHE). Evidence is required to effectively channel the efforts to lower those expenses in order to achieve universal health coverage. However, little is known about CHE and its determinants in a broad national context in Nepal. Therefore, this study was conducted to explore the cumulative incidence, distribution, and determinants of CHE in Nepal. Data were obtained from the nationally representative survey, the Nepal Living Standards Survey-third undertaken in 2010/11. Information from 5988 households was used for the analyses. Households were classified as having CHE when their out-of-pocket health payment was greater than or equal to 40% of their capacity to pay. Remaining households were classified as not having CHE. Logistic regression analyses were used to identify determinants of CHE. Based on household-weighted sample, the cumulative incidence of CHE was 10.3% per month in Nepal. This incidence was concentrated in the far-western region and households in the poorer expenditure quartiles. Multivariable logistic regression revealed that households were more likely to face CHE if they; consisted of chronically ill member(s), have a higher burden of acute illness and injuries, have elderly (≥60 years) member(s), belonged to the poor expenditure quartile, and were located in the far-western region. In contrast, households were less likely to incur CHE when their household head was educated. Having children (≤5 years) in households did not significantly affect catastrophic health expenditure. This study identified a high cumulative incidence of CHE. CHE was disproportionately concentrated in the poor households and households located in the far

Does competitive employment improve nonvocational outcomes for people with severe mental illness?

Science.gov (United States)

Bond, G R; Resnick, S G; Drake, R E; Xie, H; McHugo, G J; Bebout, R R

2001-06-01

The authors examined the cumulative effects of work on symptoms, quality of life, and self-esteem for 149 unemployed clients with severe mental illness receiving vocational rehabilitation. Nonvocational measures were assessed at 6-month intervals throughout the 18-month study period, and vocational activity was tracked continuously. On the basis of their predominant work activity over the study period, participants were classified into 4 groups: competitive work, sheltered work, minimal work, and no work. The groups did not differ at baseline on any of the nonvocational measures. Using mixed effects regression analysis to examine rates of change over time, the authors found that the competitive work group showed higher rates of improvement in symptoms; in satisfaction with vocational services, leisure, and finances; and in self-esteem than did participants in a combined minimal work-no work group. The sheltered work group showed no such advantage.

Comorbid medical illness in bipolar disorder.

Science.gov (United States)

Forty, Liz; Ulanova, Anna; Jones, Lisa; Jones, Ian; Gordon-Smith, Katherine; Fraser, Christine; Farmer, Anne; McGuffin, Peter; Lewis, Cathryn M; Hosang, Georgina M; Rivera, Margarita; Craddock, Nick

2014-12-01

Individuals with a mental health disorder appear to be at increased risk of medical illness. To examine rates of medical illnesses in patients with bipolar disorder (n = 1720) and to examine the clinical course of the bipolar illness according to lifetime medical illness burden. Participants recruited within the UK were asked about the lifetime occurrence of 20 medical illnesses, interviewed using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) and diagnosed according to DSM-IV criteria. We found significantly increased rates of several medical illnesses in our bipolar sample. A high medical illness burden was associated with a history of anxiety disorder, rapid cycling mood episodes, suicide attempts and mood episodes with a typically acute onset. Bipolar disorder is associated with high rates of medical illness. This comorbidity needs to be taken into account by services in order to improve outcomes for patients with bipolar disorder and also in research investigating the aetiology of affective disorder where shared biological pathways may play a role. Royal College of Psychiatrists.

The Relationship Between Traumatic Brain Injury and Rates of Chronic Symptomatic Illness in 202 Gulf War Veterans.

Science.gov (United States)

Chao, Linda L

2018-05-18

Although not a "signature injury" of Operation Desert Shield/Desert Storm (i.e., Gulf War, GW), some GW veterans have a history traumatic brain injury (TBI). For example, a previous study found that 12.2% of the GW veterans from the Fort Devens Cohort Study had self-reported TBIs. The present study sought to build upon this finding by examining the relationship between TBI and chronic symptomatic illness in a different sample of GW veterans. Participants were 202 GW veterans recruited from 2014 to 2018 at the San Francisco Veterans Affairs Medical Center as part of a VA-funded study on the effects of predicted exposure to low levels of sarin and cyclosarin on brain structure and function. The Ohio State University TBI identification method was used to determine lifetime history of TBI. The Kansas Gulf War Military History and Health Questionnaire was used to assess symptoms and to determine cases of Kansas Gulf War Illness (GWI) and Centers for Disease Control and Prevention (CDC) Chronic Multisymptom Illness (CMI). Nearly half (47%) the sample had a history of TBI, but only 7% of the TBIs were sustained in injuries that occurred during the GW. Most of the TBIs were sustained in injuries that occurred prior to (73%) or after (34%) the GW. History of TBI was not associated with higher rates of symptomatic illness when it was narrowly defined (i.e., Kansas GWI cases or cases of severe CMI). History of TBI was only associated with higher rates of symptomatic illness when it is broadly defined (i.e., CDC CMI or mild-moderate CMI). There was suggestive evidence that veterans who sustained TBIs during the GW (only seven in the present sample) have poorer functional outcomes compared with GW veterans with non-GW related TBIs. While TBIs were uncommon during the GW, many GW veterans sustained TBIs prior or after the GW. Because TBI and GWI/CMI share some overlapping symptoms, history of TBI may appear to be associated with increased rates of chronic symptomatic illness in

Adaptive strategies for cumulative cultural learning.

Science.gov (United States)

Ehn, Micael; Laland, Kevin

2012-05-21

The demographic and ecological success of our species is frequently attributed to our capacity for cumulative culture. However, it is not yet known how humans combine social and asocial learning to generate effective strategies for learning in a cumulative cultural context. Here we explore how cumulative culture influences the relative merits of various pure and conditional learning strategies, including pure asocial and social learning, critical social learning, conditional social learning and individual refiner strategies. We replicate the Rogers' paradox in the cumulative setting. However, our analysis suggests that strategies that resolved Rogers' paradox in a non-cumulative setting may not necessarily evolve in a cumulative setting, thus different strategies will optimize cumulative and non-cumulative cultural learning. Copyright © 2012 Elsevier Ltd. All rights reserved.

Parenting stress among caregivers of children with chronic illness: a systematic review.

Science.gov (United States)

Cousino, Melissa K; Hazen, Rebecca A

2013-09-01

To critically review, analyze, and synthesize the literature on parenting stress among caregivers of children with asthma, cancer, cystic fibrosis, diabetes, epilepsy, juvenile rheumatoid arthritis, and/or sickle cell disease. Method PsychInfo, MEDLINE, and Cumulative Index to Nursing and Allied Health Literature were searched according to inclusion criteria. Meta-analysis of 13 studies and qualitative analysis of 96 studies was conducted. Results Caregivers of children with chronic illness reported significantly greater general parenting stress than caregivers of healthy children (d = .40; p = ≤.0001). Qualitative analysis revealed that greater general parenting stress was associated with greater parental responsibility for treatment management and was unrelated to illness duration and severity across illness populations. Greater parenting stress was associated with poorer psychological adjustment in caregivers and children with chronic illness. Conclusion Parenting stress is an important target for future intervention. General and illness-specific measures of parenting stress should be used in future studies.

Rates of Cervical Cancer Screening Among Women With Severe Mental Illness in the Public Health System.

Science.gov (United States)

James, Monique; Thomas, Melanie; Frolov, Latoya; Riano, Nicholas S; Vittinghoff, Eric; Schillinger, Dean; Newcomer, John W; Mangurian, Christina

2017-08-01

This study aimed to determine cervical cancer screening rates among women with severe mental illness. California Medicaid administrative records (2010-2011) for 31,308 women with severe mental illness were examined. Participants received specialty mental health services and were not dually eligible for Medicare. Poisson models assessed association between selected predictors and cervical cancer screening. Overall, 20.2% of women with severe mental illness received cervical cancer screening during the one-year period. Compared with white women, Asian women (adjusted risk ratio [ARR]=1.23), black women (ARR=1.10), and Hispanic women (ARR=1.11) (pWomen ages 28-37 were more likely than those ages 18-27 to have been screened (ARR=1.31, phealth care use was the strongest predictor of screening (ARR=3.07, pwomen in the sample were not regularly screened for cervical cancer. Cervical cancer screening for this high-risk population should be prioritized.

Steps and pips in the history of the cumulative recorder.

OpenAIRE

Lattal, Kennon A

2004-01-01

From its inception in the 1930s until very recent times, the cumulative recorder was the most widely used measurement instrument in the experimental analysis of behavior. It was an essential instrument in the discovery and analysis of schedules of reinforcement, providing the first real-time analysis of operant response rates and patterns. This review traces the evolution of the cumulative recorder from Skinner's early modified kymographs through various models developed by Skinner and his co...

Structure functions and particle production in the cumulative region: two different exponentials

International Nuclear Information System (INIS)

Braun, M.; Vechernin, V.

1997-01-01

In the framework of the recently proposed (QCD-based parton model for the cumulative phenomena in the interactions with nuclei two mechanisms for particle production, direct and spectator ones, are analyzed. It is shown that due to final-state interactions the leading terms of the direct mechanism contribution are cancelled and the spectator mechanism is the dominant one. It leads to a smaller slope of the cumulative particle production rates compared to the slope of the nuclear structure function in the cumulative region x ≥ 1, in agreement with the recent experimental data

Magnesium supplementation and the potential association with mortality rates among critically ill non-cardiac patients

International Nuclear Information System (INIS)

Dabbagh, Ousama C.; Al-Dawood, Abdulaziz S.; Arabi, Yaseen M.; Lone, Nazir A.; Brits, R.; Pillay, M.

2006-01-01

Recent literature showed that development of hypomagnesaemia is associated with higher mortality. The objective of this study is to evaluate the impact of magnesium supplementation on mortality rates of critically ill patients. All patients admitted to the Intensive Care Unit (ICU) of King Abadole-Aziz Medical City, Riyadh, Saudi Arabia since September 2003 were included. We recorded the demographics data, APACHE score, daily magnesium levels and magnesium supplementation. We collected the data for 30 days or until discharge from ICU. Statistical analysis was performed using the student t-test for continuous data and the Fischers exact test for categorical data. Nothing was carried out to influence the behavior of intensivists in replacing magnesium. During the study period, 71 patients (45 males and 26 females) were admitted to the ICU, the mean age was 54 +/- 18 years for males and 56 +/- 19.2 years for females. The mean magnesium level on admission was 0.78 +/- 0.2 mmol/L and the majority of the patients were medical admissions. Approximately 39.4% had hypomagnesaemia on admission and the overall mortality rate was 31%. In able to standardize the supplementation of magnesium among groups, the daily magnesium supplementation index (DMSI = total magnesium supplement in grams/length of stay in days) was calculated. The mortality rates for DMSI with 1 grm/day (high group) (43.5% versus 17%, p=0.035). There was no statistically significant differences between magnesium levels of both groups of DMSI except at admission where DMSI group had higher magnesium levels (<1 grm/day). Daily magnesium supplementation index higher than 1 grm/day is associated with lower mortality rates for critically ill patients. This effect was not found to be independent and may be related to severity of illness. Given that magnesium levels were similar between the 2 groups of DMSI at almost all points of the study, magnesium supplementation per se may be beneficial in lowering mortality

Sharing a quota on cumulative carbon emissions

International Nuclear Information System (INIS)

Raupach, Michael R.; Davis, Steven J.; Peters, Glen P.; Andrew, Robbie M.; Canadell, Josep G.; Ciais, Philippe

2014-01-01

Any limit on future global warming is associated with a quota on cumulative global CO 2 emissions. We translate this global carbon quota to regional and national scales, on a spectrum of sharing principles that extends from continuation of the present distribution of emissions to an equal per-capita distribution of cumulative emissions. A blend of these endpoints emerges as the most viable option. For a carbon quota consistent with a 2 C warming limit (relative to pre-industrial levels), the necessary long-term mitigation rates are very challenging (typically over 5% per year), both because of strong limits on future emissions from the global carbon quota and also the likely short-term persistence in emissions growth in many regions. (authors)

A clinician-administered severity rating scale for illness anxiety: development, reliability, and validity of the H-YBOCS-M.

Science.gov (United States)

Skritskaya, Natalia A; Carson-Wong, Amanda R; Moeller, James R; Shen, Sa; Barsky, Arthur J; Fallon, Brian A

2012-07-01

Clinician-administered measures to assess severity of illness anxiety and response to treatment are few. The authors evaluated a modified version of the hypochondriasis-Y-BOCS (H-YBOCS-M), a 19-item, semistructured, clinician-administered instrument designed to rate severity of illness-related thoughts, behaviors, and avoidance. The scale was administered to 195 treatment-seeking adults with DSM-IV hypochondriasis. Test-retest reliability was assessed in a subsample of 20 patients. Interrater reliability was assessed by 27 interviews independently rated by four raters. Sensitivity to change was evaluated in a subsample of 149 patients. Convergent and discriminant validity was examined by comparing H-YBOCS-M scores to other measures administered. Item clustering was examined with confirmatory and exploratory factor analyses. The H-YBOCS-M demonstrated good internal consistency, interrater and test-retest reliability, and sensitivity to symptom change with treatment. Construct validity was supported by significant higher correlations with scores on other measures of hypochondriasis than with nonhypochondriacal measures. Improvement over time in response to treatment correlated with improvement both on measures of hypochondriasis and on measures of somatization, depression, anxiety, and functional status. Confirmatory factor analysis did not show adequate fit for a three-factor model. Exploratory factor analysis revealed a five-factor solution with the first two factors consistent with the separation of the H-YBOCS-M items into the subscales of illness-related avoidance and compulsions. H-YBOCS-M appears to be valid, reliable, and appropriate as an outcome measure for treatment studies of illness anxiety. Study results highlight "avoidance" as a key feature of illness anxiety-with potentially important nosologic and treatment implications. © 2012 Wiley Periodicals, Inc.

Complete cumulative index (1963-1983)

International Nuclear Information System (INIS)

1983-01-01

This complete cumulative index covers all regular and special issues and supplements published by Atomic Energy Review (AER) during its lifetime (1963-1983). The complete cumulative index consists of six Indexes: the Index of Abstracts, the Subject Index, the Title Index, the Author Index, the Country Index and the Table of Elements Index. The complete cumulative index supersedes the Cumulative Indexes for Volumes 1-7: 1963-1969 (1970), and for Volumes 1-10: 1963-1972 (1972); this Index also finalizes Atomic Energy Review, the publication of which has recently been terminated by the IAEA

Methane combustion kinetic rate constants determination: an ill-posed inverse problem analysis

Directory of Open Access Journals (Sweden)

Bárbara D. L. Ferreira

2013-01-01

Full Text Available Methane combustion was studied by the Westbrook and Dryer model. This well-established simplified mechanism is very useful in combustion science, for computational effort can be notably reduced. In the inversion procedure to be studied, rate constants are obtained from [CO] concentration data. However, when inherent experimental errors in chemical concentrations are considered, an ill-conditioned inverse problem must be solved for which appropriate mathematical algorithms are needed. A recurrent neural network was chosen due to its numerical stability and robustness. The proposed methodology was compared against Simplex and Levenberg-Marquardt, the most used methods for optimization problems.

Sociodemographic, disease status, and illness perceptions predictors of global self-ratings of health and quality of life among those with coronary heart disease

DEFF Research Database (Denmark)

Aalto, Anna-Mari; Aro, Arja R; Weinman, John

2006-01-01

This one-year follow-up study (n = 130 at baseline, n =2745 at follow-up, aged 45-74 years) examined the relationship of patients' perceptions of coronary heart disease (CHD) and illness-related factors with global health status and global quality of life (QOL) ratings. The independent variables...... were CHD history (myocardial infarction, revascularisation), CHD severity (use of nitrates, CHD risk factors and co-morbidities) and illness perceptions. In multivariate regression analysis, CHD history and severity explained 13% of variance in global health status and 8% in global QOL ratings...... at the baseline. Illness perceptions increased the share of explained variance by 18% and 16% respectively. In the follow-up, illness perceptions explained a significant but modest share of variance in change in health status and QOL when baseline health status and QOL and CHD severity were adjusted for more...

Relationship between neighborhood poverty rate and bloodstream infections in the critically ill.

Science.gov (United States)

Mendu, Mallika L; Zager, Sam; Gibbons, Fiona K; Christopher, Kenneth B

2012-05-01

Poverty is associated with increased risk of chronic illness, but its contribution to bloodstream infections is not well-defined. We performed a multicenter observational study of 14,657 patients, aged 18 yrs or older, who received critical care and had blood cultures drawn between 1997 and 2007 in two hospitals in Boston, Massachusetts. Data sources included 1990 U.S. Census and hospital administrative data. Census tracts were used as the geographic units of analysis. The exposure of interest was neighborhood poverty rate categorized as 40%. Neighborhood poverty rate is the percentage of residents with income below the federal poverty line. The primary end point was bloodstream infection occurring 48 hrs before critical care initiation to 48 hrs after. Associations between neighborhood poverty rate and bloodstream infection were estimated by logistic regression models. Adjusted odds ratios were estimated by multivariable logistic regression models. Two thousand four-hundred thirty-five patients had bloodstream infections. Neighborhood poverty rate was a strong predictor of risk of bloodstream infection, with a significant risk gradient across neighborhood poverty rate quintiles. After multivariable analysis, neighborhood poverty rate in the highest quintiles (20%-40% and >40%) were associated with a 26% and 49% increase in bloodstream infection risk, respectively, relative to patients with neighborhood poverty rate of poverty rate, a proxy for decreased socioeconomic status, appears to be associated with risk of bloodstream infection among patients who receive critical care.

Increased superior frontal gyrus activation during working memory processing in psychosis: Significant relation to cumulative antipsychotic medication and to negative symptoms.

Science.gov (United States)

Vogel, Tobias; Smieskova, Renata; Schmidt, André; Walter, Anna; Harrisberger, Fabienne; Eckert, Anne; Lang, Undine E; Riecher-Rössler, Anita; Graf, Marc; Borgwardt, Stefan

2016-08-01

Impairment in working memory (WM) is a core symptom in schizophrenia. However, little is known about how clinical features influence functional brain activity specific to WM processing during the development of first-episode psychosis (FEP) to schizophrenia (SZ). We compared functional WM-specific brain activity in FEP and SZ patients, including the effects of the duration of illness, psychopathological factors and antipsychotic medication. Cross-sectional study of male FEP (n=22) and SZ (n=20) patients performing an n-back task when undergoing functional magnetic resonance imaging (fMRI). Clinical features were collected by semi-structured interviews and medical records. The SZ group performed significantly worse than the FEP group in the 2-back condition. The SZ group also showed significantly higher activation in the left superior frontal gyrus in the 2-back versus 0-back condition (2-back>0-back). This frontal activation correlated positively with negative symptoms and with cumulative antipsychotic medication during the year before the fMRI examination. There were no significant correlations between activation and duration of illness. There was greater frontal neural activation in SZ than in FEP. This indicated differences in WM processing, and was significantly related to cumulative antipsychotic exposure and negative symptoms, but not to the duration of illness. Copyright © 2016 Elsevier B.V. All rights reserved.

Cumulative effects of wind turbines. A guide to assessing the cumulative effects of wind energy development

Energy Technology Data Exchange (ETDEWEB)

NONE

2000-07-01

This guidance provides advice on how to assess the cumulative effects of wind energy developments in an area and is aimed at developers, planners, and stakeholders interested in the development of wind energy in the UK. The principles of cumulative assessment, wind energy development in the UK, cumulative assessment of wind energy development, and best practice conclusions are discussed. The identification and assessment of the cumulative effects is examined in terms of global environmental sustainability, local environmental quality and socio-economic activity. Supplementary guidance for assessing the principle cumulative effects on the landscape, on birds, and on the visual effect is provided. The consensus building approach behind the preparation of this guidance is outlined in the annexes of the report.

The challenge of cumulative impacts

Energy Technology Data Exchange (ETDEWEB)

Masden, Elisabeth

2011-07-01

Full text: As governments pledge to combat climate change, wind turbines are becoming a common feature of terrestrial and marine environments. Although wind power is a renewable energy source and a means of reducing carbon emissions, there is a need to ensure that the wind farms themselves do not damage the environment. There is particular concern over the impacts of wind farms on bird populations, and with increasing numbers of wind farm proposals, the concern focuses on cumulative impacts. Individually, a wind farm, or indeed any activity/action, may have minor effects on the environment, but collectively these may be significant, potentially greater than the sum of the individual parts acting alone. Cumulative impact assessment is a legislative requirement of environmental impact assessment but such assessments are rarely adequate restricting the acquisition of basic knowledge about the cumulative impacts of wind farms on bird populations. Reasons for this are numerous but a recurring theme is the lack of clear definitions and guidance on how to perform cumulative assessments. Here we present a conceptual framework and include illustrative examples to demonstrate how the framework can be used to improve the planning and execution of cumulative impact assessments. The core concept is that explicit definitions of impacts, actions and scales of assessment are required to reduce uncertainty in the process of assessment and improve communication between stake holders. Only when it is clear what has been included within a cumulative assessment, is it possible to make comparisons between developments. Our framework requires improved legislative guidance on the actions to include in assessments, and advice on the appropriate baselines against which to assess impacts. Cumulative impacts are currently considered on restricted scales (spatial and temporal) relating to individual development assessments. We propose that benefits would be gained from elevating cumulative

Adverse Childhood Experiences and the Risk of Criminal Justice Involvement and Victimization Among Homeless Adults With Mental Illness.

Science.gov (United States)

Edalati, Hanie; Nicholls, Tonia L; Crocker, Anne G; Roy, Laurence; Somers, Julian M; Patterson, Michelle L

2017-12-01

Exposure to adverse childhood experiences (ACEs) is highly prevalent among homeless individuals and is associated with negative consequences during homelessness. This study examined the effect of ACEs on the risk of criminal justice involvement and victimization among homeless individuals with mental illness. The study used baseline data from a demonstration project (At Home/Chez Soi) that provided Housing First and recovery-oriented services to homeless adults with mental illness. The sample was recruited from five Canadian cities and included participants who provided valid responses on an ACEs questionnaire (N=1,888). Fifty percent reported more than four types of ACE, 19% reported three or four types, 19% reported one or two, and 12% reported none. Rates of criminal justice involvement and victimization were significantly higher among those with a history of ACEs. For victimization, the association was significant for all ten types of ACE, and for justice involvement, it was significant for seven types. Logistic regression models indicated that the effect of cumulative childhood adversity on the two outcomes was significant regardless of sociodemographic factors, duration of homelessness, and psychiatric diagnosis, with one exception: the relationship between cumulative childhood adversity and criminal justice involvement did not remain significant when the analysis controlled for a diagnosis of posttraumatic stress disorder and substance dependence. Findings support the need for early interventions for at-risk youths and trauma-informed practice and violence prevention policies that specifically target homeless populations.

Effect of hyperglycemia on mortality rates in critically ill children

Directory of Open Access Journals (Sweden)

Seongkuk Kim

2010-03-01

Full Text Available Purpose : To verify the effect of hyperglycemia on mortality rates in critically ill children and to identify the blood glucose level that influences prognosis. Methods : From July 2006 to June 2008, a total of 206 patients who were admitted to the pediatric intensive care unit (PICU at Asan Medical Center and who survived for more than 7 days were retrospectively reviewed. We analyzed the maximum glucose value within 7 days in PICU, PRISM-III score and SOFA score within 24 hours, and mortality. We did not perform an adjustment analysis of drugs affecting glucose level. Results : The maximum glucose level within 7 days in PICU was higher in the nonsurvival group than in the survival group. Using 4 cutoff values (125, 150, 175, and 200 mg/dL, the mortality of patients with hyperglycemia was found to be 13.0 %, 14.4%, 19.8%, and 21.1%, respectively, and the cutoff values of 175 and 200 mg/dL revealed significant differences in mortalities between the hyperglycemic and normoglycemic groups. The PRISM-III score was not significantly different between the hyperglycemic and normoglycemic groups under a glucose cutoff value of 175 mg/dL, but the SOFA score was higher in the hyperglycemic group. Under a glucose cutoff value of 200 mg/dL, the PRISM-III score was higher in the hyperglycemic group, and the SOFA score did not differ between the 2 groups. Conclusion : Hyperglycemia with a maximal glucose value ?#241;75 mg/dL during the first 7 days after PICU admission was associated with increased mortality in critically ill children.

Measurement of radiocesium concentration in trees using cumulative gamma radiation dose rate detection systems - A simple presumption for radiocesium concentration in living woods using glass-badge based gamma radiation dose rate detection system

Energy Technology Data Exchange (ETDEWEB)

Yoshihara, T.; Hashida, S.N. [Plant Molecular Biology, Laboratory of Environmental Science, Central Research Institute of Electric Power Industry (CRIEPI), 1646 Abiko, Chiba 270-1194 (Japan); Kawachi, N.; Suzui, N.; Yin, Y.G.; Fujimaki, S. [Radiotracer Imaging Gr., Quantum Beam Science Center, Japan Atomic Energy Agency (JAEA), 1233 Watanuki, Takasaki, Gunma 370-1292 (Japan); Nagao, Y.; Yamaguchi, M. [Takasaki Advanced Radiation Research Institute, Japan Atomic Energy Agency (JAEA), 1233 Watanuki, Takasaki, Gunma 370-1292 (Japan)

2014-07-01

Radiocesium from the severe accident at the Fukushima Dai-ichi Nuclear Power Plant on 11 March 2011 contaminates large areas. After this, a doubt for forest products, especially of mushroom, is indelible at the areas. Pruned woody parts and litters are containing a considerable amount of radiocesium, and generates a problem at incineration and composting. These mean that more attentive survey for each subject is expected; however, the present survey system is highly laborious/expensive and/or non-effective for this purpose. On the other hand, we can see a glass-badge based gamma radiation dose rate detection system. This system always utilized to detect a personal cumulative radiation dose, and thus, it is not suitable to separate a radiation from a specific object. However, if we can separate a radiation from a specific object and relate it with the own radiocesium concentration, it would enable us to presume the specific concentration with just an easy monitoring but without a destruction of the target nature and a complicated process including sampling, pre-treatment, and detection. Here, we present the concept of the measurement and results of the trials. First, we set glass-badges (type FS, Chiyoda Technol Corp., Japan) on a part of bough (approximately 10 cm in diameter) of Japanese flowering cherry trees (Prunus x yedoensis cv. Somei-Yoshino) with four different settings: A, a direct setting without any shield; B, a setting with an aluminum shield between bough and the glass-badge; C, a setting with a lead shield between bough and the glass-badge; D, a setting with a lead shield covering the glass-badge to shut the radiation from the surrounding but from bough. The deduction between the amount of each setting should separate a specific radiation of the bough from unlimited radiation from the surrounding. Even if the hourly dose rate is not enough to count the difference, a moderate cumulative dose would clear the difference. In fact, results demonstrated a

The cumulative load of depressive illness is associated with cognitive function in the remitted state of unipolar depressive disorder

DEFF Research Database (Denmark)

Hasselbalch, Jacob; Knorr, U; Hasselbalch, S G

2013-01-01

OBJECTIVE: To investigate whether the cumulative number, duration and subtypes (severity and presence of psychotic features) of previous episodes of depression in patients with unipolar depressive disorder in a remitted state are associated with decreased global cognitive function. METHODS: Via t...

Second primary pancreatic ductal carcinoma in the remnant pancreas after pancreatectomy for pancreatic ductal carcinoma: High cumulative incidence rates at 5 years after pancreatectomy.

Science.gov (United States)

Ishida, Jun; Toyama, Hirochika; Matsumoto, Ippei; Asari, Sadaki; Goto, Tadahiro; Terai, Sachio; Nanno, Yoshihide; Yamashita, Azusa; Mizumoto, Takuya; Ueda, Yuki; Kido, Masahiro; Ajiki, Tetsuo; Fukumoto, Takumi; Ku, Yonson

2016-01-01

The aim of this study was to determine the incidence rate and clinical features of second primary pancreatic ductal carcinoma (SPPDC) in the remnant pancreas after pancreatectomy for pancreatic ductal carcinoma (PDC). Data of patients undergoing R0 resection for PDC at a single high-volume center were reviewed. SPPDC was defined as a tumor in the remnant pancreas after R0 resection for PDC, and SPPDC met at least one of the following conditions: 1) the time interval between initial pancreatectomy and development of a new tumor was 3 years or more; 2) the new tumor was not located in contact with the pancreatic stump. We investigated the clinical features and treatment outcomes of patients with SPPDC. This study included 130 patients who underwent surgical resection for PDC between 2005 and 2014. Six (4.6%) patients developed SPPDC. The cumulative 3- and 5-year incidence rates were 3.1% and 17.7%, respectively. Four patients underwent remnant pancreatectomy for SPPDC. They were diagnosed with the disease in stage IIA or higher and developed recurrence within 6 months after remnant pancreatectomy. One patient received carbon ion radiotherapy and survived 45 months. One patient refused treatment and died 19 months after the diagnosis of SPPDC. The incidence rate of SPPDC is not negligible, and the cumulative 5-year incidence rate of SPPDC is markedly high. Post-operative surveillance of the remnant pancreas is critical for the early detection of SPPDC, even in long-term survivors after PDC resection. Copyright © 2016 IAP and EPC. Published by Elsevier B.V. All rights reserved.

Unified framework for triaxial accelerometer-based fall event detection and classification using cumulants and hierarchical decision tree classifier.

Science.gov (United States)

Kambhampati, Satya Samyukta; Singh, Vishal; Manikandan, M Sabarimalai; Ramkumar, Barathram

2015-08-01

In this Letter, the authors present a unified framework for fall event detection and classification using the cumulants extracted from the acceleration (ACC) signals acquired using a single waist-mounted triaxial accelerometer. The main objective of this Letter is to find suitable representative cumulants and classifiers in effectively detecting and classifying different types of fall and non-fall events. It was discovered that the first level of the proposed hierarchical decision tree algorithm implements fall detection using fifth-order cumulants and support vector machine (SVM) classifier. In the second level, the fall event classification algorithm uses the fifth-order cumulants and SVM. Finally, human activity classification is performed using the second-order cumulants and SVM. The detection and classification results are compared with those of the decision tree, naive Bayes, multilayer perceptron and SVM classifiers with different types of time-domain features including the second-, third-, fourth- and fifth-order cumulants and the signal magnitude vector and signal magnitude area. The experimental results demonstrate that the second- and fifth-order cumulant features and SVM classifier can achieve optimal detection and classification rates of above 95%, as well as the lowest false alarm rate of 1.03%.

32 CFR 651.16 - Cumulative impacts.

Science.gov (United States)

2010-07-01

... 32 National Defense 4 2010-07-01 2010-07-01 true Cumulative impacts. 651.16 Section 651.16... § 651.16 Cumulative impacts. (a) NEPA analyses must assess cumulative effects, which are the impact on the environment resulting from the incremental impact of the action when added to other past, present...

Burden of Mental Illness and Non-communicable Diseases and Risk Factors for Mental Illness Among Refugees in Buffalo, NY, 2004-2014.

Science.gov (United States)

Mulugeta, Wudeneh; Xue, Hong; Glick, Myron; Min, Jungwon; Noe, Michael F; Wang, Youfa

2018-05-21

Limited is known about mental illness and non-communicable diseases (NCDs) and their risk factors among refugees. These were studied using data collected from a refugee population in Buffalo, NY. Longitudinal data collected on 1055 adults (> 18 years) at a large refugee health center in Buffalo, NY, during 2004-2014 were used. Main outcomes were hypertension, diabetes, tobacco use, obesity, overweight/obesity, and mental illness. Risk factors were assessed using multivariate regression models. Compared to those without mental illness, refugees with mental illness had higher rates of hypertension (16.9 vs 28.4%, P mental illness (25.4 to 36.7%, P mental illness (13.0 to 24.5%, P mental illness prevalence among refugees was 16%, ranging from 6.9% among Asians to 43.9% among Cubans. Women were more likely to have mental illness (odds ratio = 2.45; 95% confidence interval [CI] = 1.68-3.58) than men. Refugees who lived longer in the USA were more likely to carry psychiatric diagnoses (OR = 1.12; 95% CI = 1.04-1.21). Mental illness rates varied considerably across various refugee groups. Rates of obesity and NCDs among refugees with mental illness were higher than among those without mental disorders. Gender, region of origin, and length of stay in the USA were associated with mental illness. Accurate and culturally sensitive screenings and assessments of mental illness are needed to reduce these health disparities.

Psychiatric disorders and leukocyte telomere length: Underlying mechanisms linking mental illness with cellular aging.

Science.gov (United States)

Lindqvist, Daniel; Epel, Elissa S; Mellon, Synthia H; Penninx, Brenda W; Révész, Dóra; Verhoeven, Josine E; Reus, Victor I; Lin, Jue; Mahan, Laura; Hough, Christina M; Rosser, Rebecca; Bersani, F Saverio; Blackburn, Elizabeth H; Wolkowitz, Owen M

2015-08-01

Many psychiatric illnesses are associated with early mortality and with an increased risk of developing physical diseases that are more typically seen in the elderly. Moreover, certain psychiatric illnesses may be associated with accelerated cellular aging, evidenced by shortened leukocyte telomere length (LTL), which could underlie this association. Shortened LTL reflects a cell's mitotic history and cumulative exposure to inflammation and oxidation as well as the availability of telomerase, a telomere-lengthening enzyme. Critically short telomeres can cause cells to undergo senescence, apoptosis or genomic instability, and shorter LTL correlates with poorer health and predicts mortality. Emerging data suggest that LTL may be reduced in certain psychiatric illnesses, perhaps in proportion to exposure to the psychiatric illnesses, although conflicting data exist. Telomerase has been less well characterized in psychiatric illnesses, but a role in depression and in antidepressant and neurotrophic effects has been suggested by preclinical and clinical studies. In this article, studies on LTL and telomerase activity in psychiatric illnesses are critically reviewed, potential mediators are discussed, and future directions are suggested. A deeper understanding of cellular aging in psychiatric illnesses could lead to re-conceptualizing them as systemic illnesses with manifestations inside and outside the brain and could identify new treatment targets. Copyright © 2015 Elsevier Ltd. All rights reserved.

Cumulative childhood stress and autoimmune diseases in adults.

Science.gov (United States)

Dube, Shanta R; Fairweather, DeLisa; Pearson, William S; Felitti, Vincent J; Anda, Robert F; Croft, Janet B

2009-02-01

To examine whether childhood traumatic stress increased the risk of developing autoimmune diseases as an adult. Retrospective cohort study of 15,357 adult health maintenance organization members enrolled in the Adverse Childhood Experiences (ACEs) Study from 1995 to 1997 in San Diego, California, and eligible for follow-up through 2005. ACEs included childhood physical, emotional, or sexual abuse; witnessing domestic violence; growing up with household substance abuse, mental illness, parental divorce, and/or an incarcerated household member. The total number of ACEs (ACE Score range = 0-8) was used as a measure of cumulative childhood stress. The outcome was hospitalizations for any of 21 selected autoimmune diseases and 4 immunopathology groupings: T- helper 1 (Th1) (e.g., idiopathic myocarditis); T-helper 2 (Th2) (e.g., myasthenia gravis); Th2 rheumatic (e.g., rheumatoid arthritis); and mixed Th1/Th2 (e.g., autoimmune hemolytic anemia). Sixty-four percent reported at least one ACE. The event rate (per 10,000 person-years) for a first hospitalization with any autoimmune disease was 31.4 in women and 34.4 in men. First hospitalizations for any autoimmune disease increased with increasing number of ACEs (p or=2 ACEs were at a 70% increased risk for hospitalizations with Th1, 80% increased risk for Th2, and 100% increased risk for rheumatic diseases (p Childhood traumatic stress increased the likelihood of hospitalization with a diagnosed autoimmune disease decades into adulthood. These findings are consistent with recent biological studies on the impact of early life stress on subsequent inflammatory responses.

Divergent Cumulative Cultural Evolution

OpenAIRE

Marriott, Chris; Chebib, Jobran

2016-01-01

Divergent cumulative cultural evolution occurs when the cultural evolutionary trajectory diverges from the biological evolutionary trajectory. We consider the conditions under which divergent cumulative cultural evolution can occur. We hypothesize that two conditions are necessary. First that genetic and cultural information are stored separately in the agent. Second cultural information must be transferred horizontally between agents of different generations. We implement a model with these ...

Cumulative trauma and partner conflict predict post-traumatic stress disorder in postpartum African-American women.

Science.gov (United States)

Hauff, Nancy J; Fry-McComish, Judith; Chiodo, Lisa M

2017-08-01

To describe relationships between cumulative trauma, partner conflict and post-traumatic stress in African-American postpartum women. Cumulative trauma exposure estimates for women in the USA range from 51-69%. During pregnancy, most trauma research has focused on physical injury to the mother. Post-traumatic stress disorder (PTSD) is associated with trauma and more prevalent in African-American women than women of other groups. Knowledge about both the rate and impact of cumulative trauma on pregnancy may contribute to our understanding of women seeking prenatal care, and disparities in infant morbidity and mortality. This retrospective, correlational, cross-sectional study took place on postpartum units of two Detroit hospitals. Participants were 150 African-American women aged between 18-45 who had given birth. Mothers completed the Cumulative Trauma Scale, Conflict Tactics Scale, Clinician Administered Post-traumatic Stress Scale, Edinburgh Postnatal Depression Scale and a Demographic Data form. Descriptive statistics, correlations and multiple regressions were used for data analysis. All participants reported at least one traumatic event in their lifetime. Cumulative trauma and partner conflict predicted PTSD, with the trauma of a life-threatening event for a loved one reported by 60% of the sample. Nearly, one-fourth of the women screened were at risk for PTSD. Increased cumulative trauma, increased partner conflict and lower level of education were related to higher rates of PTSD symptoms. Both cumulative trauma and partner conflict in the past year predict PTSD. Reasoning was used most often for partner conflict resolution. The results of this study offer additional knowledge regarding relationships between cumulative trauma, partner conflict and PTSD in African-American women. Healthcare providers need to be sensitive to patient life-threatening events, personal failures, abuse and other types of trauma. Current evidence supports the need to assess for

Convergence rates and finite-dimensional approximations for nonlinear ill-posed problems involving monotone operators in Banach spaces

International Nuclear Information System (INIS)

Nguyen Buong.

1992-11-01

The purpose of this paper is to investigate convergence rates for an operator version of Tikhonov regularization constructed by dual mapping for nonlinear ill-posed problems involving monotone operators in real reflective Banach spaces. The obtained results are considered in combination with finite-dimensional approximations for the space. An example is considered for illustration. (author). 15 refs

[How do mentally ill parents evaluate their children's quality of life? Associations with the parent's illness and family functioning].

Science.gov (United States)

Pollak, Eva; Bullinger, Monika; Jeske, Jana; Wiegand-Grefe, Silke

2008-01-01

To assess health-related quality of life (hrQoL) of children with a mentally ill parent, and its associations with the parent's illness (diagnoses, severity of disease, current symptoms) and family functioning, 51 mentally ill parents rated their children's hrQoL using the KINDL-R, a multidimensional hrQoL questionnaire for children. Parents rated their current psychiatric symptoms on the SCL-14 (Symptom Checklist-14) and family functioning on the FB-A ("Familienbögen"). The parents' therapists (psychologists or psychiatrists) provided psychiatric diagnoses as well as global ratings of disease severity (CGI) and patient's family functioning. Compared to the general population, parents rated their children's hrQoL significantly lower concerning the dimensions "Psychological Well-Being" and "Family': HrQoL ratings were moderately correlated with the parent's current depressive symptoms and moderately to highly correlated with family functioning from the parent's perspective. Lower depression severity and higher family functioning were associated with higher hrQoL ratings. Parents with affective disorders rated their children's hrQoL significantly lower than did parents with a diagnosis of substance abuse. Results show the importance of family functioning for parents' view of children's hrQoL and the influence of psychiatric symptoms on ill parents' reports. These findings are in line with previous results concerning potential psychological and behavioural problems in children of mentally ill parents. Family interventions and multi-informant assessment should be used in this high-risk group.

Anxiety in Medically Ill Children/Adolescents

OpenAIRE

Pao, Maryland; Bosk, Abigail

2010-01-01

Anxiety disorders are thought to be one of the most common psychiatric diagnoses in children/adolescents. Chronic medical illness is a significant risk factor for the development of an anxiety disorder and the prevalence rate of anxiety disorders among youths with chronic medical illnesses is higher compared to their healthy counterparts. Anxiety disorders may develop secondary to predisposing biological mechanisms related to a child’s specific medical illness, as a response to being ill or i...

The illness/non-illness model: hypnotherapy for physically ill patients.

Science.gov (United States)

Navon, Shaul

2014-07-01

This article proposes a focused, novel sub-set of the cognitive behavioral therapy approach to hypnotherapy for physically ill patients, based upon the illness/non-illness psychotherapeutic model for physically ill patients. The model is based on three logical rules used in differentiating illness from non-illness: duality, contradiction, and complementarity. The article discusses the use of hypnotic interventions to help physically ill and/or disabled patients distinguish between illness and non-illness in their psychotherapeutic themes and attitudes. Two case studies illustrate that patients in this special population group can be taught to learn the language of change and to use this language to overcome difficult situations. The model suggests a new clinical mode of treatment in which individuals who are physically ill and/or disabled are helped in coping with actual motifs and thoughts related to non-illness or non-disability.

Somali Refugees' Perceptions of Mental Illness.

Science.gov (United States)

Bettmann, Joanna E; Penney, Deb; Clarkson Freeman, Pamela; Lecy, Natalie

2015-01-01

Nearly 13% of the U.S. population is comprised of foreign-born individuals, with Somalis constituting one of the largest resettled groups. Research suggests that, among Somali refugees, rates of mental illness are high. Yet research shows Somalis underutilize mental health services. Understanding their perceptions of mental illness and its cures may help practitioners to design more effective treatments for this population. Thus, this pilot study investigated Somali refugees' perceptions of mental illness and its treatments. Using purposive sampling, this qualitative study interviewed 20 Somali refugees using a semi-structured interview guide. Qualitative analysis yielded participants' perceptions of mental illness through their descriptions of physical symptoms accompanying mental illness, the stigma of mental illness, causes of mental illness, medical and non-medical treatments for mental illness, spirit possession causing mental illness, and the Qur'an as treatment for mental illness. Such information may help practitioners in the United States approach Somali clients in the most culturally coherent manner.

Cumulative risk, cumulative outcome: a 20-year longitudinal study.

Directory of Open Access Journals (Sweden)

Leslie Atkinson

Full Text Available Cumulative risk (CR models provide some of the most robust findings in the developmental literature, predicting numerous and varied outcomes. Typically, however, these outcomes are predicted one at a time, across different samples, using concurrent designs, longitudinal designs of short duration, or retrospective designs. We predicted that a single CR index, applied within a single sample, would prospectively predict diverse outcomes, i.e., depression, intelligence, school dropout, arrest, smoking, and physical disease from childhood to adulthood. Further, we predicted that number of risk factors would predict number of adverse outcomes (cumulative outcome; CO. We also predicted that early CR (assessed at age 5/6 explains variance in CO above and beyond that explained by subsequent risk (assessed at ages 12/13 and 19/20. The sample consisted of 284 individuals, 48% of whom were diagnosed with a speech/language disorder. Cumulative risk, assessed at 5/6-, 12/13-, and 19/20-years-old, predicted aforementioned outcomes at age 25/26 in every instance. Furthermore, number of risk factors was positively associated with number of negative outcomes. Finally, early risk accounted for variance beyond that explained by later risk in the prediction of CO. We discuss these findings in terms of five criteria posed by these data, positing a "mediated net of adversity" model, suggesting that CR may increase some central integrative factor, simultaneously augmenting risk across cognitive, quality of life, psychiatric and physical health outcomes.

Secant cumulants and toric geometry

NARCIS (Netherlands)

Michalek, M.; Oeding, L.; Zwiernik, P.W.

2012-01-01

We study the secant line variety of the Segre product of projective spaces using special cumulant coordinates adapted for secant varieties. We show that the secant variety is covered by open normal toric varieties. We prove that in cumulant coordinates its ideal is generated by binomial quadrics. We

Cumulative keyboard strokes: a possible risk factor for carpal tunnel syndrome

Directory of Open Access Journals (Sweden)

Eleftheriou Andreas

2012-08-01

Full Text Available Abstract Background Contradictory reports have been published regarding the association of Carpal Tunnel Syndrome (CTS and the use of computer keyboard. Previous studies did not take into account the cumulative exposure to keyboard strokes among computer workers. The aim of the present study was to investigate the association between cumulative keyboard use (keyboard strokes and CTS. Methods Employees (461 from a Governmental data entry & processing unit agreed to participate (response rate: 84.1 % in a cross-sectional study. Α questionnaire was distributed to the participants to obtain information on socio-demographics and risk factors for CTS. The participants were examined for signs and symptoms related to CTS and were asked if they had previous history or surgery for CTS. The cumulative amount of the keyboard strokes per worker per year was calculated by the use of payroll’s registry. Two case definitions for CTS were used. The first included subjects with personal history/surgery for CTS while the second included subjects that belonged to the first case definition plus those participants were identified through clinical examination. Results Multivariate analysis used for both case definitions, indicated that those employees with high cumulative exposure to keyboard strokes were at increased risk of CTS (case definition A: OR = 2.23;95 % CI = 1.09-4.52 and case definition B: OR = 2.41; 95%CI = 1.36-4.25. A dose response pattern between cumulative exposure to keyboard strokes and CTS has been revealed (p  Conclusions The present study indicated a possible association between cumulative exposure to keyboard strokes and development of CTS. Cumulative exposure to key-board strokes would be taken into account as an exposure indicator regarding exposure assessment of computer workers. Further research is needed in order to test the results of the current study and assess causality between cumulative keyboard strokes and

Mental Illness and Mental Healthcare Receipt among Hospitalized Veterans with Serious Physical Illnesses.

Science.gov (United States)

Garrido, Melissa M; Prigerson, Holly G; Neupane, Suvam; Penrod, Joan D; Johnson, Christopher E; Boockvar, Kenneth S

2017-03-01

Psychosocial distress among patients with limited life expectancy influences treatment decisions, treatment adherence, and physical health. Veterans may be at elevated risk of psychosocial distress at the end of life, and understanding their mental healthcare needs may help identify hospitalized patients to whom psychiatric services should be targeted. To examine mental illness prevalence and mental health treatment rates among a national sample of hospitalized veterans with serious physical illnesses. Design, Subjects, and Measurements: This was a retrospective study of 11,286 veterans hospitalized in a Veterans Health Administration acute care facility in fiscal year 2011 with diagnoses of advanced cancer, congestive heart failure, chronic obstructive pulmonary disease, and/or advanced HIV/AIDS. Prevalent and incident mental illness diagnoses during and before hospitalization and rates of psychotherapy and psychotropic use among patients with incident depression and anxiety were measured. At least one-quarter of the patients in our sample had a mental illness or substance use disorder. The most common diagnoses at hospitalization were depression (11.4%), followed by alcohol abuse or dependence (5.5%), and post-traumatic stress disorder (4.9%). Of the 831 patients with incident past-year depression and 258 with incident past-year anxiety, nearly two-thirds received at least some psychotherapy or guideline-concordant medication within 90 days of diagnosis. Of 191 patients with incident depression and 47 with incident anxiety at time of hospitalization, fewer than half received mental healthcare before discharge. Many veterans hospitalized with serious physical illnesses have comorbid mental illnesses and may benefit from depression and anxiety treatment.

Measurement invariance of the Illness Intrusiveness Ratings Scale's three-factor structure in men and women with cancer.

Science.gov (United States)

Mah, Kenneth; Bezjak, Andrea; Loblaw, D Andrew; Gotowiec, Andrew; Devins, Gerald M

2011-02-01

Illness- and treatment-related disruptions to valued activities and interests (illness intrusiveness) are central to quality of life in chronic disease and are captured by three subscales of the Illness Intrusiveness Ratings Scale (IIRS): the Instrumental, Intimacy, and Relationships and Personal Development subscales. Using individual (CFA) and multisample confirmatory factor analyses (MSCFA), we evaluated measurement invariance of the IIRS's 3-factor structure in men and women with cancer. Men (n = 210) and women (n = 206) with 1 of 4 cancer diagnoses (gastrointestinal, head and neck, lymphoma, lung) recruited from outpatient clinics completed the IIRS. In the MSCFA, we applied an analysis of means and covariance structures approach to test increasingly stringent equality constraints on factor structure parameters to evaluate weak, strong, and strict measurement invariance of the 3-factor structure between men and women. Individual CFAs demonstrated fit of the hypothesized 3-factor structure for men and women, although more consistently for men. The 3-factor structure was superior to an alternative 1-factor structure. MSCFA results indicated that parameters of the 3-factor structure could be considered equivalent between the sexes up to the level of strong invariance. Strict invariance was not supported. Overall, IIRS scores can be interpreted similarly for men and women with cancer. Illness intrusiveness can be considered as important in the psychosocial adaptation of people with cancer as it is for people affected by other chronic conditions. (c) 2011 APA, all rights reserved

Using Marginal Structural Modeling to Estimate the Cumulative Impact of an Unconditional Tax Credit on Self-Rated Health.

Science.gov (United States)

Pega, Frank; Blakely, Tony; Glymour, M Maria; Carter, Kristie N; Kawachi, Ichiro

2016-02-15

In previous studies, researchers estimated short-term relationships between financial credits and health outcomes using conventional regression analyses, but they did not account for time-varying confounders affected by prior treatment (CAPTs) or the credits' cumulative impacts over time. In this study, we examined the association between total number of years of receiving New Zealand's Family Tax Credit (FTC) and self-rated health (SRH) in 6,900 working-age parents using 7 waves of New Zealand longitudinal data (2002-2009). We conducted conventional linear regression analyses, both unadjusted and adjusted for time-invariant and time-varying confounders measured at baseline, and fitted marginal structural models (MSMs) that more fully adjusted for confounders, including CAPTs. Of all participants, 5.1%-6.8% received the FTC for 1-3 years and 1.8%-3.6% for 4-7 years. In unadjusted and adjusted conventional regression analyses, each additional year of receiving the FTC was associated with 0.033 (95% confidence interval (CI): -0.047, -0.019) and 0.026 (95% CI: -0.041, -0.010) units worse SRH (on a 5-unit scale). In the MSMs, the average causal treatment effect also reflected a small decrease in SRH (unstabilized weights: β = -0.039 unit, 95% CI: -0.058, -0.020; stabilized weights: β = -0.031 unit, 95% CI: -0.050, -0.007). Cumulatively receiving the FTC marginally reduced SRH. Conventional regression analyses and MSMs produced similar estimates, suggesting little bias from CAPTs. © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Cumulative burden of comorbid mental disorders, substance use disorders, chronic medical conditions, and poverty on health among adults in the U.S.A.

Science.gov (United States)

Walker, Elizabeth Reisinger; Druss, Benjamin G

2017-07-01

The health of individuals in the U.S.A. is increasingly being defined by complexity and multimorbidity. We examined the patterns of co-occurrence of mental illness, substance abuse/dependence, and chronic medical conditions and the cumulative burden of these conditions and living in poverty on self-rated health. We conducted a secondary data analysis using publically-available data from the National Survey on Drug Use and Health (NSDUH), which is an annual nationally-representative survey. Pooled data from the 2010-2012 NSDUH surveys included 115,921 adults 18 years of age or older. The majority of adults (52.2%) had at least one type of condition (mental illness, substance abuse/dependence, or chronic medical conditions), with substantial overlap across the conditions. 1.2%, or 2.2 million people, reported all three conditions. Generally, as the number of conditions increased, the odds of reporting worse health also increased. The likelihood of reporting fair/poor health was greatest for people who reported AMI, chronic medical conditions, and poverty (AOR = 9.41; 95% CI: 7.53-11.76), followed by all three conditions and poverty (AOR = 9.32; 95% CI: 6.67-13.02). For each combination of conditions, the addition of poverty increased the likelihood of reporting fair/poor health. Traditional conceptualizations of multimorbidity should be expanded to take into account the complexities of co-occurrence between mental illnesses, chronic medical conditions, and socioeconomic factors.

Cumulative Culture and Future Thinking: Is Mental Time Travel a Prerequisite to Cumulative Cultural Evolution?

Science.gov (United States)

Vale, G. L.; Flynn, E. G.; Kendal, R. L.

2012-01-01

Cumulative culture denotes the, arguably, human capacity to build on the cultural behaviors of one's predecessors, allowing increases in cultural complexity to occur such that many of our cultural artifacts, products and technologies have progressed beyond what a single individual could invent alone. This process of cumulative cultural evolution…

Preference, resistance to change, and the cumulative decision model.

Science.gov (United States)

Grace, Randolph C

2018-01-01

According to behavioral momentum theory (Nevin & Grace, 2000a), preference in concurrent chains and resistance to change in multiple schedules are independent measures of a common construct representing reinforcement history. Here I review the original studies on preference and resistance to change in which reinforcement variables were manipulated parametrically, conducted by Nevin, Grace and colleagues between 1997 and 2002, as well as more recent research. The cumulative decision model proposed by Grace and colleagues for concurrent chains is shown to provide a good account of both preference and resistance to change, and is able to predict the increased sensitivity to reinforcer rate and magnitude observed with constant-duration components. Residuals from fits of the cumulative decision model to preference and resistance to change data were positively correlated, supporting the prediction of behavioral momentum theory. Although some questions remain, the learning process assumed by the cumulative decision model, in which outcomes are compared against a criterion that represents the average outcome value in the current context, may provide a plausible model for the acquisition of differential resistance to change. © 2018 Society for the Experimental Analysis of Behavior.

A pore structure model for the gas transport property changes, initial oxidation rates and cumulative weight loss of AGR moderator graphite

International Nuclear Information System (INIS)

Johnson, P.A.V.

1985-09-01

A quantitative model has been developed for the gas transport property variation, cumulative weight loss and initial oxidation rates of AGR moderator graphite. The model utilises the theory of dynamic moments of the pore structure to calculate the changes in physical properties brought about by radiolytic corrosion taking place within the graphite porosity. In order to account for the behaviour of the initial rate curves, and the weight loss data obtained it is necessary to invoke the presence of a group of cylindrical pore and a group of small slab-shaped pores. The latter are methane depleted. This is in addition to the pore group involved in gas transport which is best represented by cylinders of mean radius 2.13 μm. The model satisfactorily predicts the experimental weight loss data obtained from experiments in the DIDO 6V3 and BFB loops. (author)

System-Reliability Cumulative-Binomial Program

Science.gov (United States)

Scheuer, Ernest M.; Bowerman, Paul N.

1989-01-01

Cumulative-binomial computer program, NEWTONP, one of set of three programs, calculates cumulative binomial probability distributions for arbitrary inputs. NEWTONP, CUMBIN (NPO-17555), and CROSSER (NPO-17557), used independently of one another. Program finds probability required to yield given system reliability. Used by statisticians and users of statistical procedures, test planners, designers, and numerical analysts. Program written in C.

Cumulative human impacts on marine predators.

Science.gov (United States)

Maxwell, Sara M; Hazen, Elliott L; Bograd, Steven J; Halpern, Benjamin S; Breed, Greg A; Nickel, Barry; Teutschel, Nicole M; Crowder, Larry B; Benson, Scott; Dutton, Peter H; Bailey, Helen; Kappes, Michelle A; Kuhn, Carey E; Weise, Michael J; Mate, Bruce; Shaffer, Scott A; Hassrick, Jason L; Henry, Robert W; Irvine, Ladd; McDonald, Birgitte I; Robinson, Patrick W; Block, Barbara A; Costa, Daniel P

2013-01-01

Stressors associated with human activities interact in complex ways to affect marine ecosystems, yet we lack spatially explicit assessments of cumulative impacts on ecologically and economically key components such as marine predators. Here we develop a metric of cumulative utilization and impact (CUI) on marine predators by combining electronic tracking data of eight protected predator species (n=685 individuals) in the California Current Ecosystem with data on 24 anthropogenic stressors. We show significant variation in CUI with some of the highest impacts within US National Marine Sanctuaries. High variation in underlying species and cumulative impact distributions means that neither alone is sufficient for effective spatial management. Instead, comprehensive management approaches accounting for both cumulative human impacts and trade-offs among multiple stressors must be applied in planning the use of marine resources.

Effects of cumulative trauma load on perceptions of health, blood pressure, and resting heart rate in urban African American youth.

Science.gov (United States)

Conner-Warren, Rhonda

2014-04-01

This study examined relationships between cumulative trauma (CT) and urban African American (AA) adolescents' blood pressure (BP), heart rate (HR), and perceptions of health. A correlational design using secondary data analysis studied effects of CT, health outcomes, and perceptions of health. Participants were 175 urban AA youth (11-16 years) who completed structured surveys and physiological measures of HR and BP before and after exercise. AA youth were experiencing high levels of CT. Negative correlations were obtained between AA females' perceptions of their health and systolic BP with levels of trauma. No gender differences were found in HR or BP. AA females with high CT may perceive themselves as less healthy and can be at risk for health problems. © 2014, Wiley Periodicals, Inc.

Foodborne illness incidence rates and food safety risks for populations of low socioeconomic status and minority race/ethnicity: a review of the literature.

Science.gov (United States)

Quinlan, Jennifer J

2013-08-15

While foodborne illness is not traditionally tracked by race, ethnicity or income, analyses of reported cases have found increased rates of some foodborne illnesses among minority racial/ethnic populations. In some cases (Listeria, Yersinia) increased rates are due to unique food consumption patterns, in other cases (Salmonella, Shigella, Campylobacter) it is unclear why this health disparity exists. Research on safe food handling knowledge and behaviors among low income and minority consumers suggest that there may be a need to target safe food handling messages to these vulnerable populations. Another possibility is that these populations are receiving food that is less safe at the level of the retail outlet or foodservice facility. Research examining the quality and safety of food available at small markets in the food desert environment indicates that small corner markets face unique challenges which may affect the quality and potential safety of perishable food. Finally, a growing body of research has found that independent ethnic foodservice facilities may present increased risks for foodborne illness. This review of the literature will examine the current state of what is known about foodborne illness among, and food safety risks for, minority and low socioeconomic populations, with an emphasis on the United States and Europe.

Foodborne Illness Incidence Rates and Food Safety Risks for Populations of Low Socioeconomic Status and Minority Race/Ethnicity: A Review of the Literature

Directory of Open Access Journals (Sweden)

Jennifer J. Quinlan

2013-08-01

Full Text Available While foodborne illness is not traditionally tracked by race, ethnicity or income, analyses of reported cases have found increased rates of some foodborne illnesses among minority racial/ethnic populations. In some cases (Listeria, Yersinia increased rates are due to unique food consumption patterns, in other cases (Salmonella, Shigella, Campylobacter it is unclear why this health disparity exists. Research on safe food handling knowledge and behaviors among low income and minority consumers suggest that there may be a need to target safe food handling messages to these vulnerable populations. Another possibility is that these populations are receiving food that is less safe at the level of the retail outlet or foodservice facility. Research examining the quality and safety of food available at small markets in the food desert environment indicates that small corner markets face unique challenges which may affect the quality and potential safety of perishable food. Finally, a growing body of research has found that independent ethnic foodservice facilities may present increased risks for foodborne illness. This review of the literature will examine the current state of what is known about foodborne illness among, and food safety risks for, minority and low socioeconomic populations, with an emphasis on the United States and Europe.

Common-Reliability Cumulative-Binomial Program

Science.gov (United States)

Scheuer, Ernest, M.; Bowerman, Paul N.

1989-01-01

Cumulative-binomial computer program, CROSSER, one of set of three programs, calculates cumulative binomial probability distributions for arbitrary inputs. CROSSER, CUMBIN (NPO-17555), and NEWTONP (NPO-17556), used independently of one another. Point of equality between reliability of system and common reliability of components found. Used by statisticians and users of statistical procedures, test planners, designers, and numerical analysts. Program written in C.

Cumulative effects assessment: Does scale matter?

International Nuclear Information System (INIS)

Therivel, Riki; Ross, Bill

2007-01-01

Cumulative effects assessment (CEA) is (or should be) an integral part of environmental assessment at both the project and the more strategic level. CEA helps to link the different scales of environmental assessment in that it focuses on how a given receptor is affected by the totality of plans, projects and activities, rather than on the effects of a particular plan or project. This article reviews how CEAs consider, and could consider, scale issues: spatial extent, level of detail, and temporal issues. It is based on an analysis of Canadian project-level CEAs and UK strategic-level CEAs. Based on a review of literature and, especially, case studies with which the authors are familiar, it concludes that scale issues are poorly considered at both levels, with particular problems being unclear or non-existing cumulative effects scoping methodologies; poor consideration of past or likely future human activities beyond the plan or project in question; attempts to apportion 'blame' for cumulative effects; and, at the plan level, limited management of cumulative effects caused particularly by the absence of consent regimes. Scale issues are important in most of these problems. However both strategic-level and project-level CEA have much potential for managing cumulative effects through better siting and phasing of development, demand reduction and other behavioural changes, and particularly through setting development consent rules for projects. The lack of strategic resource-based thresholds constrains the robust management of strategic-level cumulative effects

Cumulative cultural learning: Development and diversity

Science.gov (United States)

2017-01-01

The complexity and variability of human culture is unmatched by any other species. Humans live in culturally constructed niches filled with artifacts, skills, beliefs, and practices that have been inherited, accumulated, and modified over generations. A causal account of the complexity of human culture must explain its distinguishing characteristics: It is cumulative and highly variable within and across populations. I propose that the psychological adaptations supporting cumulative cultural transmission are universal but are sufficiently flexible to support the acquisition of highly variable behavioral repertoires. This paper describes variation in the transmission practices (teaching) and acquisition strategies (imitation) that support cumulative cultural learning in childhood. Examining flexibility and variation in caregiver socialization and children’s learning extends our understanding of evolution in living systems by providing insight into the psychological foundations of cumulative cultural transmission—the cornerstone of human cultural diversity. PMID:28739945

Cumulative cultural learning: Development and diversity.

Science.gov (United States)

Legare, Cristine H

2017-07-24

The complexity and variability of human culture is unmatched by any other species. Humans live in culturally constructed niches filled with artifacts, skills, beliefs, and practices that have been inherited, accumulated, and modified over generations. A causal account of the complexity of human culture must explain its distinguishing characteristics: It is cumulative and highly variable within and across populations. I propose that the psychological adaptations supporting cumulative cultural transmission are universal but are sufficiently flexible to support the acquisition of highly variable behavioral repertoires. This paper describes variation in the transmission practices (teaching) and acquisition strategies (imitation) that support cumulative cultural learning in childhood. Examining flexibility and variation in caregiver socialization and children's learning extends our understanding of evolution in living systems by providing insight into the psychological foundations of cumulative cultural transmission-the cornerstone of human cultural diversity.

Cumulative emission budgets and their implications: the case for SAFE carbon

Science.gov (United States)

Allen, Myles; Bowerman, Niel; Frame, David; Mason, Charles

2010-05-01

The risk of dangerous long-term climate change due to anthropogenic carbon dioxide emissions is predominantly determined by cumulative emissions over all time, not the rate of emission in any given year or commitment period. This has profound implications for climate mitigation policy: emission targets for specific years such as 2020 or 2050 provide no guarantee of meeting any overall cumulative emission budget. By focusing attention on short-term measures to reduce the flow of emissions, they may even exacerbate the overall long-term stock. Here we consider how climate policies might be designed explicitly to limit cumulative emissions to, for example, one trillion tonnes of carbon, a figure that has been estimated to give a most likely warming of two degrees above pre-industrial, with a likely range of 1.6-2.6 degrees. Three approaches are considered: tradable emission permits with the possibility of indefinite emission banking, carbon taxes explicitly linked to cumulative emissions and mandatory carbon sequestration. Framing mitigation policy around cumulative targets alleviates the apparent tension between climate protection and short-term consumption that bedevils any attempt to forge global agreement. We argue that the simplest and hence potentially the most effective approach might be a mandatory requirement on the fossil fuel industry to ensure that a steadily increasing fraction of fossil carbon extracted from the ground is artificially removed from the active carbon cycle through some form of sequestration. We define Sequestered Adequate Fraction of Extracted (SAFE) carbon as a source in which this sequestered fraction is anchored to cumulative emissions, increasing smoothly to reach 100% before we release the trillionth tonne. While adopting the use of SAFE carbon would increase the cost of fossil energy much as a system of emission permits or carbon taxes would, it could do so with much less explicit government intervention. We contrast this proposal

Steps and Pips in the History of the Cumulative Recorder

Science.gov (United States)

Lattal, Kennon A.

2004-01-01

From its inception in the 1930s until very recent times, the cumulative recorder was the most widely used measurement instrument in the experimental analysis of behavior. It was an essential instrument in the discovery and analysis of schedules of reinforcement, providing the first real-time analysis of operant response rates and patterns. This…

Calculating Cumulative Binomial-Distribution Probabilities

Science.gov (United States)

Scheuer, Ernest M.; Bowerman, Paul N.

1989-01-01

Cumulative-binomial computer program, CUMBIN, one of set of three programs, calculates cumulative binomial probability distributions for arbitrary inputs. CUMBIN, NEWTONP (NPO-17556), and CROSSER (NPO-17557), used independently of one another. Reliabilities and availabilities of k-out-of-n systems analyzed. Used by statisticians and users of statistical procedures, test planners, designers, and numerical analysts. Used for calculations of reliability and availability. Program written in C.

Cumulative human impacts on marine predators

DEFF Research Database (Denmark)

Maxwell, Sara M; Hazen, Elliott L; Bograd, Steven J

2013-01-01

Stressors associated with human activities interact in complex ways to affect marine ecosystems, yet we lack spatially explicit assessments of cumulative impacts on ecologically and economically key components such as marine predators. Here we develop a metric of cumulative utilization and impact...

Estimation of lifetime cumulative incidence and mortality risk of gastric cancer.

Science.gov (United States)

Taniyama, Yukari; Katanoda, Kota; Charvat, Hadrien; Hori, Megumi; Ohno, Yuko; Sasazuki, Shizuka; Tsugane, Shoichiro

2017-11-01

To estimate cumulative incidence and mortality risk for gastric cancer by risk category. Risk was classified into four types according to the presence/absence of Helicobacter pylori infection and chronic atrophic gastritis: in order of lowest to highest risk, Group A: H. pylori(-) and atrophic gastritis(-); Group B: H. pylori(+) and atrophic gastritis(-); Group C:H. pylori(+) and atrophic gastritis(+); and, Group D: H. pylori(-) and atrophic gastritis(+). We used vital statistics for the crude all-cause and crude gastric cancer mortality rates in 2011 and data from population-based cancer registries (the Monitoring of Cancer Incidence in Japan) for gastric cancer incidence in 2011. For relative risk and prevalence, we used the results of a meta-analysis integrating previous studies and data from the Japan Public Health Center-based Prospective Study for the Next Generation, respectively (baseline survey 2011-16). We calculated the crude incidence and mortality rates and estimated the cumulative risk using a life-table method. The estimated lifetime cumulative incidence risk was 11.4% for men and 5.7% for women. The estimated risk for Groups A, B, C and D was 2.4%, 10.8%, 26.7% and 35.5% for men, and 1.2%, 5.5%, 13.5% and 18.0% for women, respectively. Similarly, the estimated lifetime cumulative mortality risk was 3.9% for men and 1.8% for women. The estimated risk of mortality for Groups A, B, C and D was 0.8%, 3.6%, 9.0% and 12.0% for men, and 0.4%, 1.7%, 4.2% and 5.7% for women, respectively. Our results may be useful for designing individually tailored prevention programs. © The Author 2017. Published by Oxford University Press.

An analysis of cumulative risks based on biomonitoring data for six phthalates using the Maximum Cumulative Ratio

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The Maximum Cumulative Ratio (MCR) quantifies the degree to which a single chemical drives the cumulative risk of an individual exposed to multiple chemicals. Phthalates are a class of chemicals with ubiquitous exposures in the general population that have the potential to cause ...

Chapter 19. Cumulative watershed effects and watershed analysis

Science.gov (United States)

Leslie M. Reid

1998-01-01

Cumulative watershed effects are environmental changes that are affected by more than.one land-use activity and that are influenced by.processes involving the generation or transport.of water. Almost all environmental changes are.cumulative effects, and almost all land-use.activities contribute to cumulative effects

An Analysis of Cumulative Risks Indicated by Biomonitoring Data of Six Phthalates Using the Maximum Cumulative Ratio

Science.gov (United States)

The Maximum Cumulative Ratio (MCR) quantifies the degree to which a single component of a chemical mixture drives the cumulative risk of a receptor.1 This study used the MCR, the Hazard Index (HI) and Hazard Quotient (HQ) to evaluate co-exposures to six phthalates using biomonito...

Cumulative effects assessment in Canada: an agenda for action and research

Energy Technology Data Exchange (ETDEWEB)

Peterson, E.B.; Chan, Y.-H.; Peterson, N.M.; Constable, G.A.; Caton, R.B.; Davis, C.S.; Wallace, R.R.; Yarranton, G.A.

1987-01-01

This review of cumulative environmental effects assessment in Canada identified 13 sets of issues that are considered to be of particular significance to Canadians over the next decade or two. They are: long-range transport of air pollutants; urban air quality and airshed saturation, mobilization of persistent or bioaccumulated substances, climatic modification, land occupation by man-made features, habitat alienation and fragmentation, soil losses, effects of agricultural chemicals, groundwater supply reduction and contamination, increased sediment, chemical and thermal loading of freshwater and marine habitats, accelerating rates of renewable resource harvesting, and long-term containment and disposal of toxic wastes. There is a diverse set of examples in which cumulative effects have been recognized and brought under control and management, and the scientific and institutional factors that promoted a successful approach are summarized. It was confirmed that there are well-defined limitations in the degree to which project referrals and project-specific environmental impact assessments can be adapted to manage cumulative effects successfully. In general, this review confirmed the hypothesis that current approaches for both scientific analyses and institutional arrangements to manage cumulative effects remain inadequately developed in Canada. To address this weakness, action is required on improving links between ecosystems, research, and management. Recommendations are made and a research agenda is presented. 171 refs., 5 figs., 2 tabs.

Pharmacoepidemiology of opiate use in the neonatal ICU: Increasing cumulative doses and iatrogenic opiate withdrawal.

Science.gov (United States)

Lewis, Tamorah; Erfe, Betty Luan; Ezell, Tarrah; Gauda, Estelle

2015-01-01

Neonatal intensive care unit (ICU) care involves use of opiates to treat postoperative, ventilated, or chronically ill infants. Opiates provide necessary analgesia and sedation, but the morbidities include prolonged neonatal abstinence syndrome (NAS) and extended length of stay for dose tapering. Our objective was to quantify trends in opiate exposure in a tertiary care NICU. The authors hypothesize that medical opiate exposure and resultant ICU-acquired NAS would increase over time. Retrospective cross-sectional cohort study. Tertiary care NICU. High-risk inborn infants admitted in fiscal years 2003-2004, 2007-2008, and 2010-2011. Average cumulative morphine exposure (all opiate doses converted to morphine equivalents) per time epoch was compared in cohorts of clinically similar infants. Linear regression was used to assess the primary outcome, assessing changes in opiate exposure over time. Sixty-three infants were included in the final analysis. The primary analysis assessing cumulative opiate exposure per infant showed an increase of 134 mg per time epoch (95% CI-12, 279 mg, p-value 0.071). There was a statistically significant increase in the percent of infants with a diagnosis of iatrogenic NAS, increasing from 9 to 35 to 50 percent (p-value 0.012).

Impact of influenza vaccination on respiratory illness rates in children attending private boarding schools in England, 2013-2014: a cohort study.

Science.gov (United States)

Brousseau, N; Green, H K; Andrews, N; Pryse, R; Baguelin, M; Sunderland, A; Ellis, J; Pebody, R

2015-12-01

Several private boarding schools in England have established universal influenza vaccination programmes for their pupils. We evaluated the impact of these programmes on the burden of respiratory illnesses in boarders. Between November 2013 and May 2014, age-specific respiratory disease incidence rates in boarders were compared between schools offering and not offering influenza vaccine to healthy boarders. We adjusted for age, sex, school size and week using negative binomial regression. Forty-three schools comprising 14 776 boarders participated. Almost all boarders (99%) were aged 11-17 years. Nineteen (44%) schools vaccinated healthy boarders against influenza, with a mean uptake of 48·5% (range 14·2-88·5%). Over the study period, 1468 respiratory illnesses were reported in boarders (5·66/1000 boarder-weeks); of these, 33 were influenza-like illnesses (ILIs, 0·26/1000 boarder-weeks) in vaccinating schools and 95 were ILIs (0·74/1000 boarder-weeks) in non-vaccinating schools. The impact of vaccinating healthy boarders was a 54% reduction in ILI in all boarders [rate ratio (RR) 0·46, 95% confidence interval (CI) 0·28-0·76]. Disease rates were also reduced for upper respiratory tract infections (RR 0·72, 95% CI 0·61-0·85) and chest infections (RR 0·18, 95% CI 0·09-0·36). These findings demonstrate a significant impact of influenza vaccination on ILI and other clinical endpoints in secondary-school boarders. Additional research is needed to investigate the impact of influenza vaccination in non-boarding secondary-school settings.

Managing cumulative impacts: A key to sustainability?

Energy Technology Data Exchange (ETDEWEB)

Hunsaker, C.T.

1994-12-31

This paper addresses how science can be more effectively used in creating policy to manage cumulative effects on ecosystems. The paper focuses on the scientific techniques that we have to identify and to assess cumulative impacts on ecosystems. The term ``sustainable development`` was brought into common use by the World Commission on Environment and Development (The Brundtland Commission) in 1987. The Brundtland Commission report highlighted the need to simultaneously address developmental and environmental imperatives simultaneously by calling for development that ``meets the needs of the present generation without compromising the needs of future generations.`` We cannot claim to be working toward sustainable development until we can quantitatively assess cumulative impacts on the environment: The two concepts are inextricibally linked in that the elusiveness of cumulative effects likely has the greatest potential of keeping us from achieving sustainability. In this paper, assessment and management frameworks relevant to cumulative impacts are discussed along with recent literature on how to improve such assessments. When possible, examples are given for marine ecosystems.

Teacher led school-based surveillance can allow accurate tracking of emerging infectious diseases - evidence from serial cross-sectional surveys of febrile respiratory illness during the H1N1 2009 influenza pandemic in Singapore

Directory of Open Access Journals (Sweden)

Soh Shu E

2012-12-01

Full Text Available Abstract Background Schools are important foci of influenza transmission and potential targets for surveillance and interventions. We compared several school-based influenza monitoring systems with clinic-based influenza-like illness (ILI surveillance, and assessed the variation in illness rates between and within schools. Methods During the initial wave of pandemic H1N1 (pdmH1N1 infections from June to Sept 2009 in Singapore, we collected data on nation-wide laboratory confirmed cases (Sch-LCC and daily temperature monitoring (Sch-DTM, and teacher-led febrile respiratory illness reporting in 6 sentinel schools (Sch-FRI. Comparisons were made against age-stratified clinic-based influenza-like illness (ILI data from 23 primary care clinics (GP-ILI and proportions of ILI testing positive for pdmH1N1 (Lab-ILI by computing the fraction of cumulative incidence occurring by epidemiological week 30 (when GP-ILI incidence peaked; and cumulative incidence rates between school-based indicators and sero-epidemiological pdmH1N1 incidence (estimated from changes in prevalence of A/California/7/2009 H1N1 hemagglutination inhibition titers ≥ 40 between pre-epidemic and post-epidemic sera. Variation in Sch-FRI rates in the 6 schools was also investigated through a Bayesian hierarchical model. Results By week 30, for primary and secondary school children respectively, 63% and 79% of incidence for Sch-LCC had occurred, compared with 50% and 52% for GP-ILI data, and 48% and 53% for Sch-FRI. There were 1,187 notified cases and 7,588 episodes in the Sch-LCC and Sch-DTM systems; given school enrollment of 485,723 children, this represented 0.24 cases and 1.6 episodes per 100 children respectively. Mean Sch-FRI rate was 28.8 per 100 children (95% CI: 27.7 to 29.9 in the 6 schools. We estimate from serology that 41.8% (95% CI: 30.2% to 55.9% of primary and 43.2% (95% CI: 28.2% to 60.8% of secondary school-aged children were infected. Sch-FRI rates were similar across

Rate coefficients from quantum and quasi-classical cumulative reaction probabilities for the S(1D) + H2 reaction

Science.gov (United States)

Jambrina, P. G.; Lara, Manuel; Menéndez, M.; Launay, J.-M.; Aoiz, F. J.

2012-10-01

Cumulative reaction probabilities (CRPs) at various total angular momenta have been calculated for the barrierless reaction S(1D) + H2 → SH + H at total energies up to 1.2 eV using three different theoretical approaches: time-independent quantum mechanics (QM), quasiclassical trajectories (QCT), and statistical quasiclassical trajectories (SQCT). The calculations have been carried out on the widely used potential energy surface (PES) by Ho et al. [J. Chem. Phys. 116, 4124 (2002), 10.1063/1.1431280] as well as on the recent PES developed by Song et al. [J. Phys. Chem. A 113, 9213 (2009), 10.1021/jp903790h]. The results show that the differences between these two PES are relatively minor and mostly related to the different topologies of the well. In addition, the agreement between the three theoretical methodologies is good, even for the highest total angular momenta and energies. In particular, the good accordance between the CRPs obtained with dynamical methods (QM and QCT) and the statistical model (SQCT) indicates that the reaction can be considered statistical in the whole range of energies in contrast with the findings for other prototypical barrierless reactions. In addition, total CRPs and rate coefficients in the range of 20-1000 K have been calculated using the QCT and SQCT methods and have been found somewhat smaller than the experimental total removal rates of S(1D).

Framing Climate Goals in Terms of Cumulative CO2-Forcing-Equivalent Emissions

Science.gov (United States)

Jenkins, S.; Millar, R. J.; Leach, N.; Allen, M. R.

2018-03-01

The relationship between cumulative CO2 emissions and CO2-induced warming is determined by the Transient Climate Response to Emissions (TCRE), but total anthropogenic warming also depends on non-CO2 forcing, complicating the interpretation of emissions budgets based on CO2 alone. An alternative is to frame emissions budgets in terms of CO2-forcing-equivalent (CO2-fe) emissions—the CO2 emissions that would yield a given total anthropogenic radiative forcing pathway. Unlike conventional "CO2-equivalent" emissions, these are directly related to warming by the TCRE and need to fall to zero to stabilize warming: hence, CO2-fe emissions generalize the concept of a cumulative carbon budget to multigas scenarios. Cumulative CO2-fe emissions from 1870 to 2015 inclusive are found to be 2,900 ± 600 GtCO2-fe, increasing at a rate of 67 ± 9.5 GtCO2-fe/yr. A TCRE range of 0.8-2.5°C per 1,000 GtC implies a total budget for 0.6°C of additional warming above the present decade of 880-2,750 GtCO2-fe, with 1,290 GtCO2-fe implied by the Coupled Model Intercomparison Project Phase 5 median response, corresponding to 19 years' CO2-fe emissions at the current rate.

County-level cumulative environmental quality associated with cancer incidence.

Science.gov (United States)

Jagai, Jyotsna S; Messer, Lynne C; Rappazzo, Kristen M; Gray, Christine L; Grabich, Shannon C; Lobdell, Danelle T

2017-08-01

Individual environmental exposures are associated with cancer development; however, environmental exposures occur simultaneously. The Environmental Quality Index (EQI) is a county-level measure of cumulative environmental exposures that occur in 5 domains. The EQI was linked to county-level annual age-adjusted cancer incidence rates from the Surveillance, Epidemiology, and End Results (SEER) Program state cancer profiles. All-site cancer and the top 3 site-specific cancers for male and female subjects were considered. Incident rate differences (IRDs; annual rate difference per 100,000 persons) and 95% confidence intervals (CIs) were estimated using fixed-slope, random intercept multilevel linear regression models. Associations were assessed with domain-specific indices and analyses were stratified by rural/urban status. Comparing the highest quintile/poorest environmental quality with the lowest quintile/best environmental quality for overall EQI, all-site county-level cancer incidence rate was positively associated with poor environmental quality overall (IRD, 38.55; 95% CI, 29.57-47.53) and for male (IRD, 32.60; 95% CI, 16.28-48.91) and female (IRD, 30.34; 95% CI, 20.47-40.21) subjects, indicating a potential increase in cancer incidence with decreasing environmental quality. Rural/urban stratified models demonstrated positive associations comparing the highest with the lowest quintiles for all strata, except the thinly populated/rural stratum and in the metropolitan/urbanized stratum. Prostate and breast cancer demonstrated the strongest positive associations with poor environmental quality. We observed strong positive associations between the EQI and all-site cancer incidence rates, and associations differed by rural/urban status and environmental domain. Research focusing on single environmental exposures in cancer development may not address the broader environmental context in which cancers develop, and future research should address cumulative environmental

Is the apparent decrease in injury and illness rates in construction the result of changes in reporting?

Science.gov (United States)

Welch, Laura S; Dong, Xiuwen; Carre, Francoise; Ringen, Knut

2007-01-01

Injury rates in all industries and in construction in particular have been declining. Inconsistencies in the information suggest some of the apparent decrease may be due to changes in the ways injuries are treated, misclassification of employees, or underreporting. Lost-time injury rates for the largest construction employers declined by as much as 92% between 1988 and 1999. Yet the rate for cases with restricted work activity actually increased from 0.7 to 1.2 per 100 full-time workers between 1990 and 2000, and fatalities among construction workers remain high. In Massachusetts, at least 14% of construction employers misclassified workers as independent contractors, with the effect that injuries to these workers are not recordable. Studies that compare OSHA logs with other data sources find that the OSHA logs do not include a significant proportion of injuries and illnesses identified elsewhere.

Illness cognitions and family adjustment: psychometric properties of the Illness Cognition Questionnaire for parents of a child with cancer.

Science.gov (United States)

Sint Nicolaas, Simone M; Schepers, Sasja A; van den Bergh, Esther M M; Evers, Andrea W M; Hoogerbrugge, Peter M; Grootenhuis, Martha A; Verhaak, Christianne M

2016-02-01

Illness cognitions are an important mediator between disease and psychological adjustment. This study assessed the psychometric properties of the Illness Cognition Questionnaire (ICQ), adjusted for the parents of an ill child. Participants were recruited from two multicenter studies: sample 1 included 128 parents of a child diagnosed with acute lymphoblastic leukemia (ALL) (response rate 82 %) and sample 2 included 114 parents of a child diagnosed with cancer (response rate 74 %). Parents completed an adapted version of the ICQ (Illness Cognition Questionnaire-Parent version (ICQ-P)), together with the Profile of Mood States (POMS; sample 1) or the Hospital Anxiety and Depression Scale (HADS; sample 2). The factor structure of the ICQ-P was examined by means of principal component analysis. Cronbach's alpha for each subscale and correlations between the ICQ-P scales and the HADS and POMS were calculated. The illness cognitions of parents with and without psychological distress were compared. Factor analysis confirmed the hypothesized structure of the ICQ-P in our sample (n = 242). The three scales Helplessness, Acceptance, and Perceived Benefits explained 9.8, 31.4, and 17.9 % of the variance, respectively. Cronbach's alpha showed adequate internal consistency (.80-.88). Concurrent and criterion-related validity were appropriate. The results confirm that the ICQ-P reliably assesses the illness cognitions of the parents of a child with cancer. Psychologically distressed parents showed less acceptance and more helplessness. The availability of a short and valid illness cognition questionnaire will help clinicians gain insight into parental cognitions regarding the illness of their child, information that might be helpful for targeting interventions.

El Carreto o Cumulá - Aspidosperma Dugandii Standl El Carreto o Cumulá - Aspidosperma Dugandii Standl

Directory of Open Access Journals (Sweden)

Dugand Armando

1944-03-01

Full Text Available Nombres vulgares: Carreto (Atlántico, Bolívar, Magdalena; Cumulá, Cumulá (Cundinamarca, ToIima. Según el Dr. Emilio Robledo (Lecciones de Bot. ed. 3, 2: 544. 1939 el nombre Carreto también es empleado en Puerto Berrío (Antioquia. El mismo autor (loc. cit. da el nombre Comulá para una especie indeterminada de Viburnum en Mariquita (Tolima y J. M. Duque, refiriendose a la misma planta y localidad (en Bot. Gen. Colomb. 340, 356. 1943 atribuye este nombre vulgar al Aspidosperma ellipticum Rusby.  Sin embargo, las muestras de madera de Cumulá o Comulá que yo he examinado, procedentes de la región de Mariquita -una de las cuales me fue recientemente enviada por el distinguido ictiólogo Sr. Cecil Miles- pertenecen sin duda alguna al A. Dugandii StandI. Por otra parte, Santiago Cortés (FI. Colomb. 206. 1898; ed, 2: 239. 1912 cita el Cumulá "de Anapoima y otros lugares del (rio Magdalena" diciendo que pertenece a las Leguminosas, pero la brevísima descripción que este autor hace de la madera "naranjada y notable por densidad, dureza y resistencia a la humedad", me induce a creer que se trata del mismo Cumula coleccionado recientemente en Tocaima, ya que esta población esta situada a pocos kilómetros de Anapoima. Nombres vulgares: Carreto (Atlántico, Bolívar, Magdalena; Cumulá, Cumulá (Cundinamarca, ToIima. Según el Dr. Emilio Robledo (Lecciones de Bot. ed. 3, 2: 544. 1939 el nombre Carreto también es empleado en Puerto Berrío (Antioquia. El mismo autor (loc. cit. da el nombre Comulá para una especie indeterminada de Viburnum en Mariquita (Tolima y J. M. Duque, refiriendose a la misma planta y localidad (en Bot. Gen. Colomb. 340, 356. 1943 atribuye este nombre vulgar al Aspidosperma ellipticum Rusby.  Sin embargo, las muestras de madera de Cumulá o Comulá que yo he examinado, procedentes de la región de Mariquita -una de las cuales me fue recientemente enviada por el distinguido ictiólogo Sr. Cecil Miles- pertenecen sin

Predicting Cumulative Incidence Probability by Direct Binomial Regression

DEFF Research Database (Denmark)

Scheike, Thomas H.; Zhang, Mei-Jie

Binomial modelling; cumulative incidence probability; cause-specific hazards; subdistribution hazard......Binomial modelling; cumulative incidence probability; cause-specific hazards; subdistribution hazard...

7 CFR 42.132 - Determining cumulative sum values.

Science.gov (United States)

2010-01-01

... 7 Agriculture 2 2010-01-01 2010-01-01 false Determining cumulative sum values. 42.132 Section 42... Determining cumulative sum values. (a) The parameters for the on-line cumulative sum sampling plans for AQL's... 3 1 2.5 3 1 2 1 (b) At the beginning of the basic inspection period, the CuSum value is set equal to...

The Algebra of the Cumulative Percent Operation.

Science.gov (United States)

Berry, Andrew J.

2002-01-01

Discusses how to help students avoid some pervasive reasoning errors in solving cumulative percent problems. Discusses the meaning of ."%+b%." the additive inverse of ."%." and other useful applications. Emphasizes the operational aspect of the cumulative percent concept. (KHR)

National Estimates of Recovery-Remission From Serious Mental Illness.

Science.gov (United States)

Salzer, Mark S; Brusilovskiy, Eugene; Townley, Greg

2018-05-01

A broad range of estimates of recovery among previously institutionalized persons has been reported, but no current, community-based national estimate of recovery from serious mental illness exists. This study reports recovery rate results, based on a remission definition, and explores related demographic factors. A national, geographically stratified, and random cross-sectional survey conducted from September 2014 to December 2015 resulted in responses from more than 41,000 individuals. Lifetime prevalence of serious mental illness was assessed by asking about receipt of a diagnosis (major depression, bipolar disorder, manic depression, and schizophrenia or schizoaffective disorder) and hospitalization and impairment associated with the diagnosis. Recovery was determined by asking about impairments over the past 12 months. Almost 17% reported receiving one of the diagnoses in their lifetime, 6% had a lifetime rate of a serious mental illness, and nearly 4% continued to experience interference associated with serious mental illness. One-third of those with a lifetime serious mental illness reported having been in remission for at least the past 12 months. Recovery rates were low until age 32 and then progressively increased. Lifetime estimates of diagnosed illness and current prevalence of serious mental illness are consistent with previous research. Results indicate that recovery is possible and is associated with age. Further research is needed to understand factors that promote recovery, and sustained evaluation efforts using similar parsimonious approaches may be useful in conducting timely assessments of national and local mental health policies.

Illness perceptions among cancer survivors.

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Zhang, Na; Fielding, Richard; Soong, Inda; Chan, Karen K K; Tsang, Janice; Lee, Victor; Lee, Conrad; Ng, Alice; Sze, Wing Kin; Tin, Pamela; Lam, Wendy Wing Tak

2016-03-01

The purpose of the study is to document in Hong Kong Chinese cancer survivors cross-sectional associations between illness perceptions, physical symptom distress and dispositional optimism. A consecutive sample of 1036 (response rate, 86.1%, mean age 55.18 years, 60% female) survivors of different cancers recruited within 6 months of completion of adjuvant therapy from Hong Kong public hospitals completed the Brief Illness Perception Questionnaire (B-IPQ), Chinese version of the Memorial Symptom Assessment Scale Short-Form (MSAS-SF), and the revised Chinese version of Life Orientation Test (C-LOT-R), respectively. Stepwise multiple regression analyses examined adjusted associations. IPQ seriousness, symptom identity, illness concern, and emotional impact scores varied by cancer type (p Stress-related, lifestyle, environment, psychological/personality, and health-related factors were most frequently attributed causes of cancer. After adjustment for sample differences, physical symptom distress was significantly associated with all illness perception dimensions (p differences by cancer type were eliminated by adjustment for sample characteristics. Illness perceptions did not differ by cancer type. Greater physical symptom distress and lower levels of optimism were associated with more negative illness perceptions. Understanding how cancer survivors make sense of cancer can clarify an important aspect of adaptation. This in turn can inform interventions to facilitate adjustment. Knowledge contributions include evidence of physical symptom distress correlating with most dimensions of illness perception. Optimism was also associated with cancer survivors' illness perceptions.

Radiation in relation to mutation rate, mutational damage and human ill-health

International Nuclear Information System (INIS)

Roberts, P.B.

1976-09-01

The effect of radiation in increasing the frequency of gene mutations is now reasonably understood. We discuss first how an increase in the mutation rate is reflected in the mutational damage expressed in populations. It is shown that the mutational damage, assessed by the loss of fitness in a population or the number of eventual gene extinctions, is equal to the number of new mutations arising per generation or the mutation rate. In a population of stable size, a dose of 1 rem given to 10 6 people leads to roughly 600 gene extinctions when summed over all ensuing generations if the dose is applied to only one generation; this number of extinctions will occur in each succeeding generation if the dose is given to every generation. However, the concept of genetic extinction, although quantifiable, is of limited value in assessing radiation risks since its impact on human ill-health is very speculative. In particular, no estimate can be made of the total cost of effects which are minor in each individual in which they arise, but which, because they are so minor, persist in the population for many generations. The best current estimate is for 14-140 obvious defects in the first few generations following exposure of 10 6 people to a dose of 1 rem. (auth.)

Incidence rates of enterovirus 71 infections in young children during a nationwide epidemic in Taiwan, 2008-09.

Directory of Open Access Journals (Sweden)

Min-Shi Lee

Full Text Available OBJECTIVE: Enterovirus 71 (EV71 is causing life-threatening outbreaks in tropical Asia. In Taiwan and other tropical Asian countries, although nationwide EV71 epidemics occur cyclically, age-specific incidence rates of EV71 infections that are critical to estimate disease burden and design vaccine trials are not clear. A nationwide EV71 epidemic occurred in 2008-09 in Taiwan, which provided a unique opportunity to estimate age-specific incidence rates of EV71 infections. STUDY DESIGN: We prospectively recruited 749 healthy neonates and conducted follow-ups from June 2006 to December 2009. Sera were obtained from participants at 0, 6, 12, 24, and 36 months of age for measuring EV71 neutralizing antibody titers. If the participants developed suspected enterovirus illnesses, throat swabs were collected for virus isolation. RESULTS: We detected 28 EV71 infections including 20 symptomatic and 8 asymptomatic infections. Age-specific incidence rates of EV71 infection increased from 1.71 per 100 person-years at 0-6 months of age to 4.09, 5.74, and 4.97 per 100 person-years at 7-12, 13-24, and 25-36 months of age, respectively. Cumulative incidence rate was 15.15 per 100 persons by 36 months of age, respectively. CONCLUSIONS: Risk of EV71 infections in Taiwan increased after 6 months of age during EV71 epidemics. The cumulative incidence rate was 15% by 36 months of age, and 29% of EV71 infections were asymptomatic in young children.

EXAFS cumulants of CdSe

International Nuclear Information System (INIS)

Diop, D.

1997-04-01

EXAFS functions had been extracted from measurements on the K edge of Se at different temperatures between 20 and 300 K. The analysis of the EXAFS of the filtered first two shells has been done in the wavevector range laying between 2 and 15.5 A -1 in terms of the cumulants of the effective distribution of distances. The cumulants C 3 and C 4 obtained from the phase difference and the amplitude ratio methods have shown the anharmonicity in the vibrations of atoms around their equilibrium position. (author). 13 refs, 3 figs

World survey of mental illness stigma.

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Seeman, Neil; Tang, Sabrina; Brown, Adalsteinn D; Ing, Alton

2016-01-15

To obtain rapid and reproducible opinions that address mental illness stigma around the world. Random global Web users were exposed to brief questions, asking whether they interacted daily with someone with mental illness, whether they believed that mental illness was associated with violence, whether it was similar to physical illness, and whether it could be overcome. Over a period of 1.7 years, 596,712 respondents from 229 countries completed the online survey. The response rate was 54.3%. China had the highest proportion of respondents in daily contact with a person with mental illness. In developed countries, 7% to 8% of respondents endorsed the statement that individuals with mental illness were more violent than others, in contrast to 15% or 16% in developing countries. While 45% to 51% of respondents from developed countries believed that mental illness was similar to physical illness, only 7% believed that mental illness could be overcome. To test for reproducibility, 21 repeats of the same questions were asked monthly in India for 21 months. Each time, 10.1 ± 0.11% s.e., of respondents endorsed the statement that persons who suffer from mental illness are more violent than others, indicating strong reproducibility of response. This study shows that surveys of constructs such as stigma towards mental illness can be carried out rapidly and repeatedly across the globe, so that the impact of policy interventions can be readily measured. The method engages English speakers only, mainly young, educated males. Copyright © 2015 Elsevier B.V. All rights reserved.

Cumulative trauma and current posttraumatic stress disorder status in general population and inmate samples.

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Briere, John; Agee, Elisha; Dietrich, Anne

2016-07-01

This research was undertaken to examine the role between cumulative exposure to different types of traumatic events and posttraumatic stress disorder (PTSD) status in general population and prison samples. Two archival datasets were examined: the standardization sample for the Detailed Assessment of Posttraumatic States (DAPS; Briere, 2001), and data from a study on trauma and posttraumatic sequelae among inmates and others. PTSD was found in 4% of the general population sample and 48% of the prison sample. Trauma exposure was very common among prisoners, including a 70% rate of childhood sexual abuse for women and a 50% rate for men. Lifetime number of different types of trauma was associated with PTSD in both the general population and prison samples, even when controlling for the effects of sexual trauma. Cumulative interpersonal trauma predicted PTSD, whereas cumulative noninterpersonal trauma did not. In the general population sample, participants who had only 1 type of trauma exposure had a 0% likelihood of current PTSD, whereas those with 6 or more other trauma types had a 12% likelihood. In the prison sample, those with only 1 type of trauma exposure had a 17% percent likelihood of current PTSD, whereas those exposed to 6 or more other trauma types had a 64% chance of PTSD. Cumulative trauma predicts current PTSD in both general population and prison samples, even after controlling for sexual trauma. PTSD appears to develop generally as a function of exposure to multiple types of interpersonal trauma, as opposed to a single traumatic event. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Gender roles, illness orientation and use of medical services.

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Hibbard, J H; Pope, C R

1983-01-01

The study investigates illness orientation as a factor which may account for sex differences in the utilization of medical care. First, sex differences in the way symptoms are perceived, evaluated and acted upon (illness orientation) are analyzed. Then gender role factors which may account for sex differences in illness orientation are examined. Finally, the degree to which gender role factors and illness orientation account for sex differences in medical care utilization are assessed. The study population includes 1648 adults between the ages of 18 and 59. Medical record data covering 7 years of outpatient services are linked with survey data on the respondents. The findings show that while females are more likely to perceive symptoms than males, there is no apparent sex difference in a tendency to adopt the sick role when ill. In addition, results indicate that gender role factors such as level and type of role responsibility and concern with health are related to female though not male symptom reports. Illness orientation variables are related to rates of medical utilization for both sexes. However, it is primarily the perception of symptoms and an interest and concern with health which contributes to sex differences in utilization rates. When examining respondents who report either a very low or very high number of symptoms, sex differences in utilization rates fall below statistical significance.

Estimated Glomerular Filtration Rate Correlates Poorly with Four-Hour Creatinine Clearance in Critically Ill Patients with Acute Kidney Injury

Directory of Open Access Journals (Sweden)

Christopher J. Kirwan

2013-01-01

Full Text Available Introduction. RIFLE and AKIN provide a standardised classification of acute kidney injury (AKI, but their categorical rather than continuous nature restricts their use to a research tool. A more accurate real-time description of renal function in AKI is needed, and some published data suggest that equations based on serum creatinine that estimate glomerular filtration rate (eGFR can provide this. In addition, incorporating serum cystatin C concentration into estimates of GFR may improve their accuracy, but no eGFR equations are validated in critically ill patients with AKI. Aim. This study tests whether creatinine or cystatin-C-based eGFR equations, used in patients with CKD, offer an accurate representation of 4-hour creatinine clearance (4CrCl in critically ill patients with AKI. Methods. Fifty-one critically ill patients with AKI were recruited. Thirty-seven met inclusion criteria, and the performance of eGFR equations was compared to 4CrCl. Results. eGFR equations were better than creatinine alone at predicting 4CrCl. Adding cystatin C to estimates did not improve the bias or add accuracy. The MDRD 7 eGFR had the best combination of correlation, bias, percentage error and accuracy. None were near acceptable standards quoted in patients with chronic kidney disease (CKD. Conclusions. eGFR equations are not sufficiently accurate for use in critically ill patients with AKI. Incorporating serum cystatin C does not improve estimates. eGFR should not be used to describe renal function in patients with AKI. Standards of accuracy for validating eGFR need to be set.

About the cumulants of periodic signals

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Barrau, Axel; El Badaoui, Mohammed

2018-01-01

This note studies cumulants of time series. These functions originating from the probability theory being commonly used as features of deterministic signals, their classical properties are examined in this modified framework. We show additivity of cumulants, ensured in the case of independent random variables, requires here a different hypothesis. Practical applications are proposed, in particular an analysis of the failure of the JADE algorithm to separate some specific periodic signals.

Gender Differences in Anxiety Disorders: Prevalence, Course of Illness, Comorbidity and Burden of Illness

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McLean, Carmen P.; Asnaani, Anu; Litz, Brett T.; Hofmann, Stefan G.

2011-01-01

Women have consistently higher prevalence rates of anxiety disorders, but less is known about how gender affects age of onset, chronicity, comorbidity, and burden of illness. Gender differences in DSM-IV anxiety disorders were examined in a large sample of adults (N = 20,013) in the United States using data from the Collaborative Psychiatric Epidemiology Studies (CPES). The lifetime and 12-month male:female prevalence ratios of any anxiety disorder were 1:1.7 and 1:1.79, respectively. Women had higher rates of lifetime diagnosis for each of the anxiety disorders examined, except for social anxiety disorder which showed no gender difference in prevalence. No gender differences were observed in the age of onset and chronicity of the illness. However, women with a lifetime diagnosis of an anxiety disorder were more likely than men to also be diagnosed with another anxiety disorder, bulimia nervosa, and major depressive disorder. Furthermore, anxiety disorders were associated with a greater illness burden in women than in men, particularly among European American women and to some extend also among Hispanic women. These results suggest that anxiety disorders are not only more prevalent but also more disabling in women than in men. PMID:21439576

Cumulative Student Loan Debt in Minnesota, 2015

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Williams-Wyche, Shaun

2016-01-01

To better understand student debt in Minnesota, the Minnesota Office of Higher Education (the Office) gathers information on cumulative student loan debt from Minnesota degree-granting institutions. These data detail the number of students with loans by institution, the cumulative student loan debt incurred at that institution, and the percentage…

Eating behavior in humans, characterized by cumulative food intake curves--a review.

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Westerterp-Plantenga, M S

2000-03-01

Cumulative food intake curves have been obtained by monitoring eating from a plate, placed on a scale built into a table, and connected to a digital computer. They describe and integrate parameters of consumption of an ad lib single course meal, i.e. meal size, meal duration, eating rate, change in eating rate, bite size and bite frequency. It is concluded that they are an adequate tool for analyzing dietary and clinical interventions on meal size, because the cumulative food intake curve parameters: are stable and consistent within subjects; show a clear relationship with the subject characteristics dietary restraint and obesity; show a clear relationship with the physiological parameters satiation, diet-induced thermogenesis and body-temperature near the liver, and with the cognitive parameter: estimating forthcoming ingestion; are sensitive to instructions, clinical and dietary interventions (preloads, palatability, energy density, macronutrient composition), and to a state of negative energy balance. Because of possible compensatory post-prandial effects, it is suggested that assessment of meal size should be part of a 24 h appetite profile and food intake observation.

Cumulant expansions for measuring water exchange using diffusion MRI

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Ning, Lipeng; Nilsson, Markus; Lasič, Samo; Westin, Carl-Fredrik; Rathi, Yogesh

2018-02-01

The rate of water exchange across cell membranes is a parameter of biological interest and can be measured by diffusion magnetic resonance imaging (dMRI). In this work, we investigate a stochastic model for the diffusion-and-exchange of water molecules. This model provides a general solution for the temporal evolution of dMRI signal using any type of gradient waveform, thereby generalizing the signal expressions for the Kärger model. Moreover, we also derive a general nth order cumulant expansion of the dMRI signal accounting for water exchange, which has not been explored in earlier studies. Based on this analytical expression, we compute the cumulant expansion for dMRI signals for the special case of single diffusion encoding (SDE) and double diffusion encoding (DDE) sequences. Our results provide a theoretical guideline on optimizing experimental parameters for SDE and DDE sequences, respectively. Moreover, we show that DDE signals are more sensitive to water exchange at short-time scale but provide less attenuation at long-time scale than SDE signals. Our theoretical analysis is also validated using Monte Carlo simulations on synthetic structures.

Event-rate and delta inflation when evaluating mortality as a primary outcome from randomized controlled trials of nutritional interventions during critical illness: a systematic review.

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Summers, Matthew J; Chapple, Lee-anne S; McClave, Stephen A; Deane, Adam M

2016-04-01

There is a lack of high-quality evidence that proves that nutritional interventions during critical illness reduce mortality. We evaluated whether power calculations for randomized controlled trials (RCTs) of nutritional interventions that used mortality as the primary outcome were realistic, and whether overestimation was systematic in the studies identified to determine whether this was due to overestimates of event rate or delta. A systematic review of the literature between 2005 and 2015 was performed to identify RCTs of nutritional interventions administered to critically ill adults that had mortality as the primary outcome. Predicted event rate (predicted mortality during the control), predicted mortality during intervention, predicted delta (predicted difference between mortality during the control and intervention), actual event rate (observed mortality during control), observed mortality during intervention, and actual delta (difference between observed mortality during the control and intervention) were recorded. The event-rate gap (predicted event rate minus observed event rate), the delta gap (predicted delta minus observed delta), and the predicted number needed to treat were calculated. Data are shown as median (range). Fourteen articles were extracted, with power calculations provided for 10 studies. The predicted event rate was 29.9% (20.0–52.4%), and the predicted delta was 7.9% (3.0–20.0%). If the study hypothesis was proven correct then, on the basis of the power calculations, the number needed to treat would have been 12.7 (5.0–33.3) patients. The actual event rate was 25.3% (6.1–50.0%), the observed mortality during the intervention was 24.4% (6.3–39.7%), and the actual delta was 0.5% (−10.2–10.3%), such that the event-rate gap was 2.6% (−3.9–23.7%) and delta gap was 7.5% (3.2–25.2%). Overestimates of delta occur frequently in RCTs of nutritional interventions in the critically ill that are powered to determine a mortality

The Stigma of Mental Illness as a Barrier to Self Labeling as Having a Mental Illness.

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Stolzenburg, Susanne; Freitag, Simone; Evans-Lacko, Sara; Muehlan, Holger; Schmidt, Silke; Schomerus, Georg

2017-12-01

The aim of this study was to investigate whether personal stigma decreases self-identification as having a mental illness in individuals with untreated mental health problems. We interviewed 207 persons with a currently untreated mental health problem as confirmed by a structured diagnostic interview. Measures included symptom appraisal, self-identification as having a mental illness (SELFI), self-labeling (open-ended question on the nature of their problem) stigma-related variables (explicit and implicit), as well as sociodemographics, current symptom severity, and previous treatment. Support for discrimination and implicit stigmatizing attitude were both associated with lower likelihood of self-identification. More social distance and support for discrimination were associated with less self-labeling. Previous treatment was the strongest predictor of symptom appraisal, SELFI, and self-labeling. Destigmatizing mental illness could increase awareness of personal mental health problems, potentially leading to lower rates of untreated mental illness.

High cumulants of conserved charges and their statistical uncertainties

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Li-Zhu, Chen; Ye-Yin, Zhao; Xue, Pan; Zhi-Ming, Li; Yuan-Fang, Wu

2017-10-01

We study the influence of measured high cumulants of conserved charges on their associated statistical uncertainties in relativistic heavy-ion collisions. With a given number of events, the measured cumulants randomly fluctuate with an approximately normal distribution, while the estimated statistical uncertainties are found to be correlated with corresponding values of the obtained cumulants. Generally, with a given number of events, the larger the cumulants we measure, the larger the statistical uncertainties that are estimated. The error-weighted averaged cumulants are dependent on statistics. Despite this effect, however, it is found that the three sigma rule of thumb is still applicable when the statistics are above one million. Supported by NSFC (11405088, 11521064, 11647093), Major State Basic Research Development Program of China (2014CB845402) and Ministry of Science and Technology (MoST) (2016YFE0104800)

Experiences With Insurance Plans and Providers Among Persons With Mental Illness.

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Rowan, Kathleen; Shippee, Nathan D

2016-03-01

This study used nationally representative household survey data to examine the association between mental illness and experiences with usual care providers and health plans among persons with public or private insurance (N=25,176). Data were from the 2004-2012 Medical Expenditure Panel Surveys. Mental illness was assessed with symptom scales of serious psychological distress and depression at two time points, and persons were categorized by whether mental illness was episodic or persistent over time. Questions about experiences with providers (four questions) and plans (five questions) were based on the Consumer Assessment of Healthcare Providers and Systems survey. Rates of problems with plans and providers were reported for each category of mental illness, and multivariate regression was used to examine the association of problems with mental illness. Rates of problems with health plans were high, specifically for treatment approvals, finding information, and customer service, and were higher among persons with mental illness. Rates of problems with providers were lower than problems with plans, but persons with mental illness were more likely to report problems, specifically that doctors do not explain treatment options, respect treatment choices, or seek participation in decisions. Persons with mental illness reported experiencing more clinical and administrative problems at their usual source of care, although the reasons were not clear. Efforts by plans to improve health care before and after the clinical encounter and by providers to design treatments in line with patient preferences may improve experiences for all patients and particularly for those with mental illness.

Seasonal climate change patterns due to cumulative CO2 emissions

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Partanen, Antti-Ilari; Leduc, Martin; Damon Matthews, H.

2017-07-01

Cumulative CO2 emissions are near linearly related to both global and regional changes in annual-mean surface temperature. These relationships are known as the transient climate response to cumulative CO2 emissions (TCRE) and the regional TCRE (RTCRE), and have been shown to remain approximately constant over a wide range of cumulative emissions. Here, we assessed how well this relationship holds for seasonal patterns of temperature change, as well as for annual-mean and seasonal precipitation patterns. We analyzed an idealized scenario with CO2 concentration growing at an annual rate of 1% using data from 12 Earth system models from the Coupled Model Intercomparison Project Phase 5 (CMIP5). Seasonal RTCRE values for temperature varied considerably, with the highest seasonal variation evident in the Arctic, where RTCRE was about 5.5 °C per Tt C for boreal winter and about 2.0 °C per Tt C for boreal summer. Also the precipitation response in the Arctic during boreal winter was stronger than during other seasons. We found that emission-normalized seasonal patterns of temperature change were relatively robust with respect to time, though they were sub-linear with respect to emissions particularly near the Arctic. Moreover, RTCRE patterns for precipitation could not be quantified robustly due to the large internal variability of precipitation. Our results suggest that cumulative CO2 emissions are a useful metric to predict regional and seasonal changes in precipitation and temperature. This extension of the TCRE framework to seasonal and regional climate change is helpful for communicating the link between emissions and climate change to policy-makers and the general public, and is well-suited for impact studies that could make use of estimated regional-scale climate changes that are consistent with the carbon budgets associated with global temperature targets.

A SAS-macro for estimation of the cumulative incidence using Poisson regression

DEFF Research Database (Denmark)

Waltoft, Berit Lindum

2009-01-01

the hazard rates, and the hazard rates are often estimated by the Cox regression. This procedure may not be suitable for large studies due to limited computer resources. Instead one uses Poisson regression, which approximates the Cox regression. Rosthøj et al. presented a SAS-macro for the estimation...... of the cumulative incidences based on the Cox regression. I present the functional form of the probabilities and variances when using piecewise constant hazard rates and a SAS-macro for the estimation using Poisson regression. The use of the macro is demonstrated through examples and compared to the macro presented...

Cumulative processes and quark distribution in nuclei

International Nuclear Information System (INIS)

Kondratyuk, L.; Shmatikov, M.

1984-01-01

Assuming existence of multiquark (mainly 12q) bags in nuclei the spectra of cumulative nucleons and mesons produced in high-energy particle-nucleus collisions are discussed. The exponential form of quark momentum distribution in 12q-bag (agreeing well with the experimental data on lepton-nucleus interactions at large q 2 ) is shown to result in quasi-exponential distribution of cumulative particles over the light-cone variable αsub(B). The dependence of f(αsub(B); psub(perpendicular)) (where psub(perpendicular) is the transverse momentum of the bag) upon psub(perpendicular) is considered. The yields of cumulative resonances as well as effects related to the u- and d-quark distributions in N > Z nuclei being different are dicscussed

Predicting Cumulative Incidence Probability: Marginal and Cause-Specific Modelling

DEFF Research Database (Denmark)

Scheike, Thomas H.; Zhang, Mei-Jie

2005-01-01

cumulative incidence probability; cause-specific hazards; subdistribution hazard; binomial modelling......cumulative incidence probability; cause-specific hazards; subdistribution hazard; binomial modelling...

Cumulative fission yield of Ce-148 produced by thermal-neutron fission of U-235

International Nuclear Information System (INIS)

Hasan, A.A.

1984-12-01

Cumulative fission yield of 148 cesium isotopes and some other fission products produced by thermal-neutron fission of 235 uranium is determined by Germanium/Lithium spectroscopic methods. The measuremets were done at Tsing-Hua open pool reactor using 3 to 4 mg of 93.15% enriched 235 uranium samples. Gamma rays are assigned to the responsible fission products by matching gamma rays energies and half lives. Fission rate is calculated by fission track method. Cumulative fission yields of 148 cesium, 90 krypton, 130 iodine, 144 lanthanum, 89 krypton, 136 xenon, 137 xenon and 140 cesium are calculated. This values are compared with previously predicted values and showed good agreement. 21 Ref

Decision analysis with cumulative prospect theory.

Science.gov (United States)

Bayoumi, A M; Redelmeier, D A

2000-01-01

Individuals sometimes express preferences that do not follow expected utility theory. Cumulative prospect theory adjusts for some phenomena by using decision weights rather than probabilities when analyzing a decision tree. The authors examined how probability transformations from cumulative prospect theory might alter a decision analysis of a prophylactic therapy in AIDS, eliciting utilities from patients with HIV infection (n = 75) and calculating expected outcomes using an established Markov model. They next focused on transformations of three sets of probabilities: 1) the probabilities used in calculating standard-gamble utility scores; 2) the probabilities of being in discrete Markov states; 3) the probabilities of transitioning between Markov states. The same prophylaxis strategy yielded the highest quality-adjusted survival under all transformations. For the average patient, prophylaxis appeared relatively less advantageous when standard-gamble utilities were transformed. Prophylaxis appeared relatively more advantageous when state probabilities were transformed and relatively less advantageous when transition probabilities were transformed. Transforming standard-gamble and transition probabilities simultaneously decreased the gain from prophylaxis by almost half. Sensitivity analysis indicated that even near-linear probability weighting transformations could substantially alter quality-adjusted survival estimates. The magnitude of benefit estimated in a decision-analytic model can change significantly after using cumulative prospect theory. Incorporating cumulative prospect theory into decision analysis can provide a form of sensitivity analysis and may help describe when people deviate from expected utility theory.

Illness Identity in Adults with a Chronic Illness.

Science.gov (United States)

Oris, Leen; Luyckx, Koen; Rassart, Jessica; Goubert, Liesbet; Goossens, Eva; Apers, Silke; Arat, Seher; Vandenberghe, Joris; Westhovens, René; Moons, Philip

2018-02-21

The present study examines the concept of illness identity, the degree to which a chronic illness is integrated into one's identity, in adults with a chronic illness by validating a new self-report questionnaire, the Illness Identity Questionnaire (IIQ). Self-report questionnaires on illness identity, psychological, and physical functioning were assessed in two samples: adults with congenital heart disease (22-78 year old; n = 276) and with multisystem connective tissue disorders (systemic lupus erythematosus or systemic sclerosis; 17-81 year old; n = 241). The IIQ could differentiate four illness identity states (i.e., engulfment, rejection, acceptance, and enrichment) in both samples, based on exploratory and confirmatory factor analysis. All four subscales proved to be reliable. Rejection and engulfment were related to maladaptive psychological and physical functioning, whereas acceptance and enrichment were related to adaptive psychological and physical functioning. The present findings underscore the importance of the concept of illness identity. The IIQ, a self-report questionnaire, is introduced to measure four different illness identity states in adults with a chronic illness.

Prevalence of Mental Illness among Homeless People in Hong Kong

Science.gov (United States)

Chan, Wai Chi; Lam, Marco Ho-Bun; Lim, Vivian Wai-Man

2015-01-01

Metholodogy This study examined the prevalence and correlates of mental illness in homeless people in Hong Kong and explored the barriers preventing their access to health care. Ninety-seven Cantonese-speaking Chinese who were homeless during the study period were selected at random from the records of the three organisations serving the homeless population. The response rate was 69%. Seventeen subjects could not give valid consent due to their poor mental state, so their responses were excluded from the data analysis. A psychiatrist administered the Structured Clinical Interview for DSM-IV Axis-I disorders (SCID-I) and the Mini -Mental State Examination. Consensus diagnoses for subjects who could not complete the SCID-I were established by three independent psychiatrists. Findings The point prevalence of mental illness was 56%. Seventy-one percent of the subjects had a lifetime history of mental illness, 30% had a mood disorder, 25% had an alcohol use disorder, 25% had a substance use disorder, 10% had a psychotic disorder, 10% had an anxiety disorder and 6% had dementia. Forty-one percent of the subjects with mental illness had undergone a previous psychiatric assessment. Only 13% of the subjects with mental illness were receiving psychiatric care at the time of interview. The prevalence of psychotic disorders, dementia and the rate of under treatment are hugely underestimated, as a significant proportion (18%) of the subjects initially selected were too ill to give consent to join the study. Conclusion The low treatment rate and the presence of this severely ill and unreached group of homeless people reflect the fact that the current mode of service delivery is failing to support the most severely ill homeless individuals. PMID:26484889

Prevalence of Mental Illness among Homeless People in Hong Kong.

Directory of Open Access Journals (Sweden)

Larina Chi-Lap Yim

Full Text Available This study examined the prevalence and correlates of mental illness in homeless people in Hong Kong and explored the barriers preventing their access to health care. Ninety-seven Cantonese-speaking Chinese who were homeless during the study period were selected at random from the records of the three organisations serving the homeless population. The response rate was 69%. Seventeen subjects could not give valid consent due to their poor mental state, so their responses were excluded from the data analysis. A psychiatrist administered the Structured Clinical Interview for DSM-IV Axis-I disorders (SCID-I and the Mini -Mental State Examination. Consensus diagnoses for subjects who could not complete the SCID-I were established by three independent psychiatrists.The point prevalence of mental illness was 56%. Seventy-one percent of the subjects had a lifetime history of mental illness, 30% had a mood disorder, 25% had an alcohol use disorder, 25% had a substance use disorder, 10% had a psychotic disorder, 10% had an anxiety disorder and 6% had dementia. Forty-one percent of the subjects with mental illness had undergone a previous psychiatric assessment. Only 13% of the subjects with mental illness were receiving psychiatric care at the time of interview. The prevalence of psychotic disorders, dementia and the rate of under treatment are hugely underestimated, as a significant proportion (18% of the subjects initially selected were too ill to give consent to join the study.The low treatment rate and the presence of this severely ill and unreached group of homeless people reflect the fact that the current mode of service delivery is failing to support the most severely ill homeless individuals.

Injury and illness in college outdoor education.

Science.gov (United States)

Gaudio, Flavio G; Greenwald, Peter W; Holton, Mark

2010-12-01

Many colleges offer outdoor education courses such as rock climbing, kayaking, and mountain biking. Since these sports may be perceived as dangerous, we describe the prevalence of injuries and illnesses in a large, university-based outdoor education program. We also compare composite incident rates from this outdoor program to those of traditional college sports. Cohort of college students participating in either Cornell Outdoor Education (COE) or National Collegiate Athletic Association (NCAA) sports and comparison of incident rates. COE data were prospectively collected in the field; and NCAA data were prospectively collected through the Association's Injury Surveillance System. By definition, a COE injury or illness required follow-up care, prescription medication, or limited course participation. Similarly, a NCAA injury limited further practice or play. Incident rates were calculated as injuries and illnesses per 1000 participant-days (COE) or injuries per 1000 athlete-exposures (NCAA). Included COE courses during 2002-2007 totaled 74 005 participant-days. There were 111 injuries and illnesses, rate = 1.50/1000 participant-days (95% CI 1.24-1.81). The NCAA reported 32 646 899 athlete-exposures during 1988-2004 and 181 476 injuries, rate = 5.56/1000 athlete-exposures (95% CI 5.53-5.58). Compared to COE, the relative risk of injury in NCAA sports was 3.7 (95% CI 3.1-4.5) overall and 3.3 (95% CI 2.8-4.0) after excluding the high-contact sports of football, ice hockey, and wrestling. For COE, mountain biking had the highest incident rate (7.5/1000), which was significantly lower than game injury rates in NCAA football and soccer. The most common injuries for both NCAA and COE were soft-tissue injuries such as sprains and strains. Outdoor education at this university-sponsored program was at least as safe as traditional college sports. Overall, college students were less likely to be injured while participating in COE courses than while participating in NCAA sports

Original and cumulative prospect theory: a discussion of empirical differences

NARCIS (Netherlands)

Wakker, P.P.; Fennema, H.

1997-01-01

This note discusses differences between prospect theory and cumulative prospect theory. It shows that cumulative prospect theory is not merely a formal correction of some theoretical problems in prospect theory, but it also gives different predictions. Experiments are described that favor cumulative

Cumulative radiation dose of multiple trauma patients during their hospitalization

International Nuclear Information System (INIS)

Wang Zhikang; Sun Jianzhong; Zhao Zudan

2012-01-01

Objective: To study the cumulative radiation dose of multiple trauma patients during their hospitalization and to analyze the dose influence factors. Methods: The DLP for CT and DR were retrospectively collected from the patients during June, 2009 and April, 2011 at a university affiliated hospital. The cumulative radiation doses were calculated by summing typical effective doses of the anatomic regions scanned. Results: The cumulative radiation doses of 113 patients were collected. The maximum,minimum and the mean values of cumulative effective doses were 153.3, 16.48 mSv and (52.3 ± 26.6) mSv. Conclusions: Multiple trauma patients have high cumulative radiation exposure. Therefore, the management of cumulative radiation doses should be enhanced. To establish the individualized radiation exposure archives will be helpful for the clinicians and technicians to make decision whether to image again and how to select the imaging parameters. (authors)

Perspectives on cumulative risks and impacts.

Science.gov (United States)

Faust, John B

2010-01-01

Cumulative risks and impacts have taken on different meanings in different regulatory and programmatic contexts at federal and state government levels. Traditional risk assessment methodologies, with considerable limitations, can provide a framework for the evaluation of cumulative risks from chemicals. Under an environmental justice program in California, cumulative impacts are defined to include exposures, public health effects, or environmental effects in a geographic area from the emission or discharge of environmental pollution from all sources, through all media. Furthermore, the evaluation of these effects should take into account sensitive populations and socioeconomic factors where possible and to the extent data are available. Key aspects to this potential approach include the consideration of exposures (versus risk), socioeconomic factors, the geographic or community-level assessment scale, and the inclusion of not only health effects but also environmental effects as contributors to impact. Assessments of this type extend the boundaries of the types of information that toxicologists generally provide for risk management decisions.

Cumulative particle production in the quark recombination model

International Nuclear Information System (INIS)

Gavrilov, V.B.; Leksin, G.A.

1987-01-01

Production of cumulative particles in hadron-nuclear inteactions at high energies is considered within the framework of recombination quark model. Predictions for inclusive cross sections of production of cumulative particles and different resonances containing quarks in s state are made

New use of global warming potentials to compare cumulative and short-lived climate pollutants

Science.gov (United States)

Allen, Myles R.; Fuglestvedt, Jan S.; Shine, Keith P.; Reisinger, Andy; Pierrehumbert, Raymond T.; Forster, Piers M.

2016-08-01

Parties to the United Nations Framework Convention on Climate Change (UNFCCC) have requested guidance on common greenhouse gas metrics in accounting for Nationally determined contributions (NDCs) to emission reductions. Metric choice can affect the relative emphasis placed on reductions of `cumulative climate pollutants' such as carbon dioxide versus `short-lived climate pollutants' (SLCPs), including methane and black carbon. Here we show that the widely used 100-year global warming potential (GWP100) effectively measures the relative impact of both cumulative pollutants and SLCPs on realized warming 20-40 years after the time of emission. If the overall goal of climate policy is to limit peak warming, GWP100 therefore overstates the importance of current SLCP emissions unless stringent and immediate reductions of all climate pollutants result in temperatures nearing their peak soon after mid-century, which may be necessary to limit warming to ``well below 2 °C'' (ref. ). The GWP100 can be used to approximately equate a one-off pulse emission of a cumulative pollutant and an indefinitely sustained change in the rate of emission of an SLCP. The climate implications of traditional CO2-equivalent targets are ambiguous unless contributions from cumulative pollutants and SLCPs are specified separately.

Cumulative radiation exposure in children with cystic fibrosis.

LENUS (Irish Health Repository)

O'Reilly, R

2010-02-01

This retrospective study calculated the cumulative radiation dose for children with cystic fibrosis (CF) attending a tertiary CF centre. Information on 77 children with a mean age of 9.5 years, a follow up time of 658 person years and 1757 studies including 1485 chest radiographs, 215 abdominal radiographs and 57 computed tomography (CT) scans, of which 51 were thoracic CT scans, were analysed. The average cumulative radiation dose was 6.2 (0.04-25) mSv per CF patient. Cumulative radiation dose increased with increasing age and number of CT scans and was greater in children who presented with meconium ileus. No correlation was identified between cumulative radiation dose and either lung function or patient microbiology cultures. Radiation carries a risk of malignancy and children are particularly susceptible. Every effort must be made to avoid unnecessary radiation exposure in these patients whose life expectancy is increasing.

A Cumulant-based Analysis of Nonlinear Magnetospheric Dynamics

International Nuclear Information System (INIS)

Johnson, Jay R.; Wing, Simon

2004-01-01

Understanding magnetospheric dynamics and predicting future behavior of the magnetosphere is of great practical interest because it could potentially help to avert catastrophic loss of power and communications. In order to build good predictive models it is necessary to understand the most critical nonlinear dependencies among observed plasma and electromagnetic field variables in the coupled solar wind/magnetosphere system. In this work, we apply a cumulant-based information dynamical measure to characterize the nonlinear dynamics underlying the time evolution of the Dst and Kp geomagnetic indices, given solar wind magnetic field and plasma input. We examine the underlying dynamics of the system, the temporal statistical dependencies, the degree of nonlinearity, and the rate of information loss. We find a significant solar cycle dependence in the underlying dynamics of the system with greater nonlinearity for solar minimum. The cumulant-based approach also has the advantage that it is reliable even in the case of small data sets and therefore it is possible to avoid the assumption of stationarity, which allows for a measure of predictability even when the underlying system dynamics may change character. Evaluations of several leading Kp prediction models indicate that their performances are sub-optimal during active times. We discuss possible improvements of these models based on this nonparametric approach

Illness Among Paralympic Athletes: Epidemiology, Risk Markers, and Preventative Strategies.

Science.gov (United States)

Janse Van Rensburg, Dina Christina; Schwellnus, Martin; Derman, Wayne; Webborn, Nick

2018-05-01

Paralympic athletes have unique preexisting medical conditions that predispose them to increased risk of illness, but data are limited to studies conducted during the last 3 Paralympic Games. This article reviews the epidemiology of illness (risk, patterns, and predictors) in Paralympic athletes and provides practical guidelines for illness prevention. The incidence rate of illness (per 1000 athlete-days) in Paralympic athletes is high in Summer (10.0-13.2) and Winter (18.7) Paralympic Games. The authors propose general and specific guidelines on preventative strategies regarding illness in these athletes. Copyright © 2018 Elsevier Inc. All rights reserved.

Smoking and mental illness: results from population surveys in Australia and the United States

Directory of Open Access Journals (Sweden)

Mitrou Francis

2009-08-01

Full Text Available Abstract Background Smoking has been associated with a range of mental disorders including schizophrenia, anxiety disorders and depression. People with mental illness have high rates of morbidity and mortality from smoking related illnesses such as cardiovascular disease, respiratory diseases and cancer. As many people who meet diagnostic criteria for mental disorders do not seek treatment for these conditions, we sought to investigate the relationship between mental illness and smoking in recent population-wide surveys. Methods Survey data from the US National Comorbidity Survey-Replication conducted in 2001–2003, the 2007 Australian Survey of Mental Health and Wellbeing, and the 2007 US National Health Interview Survey were used to investigate the relationship between current smoking, ICD-10 mental disorders and non-specific psychological distress. Population weighted estimates of smoking rates by disorder, and mental disorder rates by smoking status were calculated. Results In both the US and Australia, adults who met ICD-10 criteria for mental disorders in the 12 months prior to the survey smoked at almost twice the rate of adults without mental disorders. While approximately 20% of the adult population had 12-month mental disorders, among adult smokers approximately one-third had a 12-month mental disorder – 31.7% in the US (95% CI: 29.5%–33.8% and 32.4% in Australia (95% CI: 29.5%–35.3%. Female smokers had higher rates of mental disorders than male smokers, and younger smokers had considerably higher rates than older smokers. The majority of mentally ill smokers were not in contact with mental health services, but their rate of smoking was not different from that of mentally ill smokers who had accessed services for their mental health problem. Smokers with high levels of psychological distress smoked a higher average number of cigarettes per day. Conclusion Mental illness is associated with both higher rates of smoking and higher

Childhood Household Dysfunction, Social Inequality and Alcohol Related Illness in Young Adulthood. A Swedish National Cohort Study.

Directory of Open Access Journals (Sweden)

Karl Gauffin

Full Text Available The aim of this paper is to estimate the cumulative effect of childhood household dysfunction (CHD on alcohol related illness and death later in life and to test the interaction between CHD and socioeconomic background. The study utilised Swedish national registers including data of a Swedish national cohort born 1973-82 (n = 872,912, which was followed from age 18 to 29-40 years. Cox regression analyses were used to calculate hazard ratios (HR for alcohol related illness or death in young adulthood. The CHD measure consisted of seven indicators: parental alcohol/drug misuse, mental health problems, criminality, death, divorce, social assistance, and child welfare interventions. Childhood socioeconomic position (SEP was indicated by parental occupational status. Outcomes were alcohol related inpatient hospital care, specialised outpatient care or deaths. Using the highest socioeconomic group without CHD experience as a reference, those in the same socioeconomic group with one indicator of CHD had HRs of 2.1 [95% CI: 1.7-2.5], two CHD indicators 5.6 [4.4-7.1], three or more indicators 9.4 [7.1-12.4] for retrieving inpatient care. Socioeconomic disadvantage further increased the risks-those with low socioeconomic background and three CHD indicators or more had a HR of 12.5 [10.9-14.3]. Testing for interaction suggests that the combined HRs deviates from additivity [Synergy index: 1.6, 95% CI: 1.4-1.9]. The results for outpatient care were similar, but not as pronounced. In conclusion, this Swedish national cohort study shows that childhood household dysfunction is strongly and cumulatively associated to alcohol related illness later in life and that it interacts with socioeconomic disadvantage.

Epidemiological study of cumulative trauma disorder in Kerman\\'s state office workers in 2007

Directory of Open Access Journals (Sweden)

Saberi

2011-03-01

Full Text Available Occupational diseases are consequences of various workplace hazards. Cumulative trauma disorder or repetitive strain injury indicates the effect of repeated physical movements and partial pressure on muscles, tendons and other soft tissues of body. This is the most common disease caused by work. Materials and Methods: This descriptive cross-sectional study performed on state office workers in Kerman city in 2007. Data was collected using examination and three questionnaires about work-related diseases, job satisfaction and job stress. After completion of the questionnaires, a trained researcher analyzed the collected data by SPSS 13 and Chi square test. A level of P≤0.05 was considered significant. Results: Data analysis showed that factors such as repeated writing, typing, using computers at work, repeated lifting objects at the table level, traffic through the steps, traffic through the office corridor, reach of foot to the ground when sitting on the chair, using footrests under desk, using chair cushions, using lumber pillows, or swivel chair were not the cause of cumulative trauma disorder. Repetitive bending and refusal to lean against the seat when sitting were effective in causing the disease. Other findings of our research were employees’ ergonomic awareness status, job satisfaction and job stress being calculated according to the median scores for all three factors as average. Conclusion: Repetitive bending and avoidance from leaning against the chair were significant factors causing high rates of cumulative trauma disorder in office workers of Kerman city. Modification of these factors or even using lumbar supportive equipment may reduce the high prevalence of this disease. Cumulative trauma disorder was found less in employees under the age of thirty and the rates increased with age and work history, linearly.

Measurement of four-particle cumulants and symmetric cumulants with subevent methods in small collision systems with the ATLAS detector

CERN Document Server

Derendarz, Dominik; The ATLAS collaboration

2018-01-01

Measurements of symmetric cumulants SC(n,m)=⟨v2nv2m⟩−⟨v2n⟩⟨v2m⟩ for (n,m)=(2,3) and (2,4) and asymmetric cumulant AC(n) are presented in pp, p+Pb and peripheral Pb+Pb collisions at various collision energies, aiming to probe the long-range collective nature of multi-particle production in small systems. Results are obtained using the standard cumulant method, as well as the two-subevent and three-subevent cumulant methods. Results from the standard method are found to be strongly biased by non-flow correlations as indicated by strong sensitivity to the chosen event class definition. A systematic reduction of non-flow effects is observed when using the two-subevent method and the results become independent of event class definition when the three-subevent method is used. The measured SC(n,m) shows an anti-correlation between v2 and v3, and a positive correlation between v2 and v4. The magnitude of SC(n,m) is constant with Nch in pp collisions, but increases with Nch in p+Pb and Pb+Pb collisions. ...

Childhood Trauma and Chronic Illness in Adulthood: Mental Health and Socioeconomic Status as Explanatory Factors and Buffers

OpenAIRE

Mock, Steven E.; Arai, Susan M.

2011-01-01

Experiences of traumatic events in childhood have been shown to have long-term consequences for health in adulthood. With data from the 2005 Canadian Community Health Survey we take a life course perspective of cumulative disadvantage and examine the potential role of mental health and socioeconomic status in adulthood as multiple mediators of the link between childhood trauma and chronic illness in adulthood. Mental health and socioeconomic status are also tested as buffers against the typ...

Online Scheduling in Manufacturing A Cumulative Delay Approach

CERN Document Server

Suwa, Haruhiko

2013-01-01

Online scheduling is recognized as the crucial decision-making process of production control at a phase of “being in production" according to the released shop floor schedule. Online scheduling can be also considered as one of key enablers to realize prompt capable-to-promise as well as available-to-promise to customers along with reducing production lead times under recent globalized competitive markets. Online Scheduling in Manufacturing introduces new approaches to online scheduling based on a concept of cumulative delay. The cumulative delay is regarded as consolidated information of uncertainties under a dynamic environment in manufacturing and can be collected constantly without much effort at any points in time during a schedule execution. In this approach, the cumulative delay of the schedule has the important role of a criterion for making a decision whether or not a schedule revision is carried out. The cumulative delay approach to trigger schedule revisions has the following capabilities for the ...

Study about Illness: Through the Narrative of "Illness Image"

OpenAIRE

岩城, 晶子

2013-01-01

In this research, the meaning of the illness was studied from the perpective of Image. From listening to the narrative about two types of Illness Image, i.e., "my illness" and "A's illness, " we found that there was a characteristic that the Illness Image was similar to the real image. In addition, there were several differences between 2 images, which indicated that distance between the narrator and these images had an influence. From the syudy of two cases, it was indicated that Illness Ima...

Impact of socioeconomic deprivation on rate and cause of death in severe mental illness.

Science.gov (United States)

Martin, Julie Langan; McLean, Gary; Park, John; Martin, Daniel J; Connolly, Moira; Mercer, Stewart W; Smith, Daniel J

2014-09-12

Socioeconomic status has important associations with disease-specific mortality in the general population. Although individuals with Severe Mental Illnesses (SMI) experience significant premature mortality, the relationship between socioeconomic status and mortality in this group remains under investigated. We aimed to assess the impact of socioeconomic status on rate and cause of death in individuals with SMI (schizophrenia and bipolar disorder) relative to the local (Glasgow) and wider (Scottish) populations. Cause and age of death during 2006-2010 inclusive for individuals with schizophrenia or bipolar disorder registered on the Glasgow Psychosis Clinical Information System (PsyCIS) were obtained by linkage to the Scottish General Register Office (GRO). Rate and cause of death by socioeconomic status, measured by Scottish Index of Multiple Deprivation (SIMD), were compared to the Glasgow and Scottish populations. Death rates were higher in people with SMI across all socioeconomic quintiles compared to the Glasgow and Scottish populations, and persisted when suicide was excluded. Differences were largest in the most deprived quintile (794.6 per 10,000 population vs. 274.7 and 252.4 for Glasgow and Scotland respectively). Cause of death varied by socioeconomic status. For those living in the most deprived quintile, higher drug-related deaths occurred in those with SMI compared to local Glasgow and wider Scottish population rates (12.3% vs. 5.9%, p = socioeconomic quintiles compared to the Glasgow and Scottish populations but was most marked in the most deprived quintiles when suicide was excluded as a cause of death. Further work assessing the impact of socioeconomic status on specific causes of premature mortality in SMI is needed.

Labour participation of the chronically ill: a profile sketch.

NARCIS (Netherlands)

Baanders, A.N.; Rijken, P.M.; Peters, L.

2002-01-01

To improve our understanding of the problematic labour market position of people with a chronic disease, this paper describes the participation rates of several subgroups of the chronically ill in the Netherlands, as well as the aspects by which the working chronically ill differ from those who are

Acute Illness Among Surfers After Exposure to Seawater in Dry- and Wet-Weather Conditions.

Science.gov (United States)

Arnold, Benjamin F; Schiff, Kenneth C; Ercumen, Ayse; Benjamin-Chung, Jade; Steele, Joshua A; Griffith, John F; Steinberg, Steven J; Smith, Paul; McGee, Charles D; Wilson, Richard; Nelsen, Chad; Weisberg, Stephen B; Colford, John M

2017-10-01

Rainstorms increase levels of fecal indicator bacteria in urban coastal waters, but it is unknown whether exposure to seawater after rainstorms increases rates of acute illness. Our objective was to provide the first estimates of rates of acute illness after seawater exposure during both dry- and wet-weather periods and to determine the relationship between levels of indicator bacteria and illness among surfers, a population with a high potential for exposure after rain. We enrolled 654 surfers in San Diego, California, and followed them longitudinally during the 2013-2014 and 2014-2015 winters (33,377 days of observation, 10,081 surf sessions). We measured daily surf activities and illness symptoms (gastrointestinal illness, sinus infections, ear infections, infected wounds). Compared with no exposure, exposure to seawater during dry weather increased incidence rates of all outcomes (e.g., for earache or infection, adjusted incidence rate ratio (IRR) = 1.86, 95% confidence interval (CI): 1.27, 2.71; for infected wounds, IRR = 3.04, 95% CI: 1.54, 5.98); exposure during wet weather further increased rates (e.g., for earache or infection, IRR = 3.28, 95% CI: 1.95, 5.51; for infected wounds, IRR = 4.96, 95% CI: 2.18, 11.29). Fecal indicator bacteria measured in seawater (Enterococcus species, fecal coliforms, total coliforms) were strongly associated with incident illness only during wet weather. Urban coastal seawater exposure increases the incidence rates of many acute illnesses among surfers, with higher incidence rates after rainstorms. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.

Cumulative health risk assessment: integrated approaches for multiple contaminants, exposures, and effects

International Nuclear Information System (INIS)

Rice, Glenn; Teuschler, Linda; MacDonel, Margaret; Butler, Jim; Finster, Molly; Hertzberg, Rick; Harou, Lynne

2007-01-01

Available in abstract form only. Full text of publication follows: As information about environmental contamination has increased in recent years, so has public interest in the combined effects of multiple contaminants. This interest has been highlighted by recent tragedies such as the World Trade Center disaster and hurricane Katrina. In fact, assessing multiple contaminants, exposures, and effects has long been an issue for contaminated sites, including U.S. Department of Energy (DOE) legacy waste sites. Local citizens have explicitly asked the federal government to account for cumulative risks, with contaminants moving offsite via groundwater flow, surface runoff, and air dispersal being a common emphasis. Multiple exposures range from ingestion and inhalation to dermal absorption and external gamma irradiation. Three types of concerns can lead to cumulative assessments: (1) specific sources or releases - e.g., industrial facilities or accidental discharges; (2) contaminant levels - in environmental media or human tissues; and (3) elevated rates of disease - e.g., asthma or cancer. The specific initiator frames the assessment strategy, including a determination of appropriate models to be used. Approaches are being developed to better integrate a variety of data, extending from environmental to internal co-location of contaminants and combined effects, to support more practical assessments of cumulative health risks. (authors)

Fatigue during maximal sprint cycling: unique role of cumulative contraction cycles.

Science.gov (United States)

Tomas, Aleksandar; Ross, Emma Z; Martin, James C

2010-07-01

Maximal cycling power has been reported to decrease more rapidly when performed with increased pedaling rates. Increasing pedaling rate imposes two constraints on the neuromuscular system: 1) decreased time for muscle excitation and relaxation and 2) increased muscle shortening velocity. Using two crank lengths allows the effects of time and shortening velocity to be evaluated separately. We conducted this investigation to determine whether the time available for excitation and relaxation or the muscle shortening velocity was mainly responsible for the increased rate of fatigue previously observed with increased pedaling rates and to evaluate the influence of other possible fatiguing constraints. Seven trained cyclists performed 30-s maximal isokinetic cycling trials using two crank lengths: 120 and 220 mm. Pedaling rate was optimized for maximum power for each crank length: 135 rpm for the 120-mm cranks (1.7 m x s(-1) pedal speed) and 109 rpm for the 220-mm cranks (2.5 m x s(-1) pedal speed). Power was recorded with an SRM power meter. Crank length did not affect peak power: 999 +/- 276 W for the 120-mm crank versus 1001 +/- 289 W for the 220-mm crank. Fatigue index was greater (58.6% +/- 3.7% vs 52.4% +/- 4.8%, P < 0.01), and total work was less (20.0 +/- 1.8 vs 21.4 +/- 2.0 kJ, P < 0.01) with the higher pedaling rate-shorter crank condition. Regression analyses indicated that the power for the two conditions was most highly related to cumulative work (r2 = 0.94) and to cumulative cycles (r2 = 0.99). These results support previous findings and confirm that pedaling rate, rather than pedal speed, was the main factor influencing fatigue. Our novel result was that power decreased by a similar increment with each crank revolution for the two conditions, indicating that each maximal muscular contraction induced a similar amount of fatigue.

Nonparametric Estimation of Cumulative Incidence Functions for Competing Risks Data with Missing Cause of Failure

DEFF Research Database (Denmark)

Effraimidis, Georgios; Dahl, Christian Møller

In this paper, we develop a fully nonparametric approach for the estimation of the cumulative incidence function with Missing At Random right-censored competing risks data. We obtain results on the pointwise asymptotic normality as well as the uniform convergence rate of the proposed nonparametric...

Comorbidity profile and healthcare utilization in elderly patients with serious mental illnesses.

Science.gov (United States)

Hendrie, Hugh C; Lindgren, Donald; Hay, Donald P; Lane, Kathleen A; Gao, Sujuan; Purnell, Christianna; Munger, Stephanie; Smith, Faye; Dickens, Jeanne; Boustani, Malaz A; Callahan, Christopher M

2013-12-01

Patients with serious mental illness are living longer. Yet, there remain few studies that focus on healthcare utilization and its relationship with comorbidities in these elderly mentally ill patients. Comparative study. Information on demographics, comorbidities, and healthcare utilization was taken from an electronic medical record system. Wishard Health Services senior care and community mental health clinics. Patients age 65 years and older-255 patients with serious mental illness (schizophrenia, major recurrent depression, and bipolar illness) attending a mental health clinic and a representative sample of 533 nondemented patients without serious mental illness attending primary care clinics. Patients having serious mental illness had significantly higher rates of medical emergency department visits (p = 0.0027) and significantly longer lengths of medical hospitalizations (p mentally ill group (p seriously mentally ill. The differences in healthcare utilization between the groups remained significant after adjusting for comorbidity levels, lifestyle factors, and attending primary care. Our findings of higher rates of emergency care, longer hospitalizations, and increased frequency of falls, substance abuse, and alcoholism suggest that seriously mentally ill older adults remain a vulnerable population requiring an integrated model of healthcare. Copyright © 2013 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Improving cumulative effects assessment in Alberta: Regional strategic assessment

International Nuclear Information System (INIS)

Johnson, Dallas; Lalonde, Kim; McEachern, Menzie; Kenney, John; Mendoza, Gustavo; Buffin, Andrew; Rich, Kate

2011-01-01

The Government of Alberta, Canada is developing a regulatory framework to better manage cumulative environmental effects from development in the province. A key component of this effort is regional planning, which will lay the primary foundation for cumulative effects management into the future. Alberta Environment has considered the information needs of regional planning and has concluded that Regional Strategic Assessment may offer significant advantages if integrated into the planning process, including the overall improvement of cumulative environmental effects assessment in the province.

A bivariate optimal replacement policy with cumulative repair cost ...

Indian Academy of Sciences (India)

Min-Tsai Lai

Shock model; cumulative damage model; cumulative repair cost limit; preventive maintenance model. 1. Introduction ... with two types of shocks: one type is failure shock, and the other type is damage ...... Theory, methods and applications.

Measurement of soil contamination by radionuclides due to the Fukushima Dai-ichi Nuclear Power Plant accident and associated estimated cumulative external dose estimation

International Nuclear Information System (INIS)

Endo, S.; Kimura, S.; Takatsuji, T.; Nanasawa, K.; Imanaka, T.; Shizuma, K.

2012-01-01

Soil sampling was carried out at an early stage of the Fukushima Dai-ichi Nuclear Power Plant (FDNPP) accident. Samples were taken from areas around FDNPP, at four locations northwest of FDNPP, at four schools and in four cities, including Fukushima City. Radioactive contaminants in soil samples were identified and measured by using a Ge detector and included 129m Te, 129 Te, 131 I, 132 Te, 132 I, 134 Cs, 136 Cs, 137 Cs, 140 Ba and 140 La. The highest soil depositions were measured to the northwest of FDNPP. From this soil deposition data, variations in dose rates over time and the cumulative external doses at the locations for 3 months and 1 y after deposition were estimated. At locations northwest of FDNPP, the external dose rate at 3 months after deposition was 4.8–98 μSv/h and the cumulative dose for 1 y was 51 to 1.0 × 10 3 mSv; the highest values were at Futaba Yamada. At the four schools, which were used as evacuation shelters, and in the four urban cities, the external dose rate at 3 months after deposition ranged from 0.03 to 3.8 μSv/h and the cumulative doses for 1 y ranged from 3 to 40 mSv. The cumulative dose at Fukushima Niihama Park was estimated as the highest in the four cities. The estimated external dose rates and cumulative doses show that careful countermeasures and remediation will be needed as a result of the accident, and detailed measurements of radionuclide deposition densities in soil will be important input data to conduct these activities.

An evaluation paradigm for cumulative impact analysis

Science.gov (United States)

Stakhiv, Eugene Z.

1988-09-01

Cumulative impact analysis is examined from a conceptual decision-making perspective, focusing on its implicit and explicit purposes as suggested within the policy and procedures for environmental impact analysis of the National Environmental Policy Act of 1969 (NEPA) and its implementing regulations. In this article it is also linked to different evaluation and decision-making conventions, contrasting a regulatory context with a comprehensive planning framework. The specific problems that make the application of cumulative impact analysis a virtually intractable evaluation requirement are discussed in connection with the federal regulation of wetlands uses. The relatively familiar US Army Corps of Engineers' (the Corps) permit program, in conjunction with the Environmental Protection Agency's (EPA) responsibilities in managing its share of the Section 404 regulatory program requirements, is used throughout as the realistic context for highlighting certain pragmatic evaluation aspects of cumulative impact assessment. To understand the purposes of cumulative impact analysis (CIA), a key distinction must be made between the implied comprehensive and multiobjective evaluation purposes of CIA, promoted through the principles and policies contained in NEPA, and the more commonly conducted and limited assessment of cumulative effects (ACE), which focuses largely on the ecological effects of human actions. Based on current evaluation practices within the Corps' and EPA's permit programs, it is shown that the commonly used screening approach to regulating wetlands uses is not compatible with the purposes of CIA, nor is the environmental impact statement (EIS) an appropriate vehicle for evaluating the variety of objectives and trade-offs needed as part of CIA. A heuristic model that incorporates the basic elements of CIA is developed, including the idea of trade-offs among social, economic, and environmental protection goals carried out within the context of environmental

Cultural diversity in causal attributions for illness: the role of the supernatural.

Science.gov (United States)

Landrine, H; Klonoff, E A

1994-04-01

We investigated cultural diversity in beliefs about the causes of illness and assessed the possibility that popular free-form methodologies (asking subjects to generate causes) inhibit minorities from expressing their belief in supernatural causes. As predicted, when asked to generate causes of illness and rate these in terms of their importance, whites and minorities did not differ in the number or type (natural vs supernatural) of causes they generated or in the importance rating they assigned to these. However, when these same subjects were provided with natural and supernatural causes to rate in terms of importance, minorities rated supernatural causes significantly more important than did whites, and more minorities than whites endorsed such causes. Cultural differences in causal attributions for illness are examined, and the role of methodology in determining such attributions is highlighted.

Cumulants in perturbation expansions for non-equilibrium field theory

International Nuclear Information System (INIS)

Fauser, R.

1995-11-01

The formulation of perturbation expansions for a quantum field theory of strongly interacting systems in a general non-equilibrium state is discussed. Non-vanishing initial correlations are included in the formulation of the perturbation expansion in terms of cumulants. The cumulants are shown to be the suitable candidate for summing up the perturbation expansion. Also a linked-cluster theorem for the perturbation series with cumulants is presented. Finally a generating functional of the perturbation series with initial correlations is studied. We apply the methods to a simple model of a fermion-boson system. (orig.)

Impact of daily chlorhexidine baths and hand hygiene compliance on nosocomial infection rates in critically ill patients.

Science.gov (United States)

Martínez-Reséndez, Michel Fernando; Garza-González, Elvira; Mendoza-Olazaran, Soraya; Herrera-Guerra, Alexis; Rodríguez-López, Juan Manuel; Pérez-Rodriguez, Edelmiro; Mercado-Longoria, Roberto; Camacho-Ortiz, Adrián

2014-07-01

Up to 25% of all nosocomial infections (NIs) develop in critically ill patients. Our objective was to evaluate chlorhexidine (CHX) bathing and hand hygiene (HH) compliance in the reduction of NIs in the intensive care unit. The study comprised three 6-month periods: preintervention (PIP; soap/water bathing), intervention (IP; bathing with CHX-impregnated wipes), and postintervention (PoIP; soap/water bathing). An HH program was implemented during the IP and PoIP. Primary outcomes were global and specific NI rates. A total of 1007 patients were included. Infection rates per 100 discharges were higher in the PIP compared with the IP and also higher in the PoIP compared with the IP (P = .0004 and .0109, respectively). Global infection rates per 1000 hospital-days were higher in the PIP than in the IP (P = .0268). The rates of ventilator-associated pneumonia (VAP) and catheter-associated urinary tract infection (CAUTI) were higher in the PIP than in the IP (P = .036 and .0001, respectively). Isolation of Acinetobacter baumannii from VAP specimens (P = .0204) and isolation of Candida spp from CAUTI specimens (P = .0005) decreased as well. The combined intervention reduced global and specific infection rates, including rates of VAP associated with A baumannii and CAUTI associated with Candida spp. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Maintenance hemodialysis patients have high cumulative radiation exposure.

LENUS (Irish Health Repository)

Kinsella, Sinead M

2010-10-01

Hemodialysis is associated with an increased risk of neoplasms which may result, at least in part, from exposure to ionizing radiation associated with frequent radiographic procedures. In order to estimate the average radiation exposure of those on hemodialysis, we conducted a retrospective study of 100 patients in a university-based dialysis unit followed for a median of 3.4 years. The number and type of radiological procedures were obtained from a central radiology database, and the cumulative effective radiation dose was calculated using standardized, procedure-specific radiation levels. The median annual radiation dose was 6.9 millisieverts (mSv) per patient-year. However, 14 patients had an annual cumulative effective radiation dose over 20 mSv, the upper averaged annual limit for occupational exposure. The median total cumulative effective radiation dose per patient over the study period was 21.7 mSv, in which 13 patients had a total cumulative effective radiation dose over 75 mSv, a value reported to be associated with a 7% increased risk of cancer-related mortality. Two-thirds of the total cumulative effective radiation dose was due to CT scanning. The average radiation exposure was significantly associated with the cause of end-stage renal disease, history of ischemic heart disease, transplant waitlist status, number of in-patient hospital days over follow-up, and death during the study period. These results highlight the substantial exposure to ionizing radiation in hemodialysis patients.

All-Cause, 30-Day Readmissions Among Persons With Intellectual and Developmental Disabilities and Mental Illness.

Science.gov (United States)

Balogh, Robert; Lin, Elizabeth; Dobranowski, Kristin; Selick, Avra; Wilton, Andrew S; Lunsky, Yona

2018-03-01

Early hospital readmissions within 30 days of discharge are common and costly. This research describes predictors of all-cause, 30-day hospital readmissions among persons with intellectual and developmental disabilities (IDD), a group known to experience high rates of hospitalization. A cohort of 66,484 adults with IDD from Ontario, Canada, was used to create two subgroups: individuals with IDD only and those with IDD and mental illness. The rates of hospital readmission were determined and contrasted with a comparison subgroup of people without IDD who have mental illness. Compared with those with mental illness only, individuals with IDD and mental illness were 1.7 times more likely to experience a hospital readmission within 30 days. Predictors of their readmission rates included being a young adult and having high morbidity levels. The high rate of hospital readmission suggests that individuals with IDD and mental illness need attention regarding discharge planning and outpatient follow-up.

Injury and illness epidemiology at a summer sport-camp program, 2008 through 2011.

Science.gov (United States)

Oller, Daria M; Buckley, W E; Sebastianelli, Wayne J; Vairo, Giampietro L

2015-03-01

University-sponsored summer sport camps often employ athletic trainers; however, there is a dearth of epidemiologic studies describing the injury and illness experience of sport-camp participants to guide clinicians. To describe the injury and illness experience of youth participants at a university-sponsored summer sport-camp program during a 4-year period. Descriptive epidemiology study. A National Collegiate Athletic Association Division I university that sponsored 76 to 81 camps for 28 sports each summer. A total of 44, 499 camp participants enrolled during the 4 years. Male and female participants ranged in age from 10 to 17 years and in athletic skill from novice to elite. Data from handwritten injury and illness log books, maintained by sports health care personnel, were accessed retrospectively, entered into an electronic spreadsheet, and coded. Data were applied to the National Athletic Injury/Illness Reporting System. Participant-personnel contacts, defined as any instance when a participant sought health care services from personnel, were calculated per 100 participants. Injury and illness rates were calculated per 10 ,000 exposures, measured in participant-days. The distribution of injury and illness conditions and affected body regions were calculated. There were 11 ,735 contacts, for an overall rate of 26 per 100 participants, and 4949 injuries and illnesses, for a rate of 1 per 10, 000 participant-days. Participants at single-sex camps were less likely to sustain injuries and illnesses than participants at coeducational camps (rate ratio [RR] = 0.49; 95% confidence interval = 0.45, 0. 35; P < .001, and RR = 0.47; 95% confidence interval = 0.43, 0.51; P < .001, respectively). The lower extremity was injured most frequently (27.9%). Most injury and illness conditions were dermatologic (37.1%). The contact and injury and illness differences observed among sports and between sexes demonstrated potential differences in the sports health care needs

CUMBIN - CUMULATIVE BINOMIAL PROGRAMS

Science.gov (United States)

Bowerman, P. N.

1994-01-01

The cumulative binomial program, CUMBIN, is one of a set of three programs which calculate cumulative binomial probability distributions for arbitrary inputs. The three programs, CUMBIN, NEWTONP (NPO-17556), and CROSSER (NPO-17557), can be used independently of one another. CUMBIN can be used by statisticians and users of statistical procedures, test planners, designers, and numerical analysts. The program has been used for reliability/availability calculations. CUMBIN calculates the probability that a system of n components has at least k operating if the probability that any one operating is p and the components are independent. Equivalently, this is the reliability of a k-out-of-n system having independent components with common reliability p. CUMBIN can evaluate the incomplete beta distribution for two positive integer arguments. CUMBIN can also evaluate the cumulative F distribution and the negative binomial distribution, and can determine the sample size in a test design. CUMBIN is designed to work well with all integer values 0 < k <= n. To run the program, the user simply runs the executable version and inputs the information requested by the program. The program is not designed to weed out incorrect inputs, so the user must take care to make sure the inputs are correct. Once all input has been entered, the program calculates and lists the result. The CUMBIN program is written in C. It was developed on an IBM AT with a numeric co-processor using Microsoft C 5.0. Because the source code is written using standard C structures and functions, it should compile correctly with most C compilers. The program format is interactive. It has been implemented under DOS 3.2 and has a memory requirement of 26K. CUMBIN was developed in 1988.

Apparent Dependence of Rate- and State-Dependent Friction Parameters on Loading Velocity and Cumulative Displacement Inferred from Large-Scale Biaxial Friction Experiments

Science.gov (United States)

Urata, Yumi; Yamashita, Futoshi; Fukuyama, Eiichi; Noda, Hiroyuki; Mizoguchi, Kazuo

2017-06-01

We investigated the constitutive parameters in the rate- and state-dependent friction (RSF) law by conducting numerical simulations, using the friction data from large-scale biaxial rock friction experiments for Indian metagabbro. The sliding surface area was 1.5 m long and 0.5 m wide, slid for 400 s under a normal stress of 1.33 MPa at a loading velocity of either 0.1 or 1.0 mm/s. During the experiments, many stick-slips were observed and those features were as follows. (1) The friction drop and recurrence time of the stick-slip events increased with cumulative slip displacement in an experiment before which the gouges on the surface were removed, but they became almost constant throughout an experiment conducted after several experiments without gouge removal. (2) The friction drop was larger and the recurrence time was shorter in the experiments with faster loading velocity. We applied a one-degree-of-freedom spring-slider model with mass to estimate the RSF parameters by fitting the stick-slip intervals and slip-weakening curves measured based on spring force and acceleration of the specimens. We developed an efficient algorithm for the numerical time integration, and we conducted forward modeling for evolution parameters ( b) and the state-evolution distances (L_{{c}}), keeping the direct effect parameter ( a) constant. We then identified the confident range of b and L_{{c}} values. Comparison between the results of the experiments and our simulations suggests that both b and L_{{c}} increase as the cumulative slip displacement increases, and b increases and L_{{c}} decreases as the loading velocity increases. Conventional RSF laws could not explain the large-scale friction data, and more complex state evolution laws are needed.

77 FR 44571 - Rate Regulation Reforms

Science.gov (United States)

2012-07-30

... current T-bill rate to the U.S. Prime Rate, as published in The Wall Street Journal. Additional... ``exponential'' approach, the total cumulative reparations payment (including interest) is calculated by...

Cumulative Training Dose's Effects on Interrelationships Between Common Training-Load Models During Basketball Activity.

Science.gov (United States)

Scanlan, Aaron T; Fox, Jordan L; Borges, Nattai R; Dascombe, Ben J; Dalbo, Vincent J

2017-02-01

The influence of various factors on training-load (TL) responses in basketball has received limited attention. This study aimed to examine the temporal changes and influence of cumulative training dose on TL responses and interrelationships during basketball activity. Ten state-level Australian male junior basketball players completed 4 × 10-min standardized bouts of simulated basketball activity using a circuit-based protocol. Internal TL was quantified using the session rating of perceived exertion (sRPE), summated heart-rate zones (SHRZ), Banister training impulse (TRIMP), and Lucia TRIMP models. External TL was assessed via measurement of mean sprint and circuit speeds. Temporal TL comparisons were performed between 10-min bouts, while Pearson correlation analyses were conducted across cumulative training doses (0-10, 0-20, 0-30, and 0-40 min). sRPE TL increased (P basketball activity. sRPE TL was only significantly related to Lucia TRIMP (r = .66-.69; P basketball training doses lasting beyond 20 min. Thus, the interchangeability of commonly used internal and external TL approaches appears dose-dependent during basketball activity, with various psychophysiological mediators likely underpinning temporal changes.

Illness trajectories in patients with amyotrophic lateral sclerosis: How illness progression is related to life narratives and interpersonal relationships.

Science.gov (United States)

Cipolletta, Sabrina; Gammino, Giorgia Rosamaria; Palmieri, Arianna

2017-12-01

To identify illness trajectories in amyotrophic lateral sclerosis by analysing personal, social and functional dimensions related to amyotrophic lateral sclerosis progression. Previous studies have considered some psychological distinct variables that may moderate illness progression, but no research has combined an extensive qualitative understanding of amyotrophic lateral sclerosis patients' psychological characteristics and illness progression. A mixed-methods approach was used to combine quantitative and qualitative measures. Illness progression was assessed through a longitudinal design. Eighteen patients with amyotrophic lateral sclerosis attending a Neurology Department in northern Italy participated in the study. Semi-structured interviews to explore personal experience, and dependency grids to assess the distribution of dependency; ALSFRS-R and neuropsychological screening were, respectively, used to measure physical and cognitive impairment. To assess the progression of the disease, ALSFRS-R was re-administered after 8 months and mortality rate was considered. Data were analysed using the grounded theory approach. Illness progression changed according to the perception of the disease, the trust placed in medical care, self-construction and the distribution of dependency. Based on these categories, cases that had similar experiences were grouped, and four illness trajectories were identified: aggressiveness, threat, constriction and guilt. The findings suggest that it is possible to identify different illness trajectories in amyotrophic lateral sclerosis. Personalised intervention strategies may be construed based on the different trajectories identified. © 2017 John Wiley & Sons Ltd.

Kaplan-Meier survival analysis overestimates cumulative incidence of health-related events in competing risk settings: a meta-analysis.

Science.gov (United States)

Lacny, Sarah; Wilson, Todd; Clement, Fiona; Roberts, Derek J; Faris, Peter; Ghali, William A; Marshall, Deborah A

2018-01-01

Kaplan-Meier survival analysis overestimates cumulative incidence in competing risks (CRs) settings. The extent of overestimation (or its clinical significance) has been questioned, and CRs methods are infrequently used. This meta-analysis compares the Kaplan-Meier method to the cumulative incidence function (CIF), a CRs method. We searched MEDLINE, EMBASE, BIOSIS Previews, Web of Science (1992-2016), and article bibliographies for studies estimating cumulative incidence using the Kaplan-Meier method and CIF. For studies with sufficient data, we calculated pooled risk ratios (RRs) comparing Kaplan-Meier and CIF estimates using DerSimonian and Laird random effects models. We performed stratified meta-analyses by clinical area, rate of CRs (CRs/events of interest), and follow-up time. Of 2,192 identified abstracts, we included 77 studies in the systematic review and meta-analyzed 55. The pooled RR demonstrated the Kaplan-Meier estimate was 1.41 [95% confidence interval (CI): 1.36, 1.47] times higher than the CIF. Overestimation was highest among studies with high rates of CRs [RR = 2.36 (95% CI: 1.79, 3.12)], studies related to hepatology [RR = 2.60 (95% CI: 2.12, 3.19)], and obstetrics and gynecology [RR = 1.84 (95% CI: 1.52, 2.23)]. The Kaplan-Meier method overestimated the cumulative incidence across 10 clinical areas. Using CRs methods will ensure accurate results inform clinical and policy decisions. Copyright © 2017 Elsevier Inc. All rights reserved.

Cumulative effect in multiple production processes on nuclei

International Nuclear Information System (INIS)

Golubyatnikova, E.S.; Shmonin, V.L.; Kalinkin, B.N.

1989-01-01

It is shown that the cumulative effect is a natural result of the process of hadron multiple production in nuclear reactions. Interpretation is made of the universality of slopes of inclusive spectra and other characteristics of cumulative hadrons. The character of information from such reactions is discussed, which could be helpful in studying the mechanism of multiparticle production. 27 refs.; 4 figs

VALUATION OR ORAL HYGIENE CAPACITY ON WORKERS SUFFERING OF CUMULATIVE TRAUMA DISORDERS

Directory of Open Access Journals (Sweden)

Márcia Bianchi

2010-07-01

Full Text Available Through interviews with patients with cumulative trauma disorders, pathological conditions known as work related upper limb disorder (WRULD users of Sao Paulo’s workers health reference centers, the most frequently daily difficulty were related. Wue observed that most of them (76.3% can not perform their toothbrushing satisfactorily, mainly due to complaints of pain and physical limitations caused by his illness. This finding could be strengthened by raising the conditions of oral hygiene based on the index of "O'Leary", which were detected high levels of plaque (mean = 76.96%. In view of this, special attention should be paid to these workers so that they can perform their oral hygiene properly without Avaliação da capacidade de higiene bucal em portadores de TMC burden on their upper limbs affected, preventing thus possible oral problems. Dentist's role will therefore beyond teaching the techniques of brushing, but to develop sensitivity to detect limitations and difficulties of their patients, to offer alternatives to minimize discomfort and optimize techniques for patients with brushing WRULD.

Estimating a population cumulative incidence under calendar time trends

DEFF Research Database (Denmark)

Hansen, Stefan N; Overgaard, Morten; Andersen, Per K

2017-01-01

BACKGROUND: The risk of a disease or psychiatric disorder is frequently measured by the age-specific cumulative incidence. Cumulative incidence estimates are often derived in cohort studies with individuals recruited over calendar time and with the end of follow-up governed by a specific date....... It is common practice to apply the Kaplan-Meier or Aalen-Johansen estimator to the total sample and report either the estimated cumulative incidence curve or just a single point on the curve as a description of the disease risk. METHODS: We argue that, whenever the disease or disorder of interest is influenced...

Sports injuries and illnesses during the second Asian Beach Games.

Science.gov (United States)

Al-Shaqsi, Sultan; Al-Kashmiri, Ammar; Al-Risi, Ahmed; Al-Mawali, Suleiman

2012-09-01

Prevention of sport injuries and illnesses is a focus for epidemiological surveillance. To record and analyse all sports injuries and illnesses registered during the second Asian Beach Games. A descriptive epidemiological study using the International Olympic Committee Surveillance system to register injuries and illnesses during the second Asian Beach Games. The second Asian Beach Games hosted 1132 athletes from 43 countries competing in 14 beach sports. All National Olympic Committees' physicians of the participating teams were invited to report all injuries and illnesses. In addition, medical officers at the different Olympic venues and the main Olympic village reported injuries and illnesses treated at the clinics on a daily basis. A total of 177 injuries were reported equating to an incidence rate of 156.4 per 1000 registered athletes. Tent pegging recorded the highest incidence of injuries with 357 per 1000 registered athletes. The most prevalent injuries were in the foot/toe with 14.1% of all reported injuries. The majority of injuries were incurred during competition (75.4%). In addition, the most common mechanism of injury was contact with another athlete (n=42, 23.7%) and combined sudden and gradual overuse contributed to 30% of the total injury burden. Furthermore, 118 illnesses were reported resulting in an incidence rate of 104.2 illnesses per 1000 registered athletes. The most affected system was the respiratory tract (39.1%) with infection being the most common cause (n=33, 38.0%). The incidence of injury and illness differed significantly among the 14 sports. The data indicate that the risk of injury from beach games is sport dependant. This means that any preventive measures have to be tailored for each discipline. Furthermore, the study showed that respiratory infections are the commonest illness in beach sports and therefore, event organisers should focus improving public health measures and hygiene awareness.

Cumulative Significance of Hyporheic Exchange and Biogeochemical Processing in River Networks

Science.gov (United States)

Harvey, J. W.; Gomez-Velez, J. D.

2014-12-01

Biogeochemical reactions in rivers that decrease excessive loads of nutrients, metals, organic compounds, etc. are enhanced by hydrologic interactions with microbially and geochemically active sediments of the hyporheic zone. The significance of reactions in individual hyporheic flow paths has been shown to be controlled by the contact time between river water and sediment and the intrinsic reaction rate in the sediment. However, little is known about how the cumulative effects of hyporheic processing in large river basins. We used the river network model NEXSS (Gomez-Velez and Harvey, submitted) to simulate hyporheic exchange through synthetic river networks based on the best available models of network topology, hydraulic geometry and scaling of geomorphic features, grain size, hydraulic conductivity, and intrinsic reaction rates of nutrients and metals in river sediment. The dimensionless reaction significance factor, RSF (Harvey et al., 2013) was used to quantify the cumulative removal fraction of a reactive solute by hyporheic processing. SF scales reaction progress in a single pass through the hyporheic zone with the proportion of stream discharge passing through the hyporheic zone for a specified distance. Reaction progress is optimal where the intrinsic reaction timescale in sediment matches the residence time of hyporheic flow and is less efficient in longer residence time hyporheic flow as a result of the decreasing proportion of river flow that is processed by longer residence time hyporheic flow paths. In contrast, higher fluxes through short residence time hyporheic flow paths may be inefficient because of the repeated surface-subsurface exchanges required to complete the reaction. Using NEXSS we found that reaction efficiency may be high in both small streams and large rivers, although for different reasons. In small streams reaction progress generally is dominated by faster pathways of vertical exchange beneath submerged bedforms. Slower exchange

A Framework for Treating Cumulative Trauma with Art Therapy

Science.gov (United States)

Naff, Kristina

2014-01-01

Cumulative trauma is relatively undocumented in art therapy practice, although there is growing evidence that art therapy provides distinct benefits for resolving various traumas. This qualitative study proposes an art therapy treatment framework for cumulative trauma derived from semi-structured interviews with three art therapists and artistic…

Cumulative Environmental Impacts: Science and Policy to Protect Communities.

Science.gov (United States)

Solomon, Gina M; Morello-Frosch, Rachel; Zeise, Lauren; Faust, John B

2016-01-01

Many communities are located near multiple sources of pollution, including current and former industrial sites, major roadways, and agricultural operations. Populations in such locations are predominantly low-income, with a large percentage of minorities and non-English speakers. These communities face challenges that can affect the health of their residents, including limited access to health care, a shortage of grocery stores, poor housing quality, and a lack of parks and open spaces. Environmental exposures may interact with social stressors, thereby worsening health outcomes. Age, genetic characteristics, and preexisting health conditions increase the risk of adverse health effects from exposure to pollutants. There are existing approaches for characterizing cumulative exposures, cumulative risks, and cumulative health impacts. Although such approaches have merit, they also have significant constraints. New developments in exposure monitoring, mapping, toxicology, and epidemiology, especially when informed by community participation, have the potential to advance the science on cumulative impacts and to improve decision making.

Mental Illness

Science.gov (United States)

... the same time. For example, you may have depression and a substance use disorder. Complications Mental illness is a leading cause of disability. Untreated mental illness can cause severe emotional, behavioral and physical health problems. Complications sometimes linked to mental illness include: ...

Baltic Sea biodiversity status vs. cumulative human pressures

DEFF Research Database (Denmark)

Andersen, Jesper H.; Halpern, Benjamin S.; Korpinen, Samuli

2015-01-01

Abstract Many studies have tried to explain spatial and temporal variations in biodiversity status of marine areas from a single-issue perspective, such as fishing pressure or coastal pollution, yet most continental seas experience a wide range of human pressures. Cumulative impact assessments have...... been developed to capture the consequences of multiple stressors for biodiversity, but the ability of these assessments to accurately predict biodiversity status has never been tested or ground-truthed. This relationship has similarly been assumed for the Baltic Sea, especially in areas with impaired...... status, but has also never been documented. Here we provide a first tentative indication that cumulative human impacts relate to ecosystem condition, i.e. biodiversity status, in the Baltic Sea. Thus, cumulative impact assessments offer a promising tool for informed marine spatial planning, designation...

Conceptual models for cumulative risk assessment.

Science.gov (United States)

Linder, Stephen H; Sexton, Ken

2011-12-01

In the absence of scientific consensus on an appropriate theoretical framework, cumulative risk assessment and related research have relied on speculative conceptual models. We argue for the importance of theoretical backing for such models and discuss 3 relevant theoretical frameworks, each supporting a distinctive "family" of models. Social determinant models postulate that unequal health outcomes are caused by structural inequalities; health disparity models envision social and contextual factors acting through individual behaviors and biological mechanisms; and multiple stressor models incorporate environmental agents, emphasizing the intermediary role of these and other stressors. The conclusion is that more careful reliance on established frameworks will lead directly to improvements in characterizing cumulative risk burdens and accounting for disproportionate adverse health effects.

Cumulative Socioeconomic Status Risk, Allostatic Load, and Adjustment: A Prospective Latent Profile Analysis with Contextual and Genetic Protective Factors

Science.gov (United States)

Brody, Gene H.; Yu, Tianyi; Chen, Yi-Fu; Kogan, Steven M.; Evans, Gary W.; Beach, Steven R. H.; Windle, Michael; Simons, Ronald L.; Gerrard, Meg; Gibbons, Frederick X.; Philibert, Robert A.

2013-01-01

The health disparities literature has identified a common pattern among middle-aged African Americans that includes high rates of chronic disease along with low rates of psychiatric disorders despite exposure to high levels of cumulative socioeconomic status (SES) risk. The current study was designed to test hypotheses about the developmental…

Adolescent construction of mental illness: implication for engagement and treatment.

Science.gov (United States)

Chisholm, Katharine; Patterson, Paul; Greenfield, Sheila; Turner, Erin; Birchwood, Max

2016-05-11

Understanding how adolescents perceive mental illness is important for clinicians wishing to improve engagement, and for the development of educational programmes and health-behaviour directed policies. The current research aimed to develop a preliminary model of how adolescents perceive mental illness and construct their understanding of mental health. Forty-six participants aged 11-18 from six schools in Birmingham, UK, took part in one of 12 group interviews. A thematic analysis highlighted a dual perception of mental illness. Adolescents discussed stereotypes and extreme examples of illness, but also displayed an insightful understanding of mental distress which had developed through participants' own experiences. Participants attempted to reconcile and negotiate these conflicting perceptions by creating distinctions between concepts of 'craziness' and 'normality', and reported experiencing negative emotions relating to both perceptions of illness. The findings suggest that once media stereotypes have been acknowledged, adolescents demonstrate a relatively sophisticated understanding of mental illness, although one which differed at times from the diagnostic medical model of mental illness. Focusing on individual symptoms, prevalence rates and prior contact adolescents have had with individuals with mental illnesses provides a framework to discuss mental health and ill-health with adolescents. John Wiley & Sons Australia, Ltd.

Association between public views of mental illness and self-stigma among individuals with mental illness in 14 European countries.

Science.gov (United States)

Evans-Lacko, S; Brohan, E; Mojtabai, R; Thornicroft, G

2012-08-01

Little is known about how the views of the public are related to self-stigma among people with mental health problems. Despite increasing activity aimed at reducing mental illness stigma, there is little evidence to guide and inform specific anti-stigma campaign development and messages to be used in mass campaigns. A better understanding of the association between public knowledge, attitudes and behaviours and the internalization of stigma among people with mental health problems is needed. This study links two large, international datasets to explore the association between public stigma in 14 European countries (Eurobarometer survey) and individual reports of self-stigma, perceived discrimination and empowerment among persons with mental illness (n=1835) residing in those countries [the Global Alliance of Mental Illness Advocacy Networks (GAMIAN) study]. Individuals with mental illness living in countries with less stigmatizing attitudes, higher rates of help-seeking and treatment utilization and better perceived access to information had lower rates of self-stigma and perceived discrimination and those living in countries where the public felt more comfortable talking to people with mental illness had less self-stigma and felt more empowered. Targeting the general public through mass anti-stigma interventions may lead to a virtuous cycle by disrupting the negative feedback engendered by public stigma, thereby reducing self-stigma among people with mental health problems. A combined approach involving knowledge, attitudes and behaviour is needed; mass interventions that facilitate disclosure and positive social contact may be the most effective. Improving availability of information about mental health issues and facilitating access to care and help-seeking also show promise with regard to stigma.

The challenges and opportunities in cumulative effects assessment

Energy Technology Data Exchange (ETDEWEB)

Foley, Melissa M., E-mail: mfoley@usgs.gov [U.S. Geological Survey, Pacific Coastal and Marine Science Center, 400 Natural Bridges, Dr., Santa Cruz, CA 95060 (United States); Center for Ocean Solutions, Stanford University, 99 Pacific St., Monterey, CA 93940 (United States); Mease, Lindley A., E-mail: lamease@stanford.edu [Center for Ocean Solutions, Stanford University, 473 Via Ortega, Stanford, CA 94305 (United States); Martone, Rebecca G., E-mail: rmartone@stanford.edu [Center for Ocean Solutions, Stanford University, 99 Pacific St., Monterey, CA 93940 (United States); Prahler, Erin E. [Center for Ocean Solutions, Stanford University, 473 Via Ortega, Stanford, CA 94305 (United States); Morrison, Tiffany H., E-mail: tiffany.morrison@jcu.edu.au [ARC Centre of Excellence for Coral Reef Studies, James Cook University, Townsville, QLD, 4811 (Australia); Murray, Cathryn Clarke, E-mail: cmurray@pices.int [WWF-Canada, 409 Granville Street, Suite 1588, Vancouver, BC V6C 1T2 (Canada); Wojcik, Deborah, E-mail: deb.wojcik@duke.edu [Nicholas School for the Environment, Duke University, 9 Circuit Dr., Durham, NC 27708 (United States)

2017-01-15

The cumulative effects of increasing human use of the ocean and coastal zone have contributed to a rapid decline in ocean and coastal resources. As a result, scientists are investigating how multiple, overlapping stressors accumulate in the environment and impact ecosystems. These investigations are the foundation for the development of new tools that account for and predict cumulative effects in order to more adequately prevent or mitigate negative effects. Despite scientific advances, legal requirements, and management guidance, those who conduct assessments—including resource managers, agency staff, and consultants—continue to struggle to thoroughly evaluate cumulative effects, particularly as part of the environmental assessment process. Even though 45 years have passed since the United States National Environmental Policy Act was enacted, which set a precedent for environmental assessment around the world, defining impacts, baseline, scale, and significance are still major challenges associated with assessing cumulative effects. In addition, we know little about how practitioners tackle these challenges or how assessment aligns with current scientific recommendations. To shed more light on these challenges and gaps, we undertook a comparative study on how cumulative effects assessment (CEA) is conducted by practitioners operating under some of the most well-developed environmental laws around the globe: California, USA; British Columbia, Canada; Queensland, Australia; and New Zealand. We found that practitioners used a broad and varied definition of impact for CEA, which led to differences in how baseline, scale, and significance were determined. We also found that practice and science are not closely aligned and, as such, we highlight opportunities for managers, policy makers, practitioners, and scientists to improve environmental assessment.

The challenges and opportunities in cumulative effects assessment

International Nuclear Information System (INIS)

Foley, Melissa M.; Mease, Lindley A.; Martone, Rebecca G.; Prahler, Erin E.; Morrison, Tiffany H.; Murray, Cathryn Clarke; Wojcik, Deborah

2017-01-01

The cumulative effects of increasing human use of the ocean and coastal zone have contributed to a rapid decline in ocean and coastal resources. As a result, scientists are investigating how multiple, overlapping stressors accumulate in the environment and impact ecosystems. These investigations are the foundation for the development of new tools that account for and predict cumulative effects in order to more adequately prevent or mitigate negative effects. Despite scientific advances, legal requirements, and management guidance, those who conduct assessments—including resource managers, agency staff, and consultants—continue to struggle to thoroughly evaluate cumulative effects, particularly as part of the environmental assessment process. Even though 45 years have passed since the United States National Environmental Policy Act was enacted, which set a precedent for environmental assessment around the world, defining impacts, baseline, scale, and significance are still major challenges associated with assessing cumulative effects. In addition, we know little about how practitioners tackle these challenges or how assessment aligns with current scientific recommendations. To shed more light on these challenges and gaps, we undertook a comparative study on how cumulative effects assessment (CEA) is conducted by practitioners operating under some of the most well-developed environmental laws around the globe: California, USA; British Columbia, Canada; Queensland, Australia; and New Zealand. We found that practitioners used a broad and varied definition of impact for CEA, which led to differences in how baseline, scale, and significance were determined. We also found that practice and science are not closely aligned and, as such, we highlight opportunities for managers, policy makers, practitioners, and scientists to improve environmental assessment.

The challenges and opportunities in cumulative effects assessment

Science.gov (United States)

Foley, Melissa M.; Mease, Lindley A; Martone, Rebecca G; Prahler, Erin E; Morrison, Tiffany H; Clarke Murray, Cathryn; Wojcik, Deborah

2016-01-01

The cumulative effects of increasing human use of the ocean and coastal zone have contributed to a rapid decline in ocean and coastal resources. As a result, scientists are investigating how multiple, overlapping stressors accumulate in the environment and impact ecosystems. These investigations are the foundation for the development of new tools that account for and predict cumulative effects in order to more adequately prevent or mitigate negative effects. Despite scientific advances, legal requirements, and management guidance, those who conduct assessments—including resource managers, agency staff, and consultants—continue to struggle to thoroughly evaluate cumulative effects, particularly as part of the environmental assessment process. Even though 45 years have passed since the United States National Environmental Policy Act was enacted, which set a precedent for environmental assessment around the world, defining impacts, baseline, scale, and significance are still major challenges associated with assessing cumulative effects. In addition, we know little about how practitioners tackle these challenges or how assessment aligns with current scientific recommendations. To shed more light on these challenges and gaps, we undertook a comparative study on how cumulative effects assessment (CEA) is conducted by practitioners operating under some of the most well-developed environmental laws around the globe: California, USA; British Columbia, Canada; Queensland, Australia; and New Zealand. We found that practitioners used a broad and varied definition of impact for CEA, which led to differences in how baseline, scale, and significance were determined. We also found that practice and science are not closely aligned and, as such, we highlight opportunities for managers, policy makers, practitioners, and scientists to improve environmental assessment.

Developing a multi-component immune model for evaluating the risk of respiratory illness in athletes.

Science.gov (United States)

Gleeson, Maree; Pyne, David B; Elkington, Lisa J; Hall, Sharron T; Attia, John R; Oldmeadow, Christopher; Wood, Lisa G; Callister, Robin

2017-01-01

Clinical and laboratory identification of the underlying risk of respiratory illness in athletes has proved problematic. The aim of this study was to determine whether clinical data, combined with immune responses to standardised exercise protocols and genetic cytokine polymorphism status, could identify the risk of respiratory illness (symptoms) in a cohort of highly-trained athletes. Male endurance athletes (n=16; VO2max 66.5 ± 5.1 mL.kg-1.min-1) underwent a clinical evaluation of known risk factors by a physician and comprehensive laboratory analysis of immune responses both at rest and after two cycling ergometer tests: 60 min at 65% VO2max (LONG); and 6 x 3 min intervals at 90% VO2max (INTENSE). Blood tests were performed to determine Epstein Barr virus (EBV) status and DNA was genotyped for a panel of cytokine gene polymorphisms. Saliva was collected for measurement of IgA and detection of EBV DNA. Athletes were then followed for 9 months for self-reported episodes of respiratory illness, with confirmation of the underlying cause by a sports physician. There were no associations with risk of respiratory illness identified for any parameter assessed in the clinical evaluations. The laboratory parameters associated with an increased risk of respiratory illnesses in highly-trained athletes were cytokine gene polymorphisms for the high expression of IL-6 and IFN-ɣ; expression of EBV-DNA in saliva; and low levels of salivary IgA concentration. A genetic risk score was developed for the cumulative number of minor alleles for the cytokines evaluated. Athletes prone to recurrent respiratory illness were more likely to have immune disturbances that allow viral reactivation, and a genetic predisposition to pro-inflammatory cytokine responses to intense exercise. Copyright © 2016 International Society of Exercise and Immunology. All rights reserved.

Mass sociogenic illness in a youth center.

Science.gov (United States)

Desenclos, J C; Gardner, H; Horan, M

1992-01-01

In July, 1989, 63 (42%) of 150 children ages 4-14 years attending an outreach program at a youth center in Florida, but no employees, developed acute and rapidly resolving upper gastrointestinal symptoms 2 to 40 minutes after a prepackaged lunch. All ill children were sent to 3 local hospital emergency departments for evaluation. However, clinical evaluation was normal for all. Of 102 children who ate any prepackaged foods, 48 (47%) became ill compared to 1/19 (5%) for children who did not eat (rate ratio [RR] = 8.9; 95% confidence interval [CI]: 1.3-60.9). No employees ate any of the food items served. Consumption of sandwiches was associated with a moderate increased risk of illness (RR = 1.7, 95% CI: 1.0-2.9). The attack rate did not differ by age, but was greater for girls (39/56, 70%) than for boys (9/46, 20%; [RR = 3.6, 95% CI: 1.9-6.6]). Over 3,000 similar prepackaged meals from the same caterer were served in the same area of Florida that day. An inquiry in the area documented absence of similar symptoms elsewhere. Unopened meal samples tested negative for pesticide residues, heavy metals, staphylococcal toxin, or Bacillus cereus. We diagnosed the outbreak as mass sociogenic illness. Complaints of a bad tasting sandwich by the index case and possible staff anxiety about food poisoning may have contributed to the development of the outbreak.

An analytical model for cumulative infiltration into a dual-permeability media

Science.gov (United States)

Peyrard, Xavier; Lassabatere, Laurent; Angulo-Jaramillo, Rafael; Simunek, Jiri

2010-05-01

Modeling of water infiltration into the vadose zone is important for better understanding of movement of water-transported contaminants. There is a great need to take into account the soil heterogeneity and, in particular, the presence of macropores or cracks that could generate preferential flow. Several mathematical models have been proposed to describe unsaturated flow through heterogeneous soils. The dual-permeability model assumes that flow is governed by Richards equation in both porous regions (matrix and fractures). Water can be exchanged between the two regions following a first-order rate law. A previous study showed that the influence of the hydraulic conductivity of the matrix/macropore interface had a little influence on cumulative infiltration at the soil surface. As a result, one could consider the surface infiltration for a specific case of no water exchange between the fracture and matrix regions (a case of zero interfacial hydraulic conductivity). In such a case, water infiltration can be considered to be the sum of the cumulative infiltrations into the matrix and the fractures. On the basis of analytical models for each sub domain (matrix and fractures), an analytical model is proposed for the entire dual-porosity system. A sensitivity analysis is performed to characterize the influence of several factors, such as the saturated hydraulic conductivity ratio, the water pressure scale parameter ratio, and the saturated volumetric water content scale ratio, on the total cumulative infiltration. Such an analysis greatly helps in quantifying the impact of macroporosity and fractures on water infiltration, which can be of great interest for hydrological models.

The changing face of newspaper representations of the mentally ill.

Science.gov (United States)

Murphy, Neil A; Fatoye, Francis; Wibberley, Christopher

2013-06-01

Negative stereotypes presented in the media may contribute to the stigma associated with mental illness. People's attitudes towards the mentally ill are initially influenced and subsequently maintained in part by the frequent media presentation of negative stereotypes of mental illness. This could result in social rejection of individuals with mental illnesses. To explore how four main U.K. national newspapers reported on mental health/mental illness stories over a 10-year period. This study utilised content analysis to identify words, themes and trends of representation related to the mentally ill in articles from the four newspapers. The findings indicated that there was an increase in the number of articles related to mental health/illness over the time of the study. The rate of increase was far greater than that for the increase in the total number of articles carried in the press over this time period. It was also identified that pejorative terms were used, in a number of the articles, to describe the mentally ill person. Many of the newspaper reports highlighted the need for protection of the general public from the mentally ill, and that the mentally ill were in some way different to the general public. In particular, both the words "violence" and "drugs" were linked to mental health/mental illness in these articles.

Managing regional cumulative effects of oil sands development in Alberta, Canada

International Nuclear Information System (INIS)

Spaling, H.; Zwier, J.

2000-01-01

This paper demonstrates an approach to regional cumulative effects management using the case of oil sands development in Alberta, Canada. The 17 existing, approved, or planned projects, all concentrated in a relatively small region, pose significant challenges for conducting and reviewing cumulative effects assessment (CEA) on a project-by-project basis. In response, stakeholders have initiated a regional cumulative effects management system that is among the first such initiatives anywhere. Advantages of this system include (1) more efficient gathering and sharing of information, including a common regional database, (2) setting acceptable regional environmental thresholds for all projects, (3) collaborative assessment of similar cumulative effects from related projects, (4) co-ordinated regulatory review and approval process for overlapping CEAs, and (5) institutional empowerment from a Regional Sustainable Development Strategy administered by a public authority. This case provides a model for integrating project-based CEA with regional management of cumulative effects. (author)

Cumulative effects of planned industrial development and climate change on marine ecosystems

Directory of Open Access Journals (Sweden)

Cathryn Clarke Murray

2015-07-01

Full Text Available With increasing human population, large scale climate changes, and the interaction of multiple stressors, understanding cumulative effects on marine ecosystems is increasingly important. Two major drivers of change in coastal and marine ecosystems are industrial developments with acute impacts on local ecosystems, and global climate change stressors with widespread impacts. We conducted a cumulative effects mapping analysis of the marine waters of British Columbia, Canada, under different scenarios: climate change and planned developments. At the coast-wide scale, climate change drove the largest change in cumulative effects with both widespread impacts and high vulnerability scores. Where the impacts of planned developments occur, planned industrial and pipeline activities had high cumulative effects, but the footprint of these effects was comparatively localized. Nearshore habitats were at greatest risk from planned industrial and pipeline activities; in particular, the impacts of planned pipelines on rocky intertidal habitats were predicted to cause the highest change in cumulative effects. This method of incorporating planned industrial development in cumulative effects mapping allows explicit comparison of different scenarios with the potential to be used in environmental impact assessments at various scales. Its use allows resource managers to consider cumulative effect hotspots when making decisions regarding industrial developments and avoid unacceptable cumulative effects. Management needs to consider both global and local stressors in managing marine ecosystems for the protection of biodiversity and the provisioning of ecosystem services.

Illness intrusiveness among survivors of autologous blood and marrow transplantation.

Science.gov (United States)

Schimmer, A D; Elliott, M E; Abbey, S E; Raiz, L; Keating, A; Beanlands, H J; McCay, E; Messner, H A; Lipton, J H; Devins, G M

2001-12-15

Illness-induced disruptions to lifestyles, activities, and interests (i.e., illness intrusiveness) compromise subjective well-being. The authors measured illness intrusiveness in autologous blood and bone marrow transplantation (ABMT) survivors and compared the results with survivors of solid organ transplants. Forty-four of 64 consecutive ABMT survivors referred to the University of Toronto ABMT long-term follow-up clinic completed the Illness Intrusiveness Ratings Scale (IIRS), the Affect Balance Scale (ABS), the Atkinson Life Happiness Rating (ATKLH), the Beck Hopelessness Scale (BHS), and the Center for Epidemiologic Studies Depression (CES-D) Scale. Mean time from ABMT to evaluation was 4.6 +/- 2.8 years. All patients were in remission or had stable disease at the time of evaluation. Autologous blood and bone marrow transplantation patients' IIRS scores were compared with scores reported by recipients of kidney (n = 357), liver (n = 150), lung (n = 77), and heart (n = 60) transplants. Mean IIRS score for the 44 ABMT patients was 37.2 +/- 17 (maximum possible score, 91; minimum possible score, 13). Higher IIRS scores correlated with lower scores on the ABS (r = -0.54; P work, financial situation, and active recreation. Despite achieving a remission after ABMT, patients continue to experience illness intrusiveness compromising subjective well-being. Copyright 2001 American Cancer Society.

The effects of cumulative practice on mathematics problem solving.

Science.gov (United States)

Mayfield, Kristin H; Chase, Philip N

2002-01-01

This study compared three different methods of teaching five basic algebra rules to college students. All methods used the same procedures to teach the rules and included four 50-question review sessions interspersed among the training of the individual rules. The differences among methods involved the kinds of practice provided during the four review sessions. Participants who received cumulative practice answered 50 questions covering a mix of the rules learned prior to each review session. Participants who received a simple review answered 50 questions on one previously trained rule. Participants who received extra practice answered 50 extra questions on the rule they had just learned. Tests administered after each review included new questions for applying each rule (application items) and problems that required novel combinations of the rules (problem-solving items). On the final test, the cumulative group outscored the other groups on application and problem-solving items. In addition, the cumulative group solved the problem-solving items significantly faster than the other groups. These results suggest that cumulative practice of component skills is an effective method of training problem solving.

Super-Resolution Algorithm in Cumulative Virtual Blanking

Science.gov (United States)

Montillet, J. P.; Meng, X.; Roberts, G. W.; Woolfson, M. S.

2008-11-01

The proliferation of mobile devices and the emergence of wireless location-based services have generated consumer demand for precise location. In this paper, the MUSIC super-resolution algorithm is applied to time delay estimation for positioning purposes in cellular networks. The goal is to position a Mobile Station with UMTS technology. The problem of Base-Stations herability is solved using Cumulative Virtual Blanking. A simple simulator is presented using DS-SS signal. The results show that MUSIC algorithm improves the time delay estimation in both the cases whether or not Cumulative Virtual Blanking was carried out.

Analysis of LDPE-ZnO-clay nanocomposites using novel cumulative rheological parameters

Science.gov (United States)

Kracalik, Milan

2017-05-01

Polymer nanocomposites exhibit complex rheological behaviour due to physical and also possibly chemical interactions between individual phases. Up to now, rheology of dispersive polymer systems has been usually described by evaluation of viscosity curve (shear thinning phenomenon), storage modulus curve (formation of secondary plateau) or plotting information about dumping behaviour (e.g. Van Gurp-Palmen-plot, comparison of loss factor tan δ). On the contrary to evaluation of damping behaviour, values of cot δ were calculated and called as "storage factor", analogically to loss factor. Then values of storage factor were integrated over specific frequency range and called as "cumulative storage factor". In this contribution, LDPE-ZnO-clay nanocomposites with different dispersion grades (physical networks) have been prepared and characterized by both conventional as well as novel analysis approach. Next to cumulative storage factor, further cumulative rheological parameters like cumulative complex viscosity, cumulative complex modulus or cumulative storage modulus have been introduced.

Safety and efficacy of aneurysm treatment with WEB in the cumulative population of three prospective, multicenter series

DEFF Research Database (Denmark)

Pierot, Laurent; Moret, Jacques; Barreau, Xavier

2018-01-01

BACKGROUND: Flow disruption with the WEB is an innovative endovascular approach for treatment of wide-neck bifurcation aneurysms. Initial studies have shown a low complication rate with good efficacy. PURPOSE: To report clinical and anatomical results of the WEB treatment in the cumulative popula...

Förster resonance energy transfer, absorption and emission spectra in multichromophoric systems. II. Hybrid cumulant expansion.

Science.gov (United States)

Ma, Jian; Moix, Jeremy; Cao, Jianshu

2015-03-07

We develop a hybrid cumulant expansion method to account for the system-bath entanglement in the emission spectrum in the multi-chromophoric Förster transfer rate. In traditional perturbative treatments, the emission spectrum is usually expanded with respect to the system-bath coupling term in both real and imaginary time. This perturbative treatment gives a reliable absorption spectrum, where the bath is Gaussian and only the real-time expansion is involved. For the emission spectrum, the initial state is an entangled state of the system plus bath. Traditional perturbative methods are problematic when the excitations are delocalized and the energy gap is larger than the thermal energy, since the second-order expansion cannot predict the displacement of the bath. In the present method, the real-time dynamics is carried out by using the 2nd-order cumulant expansion method, while the displacement of the bath is treated more accurately by utilizing the exact reduced density matrix of the system. In a sense, the hybrid cumulant expansion is based on a generalized version of linear response theory with entangled initial states.

Expansion formulae for characteristics of cumulative cost in finite horizon production models

NARCIS (Netherlands)

Ayhan, H.; Schlegel, S.

2001-01-01

We consider the expected value and the tail probability of cumulative shortage and holding cost (i.e. the probability that cumulative cost is more than a certain value) in finite horizon production models. An exact expression is provided for the expected value of the cumulative cost for general

Natural conception rates in subfertile couples following fertility awareness training.

Science.gov (United States)

Frank-Herrmann, P; Jacobs, C; Jenetzky, E; Gnoth, C; Pyper, C; Baur, S; Freundl, G; Goeckenjan, M; Strowitzki, T

2017-04-01

To analyze cumulative pregnancy rates of subfertile couples after fertility awareness training. A prospective observational cohort study followed 187 subfertile women, who had received training in self-observation of the fertile phase of the menstrual cycle with the Sensiplan method, for 8 months. The women, aged 21-47 years, had attempted to become pregnant for 3.5 years on average (range 1-8 years) before study entry. Amenorrhea, known tubal occlusion and severe male factor had been excluded. An additional seven women, who had initially been recruited, became pregnant during the cycle immediately prior to Sensiplan training: this is taken to be the spontaneous pregnancy rate per cycle in the cohort in the absence of fertility awareness training. The cumulative pregnancy rate of subfertile couples after fertility awareness training was 38% (95% CI 27-49%; 58 pregnancies) after eight observation months, which is significantly higher than the estimated basic pregnancy rate of 21.6% in untrained couples in the same cohort. For couples who had been seeking to become pregnant for 1-2 years, the pregnancy rate increased to 56% after 8 months. A female age above 35 (cumulative pregnancy rate 25%, p = 0.06), couples who had attempted to become pregnant for more than 2 years (cumulative pregnancy rate 17%, p conceiving naturally at some point. Training women to identify their fertile window in the menstrual cycle seems to be a reasonable first-line therapy in the management of subfertility.

Cumulative Trauma Among Mayas Living in Southeast Florida.

Science.gov (United States)

Millender, Eugenia I; Lowe, John

2017-06-01

Mayas, having experienced genocide, exile, and severe poverty, are at high risk for the consequences of cumulative trauma that continually resurfaces through current fear of an uncertain future. Little is known about the mental health and alcohol use status of this population. This correlational study explored t/he relationship of cumulative trauma as it relates to social determinants of health (years in the United States, education, health insurance status, marital status, and employment), psychological health (depression symptoms), and health behaviors (alcohol use) of 102 Guatemalan Mayas living in Southeast Florida. The results of this study indicated that, as specific social determinants of health and cumulative trauma increased, depression symptoms (particularly among women) and the risk for harmful alcohol use (particularly among men) increased. Identifying risk factors at an early stage before serious disease or problems are manifest provides room for early screening leading to early identification, early treatment, and better outcomes.

Life stress versus traumatic stress: The impact of life events on psychological functioning in children with and without serious illness.

Science.gov (United States)

Willard, Victoria W; Long, Alanna; Phipps, Sean

2016-01-01

To determine the differential impact of potentially traumatic events (PTEs) and other stressful life events on psychological functioning in 2 groups of children: those with cancer and those without history of serious illness. Children with cancer age 8-17 (n = 254) and age-, sex-, and race/ethnicity-matched controls (n = 142) completed self-report measures of stressful life events and psychological functioning. Stressful life events included those that may meet Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 2000) A1 criteria (PTEs; 9 events) and others that would likely not (other events; 21 events). Children with cancer endorsed significantly more PTEs than control children. There were no differences between groups in number of other events experienced. Hierarchical regression analyses revealed that number of other events accounted for significant variance in psychological functioning, above and beyond group status, demographic factors (age and socioeconomic status), and number of PTEs. The number of cumulative other events experienced is a significant predictor of psychological functioning in both youth with serious illness and controls. In contrast, cumulative PTEs appear to have a minor (albeit significant) impact on children's psychological functioning. Assessment of psychological functioning would benefit from a thorough history of stressful life events, regardless of their potential traumatic impact. (c) 2016 APA, all rights reserved).

Infants' symptoms of illness assessed by parents: Impact and implications

DEFF Research Database (Denmark)

Ertmann, Ruth Kirk; Siersma, Volkert; Reventlow, Susanne

2011-01-01

Abstract Objectives. Some parents with a sick infant contact a doctor, while others do not. The reasons underlying such parental decisions have not been thoroughly studied. The purpose of this study was to explore how the actual symptoms in the infant were associated with parent-rated illness......, illness severity, and the probability of the parents contacting a doctor. Design. A retrospective questionnaire and a prospective diary study covering 14 months of the participating infants' lives. Setting and subjects. The 194 participating infants were followed for three months prospectively from...... with at least one symptom; 38% of the infants were reported to have had five or more symptoms for more than five days. Fever, earache, and vomiting were the symptoms most likely to cause parents to rate their infant as ill. Earache was the symptom that triggered doctor contact most immediately. The parent...

Physical activity and unplanned illness-related work absenteeism: Data from an employee wellness program.

Science.gov (United States)

Losina, Elena; Yang, Heidi Y; Deshpande, Bhushan R; Katz, Jeffrey N; Collins, Jamie E

2017-01-01

Illness-related absenteeism is a major threat to work productivity. Our objective was to assess the relationship between physical activity and unplanned illness-related absenteeism from work. We implemented physical activity program for sedentary non-clinician employees of a tertiary medical center. Financial rewards were available for reaching accelerometer-measured ambulatory physical activity goals over a 24-week period. We categorized participants into three groups based on mean levels of physical activity: low (0-74 min/week), medium (75-149 min/week) and meeting CDC guidelines (≥150 min/week). We built a multivariable Poisson regression model to evaluate the relationship between physical activity and rates of unplanned illness-related absenteeism. The sample consisted of 292 employees who participated in the program. Their mean age was 38 years (SD 11), 83% were female, and 38% were obese. Over the 24 intervention weeks, participants engaged in a mean of 90 min/week (SD 74) of physical activity and missed a mean of 14 hours of work (SD 38) due to illness. Unplanned absenteeism due to illness was associated with physical activity. As compared to the group meeting CDC guidelines, in multivariable analyses those in the medium physical activity group had a 2.4 (95% CI 1.3-4.5) fold higher rate of illness-related absenteeism and those in the lowest physical activity group had a 3.5 (95% CI 1.7-7.2) fold higher rate of illness-related absenteeism. Less physical activity was associated with more illness-related absenteeism. Workforce-based interventions to increase physical activity may thus be a promising vehicle to reduce unplanned illness-related absenteeism.

Physical activity and unplanned illness-related work absenteeism: Data from an employee wellness program.

Directory of Open Access Journals (Sweden)

Elena Losina

Full Text Available Illness-related absenteeism is a major threat to work productivity. Our objective was to assess the relationship between physical activity and unplanned illness-related absenteeism from work.We implemented physical activity program for sedentary non-clinician employees of a tertiary medical center. Financial rewards were available for reaching accelerometer-measured ambulatory physical activity goals over a 24-week period. We categorized participants into three groups based on mean levels of physical activity: low (0-74 min/week, medium (75-149 min/week and meeting CDC guidelines (≥150 min/week. We built a multivariable Poisson regression model to evaluate the relationship between physical activity and rates of unplanned illness-related absenteeism.The sample consisted of 292 employees who participated in the program. Their mean age was 38 years (SD 11, 83% were female, and 38% were obese. Over the 24 intervention weeks, participants engaged in a mean of 90 min/week (SD 74 of physical activity and missed a mean of 14 hours of work (SD 38 due to illness. Unplanned absenteeism due to illness was associated with physical activity. As compared to the group meeting CDC guidelines, in multivariable analyses those in the medium physical activity group had a 2.4 (95% CI 1.3-4.5 fold higher rate of illness-related absenteeism and those in the lowest physical activity group had a 3.5 (95% CI 1.7-7.2 fold higher rate of illness-related absenteeism.Less physical activity was associated with more illness-related absenteeism. Workforce-based interventions to increase physical activity may thus be a promising vehicle to reduce unplanned illness-related absenteeism.

Physical activity and unplanned illness-related work absenteeism: Data from an employee wellness program

Science.gov (United States)

Yang, Heidi Y.; Katz, Jeffrey N.; Collins, Jamie E.

2017-01-01

Background Illness-related absenteeism is a major threat to work productivity. Our objective was to assess the relationship between physical activity and unplanned illness-related absenteeism from work. Methods We implemented physical activity program for sedentary non-clinician employees of a tertiary medical center. Financial rewards were available for reaching accelerometer-measured ambulatory physical activity goals over a 24-week period. We categorized participants into three groups based on mean levels of physical activity: low (0–74 min/week), medium (75–149 min/week) and meeting CDC guidelines (≥150 min/week). We built a multivariable Poisson regression model to evaluate the relationship between physical activity and rates of unplanned illness-related absenteeism. Results The sample consisted of 292 employees who participated in the program. Their mean age was 38 years (SD 11), 83% were female, and 38% were obese. Over the 24 intervention weeks, participants engaged in a mean of 90 min/week (SD 74) of physical activity and missed a mean of 14 hours of work (SD 38) due to illness. Unplanned absenteeism due to illness was associated with physical activity. As compared to the group meeting CDC guidelines, in multivariable analyses those in the medium physical activity group had a 2.4 (95% CI 1.3–4.5) fold higher rate of illness-related absenteeism and those in the lowest physical activity group had a 3.5 (95% CI 1.7–7.2) fold higher rate of illness-related absenteeism. Discussion Less physical activity was associated with more illness-related absenteeism. Workforce-based interventions to increase physical activity may thus be a promising vehicle to reduce unplanned illness-related absenteeism. PMID:28472084

Cumulative distribution functions associated with bubble-nucleation processes in cavitation

KAUST Repository

Watanabe, Hiroshi

2010-11-15

Bubble-nucleation processes of a Lennard-Jones liquid are studied by molecular dynamics simulations. Waiting time, which is the lifetime of a superheated liquid, is determined for several system sizes, and the apparent finite-size effect of the nucleation rate is observed. From the cumulative distribution function of the nucleation events, the bubble-nucleation process is found to be not a simple Poisson process but a Poisson process with an additional relaxation time. The parameters of the exponential distribution associated with the process are determined by taking the relaxation time into account, and the apparent finite-size effect is removed. These results imply that the use of the arithmetic mean of the waiting time until a bubble grows to the critical size leads to an incorrect estimation of the nucleation rate. © 2010 The American Physical Society.

Psychiatric Illness in a Cohort of Adults with Prader-Willi Syndrome

Science.gov (United States)

Sinnema, Margje; Boer, Harm; Collin, Philippe; Maaskant, Marian A.; van Roozendaal, Kees E. P.; Schrander-Stumpel, Constance T. R. M.; Curfs, Leopold M. G.

2011-01-01

Previous studies have suggested an association between PWS and comorbid psychiatric illness. Data on prevalence rates of psychopathology is still scarce. This paper describes a large-scale, systematic study investigating the prevalence of psychiatric illness in a Dutch adult PWS cohort. One hundred and two individuals were screened for psychiatric…

Negative impact of high cumulative glucocorticoid dose on bone metabolism of patients with myasthenia gravis.

Science.gov (United States)

Braz, Nayara Felicidade Tomaz; Rocha, Natalia Pessoa; Vieira, Érica Leandro Marciano; Gomez, Rodrigo Santiago; Barbosa, Izabela Guimarães; Malheiro, Olívio Brito; Kakehasi, Adriana Maria; Teixeira, Antonio Lucio

2017-08-01

This current study aimed to evaluate the frequency of low bone mass, osteopenia, and osteoporosis in patients with myasthenia gravis (MG) and to investigate the possible association between bone mineral density (BMD) and plasma levels of bone metabolism markers. Eighty patients with MG and 62 controls BMD were measured in the right femoral neck and lumbar spine by dual-energy X-ray absorptiometry. Plasma concentrations of osteocalcin, osteopontin, osteoprotegerin, tumor necrosis factor (TNF-α), interleukin (IL)-1β, IL-6, dickkopf (DKK-1), sclerostin, insulin, leptin, adrenocorticotropic hormone, parathyroid hormone, and fibroblast growth factor (FGF-23) were analyzed by Luminex®. The mean age of patients was 41.9 years, with 13.5 years of length of illness, and a mean cumulative dose of glucocorticoids 38,123 mg. Patients had significant reduction in BMD of the lumbar, the femoral neck, and in the whole body when compared with controls. Fourteen percent MG patients had osteoporosis at the lumbar spine and 2.5% at the femoral neck. In comparison with controls, patients with MG presented lower levels of osteocalcin, adrenocorticotropic hormone, parathyroid hormone, sclerostin, TNF-α, and DKK-1 and higher levels of FGF-23, leptin, and IL-6. There was a significant negative correlation between cumulative glucocorticoid dose and serum calcium, lumbar spine T-score, femoral neck BMD, T-score, and Z-score. After multivariate analysis, higher TNF-α levels increased the likelihood of presenting low bone mass by 2.62. MG patients under corticotherapy presented low BMD and altered levels of bone markers.

Cumulative effects of wind turbines. Volume 3: Report on results of consultations on cumulative effects of wind turbines on birds

Energy Technology Data Exchange (ETDEWEB)

NONE

2000-07-01

This report gives details of the consultations held in developing the consensus approach taken in assessing the cumulative effects of wind turbines. Contributions on bird issues, and views of stakeholders, the Countryside Council for Wales, electric utilities, Scottish Natural Heritage, and the National Wind Power Association are reported. The scoping of key species groups, where cumulative effects might be expected, consideration of other developments, the significance of any adverse effects, mitigation, regional capacity assessments, and predictive models are discussed. Topics considered at two stakeholder workshops are outlined in the appendices.

Disease Course and Surgery Rates in Inflammatory Bowel Disease

DEFF Research Database (Denmark)

Vester-Andersen, Marianne K; Prosberg, Michelle V; Jess, Tine

2014-01-01

, immunomodulators, and anti-tumor necrosis factor agents in CD was 86.4%, 64.3%, and 23.5%, respectively. The rate of first-time intestinal resection in CD was 29.1% (n=62), and the 7-year cumulative risk was 28.5%. The cumulative risk of colectomy in UC was 12.5% at 7 years. CONCLUSIONS: UC and CD are dynamic...... diseases that progress in extent and behavior over time. The resection rate in CD and the colectomy rate in UC are still relatively high, although the rates seem to have decreased compared with historic data, which could be due to an increase in the use of immunomodulating therapy....

Higher order cumulants in colorless partonic plasma

Energy Technology Data Exchange (ETDEWEB)

Cherif, S. [Sciences and Technologies Department, University of Ghardaia, Ghardaia, Algiers (Algeria); Laboratoire de Physique et de Mathématiques Appliquées (LPMA), ENS-Kouba (Bachir El-Ibrahimi), Algiers (Algeria); Ahmed, M. A. A. [Department of Physics, College of Science, Taibah University Al-Madinah Al-Mounawwarah KSA (Saudi Arabia); Department of Physics, Taiz University in Turba, Taiz (Yemen); Laboratoire de Physique et de Mathématiques Appliquées (LPMA), ENS-Kouba (Bachir El-Ibrahimi), Algiers (Algeria); Ladrem, M., E-mail: mladrem@yahoo.fr [Department of Physics, College of Science, Taibah University Al-Madinah Al-Mounawwarah KSA (Saudi Arabia); Laboratoire de Physique et de Mathématiques Appliquées (LPMA), ENS-Kouba (Bachir El-Ibrahimi), Algiers (Algeria)

2016-06-10

Any physical system considered to study the QCD deconfinement phase transition certainly has a finite volume, so the finite size effects are inevitably present. This renders the location of the phase transition and the determination of its order as an extremely difficult task, even in the simplest known cases. In order to identify and locate the colorless QCD deconfinement transition point in finite volume T{sub 0}(V), a new approach based on the finite-size cumulant expansion of the order parameter and the ℒ{sub m,n}-Method is used. We have shown that both cumulants of higher order and their ratios, associated to the thermodynamical fluctuations of the order parameter, in QCD deconfinement phase transition behave in a particular enough way revealing pronounced oscillations in the transition region. The sign structure and the oscillatory behavior of these in the vicinity of the deconfinement phase transition point might be a sensitive probe and may allow one to elucidate their relation to the QCD phase transition point. In the context of our model, we have shown that the finite volume transition point is always associated to the appearance of a particular point in whole higher order cumulants under consideration.

The Impact of Illness Identity on Recovery from Severe Mental Illness.

Science.gov (United States)

Yanos, Philip T; Roe, David; Lysaker, Paul H

2010-04-01

The impact of the experience and diagnosis of mental illness on one's identity has long been recognized; however, little is known about the impact of illness identity, which we define as the set of roles and attitudes that a person has developed in relation to his or her understanding of having a mental illness. The present article proposes a theoretically driven model of the impact of illness identity on the course and recovery from severe mental illness and reviews relevant research. We propose that accepting a definition of oneself as mentally ill and assuming that mental illness means incompetence and inadequacy impact hope and self-esteem, which further impact suicide risk, coping, social interaction, vocational functioning, and symptom severity. Evidence supports most of the predictions made by the model. Implications for psychiatric rehabilitation services are discussed.

Use of a fermented dairy probiotic drink containing Lactobacillus casei (DN-114 001) to decrease the rate of illness in kids: the DRINK study. A patient-oriented, double-blind, cluster-randomized, placebo-controlled, clinical trial.

Science.gov (United States)

Merenstein, D; Murphy, M; Fokar, A; Hernandez, R K; Park, H; Nsouli, H; Sanders, M E; Davis, B A; Niborski, V; Tondu, F; Shara, N M

2010-07-01

To evaluate whether a fermented dairy drink containing the probiotic strain Lactobacillus casei DN-114 001 could reduce the incidence of common infectious diseases (CIDs) and the change of behavior because of illness in children. We conducted a double-blinded, randomized, placebo-controlled allocation concealment clinical trial in the Washington, DC metropolitan area. Participants were 638 children 3-6 years old in daycare/schools. The intervention was a fermented dairy drink containing a specific probiotic strain or matching placebo with no live cultures for 90 consecutive days. Two primary outcomes were assessed: incidence of CIDs and change of behavior because of illness (both assessed by parental report). The rate of change of behavior because of illness was similar among active and control groups. However, the incidence rate for CIDs in the active group (0.0782) is 19% lower than that of the control group (0.0986) (incidence rate ratio=0.81, 95% CI: 0.65, 099) P=0.046. Daily intake of a fermented dairy drink containing the probiotic strain L. casei DN-114 001 showed some promise in reducing overall incidence of illness, but was primarily driven by gastrointestinal infections and there were no differences in change of behavior.

Cumulative effects of forest management activities: how might they occur?

Science.gov (United States)

R. M. Rice; R. B. Thomas

1985-01-01

Concerns are often voiced about possible environmental damage as the result of the cumulative sedimentation effects of logging and forest road construction. In response to these concerns, National Forests are developing procedures to reduce the possibility that their activities may lead to unacceptable cumulative effects

Cumulative radiation effect

International Nuclear Information System (INIS)

Kirk, J.; Cain, O.; Gray, W.M.

1977-01-01

Cumulative Radiation Effect (CRE) represents a scale of accumulative sub-tolerance radiation damage, with a unique value of the CRE describing a specific level of radiation effect. Computer calculations have been used to simplify the evaluation of problems associated with the applications of the CRE-system in radiotherapy. In a general appraisal of the applications of computers to the CRE-system, the various problems encountered in clinical radiotherapy have been categorised into those involving the evaluation of a CRE at a point in tissue and those involving the calculation of CRE distributions. As a general guide, the computer techniques adopted at the Glasgow Institute of Radiotherapeutics for the solution of CRE problems are presented, and consist basically of a package of three interactive programs for point CRE calculations and a Fortran program which calculates CRE distributions for iso-effect treatment planning. Many examples are given to demonstrate the applications of these programs, and special emphasis has been laid on the problem of treating a point in tissue with different doses per fraction on alternate treatment days. The wide range of possible clinical applications of the CRE-system has been outlined and described under the categories of routine clinical applications, retrospective and prospective surveys of patient treatment, and experimental and theoretical research. Some of these applications such as the results of surveys and studies of time optimisation of treatment schedules could have far-reaching consequences and lead to significant improvements in treatment and cure rates with the minimum damage to normal tissue. (author)

Retrospective comparative ten-year study of cumulative survival rates of remaining teeth in large edentulism treated with implant-supported fixed partial dentures or removable partial dentures.

Science.gov (United States)

Yamazaki, Seiya; Arakawa, Hikaru; Maekawa, Kenji; Hara, Emilio Satoshi; Noda, Kinji; Minakuchi, Hajime; Sonoyama, Wataru; Matsuka, Yoshizo; Kuboki, Takuo

2013-07-01

This study aimed to compare the survival rates of remaining teeth between implant-supported fixed dentures (IFDs) and removable partial dentures (RPDs) in patients with large edentulous cases. The second goal was to assess the risk factors for remaining tooth loss. The study subjects were selected among those who received prosthodontic treatment at Okayama University Dental Hospital for their edentulous space exceeding at least four continuous missing teeth. Twenty-one patients were included in the IFD group and 82 patients were included in the RPD group. Survival rates of remaining teeth were calculated in three subcategories: (1) whole remaining teeth, (2) adjacent teeth to intended edentulous space, and (3) opposing teeth to intended edentulous space. The ten-year cumulative survival rate of the whole remaining teeth was significantly higher in the IFD group (40.0%) than in the RPD group (24.4%). On the other hand, there was no significant difference between two groups in the survival rate of teeth adjacent or opposing to intended edentulous space. A Cox proportional hazard analysis revealed that RPD restoration and gender (male) were the significant risk factors for remaining tooth loss (whole remaining teeth). These results suggest that IFD treatment can reduce the incidence of remaining tooth loss in large edentulous cases. Copyright © 2013 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

Nutritional support for critically ill children.

Science.gov (United States)

Joffe, Ari; Anton, Natalie; Lequier, Laurance; Vandermeer, Ben; Tjosvold, Lisa; Larsen, Bodil; Hartling, Lisa

2016-05-27

Nutritional support in the critically ill child has not been well investigated and is a controversial topic within paediatric intensive care. There are no clear guidelines as to the best form or timing of nutrition in critically ill infants and children. This is an update of a review that was originally published in 2009. . The objective of this review was to assess the impact of enteral and parenteral nutrition given in the first week of illness on clinically important outcomes in critically ill children. There were two primary hypotheses:1. the mortality rate of critically ill children fed enterally or parenterally is different to that of children who are given no nutrition;2. the mortality rate of critically ill children fed enterally is different to that of children fed parenterally.We planned to conduct subgroup analyses, pending available data, to examine whether the treatment effect was altered by:a. age (infants less than one year versus children greater than or equal to one year old);b. type of patient (medical, where purpose of admission to intensive care unit (ICU) is for medical illness (without surgical intervention immediately prior to admission), versus surgical, where purpose of admission to ICU is for postoperative care or care after trauma).We also proposed the following secondary hypotheses (a priori), pending other clinical trials becoming available, to examine nutrition more distinctly:3. the mortality rate is different in children who are given enteral nutrition alone versus enteral and parenteral combined;4. the mortality rate is different in children who are given both enteral feeds and parenteral nutrition versus no nutrition. In this updated review we searched: the Cochrane Central Register of Controlled Trials (CENTRAL 2016, Issue 2); Ovid MEDLINE (1966 to February 2016); Ovid EMBASE (1988 to February 2016); OVID Evidence-Based Medicine Reviews; ISI Web of Science - Science Citation Index Expanded (1965 to February 2016); Web

Application of Higher-Order Cumulant in Fault Diagnosis of Rolling Bearing

International Nuclear Information System (INIS)

Shen, Yongjun; Yang, Shaopu; Wang, Junfeng

2013-01-01

In this paper a new method of pattern recognition based on higher-order cumulant and envelope analysis is presented. The core of this new method is to construct analytical signals from the given signals and obtain the envelope signals firstly, then compute and compare the higher-order cumulants of the envelope signals. The higher-order cumulants could be used as a characteristic quantity to distinguish these given signals. As an example, this method is applied in fault diagnosis for 197726 rolling bearing of freight locomotive. The comparisons of the second-order, third-order and fourth-order cumulants of the envelope signals from different vibration signals of rolling bearing show this new method could discriminate the normal and two fault signals distinctly

Sieve estimation in a Markov illness-death process under dual censoring.

Science.gov (United States)

Boruvka, Audrey; Cook, Richard J

2016-04-01

Semiparametric methods are well established for the analysis of a progressive Markov illness-death process observed up to a noninformative right censoring time. However, often the intermediate and terminal events are censored in different ways, leading to a dual censoring scheme. In such settings, unbiased estimation of the cumulative transition intensity functions cannot be achieved without some degree of smoothing. To overcome this problem, we develop a sieve maximum likelihood approach for inference on the hazard ratio. A simulation study shows that the sieve estimator offers improved finite-sample performance over common imputation-based alternatives and is robust to some forms of dependent censoring. The proposed method is illustrated using data from cancer trials. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The impact of physical activity on cumulative cardiovascular disease risk factors among Malaysian adults.

Science.gov (United States)

Rasiah, Rajah; Thangiah, Govindamal; Yusoff, Khalid; Manikam, Rishya; Chandrasekaran, Sankara Kumar; Mustafa, Rujhan; Bakar, Najmin Binti Abu

2015-12-16

Numerous studies have shown the importance of physical activity in reducing the morbidity and mortality rates caused by cardiovascular disease (CVD). However, most of these studies emphasise little on the cumulative effect of CVD risk factors. Hence, this study investigates the association between physical exercise and cumulative CVD risk factors among adults in three different age groups. Using a sample of 7276 respondents drawn from community centers, the REDISCOVER team gathered information on physical activity, CVD risk factors (obesity, diabetes, hypertension, hypercholesterolemia, tobacco use) and socioeconomic and demographic variables in Malaysia. Because the study required medical examination, a convenience sampling frame was preferred in which all volunteers were included in the study. Fasting blood samples and anthropometric (height, weight and more) measurements were collected by trained staffs. Socio-demographic and physical activity variables were recorded through questionnaires. A Chi-square test was performed to identify the bivariate association between the covariates (socioeconomic variables, demographic variables and physical activity) and outcome variable. The association between the main exposure, physical activity, and the outcome variable, cumulative CVD risk factors, was assessed using an ordinal logistic regression model, controlling for socioeconomic status and demographic influences in three different age groups, 35-49, 50-64 and 65 and above. The mean age of participants is 51.8 (SD = 9.4). Respondents in the age groups of 35-49 (aORmoderate = 0.12; 95 % CI: 0.02 - 0.53 ) and 65 and above (aORhigh = 0.58; 95 % CI: 0.24, 0.78) showed a statistically significant inverse relationship between physical activity and cumulative CVD risk factors. However, this relationship was not significant among respondents in the 50-64 age group suggesting the possible influence of other variables, such as stress and environment. The

Associations between comorbid anxiety, diabetes control, and overall medical burden in patients with serious mental illness and diabetes.

Science.gov (United States)

Bajor, Laura A; Gunzler, Douglas; Einstadter, Douglas; Thomas, Charles; McCormick, Richard; Perzynski, Adam T; Kanuch, Stephanie W; Cassidy, Kristin A; Dawson, Neal V; Sajatovic, Martha

2015-01-01

While previous work has demonstrated elevation of both comorbid anxiety disorders and diabetes mellitus type II in individuals with serious mental illness, little is known regarding the impact of comorbid anxiety on diabetes mellitus type II outcomes in serious mental illness populations. We analyzed baseline data from patients with serious mental illness and diabetes mellitus type II to examine relationships between comorbid anxiety, glucose control as measured by hemoglobin A1c score, and overall illness burden. Using baseline data from an ongoing prospective treatment study involving 157 individuals with serious mental illness and diabetes mellitus type II, we compared individuals with and without a comorbid anxiety disorder and compared hemoglobin A1c levels between these groups to assess the relationship between anxiety and management of diabetes mellitus type II. We conducted a similar analysis using cumulative number of anxiety diagnoses as a proxy for anxiety load. Finally, we searched for associations between anxiety and overall medical illness burden as measured by Charlson score. Anxiety disorders were seen in 33.1% (N=52) of individuals with serious mental illness and diabetes mellitus type II and were associated with increased severity of depressive symptoms and decreased function. Hemoglobin A1c levels were not significantly different in those with or without anxiety, and having multiple anxiety disorders was not associated with differences in diabetes mellitus type II control. However, depressive symptoms were significantly associated with higher hemoglobin A1c levels. Neither comorbid anxiety nor anxiety load was significantly associated with overall medical burden. One in three people with serious mental illness and diabetes mellitus type II had anxiety. Depressive symptoms were significantly associated with Hb1Ac levels while anxiety symptoms had no relation to hemoglobin A1c; this is consistent with previously published work. More studies are

Understanding and Reducing Disability in Older Adults Following Critical Illness

Science.gov (United States)

Brummel, N.E.; Balas, M.C.; Morandi, A.; Ferrante, L.E.; Gill, T.M.; Ely, E.W.

2015-01-01

Objective To review how disability can develop in older adults with critical illness and to explore ways to reduce long-term disability following critical illness. Data Sources Review of the literature describing post-critical illness disability in older adults and expert opinion. Results We identified 19 studies evaluating disability outcomes in critically ill patients age 65 years and older. Newly acquired disability in activities of daily living, instrumental activities of daily living and mobility activities was commonplace among older adults who survived a critical illness. Incident dementia and less-severe cognitive impairment was also highly prevalent. Factors related to the acute critical illness, intensive care unit practices such as heavy sedation, physical restraints and immobility as well as aging physiology and coexisting geriatric conditions can combine to result in these poor outcomes. Conclusion Older adults who survive critical illness suffer physical and cognitive declines resulting in disability at greater rates than hospitalized, non-critically ill and community dwelling older adults. Interventions derived from widely available geriatric care models in use outside of the ICU, which address modifiable risk factors including immobility and delirium, are associated with improved functional and cognitive outcomes and can be used to complement ICU-focused models such as the ABCDEs. PMID:25756418

Mental Illness Statistics

Science.gov (United States)

... News & Events About Us Home > Health Information Share Statistics Research shows that mental illnesses are common in ... of mental illnesses, such as suicide and disability. Statistics Top ı cs Mental Illness Any Anxiety Disorder ...

Elaboration of a concept for the cumulative environmental exposure assessment of biocides

Energy Technology Data Exchange (ETDEWEB)

Gross, Rita; Bunke, Dirk; Moch, Katja [Oeko-Institut e.V. - Institut fuer Angewandte Oekologie e.V., Freiburg im Breisgau (Germany); Gartiser, Stefan [Hydrotox GmbH, Freiburg im Breisgau (Germany)

2011-12-15

Article 10(1) of the EU Biocidal Products Directive 98/8/EC (BPD) requires that for the inclusion of an active substance in Annex I, Annex IA or IB, cumulation effects from the use of biocidal products containing the same active substance shall be taken into account, where relevant. The study proves the feasibility of a technical realisation of Article 10(1) of the BPD and elaborates a first concept for the cumulative environmental exposure assessment of biocides. Existing requirements concerning cumulative assessments in other regulatory frameworks have been evaluated and their applicability for biocides has been examined. Technical terms and definitions used in this context were documented with the aim to harmonise terminology with other frameworks and to set up a precise definition within the BPD. Furthermore, application conditions of biocidal products have been analysed to find out for which cumulative exposure assessments may be relevant. Different parameters were identified which might serve as indicators for the relevance of cumulative exposure assessments. These indicators were then integrated in a flow chart by means of which the relevance of cumulative exposure assessments can be checked. Finally, proposals for the technical performance of cumulative exposure assessments within the Review Programme have been elaborated with the aim to bring the results of the project into the upcoming development and harmonization processes on EU level. (orig.)

Physical health indicators in major mental illness: data from the Quality and Outcome Framework in the UK.

Science.gov (United States)

Martin, Julie Langan; Lowrie, Richard; McConnachie, Alex; McLean, Gary; Mair, Frances; Mercer, Stewart; Smith, Daniel

2015-02-26

In the UK, the Quality and Outcome Framework (QOF) has specific targets for general practictioners to record body-mass index (BMI) and blood pressure (BP) in major mental illness, diabetes, and chronic kidney disease. Although incentives are given for aspects of major mental illness (schizophrenia, bipolar disorder, and related psychoses), barriers to care can occur. Our aim was to compare recording of specific targets for BP and BMI in individuals with major mental illness relative to diabetes and chronic kidney disease across the UK. Using 2012 and 2013 QOF data from 9731 general practices across all four countries in the UK, we calculated median payment, population achievement, and exception rates for BP indicators in major mental illness and chronic kidney disease and BMI indicators in major mental illness and diabetes. Differences in unweighted rates between practices in the same UK country were tested with a sign test. Differences in population achievement rate between practices in different countries were compared with those in England by use of a quantile regression analysis. UK payment and population achievement rates for BMI recording in major mental illness were significantly lower than were those in diabetes (payment 92·7% vs 95·5% and population achievement 84·0% vs 92·5%, pmental illness than for chronic kidney disease (94·1% vs 97·8% and 87·0% vs 97·1%, pmental illness were significantly lower in Scotland than in England (for BMI -1·5%, 99% CI -2·7 to -0·3, and for BP -1·8%, -2·7 to -0·9; pmental illness than in diabetes and chronic kidney disease throughout the UK. We also found variation in these rates between countries. This finding is probably multifactorial, reflecting a combination of patient, clinician, and wider organisational factors; however, it might also suggest inequality in access to certain aspects of health care for people with major mental illness. None. Copyright © 2015 Elsevier Ltd. All rights reserved.

Public attitudes toward mental illness in Africa and North America.

Science.gov (United States)

St Louis, K O; Roberts, P M

2013-03-01

Public attitudes toward mental illness in two widely disparate cultures, Canada and Cameroon, were compared using an experimental version of a survey instrument, the Public Opinion Survey of Human Attributes-Mental Illness or POSHA-MI(e). 120 respondents rated POSHA-MI(e) items relating to mental illness on 1-9 equal appearing interval scales: 30 in English and 30 in French in both Cameroon and Canada. Additionally, 30 matched, monolingual English, American respondents were included as a comparison group. In Canada (and in the USA), attitudes were generally more positive and less socially stigmatizing toward mental illness than in Cameroon. Differences between countries were much larger than differences between language groups. Consistent with other research, beliefs and reactions of the public regarding mental illness reflect stigma, especially in Cameroon. Cultural influences on these public attitudes are more likely important than language influences. Results of this field test of the POSHA-MI(e), documenting differences in public attitudes toward mental illness in two divergent cultures, support its further development.

Risk of therapy-related leukaemia and preleukaemia after Hodgkin's disease. Relation to age, cumulative dose of alkylating agents, and time from chemotherapy

DEFF Research Database (Denmark)

Pedersen-Bjergaard, J.; Specht, L.; Larsen, S.O.

1987-01-01

391 patients treated intensively for Hodgkin's disease were followed for up to 15 years to evaluate the risk of therapy-related acute non-lymphocytic leukaemia (t-ANLL) and preleukaemia. Only two independent factors, patient age and cumulative dose of alkylating agents, were related to the risk...... of t-ANLL. The hazard rate of t-ANLL was roughly proportional to the square of patient age and to the total cumulative dose of alkylating agents. In 320 patients treated with alkylating agents the cumulative risk of t-ANLL increased steadily from 1 year after the start of treatment and reached 13.......0% (SE 3.0) at 10 years after which time there were no further cases. Calculated from cessation of therapy with alkylating agents, however, the cumulative risk curve increased steeply during the first 1-2 years then gradually levelled out and no new cases were observed beyond 7 years. With a 15-year...

Inclusive fitness analysis of cumulative cultural evolution in an island-structured population.

Science.gov (United States)

Ohtsuki, Hisashi; Wakano, Joe Yuichiro; Kobayashi, Yutaka

2017-06-01

The success of humans on the globe is largely supported by our cultural excellence. Our culture is cumulative, meaning that it is improved from generation to generation. Previous works have revealed that two modes of learning, individual learning and social learning, play pivotal roles in the accumulation of culture. However, under the trade-off between learning and reproduction, one's investment into learning is easily exploited by those who copy the knowledge of skillful individuals and selfishly invest more efforts in reproduction. It has been shown that in order to prevent such a breakdown, the rate of vertical transmission (i.e. transmission from parents to their offspring) of culture must be unrealistically close to one. Here we investigate what if the population is spatially structured. In particular, we hypothesize that spatial structure should favor highly cumulative culture through endogenously arising high kinship. We employ Wright's island model and assume that cultural transmission occurs within a local island. Our inclusive fitness analysis reveals combined effects of direct fitness of the actor, indirect fitness through relatives in the current generation, and indirect fitness through relatives in future generations. The magnitude of those indirect benefits is measured by intergenerational coefficients of genetic relatedness. Our result suggests that the introduction of spatial structure raises the stationary level of culture in the population, but that the extent of its improvement compared with a well-mixed population is marginal unless spatial localization is extreme. Overall, our model implies that we need an alternative mechanism to explain highly cumulative culture of modern humans. Copyright © 2017 Elsevier Inc. All rights reserved.

Cumulative effective dose associated with radiography and CT of adolescents with spinal injuries.

Science.gov (United States)

Lemburg, Stefan P; Peters, Soeren A; Roggenland, Daniela; Nicolas, Volkmar; Heyer, Christoph M

2010-12-01

The purpose of this study was to analyze the quantity and distribution of cumulative effective doses in diagnostic imaging of adolescents with spinal injuries. At a level 1 trauma center from July 2003 through June 2009, imaging procedures during initial evaluation and hospitalization and after discharge of all patients 10-20 years old with spinal fractures were retrospectively analyzed. The cumulative effective doses for all imaging studies were calculated, and the doses to patients with spinal injuries who had multiple traumatic injuries were compared with the doses to patients with spinal injuries but without multiple injuries. The significance level was set at 5%. Imaging studies of 72 patients (32 with multiple injuries; average age, 17.5 years) entailed a median cumulative effective dose of 18.89 mSv. Patients with multiple injuries had a significantly higher total cumulative effective dose (29.70 versus 10.86 mSv, p cumulative effective dose to multiple injury patients during the initial evaluation (18.39 versus 2.83 mSv, p cumulative effective dose. Adolescents with spinal injuries receive a cumulative effective dose equal to that of adult trauma patients and nearly three times that of pediatric trauma patients. Areas of focus in lowering cumulative effective dose should be appropriate initial estimation of trauma severity and careful selection of CT scan parameters.

Heart-related anxieties in relation to general anxiety and severity of illness in cardiology patients.

Science.gov (United States)

Muschalla, Beate; Glatz, Johannes; Linden, Michael

2014-01-01

Absence of an adequate reason for anxiety is a criterion for pathological anxiety. However, the presence of danger or fear-provoking stimuli may even be a risk factor for anxiety and does not exclude that there is additionally pathological anxiety too. The question is, to what degree can heart-related anxiety be explained by the severity of illness or trait anxiety? Two hundred and nine patients (37.8% women) from a cardiology inpatient unit completed the Heart-Anxiety-Questionnaire, Progression-Anxiety-Questionnaire, Job-Anxiety-Scale and the State-Trait-Anxiety-Inventory. The severity of cardiac illness was rated by the treating cardiologists using the Multidimensional Severity of Morbidity Rating. Time absent from work due to sickness was assessed as an indicator for illness-related impairment. Heart anxiety was significantly related to progression anxiety and, to a lesser extent, trait anxiety and indicators of subjective symptoms of somatic illness. No association was found with medical ratings for prognosis, multimorbidity, or reduction in life expectancy. Heart-related anxiety is a symptom of an anxiety disorder. Although partially dependent on subjective suffering, it cannot be explained by the severity of medical illness. Treatment of health-related anxieties should focus on how to cope with subjective symptoms of illness.

Evolution of costly explicit memory and cumulative culture.

Science.gov (United States)

Nakamaru, Mayuko

2016-06-21

Humans can acquire new information and modify it (cumulative culture) based on their learning and memory abilities, especially explicit memory, through the processes of encoding, consolidation, storage, and retrieval. Explicit memory is categorized into semantic and episodic memories. Animals have semantic memory, while episodic memory is unique to humans and essential for innovation and the evolution of culture. As both episodic and semantic memory are needed for innovation, the evolution of explicit memory influences the evolution of culture. However, previous theoretical studies have shown that environmental fluctuations influence the evolution of imitation (social learning) and innovation (individual learning) and assume that memory is not an evolutionary trait. If individuals can store and retrieve acquired information properly, they can modify it and innovate new information. Therefore, being able to store and retrieve information is essential from the perspective of cultural evolution. However, if both storage and retrieval were too costly, forgetting and relearning would have an advantage over storing and retrieving acquired information. In this study, using mathematical analysis and individual-based simulations, we investigate whether cumulative culture can promote the coevolution of costly memory and social and individual learning, assuming that cumulative culture improves the fitness of each individual. The conclusions are: (1) without cumulative culture, a social learning cost is essential for the evolution of storage-retrieval. Costly storage-retrieval can evolve with individual learning but costly social learning does not evolve. When low-cost social learning evolves, the repetition of forgetting and learning is favored more than the evolution of costly storage-retrieval, even though a cultural trait improves the fitness. (2) When cumulative culture exists and improves fitness, storage-retrieval can evolve with social and/or individual learning, which

INTRA-ABDOMINAL HYPERTENSION AS A RISK FACTOR FOR ACUTE KIDNEY INJURY IN CRITICALLY ILL PATIENTS

Directory of Open Access Journals (Sweden)

Sreelatha

2016-05-01

Full Text Available BACKGROUND AND AIMS Increased intra-abdominal pressure (IAP, also referred to as intra-abdominal hypertension (IAH, affects organ function in critically ill patients. The prevalence of IAH is between 32% - 65% in intensive care units. Normal IAP is ≈ 5–7 mmHg. According to WSACS definition, IAH = IAP ≥12 mmHg and is divided into 4 grades. They are Grade I (12-15 mmHg, Grade II (16-20 mmHg, Grade III (21-25 mmHg, Grade IV (>25 mmHg. Transvesical measurement of IAP currently is the most popular technique. Several systems with or without the need for electronic equipment are available that allow IAP measurement. The aim is to study the incidence of IAH in critically ill patients, to assess the risk factors for development of IAH, to study the role of IAH as a risk factor for Acute Kidney Injury (AKI, to assess the role of IAH as a risk factor for increased (Intensive Care Unit ICU mortality. SUBJECTS AND METHODS This is a prospective observational study. Study period was six months. The study included 52 patients admitted to Medical ICU in Government Medical College, Kozhikode, Kerala. RESULTS AND CONCLUSION There was a very high incidence of intra-abdominal hypertension in critically ill patients. IAH was significantly associated with risk factors like sepsis, mechanical ventilation, pancreatitis, capillary leak, ascites, cumulative fluid balance and cirrhosis. IAH is an independent risk factor for development of acute kidney injury. IAH is an independent predictor of mortality in critically ill patients.

CUMULATE ROCKS ASSOCIATED WITH CARBONATE ASSIMILATION, HORTAVÆR COMPLEX, NORTH-CENTRAL NORWAY

Science.gov (United States)

Barnes, C. G.; Prestvik, T.; Li, Y.

2009-12-01

The Hortavær igneous complex intruded high-grade metamorphic rocks of the Caledonian Helgeland Nappe Complex at ca. 466 Ma. The complex is an unusual mafic-silicic layered intrusion (MASLI) because the principal felsic rock type is syenite and because the syenite formed in situ rather than by deep-seated partial melting of crustal rocks. Magma differentiation in the complex was by assimilation, primarily of calc-silicate rocks and melts with contributions from marble and semi-pelites, plus fractional crystallization. The effect of assimilation of calcite-rich rocks was to enhance stability of fassaitic clinopyroxene at the expense of olivine, which resulted in alkali-rich residual melts and lowering of silica activity. This combination of MASLI-style emplacement and carbonate assimilation produced three types of cumulate rocks: (1) Syenitic cumulates formed by liquid-crystal separation. As sheets of mafic magma were loaded on crystal-rich syenitic magma, residual liquid was expelled, penetrating the overlying mafic sheets in flame structures, and leaving a cumulate syenite. (2) Reaction cumulates. Carbonate assimilation, illustrated by a simple assimilation reaction: olivine + calcite + melt = clinopyroxene + CO2 resulted in cpx-rich cumulates such as clinopyroxenite, gabbro, and mela-monzodiorite, many of which contain igneous calcite. (3) Magmatic skarns. Calc-silicate host rocks underwent partial melting during assimilation, yielding a Ca-rich melt as the principal assimilated material and permitting extensive reaction with surrounding magma to form Kspar + cpx + garnet-rich ‘cumulate’ rocks. Cumulate types (2) and (3) do not reflect traditional views of cumulate rocks but instead result from a series of melt-present discontinuous (peritectic) reactions and partial melting of calc-silicate xenoliths. In the Hortavær complex, such cumulates are evident because of the distinctive peritectic cumulate assemblages. It is unclear whether assimilation of �

EPA Workshop on Epigenetics and Cumulative Risk ...

Science.gov (United States)

Agenda Download the Workshop Agenda (PDF) The workshop included presentations and discussions by scientific experts pertaining to three topics (i.e., epigenetic changes associated with diverse stressors, key science considerations in understanding epigenetic changes, and practical application of epigenetic tools to address cumulative risks from environmental stressors), to address several questions under each topic, and included an opportunity for attendees to participate in break-out groups, provide comments and ask questions. Workshop Goals The workshop seeks to examine the opportunity for use of aggregate epigenetic change as an indicator in cumulative risk assessment for populations exposed to multiple stressors that affect epigenetic status. Epigenetic changes are specific molecular changes around DNA that alter expression of genes. Epigenetic changes include DNA methylation, formation of histone adducts, and changes in micro RNAs. Research today indicates that epigenetic changes are involved in many chronic diseases (cancer, cardiovascular disease, obesity, diabetes, mental health disorders, and asthma). Research has also linked a wide range of stressors including pollution and social factors with occurrence of epigenetic alterations. Epigenetic changes have the potential to reflect impacts of risk factors across multiple stages of life. Only recently receiving attention is the nexus between the factors of cumulative exposure to environmental

Modeling the Cumulative Effects of Social Exposures on Health: Moving beyond Disease-Specific Models

Directory of Open Access Journals (Sweden)

Heather L. White

2013-03-01

Full Text Available The traditional explanatory models used in epidemiology are “disease specific”, identifying risk factors for specific health conditions. Yet social exposures lead to a generalized, cumulative health impact which may not be specific to one illness. Disease-specific models may therefore misestimate social factors’ effects on health. Using data from the Canadian Community Health Survey and Canada 2001 Census we construct and compare “disease-specific” and “generalized health impact” (GHI models to gauge the negative health effects of one social exposure: socioeconomic position (SEP. We use logistic and multinomial multilevel modeling with neighbourhood-level material deprivation, individual-level education and household income to compare and contrast the two approaches. In disease-specific models, the social determinants under study were each associated with the health conditions of interest. However, larger effect sizes were apparent when outcomes were modeled as compound health problems (0, 1, 2, or 3+ conditions using the GHI approach. To more accurately estimate social exposures’ impacts on population health, researchers should consider a GHI framework.

Hyperscaling breakdown and Ising spin glasses: The Binder cumulant

Science.gov (United States)

Lundow, P. H.; Campbell, I. A.

2018-02-01

Among the Renormalization Group Theory scaling rules relating critical exponents, there are hyperscaling rules involving the dimension of the system. It is well known that in Ising models hyperscaling breaks down above the upper critical dimension. It was shown by Schwartz (1991) that the standard Josephson hyperscaling rule can also break down in Ising systems with quenched random interactions. A related Renormalization Group Theory hyperscaling rule links the critical exponents for the normalized Binder cumulant and the correlation length in the thermodynamic limit. An appropriate scaling approach for analyzing measurements from criticality to infinite temperature is first outlined. Numerical data on the scaling of the normalized correlation length and the normalized Binder cumulant are shown for the canonical Ising ferromagnet model in dimension three where hyperscaling holds, for the Ising ferromagnet in dimension five (so above the upper critical dimension) where hyperscaling breaks down, and then for Ising spin glass models in dimension three where the quenched interactions are random. For the Ising spin glasses there is a breakdown of the normalized Binder cumulant hyperscaling relation in the thermodynamic limit regime, with a return to size independent Binder cumulant values in the finite-size scaling regime around the critical region.

Summary report of a workshop on establishing cumulative effects thresholds : a suggested approach for establishing cumulative effects thresholds in a Yukon context

International Nuclear Information System (INIS)

2003-01-01

Increasingly, thresholds are being used as a land and cumulative effects assessment and management tool. To assist in the management of wildlife species such as woodland caribou, the Department of Indian and Northern Affairs (DIAND) Environment Directorate, Yukon sponsored a workshop to develop and use cumulative thresholds in the Yukon. The approximately 30 participants reviewed recent initiatives in the Yukon and other jurisdictions. The workshop is expected to help formulate a strategic vision for implementing cumulative effects thresholds in the Yukon. The key to success resides in building relationships with Umbrella Final Agreement (UFA) Boards, the Development Assessment Process (DAP), and the Yukon Environmental and Socio-Economic Assessment Act (YESAA). Broad support is required within an integrated resource management framework. The workshop featured discussions on current science and theory of cumulative effects thresholds. Potential data and implementation issues were also discussed. It was concluded that thresholds are useful and scientifically defensible. The threshold research results obtained in Alberta, British Columbia and the Northwest Territories are applicable to the Yukon. One of the best tools for establishing and tracking thresholds is habitat effectiveness. Effects must be monitored and tracked. Biologists must share their information with decision makers. Interagency coordination and assistance should be facilitated through the establishment of working groups. Regional land use plans should include thresholds. 7 refs.

Perceived illness intrusion among patients on hemodialysis

International Nuclear Information System (INIS)

Bapat, Usha; Kedlaya, Prashanth G; Gokulnath

2009-01-01

Dialysis therapy is extremely stressful as it interferes with all spheres of daily activities of the patients. This study is aimed at understanding the perceived illness intrusion among patients on hemodialysis (HD) and to find the association between illness intrusion and patient demo-graphics as well as duration of dialysis. A cross sectional study involving 90 patients with chronic kidney disease (CKD) stage V, on HD was performed during the period from 2005 to 2006. The subjects included were above 18 years of age, willing, stable and on dialysis for at least two months. Patients with psychiatric co-morbidity were excluded. A semi-structured interview schedule covering sociodemographics and a 13 item illness intrusion checklist covering the various aspects of life was carried out. The study patients were asked to rate the illness intrusion and the extent. The data were analyzed statistically. The mean age of the subjects was 50.28 + - 13.69 years, males were predominant (85%), 73% were married, 50% belonged to Hindu religion, 25% had pre-degree education, 25% were employed and 22% were housewives. About 40% and 38% of the study patients belonged to middle and upper socio-economic strata respectively; 86% had urban background and lived in nuclear families. The mean duration on dialysis was 24 + - 29.6 months. All the subjects reported illness intrusion to a lesser or greater extent in various areas including: health (44%), work (70%) finance (55%), diet (50%) sexual life (38%) and psychological status (25%). Illness had not intruded in areas of relationship with spouse (67%), friends (76%), family (79%), social (40%) and religious functions (72%). Statistically significant association was noted between illness intrusion and occupation (P= 0.02). (author)

Perceived illness intrusion among patients on hemodialysis

Directory of Open Access Journals (Sweden)

Bapat Usha

2009-01-01

Full Text Available Dialysis therapy is extremely stressful as it interferes with all spheres of daily acti-vities of the patients. This study is aimed at understanding the perceived illness intrusion among pa-tients on hemodialysis (HD and to find the association between illness intrusion and patient demo-graphics as well as duration of dialysis. A cross sectional study involving 90 patients with chronic kidney disease (CKD stage V, on HD was performed during the period from 2005 to 2006. The subjects included were above 18 years of age, willing, stable and on dialysis for at least two months. Patients with psychiatric co-morbidity were excluded. A semi-structured interview schedule covering socio-demographics and a 13 item illness intrusion checklist covering the various aspects of life was ca-rried out. The study patients were asked to rate the illness intrusion and the extent. The data were ana-lyzed statistically. The mean age of the subjects was 50.28 ± 13.69 years, males were predominant (85%, 73% were married, 50% belonged to Hindu religion, 25% had pre-degree education, 25% were employed and 22% were housewives. About 40% and 38% of the study patients belonged to middle and upper socio-economic strata respectively; 86% had urban background and lived in nuclear fami-lies. The mean duration on dialysis was 24 ± 29.6 months. All the subjects reported illness intrusion to a lesser or greater extent in various areas including: health (44%, work (70% finance (55%, diet (50% sexual life (38% and psychological status (25%. Illness had not intruded in areas of rela-tionship with spouse (67%, friends (76%, family (79%, social (40% and religious functions (72%. Statistically significant association was noted between illness intrusion and occupation (P= 0.02.

Residual, direct and cumulative effect of zinc application on wheat and rice yield under rice-wheat syst

Directory of Open Access Journals (Sweden)

R. Khan

2009-05-01

Full Text Available Zinc (Zn deficiency is prevalent particularly on calcareous soils of arid and semiarid region. A field experiment was conducted to investigate the direct, residual and cumulative effect of zinc on the yield of wheat and rice in permanent layout for two consecutive years, 2004-05 and 2005-06 at Arid Zone Research Institute D.I. Khan. Soil under study was deficient in Zn (0.8 mg kg-1. Effect of Zn on yield, Zn concentrations in leaf and soils were assessed using wheat variety Naseer-2000 and rice variety IRRI-6. Three rates of Zn, ranging from 0 to 10 kg ha-1 in soil, were applied as zinc sulphate (ZnSO4. 7H2O along with basal dose fertilization of nitrogen, phosphorus and potassium. Mature leaf and soil samples were collected at panicle initiation stage. The results showed that grain yield of wheat and rice was significantly increased by the direct application of 5 and 10 kg Zn ha-1. Highest grain yield of wheat (5467 kg ha-1 was recorded with the direct application of 10 kg Zn ha-1 while 4994 kg ha-1 was recorded with the cumulative application of 10 kg Zn ha-1 but the yield increase due to residual effect of Zn was statistically lower than the cumulative effect of Zn. Maximum paddy yield was recorded with the cumulative application ofZn followed by residual and direct applied 10 and 5 kg Zn kg ha-1, respectively. Zn concentration in soils ranged from 0.3 to 1.5 mg kg-1 in wheat and 0.24 to 2.40 mg kg-1 in rice, while in leaves it ranged from 18-48 mg kg-1 in wheat and 15-52 mg kg-1 in rice. The concentration of Zn in soil and leaves increased due to the treatments in the order; cumulative > residual > direct effect > control (without Zn. The yield attributes like 1000- grain weight, number of spikes, spike length and plant height were increased by the residual, direct and cumulative effect of Zn levels; however, the magnitude of increase was higher in cumulative effect than residual and direct effect of Zn, respectively. Under Zn-deficient soil

Cost of illness and illness perceptions in patients with fibromyalgia.

Science.gov (United States)

Vervoort, Vera M; Vriezekolk, Johanna E; Olde Hartman, Tim C; Cats, Hans A; van Helmond, Toon; van der Laan, Willemijn H; Geenen, Rinie; van den Ende, Cornelia H

2016-01-01

The disease impact and economic burden of fibromyalgia (FM) are high for patients and society at large. Knowing potential determinants of economic costs may help in reducing this burden. Cognitive appraisals (perceptions) of the illness could affect costs. The present study estimated costs of illness in FM and examined the association between these costs and illness perceptions. Questionnaire data of FM severity (FIQ), illness perceptions (IPQ-R-FM), productivity losses (SF-HLQ) and health care use were collected in a cohort of patients with FM. Costs were calculated and dichotomised (median split). Univariate and hierarchic logistic regression models examined the unique association of each illness perception with 1) health care costs and 2) costs of productivity losses. Covariates were FM severity, comorbidity and other illness perceptions. 280 patients participated: 95% female, mean age 42 (SD=12) years. Annualised costs of FM per patient were €2944 for health care, and €5731 for productivity losses. In multivariate analyses, a higher disease impact (FIQ) and two of seven illness perceptions (IPQ-R-FM) were associated with high health care costs: 1) high scores on 'cyclical timeline' reflecting a fluctuating, unpredictable course and 2) low scores on 'emotional representations', thus not perceiving a connection between fibromyalgia and emotions. None of the variables was associated with productivity losses. Our study indicates that perceiving a fluctuating course and low emotional representation, which perhaps reflects somatic fixation, are associated with health care costs in FM. Future studies should examine whether targeting these illness perceptions results in reduction of costs.

Living well: an intervention to improve self-management of medical illness for individuals with serious mental illness.

Science.gov (United States)

Goldberg, Richard W; Dickerson, Faith; Lucksted, Alicia; Brown, Clayton H; Weber, Elyssa; Tenhula, Wendy N; Kreyenbuhl, Julie; Dixon, Lisa B

2013-01-01

Individuals with serious mental illness have elevated rates of comorbid chronic general medical conditions and may benefit from interventions designed to support illness self-management. This study examined the effectiveness of a modified version of the Chronic Disease Self-Management Program called Living Well for individuals with serious mental illness. A total of 63 mental health consumers with serious mental illness and at least one concurrent chronic general medical condition were randomly assigned to receive the 13-session peer-cofacilitated Living Well intervention or usual care. Participants were evaluated on attitudinal, behavioral, and functional outcomes at baseline, at the end of the intervention, and at a two-month follow-up. Living Well participants showed significant postintervention improvements across a range of attitudinal (self-efficacy and patient activation), behavioral (illness self-management techniques), and functional (physical and emotional well-being and general health functioning) outcomes. Although attenuation of effect was observed for most outcomes at two months postintervention, evidence was found of continued improvement in general self-management behaviors (use of action planning, brainstorming, and problem-solving). Continued advantage was found for the Living Well group in other areas, such as health-related locus of control and reports of healthy eating and physical activity. Receipt of Living Well was associated with a notable decrease in use of the emergency room for medical care, although the between-group difference was not statistically significant. Living Well shows promise in helping mental health consumers more effectively manage chronic general medical conditions and experience improved functioning and well-being.

Attitudes of college students toward mental illness stigma and the misuse of psychiatric medications.

Science.gov (United States)

Stone, Amanda M; Merlo, Lisa J

2011-02-01

Mental illness stigma remains a significant barrier to treatment. However, the recent increase in the medical and nonmedical use of prescription psychiatric medications among college students seems to contradict this phenomenon. This study explored students' attitudes and experiences related to psychiatric medications, as well as correlates of psychiatric medication misuse (ie, attitudes toward mental illness and beliefs about the efficacy of psychiatric medications). Data were collected anonymously via self-report questionnaires from April 2008 to February 2009. Measures included the Michigan Alcoholism Screening Test, the Drug Abuse Screening Test, Day's Mental Illness Stigma Scale, the Attitudes Toward Psychiatric Medication scale, and the Psychiatric Medication Attitudes Scale. Participants included 383 university students (59.2% female), recruited on the campus of a large state university or through online classes offered through the same university. High rates of psychiatric medication misuse were shown (13.8%) when compared to rates of medical use (6.8%), and students with prescriptions for psychiatric drugs were also more likely to be misusers (χ(2) = 20.60, P mental illness, including lower anxiety around the mentally ill (t = 3.26, P mental illness (t = -2.11, P mental illness, the appropriate use of psychiatric medications, and the potential consequences associated with abuse of these potent drugs. © Copyright 2011 Physicians Postgraduate Press, Inc.

Mental Illness and Labour Market Outcomes: Employment and Earnings

DEFF Research Database (Denmark)

Westergård-Nielsen, Niels Chr.; Agerbo, Esben; Eriksson, Tor Viking

1999-01-01

This paper investigates the effect of severe mental illness on the capacity to hold a job and to earn an income. We find that the employment rate is reduced with about 1/3 during the development of the disease. Hospital admission seems to stabilize employment for all diagnoses. The employment rate...

Prolonged Elevated Heart Rate and 90-Day Survival in Acutely Ill Patients: Data From the MIMIC-III Database.

Science.gov (United States)

Sandfort, Veit; Johnson, Alistair E W; Kunz, Lauren M; Vargas, Jose D; Rosing, Douglas R

2018-01-01

We sought to evaluate the association of prolonged elevated heart rate (peHR) with survival in acutely ill patients. We used a large observational intensive care unit (ICU) database (Multiparameter Intelligent Monitoring in Intensive Care III [MIMIC-III]), where frequent heart rate measurements were available. The peHR was defined as a heart rate >100 beats/min in 11 of 12 consecutive hours. The outcome was survival status at 90 days. We collected heart rates, disease severity (simplified acute physiology scores [SAPS II]), comorbidities (Charlson scores), and International Classification of Diseases (ICD) diagnosis information in 31 513 patients from the MIMIC-III ICU database. Propensity score (PS) methods followed by inverse probability weighting based on the PS was used to balance the 2 groups (the presence/absence of peHR). Multivariable weighted logistic regression was used to assess for association of peHR with the outcome survival at 90 days adjusting for additional covariates. The mean age was 64 years, and the most frequent main disease category was circulatory disease (41%). The mean SAPS II score was 35, and the mean Charlson comorbidity score was 2.3. Overall survival of the cohort at 90 days was 82%. Adjusted logistic regression showed a significantly increased risk of death within 90 days in patients with an episode of peHR ( P < .001; odds ratio for death 1.79; confidence interval, 1.69-1.88). This finding was independent of median heart rate. We found a significant association of peHR with decreased survival in a large and heterogenous cohort of ICU patients.

Mismatch or cumulative stress : Toward an integrated hypothesis of programming effects

NARCIS (Netherlands)

Nederhof, Esther; Schmidt, Mathias V.

2012-01-01

This paper integrates the cumulative stress hypothesis with the mismatch hypothesis, taking into account individual differences in sensitivity to programming. According to the cumulative stress hypothesis, individuals are more likely to suffer from disease as adversity accumulates. According to the

Finite-volume cumulant expansion in QCD-colorless plasma

Energy Technology Data Exchange (ETDEWEB)

Ladrem, M. [Taibah University, Physics Department, Faculty of Science, Al-Madinah, Al-Munawwarah (Saudi Arabia); Physics Department, Algiers (Algeria); ENS-Vieux Kouba (Bachir El-Ibrahimi), Laboratoire de Physique et de Mathematiques Appliquees (LPMA), Algiers (Algeria); Ahmed, M.A.A. [Taibah University, Physics Department, Faculty of Science, Al-Madinah, Al-Munawwarah (Saudi Arabia); ENS-Vieux Kouba (Bachir El-Ibrahimi), Laboratoire de Physique et de Mathematiques Appliquees (LPMA), Algiers (Algeria); Taiz University in Turba, Physics Department, Taiz (Yemen); Alfull, Z.Z. [Taibah University, Physics Department, Faculty of Science, Al-Madinah, Al-Munawwarah (Saudi Arabia); Cherif, S. [ENS-Vieux Kouba (Bachir El-Ibrahimi), Laboratoire de Physique et de Mathematiques Appliquees (LPMA), Algiers (Algeria); Ghardaia University, Sciences and Technologies Department, Ghardaia (Algeria)

2015-09-15

Due to the finite-size effects, the localization of the phase transition in finite systems and the determination of its order, become an extremely difficult task, even in the simplest known cases. In order to identify and locate the finite-volume transition point T{sub 0}(V) of the QCD deconfinement phase transition to a colorless QGP, we have developed a new approach using the finite-size cumulant expansion of the order parameter and the L{sub mn}-method. The first six cumulants C{sub 1,2,3,4,5,6} with the corresponding under-normalized ratios (skewness Σ, kurtosis κ, pentosis Π{sub ±}, and hexosis H{sub 1,2,3}) and three unnormalized combinations of them, (O = σ{sup 2}κΣ{sup -1},U = σ{sup -2}Σ{sup -1},N = σ{sup 2}κ) are calculated and studied as functions of (T, V). A new approach, unifying in a clear and consistent way the definitions of cumulant ratios, is proposed.Anumerical FSS analysis of the obtained results has allowed us to locate accurately the finite-volume transition point. The extracted transition temperature value T{sub 0}(V) agrees with that expected T{sub 0}{sup N}(V) from the order parameter and the thermal susceptibility χ{sub T} (T, V), according to the standard procedure of localization to within about 2%. In addition to this, a very good correlation factor is obtained proving the validity of our cumulants method. The agreement of our results with those obtained by means of other models is remarkable. (orig.)

Intestinal crosstalk: a new paradigm for understanding the gut as the "motor" of critical illness.

Science.gov (United States)

Clark, Jessica A; Coopersmith, Craig M

2007-10-01

For more than 20 years, the gut has been hypothesized to be the "motor" of multiple organ dysfunction syndrome. As critical care research has evolved, there have been multiple mechanisms by which the gastrointestinal tract has been proposed to drive systemic inflammation. Many of these disparate mechanisms have proved to be important in the origin and propagation of critical illness. However, this has led to an unusual situation where investigators describing the gut as a "motor" revving the systemic inflammatory response syndrome are frequently describing wholly different processes to support their claim (i.e., increased apoptosis, altered tight junctions, translocation, cytokine production, crosstalk with commensal bacteria, etc). The purpose of this review is to present a unifying theory as to how the gut drives critical illness. Although the gastrointestinal tract is frequently described simply as "the gut," it is actually made up of (1) an epithelium; (2) a diverse and robust immune arm, which contains most of the immune cells in the body; and (3) the commensal bacteria, which contain more cells than are present in the entire host organism. We propose that the intestinal epithelium, the intestinal immune system, and the intestine's endogenous bacteria all play vital roles driving multiple organ dysfunction syndrome, and the complex crosstalk between these three interrelated portions of the gastrointestinal tract is what cumulatively makes the gut a "motor" of critical illness.

Transitional Care for Older Adults with Chronic Illnesses as a Vulnerable Population: Theoretical Framework and Future Directions in Nursing.

Science.gov (United States)

Son, Youn Jung; You, Mi Ae

2015-12-01

Effective transitional care is needed to improve the quality of life in older adult patients with chronic illness and avoid discontinuity of care and adverse events. The aim of this article is to provide an overview of the key features, broader implications, and the utility of Meleis' transition theory intended for the transitional care of older adults with chronic illnesses. We present the role of nurse in the context of transitional care and propose future directions to increase the quality of nursing care. The online databases Cumulative Index of Nursing and Allied Health Literature, MEDLINE, and Science Direct were searched for relevant literature published since 1970 along with textbooks regarding nursing theory. An evaluation of the usefulness of transition theory based on transitional care in older adult patients with chronic illnesses is provided. Healthy transition should be the expected standard of nursing care for older adults across all healthcare settings. Nurses need to contribute to the development of transitional care for vulnerable populations; however, transition theory needs to be enhanced through additional theoretical work and repeated evaluations of the applicability in areas of transitional care.

Feasibility and safety of virtual-reality-based early neurocognitive stimulation in critically ill patients.

Science.gov (United States)

Turon, Marc; Fernandez-Gonzalo, Sol; Jodar, Mercè; Gomà, Gemma; Montanya, Jaume; Hernando, David; Bailón, Raquel; de Haro, Candelaria; Gomez-Simon, Victor; Lopez-Aguilar, Josefina; Magrans, Rudys; Martinez-Perez, Melcior; Oliva, Joan Carles; Blanch, Lluís

2017-12-01

Growing evidence suggests that critical illness often results in significant long-term neurocognitive impairments in one-third of survivors. Although these neurocognitive impairments are long-lasting and devastating for survivors, rehabilitation rarely occurs during or after critical illness. Our aim is to describe an early neurocognitive stimulation intervention based on virtual reality for patients who are critically ill and to present the results of a proof-of-concept study testing the feasibility, safety, and suitability of this intervention. Twenty critically ill adult patients undergoing or having undergone mechanical ventilation for ≥24 h received daily 20-min neurocognitive stimulation sessions when awake and alert during their ICU stay. The difficulty of the exercises included in the sessions progressively increased over successive sessions. Physiological data were recorded before, during, and after each session. Safety was assessed through heart rate, peripheral oxygen saturation, and respiratory rate. Heart rate variability analysis, an indirect measure of autonomic activity sensitive to cognitive demands, was used to assess the efficacy of the exercises in stimulating attention and working memory. Patients successfully completed the sessions on most days. No sessions were stopped early for safety concerns, and no adverse events occurred. Heart rate variability analysis showed that the exercises stimulated attention and working memory. Critically ill patients considered the sessions enjoyable and relaxing without being overly fatiguing. The results in this proof-of-concept study suggest that a virtual-reality-based neurocognitive intervention is feasible, safe, and tolerable, stimulating cognitive functions and satisfying critically ill patients. Future studies will evaluate the impact of interventions on neurocognitive outcomes. Trial registration Clinical trials.gov identifier: NCT02078206.

Cumulative Childhood Trauma and Therapeutic Alliance: The Moderator Role of Attachment in Adult Patients Consulting in Sex Therapy.

Science.gov (United States)

Lafrenaye-Dugas, Anne-Julie; Godbout, Natacha; Hébert, Martine

2018-03-05

While it is documented that clients consulting in sex therapy tend to report high rates of childhood interpersonal traumas (e.g., physical, psychological and sexual abuse), which are associated to insecure attachment and poorer therapeutic alliance, the interrelations of these variables have not yet been evaluated in this specific population. This study examined the associations between attachment, cumulative trauma and therapeutic alliance in 278 sex therapy patients who filled out self-report questionnaires. Results revealed that avoidant attachment acted as a moderator between cumulative trauma and the agreement on tasks dimension of therapeutic alliance. Results suggests the relevance for sex therapists to investigate past traumas and current attachment representations to guide interventions and optimize treatment benefits.

Impact of chronic illness timing and persistence at school entry on child and parent outcomes: Australian longitudinal study.

Science.gov (United States)

Quach, Jon; Barnett, Tony

2015-01-01

To understand the prevalence and timing of child chronic illness at school entry; associations with child learning, behavior and health-related quality of life and parent mental health at ages 6 to 7, 8 to 9, and 10 to 11 years; and cumulative health care costs. Data were drawn from the first 4 waves of the Longitudinal Study of Australian Children. Children were aged 4 to 5 years at wave 1, with data collection every 2 years. Parent-reported timing of child chronic illness at school entry was categorized into 4 chronic illness groups based on changes between waves 1 and 2: none, resolving, incident and persistent. Child outcomes included: parent-reported quality of life, parent- and teacher-reported behavior, teacher-reported child learning, teacher-reported child-teacher relationship, directly assessed nonverbal and verbal cognition and parent self-reported mental health. Linear regression, adjusted for gender and socioeconomic position, was used to quantify longitudinal associations between chronic illness timing at school entry with outcomes at age 6 to 7 years, 8 to 9 years and 10 to 11 years. Of the 4983 children enrolled in the study, chronic illness data was available for 4464 children (89.6%) at both waves 1 and 2. From wave 1, 6.1% had a condition that persisted until wave 2, while 14.1% had a condition that resolved. Furthermore, 4.7% had a newly emerging condition at wave 2. Compared with the no chronic illness group, children with persistent or emerging chronic illness during school entry had the poorest outcomes (except father's mental health) at all time points, while children with resolving conditions had smaller differences. Child chronic illness at school entry is associated with poorer longitudinal child and maternal outcomes. Therefore, future research should aim to determine the risk and protective factors that contribute to the poorer child and parent outcomes experienced in this growing population. Copyright © 2015 Academic Pediatric

Vitamin D deficiency is independently associated with mortality among critically ill patients

Directory of Open Access Journals (Sweden)

Rafael Barberena Moraes

2015-05-01

Full Text Available OBJECTIVE: Studies suggest an association between vitamin D deficiency and morbidity/mortality in critically ill patients. Several issues remain unexplained, including which vitamin D levels are related to morbidity and mortality and the relevance of vitamin D kinetics to clinical outcomes. We conducted this study to address the association of baseline vitamin D levels and vitamin D kinetics with morbidity and mortality in critically ill patients. METHOD: In 135 intensive care unit (ICU patients, vitamin D was prospectively measured on admission and weekly until discharge from the ICU. The following outcomes of interest were analyzed: 28-day mortality, mechanical ventilation, length of stay, infection rate, and culture positivity. RESULTS: Mortality rates were higher among patients with vitamin D levels 12 ng/mL (32.2% vs. 13.2%, with an adjusted relative risk of 2.2 (95% CI 1.07-4.54; p< 0.05. There were no differences in the length of stay, ventilation requirements, infection rate, or culture positivity. CONCLUSIONS: This study suggests that low vitamin D levels on ICU admission are an independent risk factor for mortality in critically ill patients. Low vitamin D levels at ICU admission may have a causal relationship with mortality and may serve as an indicator for vitamin D replacement among critically ill patients.

Complexity and demographic explanations of cumulative culture.

Science.gov (United States)

Querbes, Adrien; Vaesen, Krist; Houkes, Wybo

2014-01-01

Formal models have linked prehistoric and historical instances of technological change (e.g., the Upper Paleolithic transition, cultural loss in Holocene Tasmania, scientific progress since the late nineteenth century) to demographic change. According to these models, cumulation of technological complexity is inhibited by decreasing--while favoured by increasing--population levels. Here we show that these findings are contingent on how complexity is defined: demography plays a much more limited role in sustaining cumulative culture in case formal models deploy Herbert Simon's definition of complexity rather than the particular definitions of complexity hitherto assumed. Given that currently available empirical evidence doesn't afford discriminating proper from improper definitions of complexity, our robustness analyses put into question the force of recent demographic explanations of particular episodes of cultural change.

Childhood Cumulative Risk and Later Allostatic Load

DEFF Research Database (Denmark)

Doan, Stacey N; Dich, Nadya; Evans, Gary W

2014-01-01

State, followed for 8 years (between the ages 9 and 17). Poverty- related stress was computed using the cumulative risk approach, assessing stressors across 9 domains, including environmental, psychosocial, and demographic factors. Allostatic load captured a range of physiological responses, including......Objective: The present study investigated the long-term impact of exposure to poverty-related stressors during childhood on allostatic load, an index of physiological dysregulation, and the potential mediating role of substance use. Method: Participants (n = 162) were rural children from New York...... cardiovascular, hypothalamic pituitary adrenal axis, sympathetic adrenal medullary system, and metabolic activity. Smoking and alcohol/drug use were tested as mediators of the hypothesized childhood risk-adolescent allostatic load relationship. Results: Cumulative risk exposure at age 9 predicted increases...

Change of antibiotic susceptibility testing guidelines from CLSI to EUCAST: influence on cumulative hospital antibiograms.

Science.gov (United States)

Wolfensberger, Aline; Sax, Hugo; Weber, Rainer; Zbinden, Reinhard; Kuster, Stefan P; Hombach, Michael

2013-01-01

We studied whether the change in antibiotic susceptibility testing (AST) guidelines from CLSI to EUCAST influenced cumulative antibiograms in a tertiary care hospital in Switzerland. Antibiotic susceptibilities of non-duplicate isolates collected within a one-year period before (period A) and after (period B) changing AST interpretation from CLSI 2009 to EUCAST 1.3 (2011) guidelines were analysed. In addition, period B isolates were reinterpreted according to the CLSI 2009, CLSI 2013 and EUCAST 3.1 (2013) guidelines. The majority of species/drug combinations showed no differences in susceptibility rates comparing periods A and B. However, in some gram-negative bacilli, decreased susceptibility rates were observed when comparing CLSI 2009 with EUCAST 1.3 within period B: Escherichia coli / cefepime, 95.8% (CLSI 2009) vs. 93.1% (EUCAST 1.3), P=0.005; Enterobacter cloacae / cefepime, 97.0 (CLSI 2009) vs. 90.5% (EUCAST 1.3), P=0.012; Pseudomonas aeruginosa / meropenem, 88.1% (CLSI 2009) vs. 78.3% (EUCAST 1.3), P=0.002. These differences were still evident when comparing susceptibility rates according to the CLSI 2013 guideline with EUCAST 3.1 guideline. For P. aeruginosa and imipenem, a trend towards a lower antibiotic susceptibility rate in ICUs compared to general wards turned into a significant difference after the change to EUCAST: 87.9% vs. 79.8%, P=0.08 (CLSI 2009) and 86.3% vs. 76.8%, P=0.048 (EUCAST 1.3). The change of AST guidelines from CLSI to EUCAST led to a clinically relevant decrease of susceptibility rates in cumulative antibiograms for defined species/drug combinations, particularly in those with considerable differences in clinical susceptibility breakpoints between the two guidelines.

Acute kidney injury in critically ill child.

Science.gov (United States)

Al-Jboor, Wejdan; Almardini, Reham; Al Bderat, Jwaher; Frehat, Mahdi; Al Masri, Hazem; Alajloni, Mohammad Saleh

2016-01-01

Acute kidney injury (AKI) is a common and serious complication in patients in the Pediatric Intensive Care Unit (PICU). We conducted this study to estimate the incidence and the mortality rate of AKI in critically ill children as well as to describe some other related factors. A retrospective study was conducted at PICU of Queen Rania Abdulla Children Hospital, Amman, Jordan for the period extending from May 2011 to June 2013. The medical records of all patients admitted during this period, and their demographic data were reviewed. Patients with AKI were identified, and management and outcomes were reviewed and analyzed. AKI was evaluated according to modified RIFLE criteria. Of the 372 patients admitted to PICU, 64 (17.2%) patients developed AKI. Of these 64 patients who had AKI, 28 (43.7%) patients reached RIFLE max of risk, 21 (32.8%) patients reached injury, and 15 (23.4%) reached failure. Mean Pediatric Risk of Mortality II score at admission was significantly higher in patients with AKI than those without P <0.001. The age ranged between one month and 14 years with the median age as 5.4 year. Thirty-five (54.7%) were males. Sepsis was the most common cause of AKI. The mortality rate in critically ill children without AKI was 58.7%, whereas increased in children with AKI to 73.4%. The mortality rate in patients who received renal replacement therapy was 71.4% and was higher (81.5%) in patients who received mechanical ventilation (95%, [confidence interval (CI)] 79.3-83.4%) and was significantly higher in patients with multi-organ system dysfunction 90.3% (95%, [CI] 88.7-92.5%). The incidence of AKI in critically ill children is high and increased their mortality rate and higher mortality seen in the younger age group, especially those below one year. High mortality rate was associated with multi-organ system dysfunction and the need for mechanical ventilation.

Illness perceptions of cancer patients: relationships with illness characteristics and coping.

NARCIS (Netherlands)

Hopman, P.; Rijken, M.

2015-01-01

Objective: Illness perceptions have proven to be predictive of coping and adjustment in many chronically ill patients. However, insights into illness perceptions of cancer patients are scarce. The purpose of the present study was to explore how a heterogeneous sample of cancer patients perceive

Mapping cumulative environmental risks: examples from the EU NoMiracle project

NARCIS (Netherlands)

Pistocchi, A.; Groenwold, J.; Lahr, J.; Loos, M.; Mujica, M.; Ragas, A.M.J.; Rallo, R.; Sala, S.; Schlink, U.; Strebel, K.; Vighi, M.; Vizcaino, P.

2011-01-01

We present examples of cumulative chemical risk mapping methods developed within the NoMiracle project. The different examples illustrate the application of the concentration addition (CA) approach to pesticides at different scale, the integration in space of cumulative risks to individual organisms

Mapping Cumulative Impacts of Human Activities on Marine Ecosystems

OpenAIRE

, Seaplan

2018-01-01

Given the diversity of human uses and natural resources that converge in coastal waters, the potential independent and cumulative impacts of those uses on marine ecosystems are important to consider during ocean planning. This study was designed to support the development and implementation of the 2009 Massachusetts Ocean Management Plan. Its goal was to estimate and visualize the cumulative impacts of human activities on coastal and marine ecosystems in the state and federal waters off of Ma...

Estimating a population cumulative incidence under calendar time trends

DEFF Research Database (Denmark)

Hansen, Stefan N; Overgaard, Morten; Andersen, Per K

2017-01-01

BACKGROUND: The risk of a disease or psychiatric disorder is frequently measured by the age-specific cumulative incidence. Cumulative incidence estimates are often derived in cohort studies with individuals recruited over calendar time and with the end of follow-up governed by a specific date...... by calendar time trends, the total sample Kaplan-Meier and Aalen-Johansen estimators do not provide useful estimates of the general risk in the target population. We present some alternatives to this type of analysis. RESULTS: We show how a proportional hazards model may be used to extrapolate disease risk...... estimates if proportionality is a reasonable assumption. If not reasonable, we instead advocate that a more useful description of the disease risk lies in the age-specific cumulative incidence curves across strata given by time of entry or perhaps just the end of follow-up estimates across all strata...

The Relationship between Gender, Cumulative Adversities and ...

African Journals Online (AJOL)

The Relationship between Gender, Cumulative Adversities and Mental Health of Employees in ... CAs were measured in three forms (family adversities (CAFam), personal adversities ... Age of employees ranged between 18-65 years.

Carrion’s disease: an eradicable illness?

OpenAIRE

Gomes, Cláudia; Pons, Maria J.; Del Valle Mendoza, Juana Mercedes; Ruiz, Joaquim

2016-01-01

Carrion's disease is a neglected tropical disease caused by Bartonella bacilliformis, a vector-borne pathogen restricted to the Andean valleys of Peru, Ecuador and Colombia. Carrion's disease is a biphasic illness; in the acute phase the case-fatality rate can be as high as 88 %, related to high parasitemia, arriving to almost all erythrocytes, and secondary bacterial infections c...

Assessing the Decision-Making Capacity of Terminally Ill Patients with Cancer.

Science.gov (United States)

Kolva, Elissa; Rosenfeld, Barry; Saracino, Rebecca

2018-05-01

Despite the clinical, ethical, and legal magnitude of end-of-life decision-making, the capacity of terminally ill patients to make the medical decisions they often face is largely unknown. In practice, clinicians are responsible for determining when their patients are no longer competent to make treatment decisions, yet the accuracy of these assessments is unclear. The purpose of this study was to explore decision-making capacity and its assessment in terminally ill cancer patients. Fifty-five patients with advanced cancer receiving inpatient palliative care and 50 healthy adults were administered the MacArthur Competence Assessment Tool for Treatment (MacCAT-T) to evaluate decision-making capacity with regard to the four most commonly used legal standards: Choice, Understanding, Appreciation, and Reasoning. Participants made a hypothetical treatment decision about whether to accept artificial nutrition and hydration for treatment of cachexia. Participants' physicians independently rated their decision-making capacity. Terminally ill participants were significantly more impaired than healthy adults on all MacCAT-T subscales. Most terminally ill participants were able to express a treatment choice (85.7%), but impairment was common on the Understanding (44.2%), Appreciation (49.0%), and Reasoning (85.4%) subscales. Agreement between physician-rated capacity and performance on the MacCAT-T subscales was poor. The use of the MacCAT-T revealed high rates of decisional impairment in terminally ill participants. Participants' physicians infrequently detected impairment identified by the MacCAT-T. The findings from the present study reinforce the need for engagement in advance care planning for patients with advanced cancer. Copyright © 2018 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Cumulation of light nuclei

International Nuclear Information System (INIS)

Baldin, A.M.; Bondarev, V.K.; Golovanov, L.B.

1977-01-01

Limit fragmentation of light nuclei (deuterium, helium) bombarded with 8,6 GeV/c protons was investigated. Fragments (pions, protons and deuterons) were detected within the emission angle 50-150 deg with regard to primary protons and within the pulse range 150-180 MeV/c. By the kinematics of collision of a primary proton with a target at rest the fragments observed correspond to a target mass upto 3 GeV. Thus, the data obtained correspond to teh cumulation upto the third order

Cumulative Mass and NIOSH Variable Lifting Index Method for Risk Assessment: Possible Relations.

Science.gov (United States)

Stucchi, Giulia; Battevi, Natale; Pandolfi, Monica; Galinotti, Luca; Iodice, Simona; Favero, Chiara

2018-02-01

Objective The aim of this study was to explore whether the Variable Lifting Index (VLI) can be corrected for cumulative mass and thus test its efficacy in predicting the risk of low-back pain (LBP). Background A validation study of the VLI method was published in this journal reporting promising results. Although several studies highlighted a positive correlation between cumulative load and LBP, cumulative mass has never been considered in any of the studies investigating the relationship between manual material handling and LBP. Method Both VLI and cumulative mass were calculated for 2,374 exposed subjects using a systematic approach. Due to high variability of cumulative mass values, a stratification within VLI categories was employed. Dummy variables (1-4) were assigned to each class and used as a multiplier factor for the VLI, resulting in a new index (VLI_CMM). Data on LBP were collected by occupational physicians at the study sites. Logistic regression was used to estimate the risk of acute LBP within levels of risk exposure when compared with a control group formed by 1,028 unexposed subjects. Results Data showed greatly variable values of cumulative mass across all VLI classes. The potential effect of cumulative mass on damage emerged as not significant ( p value = .6526). Conclusion When comparing VLI_CMM with raw VLI, the former failed to prove itself as a better predictor of LBP risk. Application To recognize cumulative mass as a modifier, especially for lumbar degenerative spine diseases, authors of future studies should investigate potential association between the VLI and other damage variables.

Session: What do we know about cumulative or population impacts

Energy Technology Data Exchange (ETDEWEB)

Kerlinger, Paul; Manville, Al; Kendall, Bill

2004-09-01

This session at the Wind Energy and Birds/Bats workshop consisted of a panel discussion followed by a discussion/question and answer period. The panelists were Paul Kerlinger, Curry and Kerlinger, LLC, Al Manville, U.S. Fish and Wildlife Service, and Bill Kendall, US Geological Service. The panel addressed the potential cumulative impacts of wind turbines on bird and bat populations over time. Panel members gave brief presentations that touched on what is currently known, what laws apply, and the usefulness of population modeling. Topics addressed included which sources of modeling should be included in cumulative impacts, comparison of impacts from different modes of energy generation, as well as what research is still needed regarding cumulative impacts of wind energy development on bird and bat populations.

Evolutionary neural network modeling for software cumulative failure time prediction

International Nuclear Information System (INIS)

Tian Liang; Noore, Afzel

2005-01-01

An evolutionary neural network modeling approach for software cumulative failure time prediction based on multiple-delayed-input single-output architecture is proposed. Genetic algorithm is used to globally optimize the number of the delayed input neurons and the number of neurons in the hidden layer of the neural network architecture. Modification of Levenberg-Marquardt algorithm with Bayesian regularization is used to improve the ability to predict software cumulative failure time. The performance of our proposed approach has been compared using real-time control and flight dynamic application data sets. Numerical results show that both the goodness-of-fit and the next-step-predictability of our proposed approach have greater accuracy in predicting software cumulative failure time compared to existing approaches

Illness perceptions of cancer patients: relationships with illness characteristics and effects on coping.

NARCIS (Netherlands)

Hopman, E.P.C.; Rijken, P.M.

2013-01-01

Background: Illness perceptions have proven to be predictive of coping and adjustment in many chronically ill patients. Insights into illness perceptions of cancer patients are however scarce. The purpose of the present study was to explore how people with cancer perceive their illness. Moreover, we

Seasonal Patterns of Gastrointestinal Illness and Streamflow along the Ohio River

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Elena N. Naumova

2012-05-01

Full Text Available Waterborne gastrointestinal (GI illnesses demonstrate seasonal increases associated with water quality and meteorological characteristics. However, few studies have been conducted on the association of hydrological parameters, such as streamflow, and seasonality of GI illnesses. Streamflow is correlated with biological contamination and can be used as proxy for drinking water contamination. We compare seasonal patterns of GI illnesses in the elderly (65 years and older along the Ohio River for a 14-year period (1991–2004 to seasonal patterns of streamflow. Focusing on six counties in close proximity to the river, we compiled weekly time series of hospitalizations for GI illnesses and streamflow data. Seasonal patterns were explored using Poisson annual harmonic regression with and without adjustment for streamflow. GI illnesses demonstrated significant seasonal patterns with peak timing preceding peak timing of streamflow for all six counties. Seasonal patterns of illness remain consistent after adjusting for streamflow. This study found that the time of peak GI illness precedes the peak of streamflow, suggesting either an indirect relationship or a more direct path whereby pathogens enter water supplies prior to the peak in streamflow. Such findings call for interdisciplinary research to better understand associations among streamflow, pathogen loading, and rates of gastrointestinal illnesses.

Perceived human rights violation in persons with mental illness: role of education.

Science.gov (United States)

Vijayalakshmi, Poreddi; Ramachandra; Reddemma, Konduru; Math, Suresh Bada

2013-06-01

People with mental illness are vulnerable to human rights violations and people with illiteracy and mental illness are at a double disadvantage. To determine the role of education in ascertaining human rights needs of people with mental illness. This was a descriptive study carried out among randomly selected (N = 100) recovered psychiatric patients with mental illness in the past based on the Clinical Global Impression-Improvement scale at a tertiary care centre. Data were collected through face-to-face interview using structured needs assessment questionnaire comprising two sections related to family and community domains. Data were analysed and interpreted using descriptive and inferential statistics. Our findings revealed that human rights needs in the physical needs dimension--i.e., access to electricity (χ2 = 5.523, p < .019) and safe drinking water facilities (χ2 = 9.665, p < .022)--were rated higher in illiterates than in literates. The human rights needs in emotional dimension - i.e. feeling separated from their families because of their illness (χ2 = 13.118, p < .004), afraid of family members (χ2 = 13.388, p < .004) and called filthy nicknames (χ2 = 17.759, p < .000) - were rated higher in literates than in illiterates. The human rights needs in the religious needs dimension - i.e. allowed to go to temple, church, mosque etc. (χ2 = 12.000, p < .007) - and in the social needs dimension - i.e. friendliness with family members -were rated higher in illiterates than in literates (χ2 = 9.661, p < .022). Empowering people with mental illness by providing adequate opportunity to pursue education will play an important role in fulfilling the obligation of the United Nations Convention on the Rights of Persons with Disabilities.

Cumulative irritation potential of topical retinoid formulations.

Science.gov (United States)

Leyden, James J; Grossman, Rachel; Nighland, Marge

2008-08-01

Localized irritation can limit treatment success with topical retinoids such as tretinoin and adapalene. The factors that influence irritant reactions have been shown to include individual skin sensitivity, the particular retinoid and concentration used, and the vehicle formulation. To compare the cutaneous tolerability of tretinoin 0.04% microsphere gel (TMG) with that of adapalene 0.3% gel and a standard tretinoin 0.025% cream. The results of 2 randomized, investigator-blinded studies of 2 to 3 weeks' duration, which utilized a split-face method to compare cumulative irritation scores induced by topical retinoids in subjects with healthy skin, were combined. Study 1 compared TMG 0.04% with adapalene 0.3% gel over 2 weeks, while study 2 compared TMG 0.04% with tretinoin 0.025% cream over 3 weeks. In study 1, TMG 0.04% was associated with significantly lower cumulative scores for erythema, dryness, and burning/stinging than adapalene 0.3% gel. However, in study 2, there were no significant differences in cumulative irritation scores between TMG 0.04% and tretinoin 0.025% cream. Measurements of erythema by a chromameter showed no significant differences between the test formulations in either study. Cutaneous tolerance of TMG 0.04% on the face was superior to that of adapalene 0.3% gel and similar to that of a standard tretinoin cream containing a lower concentration of the drug (0.025%).

The cumulative risk of false-positive screening results across screening centres in the Norwegian Breast Cancer Screening Program

Energy Technology Data Exchange (ETDEWEB)

Roman, M., E-mail: Marta.Roman@kreftregisteret.no [Cancer Registry of Norway, Oslo (Norway); Department of Women and Children’s Health, Oslo University Hospital, Oslo (Norway); Skaane, P., E-mail: PERSK@ous-hf.no [Department of Radiology, Oslo University Hospital Ullevaal, University of Oslo, Oslo (Norway); Hofvind, S., E-mail: Solveig.Hofvind@kreftregisteret.no [Cancer Registry of Norway, Oslo (Norway); Oslo and Akershus University College of Applied Sciences, Faculty of Health Science, Oslo (Norway)

2014-09-15

Highlights: • We found variation in early performance measures across screening centres. • Radiologists’ performance may play a key role in the variability. • Potential to improve the effectiveness of breast cancer screening programs. • Continuous surveillance of screening centres and radiologists is essential. - Abstract: Background: Recall for assessment in mammographic screening entails an inevitable number of false-positive screening results. This study aimed to investigate the variation in the cumulative risk of a false positive screening result and the positive predictive value across the screening centres in the Norwegian Breast Cancer Screening Program. Methods: We studied 618,636 women aged 50–69 years who underwent 2,090,575 screening exams (1996–2010. Recall rate, positive predictive value, rate of screen-detected cancer, and the cumulative risk of a false positive screening result, without and with invasive procedures across the screening centres were calculated. Generalized linear models were used to estimate the probability of a false positive screening result and to compute the cumulative false-positive risk for up to ten biennial screening examinations. Results: The cumulative risk of a false-positive screening exam varied from 10.7% (95% CI: 9.4–12.0%) to 41.5% (95% CI: 34.1–48.9%) across screening centres, with a highest to lowest ratio of 3.9 (95% CI: 3.7–4.0). The highest to lowest ratio for the cumulative risk of undergoing an invasive procedure with a benign outcome was 4.3 (95% CI: 4.0–4.6). The positive predictive value of recall varied between 12.0% (95% CI: 11.0–12.9%) and 19.9% (95% CI: 18.3–21.5%), with a highest to lowest ratio of 1.7 (95% CI: 1.5–1.9). Conclusions: A substantial variation in the performance measures across the screening centres in the Norwegian Breast Cancer Screening Program was identified, despite of similar administration, procedures, and quality assurance requirements. Differences in the

The cumulative risk of false-positive screening results across screening centres in the Norwegian Breast Cancer Screening Program

International Nuclear Information System (INIS)

Roman, M.; Skaane, P.; Hofvind, S.

2014-01-01

Highlights: • We found variation in early performance measures across screening centres. • Radiologists’ performance may play a key role in the variability. • Potential to improve the effectiveness of breast cancer screening programs. • Continuous surveillance of screening centres and radiologists is essential. - Abstract: Background: Recall for assessment in mammographic screening entails an inevitable number of false-positive screening results. This study aimed to investigate the variation in the cumulative risk of a false positive screening result and the positive predictive value across the screening centres in the Norwegian Breast Cancer Screening Program. Methods: We studied 618,636 women aged 50–69 years who underwent 2,090,575 screening exams (1996–2010. Recall rate, positive predictive value, rate of screen-detected cancer, and the cumulative risk of a false positive screening result, without and with invasive procedures across the screening centres were calculated. Generalized linear models were used to estimate the probability of a false positive screening result and to compute the cumulative false-positive risk for up to ten biennial screening examinations. Results: The cumulative risk of a false-positive screening exam varied from 10.7% (95% CI: 9.4–12.0%) to 41.5% (95% CI: 34.1–48.9%) across screening centres, with a highest to lowest ratio of 3.9 (95% CI: 3.7–4.0). The highest to lowest ratio for the cumulative risk of undergoing an invasive procedure with a benign outcome was 4.3 (95% CI: 4.0–4.6). The positive predictive value of recall varied between 12.0% (95% CI: 11.0–12.9%) and 19.9% (95% CI: 18.3–21.5%), with a highest to lowest ratio of 1.7 (95% CI: 1.5–1.9). Conclusions: A substantial variation in the performance measures across the screening centres in the Norwegian Breast Cancer Screening Program was identified, despite of similar administration, procedures, and quality assurance requirements. Differences in the

The impact of adverse child and adult experiences on recovery from serious mental illness.

Science.gov (United States)

Stumbo, Scott P; Yarborough, Bobbi Jo H; Paulson, Robert I; Green, Carla A

2015-12-01

The purpose of this study was to compare effects of adverse childhood experiences and adverse adult experiences on recovery from serious mental illnesses. As part of a mixed-methods study of recovery from serious mental illnesses, we interviewed and administered questionnaires to 177 members of a not-for-profit health plan over a 2-year period. Participants had a diagnosis of bipolar disorder, affective psychosis, schizophrenia, or schizoaffective disorder. Data for analyses came from standardized self-reported measures; outcomes included recovery, functioning, quality of life, and psychiatric symptoms. Adverse events in childhood and adulthood were evaluated as predictors. Child and adult exposures to adverse experiences were high, at 91% and 82%, respectively. Cumulative lifetime exposure to adverse experiences (childhood plus adult experiences) was 94%. In linear regression analyses, adverse adult experiences were more important predictors of outcomes than adverse childhood experiences. Adult experiences were associated with lower recovery scores, quality of life, mental and physical functioning and social functioning and greater psychiatric symptoms. Emotional neglect in adulthood was associated with lower recovery scores. Early and repeated exposure to adverse events was common in this sample of people with serious mental illnesses. Adverse adult experiences were stronger predictors of worse functioning and lower recovery levels than were childhood experiences. Focusing clinical attention on adult experiences of adverse or traumatic events may result in greater benefit than focusing on childhood experiences alone. (c) 2015 APA, all rights reserved).

Excess Mortality in Treated and Untreated Hyperthyroidism Is Related to Cumulative Periods of Low Serum TSH.

Science.gov (United States)

Lillevang-Johansen, Mads; Abrahamsen, Bo; Jørgensen, Henrik Løvendahl; Brix, Thomas Heiberg; Hegedüs, Laszlo

2017-07-01

Cumulative time-dependent excess mortality in hyperthyroid patients has been suggested. However, the effect of antithyroid treatment on mortality, especially in subclinical hyperthyroidism, remains unclarified. We investigated the association between hyperthyroidism and mortality in both treated and untreated hyperthyroid individuals. Register-based cohort study of 235,547 individuals who had at least one serum thyroid-stimulating hormone (TSH) measurement in the period 1995 to 2011 (7.3 years median follow-up). Hyperthyroidism was defined as at least two measurements of low serum TSH. Mortality rates for treated and untreated hyperthyroid subjects compared with euthyroid controls were calculated using multivariate Cox regression analyses, controlling for age, sex, and comorbidities. Cumulative periods of decreased serum TSH were analyzed as a time-dependent covariate. Hazard ratio (HR) for mortality was increased in untreated [1.23; 95% confidence interval (CI), 1.12 to 1.37; P hyperthyroid patients. When including cumulative periods of TSH in the Cox regression analyses, HR for mortality per every 6 months of decreased TSH was 1.11 (95% CI, 1.09 to 1.13; P hyperthyroid patients (n = 1137) and 1.13 (95% CI, 1.11 to 1.15; P hyperthyroidism, respectively. Mortality is increased in hyperthyroidism. Cumulative periods of decreased TSH increased mortality in both treated and untreated hyperthyroidism, implying that excess mortality may not be driven by lack of therapy, but rather inability to keep patients euthyroid. Meticulous follow-up during treatment to maintain biochemical euthyroidism may be warranted. Copyright © 2017 by the Endocrine Society

Tests of Cumulative Prospect Theory with graphical displays of probability

Directory of Open Access Journals (Sweden)

Michael H. Birnbaum

2008-10-01

Full Text Available Recent research reported evidence that contradicts cumulative prospect theory and the priority heuristic. The same body of research also violates two editing principles of original prospect theory: cancellation (the principle that people delete any attribute that is the same in both alternatives before deciding between them and combination (the principle that people combine branches leading to the same consequence by adding their probabilities. This study was designed to replicate previous results and to test whether the violations of cumulative prospect theory might be eliminated or reduced by using formats for presentation of risky gambles in which cancellation and combination could be facilitated visually. Contrary to the idea that decision behavior contradicting cumulative prospect theory and the priority heuristic would be altered by use of these formats, however, data with two new graphical formats as well as fresh replication data continued to show the patterns of evidence that violate cumulative prospect theory, the priority heuristic, and the editing principles of combination and cancellation. Systematic violations of restricted branch independence also contradicted predictions of ``stripped'' prospect theory (subjectively weighted additive utility without the editing rules.

CROSSER - CUMULATIVE BINOMIAL PROGRAMS

Science.gov (United States)

Bowerman, P. N.

1994-01-01

The cumulative binomial program, CROSSER, is one of a set of three programs which calculate cumulative binomial probability distributions for arbitrary inputs. The three programs, CROSSER, CUMBIN (NPO-17555), and NEWTONP (NPO-17556), can be used independently of one another. CROSSER can be used by statisticians and users of statistical procedures, test planners, designers, and numerical analysts. The program has been used for reliability/availability calculations. CROSSER calculates the point at which the reliability of a k-out-of-n system equals the common reliability of the n components. It is designed to work well with all integer values 0 < k <= n. To run the program, the user simply runs the executable version and inputs the information requested by the program. The program is not designed to weed out incorrect inputs, so the user must take care to make sure the inputs are correct. Once all input has been entered, the program calculates and lists the result. It also lists the number of iterations of Newton's method required to calculate the answer within the given error. The CROSSER program is written in C. It was developed on an IBM AT with a numeric co-processor using Microsoft C 5.0. Because the source code is written using standard C structures and functions, it should compile correctly with most C compilers. The program format is interactive. It has been implemented under DOS 3.2 and has a memory requirement of 26K. CROSSER was developed in 1988.

Leg Power As an Indicator of Risk of Injury or Illness in Police Recruits.

Science.gov (United States)

Orr, Robin; Pope, Rodney; Peterson, Samantha; Hinton, Benjamin; Stierli, Michael

2016-02-19

Tactical trainees, like those entering the police force, are required to undergo vigorous training as part of their occupational preparation. This training has the potential to cause injuries. In addition, the physical training, communal living and pressures of tactical training are known to induce immune suppression and have the potential to increase the risk of illness. The aim of this study was to investigate the relationship between leg power, as measured by a vertical jump (VJ), and rates of reported injuries and illnesses during police recruit training. Retrospective data from recruits (n = 1021) undergoing basic police recruit training at an Australian Police Force College was collected. Recruits completed a VJ assessment at the commencement of their second state of training. Formally reported illness and injuries were collected 12 weeks later, following completion of training. Correlations between VJ height and rates of reported illness and injury were low (r = -0.16 and -0.09, respectively) but significant (p Police recruits with lower VJ height are at a significantly greater risk of suffering an injury or illness during police basic recruit training.

Mammography Among Women With Severe Mental Illness: Exploring Disparities Through a Large Retrospective Cohort Study.

Science.gov (United States)

Thomas, Melanie; James, Monique; Vittinghoff, Eric; Creasman, Jennifer M; Schillinger, Dean; Mangurian, Christina

2018-01-01

This study examined mammogram screening rates among women with severe mental illness by using a socioecological framework. Because it has been shown that people with severe mental illness receive less preventive health care overall, the analysis included psychosocial predictors of mammogram screening rates in a cohort of women with severe mental illness. This retrospective cohort study (N=14,651) used existing statewide data for women ages 48-67 in California with Medicaid insurance who received treatment in the specialty mental health care system. The primary outcome of interest was evidence of breast cancer screening via mammogram. The associations of each predictor of interest with mammogram screening were evaluated by using Poisson models with robust standard errors. Across all demographic and diagnostic categories, rates of breast cancer screening in this cohort of women with severe mental illness fell below the national average. Only 26.3% (3,859/14,651) of women in the cohort received breast cancer screening in the past year. This study replicated previous findings that women with schizophrenia spectrum disorder and those with a comorbid substance use disorder are less likely to receive screening than those with other types of mental illness. In this cohort of women with severe mental illness, evidence of nonpsychiatric health care utilization was strongly associated with breast cancer screening (adjusted risk ratio=3.30, 95% confidence interval=2.61-4.16, pmental illness, such as targeted outreach to population subsets and colocation of primary care services in mental health treatment settings.

Complexity and demographic explanations of cumulative culture.

Directory of Open Access Journals (Sweden)

Adrien Querbes

Full Text Available Formal models have linked prehistoric and historical instances of technological change (e.g., the Upper Paleolithic transition, cultural loss in Holocene Tasmania, scientific progress since the late nineteenth century to demographic change. According to these models, cumulation of technological complexity is inhibited by decreasing--while favoured by increasing--population levels. Here we show that these findings are contingent on how complexity is defined: demography plays a much more limited role in sustaining cumulative culture in case formal models deploy Herbert Simon's definition of complexity rather than the particular definitions of complexity hitherto assumed. Given that currently available empirical evidence doesn't afford discriminating proper from improper definitions of complexity, our robustness analyses put into question the force of recent demographic explanations of particular episodes of cultural change.

Alcohol-free instant hand sanitizer reduces elementary school illness absenteeism.

Science.gov (United States)

Dyer, D L; Shinder, A; Shinder, F

2000-10-01

BACKGROUND AND HYPOTHESES: A substantial percentage of school absenteeism among children is related to transmissible infection. Rates of transmission can be reduced by hand washing with soap and water, but such washing occurs infrequently. This study tested whether an alcohol-free instant hand sanitizer (CleanHands) could reduce illness absenteeism in school-age children. A 10-week, open-label, crossover study was performed on 420 elementary school-age children (ages 5-12). Students were given a brief orientation immediately prior to the start of the study on the relationship of germs, illness, and hand washing. Each student in the treatment group then received the test product in individual bottles, with instructions to apply one to two sprays to the hands after coming into the classroom, before eating, and after using the restroom, in addition to their normal hand washing with soap and water. The control group was instructed to continue hand washing as normal with non-medicated soap. After 4 weeks of treatment and a 2-week wash-out period, the control and experimental groups were reversed. Data gathered on absenteeism were classified as gastrointestinal or respiratory related and normalized for nonillness-related absenteeism and school holidays. Compared to the hand washing-only control group, students using CleanHands were found to have 41.9% fewer illness-related absence days, representing a 28.9% and a 49.7% drop in gastrointestinal- and respiratory-related illnesses, respectively. Likewise, absence incidence decreased by 31.7%, consisting of a 44.2% and 50.2% decrease in incidence of gastrointestinal- and respiratory-related illnesses, respectively. No adverse events were reported during the study. Daily use of the instant hand sanitizer was associated with significantly lower rates of illness-related absenteeism.

Live-Birth Rate Associated With Repeat In Vitro Fertilization Treatment Cycles.

Science.gov (United States)

Smith, Andrew D A C; Tilling, Kate; Nelson, Scott M; Lawlor, Debbie A

The likelihood of achieving a live birth with repeat in vitro fertilization (IVF) is unclear, yet treatment is commonly limited to 3 or 4 embryo transfers. To determine the live-birth rate per initiated ovarian stimulation IVF cycle and with repeated cycles. Prospective study of 156,947 UK women who received 257,398 IVF ovarian stimulation cycles between 2003 and 2010 and were followed up until June 2012. In vitro fertilization, with a cycle defined as an episode of ovarian stimulation and all subsequent separate fresh and frozen embryo transfers. Live-birth rate per IVF cycle and the cumulative live-birth rates across all cycles in all women and by age and treatment type. Optimal, prognosis-adjusted, and conservative cumulative live-birth rates were estimated, reflecting 0%, 30%, and 100%, respectively, of women who discontinued due to poor prognosis and having a live-birth rate of 0 had they continued. Among the 156,947 women, the median age at start of treatment was 35 years (interquartile range, 32-38; range, 18-55), and the median duration of infertility for all 257,398 cycles was 4 years (interquartile range, 2-6; range, cycle was 29.5% (95% CI, 29.3%-29.7%). This remained above 20% up to and including the fourth cycle. The cumulative prognosis-adjusted live-birth rate across all cycles continued to increase up to the ninth cycle, with 65.3% (95% CI, 64.8%-65.8%) of women achieving a live birth by the sixth cycle. In women younger than 40 years using their own oocytes, the live-birth rate for the first cycle was 32.3% (95% CI, 32.0%-32.5%) and remained above 20% up to and including the fourth cycle. Six cycles achieved a cumulative prognosis-adjusted live-birth rate of 68.4% (95% CI, 67.8%-68.9%). For women aged 40 to 42 years, the live-birth rate for the first cycle was 12.3% (95% CI, 11.8%-12.8%), with 6 cycles achieving a cumulative prognosis-adjusted live-birth rate of 31.5% (95% CI, 29.7%-33.3%). For women older than 42 years, all rates within each cycle

Family Resources and Effects on Child Behavior Problem Interventions: A Cumulative Risk Approach.

Science.gov (United States)

Tømmerås, Truls; Kjøbli, John

2017-01-01

Family resources have been associated with health care inequality in general and with social gradients in treatment outcomes for children with behavior problems. However, there is limited evidence concerning cumulative risk-the accumulation of social and economic disadvantages in a family-and whether cumulative risk moderates the outcomes of evidence-based parent training interventions. We used data from two randomized controlled trials evaluating high-intensity ( n  = 137) and low-intensity ( n  = 216) versions of Parent Management Training-Oregon (PMTO) with a 50:50 allocation between participants receiving PMTO interventions or regular care. A nine-item family cumulative risk index tapping socioeconomic resources and parental health was constructed to assess the family's exposure to risk. Autoregressive structured equation models (SEM) were run to investigate whether cumulative risk moderated child behaviors at post-treatment and follow-up (6 months). Our results showed opposite social gradients for the treatment conditions: the children exposed to cumulative risk in a pooled sample of both PMTO groups displayed lower levels of behavior problems, whereas children with identical risk exposures who received regular care experienced more problems. Furthermore, our results indicated that the social gradients differed between PMTO interventions: children exposed to cumulative risk in the low-intensity (five sessions) Brief Parent Training fared equally well as their high-resource counterparts, whereas children exposed to cumulative risk in the high-intensity PMTO (12 sessions) experienced vastly better treatment effects. Providing evidence-based parent training seem to be an effective way to counteract health care inequality, and the more intensive PMTO treatment seemed to be a particularly effective way to help families with cumulative risk.

Attitudes of Malaysian general hospital staff towards patients with mental illness and diabetes

Directory of Open Access Journals (Sweden)

Midin Marhani

2011-05-01

Full Text Available Abstract Background The context of the study is the increased assessment and treatment of persons with mental illness in general hospital settings by general health staff, as the move away from mental hospitals gathers pace in low and middle income countries. The purpose of the study was to examine whether general attitudes of hospital staff towards persons with mental illness, and extent of mental health training and clinical experience, are associated with different attitudes and behaviours towards a patient with mental illness than towards a patients with a general health problem - diabetes. Methods General hospital health professionals in Malaysia were randomly allocated one of two vignettes, one describing a patient with mental illness and the other a patient with diabetes, and invited to complete a questionnaire examining attitudes and health care practices in relation to the case. The questionnaires completed by respondents included questions on demographics, training in mental health, exposure in clinical practice to people with mental illness, attitudes and expected health care behaviour towards the patient in the vignette, and a general questionnaire exploring negative attitudes towards people with mental illness. Questionnaires with complete responses were received from 654 study participants. Results Stigmatising attitudes towards persons with mental illness were common. Those responding to the mental illness vignette (N = 356 gave significantly lower ratings on care and support and higher ratings on avoidance and negative stereotype expectations compared with those responding the diabetes vignette (N = 298. Conclusions Results support the view that, in the Malaysian setting, patients with mental illness may receive differential care from general hospital staff and that general stigmatising attitudes among professionals may influence their care practices. More direct measurement of clinician behaviours than able to be implemented

Epidemic infectious gastrointestinal illness aboard U.S. Navy ships deployed to the Middle East during peacetime operations – 2000–2001

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Bresee Joseph S

2006-02-01

Full Text Available Abstract Background Infectious gastrointestinal illness (IGI outbreaks have been reported in U.S. Navy ships and could potentially have an adverse mission impact. Studies to date have been anecdotal. Methods We conducted a retrospective analysis of weekly reported disease and non-battle injury health data collected in 2000 – 2001 from 44 U.S. Navy ships while sailing in the 5th Fleet (Persian Gulf and nearby seas. Results During this period, 11 possible IGI outbreaks were identified. Overall, we found 3.3 outbreaks per 100 ship-weeks, a mean outbreak duration of 4.4 weeks, and a mean cumulative ship population attack rate of 3.6%. Morbidity, represented by days lost due to personnel being placed on sick-in-quarters status, was higher during outbreak weeks compared to non-outbreak weeks (p = 0.002. No clear seasonal distribution was identified. Conclusion Explosive outbreaks due to viruses and bacteria with the potential of incapacitating large proportions of the crew raise serious concerns of mission impact and military readiness.

Work Change in Multiple Sclerosis as Motivated by the Pursuit of Illness-Work-Life Balance: A Qualitative Study

Directory of Open Access Journals (Sweden)

Lavanya Vijayasingham

2017-01-01

Full Text Available Individuals with multiple sclerosis have a tendency to make early decisions for work change, even in reversible, episodic, or mild disease stages. To better understand how a multiple sclerosis (MS diagnosis influences perceptions of work and motivations for work changes, we conducted a hermeneutic phenomenology study to explore the work lives of ten individuals with MS in Malaysia. The interpretive analysis and cumulative narratives depict an overarching change in their concept of ideal work and life aspirations and how participants make preemptive work changes to manage illness-work-life futures in subjectively meaningful ways. Discussions on their integrated pursuit of finding dynamic and subjective illness-work-life balance include reconciling the problem of hard work and stress on disease activity and progress, making positive lifestyle changes as health management behaviour, and the motivational influence of their own life and family roles: the consideration of their spouses, parents, and children. At an action level, work change was seen as moral and necessary for the management of illness futures. Our findings contribute insights on how individual perceptions and holistic life management decisions contribute to on-going and disrupted work trajectories, which can inform practice and policy on early interventions to support continued employment.

Work Change in Multiple Sclerosis as Motivated by the Pursuit of Illness-Work-Life Balance: A Qualitative Study.

Science.gov (United States)

Vijayasingham, Lavanya; Jogulu, Uma; Allotey, Pascale

2017-01-01

Individuals with multiple sclerosis have a tendency to make early decisions for work change, even in reversible, episodic, or mild disease stages. To better understand how a multiple sclerosis (MS) diagnosis influences perceptions of work and motivations for work changes, we conducted a hermeneutic phenomenology study to explore the work lives of ten individuals with MS in Malaysia. The interpretive analysis and cumulative narratives depict an overarching change in their concept of ideal work and life aspirations and how participants make preemptive work changes to manage illness-work-life futures in subjectively meaningful ways. Discussions on their integrated pursuit of finding dynamic and subjective illness-work-life balance include reconciling the problem of hard work and stress on disease activity and progress, making positive lifestyle changes as health management behaviour, and the motivational influence of their own life and family roles: the consideration of their spouses, parents, and children. At an action level, work change was seen as moral and necessary for the management of illness futures. Our findings contribute insights on how individual perceptions and holistic life management decisions contribute to on-going and disrupted work trajectories, which can inform practice and policy on early interventions to support continued employment.

Cumulative and current exposure to potentially nephrotoxic antiretrovirals and development of chronic kidney disease in HIV-positive individuals with a normal baseline estimated glomerular filtration rate

DEFF Research Database (Denmark)

Mocroft, Amanda; Lundgren, Jens D; Ross, Michael

2016-01-01

BACKGROUND: Whether or not the association between some antiretrovirals used in HIV infection and chronic kidney disease is cumulative is a controversial topic, especially in patients with initially normal renal function. In this study, we aimed to investigate the association between duration...... of exposure to antiretrovirals and the development of chronic kidney disease in people with initially normal renal function, as measured by estimated glomerular filtration rate (eGFR). METHODS: In this prospective international cohort study, HIV-positive adult participants (aged ≥16 years) from the D......:A:D study (based in Europe, the USA, and Australia) with first eGFR greater than 90 mL/min per 1·73 m(2) were followed from baseline (first eGFR measurement after Jan 1, 2004) until the occurrence of one of the following: chronic kidney disease; last eGFR measurement; Feb 1, 2014; or final visit plus 6...

Implications of applying cumulative risk assessment to the workplace.

Science.gov (United States)

Fox, Mary A; Spicer, Kristen; Chosewood, L Casey; Susi, Pam; Johns, Douglas O; Dotson, G Scott

2018-06-01

Multiple changes are influencing work, workplaces and workers in the US including shifts in the main types of work and the rise of the 'gig' economy. Work and workplace changes have coincided with a decline in unions and associated advocacy for improved safety and health conditions. Risk assessment has been the primary method to inform occupational and environmental health policy and management for many types of hazards. Although often focused on one hazard at a time, risk assessment frameworks and methods have advanced toward cumulative risk assessment recognizing that exposure to a single chemical or non-chemical stressor rarely occurs in isolation. We explore how applying cumulative risk approaches may change the roles of workers and employers as they pursue improved health and safety and elucidate some of the challenges and opportunities that might arise. Application of cumulative risk assessment should result in better understanding of complex exposures and health risks with the potential to inform more effective controls and improved safety and health risk management overall. Roles and responsibilities of both employers and workers are anticipated to change with potential for a greater burden of responsibility on workers to address risk factors both inside and outside the workplace that affect health at work. A range of policies, guidance and training have helped develop cumulative risk assessment for the environmental health field and similar approaches are available to foster the practice in occupational safety and health. Copyright © 2018 Elsevier Ltd. All rights reserved.

Toward a theory of online communication in illness: concept analysis of illness blogs.

Science.gov (United States)

Heilferty, Catherine McGeehin

2009-07-01

This paper is a report of a concept analysis of illness blogs and their relevance to nursing research on communication during illness. Blogs are being used by patients and family members to describe the experience of illness, but very little is known about this phenomenon. Seventeen English language databases and one Internet search engine were searched from 1990 to 2007 using the truncated term 'blog*'. Specific illness terms together with 'blog*', for example, blog* and diabetes; and blog* and cancer, were used to expand the search. Reports were included if they were of qualitative or quantitative research that included a definition of blogs or blogging and some identification or description of blog uses pertinent to the discipline. Specific emphasis was placed on blog use by individuals coping with illness experiences. 'Meta' writings by authors about their own blogging intentions and experiences were excluded. An illness blog is the online expression of the narrative of illness. Theoretical and operational definitions, defining attributes, uses, antecedents and consequences were developed. The literature search returned 45 works from 17 disciplines referring to the definition and uses of blogging. Support is offered from the review of literature and analysis of the concept for the development of a theory of online communication during illness. Reading and incorporating illness blogs into care will enhance patient-provider relationships. Analysis of the narratives being created online about the illness experience will contribute significantly to nursing's body of knowledge.

Change of antibiotic susceptibility testing guidelines from CLSI to EUCAST: influence on cumulative hospital antibiograms.

Directory of Open Access Journals (Sweden)

Aline Wolfensberger

Full Text Available OBJECTIVE: We studied whether the change in antibiotic susceptibility testing (AST guidelines from CLSI to EUCAST influenced cumulative antibiograms in a tertiary care hospital in Switzerland. METHODS: Antibiotic susceptibilities of non-duplicate isolates collected within a one-year period before (period A and after (period B changing AST interpretation from CLSI 2009 to EUCAST 1.3 (2011 guidelines were analysed. In addition, period B isolates were reinterpreted according to the CLSI 2009, CLSI 2013 and EUCAST 3.1 (2013 guidelines. RESULTS: The majority of species/drug combinations showed no differences in susceptibility rates comparing periods A and B. However, in some gram-negative bacilli, decreased susceptibility rates were observed when comparing CLSI 2009 with EUCAST 1.3 within period B: Escherichia coli / cefepime, 95.8% (CLSI 2009 vs. 93.1% (EUCAST 1.3, P=0.005; Enterobacter cloacae / cefepime, 97.0 (CLSI 2009 vs. 90.5% (EUCAST 1.3, P=0.012; Pseudomonas aeruginosa / meropenem, 88.1% (CLSI 2009 vs. 78.3% (EUCAST 1.3, P=0.002. These differences were still evident when comparing susceptibility rates according to the CLSI 2013 guideline with EUCAST 3.1 guideline. For P. aeruginosa and imipenem, a trend towards a lower antibiotic susceptibility rate in ICUs compared to general wards turned into a significant difference after the change to EUCAST: 87.9% vs. 79.8%, P=0.08 (CLSI 2009 and 86.3% vs. 76.8%, P=0.048 (EUCAST 1.3. CONCLUSIONS: The change of AST guidelines from CLSI to EUCAST led to a clinically relevant decrease of susceptibility rates in cumulative antibiograms for defined species/drug combinations, particularly in those with considerable differences in clinical susceptibility breakpoints between the two guidelines.

Implementation in action: how Australian Exercise Physiologists approach exercise prescription for people with mental illness.

Science.gov (United States)

Stanton, Robert; Rosenbaum, Simon; Lederman, Oscar; Happell, Brenda

2018-04-01

Accredited Exercise Physiologists (AEPs) are trained to deliver exercise and physical activity interventions for people with chronic and complex health conditions including those with mental illness. However, their views on exercise for mental illness, their exercise prescription practices, and need for further training are unknown. To examine the way in which Australian AEPs prescribe exercise for people with mental illness. Eighty-one AEPs (33.3 ± 10.4 years) completed an online version of the Exercise in Mental Illness Questionnaire. Findings are reported using descriptive statistics. AEPs report a high level of knowledge and confidence in prescribing exercise for people with mental illness. AEPs rate exercise to be at least of equal value to many established treatments for mental illness, and frequently prescribe exercise based on current best-practice principles. A need for additional training was identified. The response rate was low (2.4%) making generalisations from the findings difficult. Exercise prescription practices utilised by AEPs are consistent with current best-practice guidelines and there is frequent consultation with consumers to individualise exercise based on their preferences and available resources. Further training is deemed important.

Clinical significance of cumulative biological effective dose and overall treatment time in the treatment of carcinoma cervix

Directory of Open Access Journals (Sweden)

Mandal Abhijit

2007-01-01

Full Text Available The purpose of this retrospective study is to report the radiotherapy treatment response of, and complications in, patients with cervical cancer on the basis of cumulative biologic effective dose (BED and overall treatment time (OTT. Sixty-four (stage II - 35/64; stage III - 29/64 patients of cervical cancer were treated with combination of external beam radiotherapy (EBRT and low dose rate intracavitary brachytherapy (ICBT. The cumulative BED was calculated at Point A (BED 10 ; and bladder, rectal reference points (BED 2.5 using the linear-quadratic BED equations. The local control (LC rate and 5-year disease-free survival (DFS rate in patients of stage II were comparable for BED 10 < 84.5 and BED 10 > 84.5 but were much higher for BED 10 > 84.5 than BED 10 < 84.5 ( P < 0.01 in stage III patients. In the stage II patients, The LC rate and 5-year DFS rate were comparable for OTT < 50 days and for OTT> 50 days but were much higher in stage III patients with OTT < 50 than OTT> 50 days ( P < 0.001. It was also observed that patients who received BED 2.5 < 105 had lesser rectal ( P < 0.001 and bladder complications than BED 2.5 > 105. Higher rectal complication-free survival (CFS R rate, bladder complication-free survival (CFS B rate and all-type late complication-free survival rate were observed in patients who received BED 2.5 < 105 than BED 2.5 > 105. A balanced, optimal and justified radiotherapy treatment schedule to deliver higher BED 10 (>84.5 and lower BED 2.5 (< 105 in lesser OTT (< 50 days is essential in carcinoma cervix to expect a better treatment outcome in all respects.

Transmission fidelity is the key to the build-up of cumulative culture.

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Lewis, Hannah M; Laland, Kevin N

2012-08-05

Many animals have socially transmitted behavioural traditions, but human culture appears unique in that it is cumulative, i.e. human cultural traits increase in diversity and complexity over time. It is often suggested that high-fidelity cultural transmission is necessary for cumulative culture to occur through refinement, a process known as 'ratcheting', but this hypothesis has never been formally evaluated. We discuss processes of information transmission and loss of traits from a cognitive viewpoint alongside other cultural processes of novel invention (generation of entirely new traits), modification (refinement of existing traits) and combination (bringing together two established traits to generate a new trait). We develop a simple cultural transmission model that does not assume major evolutionary changes (e.g. in brain architecture) and show that small changes in the fidelity with which information is passed between individuals can lead to cumulative culture. In comparison, modification and combination have a lesser influence on, and novel invention appears unimportant to, the ratcheting process. Our findings support the idea that high-fidelity transmission is the key driver of human cumulative culture, and that progress in cumulative culture depends more on trait combination than novel invention or trait modification.

A paradox of cumulative culture.

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Kobayashi, Yutaka; Wakano, Joe Yuichiro; Ohtsuki, Hisashi

2015-08-21

Culture can grow cumulatively if socially learnt behaviors are improved by individual learning before being passed on to the next generation. Previous authors showed that this kind of learning strategy is unlikely to be evolutionarily stable in the presence of a trade-off between learning and reproduction. This is because culture is a public good that is freely exploited by any member of the population in their model (cultural social dilemma). In this paper, we investigate the effect of vertical transmission (transmission from parents to offspring), which decreases the publicness of culture, on the evolution of cumulative culture in both infinite and finite population models. In the infinite population model, we confirm that culture accumulates largely as long as transmission is purely vertical. It turns out, however, that introduction of even slight oblique transmission drastically reduces the equilibrium level of culture. Even more surprisingly, if the population size is finite, culture hardly accumulates even under purely vertical transmission. This occurs because stochastic extinction due to random genetic drift prevents a learning strategy from accumulating enough culture. Overall, our theoretical results suggest that introducing vertical transmission alone does not really help solve the cultural social dilemma problem. Copyright © 2015 Elsevier Ltd. All rights reserved.

Shelter-based palliative care for the homeless terminally ill.

Science.gov (United States)

Podymow, Tiina; Turnbull, Jeffrey; Coyle, Doug

2006-03-01

The homeless have high rates of mortality, but live in environments not conducive to terminal care. Traditional palliative care hospitals may be reluctant to accept such patients, due to behavior or lifestyle concerns. The Ottawa Inner City Health Project (OICHP) is a pilot study to improve health care delivery to homeless adults. This is a retrospective analysis of a cohort of terminally ill homeless individuals and the effectiveness of shelter-based palliative care. As proof of principle, a cost comparison was performed. 28 consecutive homeless terminally ill patients were admitted and died at a shelter-based palliative care hospice. Demographics, diagnoses at admission and course were recorded. Burden of illness was assessed by medical and psychiatric diagnoses, addictions, Karnofsky scale and symptom management. An expert panel was convened to identify alternate care locations. Using standard costing scales, direct versus alternate care costs were compared. 28 patients had a mean age 49 years; average length of stay 120 days. DIAGNOSES: liver disease 43%, HIV/AIDS 25%, malignancy 25% and other 8%. Addiction to drugs or alcohol and mental illness in 82% of patients. Karnofsky performance score mean 40 +/- 16.8. Pain management with continuous opiates in 71%. The majority reunited with family. Compared to alternate care locations, the hospice projected 1.39 million dollars savings for the patients described. The homeless terminally ill have a heavy burden of disease including physical illness, psychiatric conditions and addictions. Shelter-based palliative care can provide effective end-of-life care to terminally ill homeless individuals at potentially substantial cost savings.

Applicability of the tissue stem cell turnover concept on the validity of cumulative dose based radiation risk evaluation

International Nuclear Information System (INIS)

Otsuka, Kensuke; Hamada, Nobuyuki; Iwasaki, Toshiyasu; Yoshida, Kazuo

2011-01-01

The radiation protection system adopts the linear no-threshold model to achieve proper radiation protection for considering cancer risks resulting from radiation exposure. This model uses cumulative dose to a tissue for risk evaluation in which cumulative dose is related to the amount of DNA damage and consequential induction of gene mutation. In this concept, gene mutation accumulates in tissue stem cells, the putative target of carcinogenesis, with total dose given to the tissue. Unlike high-dose-rate exposure, epidemiological studies in high radiation background areas, such as Kerala in India, revealed that cancer risks is not elevated by the dose to the inhabitants, suggesting that there exists some mechanisms to eliminate the damage/mutation in the exposed tissue under extremely low-dose-rate exposure situations. In this report, the dynamics of tissue stem cell turnover is evaluated as a possible mechanism under extremely low-dose-rate exposure situations. To this end, we reviewed recent literatures studying tissue stem cell turnover, and found that great advances in stem cell research have made it possible to trace a fate of stem cells in tissues. Furthermore, turnover of tissue stem cells is found to occur after irradiation, due to competition of stem cells within tissues. This raises a possibility that radiation effects may not accumulate in a tissue depending on the dose-rate and duration of exposure period. (author)

Five dramas of illness.

Science.gov (United States)

Frank, Arthur W

2007-01-01

First-person narratives of illness experience are dramatic: the narrator, who is also the sufferer, is caught in conflicts of forces that permit understanding more than control. Among the dramas of illness, five occur frequently in autobiographical accounts of illness. These dramas overlap and have varying emphases in different people's stories. They are the drama of genesis (what instigated the illness); the drama of emotion work (what emotional displays are required or prohibited); the drama of fear and loss; the drama of meaning; and finally, the drama of self. This five-drama framework can focus critical and clinical attention on which conflicting forces the ill person is working to reconcile, what makes that work difficult, and how conceiving of one's illness as a drama can be a source of meaning and value.

Exploring the relationship between food access and foodborne illness by using spatial analysis.

Science.gov (United States)

Newbold, Bruce; Watson, Susannah; Mackay, Kevin; Isaacs, Sandy

2013-09-01

There is some evidence that neighborhood deprivation increases residents' risk of foodborne illnesses. Because urban areas with the least available access to adequate amounts of nutritious or affordable food options (or "food deserts") also tend to be the most deprived areas within a city, it is hypothesized that food access and foodborne illness risk are linked. However, the complexity of tracking numbers and sources of gastrointestinal (GI) illnesses often leads researchers to speculate about reasons for disproportionate rates of pathogen outbreaks among demographic groups. This study explores the suitability of existing data to examine associations between food deserts and the spatial distribution of GI illnesses in Hamilton, Ontario, Canada. A spatial analysis by using GIS software methodology was used to identify and map food retail outlets and accessibility, as well as GI illness outbreaks and sales of antidiarrhea, antinausea, and rehydration products (used as a proxy for GI cases) within the city, based on available data. Statistical analysis of the maps shows no statistical relationship between location, access to food outlets, and rates of GI illness. The analysis points to shortfalls and gaps in the existing data, which leaves us unable to draw conclusions either supporting or refuting our hypothesis. This article includes recommendations to improve the current system of illness reporting and to continue to refine the definition and process of mapping food access issues. A more comprehensive set of data would enable municipalities to more easily identify groups most at risk, depending on exposures and the type of pathogen, and reduce the occurrence of foodborne disease.

Sports injuries and illnesses in the Sochi 2014 Olympic Winter Games.

Science.gov (United States)

Soligard, Torbjørn; Steffen, Kathrin; Palmer-Green, Debbie; Aubry, Mark; Grant, Marie-Elaine; Meeuwisse, Willem; Mountjoy, Margo; Budgett, Richard; Engebretsen, Lars

2015-04-01

Systematic surveillance of injuries and illnesses is the foundation for developing preventive measures in sport. To analyse the injuries and illnesses that occurred during the XXII Olympic Winter Games, held in Sochi in 2014. We recorded the daily occurrence (or non-occurrence) of injuries and illnesses (1) through the reporting of all National Olympic Committee (NOC) medical teams and (2) in the polyclinic and medical venues by the Sochi 2014 medical staff. NOC and Sochi 2014 medical staff reported 391 injuries and 249 illnesses among 2780 athletes from 88 NOCs, equalling incidences of 14 injuries and 8.9 illnesses per 100 athletes over an 18-day period of time. Altogether, 12% and 8% of the athletes incurred at least one injury or illness, respectively. The percentage of athletes injured was highest in aerial skiing, snowboard slopestyle, snowboard cross, slopestyle skiing, halfpipe skiing, moguls skiing, alpine skiing, and snowboard halfpipe. Thirty-nine per cent of the injuries were expected to prevent the athlete from participating in competition or training. Women suffered 50% more illnesses than men. The rate of illness was highest in skeleton, short track, curling, cross-country skiing, figure skating, bobsleigh and aerial skiing. A total of 159 illnesses (64%) affected the respiratory system, and the most common cause of illness was infection (n=145, 58%). Overall, 12% of the athletes incurred at least one injury during the games, and 8% an illness, which is similar to prior Olympic Games. The incidence of injuries and illnesses varied substantially between sports. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Access to dental care and dental ill-health of people with serious mental illness: views of nurses working in mental health settings in Australia.

Science.gov (United States)

Happell, Brenda; Platania-Phung, Chris; Scott, David; Hanley, Christine

2015-01-01

People with serious mental illness experience higher rates of oral and dental health problems than the wider population. Little is known about how dental health is viewed or addressed by nurses working with mental health consumers. This paper presents the views of nurses regarding the nature and severity of dental health problems of consumers with serious mental illness, and how often they provide advice on dental health. Mental health sector nurses (n=643) completed an online survey, including questions on dental and oral health issues of people with serious mental illness. The majority of nurses considered the oral and dental conditions of people with serious mental illness to be worse than the wider community. When compared with a range of significant physical health issues (e.g. cardiovascular disease), many nurses emphasised that dental and oral problems are one of the most salient health issues facing people with serious mental illness, their level of access to dental care services is severely inadequate and they suffer significantly worse dental health outcomes as a result. This study highlights the need for reforms to increase access to dental and oral health care for mental health consumers.

Advances in Biomarkers in Critical Ill Polytrauma Patients.

Science.gov (United States)

Papurica, Marius; Rogobete, Alexandru F; Sandesc, Dorel; Dumache, Raluca; Cradigati, Carmen A; Sarandan, Mirela; Nartita, Radu; Popovici, Sonia E; Bedreag, Ovidiu H

2016-01-01

The complexity of the cases of critically ill polytrauma patients is given by both the primary, as well as the secondary, post-traumatic injuries. The severe injuries of organ systems, the major biochemical and physiological disequilibrium, and the molecular chaos lead to a high rate of morbidity and mortality in this type of patient. The 'gold goal' in the intensive therapy of such patients resides in the continuous evaluation and monitoring of their clinical status. Moreover, optimizing the therapy based on the expression of certain biomarkers with high specificity and sensitivity is extremely important because of the clinical course of the critically ill polytrauma patient. In this paper we wish to summarize the recent studies of biomarkers useful for the intensive care unit (ICU) physician. For this study the available literature on specific databases such as PubMed and Scopus was thoroughly analyzed. Each article was carefully reviewed and useful information for this study extracted. The keywords used to select the relevant articles were "sepsis biomarker", "traumatic brain injury biomarker" "spinal cord injury biomarker", "inflammation biomarker", "microRNAs biomarker", "trauma biomarker", and "critically ill patients". For this study to be carried out 556 original type articles were analyzed, as well as case reports and reviews. For this review, 89 articles with relevant topics for the present paper were selected. The critically ill polytrauma patient, because of the clinical complexity the case presents with, needs a series of evaluations and specific monitoring. Recent studies show a series of either tissue-specific or circulating biomarkers that are useful in the clinical status evaluation of these patients. The biomarkers existing today, with regard to the critically ill polytrauma patient, can bring a significant contribution to increasing the survival rate, by adapting the therapy according to their expressions. Nevertheless, the necessity remains to

Complexity and demographic explanations of cumulative culture

NARCIS (Netherlands)

Querbes, A.; Vaesen, K.; Houkes, W.N.

2014-01-01

Formal models have linked prehistoric and historical instances of technological change (e.g., the Upper Paleolithic transition, cultural loss in Holocene Tasmania, scientific progress since the late nineteenth century) to demographic change. According to these models, cumulation of technological

Fragmentation of tensor polarized deuterons into cumulative pions

International Nuclear Information System (INIS)

Afanas'ev, S.; Arkhipov, V.; Bondarev, V.

1998-01-01

The tensor analyzing power T 20 of the reaction d polarized + A → π - (0 0 ) + X has been measured in the fragmentation of 9 GeV tensor polarized deuterons into pions with momenta from 3.5 to 5.3 GeV/c on hydrogen, beryllium and carbon targets. This kinematic range corresponds to the region of cumulative hadron production with the cumulative variable x c from 1.08 to 1.76. The values of T 20 have been found to be small and consistent with positive values. This contradicts the predictions based on a direct mechanism assuming NN collision between a high momentum nucleon in the deuteron and a target nucleon (NN → NNπ)

Cumulants of heat transfer across nonlinear quantum systems

Science.gov (United States)

Li, Huanan; Agarwalla, Bijay Kumar; Li, Baowen; Wang, Jian-Sheng

2013-12-01

We consider thermal conduction across a general nonlinear phononic junction. Based on two-time observation protocol and the nonequilibrium Green's function method, heat transfer in steady-state regimes is studied, and practical formulas for the calculation of the cumulant generating function are obtained. As an application, the general formalism is used to study anharmonic effects on fluctuation of steady-state heat transfer across a single-site junction with a quartic nonlinear on-site pinning potential. An explicit nonlinear modification to the cumulant generating function exact up to the first order is given, in which the Gallavotti-Cohen fluctuation symmetry is found still valid. Numerically a self-consistent procedure is introduced, which works well for strong nonlinearity.

Gender Differences in Anxiety Disorders: Prevalence, Course of Illness, Comorbidity and Burden of Illness

OpenAIRE

McLean, Carmen P.; Asnaani, Anu; Litz, Brett T.; Hofmann, Stefan G.

2011-01-01

Women have consistently higher prevalence rates of anxiety disorders, but less is known about how gender affects age of onset, chronicity, comorbidity, and burden of illness. Gender differences in DSM-IV anxiety disorders were examined in a large sample of adults (N = 20,013) in the United States using data from the Collaborative Psychiatric Epidemiology Studies (CPES). The lifetime and 12-month male:female prevalence ratios of any anxiety disorder were 1:1.7 and 1:1.79, respectively. Women h...

Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care

NARCIS (Netherlands)

De Hert, Marc; Correll, Christoph U.; Bobes, Julio; Cetkovich-Bakmas, Marcelo; Cohen, Dan; Asai, Itsuo; Detraux, Johan; Gautam, Shiv; Moeller, Hans-Jurgen; Ndetei, David M.; Newcomer, John W.; Uwakwe, Richard; Leucht, Stefan

The lifespan of people with severe mental illness (SMI) is shorter compared to the general population. This excess mortality is mainly due to physical illness. We report prevalence rates of different physical illnesses as well as important individual lifestyle choices, side effects of psychotropic

Sports injuries and illnesses during the London Summer Olympic Games 2012.

Science.gov (United States)

Engebretsen, Lars; Soligard, Torbjørn; Steffen, Kathrin; Alonso, Juan Manuel; Aubry, Mark; Budgett, Richard; Dvorak, Jiri; Jegathesan, Manikavasagam; Meeuwisse, Willem H; Mountjoy, Margo; Palmer-Green, Debbie; Vanhegan, Ivor; Renström, Per A

2013-05-01

The Olympic Movement Medical Code encourages all stakeholders to ensure that sport is practised without danger to the health of the athletes. Systematic surveillance of injuries and illnesses is the foundation for developing preventive measures in sport. To analyse the injuries and illnesses that occurred during the Games of the XXX Olympiad, held in London in 2012. We recorded the daily occurrence (or non-occurrence) of injuries and illnesses (1) through the reporting of all National Olympic Committee (NOC) medical teams and (2) in the polyclinic and medical venues by the London Organising Committee of the Olympic and Paralympic Games' (LOCOG) medical staff. In total, 10 568 athletes (4676 women and 5892 men) from 204 NOCs participated in the study. NOC and LOCOG medical staff reported 1361 injuries and 758 illnesses, equalling incidences of 128.8 injuries and 71.7 illnesses per 1000 athletes. Altogether, 11% and 7% of the athletes incurred at least one injury or illness, respectively. The risk of an athlete being injured was the highest in taekwondo, football, BMX, handball, mountain bike, athletics, weightlifting, hockey and badminton, and the lowest in archery, canoe slalom and sprint, track cycling, rowing, shooting and equestrian. 35% of the injuries were expected to prevent the athlete from participating during competition or training. Women suffered 60% more illnesses than men (86.0 vs 53.3 illnesses per 1000 athletes). The rate of illness was the highest in athletics, beach volleyball, football, sailing, synchronised swimming and taekwondo. A total of 310 illnesses (41%) affected the respiratory system and the most common cause of illness was infection (n=347, 46%). At least 11% of the athletes incurred an injury during the games and 7% of the athletes' an illness. The incidence of injuries and illnesses varied substantially among sports. Future initiatives should include the development of preventive measures tailored for each specific sport and the

How Mental Illness is Perceived by Iranian Medical Students: A Preliminary Study

Science.gov (United States)

Amini, Homayoun; Majdzadeh, Reza; Eftekhar-Ardebili, Hasan; Shabani, Amir; Davari-Ashtiani, Rozita

2013-01-01

The study aimed to assess medical students' attitudes toward mental illness following a 4-week psychiatry clerkship. All fifth-year medical students from three academic centers in Tehran were asked to participate in the study. They completed the questionnaire on the last day of their 4-week psychiatry clerkship. A self-administered questionnaire was used to examine participants' Attitudes Toward Mental Illness (ATMI). One hundred and sixty eight students completed the questionnaires (88.9% response rate). In general, the students had favorable attitudes toward mental illness at the end of their clerkship, with mean (± SD) ATMI total score of 78.6 (± 8.1) (neutral score, 66.0). The students showed the most favorable opinion (95.2%) about Category 5 (stereotypic attitude toward people with mental illness) whilst they revealed the least favorable opinion (64.3%) regarding Category 1 (social relations with people affected by mental illness). In addition, the students thought that movies were on the top of influential media on shaping the attitudes toward mental illness. Overall, most of Iranian medical students had generally favorable attitudes toward people with mental illness at the end of their clerkship. Therefore, it may be expected next generation of medical doctors show more favorable attitude toward mental illness. PMID:23878611

Ethnic differences in mental illness and mental health service use among Black fathers.

Science.gov (United States)

Doyle, Otima; Joe, Sean; Caldwell, Cleopatra H

2012-05-01

We have presented nationally representative data on the prevalence and correlates of mental illness and mental health service use among African American and Caribbean Black (US-born and foreign-born) fathers in the United States. We have reported national estimates of lifetime and 12-month prevalence rates of mental illness, correlates, and service use among African American (n = 1254) and Caribbean Black (n = 633) fathers using data from the National Survey of American Life, a national household survey of Black Americans. We used bivariate cross-tabulations and Cox proportional hazards regression approaches and adjusted for the National Survey of American Life's complex sample design. The prevalence of mental illness, sociodemographic correlates, and service use among Black fathers varied by ethnicity and nativity. US-born Caribbean Black fathers had alarmingly high rates of most disorders, including depression, anxiety, and substance disorders. Mental health service use was particularly low for African American and foreign-born Caribbean Black fathers. These results demonstrate the need for more research on the causes and consequences of mental illness and the help-seeking behavior of ethnically diverse Black fathers.

Cumulative watershed effects: a research perspective

Science.gov (United States)

Leslie M. Reid; Robert R. Ziemer

1989-01-01

A cumulative watershed effect (CWE) is any response to multiple land-use activities that is caused by, or results in, altered watershed function. The CWE issue is politically defined, as is the significance of particular impacts. But the processes generating CWEs are the traditional focus of geomorphology and ecology, and have thus been studied for decades. The CWE...

Long-term cumulative depressive symptom burden and risk of cognitive decline and dementia among very old women.

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Zeki Al Hazzouri, Adina; Vittinghoff, Eric; Byers, Amy; Covinsky, Ken; Blazer, Dan; Diem, Susan; Ensrud, Kristine E; Yaffe, Kristine

2014-05-01

Depressive symptoms and cognitive outcomes are strongly interrelated. Despite that rates of depressive symptoms fluctuate during late life, little is known about the impact of long-term cumulative depressive symptom burden on cognitive decline and dementia in older adults. This study examines the association of nearly 20 years of cumulative depressive symptoms with cognitive outcomes in a cohort of older women. We assessed depressive symptoms in 7,240 women using the Geriatric Depression scale (GDS) at serial visits. We used a Poisson model with random slopes to estimate GDS trajectories for each participant from baseline to death or end of follow-up, and then characterized depressive symptom burden by quartile of the area under the curve. We assessed cognitive outcomes using repeated measures of the Mini-Mental State Examination (MMSE) and Trails B score over 20 years, Year-20 neuropsychological test battery, and adjudicated dementia and mild cognitive impairment (MCI). Adjusting for potential confounders, compared with women in the lowest quartile of cumulative depressive symptoms burden, women in the highest quartile had 21% more MMSE errors over time (95% CI = 17%, 26%), 20% worse Trails B score over time (95% CI = 17%, 23%), worse scores on most of the Year-20 cognitive tests, and a twofold greater likelihood of developing dementia or MCI (95% CI = 1.48, 3.11). Long-term cumulative depressive symptom burden was associated with cognitive decline and risk of dementia or MCI. Older adults with a history of depression should be closely monitored for recurrent episodes or unresolved depressive symptoms as well as any cognitive deficits.

Do Holocaust survivors show increased vulnerability or resilience to post-Holocaust cumulative adversity?

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Shrira, Amit; Palgi, Yuval; Ben-Ezra, Menachem; Shmotkin, Dov

2010-06-01

Prior trauma can hinder coping with additional adversity or inoculate against the effect of recurrent adversity. The present study further addressed this issue by examining whether a subsample of Holocaust survivors and comparison groups, drawn from the Israeli component of the Survey of Health, Ageing, and Retirement in Europe, were differentially affected by post-Holocaust cumulative adversity. Post-Holocaust cumulative adversity had a stronger effect on the lifetime depression of Holocaust survivors than on that of comparisons. However, comparisons were more negatively affected by post-Holocaust cumulative adversity when examining markers of physical and cognitive functioning. Our findings suggest that previous trauma can both sensitize and immunize, as Holocaust survivors show general resilience intertwined with specific vulnerability when confronted with additional cumulative adversity.

Cumulative second-harmonic generation of Lamb waves propagating in a two-layered solid plate

International Nuclear Information System (INIS)

Xiang Yanxun; Deng Mingxi

2008-01-01

The physical process of cumulative second-harmonic generation of Lamb waves propagating in a two-layered solid plate is presented by using the second-order perturbation and the technique of nonlinear reflection of acoustic waves at an interface. In general, the cumulative second-harmonic generation of a dispersive guided wave propagation does not occur. However, the present paper shows that the second-harmonic of Lamb wave propagation arising from the nonlinear interaction of the partial bulk acoustic waves and the restriction of the three boundaries of the solid plates does have a cumulative growth effect if some conditions are satisfied. Through boundary condition and initial condition of excitation, the analytical expression of cumulative second-harmonic of Lamb waves propagation is determined. Numerical results show the cumulative effect of Lamb waves on second-harmonic field patterns. (classical areas of phenomenology)

Illness Insight and Recovery: How Important is Illness Insight in Peoples’ Recovery Process?

DEFF Research Database (Denmark)

Korsbek, Lisa

2013-01-01

. Sources Used:The writing is based on research literature related to illness insight and on personal recovery experiences.Conclusions and Implications for Practice: It is helpful to consider the integration of the issue of illness insight when addressing the questions and consequences of diagnosis......Topic: This account reflects on the topic of illness insight and recovery. Purpose: The purpose of the account is to clarify our understanding about the importance of illness insight in peoples’ recovery process, especially when relating the question of illness insight to the question of identity......, and to assist individuals to work through the false analogy between illness and identity while supporting the transformation from patient to person. It is also necessary for clinicians to develop a clear understanding of peoples’ actual needs and gain more knowledge about peoples’ own views and experiences...

Finding joy in poor health: The leisure-scapes of chronic illness.

Science.gov (United States)

McQuoid, Julia

2017-06-01

Globally, increasing numbers of people face the challenge of enjoying life while living with long-term illness. Little research addresses leisure participation for people with chronic illness despite its links with mental and physical health and self-rated quality of life. I use a space-time geographical approach to explore experiences with leisure in everyday life for 26 individuals with chronic kidney disease (CKD) in Australia. I examine ways in which the spatial and temporal characteristics of illness management and symptoms shape where, when, and how participants can enjoy leisure, focusing on: 1) logistical conflicts between illness and leisure; 2) rhythmic interferences with the force of habit in skilful leisure performance; and 3) absorbing experiences of encounter with self and place through leisure. Data were collected from 2013 to 2014. Participants kept diaries over two sample days and then participated in semi-structured interviews. Findings show that the voluntary nature of leisure offered participants important benefits in coping with and managing illness over the long-term, including opportunities to experience greater sense of control, an alternative experience of one's body to the 'sick body', and knowledge creation that supports adaptation to the uncertainties of illness trajectories. The ability to engage in meaningful leisure was constrained by the shaping forces of illness symptoms and management on participants' leisure-scapes. Illness treatment regimens should therefore be adapted to better accommodate leisure participation for chronically ill patients, and leisure should be explicitly incorporated into illness management plans negotiated between patients and health practitioners. Finally, greater understanding of the transformative capacity of habit in activities of experimentation and play may have wider-reaching implications for leisure's potential applications in public health. Leisure should be taken seriously as a vehicle for enhancing

Finding joy in poor health: The leisure-scapes of chronic illness

Science.gov (United States)

2017-01-01

Globally, increasing numbers of people face the challenge of enjoying life while living with long-term illness. Little research addresses leisure participation for people with chronic illness despite its links with mental and physical health and self-rated quality of life. I use a space-time geographical approach to explore experiences with leisure in everyday life for 26 individuals with chronic kidney disease (CKD) in Australia. I examine ways in which the spatial and temporal characteristics of illness management and symptoms shape where, when, and how participants can enjoy leisure, focusing on: 1) logistical conflicts between illness and leisure; 2) rhythmic interferences with the force of habit in skilful leisure performance; and 3) absorbing experiences of encounter with self and place through leisure. Data were collected from 2013 to 2014. Participants kept diaries over two sample days and then participated in semi-structured interviews. Findings show that the voluntary nature of leisure offered participants important benefits in coping with and managing illness over the long-term, including opportunities to experience greater sense of control, an alternative experience of one’s body to the ‘sick body’, and knowledge creation that supports adaptation to the uncertainties of illness trajectories. The ability to engage in meaningful leisure was constrained by the shaping forces of illness symptoms and management on participants’ leisure-scapes. Illness treatment regimens should therefore be adapted to better accommodate leisure participation for chronically ill patients, and leisure should be explicitly incorporated into illness management plans negotiated between patients and health practitioners. Finally, greater understanding of the transformative capacity of habit in activities of experimentation and play may have wider-reaching implications for leisure’s potential applications in public health. Leisure should be taken seriously as a vehicle for

Reexamining the Dissolution of Spent Fuel: A Comparison of Different Methods for Calculating Rates

International Nuclear Information System (INIS)

Hanson, Brady D.; Stout, Ray B.

2004-01-01

Dissolution rates for spent fuel have typically been reported in terms of a rate normalized to the surface area of the specimen. Recent evidence has shown that neither the geometric surface area nor that measured with BET accurately predicts the effective surface area of spent fuel. Dissolution rates calculated from results obtained by flowthrough tests were reexamined comparing the cumulative releases and surface area normalized rates. While initial surface area is important for comparison of different rates, it appears that normalizing to the surface area introduces unnecessary uncertainty compared to using cumulative or fractional release rates. Discrepancies in past data analyses are mitigated using this alternative method

Comorbidity between pain and mental illness - Evidence of a bidirectional relationship.

Science.gov (United States)

Bondesson, E; Larrosa Pardo, F; Stigmar, K; Ringqvist, Å; Petersson, I F; Jöud, A; Schelin, M E C

2018-03-25

Pain from various locations in the body and mental illness are common and the comorbidity between the two is well-known although the temporal relationship remains to be determined. Our aim was to follow patients over time to study if pain (here dorsalgia/abdominal pain) or fibromyalgia lead to an increased risk of developing mental illness (here depression/anxiety) and/or the reverse, that is whether patients with mental illness have an increased risk to develop pain or fibromyalgia, compared to the rest of the population. This prospective cohort study used the Skåne Healthcare Register, covering all care in the region of Skåne, southern Sweden (population ~1.3 million). The cohort included healthcare consultations in primary care, outpatient specialized care and inpatient care between 2007 and 2016 for all patients without prior registered diagnosis of mental illness or pain, aged 18 or older (n = 504,365). The incidence rate ratio (IRR) for developing mental illness after pain was 2.18 (95% CI = 2.14-2.22) compared to without pain. IRR for developing pain after mental illness was 2.02 (95% CI = 1.98-2.06) compared to without mental illness. Corresponding IRR for developing mental illness after fibromyalgia was 4.05 (95% CI = 3.58-4.59) and for developing fibromyalgia after mental illness 5.54 (95% CI = 4.99-6.16). This study shows a bidirectional influence of similar magnitude of pain and mental illness, respectively. In monitoring patients with pain or mental illness, a focus on both conditions is thus important to develop appropriate, targeted interventions and may increase the likelihood of improved outcomes. We followed a population-based cohort over a period of 10 years, including incident cases of both exposure and outcome and found a bidirectional relationship between pain and mental illness. Clinicians need to pay attention on both conditions, in patients seeking care due to mental illness or pain. © 2018 European Pain Federation - EFIC®.

Modification of the Clinical Global Impressions (CGI) Scale for use in bipolar illness (BP): the CGI-BP.

Science.gov (United States)

Spearing, M K; Post, R M; Leverich, G S; Brandt, D; Nolen, W

1997-12-05

The Clinical Global Impressions Scale (CGI) was modified specifically for use in assessing global illness severity and change in patients with bipolar disorder. Criticisms of the original CGI were addressed by correcting inconsistencies in scaling, identifying time frames for comparison, clarifying definitions of illness severity and change, and separating out assessment of treatment side effects from illness improvement during treatment. A Detailed User's Guide was developed to train clinicians in the use of the new CGI-Bipolar Version (CGI-BP) for rating severity of manic and depressive episodes and the degree of change from the immediately preceding phase and from the worst phase of illness. The revised scale and manual provide a focused set of instructions to facilitate the reliability of these ratings of mania, depression, and overall bipolar illness during treatment of an acute episode or in longer-term illness prophylaxis. Interrater reliability of the scale was demonstrated in preliminary analyses. Thus, the modified CGI-BP is anticipated to be more useful than the original CGI in studies of bipolar disorder.

Cumulative live birth rates after one or more complete cycles of IVF: a population-based study of linked cycle data from 178,898 women.

Science.gov (United States)

McLernon, David J; Maheshwari, Abha; Lee, Amanda J; Bhattacharya, Siladitya

2016-03-01

What is the chance of a live birth following one or more linked complete cycles of IVF (including ICSI)? The chance of a live birth after three complete cycles of IVF was 42.3% for treatment commencing from 1999 to 2007. IVF success has generally been reported on the basis of live birth rates after a single episode of treatment resulting in the transfer of a fresh embryo. This fails to capture the real chance of having a baby after a number of complete cycles-each involving the replacement of fresh as well as frozen-thawed embryos. Population-based observational cohort study of 178 898 women between 1992 and 2007. Participants included all women who commenced IVF treatment at a licenced clinic in the UK as recorded in the Human Fertilisation and Embryology Authority (HFEA) national database. Exclusion criteria included women whose treatment involved donor insemination, egg donation, surrogacy and the transfer of more than three embryos. Cumulative rates of live birth, term (>37 weeks) singleton live birth, and multiple pregnancy were estimated for two time-periods, 1992-1998 and 1999-2007. Conservative estimates assumed that women who did not return for IVF would not have the outcome of interest while optimal estimates assumed that these women would have similar outcome rates to those who continued IVF. A total of 71 551 women commenced IVF treatment during 1992-1998 and an additional 107 347 during 1999-2007. After the third complete IVF cycle (defined as three fresh IVF treatments-including replacement of any surplus frozen-thawed embryos), the conservative CLBR in women who commenced IVF during 1992-1998 was 30.8% increasing to 42.3% during 1999-2007. The optimal CLBRs were 44.6 and 57.1%, respectively. After eight complete cycles the optimal CLBR was 82.4% in the latter time period. The conservative rate for multiple pregnancy per pregnant woman fell from 31.9% during the earlier time period to 26.2% during the latter. Linkage of all IVF treatments to

An Integrated Cumulative Transformation and Feature Fusion Approach for Bearing Degradation Prognostics

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Lixiang Duan

2018-01-01

Full Text Available Aimed at degradation prognostics of a rolling bearing, this paper proposed a novel cumulative transformation algorithm for data processing and a feature fusion technique for bearing degradation assessment. First, a cumulative transformation is presented to map the original features extracted from a vibration signal to their respective cumulative forms. The technique not only makes the extracted features show a monotonic trend but also reduces the fluctuation; such properties are more propitious to reflect the bearing degradation trend. Then, a new degradation index system is constructed, which fuses multidimensional cumulative features by kernel principal component analysis (KPCA. Finally, an extreme learning machine model based on phase space reconstruction is proposed to predict the degradation trend. The model performance is experimentally validated with a whole-life experiment of a rolling bearing. The results prove that the proposed method reflects the bearing degradation process clearly and achieves a good balance between model accuracy and complexity.

Extending the relationship between global warming and cumulative carbon emissions to multi-millennial timescales

International Nuclear Information System (INIS)

Frölicher, Thomas L; Paynter, David J

2015-01-01

The transient climate response to cumulative carbon emissions (TCRE) is a highly policy-relevant quantity in climate science. The TCRE suggests that peak warming is linearly proportional to cumulative carbon emissions and nearly independent of the emissions scenario. Here, we use simulations of the Earth System Model (ESM) from the Geophysical Fluid Dynamics Laboratory (GFDL) to show that global mean surface temperature may increase by 0.5 °C after carbon emissions are stopped at 2 °C global warming, implying an increase in the coefficient relating global warming to cumulative carbon emissions on multi-centennial timescales. The simulations also suggest a 20% lower quota on cumulative carbon emissions allowed to achieve a policy-driven limit on global warming. ESM estimates from the Coupled Model Intercomparison Project Phase 5 (CMIP5–ESMs) qualitatively agree on this result, whereas Earth System Models of Intermediate Complexity (EMICs) simulations, used in the IPCC 5th assessment report to assess the robustness of TCRE on multi-centennial timescales, suggest a post-emissions decrease in temperature. The reason for this discrepancy lies in the smaller simulated realized warming fraction in CMIP5–ESMs, including GFDL ESM2M, than in EMICs when carbon emissions increase. The temperature response to cumulative carbon emissions can be characterized by three different phases and the linear TCRE framework is only valid during the first phase when carbon emissions increase. For longer timescales, when emissions tape off, two new metrics are introduced that better characterize the time-dependent temperature response to cumulative carbon emissions: the equilibrium climate response to cumulative carbon emissions and the multi-millennial climate response to cumulative carbon emissions. (letter)

The Scarring Effects of Bankruptcy: Cumulative Disadvantage across Credit and Labor Markets

Science.gov (United States)

Maroto, Michelle

2012-01-01

As the recent economic crisis has demonstrated, inequality often spans credit and labor markets, supporting a system of cumulative disadvantage. Using data from the National Longitudinal Survey of Youth, this research draws on stigma, cumulative disadvantage and status characteristics theories to examine whether credit and labor markets intersect…

Effect Evaluation of a Randomized Trial to Reduce Infectious Illness and Illness-Related Absenteeism Among Schoolchildren

DEFF Research Database (Denmark)

Denbæk, Anne Maj; Andersen, Anette; Bonnesen, Camilla Thørring

2018-01-01

-based multi-component intervention to improve hand washing among schoolchildren, the Hi Five study, succeeded in reducing infectious illness and illness-related absenteeism in schools. METHODS: The Hi Five study was a three-armed cluster-randomized controlled trial involving 43 randomly selected Danish...... schools; two intervention arms involving 14 schools each, and 15 control schools. Infectious illness days, infectious illness episodes and illness-related absenteeism were estimated in multilevel regressions, based on available cases of text messages answered by parents and based on questionnaire data.......84-1.16)) or in reporting illness-related absenteeism(OR I-arm I : 1.09 (0.83-1.43) & ORI-arm II: 1.06 (0.81-1.40)). CONCLUSIONS: The multi component Hi Five intervention achieved no difference in the number of illness days, illness episodes or illness-related absenteeism among children in intervention schools compared...

Perceived illness intrusions among continuous ambulatory peritoneal dialysis patients

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Usha Bapat

2012-01-01

Full Text Available To study the perceived illness intrusion of continuous ambulatory peritoneal dialysis (CAPD patients, to examine their demographics, and to find out the association among demographics, duration of illness as well as illness intrusion, 40 chronic kidney disease stage V patients on CAPD during 2006-2007 were studied. Inclusion criteria were patients′ above 18 years, willing, stable, and completed at least two months of dialysis. Those with psychiatric co-morbidity were excluded. Sociodemographics were collected using a semi-structured interview schedule. A 14-item illness intrusion checklist covering various aspects of life was administered. The subjects had to rate the illness intrusion in their daily life and the extent of intrusion. The data was analyzed using descriptive statistics and chi square test of association. The mean age of the subjects was 56.05 ± 10.05 years. There was near equal distribution of gender. 82.5% were married, 70.0% belonged to Hindu religion, 45.0% were pre-degree, 25.0% were employed, 37.5% were housewives and 30.0% had retired. 77.5% belonged to the upper socioeconomic strata, 95.0% were from an urban background and 65.0% were from nuclear families. The mean duration of dialysis was 19.0 ± 16.49 months. Fifty-eight percent of the respondents were performing the dialysis exchanges by themselves. More than 95.0%were on three or four exchanges per day. All the 40 subjects reported illness intrusion in their daily life. Intrusion was perceived to some extent in the following areas: health 47.5%, work 25.0%, finance 37.5%, diet 40.0%, and psychological 50.0%. Illness had not intruded in the areas of relationship with spouse 52.5%, sexual life 30.0%, with friends 92.5%, with family 85.5%, social functions 52.5%, and religious functions 75.0%. Statistically significant association was not noted between illness intrusion and other variables. CAPD patients perceived illness intrusion to some extent in their daily life

Problems of describing the cumulative effect in relativistic nuclear physics

International Nuclear Information System (INIS)

Baldin, A.M.

1979-01-01

The problem of describing the cumulative effect i.e., the particle production on nuclei in the range kinematically forbidden for one-nucleon collisions, is studied. Discrimination of events containing cumulative particles fixes configurations in the wave function of a nucleus, when several nucleons are closely spaced and their quark-parton components are collectivized. For the cumulative processes under consideration large distances between quarks are very important. The fundamental facts and theoretical interpretation of the quantum field theory and of the condensed media theory in the relativistic nuclear physics are presented in brief. The collisions of the relativistic nuclei with low momentum transfers is considered in a fast moving coordinate system. The basic parameter determining this type of collisions is the energy of nucleon binding in nuclei. It has been shown that the short-range correlation model provides a good presentation of many characteristics of the multiple particle production and it may be regarded as an approximate universal property of hadron interactions

A review of learning rates for electricity supply technologies

International Nuclear Information System (INIS)

Rubin, Edward S.; Azevedo, Inês M.L.; Jaramillo, Paulina; Yeh, Sonia

2015-01-01

A variety of mathematical models have been proposed to characterize and quantify the dependency of electricity supply technology costs on various drivers of technological change. The most prevalent model form, called a learning curve, or experience curve, is a log-linear equation relating the unit cost of a technology to its cumulative installed capacity or electricity generated. This one-factor model is also the most common method used to represent endogenous technical change in large-scale energy-economic models that inform energy planning and policy analysis. A characteristic parameter is the “learning rate,” defined as the fractional reduction in cost for each doubling of cumulative production or capacity. In this paper, a literature review of the learning rates reported for 11 power generation technologies employing an array of fossil fuels, nuclear, and renewable energy sources is presented. The review also includes multi-factor models proposed for some energy technologies, especially two-factor models relating cost to cumulative expenditures for research and development (R&D) as well as the cumulative installed capacity or electricity production of a technology. For all technologies studied, we found substantial variability (as much as an order of magnitude) in reported learning rates across different studies. Such variability is not readily explained by systematic differences in the time intervals, geographic regions, choice of independent variable, or other parameters of each study. This uncertainty in learning rates, together with other limitations of current learning curve formulations, suggests the need for much more careful and systematic examination of the influence of how different factors and assumptions affect policy-relevant outcomes related to the future choice and cost of electricity supply and other energy technologies. - Highlights: • We review models explaining the cost of 11 electricity supply technologies. • The most prevalent model

Heat-Related Illnesses

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Full Text Available ... Your Wishes Visiting The ER Who Takes Care Of You In An Emergency? Checking Into ... Illnesses Dr. Glenn Mitchell , Emergency physician at Mercy Health System in Chesterfield, Missouri Heat-related illness can be ...

Motor skills, cognition, and work performance of people with severe mental illness.

Science.gov (United States)

Lipskaya-Velikovsky, Lena; Elgerisi, Dikla; Easterbrook, Adam; Ratzon, Navah Z

2018-01-12

Employment offers many benefits to people with mental illness, yet their employment rate is much lower than that of the general population. We investigated the effect of work-related motor skills, neurocognition, and job attitudes on the work performance of people with mental illness, comparing those working in sheltered workshops, with controls working in similar jobs. Twenty-nine adults with severe mental illness and 27 controls matched by gender and age were enrolled into the study using convenience sampling. They were assessed for gross and fine motor hand functioning, job attitudes, work performance, and cognition. People with mental illness scored lower on work performance, cognitive functioning, and hand dexterity while sitting and working with tools. They were assigned lower job loads than were controls, and perceived the physical environment at work as more constraining than did controls. Assembling motor skills significantly explained the work performance of people with mental illness. The results expand our understanding of the complexities involved in the employment of people with severe mental illness, and point to new paths for improving vocational outcomes of people with severe mental illness, taking into account their motor skills and job attitudes. Implications for rehabilitation Therapists should be aware that employed people with severe mental illness may have various unmet needs, affecting their work performance and experience of stress. This study results demonstrate importance of motor skills and perception of the work environment for the promotion of vocational outcomes among individuals with severe mental illness. Employment of people with severe mental illness should be viewed from holistic perspective as with general population, rather than focused on traditionally illness-related factors.

Energy Current Cumulants in One-Dimensional Systems in Equilibrium

Science.gov (United States)

Dhar, Abhishek; Saito, Keiji; Roy, Anjan

2018-06-01

A recent theory based on fluctuating hydrodynamics predicts that one-dimensional interacting systems with particle, momentum, and energy conservation exhibit anomalous transport that falls into two main universality classes. The classification is based on behavior of equilibrium dynamical correlations of the conserved quantities. One class is characterized by sound modes with Kardar-Parisi-Zhang scaling, while the second class has diffusive sound modes. The heat mode follows Lévy statistics, with different exponents for the two classes. Here we consider heat current fluctuations in two specific systems, which are expected to be in the above two universality classes, namely, a hard particle gas with Hamiltonian dynamics and a harmonic chain with momentum conserving stochastic dynamics. Numerical simulations show completely different system-size dependence of current cumulants in these two systems. We explain this numerical observation using a phenomenological model of Lévy walkers with inputs from fluctuating hydrodynamics. This consistently explains the system-size dependence of heat current fluctuations. For the latter system, we derive the cumulant-generating function from a more microscopic theory, which also gives the same system-size dependence of cumulants.

Ecological correlates of multiple sexual partnerships among adolescents and young adults in urban Cape Town: a cumulative risk factor approach.

Science.gov (United States)

Muchiri, Evans; Odimegwu, Clifford; Banda, Pamela; Ntoimo, Lorreta; Adedini, Sunday

2017-07-01

Studies in South Africa have reported unsafe levels of risky sexual behvaiours among adolescents and young adults, with the country reporting the highest burden of HIV/AIDS globally, as well as a high rate of teenage pregnancy. While determinants of risky sexual behaviours have been investigated for factors occurring at the individual and household levels, not fully explored in the literature is the effect of community level factors. Furthermore, it is unclear whether risk factors occurring within the ecology of adolescents and young adults act cumulatively to influence their sexual practices. This article aims to address this knowledge gap using a case study of the Cape Area Panel Study of adolescents and young adults in urban Cape Town, South Africa. The ecological framework was adopted to guide the selection of risk factors at the individual, household, and community levels. Multivariate linear discriminant function analyses were used to select significant risk factors for multiple sexual partnerships and used to produce risk indices for the respondents. The cumulative risk approach was applied to test whether significant risk factors acted cumulatively. Findings point to the importance of ecological factors in influencing outcomes of multiple sexual partnerships among respondents and further demonstrate that ecological risk factors may act cumulatively. These findings are important for South Africa that is grappling with teenage pregnancy and disproportionate HIV epidemic among the youth.

Assessing environmental impacts on stream water quality: the use of cumulative flux and cumulative flux difference approaches to deforestation of the Hafren Forest, mid-Wales

Directory of Open Access Journals (Sweden)

C. Neal

2002-01-01

Full Text Available A method for examining the impacts of disturbance on stream water quality based on paired catchment “controlâ€? and “responseâ€? water quality time series is described in relation to diagrams of cumulative flux and cumulative flux difference. The paper describes the equations used and illustrates the patterns expected for idealised flux changes followed by an application to stream water quality data for a spruce forested catchment, the Hore, subjected to clear fell. The water quality determinands examined are sodium, chloride, nitrate, calcium and acid neutralisation capacity. The anticipated effects of felling are shown in relation to reduction in mist capture and nitrate release with felling as well as to the influence of weathering and cation exchange mechanisms, but in a much clearer way than observed previously using other approaches. Keywords: Plynlimon, stream, Hore, acid neutralisation capacity, calcium, chloride, nitrate, sodium, cumulative flux, flux

The role of factorial cumulants in reactor neutron noise theory

International Nuclear Information System (INIS)

Colombino, A.; Pacilio, N.; Sena, G.

1979-01-01

The physical meaning and the combinatorial implications of the factorial cumulant of a state variable such as the number of neutrons or the number of neutron counts are specified. Features of the presentation are: (1) the fission process is treated in its entirety without the customary binary emission restriction, (b) the introduction of the factorial cumulants helps in reducing the complexity of the mathematical problems, (c) all the solutions can be obtained analytically. Only the ergodic hypothesis for the neutron population evolution is dealt with. (author)

Acute and Cumulative Effects of Unmodified 50-nm Nano-ZnO on Mice.

Science.gov (United States)

Kong, Tao; Zhang, Shu-Hui; Zhang, Ji-Liang; Hao, Xue-Qin; Yang, Fan; Zhang, Cai; Yang, Zi-Jun; Zhang, Meng-Yu; Wang, Jie

2018-01-02

Nanometer zinc oxide (nano-ZnO) is widely used in diverse industrial and agricultural fields. Due to the extensive contact humans have with these particles, it is crucial to understand the potential effects that nano-ZnO have on human health. Currently, information related to the toxicity and mechanisms of nano-ZnO is limited. The aim of the present study was to investigate acute and cumulative toxic effects of 50-nm unmodified ZnO in mice. This investigation will seek to establish median lethal dose (LD50), a cumulative coefficient, and target organs. The acute and cumulative toxicity was investigated by Karber's method and via a dose-increasing method, respectively. During the experiment, clinical signs, mortality, body weights, hematology, serum biochemistry, gross pathology, organ weight, and histopathology were examined. The LD50 was 5177-mg/kg·bw; the 95% confidence limits for the LD50 were 5116-5238-mg/kg·bw. It could be concluded that the liver, kidney, lung, and gastrointestinal tract were target organs for the 50-nm nano-ZnO acute oral treatment. The cumulative coefficient (K) was 1.9 which indicated that the cumulative toxicity was apparent. The results also indicated that the liver, kidney, lung, and pancrea were target organs for 50-nm nano-ZnO cumulative oral exposure and might be target organs for subchronic and chronic toxicity of oral administered 50-nm ZnO.

Increasing illness severity in very low birth weight infants over a 9-year period

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Locke Robert G

2006-02-01

Full Text Available Abstract Background Recent reports have documented a leveling-off of survival rates in preterm infants through the 1990's. The objective of this study was to determine temporal changes in illness severity in very low birth weight (VLBW infants in relationship to the outcomes of death and/or severe IVH. Methods Cohort study of 1414 VLBW infants cared for in a single level III neonatal intensive care unit in Delaware from 1993–2002. Infants were divided into consecutive 3-year cohorts. Illness severity was measured by two objective methods: the Score for Neonatal Acute Physiology (SNAP, based on data from the 1st day of life, and total thyroxine (T4, measured on the 5th day of life. Death before hospital discharge and severe intraventricular hemorrhage (IVH were investigated in the study sample in relation to illness severity. The fetal death rate was also investigated. Statistical analyses included both univariate and multivariate analysis. Results Illness severity, as measured by SNAP and T4, increased steadily over the 9-year study period with an associated increase in severe IVH and the combined outcome of death and/or severe IVH. During the final 3 years of the study, the observed increase in illness severity accounted for 86% (95% CI 57–116% of the variability in the increase in death and/or severe IVH. The fetal death rate dropped from 7.8/1000 (1993–1996 to 5.3/1000 (1999–2002, p = .01 over the course of the study. Conclusion These data demonstrate a progressive increase in illness in VLBW infants over time, associated with an increase in death and/or severe IVH. We speculate that the observed decrease in fetal death, and the increase in neonatal illness, mortality and/or severe IVH over time represent a shift of severely compromised patients that now survive the fetal time period and are presented for care in the neonatal unit.

Cost-of-Illness Trends Associated with Thyroid Disease in Korea

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Kyung-Rae Hyun

2014-09-01

Full Text Available BackgroundThe purpose of this study is to analyze the scale of and trends associated with the cost-of-illness of thyroid disease in Korea at 2-year intervals during the last 10 years for which data are available.MethodsCost-of-illness was estimated in terms of direct and indirect costs. Direct costs include direct medical costs due to hospitalization, outpatient and pharmacy sectors, transportation, and care-giver costs. Indirect costs include future income loss due to premature death and loss of productivity as a result of absence from work.ResultsThe cost-of-illness of thyroid disease in Korea was estimated at 224.2 billion won in 2002, 303.4 billion won in 2004, 400.3 billion won in 2006, 570.4 billion won in 2008, and 762.2 billion won in 2010. For example, the cost-of-illness of thyroid disease in 2010 was 3.4 times greater compared to 2002. The direct cost of the total cost-of-illness was 69.7%, which accounted for the highest proportion of costs. Cost-of-illness for individuals between the ages of 30 and 50 accounted for the greatest share of costs.ConclusionThe cost-of-illness of thyroid disease was relatively large in economically active age groups, and demonstrated a very rapid growth rate compared to other major diseases in Korea. Therefore, we suggest nationwide recognition of the importance of prevention and management of thyroid disease and prioritization of the management of thyroid disease among current and future health promotion policies in Korea.

Retooling CalEnviroScreen: Cumulative Pollution Burden and Race-Based Environmental Health Vulnerabilities in California

Science.gov (United States)

2018-01-01

The California Community Environmental Health Screening Tool (CalEnviroScreen) advances research and policy pertaining to environmental health vulnerability. However, CalEnviroScreen departs from its historical foundations and comparable screening tools by no longer considering racial status as an indicator of environmental health vulnerability and predictor of cumulative pollution burden. This study used conceptual frameworks and analytical techniques from environmental health and inequality literature to address the limitations of CalEnviroScreen, especially its inattention to race-based environmental health vulnerabilities. It developed an adjusted measure of cumulative pollution burden from the CalEnviroScreen 2.0 data that facilitates multivariate analyses of the effect of neighborhood racial composition on cumulative pollution burden, net of other indicators of population vulnerability, traffic density, industrial zoning, and local and regional clustering of pollution burden. Principal component analyses produced three new measures of population vulnerability, including Latina/o cumulative disadvantage that represents the spatial concentration of Latinas/os, economic disadvantage, limited English-speaking ability, and health vulnerability. Spatial error regression analyses demonstrated that concentrations of Latinas/os, followed by Latina/o cumulative disadvantage, are the strongest demographic determinants of adjusted cumulative pollution burden. Findings have implications for research and policy pertaining to cumulative impacts and race-based environmental health vulnerabilities within and beyond California. PMID:29659481

Retooling CalEnviroScreen: Cumulative Pollution Burden and Race-Based Environmental Health Vulnerabilities in California

Directory of Open Access Journals (Sweden)

Raoul S. Liévanos

2018-04-01

Full Text Available The California Community Environmental Health Screening Tool (CalEnviroScreen advances research and policy pertaining to environmental health vulnerability. However, CalEnviroScreen departs from its historical foundations and comparable screening tools by no longer considering racial status as an indicator of environmental health vulnerability and predictor of cumulative pollution burden. This study used conceptual frameworks and analytical techniques from environmental health and inequality literature to address the limitations of CalEnviroScreen, especially its inattention to race-based environmental health vulnerabilities. It developed an adjusted measure of cumulative pollution burden from the CalEnviroScreen 2.0 data that facilitates multivariate analyses of the effect of neighborhood racial composition on cumulative pollution burden, net of other indicators of population vulnerability, traffic density, industrial zoning, and local and regional clustering of pollution burden. Principal component analyses produced three new measures of population vulnerability, including Latina/o cumulative disadvantage that represents the spatial concentration of Latinas/os, economic disadvantage, limited English-speaking ability, and health vulnerability. Spatial error regression analyses demonstrated that concentrations of Latinas/os, followed by Latina/o cumulative disadvantage, are the strongest demographic determinants of adjusted cumulative pollution burden. Findings have implications for research and policy pertaining to cumulative impacts and race-based environmental health vulnerabilities within and beyond California.

Retooling CalEnviroScreen: Cumulative Pollution Burden and Race-Based Environmental Health Vulnerabilities in California.

Science.gov (United States)

Liévanos, Raoul S

2018-04-16

The California Community Environmental Health Screening Tool (CalEnviroScreen) advances research and policy pertaining to environmental health vulnerability. However, CalEnviroScreen departs from its historical foundations and comparable screening tools by no longer considering racial status as an indicator of environmental health vulnerability and predictor of cumulative pollution burden. This study used conceptual frameworks and analytical techniques from environmental health and inequality literature to address the limitations of CalEnviroScreen, especially its inattention to race-based environmental health vulnerabilities. It developed an adjusted measure of cumulative pollution burden from the CalEnviroScreen 2.0 data that facilitates multivariate analyses of the effect of neighborhood racial composition on cumulative pollution burden, net of other indicators of population vulnerability, traffic density, industrial zoning, and local and regional clustering of pollution burden. Principal component analyses produced three new measures of population vulnerability, including Latina/o cumulative disadvantage that represents the spatial concentration of Latinas/os, economic disadvantage, limited English-speaking ability, and health vulnerability. Spatial error regression analyses demonstrated that concentrations of Latinas/os, followed by Latina/o cumulative disadvantage, are the strongest demographic determinants of adjusted cumulative pollution burden. Findings have implications for research and policy pertaining to cumulative impacts and race-based environmental health vulnerabilities within and beyond California.

Turning stumbling blocks into stepping stones in the analysis of cumulative impacts

Science.gov (United States)

Leslie M. Reid

2004-01-01

Federal and state legislation, such as the National Environmental Policy Act and the California Environmental Quality Act, require that responsible agency staff consider the cumulative impacts of proposed activities before permits are issued for certain kinds of public or private projects. The Council on Environmental Quality (CEQ 1997) defined a cumulative impact as...

Experience of cumulative effects assessment in the UK

Directory of Open Access Journals (Sweden)

Piper Jake

2004-01-01

Full Text Available Cumulative effects assessment (CEA is a development of environmental impact assessment which attempts to take into account the wider picture of what impacts may affect the environment as a result of either multiple or linear projects, or development plans. CEA is seen as a further valuable tool in promoting sustainable development. The broader canvas upon which the assessment is made leads to a suite of issues such as complexity in methods and assessment of significance, the desirability of co-operation between developers and other parties, new ways of addressing mitigation and monitoring. After outlining the legislative position and the process of CEA, this paper looks at three cases studies in the UK where cumulative assessment has been carried out - the cases concern wind farms, major infrastructure and off-shore developments.

Heat-Related Illnesses

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... Share this! EmergencyCareForYou » Emergency 101 » Heat-Related Illnesses Heat-Related Illnesses Dr. Glenn Mitchell , Emergency physician at ... about heat cramps and heat stroke and exhaustion. Heat Cramps Symptoms include muscle spasms, usually in the ...

A Review of Non-Chemical Stressors and Their Importance in Cumulative Risk Assessment

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Cumulative exposure/risk assessments need to include non-chemical stressors as well as human activities and chemical data. Multiple stressor research can offer information on the interactions between chemical and non-chemical stressors needed for cumulative risk assessment resea...

Geneflow and Cumulative discounted Revenues of Dairy Cattle Cross-Breeding Schemes

International Nuclear Information System (INIS)

Kosgey, I.S.; Bebe, B.O.; Kahi, A.K.; Arendonk, J.A.M.V.

1999-01-01

A simulation study Using Matrix formulation was used to asses the flow of genes from the nucleus to the commercial population for three nucleus dairy cattle crossbreeding schemes involving indigenous (Zebu or native ) and exotic (European) animals under Kenyan conditions: Artificial insemination (A.I.) or natural mating F 1 production, continuous crossbred (F 2 inter se) production and multiple ovulation and embryo transfer (MOET) F 1 production. The latter two schemes used MOET in the nucleus. cumulative discounted expressions (CDES) and cumulative discounted Revenues (CDR) were calculated to rank these schemes. The Pathways considered were sires and dams to produce sires and dams. The evaluation Criterion was milk production measured in age class 3 through 10 in F 1 and F 2 cow populations. the schemes were evaluated over a 30-year projected period with assumed interest rates of 0% and 10%. Further, the genetic level between the indigenous nucleus animals, the F 1 males and commercial female population was calculated by defining the incidence vector h as the difference between the three groups. The F 1 A.I. or natural scheme had higher CDES of 0.978 and 0.161 at 0% and 10% interest rates respectively. The corresponding values for F 1 MOET scheme were 0.735 and 0.070 and those of F 2 inter se were 0.676 and 0.079 at 0% and 10% interest rates, respectively. For a nucleus with 64 dams, CDR (US$) were 95.50 and 15.80 at 0% and 10% interest rates, respectively for F 1 A.I. or natural scheme. The F 1 MOET scheme had corresponding values of 62.05 and 6.90 while F 2 inter se had 66.10 and 7.75. Under both interest rates, the F 1 A.I. or natural mating schemes had higher CDES and CDR than the other two schemes and is faster in dissemination of genes to the commercial population. F 2 inter se was intermediate. The genetic level of nucleus animal is higher than of F 1 male and females because indigenous nucleus females contribute 50% of the genes. F 2 cows are expected to

Psychiatric aspec ts of chronic physical illness in adolescence

African Journals Online (AJOL)

2008-05-18

May 18, 2008 ... Survival rates for children who suffer chronic physical illnesses have increased dramatically in ... may have a profound impact on development, quality of life, treatment .... emotional, cognitive and social elements. ... trigger psychiatric disorder in a parent, which in .... attainment and employment suggest mild.

The EPA's human exposure research program for assessing cumulative risk in communities.

Science.gov (United States)

Zartarian, Valerie G; Schultz, Bradley D

2010-06-01

Communities are faced with challenges in identifying and prioritizing environmental issues, taking actions to reduce their exposures, and determining their effectiveness for reducing human health risks. Additional challenges include determining what scientific tools are available and most relevant, and understanding how to use those tools; given these barriers, community groups tend to rely more on risk perception than science. The U.S. Environmental Protection Agency's Office of Research and Development, National Exposure Research Laboratory (NERL) and collaborators are developing and applying tools (models, data, methods) for enhancing cumulative risk assessments. The NERL's "Cumulative Communities Research Program" focuses on key science questions: (1) How to systematically identify and prioritize key chemical stressors within a given community?; (2) How to develop estimates of exposure to multiple stressors for individuals in epidemiologic studies?; and (3) What tools can be used to assess community-level distributions of exposures for the development and evaluation of the effectiveness of risk reduction strategies? This paper provides community partners and scientific researchers with an understanding of the NERL research program and other efforts to address cumulative community risks; and key research needs and opportunities. Some initial findings include the following: (1) Many useful tools exist for components of risk assessment, but need to be developed collaboratively with end users and made more comprehensive and user-friendly for practical application; (2) Tools for quantifying cumulative risks and impact of community risk reduction activities are also needed; (3) More data are needed to assess community- and individual-level exposures, and to link exposure-related information with health effects; and (4) Additional research is needed to incorporate risk-modifying factors ("non-chemical stressors") into cumulative risk assessments. The products of this

Procalcitonin-guided antibiotic treatment in critically ill patients.

Science.gov (United States)

Hohn, Andreas; Heising, Bernhard; Schütte, Jan-Karl; Schroeder, Olaf; Schröder, Stefan

2017-02-01

In critically ill patients, length of antibiotic treatment can be effectively guided by procalcitonin (PCT) protocols. International sepsis guidelines and guidelines on antibiotic stewardship strategies recommend PCT as helpful laboratory marker for a rational use of antibiotics. A number of studies and meta-analyses have confirmed the effectiveness of PCT-protocols for shortening antibiotic treatment without compromising clinical outcome in critically ill patients. But in clinical practice, there is still uncertainty how to interpret PCT levels and how to adjust antibiotic treatment in various infectious situations, especially in the perioperative period. This narrative review gives an overview on the application of PCT-protocols in critically ill patients with severe bacterial infections on the basis of 5 case reports and the available literature. Beside strengths and limitations of this biomarker, also varying kinetics and different maximum values with regard to the infectious focus and pathogens are discussed. PCT-guided antibiotic treatment appears to be safe and effective. Most of the studies revealed a shorter antibiotic treatment without negative clinical outcomes. Cost effectiveness is still a matter of debate and effects on bacterial resistance due to shorter treatments, possible lower rates of drug-related adverse events, or decreased rates of Clostridium difficile infections are not yet evaluated. Guidance of antibiotic treatment can effectively be supported by PCT-protocols. However, it is important to consider the limitations of this biomarker and to use PCT protocols along with antibiotic stewardship programmes and regular clinical rounds together with infectious diseases specialists.

Cumulative Author Index for Soviet Laser Bibliographies Nos. 67-93, September 1983-February 1989

Science.gov (United States)

1990-02-01

C) 0 00 I: Cumulative Author Index for Soviet Laser Bibliographies September 1983 - February 1989 A Defense S&T Intelligence Special Purpose Document...90 CUMULATIVE AUTHOR INDEX FOR SOVIET LASER BIBLIOGRAPHIES Nos. 67-93 SEPTEMBER 1983 - FEBRUARY 1989 Date of Report March 31, 19 Vice Director for...RECIPIENT’S CATALOG NUMBER DST-2700Z-001-90 4. TITLE (and Subtitle) S. TYPE OF REPORT & PERIOD COVERED CUMULATIVE AUTHOR INDEX FOR SOVIET LASER

Trends In News Media Coverage Of Mental Illness In The United States: 1995-2014.

Science.gov (United States)

McGinty, Emma E; Kennedy-Hendricks, Alene; Choksy, Seema; Barry, Colleen L

2016-06-01

The United States is engaged in ongoing dialogue around mental illness. To assess trends in this national discourse, we studied the volume and content of a random sample of 400 news stories about mental illness from the period 1995-2014. Compared to news stories in the first decade of the study period, those in the second decade were more likely to mention mass shootings by people with mental illnesses. The most frequently mentioned topic across the study period was violence (55 percent overall) divided into categories of interpersonal violence or self-directed (suicide) violence, followed by stories about any type of treatment for mental illness (47 percent). Fewer news stories, only 14 percent, described successful treatment for or recovery from mental illness. The news media's continued emphasis on interpersonal violence is highly disproportionate to actual rates of violence among those with mental illnesses. Research suggests that this focus may exacerbate social stigma and decrease support for public policies that benefit people with mental illnesses. Project HOPE—The People-to-People Health Foundation, Inc.

Cultural syndromes and age moderate the emotional impact of illness intrusiveness in rheumatoid arthritis.

Science.gov (United States)

Devins, Gerald M; Gupta, Anita; Cameron, Jill; Woodend, Kirsten; Mah, Kenneth; Gladman, Dafna

2009-02-01

The authors investigated cultural syndromes (multidimensional vectors comprising culturally based attitudes, values, and beliefs) and age as moderators of the emotional impact of illness intrusiveness--illness-induced lifestyle disruptions--in rheumatoid arthritis (RA) and examined illness intrusiveness effects in total and separately for three life domains (relationships and personal development, intimacy, and instrumental). People with RA (n = 105) completed the Illness Intrusiveness Ratings, Individualism-Collectivism, and Center for Epidemiologic Studies--Depression scales in a one-on-one interview. Controlling for disease and background characteristics, the association between illness intrusiveness (total score and the Relationships and Personal Development subscale) and distress was inverse when young adults with RA endorsed high horizontal individualism. Illness intrusiveness into intimacy was associated with increased distress, and this intensified when respondents endorsed high vertical individualism, horizontal collectivism, vertical collectivism, or low horizontal individualism. The negative emotional impact of illness intrusiveness into intimacy diminished with increasing age. Given an aging and increasingly pluralistic society, diversity can no longer be ignored in addressing the psychosocial impact of chronic, disabling disease.

The Role of Cumulative Trauma, Betrayal, and Appraisals in Understanding Trauma Symptomatology.

Science.gov (United States)

Martin, Christina Gamache; Cromer, Lisa Demarni; Deprince, Anne P; Freyd, Jennifer J

2013-03-01

Poor psychological outcomes are common among trauma survivors, yet not all survivors experience adverse sequelae. The current study examined links between cumulative trauma exposure as a function of the level of betrayal (measured by the relational closeness of the survivor and the perpetrator), trauma appraisals, gender, and trauma symptoms. Participants were 273 college students who reported experiencing at least one traumatic event on a trauma checklist. Three cumulative indices were constructed to assess the number of different types of traumas experienced that were low (LBTs), moderate (MBTs), or high in betrayal (HBTs). Greater trauma exposure was related to more symptoms of depression, dissociation, and PTSD, with exposure to HBTs contributing the most. Women were more likely to experience HBTs than men, but there were no gender differences in trauma-related symptoms. Appraisals of trauma were predictive of trauma-related symptoms over and above the effects explained by cumulative trauma at each level of betrayal. The survivor's relationship with the perpetrator, the effect of cumulative trauma, and their combined impact on trauma symptomatology are discussed.

Viruses associated with influenza-like-illnesses in Papua New Guinea, 2010.

Science.gov (United States)

Kono, Jacinta; Jonduo, Marinjho H; Omena, Matthew; Siba, Peter M; Horwood, Paul F

2014-05-01

Influenza-like-illness can be caused by a wide range of respiratory viruses. The etiology of influenza-like-illness in developing countries such as Papua New Guinea is poorly understood. The etiological agents associated with influenza-like-illness were investigated retrospectively for 300 nasopharyngeal swabs received by the Papua New Guinea National Influenza Centre in 2010. Real-time PCR/RT-PCR methods were used for the detection of 13 respiratory viruses. Patients with influenza-like-illness were identified according to the World Health Organization case definition: sudden onset of fever (>38°C), with cough and/or sore throat, in the absence of other diagnoses. At least one viral respiratory pathogen was detected in 66.3% of the samples tested. Rhinoviruses (17.0%), influenza A (16.7%), and influenza B (12.7%) were the pathogens detected most frequently. Children 5 years of age. Influenza B, adenovirus, and respiratory syncytial virus were all detected at significantly higher rates in children Papua New Guinea. © 2013 Wiley Periodicals, Inc.

Is quality of life related to illness and acceptance of illness?

Directory of Open Access Journals (Sweden)

Janusz Kocjan

2015-06-01

SUMMARY Introduction: Although, that the general well-being is extensively studied in wide range of contexts, still little place is devoting to relationship between acceptance of illness (AIS and quality of life (QoL, especially among cardiac patients. Aim: The aim of this study was to: (1 determine an association between these two variables; (2 examine relationship between selected variables (age, sex, education level, NYHA class, time since CVDs diagnosis, cardiosurgery intervention and presence of comorbid diseases and quality of life. Material and methods: The study included 172 patients with diagnose cardiac disease. All participants were examined used standardized questionnaires: Short Form of health survey (SF-36 questionnaire and Acceptance of Illness Scale (AIS. Results: The patients presented moderate level of illness acceptance and quality of life level. Over than half of participants did not accept their illness. Significant, positive relatioship between AIS and QoL were noted. NYHA class, number of cardiac hospitalization and time since cardiovascular disease diagnosis was negatively correlated with QoL. Conclusions: Findings presented in this study demonstrated, that AIS is strongly related with QoL.    Key words: illness acceptance, quality of life, AIS, QoL, cardiac diseases.

Illness Uncertainty and Illness Intrusiveness as Predictors of Depressive and Anxious Symptomology in College Students with Chronic Illnesses

Science.gov (United States)

Mullins, Alexandria J.; Gamwell, Kaitlyn L.; Sharkey, Christina M.; Bakula, Dana M.; Tackett, Alayna P.; Suorsa, Kristina I.; Chaney, John M.; Mullins, Larry L.

2017-01-01

Objective: To examine predictors of psychological functioning in college students with chronic illnesses. Participants: Participants (N = 1413) included 364 students with self-reported diagnoses of asthma or allergies, 148 students with other chronic illnesses (eg, epilepsy, type 1 diabetes), and 901 healthy students. Data were collected between…

Heat-Related Illnesses

Medline Plus

Full Text Available ... Share this! EmergencyCareForYou » Emergency 101 » Heat-Related Illnesses Heat-Related Illnesses Dr. Glenn Mitchell , Emergency physician at ... about heat cramps and heat stroke and exhaustion. Heat Cramps Symptoms include muscle spasms, usually in the ...

14 CFR Section 18 - Objective Classification-Cumulative Effect of Changes in Accounting Principles

Science.gov (United States)

2010-01-01

... of Changes in Accounting Principles Section 18 Section 18 Aeronautics and Space OFFICE OF THE... Objective Classification—Cumulative Effect of Changes in Accounting Principles 98Cumulative Effect of Changes in Accounting Principles. Record here the difference between the amount of retained earnings at...

Pesticide Cumulative Risk Assessment: Framework for Screening Analysis

Science.gov (United States)

This document provides guidance on how to screen groups of pesticides for cumulative evaluation using a two-step approach: begin with evaluation of available toxicological information and, if necessary, follow up with a risk-based screening approach.

Drinking-water treatment, climate change, and childhood gastrointestinal illness projections for northern Wisconsin (USA) communities drinking untreated groundwater

Science.gov (United States)

Uejio, Christopher K.; Christenson, Megan; Moran, Colleen; Gorelick, Mark

2017-06-01

This study examined the relative importance of climate change and drinking-water treatment for gastrointestinal illness incidence in children (age first quantified the observed (1991-2010) precipitation and gastrointestinal illness associations after controlling for seasonality and temporal trends. Precipitation likely transported pathogens into drinking-water sources or into leaking water-distribution networks. Building on observed relationships, the second analysis projected how climate change and drinking-water treatment installation may alter gastrointestinal illness incidence. Future precipitation values were modeled by 13 global climate models and three greenhouse-gas emissions levels. The second analysis was rerun using three pathways: (1) only climate change, (2) climate change and the same slow pace of treatment installation observed over 1991-2010, and (3) climate change and the rapid rate of installation observed over 2011-2016. The results illustrate the risks that climate change presents to small rural groundwater municipalities without drinking water treatment. Climate-change-related seasonal precipitation changes will marginally increase the gastrointestinal illness incidence rate (mean: ˜1.5%, range: -3.6-4.3%). A slow pace of treatment installation somewhat decreased precipitation-associated gastrointestinal illness incidence (mean: ˜3.0%, range: 0.2-7.8%) in spite of climate change. The rapid treatment installation rate largely decreases the gastrointestinal illness incidence (mean: ˜82.0%, range: 82.0-83.0%).

Pharmacoeconomics of parenteral nutrition in surgical and critically ill patients receiving structured triglycerides in China.

Science.gov (United States)

Wu, Guo Hao; Ehm, Alexandra; Bellone, Marco; Pradelli, Lorenzo

2017-01-01

A prior meta-analysis showed favorable metabolic effects of structured triglyceride (STG) lipid emulsions in surgical and critically ill patients compared with mixed medium-chain/long-chain triglycerides (MCT/LCT) emulsions. Limited data on clinical outcomes precluded pharmacoeconomic analysis. We performed an updated meta-analysis and developed a cost model to compare overall costs for STGs vs MCT/LCTs in Chinese hospitals. We searched Medline, Embase, Wanfang Data, the China Hospital Knowledge Database, and Google Scholar for clinical trials comparing STGs to mixed MCT/LCTs in surgical or critically ill adults published between October 10, 2013 and September 19, 2015. Newly identified studies were pooled with the prior studies and an updated meta-analysis was performed. A deterministic simulation model was used to compare the effects of STGs and mixed MCT/LCT's on Chinese hospital costs. The literature search identified six new trials, resulting in a total of 27 studies in the updated meta-analysis. Statistically significant differences favoring STGs were observed for cumulative nitrogen balance, pre- albumin and albumin concentrations, plasma triglycerides, and liver enzymes. STGs were also associated with a significant reduction in the length of hospital stay (mean difference, -1.45 days; 95% confidence interval, -2.48 to -0.43; p=0.005) versus mixed MCT/LCTs. Cost analysis demonstrated a net cost benefit of ¥675 compared with mixed MCT/LCTs. STGs are associated with improvements in metabolic function and reduced length of hospitalization in surgical and critically ill patients compared with mixed MCT/LCT emulsions. Cost analysis using data from Chinese hospitals showed a corresponding cost benefit.

Association between psychosomatic health symptoms and common mental illness in Ghanaian adolescents: Age and gender as potential moderators.

Science.gov (United States)

Glozah, Franklin N; Pevalin, David J

2017-09-01

Little is known about the role of age and gender in the association between psychosomatic symptoms and common mental illness in Ghanaian adolescents. This cross-sectional study examined age and gender as moderators between psychosomatic symptoms and common mental illness using data from a school-based survey ( N = 770). Males reported higher psychosomatic symptoms and common mental illness, while younger adolescents reported higher common mental illness only. Psychosomatic symptoms were positively associated with common mental illness, but age and gender did not moderate this association. Interventions aimed at reducing the prevalence rate in psychosomatic symptoms are crucial in decreasing common mental illness in Ghanaian adolescents.

Economic and policy implications of the cumulative carbon budget

Science.gov (United States)

Allen, M. R.; Otto, F. E. L.; Otto, A.; Hepburn, C.

2014-12-01

The importance of cumulative carbon emissions in determining long-term risks of climate change presents considerable challenges to policy makers. The traditional notion of "total CO2-equivalent emissions", which forms the backbone of agreements such as the Kyoto Protocol and the European Emissions Trading System, is fundamentally flawed. Measures to reduce short-lived climate pollutants benefit the current generation, while measures to reduce long-lived climate pollutants benefit future generations, so there is no sense in which they can ever be considered equivalent. Debates over the correct metric used to compute CO2-equivalence are thus entirely moot: both long-lived and short-lived emissions will need to be addressed if all generations are to be protected from dangerous climate change. As far as long-lived climate pollutants are concerned, the latest IPCC report highlights the overwhelming importance of carbon capture and storage in determining the cost of meeting the goal of limiting anthropogenic warming to two degrees. We will show that this importance arises directly from the cumulative carbon budget and the role of CCS as the technology of last resort before economic activity needs to be restricted to meet ambitious climate targets. It highlights the need to increase the rate of CCS deployment by orders of magnitude if the option of avoiding two degrees is to be retained. The difficulty of achieving this speed of deployment through conventional incentives and carbon-pricing mechanisms suggests a need for a much more direct mandatory approach. Despite their theoretical economic inefficiency, the success of recent regulatory measures in achieving greenhouse gas emissions reductions in jurisdictions such as the United States suggests an extension of the regulatory approach could be a more effective and politically acceptable means of achieving adequately rapid CCS deployment than conventional carbon taxes or cap-and-trade systems.

Chimpanzees (Pan troglodytes) and the question of cumulative culture: an experimental approach.

Science.gov (United States)

Marshall-Pescini, Sarah; Whiten, Andrew

2008-07-01

There is increasing evidence for cultural variations in behaviour among non-human species, but human societies additionally display elaborate cumulative cultural evolution, with successive generations building on earlier achievements. Evidence for cumulative culture in non-human species remains minimal and controversial. Relevant experiments are also lacking. Here we present a first experiment designed to examine chimpanzees' capacity for cumulative social learning. Eleven young chimpanzees were presented with a foraging device, which afforded both a relatively simple and a more complex tool-use technique for extracting honey. The more complex 'probing' technique incorporated the core actions of the simpler 'dipping' one and was also much more productive. In a baseline, exploration condition only two subjects discovered the dipping technique and a solitary instance of probing occurred. Demonstrations of dipping by a familiar human were followed by acquisition of this technique by the five subjects aged three years or above, whilst younger subjects showed a significant increase only in the elements of the dipping technique. By contrast, subsequent demonstrations of the probing task were not followed by acquisition of this more productive technique. Subjects stuck to their habitual dipping method despite an escalating series of demonstrations eventually exceeding 200. Supplementary tests showed this technique is within the capability of chimpanzees of this age. We therefore tentatively conclude that young chimpanzees exhibit a tendency to become 'stuck' on a technique they initially learn, inhibiting cumulative social learning and possibly constraining the species' capacity for cumulative cultural evolution.

Cumulative release to the accessible environment

International Nuclear Information System (INIS)

Kanehiro, B.

1985-01-01

The Containment and Isolation Working Group considered issues related to the postclosure behavior of repositories in crystalline rock. This working group was further divided into subgroups to consider the progress since the 1978 GAIN Symposium and identify research needs in the individual areas of regional ground-water flow, ground-water travel time, fractional release, and cumulative release. The analysis and findings of the Fractional Release Subgroup are presented

Criminal victimisation in people with severe mental illness: a multi-site prevalence and incidence survey in the Netherlands.

Directory of Open Access Journals (Sweden)

Astrid M Kamperman

Full Text Available BACKGROUND: Although crime victimisation is as prevalent in psychiatric patients as crime perpetration (and possibly more so, few European figures for it are available. We therefore assessed its one-year prevalence and incident rates in Dutch severely mentally ill outpatients, and compared the results with victimisation rates in the general population. METHOD: This multisite epidemiological survey included a random sample of 956 adult severely mentally ill outpatients. Data on victimisation were obtained using the victimisation scale of the Dutch Crime and Victimisation Survey, which assesses crime victimisation over the preceding 12 months. Comparison data were derived from the nationwide survey on safety and victimisation in the Netherlands. Prevalence and incident rates were weighted for sex, age, ethnicity and socioeconomic status, and compared with a general population sample matched by region (N = 38,227. RESULTS: In the past year, almost half of the severely mentally ill outpatients (47% had been victim of a crime. After control for demographic differences, prevalence rates of overall and specific victimisation measures were significantly higher in severely mentally ill outpatients than in the general population. The relative rates were especially high for personal crimes such as violent threats (RR = 2.12, 95% CI: 1.72-2.61, physical assaults (RR = 4.85, 95% CI: 3.69-6.39 and sexual harassment and assaults (RR = 3.94, 95% CI: 3.05-5.09. In concordance, severely mentally ill outpatients reported almost 14 times more personal crime incidents than persons from the general population (IRR = 13.68, 95% CI: 12.85-14.56. CONCLUSION: Crime victimisation is a serious problem in Dutch severely mentally ill outpatients. Mental-healthcare institutions and clinicians should become aware of their patients' victimisation risk, and should implement structural measures to detect and prevent (re-victimisation.

Anti-irritants II: Efficacy against cumulative irritation

DEFF Research Database (Denmark)

Andersen, Flemming; Hedegaard, Kathryn; Petersen, Thomas Kongstad

2006-01-01

window of opportunity in which to demonstrate efficacy. Therefore, the effect of AI was studied in a cumulative irritation model by inducing irritant dermatitis with 10 min daily exposures for 5+4 days (no irritation on weekend) to 1% sodium lauryl sulfate on the right and 20% nonanoic acid on the left...

An investigation of models of illness in carers of schizophrenia patients using the Illness Perception Questionnaire.

Science.gov (United States)

Barrowclough, C; Lobban, F; Hatton, C; Quinn, J

2001-11-01

Although carers' reactions to schizophrenic illness in a close family member may have important implications for the patient and for themselves, little is known of factors that influence the way carers respond. In the area of physical health problems, people's models of their illness or illness representations have been found to be related to the ways they react and cope with their illness. This study examines the use of a modified form of the Illness Perception Questionnaire (IPQ) to investigate illness models in a sample of carers of schizophrenia patients. Forty-seven carers participated. The psychometric properties of the modified IPQ were examined, and a number of carer and patient outcomes were investigated in relation to carer scores on the illness identity, consequences, control-cure and timeline subscales of the modified IPQ. These outcomes included measures of carer distress and burden, expressed emotion dimensions, and patient functioning. The modified IPQ was found to be a reliable measure of carers' perceptions of schizophrenia. Carer functioning, the patient-carer relationship and patient illness characteristics were associated with different dimensions of illness perceptions. The findings support the proposal that carer cognitive representations of the illness may have important implications for both carer and patient outcomes in schizophrenia.

Genetic algorithm-based improved DOA estimation using fourth-order cumulants

Science.gov (United States)

Ahmed, Ammar; Tufail, Muhammad

2017-05-01

Genetic algorithm (GA)-based direction of arrival (DOA) estimation is proposed using fourth-order cumulants (FOC) and ESPRIT principle which results in Multiple Invariance Cumulant ESPRIT algorithm. In the existing FOC ESPRIT formulations, only one invariance is utilised to estimate DOAs. The unused multiple invariances (MIs) must be exploited simultaneously in order to improve the estimation accuracy. In this paper, a fitness function based on a carefully designed cumulant matrix is developed which incorporates MIs present in the sensor array. Better DOA estimation can be achieved by minimising this fitness function. Moreover, the effectiveness of Newton's method as well as GA for this optimisation problem has been illustrated. Simulation results show that the proposed algorithm provides improved estimation accuracy compared to existing algorithms, especially in the case of low SNR, less number of snapshots, closely spaced sources and high signal and noise correlation. Moreover, it is observed that the optimisation using Newton's method is more likely to converge to false local optima resulting in erroneous results. However, GA-based optimisation has been found attractive due to its global optimisation capability.

Intestinal crosstalk – a new paradigm for understanding the gut as the “motor” of critical illness

Science.gov (United States)

Clark, Jessica A; Coopersmith, Craig M

2007-01-01

For more than 20 years, the gut has been hypothesized to be the “motor” of multiple organ dysfunction syndrome (MODS). As critical care research has evolved, there have been multiple mechanisms by which the gastrointestinal tract has been proposed to drive systemic inflammation. Many of these disparate mechanisms have proved to be important in the origin and propagation of critical illness. However, this has led to an unusual situation where investigators describing the gut as a “motor” revving the systemic inflammatory response syndrome (SIRS) are frequently describing wholly different processes to support their claim (i.e. increased apoptosis, altered tight junctions, translocation, cytokine production, crosstalk with commensal bacteria, etc). The purpose of this review is to present a unifying theory as to how the gut drives critical illness. Although the gastrointestinal tract is frequently described simply as “the gut,” it is actually made up of a) an epithelium, b) a diverse and robust immune arm, which contains the majority of immune cells in the body, and c) the commensal bacteria, which contain more cells than are present in the entire host organism. We propose that the intestinal epithelium, the intestinal immune system and the intestine’s endogenous bacteria all play vital roles driving MODS, and the complex crosstalk between these three interrelated portions of the gastrointestinal tract are cumulatively what makes the gut a “motor” of critical illness. PMID:17577136

Viewing lava safely: an epidemiology of hiker injury and illness in Hawaii Volcanoes National Park.

Science.gov (United States)

Heggie, Travis W; Heggie, Tracey M

2004-01-01

To report the injuries and illnesses encountered by wilderness hikers in Hawaii Volcanoes National Park attempting to hike to active lava flows and to investigate the roles that demographics, prior hiking experience, hiking behavior, and preparedness play in hiker vulnerability to injury and illness. During an 8-week period, daily on-site exit interviews of lava hikers were conducted by a uniformed park ranger and park volunteer. Information about the hiker's home residence, wilderness hiking experience, preparedness, health status, and health problems encountered during the hike was collected from a total of 804 hikers. A high rate of injury and illness was found among the study population. Scrapes and abrasions (59%), blisters (51%), and muscle strains and sprains (47%) were the most common injuries. Dehydration (77%) and respiratory irritation (46%) were the most common illnesses. Lower extremities were the most common site of injuries, and beginning hikers were the most vulnerable to injury and illness. Many hikers were inexperienced tourists willing to disregard warning signs and enter high-risk areas. Hawaii Volcanoes National Park is one of 22 US national park units with volcanic resources. The injuries and illnesses reported by the study group identify the impact that this type of environment can have on the safety of wilderness users in areas with similar resources. Recreating in remote and severe areas has inherent risks, but the high rate of injuries and illnesses sustained by the hikers of this study can potentially be reduced through the development of more direct risk management methods.

What proportion of international travellers acquire a travel-related illness? A review of the literature.

Science.gov (United States)

Angelo, Kristina M; Kozarsky, Phyllis E; Ryan, Edward T; Chen, Lin H; Sotir, Mark J

2017-09-01

As international travel increases, travellers may be at increased risk of acquiring infectious diseases not endemic in their home countries. Many journal articles and reference books related to travel medicine cite that between 22-64% of international travellers become ill during or after travel; however, this information is minimal, outdated and limited by poor generalizability. We aim to provide a current and more accurate estimate of the proportion of international travellers who acquire a travel-related illness. We identified studies via PubMed or travel medicine experts, published between January 1, 1976-December 31, 2016 that included the number of international travellers acquiring a travel-related illness. We excluded studies that focused on a single disease or did not determine a rate based on the total number of travellers. We abstracted information on traveller demographics, trip specifics, study enrollment and follow-up and number of ill travellers and their illnesses. Of 743 studies, nine met the inclusion criteria. The data sources were from North America (four studies) and Europe (five studies). Most travellers were tourists, the most frequent destination regions were Asia and Africa, and the median trip duration ranged from 8-21 days. Six studies enrolled participants at the travellers' pre-travel consultation. All studies collected data through either extraction from the medical record, weekly diaries, or pre- and post-travel questionnaires. Data collection timeframes varied by study. Between 6-87% of travellers became ill across all studies. Four studies provided the best estimate: between 43-79% of travellers who frequently visited developing nations (e.g. India, Tanzania, and Kenya) became ill; travellers most frequently reported diarrhoea. This is the most comprehensive assessment available on the proportion of international travellers that develop a travel-related illness. Additional cohort studies would provide needed data to more precisely

Cumulative effect of multiple trauma on symptoms of posttraumatic stress disorder, anxiety, and depression in adolescents.

Science.gov (United States)

Suliman, Sharain; Mkabile, Siyabulela G; Fincham, Dylan S; Ahmed, Rashid; Stein, Dan J; Seedat, Soraya

2009-01-01

Recent literature has indicated that exposure to multiple traumatic events in adults is associated with high levels of posttraumatic stress disorder (PTSD), anxiety, and depression. Against the backdrop of stressful life events and childhood abuse and neglect, we investigated the cumulative effect of multiple trauma exposure on PTSD, anxiety, and depression in an adolescent sample. One thousand one hundred forty 10th-grade learners from 9 Cape Town (South Africa) schools completed questionnaires on stressful life experiences; trauma exposure; and symptoms of anxiety, depression, and PTSD. Our population of interest for this study was adolescents between the ages of 14 and 18 years who had been exposed to serious, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, qualifying traumatic events. The final sample size was thus 922. Rates of trauma exposure, PTSD, depression, and anxiety were high. Controlling for sex, stressful life experiences in the past year, and childhood adversity, we found an effect of cumulative trauma exposure effect on PTSD and depression, with an increase in the number of traumas linearly associated with an increase in symptoms of PTSD (F((4,912)) = 7.60, P cumulative effect on anxiety. Our findings indicate that adolescents exposed to multiple traumas are more likely to experience more severe symptoms of PTSD and depression than those who experience a single event, with this effect independent of childhood adversity and everyday stressful life experiences. Exposure to multiple trauma, however, does not seem to be associated with more severe anxiety symptoms.

The рopulation сomposition of lymphocyte and the rate of infection by by the herpes simplex virus in patients ill with autoimmune autoimmune thyroiditis

Directory of Open Access Journals (Sweden)

E B Kravez

2006-12-01

Full Text Available The objective of the research is the analysis of blood lymphocyte composition and the rate of infection by the herpes simplex virus (HSV, cytomegalovirus (CMV and Epstein-Barr virus (EBV in patients with AIT. Two men and twenty six women (with the average age 44.0 ± 2.3 years ill with the disease for 6.0 ± 2.7 years were examined. 85.7% of the ill were in the euthyroid state, 14.3% were in hypothyroidism. 25% ofthe patients were diagnosed with atrophic AIT, 60,7% got the diagnoses of fibroid and fibronodular AIT and 14.3% got hypertrophic AIT diagnoses. It was found that the course of AIT was accompanied with the increase of the rate of CD20 +-lymphocytes in blood at the normal number of CD3 +-, CD4 +-, CD8 +- и CD56 + cells. The IgG to the HSV was found in 92.9% patients with AIT, to the CMV - in 96.4% cases, to the pre-early antigen (ЕА of CMV (acute infection - in 39.3% patients and to the nuclear antigen of EBV (КА (late past-infection - in 67.6% cases. In two cases we found EBV-IgG to EA and КА simultaneously (late stage of primary EBV-infection or reactivation of its chronic form. It was proved that 39.3% of the patients with AIT associate this disease with acute cytomegalovirus infection.

Under-recording of work-related injuries and illnesses: An OSHA priority.

Science.gov (United States)

Fagan, Kathleen M; Hodgson, Michael J

2017-02-01

A 2009 Government Accounting Office (GAO) report, along with numerous published studies, documented that many workplace injuries are not recorded on employers' recordkeeping logs required by the Occupational Safety and Health Administration (OSHA) and consequently are under-reported to the Bureau of Labor Statistics (BLS), resulting in a substantial undercount of occupational injuries in the United States. OSHA conducted a Recordkeeping National Emphasis Program (NEP) from 2009 to 2012 to identify the extent and causes of unrecorded and incorrectly recorded occupational injuries and illnesses. OSHA found recordkeeping violations in close to half of all facilities inspected. Employee interviews identified workers' fear of reprisal and employer disciplinary programs as the most important causes of under-reporting. Subsequent inspections in the poultry industry identified employer medical management policies that fostered both under-reporting and under-recording of workplace injuries and illnesses. OSHA corroborated previous research findings and identified onsite medical units as a potential new cause of both under-reporting and under-recording. Research is needed to better characterize and eliminate obstacles to the compilation of accurate occupational injury and illness data. Occupational health professionals who work with high hazard industries where low injury rates are being recorded may wish to scrutinize recordkeeping practices carefully. This work suggests that, although many high-risk establishments manage recordkeeping with integrity, the lower the reported injury rate, the greater the likelihood of under-recording and under-reporting of work-related injuries and illnesses. Published by Elsevier Ltd.

Exertional Heat Illnesses and Environmental Conditions During High School Football Practices.

Science.gov (United States)

Tripp, Brady L; Eberman, Lindsey E; Smith, Michael Seth

2015-10-01

Guidelines for preventing exertional heat illnesses (EHIs) during extreme heat stress should be specific to regional environments, age, and sport and should be based on evidence of reducing the risk. Each year in the United States, over 1 million high school football players practice in the August heat; however, no published data describe the incidence of EHIs in these athletes. To describe the environmental conditions and incidence of EHIs during high school football practices over a 3-month period. Descriptive epidemiology study. For a 3-month period (August-October), athletic trainers at 12 high schools in North Central Florida recorded the practice time and length, environmental conditions (wet-bulb globe temperature), and incidences of EHIs in varsity football athletes. Athletes suffered 57 total EHIs during 29,759 athlete-exposures (AEs) for the 3-month data collection period (rate = 1.92/1000 AEs). August accounted for the majority of all EHIs, with 82.5% (47/57) and the highest rate (4.35/1000 AEs). Of total heat illnesses, heat cramps accounted for 70.2% (40/57), heat exhaustion 22.8% (13/57), and heat syncope 7.0% (4/57). The odds ratio indicated that athletes in August practices that lasted longer than the recommended 3 hours were 9.84 times more likely to suffer a heat illness than those in practices lasting ≤3 hours. The highest rate of EHIs was during August. Practices in August that exceeded the recommended 3 hours were associated with a greater risk of heat illnesses. The overall rate of EHIs was lower for the high school football athletes observed in the study compared with that reported for collegiate football athletes in the region. The low rates of EHIs recorded suggest that the prevention guidelines employed by sports medicine teams are appropriate for the region and population. Team physicians and athletic trainers should employ evidence-based, region- and population-specific EHI prevention guidelines. Sports medicine teams, coaches, and

Neutrophils in critical illness.

Science.gov (United States)

McDonald, Braedon

2018-03-01

During critical illness, dramatic alterations in neutrophil biology are observed including abnormalities of granulopoeisis and lifespan, cell trafficking and antimicrobial effector functions. As a result, neutrophils transition from powerful antimicrobial protectors into dangerous mediators of tissue injury and organ dysfunction. In this article, the role of neutrophils in the pathogenesis of critical illness (sepsis, trauma, burns and others) will be explored, including pathological changes to neutrophil function during critical illness and the utility of monitoring aspects of the neutrophil phenotype as biomarkers for diagnosis and prognostication. Lastly, we review findings from clinical trials of therapies that target the harmful effects of neutrophils, providing a bench-to-bedside perspective on neutrophils in critical illness.

A mixed methods exploration of family involvement in medical care for older adults with serious mental illness

NARCIS (Netherlands)

Aschbrenner, K.A.; Pepin, R.; Mueser, K.T.; Naslund, J.A.; Rolin, S.A.; Faber, M.J.; Bartels, S.J.

2014-01-01

OBJECTIVE: Many older persons with serious mental illness (SMI) suffer from high rates of comorbid medical conditions. Although families play a critical role in psychiatric illness management among adults with SMI, their contributions to improving health outcomes in this population has received

Schizophrenia illness severity is associated with reduced loss aversion.

Science.gov (United States)

Currie, James; Buruju, Dheeraj; Perrin, Jennifer S; Reid, Ian C; Steele, J Douglas; Feltovich, Nick

2017-06-01

Loss aversion, whereby losses weigh more heavily than equal-sized gains, has been demonstrated in many decision-making settings. Previous research has suggested reduced loss aversion in schizophrenia, but with little evidence of a link between loss aversion and schizophrenia illness severity. In this study, 20 individuals with schizophrenia and 16 control participants, matched by age and sex, played two versions of the Iterated Prisoners' Dilemma, one version with only positive payoffs and another version in which negative payoffs were possible, with the second version being derived from the first by subtracting a constant value from all payoffs. The control group demonstrated significantly lower cooperation rates under negative payoffs, compared with the version with only positive payoffs, indicative of loss aversion. The patient group on average showed no loss aversion response. Moreover, the extent of loss aversion in patients was found to be negatively correlated with schizophrenia illness severity, with less ill patients showing loss aversion more similar to controls. Results were found to be robust to the inclusion of potential confounding factors as covariates within rigorous probit regression analyses. Reduced loss aversion is a feature of schizophrenia and related to illness severity. Copyright © 2017. Published by Elsevier B.V.

Cumulative Beam Breakup with Time-Dependent Parameters

CERN Document Server

Delayen, J R

2004-01-01

A general analytical formalism developed recently for cumulative beam breakup (BBU) in linear accelerators with arbitrary beam current profile and misalignments [1] is extended to include time-dependent parameters such as energy chirp or rf focusing in order to reduce BBU-induced instabilities and emittance growth. Analytical results are presented and applied to practical accelerator configurations.

Error Analysis on the Estimation of Cumulative Infiltration in Soil Using Green and AMPT Model

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Muhamad Askari

2006-08-01

Full Text Available Green and Ampt infiltration model is still useful for the infiltration process because of a clear physical basis of the model and of the existence of the model parameter values for a wide range of soil. The objective of thise study was to analyze error on the esimation of cumulative infiltration in sooil using Green and Ampt model and to design laboratory experiment in measuring cumulative infiltration. Parameter of the model was determined based on soil physical properties from laboratory experiment. Newton –Raphson method was esed to estimate wetting front during calculation using visual Basic for Application (VBA in MS Word. The result showed that  contributed the highest error in estimation of cumulative infiltration and was followed by K, H0, H1, and t respectively. It also showed that the calculated cumulative infiltration is always lower than both measured cumulative infiltration and volumetric soil water content.

Incorporating cumulative effects into environmental assessments of mariculture: Limitations and failures of current siting methods

International Nuclear Information System (INIS)

King, Sarah C.; Pushchak, Ronald

2008-01-01

Assessing and evaluating the cumulative impacts of multiple marine aquaculture facilities has proved difficult in environmental assessment. A retrospective review of 23 existing mariculture farms in southwestern New Brunswick was conducted to determine whether cumulative interactions would have justified site approvals. Based on current scientific evidence of cumulative effects, six new criteria were added to a set of far-field impacts and other existing criteria were expanded to include regional and cumulative environmental impacts in Hargrave's [Hargrave BT. A traffic light decision system for marine finfish aquaculture siting. Ocean Coast Manag 2002; 45:215-35.] Traffic Light Decision Support System (DSS) presently used in Canadian aquaculture environmental assessments. Before mitigation, 19 of the 23 sites failed the amended set of criteria and after considering mitigation, 8 sites failed. Site and ecosystem indices yielded varying site acceptability scores; however, many sites would not have been approved if siting decisions had been made within a regional management framework and cumulative impact criteria were considered in the site evaluation process

The Implementation of Cumulative Learning Theory in Calculating Triangular Prism and Tube Volumes

Science.gov (United States)

Muklis, M.; Abidin, C.; Pamungkas, M. D.; Masriyah

2018-01-01

This study aims at describing the application of cumulative learning theory in calculating the volume of a triangular prism and a tube as well as revealing the students’ responses toward the learning. The research method used was descriptive qualitative with elementary school students as the subjects of the research. Data obtained through observation, field notes, questionnaire, tests, and interviews. The results from the application of cumulative learning theory obtained positive students’ responses in following the learning and students’ learning outcomes was dominantly above the average. This showed that cumulative learning could be used as a reference to be implemented in learning, so as to improve the students’ achievement.

ILL. Annual report 1979. Annex

International Nuclear Information System (INIS)

1980-01-01

This second volume, entitled 'Annex to the Annual Report' deals in more detail with the scientific work of the I.L.L. The scientific activity of theoreticians at the I.L.L. for 1979 is described. The experimental reports giving details on the experiments performed at the I.L.L. up to October 1, 1979 have been compiled. They are published here under their proposal number within the classification cheme in use at the I.L.L

A cumulant functional for static and dynamic correlation

International Nuclear Information System (INIS)

Hollett, Joshua W.; Hosseini, Hessam; Menzies, Cameron

2016-01-01

A functional for the cumulant energy is introduced. The functional is composed of a pair-correction and static and dynamic correlation energy components. The pair-correction and static correlation energies are functionals of the natural orbitals and the occupancy transferred between near-degenerate orbital pairs, rather than the orbital occupancies themselves. The dynamic correlation energy is a functional of the statically correlated on-top two-electron density. The on-top density functional used in this study is the well-known Colle-Salvetti functional. Using the cc-pVTZ basis set, the functional effectively models the bond dissociation of H 2 , LiH, and N 2 with equilibrium bond lengths and dissociation energies comparable to those provided by multireference second-order perturbation theory. The performance of the cumulant functional is less impressive for HF and F 2 , mainly due to an underestimation of the dynamic correlation energy by the Colle-Salvetti functional.

Trends In News Media Coverage Of Mental Illness In The United States: 1995–2014

Science.gov (United States)

McGinty, Emma E.; Kennedy-Hendricks, Alene; Choksy, Seema; Barry, Colleen L.

2016-01-01

The United States is engaged in ongoing dialogue around mental illness. To assess trends in this national discourse, we studied the volume and content of a random sample of 400 news stories about mental illness from the period 1995–2014. Compared to news stories in the first decade of the study period, those in the second decade were more likely to mention mass shootings by people with mental illnesses. The most frequently mentioned topic across the study period was violence (55 percent overall) divided into categories of interpersonal violence or self-directed (suicide) violence, followed by stories about any type of treatment for mental illness (47 percent). Fewer news stories, only 14 percent, described successful treatment for or recovery from mental illness. The news media’s continued emphasis on interpersonal violence is highly disproportionate to actual rates of violence among those with mental illnesses. Research suggests that this focus may exacerbate social stigma and decrease support for public policies that benefit people with mental illnesses. PMID:27269031

Cumulative environmental effects. Summary

International Nuclear Information System (INIS)

2012-01-01

This report presents a compilation of knowledge about the state of the environment and human activity in the Norwegian part of the North Sea and Skagerrak. The report gives an overview of pressures and impacts on the environment from normal activity and in the event of accidents. This is used to assess the cumulative environmental effects, which factors have most impact and where the impacts are greatest, and to indicate which problems are expected to be most serious in the future. The report is intended to provide relevant information that can be used in the management of the marine area in the future. It also provides input for the identification of environmental targets and management measures for the North Sea and Skagerrak.(Author)

Cumulative environmental effects. Summary

Energy Technology Data Exchange (ETDEWEB)

NONE

2012-07-01

This report presents a compilation of knowledge about the state of the environment and human activity in the Norwegian part of the North Sea and Skagerrak. The report gives an overview of pressures and impacts on the environment from normal activity and in the event of accidents. This is used to assess the cumulative environmental effects, which factors have most impact and where the impacts are greatest, and to indicate which problems are expected to be most serious in the future. The report is intended to provide relevant information that can be used in the management of the marine area in the future. It also provides input for the identification of environmental targets and management measures for the North Sea and Skagerrak.(Author)

Cumulative trauma, gender discrimination and mental health in women: mediating role of self-esteem.

Science.gov (United States)

Kucharska, Justyna

2017-12-20

Evidence suggests that women show symptoms of trauma-related symptoms more often than men. Gender discrimination is also associated with the severity of symptoms in women. This study explored the relations among cumulative trauma, gender discrimination and mental health in women with a mediating role of self-esteem and emotion regulation. Two types of gender discrimination were taken into account: discrimination by parents and in the social context. Cumulative trauma over the lifetime was assessed, as well as three types of symptoms: internalising, externalising, psychoticism. A total of 277 females from Poland participated in the study. It was hypothesised that gender discrimination and cumulative trauma would be positively related to symptoms and that lowered self-esteem mediates these relations. Hypotheses received partial confirmation, as both gender discrimination and cumulative trauma have been shown to be related to three types of symptoms. Self-esteem was a partial mediator between gender discrimination in the social context and symptoms. It was also demonstrated that emotion suppression is a partial mediator between cumulative trauma and symptoms. It has been demonstrated that socio-cultural factors, such as gender discrimination, play an important role in psychiatric symptoms development.

Cumulative (DisAdvantage and the Matthew Effect in Life-Course Analysis.

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Miia Bask

Full Text Available To foster a deeper understanding of the mechanisms behind inequality in society, it is crucial to work with well-defined concepts associated with such mechanisms. The aim of this paper is to define cumulative (disadvantage and the Matthew effect. We argue that cumulative (disadvantage is an intra-individual micro-level phenomenon, that the Matthew effect is an inter-individual macro-level phenomenon and that an appropriate measure of the Matthew effect focuses on the mechanism or dynamic process that generates inequality. The Matthew mechanism is, therefore, a better name for the phenomenon, where we provide a novel measure of the mechanism, including a proof-of-principle analysis using disposable personal income data. Finally, because socio-economic theory should be able to explain cumulative (disadvantage and the Matthew mechanism when they are detected in data, we discuss the types of models that may explain the phenomena. We argue that interactions-based models in the literature traditions of analytical sociology and statistical mechanics serve this purpose.

Cumulative or delayed nephrotoxicity after cisplatin (DDP) treatment.

Science.gov (United States)

Pinnarò, P; Ruggeri, E M; Carlini, P; Giovannelli, M; Cognetti, F

1986-04-30

The present retrospective study reports data regarding renal toxicity in 115 patients (63 males, 52 females; median age, 56 years) who received cumulative doses of cisplatin (DDP) greater than or equal to 200 mg/m2. DDP was administered alone or in combination at a dose of 50-70 mg/m2 in 91 patients, and at a dose of 100 mg/m2 in 22 patients. Two patients after progression of ovarian carcinoma treated with conventional doses of DDP received 4 and 2 courses, respectively, of high-dose DDP (40 mg/m2 for 5 days) in hypertonic saline. The median number of DDP courses was 6 (range 2-14), and the median cumulative dose was 350 mg/m2 (range, 200-1200). Serum creatinine and urea nitrogen were determined before initiating the treatment and again 13-16 days after each administration. The incidence of azotemia (creatinina levels that exceeded 1.5 mg/dl) was similar before (7.8%) and after (6.1%) DDP doses of 200 mg/m2. Azotemia appears to be related to the association of DDP with other potentially nephrotoxic antineoplastic drugs (methotrexate) more than to the dose per course of DDP. Of 59 patients followed for 2 months or more after discontinuing the DDP treatment, 3 (5.1%) presented creatinine values higher than 1.5 mg/dl. The data deny that the incidence of nephrotoxicity is higher in patients receiving higher cumulative doses of DDP and confirm that increases in serum creatinine levels may occur some time after discontinuation of the drug.

Hand sanitiser provision for reducing illness absences in primary school children: a cluster randomised trial.

Directory of Open Access Journals (Sweden)

Patricia Priest

2014-08-01

Full Text Available BACKGROUND: The potential for transmission of infectious diseases offered by the school environment are likely to be an important contributor to the rates of infectious disease experienced by children. This study aimed to test whether the addition of hand sanitiser in primary school classrooms compared with usual hand hygiene would reduce illness absences in primary school children in New Zealand. METHODS AND FINDINGS: This parallel-group cluster randomised trial took place in 68 primary schools, where schools were allocated using restricted randomisation (1:1 ratio to the intervention or control group. All children (aged 5 to 11 y in attendance at participating schools received an in-class hand hygiene education session. Schools in the intervention group were provided with alcohol-based hand sanitiser dispensers in classrooms for the winter school terms (27 April to 25 September 2009. Control schools received only the hand hygiene education session. The primary outcome was the number of absence episodes due to any illness among 2,443 follow-up children whose caregivers were telephoned after each absence from school. Secondary outcomes measured among follow-up children were the number of absence episodes due to specific illness (respiratory or gastrointestinal, length of illness and illness absence episodes, and number of episodes where at least one other member of the household became ill subsequently (child or adult. We also examined whether provision of sanitiser was associated with experience of a skin reaction. The number of absences for any reason and the length of the absence episode were measured in all primary school children enrolled at the schools. Children, school administrative staff, and the school liaison research assistants were not blind to group allocation. Outcome assessors of follow-up children were blind to group allocation. Of the 1,301 and 1,142 follow-up children in the hand sanitiser and control groups, respectively, the

Self-esteem of children and adolescents with chronic illness: a meta-analysis.

Science.gov (United States)

Pinquart, M

2013-03-01

Chronic illness may be a risk factor for low self-esteem; however, previous meta-analyses are inconclusive whether children with a chronic illness have lower self-esteem than their healthy peers. The goal of the present study was to summarize available research in order to compare the self-esteem of children and adolescents with a chronic illness with that of healthy children. Random-effects meta-analysis was used to integrate the results of 621 empirical studies that compare levels of self-esteem of children with a chronic physical illness with healthy peers or general test norms. Studies were identified via the electronic databases Adolesc, Embase, Google Scholar, MEDLINE, PSNYDEX, PSYCINFO, and cross-referencing. Children with chronic illnesses have lower self-esteem than healthy peers or test norms (g = -0.18 standard deviation units). The lowest levels of self-esteem were observed in children with chronic fatigue syndrome and chronic headaches. Lower levels of self-esteem in children with a chronic illness were found in girls than in boys, in adolescents than in children, in children from developing or threshold countries, when results were collected from observer ratings rather than child reports, in studies published in the 1990s, and when children with chronic illnesses were directly compared with healthy children instead of test norms. Paediatricians, parents, and teachers should promote experiences of success and positive peer-relations, which are important sources of self-esteem. In addition, psychosocial interventions for children with chronic illnesses should be offered for children with reduced self-esteem. © 2012 Blackwell Publishing Ltd.

30 CFR 250.921 - How do I analyze my platform for cumulative fatigue?

Science.gov (United States)

2010-07-01

... 30 Mineral Resources 2 2010-07-01 2010-07-01 false How do I analyze my platform for cumulative fatigue? 250.921 Section 250.921 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR... fatigue? (a) If you are required to analyze cumulative fatigue on your platform because of the results of...

Patterns of regional gray matter loss at different stages of schizophrenia: A multisite, cross-sectional VBM study in first-episode and chronic illness

Directory of Open Access Journals (Sweden)

Ulysses S. Torres

2016-01-01

Conclusion: The above data indicate that brain changes associated with the diagnosis of schizophrenia are more widespread in chronic schizophrenia compared to first-episode patients. Our findings also suggest that relative GM volume deficits may be greater in (presumably more severe cases with earlier age of onset, as well as varying as a function of illness duration in specific frontal brain regions. Finally, our results highlight the potentially complex effects of the continued use of antipsychotic drugs on structural brain abnormalities in schizophrenia, as we found that cumulative doses of antipsychotics affected brain volumes globally rather than selectively on frontal-temporal regions.

Hierarchical Bayesian parameter estimation for cumulative prospect theory

NARCIS (Netherlands)

Nilsson, H.; Rieskamp, J.; Wagenmakers, E.-J.

2011-01-01

Cumulative prospect theory (CPT Tversky & Kahneman, 1992) has provided one of the most influential accounts of how people make decisions under risk. CPT is a formal model with parameters that quantify psychological processes such as loss aversion, subjective values of gains and losses, and

Dependency in Critically Ill Patients

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Rumei Yang

2016-03-01

Full Text Available By necessity, critically ill patients admitted to intensive care units (ICUs have a high level of dependency, which is linked to a variety of negative feelings, such as powerlessness. However, the term dependency is not well defined in the critically ill patients. The concept of “dependency” in critically ill patients was analyzed using a meta-synthesis approach. An inductive process described by Deborah Finfgeld-Connett was used to analyze the data. Overarching themes emerged that reflected critically ill patients’ experience and meaning of being in dependency were (a antecedents: dependency in critically ill patients was a powerless and vulnerable state, triggered by a life-threatening crisis; (b attributes: the characteristic of losing “self” was featured by dehumanization and disembodiment, which can be alleviated by a “self”-restoring process; and (c outcomes: living with dependency and coping with dependency. The conceptual model explicated here may provide a framework for understanding dependency in critically ill patients.

The effect of statins on influenza-like illness morbidity and mortality.

Science.gov (United States)

Brassard, Paul; Wu, Jennifer W; Ernst, Pierre; Dell'Aniello, Sophie; Smiechowski, Brielan; Suissa, Samy

2017-01-01

The effect of statins on cytokine-mediated inflammatory responses may impact on the prognosis of influenza. We assessed whether statin use decreases the incidence of adverse influenza-related outcomes. Additionally, we used a new-user study design to minimize healthy user bias. We further examined the possibility of non-causal associations by using unrelated outcomes. We used the UK Clinical Practice Research Datalink to identify all patients aged 30 or older diagnosed with influenza-like illness during 1997-2010. Statin users were compared with propensity score-matched patients not receiving statins. The outcome was hospitalization for influenza or pneumonia or death in the 30 days following influenza diagnosis. Logistic regression estimated cumulative incidence ratios. The study cohort included 5181 statin users matched to 5181 non-users. The 30-day incidence of hospitalization or death was 3.5% in statin users and 5.2% in non-users, resulting in a 27% lower incidence with statin use (cumulative incidence ratio: 0.73, 95%CI: 0.59-0.89). New statin users were less protected against our composite outcome. The effect of statins was less pronounced among those with respiratory and cardiac disease. Statin use was shown to be associated with a non-statistically significant risk reduction of motor vehicle accident and burns. The attenuation of the effect of statins with the new-user design, supporting evidence from the assessment of effect modification, and additional sub-analyses evaluating the effect of statins on non-related outcomes suggest that the beneficial effect of statins on influenza-related adverse outcomes may be explained by a healthy user bias. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Public stigma associated with mental illnesses in Pakistani university students: a cross sectional survey

Science.gov (United States)

Zubair, Muhammad; Ghulam, Hamzah; Wajih Ullah, Muhammad; Zubair Tariq, Muhammad

2014-01-01

Background. The objectives of the study were to explore the knowledge and attitudes of Pakistani university students toward mental illnesses. People with mental illnesses are challenged not only by their symptoms but also by the prejudices associated with their illness. Acknowledging the stigma of mental illness should be the first essential step toward devising an appropriate treatment plan. Methods. A cross-sectional survey was conducted at the University of Punjab, Lahore, CMH Lahore Medical and Dental College, Lahore, and University of Sargodha, Sub-campus Lahore, from February to May 2014. The self-administered questionnaire consisted of three sections: demographics, general knowledge of psychiatric illnesses, and Community Attitudes towards Mental Illnesses (CAMI) Scale. The questionnaire was distributed to 650 participants enrolled in different disciplines (Social Sciences, Medicine and Formal Sciences). Results. Response rate was 81% (527/650 respondents). Mean age was 20.98 years. Most of the students (331, 62.8%) had an urban background and studied Social Sciences (238, 45.2%). Four hundred and eighteen respondents (79.3%) considered religion very important and most respondents considered psychiatrists (334, 63.4%) and spiritual leaders (72, 13.7%) to be best able to treat mental illnesses. One hundred and sixty nine respondents (32.1%) considered black magic to be a cause of mental illness. Only 215 (41%) respondents had ever read an article on mental illnesses. Multiple regression analysis revealed study discipline, exposure, perceived causes of mental illnesses and superstitions to be significantly associated with attitudes towards mental illnesses (p supernatural explanations for mental illnesses but only a few believed that spiritual leaders can play a role in treatment. PMID:25548734

Long-term cumulative survival and mechanical complications of single-tooth Ankylos Implants: focus on the abutment neck fractures.

Science.gov (United States)

Shim, Hye Won; Yang, Byoung-Eun

2015-12-01

To evaluate the cumulative survival rate (CSR) and mechanical complications of single-tooth Ankylos® implants. This was a retrospective clinical study that analyzed 450 single Ankylos® implants installed in 275 patients between December 2005 and December 2012. The main outcomes were survival results CSR and implant failure) and mechanical complications (screw loosening, fracture, and cumulative fracture rate [CFR]). The main outcomes were analyzed according to age, sex, implant length or diameter, bone graft, arch, and position. The 8-year CSR was 96.9%. Thirteen (2.9%) implants failed because of early osseointegration failure in 3, marginal bone loss in 6, and abutment fracture in 4. Screw loosening occurred in 10 implants (2.2%), and 10 abutment fractures occurred. All abutment fractures were located in the neck, and concurrent screw fractures were observed. The CSR and rate of screw loosening did not differ significantly according to factors. The CFR was higher in middle-aged patients (5.3% vs 0.0% in younger and older patients); for teeth in a molar position (5.8% vs 0.0% for premolar or 1.1% for anterior position); and for larger-diameter implants (4.5% for 4.5 mm and 6.7% for 5.5 mm diameter vs 0.5% for 3.5 mm diameter) (all Pabutment fractures (2.2%) were observed and some fractures resulted in implant failures. Middle-aged patients, the molar position, and a large implant diameter were associated with a high incidence of abutment fracture.

A randomized, controlled trial of a multifaceted intervention including alcohol-based hand sanitizer and hand-hygiene education to reduce illness transmission in the home.

Science.gov (United States)

Sandora, Thomas J; Taveras, Elsie M; Shih, Mei-Chiung; Resnick, Elissa A; Lee, Grace M; Ross-Degnan, Dennis; Goldmann, Donald A

2005-09-01

Good hand hygiene may reduce the spread of infections in families with children who are in out-of-home child care. Alcohol-based hand sanitizers rapidly kill viruses that are commonly associated with respiratory and gastrointestinal (GI) infections. The objective of this study was to determine whether a multifactorial campaign centered on increasing alcohol-based hand sanitizer use and hand-hygiene education reduces illness transmission in the home. A cluster randomized, controlled trial was conducted of homes of 292 families with children who were enrolled in out-of-home child care in 26 child care centers. Eligible families had > or =1 child who was 6 months to 5 years of age and in child care for > or =10 hours/week. Intervention families received a supply of hand sanitizer and biweekly hand-hygiene educational materials for 5 months; control families received only materials promoting good nutrition. Primary caregivers were phoned biweekly and reported respiratory and GI illnesses in family members. Respiratory and GI-illness-transmission rates (measured as secondary illnesses per susceptible person-month) were compared between groups, adjusting for demographic variables, hand-hygiene practices, and previous experience using hand sanitizers. Baseline demographics were similar in the 2 groups. A total of 1802 respiratory illnesses occurred during the study; 443 (25%) were secondary illnesses. A total of 252 GI illnesses occurred during the study; 28 (11%) were secondary illnesses. The secondary GI-illness rate was significantly lower in intervention families compared with control families (incidence rate ratio [IRR]: 0.41; 95% confidence interval [CI]: 0.19-0.90). The overall rate of secondary respiratory illness was not significantly different between groups (IRR: 0.97; 95% CI: 0.72-1.30). However, families with higher sanitizer usage had a marginally lower secondary respiratory illness rate than those with less usage (IRR: 0.81; 95% CI: 0.65-1.09). A

Cumulative growth of minor hysteresis loops in the Kolmogorov model

International Nuclear Information System (INIS)

Meilikhov, E. Z.; Farzetdinova, R. M.

2013-01-01

The phenomenon of nonrepeatability of successive remagnetization cycles in Co/M (M = Pt, Pd, Au) multilayer film structures is explained in the framework of the Kolmogorov crystallization model. It is shown that this model of phase transitions can be adapted so as to adequately describe the process of magnetic relaxation in the indicated systems with “memory.” For this purpose, it is necessary to introduce some additional elements into the model, in particular, (i) to take into account the fact that every cycle starts from a state “inherited” from the preceding cycle and (ii) to assume that the rate of growth of a new magnetic phase depends on the cycle number. This modified model provides a quite satisfactory qualitative and quantitative description of all features of successive magnetic relaxation cycles in the system under consideration, including the surprising phenomenon of cumulative growth of minor hysteresis loops.

Dynamic prediction of cumulative incidence functions by direct binomial regression.

Science.gov (United States)

Grand, Mia K; de Witte, Theo J M; Putter, Hein

2018-03-25

In recent years there have been a series of advances in the field of dynamic prediction. Among those is the development of methods for dynamic prediction of the cumulative incidence function in a competing risk setting. These models enable the predictions to be updated as time progresses and more information becomes available, for example when a patient comes back for a follow-up visit after completing a year of treatment, the risk of death, and adverse events may have changed since treatment initiation. One approach to model the cumulative incidence function in competing risks is by direct binomial regression, where right censoring of the event times is handled by inverse probability of censoring weights. We extend the approach by combining it with landmarking to enable dynamic prediction of the cumulative incidence function. The proposed models are very flexible, as they allow the covariates to have complex time-varying effects, and we illustrate how to investigate possible time-varying structures using Wald tests. The models are fitted using generalized estimating equations. The method is applied to bone marrow transplant data and the performance is investigated in a simulation study. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

The Role of Cumulative Trauma, Betrayal, and Appraisals in Understanding Trauma Symptomatology

OpenAIRE

Martin, Christina Gamache; Cromer, Lisa DeMarni; DePrince, Anne P.; Freyd, Jennifer J.

2011-01-01

Poor psychological outcomes are common among trauma survivors, yet not all survivors experience adverse sequelae. The current study examined links between cumulative trauma exposure as a function of the level of betrayal (measured by the relational closeness of the survivor and the perpetrator), trauma appraisals, gender, and trauma symptoms. Participants were 273 college students who reported experiencing at least one traumatic event on a trauma checklist. Three cumulative indices were const...

The Stigma of Mental Illness

Science.gov (United States)

Overton, Stacy L.; Medina, Sondra L.

2008-01-01

Stigma surrounding major mental illness creates many barriers. People who experience mental illness face discrimination and prejudice when renting homes, applying for jobs, and accessing mental health services. The authors review the current literature regarding stigma and mental illness. They define stigma and review theories that explain its…

Childhood abuse and neglect among women outpatients with chronic mental illness.

Science.gov (United States)

Muenzenmaier, K; Meyer, I; Struening, E; Ferber, J

1993-07-01

The purposes of the study were to determine the prevalence of childhood sexual abuse, physical abuse, and neglect among women outpatients with severe and persistent mental illness; to examine patterns of co-occurrence of the various types of abuse; and to explore the relationships between childhood abuse and adult psychiatric symptomatology. Childhood histories of abuse and data on clinical characteristics of 78 women enrolled in a New York State outpatient clinic were elicited in face-to-face interviews using a structured questionnaire. Sixty-five percent of the women reported histories of some type of abuse or neglect during childhood. Forty-five percent of the sample had been sexually abused, 51 percent had been physically abused, and 22 percent had experienced neglect. Seventy-four percent of the sexually abused women, 70 percent of the physically abused women, and 94 percent of the women who experienced neglect reported at least one additional form of abuse or neglect. Respondents who had been abused in childhood had higher levels of depressive and psychotic symptoms and higher rates of sexual victimization in adulthood than those who had not been abused. Women who experienced neglect as children had higher rates of homelessness in adulthood. Chronic mentally ill women seem to experience higher rates of abuse and more types of abuse than the general population. Clinicians should try to determine whether chronic mentally ill women have histories of abuse and to develop interventions to meet their special needs.

Public stigma associated with mental illnesses in Pakistani university students: a cross sectional survey

Directory of Open Access Journals (Sweden)

Ahmed Waqas

2014-12-01

Full Text Available Background. The objectives of the study were to explore the knowledge and attitudes of Pakistani university students toward mental illnesses. People with mental illnesses are challenged not only by their symptoms but also by the prejudices associated with their illness. Acknowledging the stigma of mental illness should be the first essential step toward devising an appropriate treatment plan.Methods. A cross-sectional survey was conducted at the University of Punjab, Lahore, CMH Lahore Medical and Dental College, Lahore, and University of Sargodha, Sub-campus Lahore, from February to May 2014. The self-administered questionnaire consisted of three sections: demographics, general knowledge of psychiatric illnesses, and Community Attitudes towards Mental Illnesses (CAMI Scale. The questionnaire was distributed to 650 participants enrolled in different disciplines (Social Sciences, Medicine and Formal Sciences.Results. Response rate was 81% (527/650 respondents. Mean age was 20.98 years. Most of the students (331, 62.8% had an urban background and studied Social Sciences (238, 45.2%. Four hundred and eighteen respondents (79.3% considered religion very important and most respondents considered psychiatrists (334, 63.4% and spiritual leaders (72, 13.7% to be best able to treat mental illnesses. One hundred and sixty nine respondents (32.1% considered black magic to be a cause of mental illness. Only 215 (41% respondents had ever read an article on mental illnesses. Multiple regression analysis revealed study discipline, exposure, perceived causes of mental illnesses and superstitions to be significantly associated with attitudes towards mental illnesses (p < .05.Conclusion. Although low awareness and exposure were found in this sample of Pakistani university students, their attitude towards mental illnesses was generally positive. Most respondents gave supernatural explanations for mental illnesses but only a few believed that spiritual leaders can

Cumulative effective and individual organ dose levels in paediatric patients undergoing multiple catheterizations for congenital heart disease

International Nuclear Information System (INIS)

Jones, T.P.; Brennan, P.C.; Ryan, E.

2017-01-01

This study examines the cumulative radiation dose levels received by a group of children who underwent multiple cardiac catheterisation procedures during the investigation and management of congenital heart disease (CHD). The purpose is to calculate cumulative doses, identify higher dose individuals, outline the inconsistencies with risk assessment and encourage the establishment of dose databases in order to facilitate the longitudinal research necessary to better understand health risks. A retrospective review of patient records for 117 paediatric patients who have undergone two or more cardiac catheterizations for the investigation of CHD was undertaken. This cohort consisted of patients who were catheterised over a period from September 2002 to August 2014. The age distribution was from newborn to 17 y. Archived kerma-area product (P KA ) and fluoroscopy time (T) readings were retrieved and analysed. Cumulative effective and individual organ doses were determined. The cumulative P KA levels ranged from 1.8 to 651.2 Gycm 2 , whilst cumulative effective dose levels varied from 2 to 259 mSv. The cumulative fluoroscopy time was shown to vary from 8.1 to 193.5 min. Median cumulative organ doses ranged from 3 to 94 mGy. Cumulative effective dose levels are highly variable but may exceed 250 mSv. Individual organ and effective dose measurements remain useful for comparison purposes between institutions although current methodologies used for determining lifetime risks are inadequate. (authors)

Multiparty correlation measure based on the cumulant

International Nuclear Information System (INIS)

Zhou, D. L.; Zeng, B.; Xu, Z.; You, L.

2006-01-01

We propose a genuine multiparty correlation measure for a multiparty quantum system as the trace norm of the cumulant of the state. The legitimacy of our multiparty correlation measure is explicitly demonstrated by proving it satisfies the five basic conditions required for a correlation measure. As an application we construct an efficient algorithm for the calculation of our measures for all stabilizer states

78 FR 25440 - Request for Information and Citations on Methods for Cumulative Risk Assessment

Science.gov (United States)

2013-05-01

... Citations on Methods for Cumulative Risk Assessment AGENCY: Office of the Science Advisor, Environmental... influence exposures, dose-response or risk/hazard posed by environmental contaminant exposures, and methods... who wish to receive further information about submitting information on methods for cumulative risk...

Risk of Being Subjected to Crime, Including Violent Crime, After Onset of Mental Illness

DEFF Research Database (Denmark)

Dean, Kimberlie; Laursen, Thomas M; Pedersen, Carsten B

2018-01-01

Importance: People with mental illness are more likely to have contact with the criminal justice system, but research to date has focused on risk of offense perpetration, while less is known about risk of being subjected to crime and violence. Objectives: To establish the incidence of being...... subjected to all types of criminal offenses, and by violent crimes separately, after onset of mental illness across the full diagnostic spectrum compared with those in the population without mental illness. Design, Setting, and Participants: This investigation was a longitudinal national cohort study using...... of mental illness, recorded as first contact with outpatient or inpatient mental health services. Diagnoses across the full spectrum of psychiatric diagnoses were considered separately for men and women. Main Outcomes and Measures: Incidence rate ratios (IRRs) were estimated for first subjection to crime...

Mental illness sexual stigma: Implications for health and recovery.

Science.gov (United States)

Wainberg, Milton L; Cournos, Francine; Wall, Melanie M; Norcini Pala, Andrea; Mann, Claudio Gruber; Pinto, Diana; Pinho, Veronica; McKinnon, Karen

2016-06-01

The majority of people in psychiatric care worldwide are sexually active, and studies have revealed sharply elevated rates of HIV infection in that group compared with the general population. Recovery-oriented treatment does not routinely address sexuality. We examined the relationship between gender, severe mental illness diagnosis, and stigma experiences related to sexuality among people in psychiatric outpatient care. Sexually active adults attending 8 public outpatient psychiatric clinics in Rio de Janeiro (N = 641) were interviewed for psychiatric diagnosis and stigma experiences. Stigma mechanisms well-established in the literature but not previously examined in relation to sexuality were measured with the Mental Illness Sex Stigma Questionnaire, a 27-item interview about stigma in sexual situations and activities. Experiences of stigma were reported by a majority of participants for 48% of questionnaire items. Most people reported supportive attitudes toward their sexuality from providers and family members. Those with severe mental illness diagnoses showed greater stigma on individual discrimination and structural stigma mechanisms than did those with nonsevere mental illness diagnoses, whereas there was no difference on the social psychological processes (internalized stigma) mechanism. Regardless of diagnosis or gender, a majority of participants devalued themselves as sexual partners. Adults in psychiatric outpatient care frequently reported stigma experiences related to aspects of their sexual lives. From the perspectives of both HIV prevention and recovery from mental illness, examinations of the consequences of stigma in the sexual lives of people in psychiatric care and improving their measurement would have wide applicability. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Spiritual beliefs in bipolar affective disorder: their relevance for illness management.

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Mitchell, Logan; Romans, Sarah

2003-08-01

There has been growing interest in investigating religion as a relevant element in illness outcome. Having religious beliefs has been shown repeatedly to be associated with lessened rates of depression. Most of the limited published research has been restricted to elderly samples. Religious coping is thought to play a key role in religion's effects. Strangely, psychiatric research has neglected this area. A questionnaire covering religious, spiritual and philosophical beliefs and religious practice was given to a sample of patients with bipolar affective disorder in remission. Most patients often held strong religious or spiritual beliefs (78%) and practised their religion frequently (81.5%). Most saw a direct link between their beliefs and the management of their illness. Many used religious coping, and often religio-spiritual beliefs and practice put them in conflict with illness models (24%) and advice (19%) used by their medical advisors. This was a cross-sectional design without a control group and thus it is not possible to determine causal associations from the data set. Religio-spiritual ideas are of great salience to many patients with bipolar disorder and shape the ways in which they think about their illness. Many reported experiencing significant paradigm conflict in understanding and managing their illness between medical and their spiritual advisors. These data suggest that the whole area of religion and spirituality is directly relevant to people living with a chronic psychiatric illness and should be firmly on the discussion agenda of clinicians working with patients with bipolar disorder.

Looking up, down, and sideways: Reconceiving cumulative effects assessment as a mindset

Energy Technology Data Exchange (ETDEWEB)

Sinclair, A. John, E-mail: jsincla@umanitoba.ca [Natural Resources Institute, University of Manitoba, Winnipeg, MB R3T 2N2 (Canada); Doelle, Meinhard, E-mail: mdoelle@dal.ca [Marine & Environmental Law Institute, Dalhousie University, Schulich School of Law, Dalhousie University, 6061 University Ave., Halifax, Nova Scotia B3H 4R2 (Canada); Duinker, Peter N., E-mail: peter.duinker@dal.ca [School for Resource and Environmental Studies, Dalhousie University, 6100 University Ave., Halifax, Nova Scotia B3H 4R2 (Canada)

2017-01-15

Despite all the effort that has gone into defining, researching and establishing best practices for cumulative effects assessment (CEA), understanding remains weak and practice wanting. At one extreme of implementation, CEA can be described as merely an irritant to the completion of a project-specific environmental assessment (EA). At the other extreme, the conceptual view is that all effects in EA should be deemed cumulative unless demonstrated otherwise. Our purpose here is to consider how we might reconceive CEA as a mindset that is at the heart of absolutely every assessment of valued ecosystem component (VEC) to ensure that we understand the relative contributions of various stressors and can decide when cumulative effects may foreclose future activities due to impacts on VECs. Conceptually, we ground the CEA mindset in the context of three lenses that must all be functioning and working together for the mindset to be operative: a technical lens; a law and policy lens; and a participatory lens. Our arguments are based on a review of the CEA, strategic effects assessment (SEA) and regional effects assessment literatures, an examination and consideration of Canadian EA and SEA case practice, and our combined professional experiences. Through using the Bay of Fundy in Canada as a case example, we establish the concept of the CEA mindset and an approach for moving forward with implementation. - Highlights: • Conceptualization of cumulative effects assessment as a mindset. • Elaboration of technical, law and policy and participation lenses critical to CEA • Coordination and integration of cumulative effects for valued ecosystem components • Application in Bay of Fundy ecosystem and terrestrial watershed.

Evaluation of the learning curve for external cephalic version using cumulative sum analysis.

Science.gov (United States)

Kim, So Yun; Han, Jung Yeol; Chang, Eun Hye; Kwak, Dong Wook; Ahn, Hyun Kyung; Ryu, Hyun Mi; Kim, Moon Young

2017-07-01

We evaluated the learning curve for external cephalic version (ECV) using learning curve-cumulative sum (LC-CUSUM) analysis. This was a retrospective study involving 290 consecutive cases between October 2013 and March 2017. We evaluated the learning curve for ECV on nulli and over para 1 group using LC-CUSUM analysis on the assumption that 50% and 70% of ECV procedures succeeded by description a trend-line of quadratic function with reliable R 2 values. The overall success rate for ECV was 64.8% (188/290), while the success rate for nullipara and over para 1 groups was 56.2% (100/178) and 78.6% (88/112), respectively. 'H' value, that the actual failure rate does not differ from the acceptable failure rate, was -3.27 and -1.635 when considering ECV success rates of 50% and 70%, respectively. Consequently, in order to obtain a consistent 50% success rate, we would require 57 nullipara cases, and in order to obtain a consistent 70% success rate, we would require 130 nullipara cases. In contrast, 8 to 10 over para 1 cases would be required for an expected success rate of 50% and 70% on over para 1 group. Even a relatively inexperienced physician can experience success with multipara and after accumulating experience, they will manage nullipara cases. Further research is required for LC-CUSUM involving several practitioners instead of a single practitioner. This will lead to the gradual implementation of standard learning curve guidelines for ECV.

Caregiving for ill dependents and its association with employee health risks and productivity.

Science.gov (United States)

Burton, Wayne N; Chen, Chin-Yu; Conti, Daniel J; Pransky, Glenn; Edington, Dee W

2004-10-01

This study examined the loss of productivity and health risk status associated with employees who provide care for an ill dependent. A total of 16,651 employees (23% response rate) of a major financial services company completed a confidential Health Risk Appraisal (HRA) that included an eight-item version of the Work Limitations Questionnaire and a self-report of time missed from work during the previous 2 weeks to care for an ill dependent. A total of 10.6% of the respondents reported an average of 7.7 hours absent from work during the previous 2-week period to provide care for an ill dependent. Caregiving also was associated with a significant increase in the number of health risks for the employee. As the demand for caregiving time increased, caregivers reported a significant increase in work limitations. Caregiving for an ill dependent is associated with increased absenteeism and significant work limitations while on the job. Programs and work organization that helps employees balance their caregiving responsibilities for ill dependents may have a positive effect on health and productivity.

Cumulative impact assessments and bird/wind farm interactions: Developing a conceptual framework

International Nuclear Information System (INIS)

Masden, Elizabeth A.; Fox, Anthony D.; Furness, Robert W.; Bullman, Rhys; Haydon, Daniel T.

2010-01-01

The wind power industry has grown rapidly in the UK to meet EU targets of sourcing 20% of energy from renewable sources by 2020. Although wind power is a renewable energy source, there are environmental concerns over increasing numbers of wind farm proposals and associated cumulative impacts. Individually, a wind farm, or indeed any action, may have minor effects on the environment, but collectively these may be significant, potentially greater than the sum of the individual parts acting alone. EU and UK legislation requires a cumulative impact assessment (CIA) as part of Environmental Impact Assessments (EIA). However, in the absence of detailed guidance and definitions, such assessments within EIA are rarely adequate, restricting the acquisition of basic knowledge about the cumulative impacts of wind farms on bird populations. Here we propose a conceptual framework to promote transparency in CIA through the explicit definition of impacts, actions and scales within an assessment. Our framework requires improved legislative guidance on the actions to include in assessments, and advice on the appropriate baselines against which to assess impacts. Cumulative impacts are currently considered on restricted scales (spatial and temporal) relating to individual development EIAs. We propose that benefits would be gained from elevating CIA to a strategic level, as a component of spatially explicit planning.

Quantitative methods for analysing cumulative effects on fish migration success: a review.

Science.gov (United States)

Johnson, J E; Patterson, D A; Martins, E G; Cooke, S J; Hinch, S G

2012-07-01

It is often recognized, but seldom addressed, that a quantitative assessment of the cumulative effects, both additive and non-additive, of multiple stressors on fish survival would provide a more realistic representation of the factors that influence fish migration. This review presents a compilation of analytical methods applied to a well-studied fish migration, a more general review of quantitative multivariable methods, and a synthesis on how to apply new analytical techniques in fish migration studies. A compilation of adult migration papers from Fraser River sockeye salmon Oncorhynchus nerka revealed a limited number of multivariable methods being applied and the sub-optimal reliance on univariable methods for multivariable problems. The literature review of fisheries science, general biology and medicine identified a large number of alternative methods for dealing with cumulative effects, with a limited number of techniques being used in fish migration studies. An evaluation of the different methods revealed that certain classes of multivariable analyses will probably prove useful in future assessments of cumulative effects on fish migration. This overview and evaluation of quantitative methods gathered from the disparate fields should serve as a primer for anyone seeking to quantify cumulative effects on fish migration survival. © 2012 The Authors. Journal of Fish Biology © 2012 The Fisheries Society of the British Isles.

Cumulative environmental impacts and integrated coastal management: the case of Xiamen, China.

Science.gov (United States)

Xue, Xiongzhi; Hong, Huasheng; Charles, Anthony T

2004-07-01

This paper examines the assessment of cumulative environmental impacts and the implementation of integrated coastal management within the harbour of Xiamen, China, an urban region in which the coastal zone is under increasing pressure as a result of very rapid economic growth. The first stage of analysis incorporates components of a cumulative effects assessment, including (a) identification of sources of environmental impacts, notably industrial expansion, port development, shipping, waste disposal, aquaculture and coastal construction, (b) selection of a set of valued ecosystem components, focusing on circulation and siltation, water quality, sediment, the benthic community, and mangrove forests, and (c) use of a set of key indicators to examine cumulative impacts arising from the aggregate of human activities. In the second stage of analysis, the paper describes and assesses the development of an institutional framework for integrated coastal management in Xiamen, one that combines policy and planning (including legislative and enforcement mechanisms) with scientific and monitoring mechanisms (including an innovative 'marine functional zoning' system). The paper concludes that the integrated coastal management framework in Xiamen has met all relevant requirements for 'integration' as laid out in the literature, and has explicitly incorporated consideration of cumulative impacts within its management and monitoring processes.

Cultural Variation in Implicit Mental Illness Stigma.

Science.gov (United States)

Cheon, Bobby K; Chiao, Joan Y

2012-10-01

Culture shapes how individuals perceive and respond to others with mental illness. Prior studies have suggested that Asians and Asian Americans typically endorse greater stigma of mental illness compared to Westerners (White Europeans and Americans). However, whether these differences in stigma arise from cultural variations in automatic affective reactions or deliberative concerns of the appropriateness of one's reactions to mental illness remains unknown. Here we compared implicit and explicit attitudes toward mental illness among Asian and Caucasian Americans. Asian Americans showed stronger negative implicit attitudes toward mental illness relative to Caucasian Americans, suggesting that cultural variation in stigma of mental illness can be observed even when concerns regarding the validity and appropriateness of one's attitudes toward mental illness are minimized. Asian Americans also explicitly endorsed greater desire for social distance from mental illness relative to Caucasian Americans. These findings suggest that cultural variations in mental illness stigma may arise from cultural differences in automatic reactions to mental illness, though cultural variations in deliberative processing may further shape differences in these immediate reactions to mental illness.

Ten-Year Cumulative Author Index Volume 2001, 36(1) through 2010, 45(4)

Science.gov (United States)

Zucker, Stanley H.; Hassert, Silva

2011-01-01

This cumulative author index was developed as a service for the readership of Education and Training in Autism and Developmental Disabilities. It was prepared as a resource for scholars wishing to access the 391 articles published in volumes 36-45 of this journal. It also serves as a timely supplement to the 25-year (1966-1990) cumulative author…

Assessing glomerular filtration rate (GFR) in critically ill patients with acute kidney injury - true GFR versus urinary creatinine clearance and estimating equations

Science.gov (United States)

2013-01-01

Introduction Estimation of kidney function in critically ill patients with acute kidney injury (AKI), is important for appropriate dosing of drugs and adjustment of therapeutic strategies, but challenging due to fluctuations in kidney function, creatinine metabolism and fluid balance. Data on the agreement between estimating and gold standard methods to assess glomerular filtration rate (GFR) in early AKI are lacking. We evaluated the agreement of urinary creatinine clearance (CrCl) and three commonly used estimating equations, the Cockcroft Gault (CG), the Modification of Diet in Renal Disease (MDRD) and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations, in comparison to GFR measured by the infusion clearance of chromium-ethylenediaminetetraacetic acid (51Cr-EDTA), in critically ill patients with early AKI after complicated cardiac surgery. Methods Thirty patients with early AKI were studied in the intensive care unit, 2 to 12 days after complicated cardiac surgery. The infusion clearance for 51Cr-EDTA obtained as a measure of GFR (GFR51Cr-EDTA) was calculated from the formula: GFR (mL/min/1.73m2) = (51Cr-EDTA infusion rate × 1.73)/(arterial 51Cr-EDTA × body surface area) and compared with the urinary CrCl and the estimated GFR (eGFR) from the three estimating equations. Urine was collected in two 30-minute periods to measure urine flow and urine creatinine. Urinary CrCl was calculated from the formula: CrCl (mL/min/1.73m2) = (urine volume × urine creatinine × 1.73)/(serum creatinine × 30 min × body surface area). Results The within-group error was lower for GFR51Cr-EDTA than the urinary CrCl method, 7.2% versus 55.0%. The between-method bias was 2.6, 11.6, 11.1 and 7.39 ml/min for eGFRCrCl, eGFRMDRD, eGFRCKD-EPI and eGFRCG, respectively, when compared to GFR51Cr-EDTA. The error was 103%, 68.7%, 67.7% and 68.0% for eGFRCrCl, eGFRMDRD, eGFRCKD-EPI and eGFRCG, respectively, when compared to GFR51Cr-EDTA. Conclusions The study

Youth blogging and serious illness.

Science.gov (United States)

Nesby, Linda; Salamonsen, Anita

2016-03-01

In recent years, a growing number of young people who experience illness tend to blog about it. In this paper, we question whether and how illness blogs illustrate the intercommunicative aspect of blogging by bringing forth both the literary concept of the implied reader and the sociological concepts of empowerment and agency in the analysis. We argue that young people blogging about serious illness demonstrate the inherent intercommunicative potential of blogging. We also argue that youth blogging about serious illness may represent a fruitful strategy for ill young people to create meaning, stay front-stage in youth communities and build self-esteem and confidence out of chaos. Furthermore, we argue that these blogs may contribute rather unique experience-based knowledge and reflections about existential issues to other young blog readers, who may otherwise not get access to this aspect of life. Youth blogging about serious illness thereby reflects a patient group so far not very visible and through the genre youth stand out as more competent when it comes to illness and healthcare issues than what is often presumed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Approximate source conditions for nonlinear ill-posed problems—chances and limitations

International Nuclear Information System (INIS)

Hein, Torsten; Hofmann, Bernd

2009-01-01

In the recent past the authors, with collaborators, have published convergence rate results for regularized solutions of linear ill-posed operator equations by avoiding the usual assumption that the solutions satisfy prescribed source conditions. Instead the degree of violation of such source conditions is expressed by distance functions d(R) depending on a radius R ≥ 0 which is an upper bound of the norm of source elements under consideration. If d(R) tends to zero as R → ∞ an appropriate balancing of occurring regularization error terms yields convergence rates results. This approach was called the method of approximate source conditions, originally developed in a Hilbert space setting. The goal of this paper is to formulate chances and limitations of an application of this method to nonlinear ill-posed problems in reflexive Banach spaces and to complement the field of low order convergence rates results in nonlinear regularization theory. In particular, we are going to establish convergence rates for a variant of Tikhonov regularization. To keep structural nonlinearity conditions simple, we update the concept of degree of nonlinearity in Hilbert spaces to a Bregman distance setting in Banach spaces

Evaluating Cumulative Ecosystem Response to Restoration Projects in the Lower Columbia River and Estuary, 2009

Energy Technology Data Exchange (ETDEWEB)

Johnson, Gary E.; Diefenderfer, Heida L.; Borde, Amy B.; Bryson, Amanda J.; Cameron, April; Coleman, Andre M.; Corbett, C.; Dawley, Earl M.; Ebberts, Blaine D.; Kauffman, Ronald; Roegner, G. Curtis; Russell, Micah T.; Silva, April; Skalski, John R.; Thom, Ronald M.; Vavrinec, John; Woodruff, Dana L.; Zimmerman, Shon A.

2010-10-26

This is the sixth annual report of a seven-year project (2004 through 2010) to evaluate the cumulative effects of habitat restoration actions in the lower Columbia River and estuary (LCRE). The project, called the Cumulative Effects Study, is being conducted for the U.S. Army Corps of Engineers Portland District (USACE) by the Marine Sciences Laboratory of the Pacific Northwest National Laboratory (PNNL), the Pt. Adams Biological Field Station of the National Marine Fisheries Service (NMFS), the Columbia River Estuary Study Taskforce (CREST), and the University of Washington. The goal of the Cumulative Effects Study is to develop a methodology to evaluate the cumulative effects of multiple habitat restoration projects intended to benefit ecosystems supporting juvenile salmonids in the 235-km-long LCRE. Literature review in 2004 revealed no existing methods for such an evaluation and suggested that cumulative effects could be additive or synergistic. From 2005 through 2009, annual field research involved intensive, comparative studies paired by habitat type (tidal swamp versus marsh), trajectory (restoration versus reference site), and restoration action (tidegate replacement vs. culvert replacement vs. dike breach).

NEWTONP - CUMULATIVE BINOMIAL PROGRAMS

Science.gov (United States)

Bowerman, P. N.

1994-01-01

The cumulative binomial program, NEWTONP, is one of a set of three programs which calculate cumulative binomial probability distributions for arbitrary inputs. The three programs, NEWTONP, CUMBIN (NPO-17555), and CROSSER (NPO-17557), can be used independently of one another. NEWTONP can be used by statisticians and users of statistical procedures, test planners, designers, and numerical analysts. The program has been used for reliability/availability calculations. NEWTONP calculates the probably p required to yield a given system reliability V for a k-out-of-n system. It can also be used to determine the Clopper-Pearson confidence limits (either one-sided or two-sided) for the parameter p of a Bernoulli distribution. NEWTONP can determine Bayesian probability limits for a proportion (if the beta prior has positive integer parameters). It can determine the percentiles of incomplete beta distributions with positive integer parameters. It can also determine the percentiles of F distributions and the midian plotting positions in probability plotting. NEWTONP is designed to work well with all integer values 0 < k <= n. To run the program, the user simply runs the executable version and inputs the information requested by the program. NEWTONP is not designed to weed out incorrect inputs, so the user must take care to make sure the inputs are correct. Once all input has been entered, the program calculates and lists the result. It also lists the number of iterations of Newton's method required to calculate the answer within the given error. The NEWTONP program is written in C. It was developed on an IBM AT with a numeric co-processor using Microsoft C 5.0. Because the source code is written using standard C structures and functions, it should compile correctly with most C compilers. The program format is interactive. It has been implemented under DOS 3.2 and has a memory requirement of 26K. NEWTONP was developed in 1988.

Good-parent beliefs of parents of seriously ill children.

Science.gov (United States)

Feudtner, Chris; Walter, Jennifer K; Faerber, Jennifer A; Hill, Douglas L; Carroll, Karen W; Mollen, Cynthia J; Miller, Victoria A; Morrison, Wynne E; Munson, David; Kang, Tammy I; Hinds, Pamela S

2015-01-01

Parents' beliefs about what they need to do to be a good parent when their children are seriously ill influence their medical decisions, and better understanding of these beliefs may improve decision support. To assess parents' perceptions regarding the relative importance of 12 good-parent attributes. A cross-sectional, discrete-choice experiment was conducted at a children's hospital. Participants included 200 parents of children with serious illness. Ratings of 12 good-parent attributes, with subsequent use of latent class analysis to identify groups of parents with similar ratings of attributes, and ascertainment of whether membership in a particular group was associated with demographic or clinical characteristics. The highest-ranked good-parent attribute was making sure that my child feels loved, followed by focusing on my child's health, making informed medical care decisions, and advocating for my child with medical staff. We identified 4 groups of parents with similar patterns of good-parent-attribute ratings, which we labeled as: child feels loved (n=68), child's health (n=56), advocacy and informed (n=55), and spiritual well-being (n=21). Compared with the other groups, the child's health group reported more financial difficulties, was less educated, and had a higher proportion of children with new complex, chronic conditions. Parents endorse a broad range of beliefs that represent what they perceive they should do to be a good parent for their seriously ill child. Common patterns of how parents prioritize these attributes exist, suggesting future research to better understand the origins and development of good-parent beliefs among these parents. More important, engaging parents individually regarding what they perceive to be the core duties they must fulfill to be a good parent may enable more customized and effective decision support.

Assessing the cumulative environmental effects of marine renewable energy developments: Establishing common ground.