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Sample records for heat related illness

  1. Heat-Related Illnesses

    ... 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 ...

  2. Heat-Related Illnesses

    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 ...

  3. Heat-Related Illnesses

    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 ...

  4. Heat-Related Illnesses

    Full Text Available ... Health System in Chesterfield, Missouri Heat-related illness can be caused by overexposure to the sun or ... the elderly are most at risk, but anyone can be affected. Here you will find information about ...

  5. Heat-Related Illnesses

    Full Text Available ... ICE” in Your Cell Phone Prepare for Disasters Communication With Your Family And Your Doctor About Your ... Dr. Glenn Mitchell , Emergency physician at Mercy Health System in Chesterfield, Missouri Heat-related illness can be ...

  6. Heat Related Illnesses

    Carter, R; Cheuvront, S. N; Sawka, M. N

    2006-01-01

    .... The risk of serious heat illness can be markedly reduced by implementing a variety of countermeasures, including becoming acclimated to the heat, managing heat stress exposure, and maintaining hydration...

  7. Heat-Related Illnesses

    Full Text Available ... exhaustion symptoms include cool, moist, pale or flushed skin; headache; dizziness; weakness; feeling exhausted; heavy sweating; nausea; ... stage of heat illness) include flushed, hot, dry skin; fainting; a rapid, weak pulse; rapid, shallow breathing; ...

  8. Disaster related heat illness

    Miyake, Yasufumi

    2012-01-01

    Explained and discussed are the outline of heat illness (HI), its raised risk and measures taken at the disaster of the Fukushima Nuclear Power Plant Accident (FNPPA; Mar. 2011). High temperature and humid environment induce HI through the fervescence and dehydration resulting in the intestinal ischemia/hypoxia and organ failure. Epidemiologic data of the heatstroke in Japan suggest its seemingly parallel incidence to seasonal hotness of the summer. HI is classified in either classical (non-exertional) or exertional heatstroke, both with severity of I (slight), II (slight symptom of the central nervous system (CNS); necessary for consultation) and III (most serious; having dysfunction of CNS, organ or coagulation). Therapy depends on the severity: I for the first aid on site, II necessary for carrying to hospital and III for hospitalization. Protection is possible by personal, neighbors' and managers' carefulness, and supply of sufficient water and minerals. Risk of HI was suddenly raised at taking measures to meet with the FNPPA. Japanese Association for Acute Medicine (JAAM) promptly organized JAAM-FNPPA Working Group to treat the emergent multiple incidents including the radiation exposure and HI as well. Exertional HI was mainly in labors wearing rather sealed closes to protect radiation to work for steps of the Accident, and which was similar to evacuees temporarily entering the evacuation area for visit to their own vacant houses. In the summer, classical HI was also a problem mainly in elderly living in the evacuation dwellings. Document of HI incidents and patients at FNPPA should be recorded for the reference to possible disaster in future. (T.T.)

  9. Heat-Related Illnesses

    Full Text Available ... Be Prepared Safe Citizen Day Organize Important Medical Information ER Checklists Preparing for Emergencies Be ready to ... anyone can be affected. Here you will find information about heat cramps and heat stroke and exhaustion. ...

  10. Heat-Related Illnesses

    Full Text Available ... moist, pale skin, rapid pulse, elevated or lowered blood pressure, nausea, loss of consciousness, vomiting or a high body temperature. For late stage heat stroke symptoms, cool the person further by positioning ...

  11. Heat-Related Illnesses

    Full Text Available ... weak pulse; rapid, shallow breathing; vomiting; and increased body temperature of more than 104 degrees. People with ... nausea, loss of consciousness, vomiting or a high body temperature. For late stage heat stroke symptoms, cool ...

  12. Heat-Related Illnesses

    Full Text Available ... or a high body temperature. For late stage heat stroke symptoms, cool the person further by positioning ice or cold packs on ... Injury Chest Pain Is ALWAYS A Reason To Go To The ...

  13. Heat-Related Illnesses

    Full Text Available ... weak pulse; rapid, shallow breathing; vomiting; and increased body temperature of more than 104 degrees. People with these ... nausea, loss of consciousness, vomiting or a high body temperature. For late stage heat stroke symptoms, cool the ...

  14. Heat-related illness in the African wilderness

    Wilderness heat-related illnesses span a continuum of medical problems caused by ... of modern science, clothing technology, and an understanding of physiology ..... guidelines for wilderness emergency care, heat-related illnesses, and EAH ...

  15. Heat-Related Illness among Oregon Farmworkers

    Jeffrey W. Bethel

    2014-09-01

    Full Text Available Farmworkers are particularly vulnerable to climate-sensitive health outcomes such as heat-related illness (HRI given their tasks involve heavy exertion in an outdoor setting. The objectives of the study were to: (1 describe symptoms of HRI experienced by farmworkers and (2 explore factors associated with heat knowledge, level of concern regarding HRI, and comfort level taking breaks at work. Bilingual research staff conducted personal interviews of 100 farmworkers during July and August 2013. Data collected included demographics, work history and current work practices, trainings received, HRI symptoms experienced, health status, and health behaviors. Nearly 30% of participants reported experiencing ≥2 HRI symptoms during the previous work. Few participants had high level of heat knowledge (21.0% and 15.6% of participants reported being “very concerned” about the health effects of working in hot conditions. Participants who were paid by the piece were more likely to have a high heat knowledge score and be “very concerned” about HRI but less likely to be “very comfortable” taking a break compared to workers paid by the hour than those who had not received HRI training. Results suggest several areas in which employers and agencies conducting outreach and education to the workers about HRI can change their practices including providing cooling measures and HRI training about risk factors for HRI.

  16. Preventing Heat-Related Illness or Death of Outdoor Workers

    ... instructed him to rest, but the man continued working. An hour later, the man appeared confused and coworkers carried ... for conducting research and making recommendations to prevent work-related illness and ... significantly reduced Preventing Heat-related Illness or Death of Outdoor ...

  17. Heat-related illness in China, summer of 2013

    Gu, Shaohua; Huang, Cunrui; Bai, Li; Chu, Cordia; Liu, Qiyong

    2016-01-01

    Extreme heat events have occurred more frequently in China in recent years, leading to serious impacts on human life and the health care system. To identify the characteristics of individuals with heat-related illnesses in China during the summer of 2013, we collected the data from the Heat-related Illness Surveillance System in Chinese Center for Disease Control and Prevention (China CDC). A total of 5758 cases were reported in the summer of 2013, mostly concentrated in urban areas around the middle and lower reaches of the Yangtze River. We found a difference in age distribution of percentage of deaths from heat-related illness between males and females. Severe cases in males mostly occurred in the age group 45-74 years but in females mostly in the age group over 75. A distributed lag non-linear model had been used to identify population vulnerabilities in Ningbo and Chongqing. The results show that there was a clear positive relationship between maximum temperature and heat-related illness, and the heat effect was nonlinear and could last for 3 days. The elderly and males in the range of 45-64 years old might be the most vulnerable people of heat-related illness in China. We also highlighted some deficiencies of the surveillance system, such that the reported data were not accurate, comprehensive, or timely enough at this stage.

  18. Pathophysiology of Heat-Related Illnesses

    2012-01-01

    Figure 10-4). deHydrATion And elecTrolyTe imBAlAnce Water requirements during heat exposure are primarily deter- mined by a person’s sweat losses. Water...the effect of cyclooxygenase inhibition, J Clin Invest 81:1162, 1988. 241. Opal SM, Fisher CJ Jr, Dhainaut JF, et al: Confirmatory interleukin-1...inhibition, J Clin Invest 81:1162, 1988. 241. Opal SM, Fisher CJ Jr, Dhainaut JF, et al: Confirmatory interleukin-1 receptor antagonist trial in severe

  19. FEMALE FARMWORKERS’ PERCEPTIONS OF HEAT-RELATED ILLNESS AND PREGNANCY HEALTH

    Flocks, Joan; Mac, Valerie Vi Thien; Runkle, Jennifer; Tovar-Aguilar, Jose Antonio; Economos, Jeannie; McCauley, Linda A.

    2013-01-01

    While agricultural workers have elevated risks of heat-related illnesses (HRI), pregnant farmworkers exposed to extreme heat face additional health risk, including poor pregnancy health and birth outcomes. Qualitative data from five focus groups with 35 female Hispanic and Haitian nursery and fernery workers provide details about the women’s perceptions of HRI and pregnancy. Participants believe that heat exposure can adversely affect general, pregnancy, and fetal health, yet feel they lack c...

  20. Heat-related illness in the African wilderness | Hofmeyr | South ...

    ... and culminate in life-threatening heat stroke. The differential diagnosis in the wilderness is broad and should include exercise-associated hyponatraemia with or without encephalopathy. Clinical guidelines for wilderness and hospital management of these conditions are available. Field management and evacuation are ...

  1. The descriptive epidemiology of sports/leisure-related heat illness hospitalisations in New South Wales, Australia.

    Finch, Caroline F; Boufous, Soufiane

    2008-01-01

    Sport-related heat illness has not been commonly studied from an epidemiological perspective. This study presents the descriptive epidemiology of sports/leisure-related heat illness hospitalisations in New South Wales, Australia. All in-patient separations from all acute hospitals in NSW during 2001-2004, with an International Classification of Diseases external cause of injury code indicating "exposure to excessive natural heat (X30)" or any ICD-10 diagnosis code in the range: "effects of heat and light (T67.0-T67.9)", were analysed. The sport/leisure relatedness of cases was defined by ICD-10-AM activity codes indicating involvement in sport/leisure activities. Cases of exposure to heat while engaged in sport/leisure were described by gender, year, age, principal diagnosis, type of activity/sport and length of stay. There were 109 hospital separations for exposure to heat while engaging in sport/leisure activity, with the majority occurring during the hottest months. The number of male cases significantly increased over the 4-year period and 45+ -year olds had the largest number of cases. Heat exhaustion was the leading cause of hospital separation (40% of cases). Marathon running, cricket and golf were the activities most commonly associated with heat-related hospitalisation. Ongoing development and refinement of expert position statements regarding heat illnesses need to draw on both epidemiological and physiological evidence to ensure their relevance to all levels of risk from the real world sport training and competition contexts.

  2. Pediatric heat-related illness: recommendations for prevention and management [digest].

    Dunn, Roberta J; Kim, Tommy Y; Chaudhari, Pradip

    2017-08-22

    Infants, children, and adolescents are at increased risk for heat-related illness due to their inability to remove themselves from dangerous environments. Evidence shows that morbidity and mortality from heat illness is related to the length of time core temperature is elevated, so rapid reduction and accurate serial measurements are crucial to prevention of organ system damage and death. The primary methods of patient cooling are conduction (ice-water immersion, cold packs) and convection (moisture and moving air). The choice of method used may depend on availability of equipment, but there is evidence that can guide optimal use of resources. This issue presents evidence-based recommendations and best practices in heat-illness resuscitation, including managing children who are obese, have special needs or take medications, and advocacy for prevention strategies. [Points & Pearls is a digest of Pediatric Emergency Medicine Practice].

  3. Risk characterization of hospitalizations for mental illness and/or behavioral disorders with concurrent heat-related illness.

    Michael T Schmeltz

    Full Text Available Many studies have found significant associations between high ambient temperatures and increases in heat-related morbidity and mortality. Several studies have demonstrated that increases in heat-related hospitalizations are elevated among individuals with diagnosed mental illnesses and/or behavioral disorders (MBD. However, there are a limited number of studies regarding risk factors associated with specific mental illnesses that contribute, at least in part, to heat-related illnesses (HRI in the United States.To identify and characterize individual and environmental risk factors associated with MBD hospitalizations with a concurrent HRI diagnosis.This study uses hospitalization data from the Nationwide Inpatient Sample (2001-2010. Descriptive analyses of primary and secondary diagnoses of MBDs with an HRI were examined. Risk ratios (RR were calculated from multivariable models to identify risk factors for hospitalizations among patients with mental illnesses and/or behavioral disorders and HRI.Nondependent alcohol/drug abuse, dementia, and schizophrenia were among the disorders that were associated with increased frequency of HRI hospitalizations among MBD patients. Increased risk of MBD hospitalizations with HRI was observed for Males (RR, 3.06, African Americans (RR, 1.16, Native Americans (RR, 1.70, uninsured (RR, 1.92, and those 40 years and older, compared to MBD hospitalizations alone.Previous studies outside the U.S. have found that dementia and schizophrenia are significant risk factors for HRI hospitalizations. Our results suggest that hospitalizations among substance abusers may also be an important risk factor associated with heat morbidity. Improved understanding of these relative risks could help inform future public health strategies.

  4. Community Trial on Heat Related-Illness Prevention Behaviors and Knowledge for the Elderly

    Noriko Takahashi

    2015-03-01

    Full Text Available This study aims to explore whether broadcasting heat health warnings (HHWs, to every household and whether the additional home delivery of bottled water labeled with messages will be effective in improving the behaviors and knowledge of elderly people to prevent heat-related illness. A community trial on heat-related-illness-prevention behaviors and knowledge for people aged between 65 and 84 years was conducted in Nagasaki, Japan. Five hundred eight subjects were selected randomly from three groups: heat health warning (HHW, HHW and water delivery (HHW+W, and control groups. Baseline and follow-up questionnaires were conducted in June and September 2012, respectively. Of the 1524 selected subjects, the 1072 that completed both questionnaires were analyzed. The HHW+W group showed improvements in nighttime AC use (p = 0.047, water intake (p = 0.003, cooling body (p = 0.002 and reduced activities in heat (p = 0.047 compared with the control, while the HHW group improved hat or parasol use (p = 0.008. An additional effect of household water delivery was observed in water intake (p = 0.067 and cooling body (p = 0.095 behaviors. HHW and household bottled water delivery improved heat-related-illness-prevention behaviors. The results indicate that home water delivery in addition to a HHW may be needed to raise awareness of the elderly.

  5. FEMALE FARMWORKERS’ PERCEPTIONS OF HEAT-RELATED ILLNESS AND PREGNANCY HEALTH

    Flocks, Joan; Mac, Valerie Vi Thien; Runkle, Jennifer; Tovar-Aguilar, Jose Antonio; Economos, Jeannie; McCauley, Linda A.

    2017-01-01

    While agricultural workers have elevated risks of heat-related illnesses (HRI), pregnant farmworkers exposed to extreme heat face additional health risk, including poor pregnancy health and birth outcomes. Qualitative data from five focus groups with 35 female Hispanic and Haitian nursery and fernery workers provide details about the women’s perceptions of HRI and pregnancy. Participants believe that heat exposure can adversely affect general, pregnancy, and fetal health, yet feel they lack control over workplace conditions and that they lack training about these specific risks. These data are being used to develop culturally appropriate educational materials emphasizing health promoting and protective behaviors during pregnancy. PMID:24125050

  6. Female farmworkers' perceptions of heat-related illness and pregnancy health.

    Flocks, Joan; Vi Thien Mac, Valerie; Runkle, Jennifer; Tovar-Aguilar, Jose Antonio; Economos, Jeannie; McCauley, Linda A

    2013-01-01

    Although agricultural workers have elevated risks of heat-related illnesses (HRI), pregnant farmworkers exposed to extreme heat face additional health risk, including poor pregnancy health and birth outcomes. Qualitative data from five focus groups with 35 female Hispanic and Haitian nursery and fernery workers provide details about the women's perceptions of HRI and pregnancy. Participants believe that heat exposure can adversely affect general, pregnancy, and fetal health, yet feel they lack control over workplace conditions and that they lack training about these specific risks. These data are being used to develop culturally appropriate educational materials emphasizing health promoting and protective behaviors during pregnancy.

  7. Summer outdoor temperature and occupational heat-related illnesses in Quebec (Canada)

    Adam-Poupart, Ariane; Smargiassi, Audrey; Busque, Marc-Antoine; Duguay, Patrice; Fournier, Michel; Zayed, Joseph; Labrèche, France

    2014-01-01

    Background: Predicted rise in global mean temperature and intensification of heat waves associated with climate change present an increasing challenge for occupational health and safety. Although important scientific knowledge has been gathered on the health effects of heat, very few studies have focused on quantifying the association between outdoor heat and mortality or morbidity among workers. Objective: To quantify the association between occupational heat-related illnesses and exposure to summer outdoor temperatures. Methods: We modeled 259 heat-related illnesses compensated by the Workers' Compensation Board of Quebec between May and September, from 1998 to 2010, with maximum daily summer outdoor temperatures in 16 health regions of Quebec (Canada) using generalized linear models with negative binomial distributions, and estimated the pooled effect sizes for all regions combined, by sex and age groups, and for different time lags with random-effect models for meta-analyses. Results: The mean daily compensation count was 0.13 for all regions of Quebec combined. The relationship between daily counts of compensations and maximum daily temperatures was log-linear; the pooled incidence rate ratio (IRR) of daily heat-related compensations per 1 °C increase in daily maximum temperatures was 1.419 (95% CI 1.326 to 1.520). Associations were similar for men and women and by age groups. Increases in daily maximum temperatures at lags 1 and 2 and for two and three-day lag averages were also associated with increases in daily counts of compensations (IRRs of 1.206 to 1.471 for every 1 °C increase in temperature). Conclusion: This study is the first to quantify the association between occupational heat-related illnesses and exposure to summer temperatures in Canada. The model (risk function) developed in this study could be useful to improve the assessment of future impacts of predicted summer outdoor temperatures on workers and vulnerable groups, particularly in

  8. Summer outdoor temperature and occupational heat-related illnesses in Quebec (Canada)

    Adam-Poupart, Ariane [Department of Environmental and Occupational Health, School of Public Health, Université de Montréal, Montreal, QC (Canada); Smargiassi, Audrey [Department of Environmental and Occupational Health, School of Public Health, Université de Montréal, Montreal, QC (Canada); Institut national de santé publique du Québec (INSPQ), Montreal, QC (Canada); Busque, Marc-Antoine; Duguay, Patrice [Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), Montreal, QC (Canada); Fournier, Michel [Direction de santé publique, Agence de la santé et des services sociaux de Montréal, Montreal, QC (Canada); Zayed, Joseph [Department of Environmental and Occupational Health, School of Public Health, Université de Montréal, Montreal, QC (Canada); Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), Montreal, QC (Canada); Labrèche, France, E-mail: labreche.france@irsst.qc.ca [Department of Environmental and Occupational Health, School of Public Health, Université de Montréal, Montreal, QC (Canada); Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), Montreal, QC (Canada)

    2014-10-15

    Background: Predicted rise in global mean temperature and intensification of heat waves associated with climate change present an increasing challenge for occupational health and safety. Although important scientific knowledge has been gathered on the health effects of heat, very few studies have focused on quantifying the association between outdoor heat and mortality or morbidity among workers. Objective: To quantify the association between occupational heat-related illnesses and exposure to summer outdoor temperatures. Methods: We modeled 259 heat-related illnesses compensated by the Workers' Compensation Board of Quebec between May and September, from 1998 to 2010, with maximum daily summer outdoor temperatures in 16 health regions of Quebec (Canada) using generalized linear models with negative binomial distributions, and estimated the pooled effect sizes for all regions combined, by sex and age groups, and for different time lags with random-effect models for meta-analyses. Results: The mean daily compensation count was 0.13 for all regions of Quebec combined. The relationship between daily counts of compensations and maximum daily temperatures was log-linear; the pooled incidence rate ratio (IRR) of daily heat-related compensations per 1 °C increase in daily maximum temperatures was 1.419 (95% CI 1.326 to 1.520). Associations were similar for men and women and by age groups. Increases in daily maximum temperatures at lags 1 and 2 and for two and three-day lag averages were also associated with increases in daily counts of compensations (IRRs of 1.206 to 1.471 for every 1 °C increase in temperature). Conclusion: This study is the first to quantify the association between occupational heat-related illnesses and exposure to summer temperatures in Canada. The model (risk function) developed in this study could be useful to improve the assessment of future impacts of predicted summer outdoor temperatures on workers and vulnerable groups, particularly in

  9. Heat-related illness in Washington State agriculture and forestry sectors.

    Spector, June T; Krenz, Jennifer; Rauser, Edmund; Bonauto, David K

    2014-08-01

    We sought to describe heat-related illness (HRI) in agriculture and forestry workers in Washington State. Demographic and clinical Washington State Fund workers' compensation agriculture and forestry HRI claims data (1995-2009) and Washington Agriculture Heat Rule citations (2009-2012) were accessed and described. Maximum daily temperature (Tmax) and Heat Index (HImax) were estimated by claim date and location using AgWeatherNet's weather station network. There were 84 Washington State Fund agriculture and forestry HRI claims and 60 Heat Rule citations during the study period. HRI claims and citations were most common in crop production and support subsectors. The mean Tmax (HImax) was 95°F (99°F) for outdoor HRI claims. Potential HRI risk factors and HRI-related injuries were documented for some claims. Agriculture and forestry HRI cases are characterized by potential work-related, environmental, and personal risk factors. Further work is needed to elucidate the relationship between heat exposure and occupational injuries. © 2014 Wiley Periodicals, Inc.

  10. Risk Factors for Heat-related Illness in U.S. Workers: An OSHA Case Series.

    Tustin, Aaron W; Cannon, Dawn L; Arbury, Sheila B; Thomas, Richard J; Hodgson, Michael J

    2018-05-30

    The aim of this study was to describe risk factors for heat-related illness (HRI) in U.S. workers. We reviewed a subset of HRI enforcement investigations conducted by the Occupational Safety and Health Administration (OSHA) from 2011 through 2016. We assessed characteristics of the workers, employers, and events. We stratified cases by severity to assess whether risk factors were more prevalent in fatal HRIs. We analyzed 38 investigations involving 66 HRIs. Many workers had predisposing medical conditions or used predisposing medications. Comorbidities were more prevalent in workers who died. Most (73%) fatal HRIs occurred during the first week on the job. Common clinical findings in heat stroke cases included multiorgan failure, muscle breakdown, and systemic inflammation. Severe HRI is more likely when personal susceptibilities coexist with work-related and environmental risk factors. Almost all HRIs occur when employers do not adhere to preventive guidelines.

  11. Analysis of a Community-based Intervention to Reduce Heat-related Illness during Heat Waves in Licheng, China: a Quasi-experimental Study.

    Li, Jing; Xu, Xin; Wang, Jun; Zhao, Yun; Song, Xiu Ping; Liu, Zhi Dong; Cao, Li Na; Jiang, Bao Fa; Liu, Qi Yong

    2016-11-01

    To reduce health-related threats of heat waves, interventions have been implemented in many parts of the world. However, there is a lack of higher-level evidence concerning the intervention efficacy. This study aimed to determine the efficacy of an intervention to reduce the number of heat-related illnesses. A quasi-experimental design was employed by two cross-sectional surveys in the year 2014 and 2015, including 2,240 participants and 2,356 participants, respectively. Each survey was designed to include one control group and one intervention group, which conducted in Licheng, China. A representative sample was selected using a multistage sampling method. Data, collected from questionnaires about heat waves in 2014 and 2015, were analyzed using a difference-in-difference analysis and cost effectiveness analysis. Outcomes included changes in the prevalence of heat-related illnesses and cost-effectiveness variables. Relative to the control participants, the prevalence of heat-related illness in the intervention participants decreased to a greater extent in rural areas than in urban areas (OR=0.495 vs. OR=1.281). Moreover, the cost-effectiveness ratio in the intervention group was less than that in the control group (US$15.06 vs. US$15.69 per participant). Furthermore, to avoid one additional patient, the incremental cost-effectiveness ratio showed that an additional US$14.47 would be needed for the intervention compared to when no intervention was applied. The intervention program may be considered a worthwhile investment for rural areas that are more likely to experience heat waves. Meanwhile, corresponding improving measures should be presented towards urban areas. Future research should examine whether the intervention strategies could be spread out in other domestic or international regions where heat waves are usually experienced. Copyright © 2016 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

  12. Cost of preventing workplace heat-related illness through worker breaks and the benefit of climate-change mitigation

    Takakura, Jun'ya; Fujimori, Shinichiro; Takahashi, Kiyoshi; Hijioka, Yasuaki; Hasegawa, Tomoko; Honda, Yasushi; Masui, Toshihiko

    2017-06-01

    The exposure of workers to hot environments is expected to increase as a result of climate change. In order to prevent heat-related illness, it is recommended that workers take breaks during working hours. However, this would lead to reductions in worktime and labor productivity. In this study, we estimate the economic cost of heat-related illness prevention through worker breaks associated with climate change under a wide range of climatic and socioeconomic conditions. We calculate the worktime reduction based on the recommendation of work/rest ratio and the estimated future wet bulb glove temperature, which is an index of heat stresses. Corresponding GDP losses (cost of heat-related illness prevention through worker breaks) are estimated using a computable general equilibrium model throughout this century. Under the highest emission scenario, GDP losses in 2100 will range from 2.6 to 4.0% compared to the current climate conditions. On the other hand, GDP losses will be less than 0.5% if the 2.0 °C goal is achieved. The benefit of climate-change mitigation for avoiding worktime loss is comparable to the cost of mitigation (cost of the greenhouse gas emission reduction) under the 2.0 °C goal. The relationship between the cost of heat-related illness prevention through worker breaks and global average temperature rise is approximately linear, and the difference in economic loss between the 1.5 °C goal and the 2.0 °C goal is expected to be approximately 0.3% of global GDP in 2100. Although climate mitigation and socioeconomic development can limit the vulnerable regions and sectors, particularly in developing countries, outdoor work is still expected to be affected. The effectiveness of some adaptation measures such as additional installation of air conditioning devices or shifting the time of day for working are also suggested. In order to reduce the economic impacts, adaptation measures should also be implemented as well as pursing ambitious climate change

  13. Heat-Related Illnesses

    Full Text Available ... ICE” in Your Cell Phone Prepare for Disasters Communication With Your Family And Your Doctor About Your Wishes Visiting The ER Who Takes Care Of You In An Emergency? Checking Into the ...

  14. Heat-Related Illnesses

    1988-04-01

    dyspnea, dysphagia , and urinary incontinence. 2 6 Although the muscular rigidity and hyperthermia are reminiscent of malignant hyperthermia, the putative...401, 1986. 106. Litman, R.E.: Heatstroke in parkinsonism . Arch Int Med, 89:562- 567, 1952. 107. Logue, R.B., Hanson, J.F.: Electrocardiographic

  15. Heat-Related Illnesses

    Full Text Available ... person rest in a cool place and give small amounts of cool water, juice or a commercial sports liquid. (Do not give liquids if the person is unconscious.) Gently stretch and massage the affected area. Do not administer salt tablets. Check for signs ...

  16. Heat-Related Illnesses

    Full Text Available ... a Medical Emergency Childhood Emergencies Careers in Emergency Medicine Seconds Save Lives Be Prepared Safe Citizen Day ... So Long Admission to the Hospital Heroes On Medicine's Front Line Observation Emergency Care Fact Sheet Health & ...

  17. Heat-Related Illnesses

    Full Text Available ... or cold packs on wrists, ankles, groin and neck and in armpits. Administer CPR if the person becomes unconscious. READ IN EMERGENCIES A-Z Head Injury Chest Pain Is ALWAYS A Reason To Go To The ...

  18. Heat-Related Illnesses

    Full Text Available ... Until Help Arrives What To Do In A Medical Emergency Childhood Emergencies Careers in Emergency Medicine Seconds ... Lives Be Prepared Safe Citizen Day Organize Important Medical Information ER Checklists Preparing for Emergencies Be ready ...

  19. Heat-Related Illnesses

    Full Text Available ... by positioning ice or cold packs on wrists, ankles, groin and neck and in armpits. Administer CPR if the person becomes unconscious. READ IN EMERGENCIES A-Z Vomiting and Diarrhea Sore Throat Sprains and Strains Resources Home Safety Checklist ACEP Coloring ...

  20. Heat-Related Illnesses

    Full Text Available ... To Call 911 Until Help Arrives What To Do In A Medical Emergency Childhood Emergencies Careers in ... cool water, juice or a commercial sports liquid. (Do not give liquids if the person is unconscious.) ...

  1. Heat-Related Illnesses

    Full Text Available ... moist, pale skin, rapid pulse, elevated or lowered blood pressure, nausea, loss of consciousness, vomiting or a high ... becomes unconscious. READ IN EMERGENCIES A-Z Your Blood Pressure Score is as Important as Your Credit Score! ...

  2. Heat-Related Illnesses

    Full Text Available ... legs and stomach area. To treat, have the person rest in a cool place and give small ... sports liquid. (Do not give liquids if the person is unconscious.) Gently stretch and massage the affected ...

  3. Heat-Related Illnesses

    Full Text Available ... A Medical Emergency Childhood Emergencies Careers in Emergency Medicine Seconds Save Lives Be Prepared Safe Citizen Day ... So Long? Admission to the Hospital Heroes on Medicine's Front Line Observation Emergency Care Fact Sheet Health & ...

  4. Heat-Related Illnesses

    Full Text Available ... cool place and give small amounts of cool water, juice or a commercial sports liquid. (Do not ... non-caffeinated fluids. Apply cool, wet cloths or water mist while fanning the person. Seek immediate medical ...

  5. Exertional Heat Illness and Human Gene Expression

    Sonna, L.A; Sawka, M. N; Lilly, C. M

    2007-01-01

    Microarray analysis of gene expression at the level of RNA has generated new insights into the relationship between cellular responses to acute heat shock in vitro, exercise, and exertional heat illness...

  6. Heated hatha yoga to target cortisol reactivity to stress and affective eating in women at risk for obesity-related illnesses: A randomized controlled trial.

    Hopkins, Lindsey B; Medina, Johnna L; Baird, Scarlett O; Rosenfield, David; Powers, Mark B; Smits, Jasper A J

    2016-06-01

    Cortisol reactivity to stress is associated with affective eating, an important behavioral risk factor for obesity and related metabolic diseases. Yoga practice is related to decreases in stress and cortisol levels, thus emerging as a potential targeted complementary intervention for affective eating. This randomized controlled trial examined the efficacy of a heated, hatha yoga intervention for reducing cortisol reactivity to stress and affective eating. Females (N = 52; ages 25-46 years; 75% White) at risk for obesity and related illnesses were randomly assigned to 8 weeks of Bikram Yoga practice or to waitlist control. Cortisol reactivity to a laboratory stress induction were measured at Weeks 0 (pretreatment) and 9 (posttreatment). Self-reported binge eating frequency and coping motives for eating were assessed at Weeks 0, 3, 6, and 9. Among participants with elevated cortisol reactivity at pretreatment ("high reactors"), those randomized to the yoga condition evidenced greater pre- to posttreatment reductions in cortisol reactivity (p = .042, d = .85), but there were not significant condition differences for the "low reactors" (p = .178, d = .53). Yoga participants reported greater decreases in binge eating frequency (p = .040, d = .62) and eating to cope with negative affect (p = .038, d = .54). This study provides preliminary support for the efficacy of heated hatha yoga for treating physiological stress reactivity and affective eating among women at risk for obesity-related illnesses. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  7. Identification of barriers to the prevention and treatment of heat-related illness in Latino farmworkers using activity-oriented, participatory rural appraisal focus group methods.

    Lam, Michelle; Krenz, Jennifer; Palmández, Pablo; Negrete, Maria; Perla, Martha; Murphy-Robinson, Helen; Spector, June T

    2013-10-24

    Heat-related illness (HRI) is an important cause of non-fatal illness and death in farmworkers. We sought to identify potential barriers to HRI prevention and treatment in Latino farmworkers. We conducted three semi-structured focus group discussions with 35 Latino farmworkers in the Central Washington, USA area using participatory rural appraisal techniques. Interviews were audio taped and transcribed in Spanish. Three researchers reviewed and coded transcripts and field notes, and investigator triangulation was used to identify relevant themes and quotes. Although the majority of participants in our study reported never receiving formal HRI training, most participants were aware that extreme heat can cause illness and were able to accurately describe HRI symptoms, risk factors, and certain prevention strategies. Four main observations regarding farmworkers' HRI-relevant beliefs and attitudes were identified: 1) farmworkers subscribe to varying degrees to the belief that cooling treatments should be avoided after heat exposure, with some believing that such treatments should be avoided after heat exposure, and others encouraging the use of such treatments; 2) the desire to lose weight may be reflected in behaviors that promote increased sweating; 3) highly caffeinated energy drinks are preferred to increase work efficiency and maintain alertness; and 4) the location of drinking water at work (e.g. next to restrooms) and whether water is clean, but not necessarily chemically-treated, are important considerations in deciding whether to drink the water provided at worksites. We identified potential barriers to HRI prevention and treatment related to hydration, certain HRI treatments, clothing use, and the desire to lose weight among Latino farmworkers. Strategies to address potential barriers to HRI prevention and treatment in this population may include engineering, administrative, and health education and health promotion strategies at individual, workplace

  8. Temperature-Related Death and Illness. Chapter 2

    Sarofim, Marcus C.; Saha, Shubhayu; Hawkins, Michelle D.; Mills, David M.; Hess, Jeremy; Horton, Radley; Kinney, Patrick; Schwartz, Joel; St. Juliana, Alexis

    2016-01-01

    Based on present-day sensitivity to heat, an increase of thousands to tens of thousands of premature heat-related deaths in the summer and a decrease of premature cold-related deaths in the winter are projected each year as a result of climate change by the end of the century. Future adaptation will very likely reduce these impacts (see Changing Tolerance to Extreme Heat Finding). The reduction in cold-related deaths is projected to be smaller than the increase in heat-related deaths in most regions. Days that are hotter than usual in the summer or colder than usual in the winter are both associated with increased illness and death. Mortality effects are observed even for small differences from seasonal average temperatures. Because small temperature differences occur much more frequently than large temperature differences, not accounting for the effect of these small differences would lead to underestimating the future impact of climate change. An increase in population tolerance to extreme heat has been observed over time. Changes in this tolerance have been associated with increased use of air conditioning, improved social responses, and or physiological acclimatization, among other factors. Expected future increases in this tolerance will reduce the projected increase in deaths from heat. Older adults and children have a higher risk of dying or becoming ill due to extreme heat. People working outdoors, the socially isolated and economically disadvantaged, those with chronic illnesses, as well as some communities of color, are also especially vulnerable to death or illness.

  9. Exertional heat illness: emerging concepts and advances in prehospital care.

    Pryor, Riana R; Roth, Ronald N; Suyama, Joe; Hostler, David

    2015-06-01

    Exertional heat illness is a classification of disease with clinical presentations that are not always diagnosed easily. Exertional heat stroke is a significant cause of death in competitive sports, and the increasing popularity of marathons races and ultra-endurance competitions will make treating many heat illnesses more common for Emergency Medical Services (EMS) providers. Although evidence is available primarily from case series and healthy volunteer studies, the consensus for treating exertional heat illness, coupled with altered mental status, is whole body rapid cooling. Cold or ice water immersion remains the most effective treatment to achieve this goal. External thermometry is unreliable in the context of heat stress and direct internal temperature measurement by rectal or esophageal probes must be used when diagnosing heat illness and during cooling. With rapid recognition and implementation of effective cooling, most patients suffering from exertional heat stroke will recover quickly and can be discharged home with instructions to rest and to avoid heat stress and exercise for a minimum of 48 hours; although, further research pertaining to return to activity is warranted.

  10. A novel early risk assessment tool for detecting clinical outcomes in patients with heat-related illness (J-ERATO score: Development and validation in independent cohorts in Japan.

    Kei Hayashida

    Full Text Available We sought to develop a novel risk assessment tool to predict the clinical outcomes after heat-related illness.Prospective, multicenter observational study. Patients who transferred to emergency hospitals in Japan with heat-related illness were registered. The sample was divided into two parts: 60% to construct the score and 40% to validate it. A binary logistic regression model was used to predict hospital admission as a primary outcome. The resulting model was transformed into a scoring system.A total of 3,001 eligible patients were analyzed. There was no difference in variables between development and validation cohorts. Based on the result of a logistic regression model in the development phase (n = 1,805, the J-ERATO score was defined as the sum of the six binary components in the prehospital setting (respiratory rate≥22 /min, Glasgow coma scale0.2 by Hosmer-Lemeshow test. The observed proportion of hospital admission increased with increasing J-ERATO score (score = 0, 5.0%; score = 1, 15.0%; score = 2, 24.6%; score = 3, 38.6%; score = 4, 68.0%; score = 5, 85.2%; score = 6, 96.4%. Multivariate analyses showed that the J-ERATO score was an independent positive predictor of hospital admission (adjusted OR, 2.43; 95% CI, 2.06-2.87; P<0.001, intensive care unit (ICU admission (3.73; 2.95-4.72; P<0.001 and in-hospital mortality (1.65; 1.18-2.32; P = 0.004.The J-ERATO score is simply assessed and can facilitate the identification of patients with higher risk of heat-related hospitalization. This scoring system is also significantly associated with the higher likelihood of ICU admission and in-hospital mortality after heat-related hospitalization.

  11. Exertional Heat Illness among Secondary School Athletes: Statewide Policy Implications

    Rodgers, Jill; Slota, Peggy; Zamboni, Beth

    2018-01-01

    Exertional heat illness (EHI) is a leading cause of preventable death among student athletes. While causes and preventative measures for EHI are known, school districts may not be implementing evidence-based practices. This descriptive, exploratory study explored school policies, resources, and practices of coaches in a mid-Atlantic state in the…

  12. Conjugate gradient heat bath for ill-conditioned actions.

    Ceriotti, Michele; Bussi, Giovanni; Parrinello, Michele

    2007-08-01

    We present a method for performing sampling from a Boltzmann distribution of an ill-conditioned quadratic action. This method is based on heat-bath thermalization along a set of conjugate directions, generated via a conjugate-gradient procedure. The resulting scheme outperforms local updates for matrices with very high condition number, since it avoids the slowing down of modes with lower eigenvalue, and has some advantages over the global heat-bath approach, compared to which it is more stable and allows for more freedom in devising case-specific optimizations.

  13. Exertional Heat Illness and Hyponatremia: An Epidemiological Prospective

    2008-01-01

    physical fitness Excessive body weight Dehydration >1-h aerobic intense exercise Alcohol Peer pressure/motivation Medical Febrile illness...The use of stimulants (e.g., ephedra, cocaine, heroin , and methamphetamine) has been associated as a risk factor in EHI. Stimulants increase heat...the casual pathway of HYPO. Hyponatremia (water intoxication ) during endurance exercise was first described by Noakes and colleagues (2) and has been

  14. Heated hatha yoga to target cortisol reactivity to stress and affective eating in women at risk for obesity-related illnesses: A randomized controlled trial

    Hopkins, L.B.; Medina, J.L.; Baird, S.O.; Rosenfield, D.; Powers, M.B.; Smits, J.A.J.

    2016-01-01

    Objective: Cortisol reactivity to stress is associated with affective eating, an important behavioral risk factor for obesity and related metabolic diseases. Yoga practice is related to decreases in stress and cortisol levels, thus emerging as a potential targeted complementary intervention for

  15. Preventing heat illness in the anticipated hot climate of the Tokyo 2020 Summer Olympic Games.

    Kakamu, Takeyasu; Wada, Koji; Smith, Derek R; Endo, Shota; Fukushima, Tetsuhito

    2017-09-19

    Amid the effects of global warming, Tokyo has become an increasingly hot city, especially during the summertime. To prepare for the upcoming 2020 Summer Olympics and Paralympics in Tokyo, all participants, including the athletes, staff, and spectators, will need to familiarize themselves with Tokyo's hot and humid summer conditions. This paper uses the wet-bulb globe temperature (WBGT) index, which estimates the risk of heat illness, to compare climate conditions of sports events in Tokyo with the conditions of the past three Summer Olympics (held in Rio de Janeiro, London, and Beijing) and to subsequently detail the need for establishing appropriate countermeasures. We compared WBGT results from the past three Summer Olympics with the same time periods in Tokyo during 2016. There was almost no time zone where a low risk of heat illness could be expected during the time frame of the upcoming 2020 Tokyo Olympics. We also found that Tokyo had a higher WBGT than any of those previous host cities and is poorly suited for outdoor sporting events. Combined efforts by the official organizers, government, various related organizations, and the participants will be necessary to deal with these challenging conditions and to allow athletes to perform their best, as well as to prevent heat illnesses among staff and spectators. The sporting committees, as well as the Olympic organizing committee, should consider WBGT measurements in determining the venues and timing of the events to better avoid heat illness and facilitate maximum athletic performance.

  16. National Athletic Trainers' Association Position Statement: Exertional Heat Illnesses.

    Casa, Douglas J; DeMartini, Julie K; Bergeron, Michael F; Csillan, Dave; Eichner, E Randy; Lopez, Rebecca M; Ferrara, Michael S; Miller, Kevin C; O'Connor, Francis; Sawka, Michael N; Yeargin, Susan W

    2015-09-01

    To present best-practice recommendations for the prevention, recognition, and treatment of exertional heat illnesses (EHIs) and to describe the relevant physiology of thermoregulation. Certified athletic trainers recognize and treat athletes with EHIs, often in high-risk environments. Although the proper recognition and successful treatment strategies are well documented, EHIs continue to plague athletes, and exertional heat stroke remains one of the leading causes of sudden death during sport. The recommendations presented in this document provide athletic trainers and allied health providers with an integrated scientific and clinically applicable approach to the prevention, recognition, treatment of, and return-to-activity guidelines for EHIs. These recommendations are given so that proper recognition and treatment can be accomplished in order to maximize the safety and performance of athletes. Athletic trainers and other allied health care professionals should use these recommendations to establish onsite emergency action plans for their venues and athletes. The primary goal of athlete safety is addressed through the appropriate prevention strategies, proper recognition tactics, and effective treatment plans for EHIs. Athletic trainers and other allied health care professionals must be properly educated and prepared to respond in an expedient manner to alleviate symptoms and minimize the morbidity and mortality associated with these illnesses.

  17. Clinical Management of Heat-Related Illnesses

    2012-01-01

    from CNS impairment.18,41,102 Hyperventilation and elevation of Tco primarily lead to respiratory alkalosis , which in EHS may be masked by metabolic...acute phase.69,102,116 Other common disturbances during the acute phase occur in the gastrointestinal and respiratory systems. Gastrointestinal dys...acidosis as a result of increased glycolysis and hyperlacticacidemia.26,74 Hypoxemia may be present in patients with respiratory complica- tions

  18. Relatives perception of writing diaries for critically ill

    Nielsen, Anne Højager; Angel, Sanne

    2015-01-01

    BACKGROUND: Diaries written by nurses for the critically ill patient help the relatives cope and support the patient. Relatives may participate in writing a diary for the critically ill and when they do this is appreciated by the patients. However, the relative's perception of writing a diary has...... not previously been explored. AIM: To explore how relatives perceive writing a diary for the critically ill patient. METHOD: In a phenomenological-hermeneutic study building on the theory of Ricoeur interviews with seven relatives were conducted and interpreted. FINDINGS: When relatives wrote a diary...

  19. Job anxiety, work-related psychological illness and workplace performance

    Jones, Melanie; Latreille, Paul L.; Sloane, Peter J.

    2016-01-01

    This paper uses matched employee-employer data from the British Workplace Employment Relations Survey (WERS) 2004 to examine the determinants of employee job anxiety and work-related psychological illness. Job anxiety is found to be strongly related to the demands of the job as measured by factors such as occupation, education and hours of work. Average levels of employee job anxiety, in turn, are positively associated with work-related psychological illness among the workforce as reported by...

  20. Heat illness and death among workers - United States, 2012-2013.

    Arbury, Sheila; Jacklitsch, Brenda; Farquah, Opeyemi; Hodgson, Michael; Lamson, Glenn; Martin, Heather; Profitt, Audrey

    2014-08-08

    Exposure to heat and hot environments puts workers at risk for heat stress, which can result in heat illnesses and death. This report describes findings from a review of 2012‒2013 Occupational Safety and Health Administration (OSHA) federal enforcement cases (i.e., inspections) resulting in citations under paragraph 5(a)(1), the "general duty clause" of the Occupational Safety and Health Act of 1970. That clause requires that each employer "furnish to each of his employees employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm to his employees". Because OSHA has not issued a heat standard, it must use 5(a)(1) citations in cases of heat illness or death to enforce employers' obligations to provide a safe and healthy workplace. During the 2-year period reviewed, 20 cases of heat illness or death were cited for federal enforcement under paragraph 5(a)(1) among 18 private employers and two federal agencies. In 13 cases, a worker died from heat exposure, and in seven cases, two or more employees experienced symptoms of heat illness. Most of the affected employees worked outdoors, and all performed heavy or moderate work, as defined by the American Conference of Governmental Industrial Hygienists. Nine of the deaths occurred in the first 3 days of working on the job, four of them occurring on the worker's first day. Heat illness prevention programs at these workplaces were found to be incomplete or absent, and no provision was made for the acclimatization of new workers. Acclimatization is the result of beneficial physiologic adaptations (e.g., increased sweating efficiency and stabilization of circulation) that occur after gradually increased exposure to heat or a hot environment. Whenever a potential exists for workers to be exposed to heat or hot environments, employers should implement heat illness prevention programs (including acclimatization requirements) at their

  1. Parents' and Coaches' Guide to Dehydration and Other Heat Illnesses in Children

    ... gives specific return-to-play instructions. Parents should work with the child’s doctor to rule out or treat any other conditions or illnesses that may cause continued problems with heat stroke. The child should ...

  2. National Database for Clinical Trials Related to Mental Illness (NDCT)

    U.S. Department of Health & Human Services — The National Database for Clinical Trials Related to Mental Illness (NDCT) is an extensible informatics platform for relevant data at all levels of biological and...

  3. Conceptualizations of illness among relatives of patients diagnosed with schizophrenia.

    Villares, Cecília C; Redko, Cristina P; Mari, Jair J

    2017-06-01

    Family concepts of a relative's illness are an important part of the coping process and reveal the cultural construction of the experience of illness. As part of a qualitative study conducted in the Schizophrenia Outpatient Clinic of the Department of Psychiatry, Escola Paulista de Medicina - UNIFESP, 14 relatives of eight outpatients diagnosed with schizophrenia were interviewed and invited to talk freely about their ideas and feelings concerning their relative's problem. Qualitative analysis was used to identify categories of illness representations. Three main categories were discussed, including Problema de Nervoso, Problema na Cabeça and Problema Espiritual (Problem of the Nerves, Problem in the Head and Spiritual Problem). The authors present evidence of these categories as cultural constructions, and discuss the relevance of popular notions of illness to the understanding of the course and outcome of schizophrenia, and the planning of culturally meaningful interventions.

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

    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...

  5. Recruitment, Methods, and Descriptive Results of a Physiologic Assessment of Latino Farmworkers: The California Heat Illness Prevention Study.

    Mitchell, Diane C; Castro, Javier; Armitage, Tracey L; Vega-Arroyo, Alondra J; Moyce, Sally C; Tancredi, Daniel J; Bennett, Deborah H; Jones, James H; Kjellstrom, Tord; Schenker, Marc B

    2017-07-01

    The California heat illness prevention study (CHIPS) devised methodology and collected physiological data to assess heat related illness (HRI) risk in Latino farmworkers. Bilingual researchers monitored HRI across a workshift, recording core temperature, work rate (metabolic equivalents [METs]), and heart rate at minute intervals. Hydration status was assessed by changes in weight and blood osmolality. Personal data loggers and a weather station measured exposure to heat. Interviewer administered questionnaires were used to collect demographic and occupational information. California farmworkers (n = 588) were assessed. Acceptable quality data was obtained from 80% of participants (core temperature) to 100% of participants (weight change). Workers (8.3%) experienced a core body temperature more than or equal to 38.5 °C and 11.8% experienced dehydration (lost more than 1.5% of body weight). Methodology is presented for the first comprehensive physiological assessment of HRI risk in California farmworkers.

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

    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.

  7. Categorizing food-related illness: Have we got it right?

    Manning, Louise

    2017-06-13

    Since the 1950s food safety hazards have been categorized simply as (micro) biological, chemical or physical hazards with no clear differentiation between those that cause acute and chronic harm. Indeed international risk assessment methods, including hazard analysis critical control point (HACCP) use these criteria. However, the spectrum of food related illness continues to grow now encompassing food allergy and intolerance, obesity, type 2 diabetes, stroke, heart disease, cancer as well as food poisoning, foodborne illness and food contamination. Therefore over a half-century later is this the time to redefine the spectrum of what constitutes food related illness? This paper considers whether such "redefinition" of food related intoxicating and infectious agents would provide more targeted policy instruments and lead to better risk assessment and thus mitigation of such risk within the food supply chain.

  8. Relatives to Critically Ill Patients Have No Sense of Coherence

    Laursen, Jannie; Andresen, Kristoffer; Rosenberg, Jacob

    2016-01-01

    shown that relatives do not always receive the attention they need from health professionals. There is a lack of studies that focus on relatives' satisfaction and involvement during their family members' hospitalization. Design. A mixed methods design was chosen. Methods. A quantitative study...... of the dissatisfaction, a qualitative approach was used and the in-depth interviews revealed three themes: lack of continuity and structure, responsibility of coordination, and relatives feeling left on their own with no guiding and support. Conclusion. Health professionals' key role in relation to relatives must......Aims and Objective. To investigate the relatives' satisfaction and involvement on a general surgery ward regarding the critically ill patient. Introduction. Relatives to critically ill patients are affected both physically and mentally during the hospitalization of a family member. Research has...

  9. Burden and Risk Factors for Cold-Related Illness and Death in New York City

    Kathryn Lane

    2018-03-01

    Full Text Available Exposure to cold weather can cause cold-related illness and death, which are preventable. To understand the current burden, risk factors, and circumstances of exposure for illness and death directly attributed to cold, we examined hospital discharge, death certificate, and medical examiner data during the cold season from 2005 to 2014 in New York City (NYC, the largest city in the United States. On average each year, there were 180 treat-and-release emergency department visits (average annual rate of 21.6 per million and 240 hospital admissions (29.6 per million for cold-related illness, and 15 cold-related deaths (1.8 per million. Seventy-five percent of decedents were exposed outdoors. About half of those exposed outdoors were homeless or suspected to be homeless. Of the 25% of decedents exposed indoors, none had home heat and nearly all were living in single-family or row homes. The majority of deaths and illnesses occurred outside of periods of extreme cold. Unsheltered homeless individuals, people who use substances and become incapacitated outdoors, and older adults with medical and psychiatric conditions without home heat are most at risk. This information can inform public health prevention strategies and interventions.

  10. How diaries written for critically ill influence the relatives

    Nielsen, Anne Højager; Angel, Sanne

    2016-01-01

    BACKGROUND: Diaries written by nurses for the critically ill patient helps relatives cope and support the patient. When relatives participate in writing a diary for the critically ill, patients appreciate it. Furthermore, the diary may reduce post-traumatic stress disorder, anxiety and depression......-selected articles. Finally, 10 articles were included in this review structured by the Matrix method. INCLUSION CRITERIA: (a) Original scientific work, (b) relatives participation and experience of the diary as subject and (c) diaries studied in an intensive care unit setting. FINDINGS: Relatives were given...... instructions on how to write in the diary. They expressed strong feelings in the diary in a very different way than health care staff. The relatives used the diary themselves to gain understanding and to cope. The diary has been shown to prevent post-traumatic stress symptoms. CONCLUSION: The relatives express...

  11. Individual Differences on Job Stress and Related Ill Health

    Miodraga Stefanovska Petkovska

    2014-03-01

    Conclusion: Employees are exposed to many potential work related stressors which differently affect their job satisfaction and result in ill health. A better understanding of the individual characteristics and potential stressors should subsequently help managers' better deal with this problem. This underlines the need for further research and design of stress reduction interventions.

  12. Job Stress, Job Dissatisfaction and Stress Related Illnesses Among ...

    The aim of this study was to explore the relationship between self-reported job stress and job dissatisfaction and the prevalence of stress related illnesses and risk factors amongst educators. A cross-sectional survey was conducted in a representative sample of 21,307 educators from public schools in South Africa.

  13. 'This stroke was sent…': Stroke-related illness concepts and ...

    Though there is evidence that stroke incidence is increasing even in low and middle income countries, there is no study of stroke-related illness concepts and HSB in Nigerians. Data from 960 educated Nigerians were analysed. Eight hundred and fifty four respondents (431 aged 20-40 years and 423 aged 41 years or ...

  14. Climatic and psychosocial risks of heat illness incidents on construction site.

    Jia, Yunyan Andrea; Rowlinson, Steve; Ciccarelli, Marina

    2016-03-01

    The study presented in this paper aims to identify prominent risks leading to heat illness in summer among construction workers that can be prioritised for developing effective interventions. Samples are 216 construction workers' cases at the individual level and 26 construction projects cases at the organisation level. A grounded theory is generated to define the climatic heat and psychosocial risks and the relationships between risks, timing and effectiveness of interventions. The theoretical framework is then used to guide content analysis of 36 individual onsite heat illness cases to identify prominent risks. The results suggest that heat stress risks on construction site are socially constructed and can be effectively managed through elimination at supply chain level, effective engineering control, proactive control of the risks through individual interventions and reactive control through mindful recognition and response to early symptoms. The role of management infrastructure as a base for effective interventions is discussed. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  15. Knowledge and awareness of heat-related morbidity among adult recreational endurance athletes

    Shendell, Derek G.; Alexander, Melannie S.; Lorentzson, Lauren; McCarty, Frances A.

    2010-07-01

    Adults have been increasingly motivated to compete in recreational endurance sports events. Amateurs may lack a complete understanding of recommended strategies for handling heat and humidity, making heat-related illnesses increasingly possible. This is compounded by global climate change and increasing average surface and air temperatures, especially in urban areas of industrialized nations in Europe and North America that have hosted most events to date. We conducted an on-line, secure survey at the 2nd Annual ING Georgia Marathon and Half-Marathon in Atlanta, Georgia, in 2008. We included previously validated questions on participant socio-demographics, training locations, and knowledge and awareness of heat-related illnesses. Participants were aware of heat illnesses, and of heat stroke as a serious form of heat stress. However, the majority, across age and gender, did not understand the potential severity of heat stroke. Furthermore, 1-in-5 participants did not understand the concept of heat stress as a form of heat-related illness, and how heat stress may result from buildup of muscle-generated heat in the body. Adult recreational endurance athletes are another susceptible, vulnerable population sub-group for applied research and public health educational interventions, especially in urban areas of industrialized nations in Europe and North America.

  16. Heat illness surveillance in schoolboys participating in physical education class in tropical climate: an analytical prospective descriptive study.

    Somboonwong, Juraiporn; Sanguanrungsirikul, Sompol; Pitayanon, Chatchatchai

    2012-01-01

    This study aimed to determine thermoregulatory and cardiovascular responses as well as the occurrence of heat illness in children exercising outdoors in physical education class under hot and humid climate. Little information regarding this issue under real-life situation is available, especially in the Southeast Asia. Analytical, prospective descriptive study. A primary school in Bangkok, Thailand. A total of 457 schoolboys (aged 5.5-12 years) were observed while exercising outdoors during their physical education classes throughout the academic year of 2009, including semester 1 (between July and September 2009) and semester 2 (between November 2009 and February 2010). Primary outcome measure was tympanic temperature. Secondary outcome measures included blood pressure, heart rate, hydration status and the occurrence of heat-related illness. Outdoor physical activity consisted of skill practice (duration 24.11±11.04 min, intensity risk for heat illness during outdoor activities in physical education class in primary school children, especially those who are overweight and have poor hydration status.

  17. Numerical approximation of null controls for the heat equation: Ill-posedness and remedies

    Münch, Arnaud; Zuazua, Enrique

    2010-01-01

    The numerical approximation of exact or trajectory controls for the wave equation is known to be a delicate issue, since the pioneering work of Glowinski–Lions in the nineties, because of the anomalous behavior of the high-frequency spurious numerical waves. Various efficient remedies have been developed and analyzed in the last decade to filter out these high-frequency components: Fourier filtering, Tychonoff's regularization, mixed finite-element methods, multi-grid strategies, etc. Recently convergence rate results have also been obtained. This work is devoted to analyzing this issue for the heat equation, which is the opposite paradigm because of its strong dissipativity and smoothing properties. The existing analytical results guarantee that, at least in some simple situations, as in the finite-difference scheme in 1 − d, the null or trajectory controls for numerical approximation schemes converge. This is due to the intrinsic high-frequency damping of the heat equation that is inherited by its numerical approximation schemes. But when developing numerical simulations the topic appears to be much more subtle and difficult. In fact, efficiently computing the null control for a numerical approximation scheme of the heat equation is a difficult problem in itself. The difficulty is strongly related to the regularizing effect of the heat kernel. The controls of minimal L 2 -norm are characterized as minima of quadratic functionals on the solutions of the adjoint heat equation, or its numerical versions. These functionals are shown to be coercive in very large spaces of solutions, sufficient to guarantee the L 2 character of controls, but very far from being identifiable as energy spaces for the adjoint system. The very weak coercivity of the functionals under consideration makes the approximation problem exponentially ill-posed and the functional framework far from being well adapted to standard techniques in numerical analysis. In practice, the controls of the

  18. Exertional Heat Illnesses and Environmental Conditions During High School Football Practices.

    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

  19. Illness related wage and productivity losses: Valuing 'presenteeism'.

    Zhang, Wei; Sun, Huiying; Woodcock, Simon; Anis, Aslam

    2015-12-01

    One source of productivity loss due to illness is the reduced "quantity" or "quality" of labor input while working, often referred to as presenteeism. Illness-related presenteeism has been found to be potentially more costly than absenteeism. To value presenteeism, existing methods use wages as a proxy for marginal productivity at the firm level. However, wage may not equal marginal productivity in some scenarios. One instance is when a job involves team production and perfect substitutes for workers are not readily available. Using a Canadian linked employer-employee survey (2001-2005), we test whether relative wage equals relative marginal productivity among team workers and non-team workers with different frequencies of presenteeism (reduction at work due to illness). For the pooled cross-sectional estimates (2001, 2003, 2005) we obtain 13,755 observations with 6842 unique workplaces. There are 6490 observations for the first differences estimates from the odd years and 5263 observations for the first differences estimates from 2001 to 2002 and 2003 to 2004. We find that in both small and large firms, team workers with frequent reductions at work are less productive but earn similarly compared with non-team workers without reductions. We also find that in small firms, workers with occasional work reductions are more productive than workers without reductions, but the reverse is true in large firms. The study findings partially support the literature stating that productivity loss resulting from employee presenteeism could exceed wages if team work is involved. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Prediction of heat-illness symptoms with the prediction of human vascular response in hot environment under resting condition.

    Aggarwal, Yogender; Karan, Bhuwan Mohan; Das, Barsa Nand; Sinha, Rakesh Kumar

    2008-04-01

    The thermoregulatory control of human skin blood flow is vital to maintain the body heat storage during challenges of thermal homeostasis under heat stress. Whenever thermal homeostasis disturbed, the heat load exceeds heat dissipation capacity, which alters the cutaneous vascular responses along with other body physiological variables. Whole body skin blood flow has been calculated from the forearm blood flow. Present model has been designed using electronics circuit simulator (Multisim 8.0, National Instruments, USA), is to execute a series of predictive equations for early prediction of physiological parameters of young nude subjects during resting condition at various level of dry heat stress under almost still air to avoid causalities associated with hot environmental. The users can execute the model by changing the environmental temperature in degrees C and exposure time in minutes. The model would be able to predict and detect the changes in human vascular responses along with other physiological parameters and from this predicted values heat related-illness symptoms can be inferred.

  1. Implementing exertional heat illness prevention strategies in US high school football.

    Kerr, Zachary Y; Marshall, Stephen W; Comstock, R Dawn; Casa, Douglas J

    2014-01-01

    Approximately 6500 high school football athletes are treated annually for exertional heat illness (EHI). In 2009, the National Athletic Trainers Association (NATA)-led Inter-Association Task Force (NATA-IATF) released preseason heat acclimatization guidelines to help athletes become accustomed to environmental factors contributing to EHI. This study examines compliance with NATA-IATF guidelines and related EHI prevention strategies. The study used a cross-sectional survey completed by 1142 certified athletic trainers (AT), which captured compliance with 17 NATA-IATF guidelines and EHI prevention strategies in high school football during the 2011 preseason. On average, AT reported football programs complying with 10.4 NATA-IATF guidelines (SD = 3.2); 29 AT (2.5%) reported compliance with all 17. Guidelines with the lowest compliance were as follows: "Single-practice days consisted of practice no more than three hours in length" (39.7%); and "During days 3-5 of acclimatization, only helmets and shoulder pads should be worn" (39.0%). An average of 7.6 EHI prevention strategies (SD = 2.5) were used. Common EHI prevention strategies were as follows: having ice bags/cooler available (98.5%) and having a policy with written instructions for initiating emergency medical service response (87.8%). Programs in states with mandated guidelines had higher levels of compliance with guidelines and greater prevalence of EHI prevention strategies. A low proportion of surveyed high school football programs fully complied with all 17 NATA-IATF guidelines. However, many EHI prevention strategies were voluntarily implemented. State-level mandated EHI prevention guidelines may increase compliance with recognized best practices recommendations. Ongoing longitudinal monitoring of compliance is also recommended.

  2. Illness perception and related behaviour in lower respiratory tract infections-a European study

    Hordijk, Patricia M.; Broekhuizen, Berna D L; Butler, Chris C.; Coenen, Samuel; Godycki-Cwirko, Maciek; Goossens, Herman; Hood, Kerry; Smith, Richard; de Vries-van Vugt, Saskia F.; Little, Paul; Verheij, Theo J M

    2015-01-01

    Background. Lower respiratory tract infection (LRTI) is a common presentation in primary care, but little is known about associated patients' illness perception and related behaviour. Objective. To describe illness perceptions and related behaviour in patients with LRTI visiting their general

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

    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.

  4. Illness Perceptions and Depression in Relation to Self-care ...

    depression and illness beliefs influence self-care behaviour. Keywords: Illness ... patients in Rwanda will provide new information on which to base further ... English, to facilitate the data collection process we used a translated version of the ...

  5. Attending Weak Signals: The Prevention of Work-related Illnesses

    Roy Liff

    2017-06-01

    Full Text Available This article examines the characteristics of communication among managers, human resource (HR experts, and occupational health care specialists, as they deal with such informal information as weak signals in the prevention of work-related illnesses, using a theoretical framework in which the prevention of work-related illness is analogous to theory on crisis management. This is a qualitative study in which individual and focus-group interviews were conducted in a Swedish context with occupational health care specialists, managers, and HR experts. The results suggest that organizational solutions have failed and continue to fail at controlling workers’ health problems, although the main difficulty is not in identifying the ‘right’ individually oriented weak signals. Rather, it is upper management’s reliance on formal information (e.g., statistics and surveys – because of the difficulty in supplementing it with informal information (e.g., rumors and gossip – that makes it difficult to improve traditional health and safety work

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

    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.

  7. The challenge of unravelling family resemblance related to illness behaviour.

    Cardol, M.; Groenewegen, P.P.; Spreeuwenberg, P.; Dijk, L. van; Bosch, W. van den; Bakker, D.H. de

    2005-01-01

    Background: Efforts to promote health or prevent disease may conflict with patients’ habits at home. Irrespective of the national setting, families are important social contexts in which illness occurs and resolves. Family members resemble each other in their illness behaviour, even across

  8. Perceptions of mental illness and related stigma among Vietnamese populations: findings from a mixed method study.

    Do, Mai; Pham, Nhu Ngoc K; Wallick, Stacy; Nastasi, Bonnie Kaul

    2014-12-01

    Mental-illness-related (MIR) stigma is recognized as a major barrier to health care. Yet very little is known about mental illness and stigma among Vietnamese populations, or how emigration and acculturation processes might affect traditional views. Focus group discussions were conducted with Vietnamese Americans in New Orleans (Louisiana) and Vietnamese nationals in Bui Chu (Vietnam), who shared historical and cultural backgrounds, in 2010 to assess differences in their perceptions of mental illness and stigma. Results show several significant differences in mental illness perceptions between Vietnamese Americans and Vietnamese nationals, while MIR stigma seemed prevalent and understanding of mental illness was low among both groups.

  9. Climate and heat-related emergencies in Chicago, Illinois (2003-2006).

    Hartz, Donna A; Golden, Jay S; Sister, Chona; Chuang, Wen-Ching; Brazel, Anthony J

    2012-01-01

    Extreme heat events are responsible for more deaths in the United States than floods, hurricanes and tornados combined. Yet, highly publicized events, such as the 2003 heat wave in Europe which caused in excess of 35,000 deaths, and the Chicago heat wave of 1995 that produced over 500 deaths, draw attention away from the countless thousands who, each year, fall victim to nonfatal health emergencies and illnesses directly attributed to heat. The health impact of heat waves and excessive heat are well known. Cities worldwide are seeking to better understand heat-related illnesses with respect to the specifics of climate, social demographics and spatial distributions. This information can support better preparation for heat-related emergency situations with regards to planning for response capacity and placement of emergency resources and personnel. This study deals specifically with the relationship between climate and heat-related dispatches (HRD, emergency 911 calls) in Chicago, Illinois, between 2003 and 2006. It is part of a larger, more in-depth, study that includes urban morphology and social factors that impact heat-related emergency dispatch calls in Chicago. The highest occurrences of HRD are located in the central business district, but are generally scattered across the city. Though temperature can be a very good predictor of high HRD, heat index is a better indicator. We determined temperature and heat index thresholds for high HRD. We were also able to identify a lag in HRD as well as other situations that triggered higher (or lower) HRD than would typically be generated for the temperature and humidity levels, such as early afternoon rainfall and special events.

  10. Body Consciousness, Illness-Related Impairment, and Patient Adherence in Hemodialysis.

    Christensen, Alan J.; And Others

    1996-01-01

    Examined the joint effects of private body consciousness (PBC) and degree of illness-related physical impairment on treatment regimen adherence in a sample of 52 hemodialysis patients. Predicted the effect of PBC on adherence would vary as a function of patients' level of illness-related physical impairment. Results are discussed in terms of…

  11. Illnesses in siblings of US patients with bipolar disorder relate to multigenerational family history and patients severity of illness.

    Post, Robert M; Altshuler, Lori L; Kupka, Ralph; McElroy, Susan L; Frye, Mark A; Rowe, Michael; Grunze, Heinz; Suppes, Trisha; Keck, Paul E; Nolen, Willem A

    2017-01-01

    Patients with bipolar disorder from the US have more early-onset illness and a greater familial loading for psychiatric problems than those from the Netherlands or Germany (abbreviated here as Europe). We hypothesized that these regional differences in illness burden would extend to the patients siblings. Outpatients with bipolar disorder gave consent for participation in a treatment outcome network and for filling out detailed questionnaires. This included a family history of unipolar depression, bipolar disorder, suicide attempt, alcohol abuse/dependence, drug abuse/dependence, and "other" illness elicited for the patients' grandparents, parents, spouses, offspring, and siblings. Problems in the siblings were examined as a function of parental and grandparental problems and the patients' adverse illness characteristics or poor prognosis factors (PPFs). Each problem in the siblings was significantly (pUS than in those from Europe. In the US, problems in the parents and grandparents were almost uniformly associated with the same problems in the siblings, and sibling problems were related to the number of PPFs observed in the patients. Family history was based on patient report. Increased familial loading for psychiatric problems extends through 4 generations of patients with bipolar disorder from the US compared to Europe, and appears to "breed true" into the siblings of the patients. In addition to early onset, a variety of PPFs are associated with the burden of psychiatric problems in the patients' siblings and offspring. Greater attention to the multigenerational prevalence of illness in patients from the US is indicated. Copyright © 2016 Elsevier B.V. All rights reserved.

  12. Agreement between children and parents demonstrated that illness-related absenteeism was validly reported by children.

    Denbæk, Anne Maj; Bonnesen, Camilla Thørring; Andersen, Anette; Holstein, Bjørn Evald; Laursen, Bjarne; Due, Pernille; Johansen, Anette

    2016-01-01

    To examine the agreement between children's and parents' reporting of illness-related absenteeism from school and to examine predictors for disagreement between children and parents. A total of 8,438 schoolchildren aged from 5 to 15 years (grade 0-8) and one parent of each child were invited to participate in the Hi Five baseline study. The response rate for children answering a questionnaire was 89% (n = 7,525), and 36% of the parents (n = 3,008) participated in a weekly illness registration study using text messages (short message service) over a period of 22 weeks. Text messages and questionnaire data were linked at the individual level, leaving 2,269 child-parent pairs in the analysis, corresponding to 27% of the eligible sample. The agreement between children's and parents' reports of illness-related absenteeism was good, with high absolute agreement and slight to moderate Ƙ values. Agreement was lowest for 6- to 8-year-olds and highest for 11- to 12-year-olds. Children's reports of illness symptoms and parents' reports of their children's illnesses in the preceding week were strong predictors for children reporting illness-related absenteeism when parents did not. Illness-related absenteeism can be reported by children, and children report higher prevalence of illness-related absenteeism than parents. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Agreement between children and parents demonstrated that illness-related absenteeism was validly reported by children

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

    2016-01-01

    OBJECTIVES: To examine the agreement between children's and parents' reporting of illness-related absenteeism from school and to examine predictors for disagreement between children and parents. STUDY DESIGN AND SETTING: A total of 8,438 schoolchildren aged from 5 to 15 years (grade 0-8) and one...... of 22 weeks. Text messages and questionnaire data were linked at the individual level, leaving 2,269 child-parent pairs in the analysis, corresponding to 27% of the eligible sample. RESULTS: The agreement between children's and parents' reports of illness-related absenteeism was good, with high absolute...... agreement and slight to moderate Ƙ values. Agreement was lowest for 6- to 8-year-olds and highest for 11- to 12-year-olds. Children's reports of illness symptoms and parents' reports of their children's illnesses in the preceding week were strong predictors for children reporting illness-related absenteeism...

  14. Relative Effects of Three Questioning Strategies in Ill-Structured, Small Group Problem Solving

    Byun, Hyunjung; Lee, Jung; Cerreto, Frank A.

    2014-01-01

    The purpose of this research is to investigate the relative effectiveness of using three different question-prompt strategies on promoting metacognitive skills and performance in ill-structured problem solving by examining the interplay between peer interaction and cognitive scaffolding. An ill-structured problem-solving task was given to three…

  15. Epidemiology of Exertional Heat Illnesses in Youth, High School, and College Football.

    Yeargin, Susan W; Kerr, Zachary Y; Casa, Douglas J; Djoko, Aristarque; Hayden, Ross; Parsons, John T; Dompier, Thomas P

    2016-08-01

    Data on exertional heat illness (EHI) in youth football are limited and have not been compared across competition levels. This study describes the epidemiology of EHI events in youth, high school (HS), and college football in the 2012-2014 seasons. One hundred and eighteen youth teams (players age 5-14 yr), 96 HS programs (~14-18 yr), and 34 college programs (~18-23 yr) participated. During games and practices, athletic trainers recorded EHI events and athlete exposures (AE), defined as one athlete participating in one game/practice. We calculated the number of reported EHI by time in season, game/practice, and need for emergency transportation. EHI rates, risk, included rate ratios (IRR), and risk ratios (RR) with 95% confidence intervals (CI) were calculated in 2015. EHI rates for youth, HS, and college football were 1.82, 0.57, and 1.67/10,000 AE, respectively. Rates were highest during the preseason (youth: 2.76; HS: 1.47; college: 3.66/10,000 AE). Game rates were higher than practice rates in youth (4.04 vs 1.22/10,000 AE; IRR = 3.31; 95% CI, 1.75-6.26) and college (4.42 vs 1.38/10,000 AE; IRR = 3.21; 95% CI, 2.00-5.16); the practice rate was higher than the game rate in HS (0.63 vs 0.27/10,000 AE; IRR = 2.33; 95% CI, 1.01-5.38). The EHI risk was higher in college (0.9%) than in youth (0.6%; RR = 1.59; 95% CI, 1.06-2.37) and HS (0.5%; RR = 2.01; 95% CI, 1.43-2.81). Common EHI events included heat cramps (youth: 15.8%; HS: 28.6%; college: 45.6%), heat exhaustion (youth: 42.1%; HS: 32.9%; college: 20.0%), and dehydration (youth: 31.6%; HS: 28.6%; college: 28.9%). EHI risk was low. Higher preseason football EHI rates across levels emphasize developing and continually modifying preseason heat acclimatization policies. Lower EHI rates in HS games and youth practices may be attributable to night events, suggesting the importance of modifying/canceling events based on environmental conditions.

  16. Leave for illness/accident or in the event of illness of a close relative - New medical certificate templates

    HR department

    2016-01-01

    Medical certificate templates are now available in the Admin e-guide (follow the “Forms and templates” link):    Medical certificate for illness/accident Medical certificate for a medical examination or treatment Medical certificate in the event of illness of a close relative These templates are provided for the convenience of members of the personnel and their use is recommended but not compulsory. Other forms of medical certificates issued by a medical doctor may also be submitted, provided they contain the same items of information as those given in the templates. More information on the applicable rules and on the way leave is managed at CERN can be found in the Admin e-guide web pages. Human Resources department HR.leave@cern.ch

  17. Workers’ perceptions of climate change related extreme heat exposure in South Australia: a cross-sectional survey

    Jianjun Xiang

    2016-07-01

    Full Text Available Abstract Background Occupational exposure to extreme heat without sufficient protection may not only increase the risk of heat-related illnesses and injuries but also compromise economic productivity. With predictions of more frequent and intense bouts of hot weather, workplace heat exposure is presenting a growing challenge to workers’ health and safety. This study aims to investigate workers’ perceptions and behavioural responses towards extreme heat exposure in a warming climate. Methods A cross-sectional questionnaire survey was conducted in 2012 in South Australia among selected outdoor industries. Workers’ heat risk perceptions were measured in the following five aspects: concerns about heat exposure, attitudes towards more training, policy and guideline support, the adjustment of work habits, and degree of satisfaction of current preventive measures. Bivariate and multivariate logistic regression analyses were used to identify factors significantly associated with workers’ heat perceptions. Results A total of 749 respondents participated in this survey, with a response rate of 50.9 %. A little more than half (51.2 % of respondents were moderately or very much concerned about workplace heat exposure. Factors associated with workers’ heat concerns included age, undertaking very physically demanding work, and the use of personal protective equipment, heat illness history, and injury experience during hot weather. Less than half (43.4 % of the respondents had received heat-related training. Workers aged 25–54 years and those with previous heat-related illness/injury history showed more supportive attitudes towards heat-related training. The provision of cool drinking water was the most common heat prevention measure. A little more than half (51.4 % of respondents were satisfied with the current heat prevention measures. About two-thirds (63.8 % of respondents agreed that there should be more heat-related regulations and

  18. Relating illness complexity to reimbursement in CKD patients.

    Bessette, Russell W; Carter, Randy L

    2011-01-01

    Despite significant investments of federal and state dollars to transition patient medical records to an all-electronic system, a chasm still exists between health care quality and payment for it. A major reason for this gap is the difficulty in evaluating health care outcomes based on claims data. Since both payers and patients may not appreciate how illness complexity impacts treatment outcomes, it is difficult to determine fair provider compensation. Chronic kidney disease (CKD) typifies these problems and is often associated with comorbidities that impact cost, health, and work productivity. Thus, the objective of this study was to evaluate an illness complexity score (ICS) based on a linear regression of select blood values that might assist in predicting average monthly reimbursements in CKD patients. A second objective was to compare the results of this ICS prediction to results obtained by prediction of average monthly reimbursement using CKD stage. A third objective was to analyze the relationship between the change in ICS, estimated glomerular filtration rate (eGFR), and CKD stage over time to average monthly reimbursement. We calculated parsimonious values for select variables associated with CKD patients and compared the ICS to ordinal staging of renal disease. Data from 177 de-identified patients over 13 months was collected, which included 15 blood chemistry observations along with complete claims data for all medical expenses. To test for the relationship between average blood chemistry values, stages of CKD, age, and average monthly reimbursement, we modeled an association through a linear regression function of age, eGFR, and the Z-scores calculated from average monthly values of phosphorus, parathyroid hormone, glucose, hemoglobin, bicarbonate, albumin, creatinine, blood urea nitrogen, potassium, calcium, sodium, alkaline phosphatase, alanine aminotransferase, and white blood cells. The results of our study demonstrated that the association

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

    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.

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

    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.

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

    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

  2. Relating illness complexity to reimbursement in CKD patients

    Bessette RW

    2011-09-01

    Full Text Available Russell W Bessette1, Randy L Carter2,3 1Department of Health Sciences, Institute for Healthcare Informatics, 2Department of Biostatistics, 3Population Health Observatory, University at Buffalo, State University of New York, Buffalo, NY, USA Background: Despite significant investments of federal and state dollars to transition patient medical records to an all-electronic system, a chasm still exists between health care quality and payment for it. A major reason for this gap is the difficulty in evaluating health care outcomes based on claims data. Since both payers and patients may not appreciate how illness complexity impacts treatment outcomes, it is difficult to determine fair provider compensation. Objectives: Chronic kidney disease (CKD typifies these problems and is often associated with comorbidities that impact cost, health, and work productivity. Thus, the objective of this study was to evaluate an illness complexity score (ICS based on a linear regression of select blood values that might assist in predicting average monthly reimbursements in CKD patients. A second objective was to compare the results of this ICS prediction to results obtained by prediction of average monthly reimbursement using CKD stage. A third objective was to analyze the relationship between the change in ICS, estimated glomerular filtration rate (eGFR, and CKD stage over time to average monthly reimbursement. Methods: We calculated parsimonious values for select variables associated with CKD patients and compared the ICS to ordinal staging of renal disease. Data from 177 de-identified patients over 13 months was collected, which included 15 blood chemistry observations along with complete claims data for all medical expenses. To test for the relationship between average blood chemistry values, stages of CKD, age, and average monthly reimbursement, we modeled an association through a linear regression function of age, eGFR, and the Z-scores calculated from average

  3. Short- and long-term impact of critical illness on relatives: literature review.

    Paul, Fiona; Rattray, Janice

    2008-05-01

    This paper is a report of a literature review undertaken to identify the short- and long-term impact of critical illness on relatives. Patients in intensive care can experience physical and psychological consequences, and their relatives may also experience such effects. Although it is recognized that relatives have specific needs, it is not clear whether these needs are always met and whether further support is required, particularly after intensive care. The following databases were searched for the period 1950-2007: Medline, British Nursing Index and Archive, EMBASE, CINAHL, PsycINFO and EMB Reviews--Cochrane Central Register of Clinical Trials. Search terms focused on adult relatives of critically ill adult patients during and after intensive care. Recurrent topics were categorized to structure the review, i.e. 'relatives needs', 'meeting relatives' needs', 'interventions', 'satisfaction', 'psychological outcomes' and 'coping'. Studies have mainly identified relatives' immediate needs using the Critical Care Family Needs Inventory. There are few studies of interventions to meet relatives' needs and the short- and long-term effects of critical illness on relatives. Despite widespread use of the Critical Care Family Needs Inventory, factors such as local or cultural differences may influence relatives' needs. Relatives may also have unidentified needs, and these needs should be explored. Limited research has been carried out into interventions to meet relatives' needs and the effects of critical illness on their well-being, yet some relatives may experience negative psychological consequences far beyond the acute phase of the illness.

  4. Work-related illness, work-related accidents, and lack of social security in Colombia.

    Buitrago Echeverri, María Teresa; Abadía-Barrero, César Ernesto; Granja Palacios, Consuelo

    2017-08-01

    The impacts of neoliberal or market-based social security reforms in health have been extensively studied. How such reforms transformed employment-related insurance and entitlements, however, has received significantly less attention. This study aims to understand how the employment insurance system operates in Colombia and to assess how the experience of workers seeking social security entitlements relates to the system's structure. We conducted an ethnographic study of the Colombian Occupational Risk System between May 2014 and March 2016, with two main components: 1) analysis of the system itself through in-depth interviews with 32 people working in leadership positions and a systematic review of the system's most important legislation, and 2) a study of people who experienced problems receiving entitlements and were challenging the assessment of their work-related illness or accident. We conducted in-depth interviews with 22 people, followed up with half of them, and reviewed their case files. We found that difficulties accessing health care services, payments for medical leave, job reassignments, severance packages, and filing for pension benefits were common to all cases and resulted from overwhelming bureaucratic and administrative demands. Regional and national evaluation bodies dictate whether a given illness or accident is work-related, and establish a percentage of Loss of Wage Earning Capacity (LWEC). People's disabled bodies rarely reached the threshold of 50% LWEC to qualify for disability pensions. The lengthy process that workers were forced to endure to obtain work-related entitlements always involved the judiciary. The three competing for-profit financial sectors (health insurance, pension funds, and Occupational Risk Administrators) actively challenged workers' demands in order to increase their profits. We conclude that these for-profit sectors work contrary to the principles that sustain social security. Indeed, they push sick and disabled

  5. Improvements in or relating to heat exchangers

    Taylor, P.A.

    1978-01-01

    According to the present invention there is provided a method of producing superheated steam by use of the heat in liquid sodium, in which liquid sodium is caused to flow through a space having boundaries of which no part is common with the boundaries of a space in which vapour is produced, a fluid that is inert to sodium is heated by heat exchange at the boundaries of the space through which the liquid sodium flows and serves as the heating medium for the production of vapour, and the vapour is subsequently heated to the final degree of superheat by heat exchange with liquid sodium in a space that has a common boundary with a space through which liquid sodium is passed. (U.K.)

  6. Effect Evaluation of a Randomized Trial to Reduce Infectious Illness and Illness-related Absenteeism Among Schoolchildren: The Hi Five Study.

    Denbæk, Anne Maj; Andersen, Anette; Bonnesen, Camilla Thørring; Laursen, Bjarne; Ersbøll, Annette Kjær; Due, Pernille; Johansen, Anette

    2018-01-01

    Previous school-based hand hygiene interventions have reported to successfully reduce infectious illness among schoolchildren. But few studies have tested the effect in large populations with adequate statistical power and analyses. The aim of this study was to evaluate whether a school-based multicomponent intervention to improve handwashing among schoolchildren, the Hi Five study, succeeded in reducing infectious illness and illness-related absenteeism in schools. 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 reported by schoolchildren, respectively. At follow-up, children in the intervention schools did not differ from the control schools in number of illness days [odds ratio (OR)I-arm I: 0.91 (0.77-1.07) and ORI-arm II: 0.94 (0.79-1.12)] and illness episodes [ORI-arm I: 0.95 (0.81-1.11) and ORI-arm II: 0.98 (0.84-1.16)] or in reporting illness-related absenteeism [ORI-arm I: 1.09 (0.83-1.43) & ORI-arm II: 1.06 (0.81-1.40)]. The multicomponent Hi Five intervention achieved no difference in the number of illness days, illness episodes or illness-related absenteeism among children in intervention schools compared with control schools. It is noteworthy that one of the main components in the intervention, a mandatory daily handwashing before lunch, was only implemented by 1 of 3 of teachers in intervention schools.

  7. Families of Children with Chronic Illness and the Relational Family Model

    Tanja Pate

    2016-09-01

    Full Text Available Families of children with chronic illness experience persistent stress. Facing the diagnosis and learning how to cope with it is a stressful experience not only for the child but also for the parents and for the whole family. The illness, with its unpredictability and treatment, disturbs their daily routine and threatens the whole family system. Parental involvement in the child’s disease management and their emotional support are crucial for effective coping and adaptation to the child’s chronic illness. The aim of this article is to present the importance of the parental role in these families through theoretical findings of the relational family model.

  8. Illness perception and related behaviour in lower respiratory tract infections—a European study

    Hordijk, Patricia M; Broekhuizen, Berna D L; Butler, Chris C; Coenen, Samuel; Godycki-Cwirko, Maciek; Goossens, Herman; Hood, Kerry; Smith, Richard; van Vugt, Saskia F; Little, Paul; Verheij, Theo J M

    2015-01-01

    Background. Lower respiratory tract infection (LRTI) is a common presentation in primary care, but little is known about associated patients’ illness perception and related behaviour. Objective. To describe illness perceptions and related behaviour in patients with LRTI visiting their general practitioner (GP) and identify differences between European regions and types of health care system. Methods. Adult patients presenting with acute cough were included. GPs recorded co morbidities and clinical findings. Patients filled out a diary for up to 4 weeks on their symptoms, illness perception and related behaviour. The chi-square test was used to compare proportions between groups and the Mann-Whitney U or Kruskal Wallis tests were used to compare means. Results. Three thousand one hundred six patients from 12 European countries were included. Eighty-one per cent (n = 2530) of the patients completed the diary. Patients were feeling unwell for a mean of 9 (SD 8) days prior to consulting. More than half experienced impairment of normal or social activities for at least 1 week and were absent from work/school for a mean of 4 (SD 5) days. On average patients felt recovered 2 weeks after visiting their GP, but 21% (n = 539) of the patients did not feel recovered after 4 weeks. Twenty-seven per cent (n = 691) reported feeling anxious or depressed, and 28% (n = 702) re-consulted their GP at some point during the illness episode. Reported illness duration and days absent from work/school differed between countries and regions (North-West versus South-East), but there was little difference in reported illness course and related behaviour between health care systems (direct access versus gate-keeping). Conclusion. Illness course, perception and related behaviour in LRTI differ considerably between countries. These finding should be taken into account when developing International guidelines for LRTI and interventions for setting realistic expectations about illness course

  9. Temperament and Character Personality Profile and Illness-Related Stress in Central Serous Chorioretinopathy

    Rupert Conrad

    2014-01-01

    Full Text Available Psychological stress is a risk factor as well as a consequence of central serous chorioretinopathy (CSC. Impulsiveness, overachievement, emotional instability, and hard-driving competitiveness have been discussed as personality features in CSC patients. We investigated 57 consecutive CSC patients and 57 age- and gender-matched controls by means of the Symptom Checklist 90-R and the Temperament and Character Inventory. Somatic risk factors, illness characteristics, subjective assessment of severity of illness, and illness-related stress in different areas of life (work, private life were evaluated. CSC patients showed significantly higher emotional distress as measured by the Global Severity Index. The CSC personality was characterized by lower scoring on the character dimension cooperativeness and the temperament dimension reward dependence. Cooperativeness as well as subjective assessment of severity of CSC has been recognized as significant predictors of illness-related work stress accounting for 30% of variance. Implicating competitiveness, hostility and emotional detachment, lower level of cooperativeness, and reward dependence support the existence of specific aspects of type A behaviour in CSC patients. Low perceived social support and loss of control may explain the significant contribution of this personality dimension to illness-related work stress. Treatment of CSC should thus incorporate psychoeducation about factors contributing to illness-related stress.

  10. Importance of implementation level when evaluating the effect of the Hi Five Intervention on infectious illness and illness-related absenteeism.

    Denbæk, Anne Maj; Andersen, Anette; Bast, Lotus Sofie; Bonnesen, Camilla Thørring; Ersbøll, Annette Kjær; Due, Pernille; Johansen, Anette

    2018-05-01

    There is limited research on the importance of implementation when evaluating the effect of hand hygiene interventions in school settings in developed countries. The aim of this study was to examine the association between an implementation index and the effect of the intervention. The Hi Five Intervention was evaluated in a 3-armed cluster randomized controlled trial involving 43 randomly selected Danish schools. Analyses investigating the association between implementation of the Hi Five Intervention and infectious illness days, infectious illness episodes, illness-related absenteeism, and hand hygiene were carried out in a multilevel model (school, class, and child). The level of implementation was associated with hand hygiene and potentially associated with number of infectious illness days and infectious illness episodes among children. This association was not found for illness-related absenteeism. Classes that succeeded in achieving a high level of implementation of the Hi Five Intervention had a lower number of infectious illness days and infectious illness episodes, suggesting that the Hi Five Intervention, if implemented adequately, may be relevant as a tool to decrease infectious illness in a Danish school setting. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  11. Work-related mental ill-health and 'stress' in the UK (2002-05).

    Carder, Melanie; Turner, Susan; McNamee, Roseanne; Agius, Raymond

    2009-12-01

    There is concern about the frequency of work-related mental ill-health and 'stress' within the UK. To provide a measure of the incidence of work-related mental ill-health reported by specialist psychiatrists and occupational physicians to UK voluntary reporting schemes during the period 2002-05. Additionally, an investigation of determinants, notably factors identified by reporters as precipitants in cases of work-related mental ill-health was undertaken. The study used data collected by The Health and Occupation Reporting Network (THOR) from 2002 to 2005. Cases were analysed by age, gender, industry and precipitating event. Estimated annual average incidence rates and 95% confidence intervals of work-related mental ill-health diagnoses reported to THOR between 2002 and 2005 by psychiatrists were 89 (78, 101) per million and by occupational physicians were 1589 (1443, 1735) per million. For both groups of reporters, anxiety and depression continued to make up the largest proportion of diagnoses. The majority of cases were attributed to factors such as workload and difficulties with other workers. There was some suggestion that the type of factors associated with the mental ill-health case reports varied between industrial sectors. Work-related anxiety and depression and stress continue to constitute a significant proportion of all work-related mental ill-health diagnoses in the UK, with workload and interpersonal relationships reported as significant risk factors. Further investigations may determine whether guidance for employers and employees on work-related mental ill-health would benefit from being more industry specific.

  12. Improvements in or relating to heat exchangers

    Graham, L.W.; Sturge, D.W.J.; Ridealgh, F.

    1978-01-01

    A heat exchanger is described that is suitable for use with high temperature gas cooled reactors in which the heat is used as process heat. The construction which is of necessity of large size, is of much lighter weight than current constructions and is better able to withstand the high operating temperature (up to about 1000 0 C). Carbon fibre reinforced carbon materials are employed as constructional materials. A method of fabrication is described. The heat exchanger comprises a tube or bundle of tubes associated with a header plate, and the tube can be of helical form. The carbon materials may be formed by carbonisation of a thermosetting plastic such as a phenolic resin. The exchanger is rendered substantially impermeable to gas by an infiltration treatment of the carbon material using a cracked hydrocarbon gas. (U.K.)

  13. Improvements in or relating to heat exchangers

    Graham, L W; Sturge, D W.J.; Ridealgh, F

    1978-04-05

    A heat exchanger is described that is suitable for use with high temperature gas cooled reactors in which the heat is used as process heat. The construction which is of necessity of large size, is of much lighter weight than current constructions and is better able to withstand the high operating temperature (up to about 1000/sup 0/C). Carbon fibre reinforced carbon materials are employed as constructional materials. A method of fabrication is described. The heat exchanger comprises a tube or bundle of tubes associated with a header plate, and the tube can be of helical form. The carbon materials may be formed by carbonisation of a thermosetting plastic such as a phenolic resin. The exchanger is rendered substantially impermeable to gas by an infiltration treatment of the carbon material using a cracked hydrocarbon gas.

  14. Improvements in or relating to heat exchangers

    Linning, D.L.

    1976-01-01

    A 'tube-in-shell' heat exchanger is described for effecting heat exchange between liquid metal and water. In conventional heat exchangers of this type a condition can arise wherein Na passing through the tube plate at the water inlet end of the heat exchanger may be above the saturation temperature of the water, and although resultant boiling of the water in the region of the tube plate would tend to counter stagnation there is a possibility that sub-cooled boiling associated with stagnation may occur in the central area of the tube plate, and this could be the source of corrosion. The design of heat exchanger described is directed towards a solution of this problem. The heat exchanger comprises an elongated shell having two spaced transverse tube plates sealed to the shell so as to provide end and intermediate chambers. A bundle of spaced parallel heat exchange tubes extends between the tube plates, interconnecting the end chambers with an inlet port for liquid metal flow to one of the end chambers and an outlet port for liquid metal flow from the other of the end chambers, and inlet and outlet ports for flow of water through the intermediate chamber, these ports being at opposite ends of the intermediate chamber. The intermediate chamber has a tube closed to liquid metal flow extending between the tube plates, this tube having an inlet port for water adjacent to the tube plate at the inlet region of the intermediate chamber and an outlet port at the outlet region. This tube has open ends and is laterally supported by neighbouring heat exchange tubes, or alternatively may have closed ends and be end supported by penetration of the tube plates, the inlet and outlet ports for flow of water being perforations in the wall of the tube. (U.K.)

  15. Attitudes and beliefs about mental illness among relatives of patients ...

    2017-08-03

    Aug 3, 2017 ... Objective: To explore the different attitudes and beliefs amongst relatives of patients having schizophrenia ... across racial and socioeconomic factors. ... the beliefs about schizophrenia, also among health .... Schizophrenic people should not be living with people and spend money like other family members.

  16. Causal Beliefs and Effects upon Mental Illness Identification Among Chinese Immigrant Relatives of Individuals with Psychosis.

    Yang, Lawrence H; Wonpat-Borja, Ahtoy J

    2012-08-01

    Identifying factors that facilitate treatment for psychotic disorders among Chinese-immigrants is crucial due to delayed treatment use. Identifying causal beliefs held by relatives that might predict identification of 'mental illness' as opposed to other 'indigenous labels' may promote more effective mental health service use. We examine what effects beliefs of 'physical causes' and other non-biomedical causal beliefs ('general social causes', and 'indigenous Chinese beliefs' or culture-specific epistemologies of illness) might have on mental illness identification. Forty-nine relatives of Chinese-immigrant consumers with psychosis were sampled. Higher endorsement of 'physical causes' was associated with mental illness labeling. However among the non-biomedical causal beliefs, 'general social causes' demonstrated no relationship with mental illness identification, while endorsement of 'indigenous Chinese beliefs' showed a negative relationship. Effective treatment- and community-based psychoeducation, in addition to emphasizing biomedical models, might integrate indigenous Chinese epistemologies of illness to facilitate rapid identification of psychotic disorders and promote treatment use.

  17. What proportion of international travellers acquire a travel-related illness? A review of the literature.

    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

  18. Attitudes toward the mentally ill among community health-related personnel in South Korea.

    Jung, Wook; Choi, Eunkyung; Yu, Jaehak; Park, Doo-Heum; Ryu, Seung-Ho; Ha, Jee Hyun

    2017-01-01

    Prejudice and negative attitudes toward mental illness are major obstacles in the rehabilitation and functional recovery of patients. The objective of this study was to evaluate the attitudes of health-related personnel toward mentally ill patients in a local urban community in South Korea. In total, 401 participants (men, 132; women, 269; mean age, 37.3 ± 9.5 years) were recruited. The participants were health-related personnel in a district of Seoul, who were recruited from three different workplaces: a local administration office, a public health center, and a community welfare center. Sociodemographic data were gathered, and the community attitudes toward the mentally ill (CAMI) inventory were administered. Comparisons of the CAMI subscales were conducted among participants using statistical analysis. Community welfare center workers showed more authoritarianism and social restriction and less community mental health ideology than the other two groups. Among the demographic variables, a shorter working career, higher education, female gender, and younger age were also related to a more negative attitude toward mentally ill patients. Community health-related personnel who have contact with patients with mental illness should be encouraged to have a fair, hospitable, and open-minded attitude. It is advisable for these workers to receive interventions such as regular educational programs early in their careers.

  19. Cost-of-illness and disease burden of food-related pathogens in the Netherlands, 2011

    Mangen, Marie Josée J; Bouwknegt, Martijn; Friesema, Ingrid H M; Haagsma, Juanita A.; Kortbeek, Laetitia M.; Tariq, Luqman; Wilson, Margaret; van Pelt, Wilfrid; Havelaar, Arie H.|info:eu-repo/dai/nl/072306122

    2015-01-01

    To inform risk management decisions on control and prevention of food-related disease, both the disease burden expressed in Disability Adjusted Life Years (DALY) and the cost-of-illness of food-related pathogens are estimated and presented. Disease burden of fourteen pathogens that can be

  20. Prevalence of interpersonal trauma exposure and trauma-related disorders in severe mental illness

    Mauritz, M.W.; Goossens, P.J.J.; Draijer, N.; Achterberg, T. van

    2013-01-01

    BACKGROUND: Interpersonal trauma exposure and trauma-related disorders in people with severe mental illness (SMI) are often not recognized in clinical practice. OBJECTIVE: To substantiate the prevalence of interpersonal trauma exposure and trauma-related disorders in people with SMI. METHODS: We

  1. Prevalence of interpersonal trauma exposure and trauma-related disorders in severe mental illness

    Mauritz, M.W.; Goossens, P.J.J.; Draijer, N.; van Achterberg, T.

    2013-01-01

    Background: Interpersonal trauma exposure and trauma-related disorders in people with severe mental illness (SMI) are often not recognized in clinical practice. Objective: To substantiate the prevalence of interpersonal trauma exposure and trauma-related disorders in people with SMI. Methods: We

  2. Self-complexity as a cognitive buffer against stress-related illness and depression.

    Linville, P W

    1987-04-01

    This prospective study tested the self-complexity buffering hypothesis that greater self-complexity moderates the adverse impact of stress on depression and illness. This hypothesis follows from a model that assumes self-knowledge is represented in terms of multiple self-aspects. As defined in this model, greater self-complexity involves representing the self in terms of a greater number of cognitive self-aspects and maintaining greater distinctions among self-aspects. Subjects completed measures of stressful events, self-complexity, depression, and illness in two sessions separated by 2 weeks. A multiple regression analysis used depression and illness at Time 2 as outcomes, stressful life events and self-complexity at Time 1 as predictors, and depression and illness at Time 1 as control variables. The Stress X Self-Complexity interaction provided strong support for the buffering hypothesis. Subjects higher in self-complexity were less prone to depression, perceived stress, physical symptoms, and occurrence of the flu and other illnesses following high levels of stressful events. These results suggest that vulnerability to stress-related depression and illness is due, in part, to differences in cognitive representations of the self.

  3. Illnesses in siblings of US patients with bipolar disorder relate to multigenerational family history and patients severity of illness

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

    2017-01-01

    Background: Patients with bipolar disorder from the US have more early-onset illness and a greater familial loading for psychiatric problems than those from the Netherlands or Germany (abbreviated here as Europe). We hypothesized that these regional differences in illness burden would extend to the

  4. Improvements in or relating to microwave heating

    Hardwick, W.H.; Gayler, R.

    1984-01-01

    The invention is concerned with microwave heating and more particularly with microwave heating to effect melting. Material is contained in a container and microwave energy is applied to melt material while a portion of the material adjacent to the internal surfaces of the container is maintained at a temperature at which it is not molten. This may be by cooling water in vessel. The invention therefore provides for ''skull'' melting in which a layer of non-molten material protects the container from molten material. Examples of materials which may be treated in accordance with the present invention are glasses and glass-like materials and precursors therefor (e.g. glasses and glass-like materials or precursors therefor containing radioactive wastes). (author)

  5. Hand hygiene instruction decreases illness-related absenteeism in elementary schools: a prospective cohort study

    2012-01-01

    Background Illness-related absences have been shown to lead to negative educational and economic outcomes. Both hand washing and hand sanitizer interventions have been shown to be effective in reducing illness-related absences. However, while the importance of hand hygiene in schools is clear, the role of instruction in use is less obvious. The purpose of this study was to compare absenteeism rates among elementary students given access to hand hygiene facilities versus students given both access and short repetitive instruction in use, particularly during influenza season when illness-related absences are at a peak. Methods A hand hygiene intervention was implemented from October to May during the 2009/2010 academic year, including peak flu season, in two Chicago Public Elementary Schools among students grades pre-kindergarten to eighth grade (ages 4–14). Classrooms were systematically assigned to an intervention or control group by grade (cluster design). Hand hygiene facilities (sanitizer and soap) were made available to all students. Students in the intervention group also received short repetitive instruction in hand hygiene every 2 months. Only absences as a result of respiratory or gastrointestinal illness were used to establish illness-related absenteeism rates. Percent absent days were calculated and bivariate analyses were performed to compare percent absent days among students given access to hand hygiene facilities versus students given both access and instruction. Prior to the intervention, teachers’ perceptions of students’ hand hygiene were also evaluated. Teacher perceptions were analysed to describe attitudes and beliefs. Results Data were collected and analysed for 773 students reporting 1,886 absences during the study period (1.73% of total school days). Both the percent total absent days and percent illness-related absent days were significantly lower in the group receiving short instruction during flu season (P = 0.002, P

  6. Fluctuation relation for heat exchange in Markovian open quantum systems

    Ramezani, M.; Golshani, M.; Rezakhani, A. T.

    2018-04-01

    A fluctuation relation for the heat exchange of an open quantum system under a thermalizing Markovian dynamics is derived. We show that the probability that the system absorbs an amount of heat from its bath, at a given time interval, divided by the probability of the reverse process (releasing the same amount of heat to the bath) is given by an exponential factor which depends on the amount of heat and the difference between the temperatures of the system and the bath. Interestingly, this relation is akin to the standard form of the fluctuation relation (for forward-backward dynamics). We also argue that the probability of the violation of the second law of thermodynamics in the form of the Clausius statement (i.e., net heat transfer from a cold system to its hot bath) drops exponentially with both the amount of heat and the temperature differences of the baths.

  7. Illness Attitudes Scale dimensions and their associations with anxiety-related constructs in a nonclinical sample.

    Stewart, S H; Watt, M C

    2000-01-01

    The Illness Attitudes Scale (IAS) is a self-rated measure that consists of nine subscales designed to assess fears, attitudes and beliefs associated with hypochondriacal concerns and abnormal illness behavior [Kellner, R. (1986). Somatization and hypochondriasis. New York: Praeger; Kellner, R. (1987). Abridged manual of the Illness Attitudes Scale. Department of Psychiatry, School of Medicine, University of New Mexico]. The purposes of the present study were to explore the hierarchical factor structure of the IAS in a nonclinical sample of young adult volunteers and to examine the relations of each illness attitudes dimension to a set of anxiety-related measures. One-hundred and ninety-seven undergraduate university students (156 F, 41 M; mean age = 21.9 years) completed the IAS as well as measures of anxiety sensitivity, trait anxiety and panic attack history. The results of principal components analyses with oblique (Oblimin) rotation suggested that the IAS is best conceptualized as a four-factor measure at the lower order level (with lower-order dimensions tapping illness-related Fears, Behavior, Beliefs and Effects, respectively), and a unifactorial measure at the higher-order level (i.e. higher-order dimension tapping General Hypochondriacal Concerns). The factor structure overlapped to some degree with the scoring of the IAS proposed by Kellner (1986, 1987), as well as with the factor structures identified in previously-tested clinical and nonclinical samples [Ferguson, E. & Daniel, E. (1995). The Illness Attitudes Scale (IAS): a psychometric evaluation on a nonclinical population. Personality and Individual Differences, 18, 463-469; Hadjistavropoulos, H. D. & Asmundson, G. J. G. (1998). Factor analytic investigation of the Illness Attitudes Scale in a chronic pain sample. Behaviour Research and Therapy, 36, 1185-1195; Hadjistavropoulos, H. D., Frombach, I. & Asmundson, G. J. G. (in press). Exploratory and confirmatory factor analytic investigations of the

  8. Illness appraisals and health-related quality of life in adolescents and young adults with allergies and asthma.

    Hullmann, Stephanie E; Eddington, Angelica R; Molzon, Elizabeth S; Mullins, Larry L

    2013-01-01

    The current study sought to: 1) assess differences in levels of physical and mental health-related quality of life (HRQOL), illness uncertainty, and intrusiveness in adolescents and young adults (AYAs) with allergies and asthma, as well as 2) examine the effect of illness appraisals on HRQOL. Participants were undergraduate students with self-reported allergies (n=74) and asthma (n=74) who completed the Mishel Uncertainty in Illness Scale (MUIS), the Illness Intrusiveness Scale (IIS), and the SF-36 Health Survey Questionnaire. Paired t-tests indicated that AYAs with allergies reported higher levels of illness uncertainty and poorer mental HRQOL than AYAs with asthma; the groups did not differ on reported levels of illness intrusiveness or physical HRQOL. Hierarchical regressions were conducted to examine the relationship between illness appraisals and HRQOL. Results revealed that poorer mental HRQOL was associated with higher illness uncertainty in AYAs with allergies and higher illness intrusiveness in AYAs with asthma. Poorer physical HRQOL was associated with higher illness uncertainty in AYAs with asthma and higher illness intrusiveness in AYAs with allergies and asthma. The current examination suggests that illness appraisals may be differentially related to HRQOL in AYAs with allergies compared to those with asthma.

  9. A literature review on self-care of chronic illness: definition, assessment and related outcomes.

    Ausili, Davide; Masotto, Matteo; Dall'Ora, Chiara; Salvini, Lorena; Di Mauro, Stefania

    2014-01-01

    Chronic illnesses care represents a challenging issue for people well-being and future health systems' sustainability. Promotion of self-care is considered a key point for chronically ill patients' care. The aim of this literature was to explore: how self-care of chronic illness has been theoretically defined; how self-care can be assessed in clinical and research settings; what associations exist between self-care and health outcomes of chronically ill patients. A wide range of definitions and terminologies related to self-care of chronic illness has been found in the literature. Although some common elements useful to explain the concept of self-care have been identified, the physical, cognitive, emotional and social processes underlying self-care remain controversial and poorly defined. Valid and reliable disease-specific assessment tools have been developed and used in a growing number of studies; however, the lack of utilization of standardized instruments in clinical practice has been referred by many authors. Significant correlations between self-care of chronic illness and outcome measures e.g. general health status, quality of life and healthcare costs, are reported by a limited number of studies. Supporting patient self-care is recognized as a crucial factor in chronic illness care. A deeper analysis of variables and processes influencing self-care could help for a full description of the phenomenon. A systematic evaluation of self-care in health professionals' everyday clinical practice is strongly recommended. The development of general non-disease-specific assessment tools could facilitate the evaluation of complex patients, especially those with multiple co-morbidities. Although self-care has been recognized as a vital intermediate outcome, further large-scale studies clarifying the association between self-care and patients' and health systems' outcomes are needed.

  10. Mental Illness Related Internalized Stigma: Psychometric Properties of the Brief ISMI Scale in Greece.

    Paraskevoulakou, Alexia; Vrettou, Kassiani; Pikouli, Katerina; Triantafillou, Evgenia; Lykou, Anastasia; Economou, Marina

    2017-09-01

    Since evaluation regarding the impact of mental illness related internalized stigma is scarce, there is a great need for psychometric instruments which could contribute to understanding its adverse effects among Greek patients with severe mental illness. The Brief Internalized Stigma of Mental Illness (ISMI) scale is one of the most widely used measures designed to assess the subjective experience of stigma related to mental illness. The present study aimed to investigate the psychometric properties of the Greek version of the Brief ISMI scale. In addition to presenting psychometric findings, we explored the relationship of the Greek version of the Brief ISMI subscales with indicators of self-esteem and quality of life. 272 outpatients (108 males, 164 females) meeting the DSM-IV TR criteria for severe mental disorder (schizophrenia, bipolar disorder, major depression) completed the Brief ISMI, the RSES and the WHOQOL-BREF scales. Patients reported age and educational level. A retest was conducted with 124 patients. The Chronbach's alpha coefficient was 0 0.83. The test-retest reliability coefficients varied from 0.81 to 0.91, indicating substantial agreement. The ICC was for the total score 0.83 and for the two factors, 0.69 and 0.77 respectively. Factor analysis provided strong evidence for a two factor model. Factors 1 and 2 were named respectively "how others view me" and "how I view myself". They were negatively correlated with both RSES and WHOQOL-BREF scales, as well as with educational level. Factor 2 was significantly associated with the type of diagnosis. The Greek version of the Brief ISMI scale can be used as a reliable and valid tool for assessing mental illness related internalized stigma among Greek patients with severe mental illness.

  11. The absence of exanthema is related with death and illness severity in acute enterovirus infection

    Hong-Tao Zhou

    2014-11-01

    Conclusions: A considerable proportion of children with an acute enterovirus infection in Guangdong Province, China during 2009–2012 presented no exanthema, and the absence of exanthema was found to be related to death and illness severity for these acute enterovirus infections. Clinicians in China should consider enterovirus as the possible pathogen when treating children with an acute pathogen infection without exanthema.

  12. Relation between perceived health and sick leave in employees with a chronic illness

    Boot, C.R.L.; Koppes, L.L.J.; Bossche, S.N.J. van den; Anema, J.R.; Beek, A.J. van der

    2011-01-01

    Introduction: To improve work participation in individuals with a chronic illness, insight into the role of work-related factors in the association between health and sick leave is needed. The aim of this study was to gain insight into the contribution of work limitations, work characteristics, and

  13. The Relation Between Parental Mental Illness and Adolescent Mental Health: The Role of Family Factors

    Loon, L.M.A. van; Ven, M.O.M. van de; Doesum, K.T.M. van; Witteman, C.L.M.; Hosman, C.M.H.

    2014-01-01

    Children of parents with a mental illness are often found to be at high risk of developing psychological problems themselves. Little is known about the role of family factors in the relation between parental and adolescent mental health. The current study focused on parent-child interaction and

  14. A controlled trial of mental illness related stigma training for medical students

    Leese Morven

    2011-07-01

    Full Text Available Abstract Background The evidence base for mental illness related stigma interventions in health care professionals and trainees is underdeveloped. This study aimed to examine the impact of mental illness related stigma training on third year medical students' knowledge, attitudes and behaviour related to people with mental illness. Methods A non-randomised controlled trial was conducted with 110 third year medical students at a medical school in England to determine the effectiveness of a mental illness related stigma training package that targeted their knowledge, attitudes and behaviour. Results We detected a significant positive effect of factual content and personal testimonies training upon an improvement in knowledge, F(1, 61 = 16.3, p = 0.0002. No such difference was determined with attitudes or for behaviour. Conclusions Knowledge, attitudes and behaviour may need to be separately targeted in stigma reduction interventions, and separately assessed. The inter-relationships between these components in mental health promotion and medical education warrant further research. The study next needs to be replicated with larger, representative samples using appropriate evaluation instruments. More intensive training for medical students may also be required.

  15. Illness representations of type 2 diabetes patients are associated with perceptions of diabetes threat in relatives

    van Esch, S.C.M.; Nijkamp, M.D.; Cornel, M.C.; Snoek, F.J.

    2014-01-01

    In the fight against the type 2 diabetes epidemic, patients might be asked to discuss familial susceptibility to type 2 diabetes in their family. Illness representations of patients (N = 546) were assessed to explore their impact on perceived type 2 diabetes threat in relatives. Reporting high type

  16. BUYING BEHAVIOUR RELATED TO HEATING SYSTEMS IN GERMANY

    Decker, Thomas; Zapilko, Marina; Menrad, Klaus

    2010-01-01

    The decision for buying a heating system is a long-term one, as many different aspects have an influence on this choice which were analysed in a Germany-wide, written survey. The respondents (only owners of a private house) had to answer questions about their attitude towards e.g. economics, convenience or ecological aspects related to heating systems and the respective combustibles. Using a multinomial logistic regression model the choice of the heating system is mainly explained by ecologic...

  17. Belgian coca-cola-related outbreak: intoxication, mass sociogenic illness, or both?

    Gallay, A; Van Loock, F; Demarest, S; Van der Heyden, J; Jans, B; Van Oyen, H

    2002-01-15

    An epidemic of health complaints occurred in five Belgian schools in June 1999. A qualitative investigation described the scenario. The role of soft drinks was assessed by using a case-control study. Cases were students complaining of headache, dizziness, nausea, vomiting, abdominal pain, diarrhea, or trembling. Controls were students present at school on the day of the outbreak but not taken ill. An analysis was performed separately for school A, where the outbreak started, and was pooled for schools B-E. In school A, the attack rate (13.2%) was higher than in schools B-E (3.6%, relative risk = 3.6, 95% confidence interval (CI): 2.5, 5.3). Exclusive consumption of regular Coca-Cola (school A: odds ratio (OR) = 29.7, 95% CI: 1.32, 663.6; schools B-E: OR = 7.3, 95% CI: 2.9, 18.0) and low mental health score (school A: OR = 16.1, 95% CI: 1.3, 201.9; schools B-E: OR = 3.1, 95% CI: 1.5, 6.6) were independently associated with the illness. In schools B-E, consumption of Fanta, consumption of Coca-Cola light, and female gender were also associated with the illness. It seems reasonable to attribute the first cases of illness in school A to regular Coca-Cola consumption. However, mass sociogenic illness could explain the majority of the other cases.

  18. Medical Care Expenditure in Suicides From Non-illness-related Causes

    Jungwoo Sohn

    2014-11-01

    Full Text Available Objectives: Several epidemiological studies on medical care utilization prior to suicide have considered the motivation of suicide, but focused on the influence of physical illnesses. Medical care expenditure in suicide completers with non-illness-related causes has not been investigated. Methods: Suicides motivated by non-illness-related factors were identified using the investigator’s note from the National Police Agency, which was then linked to the Health Insurance Review and Assessment data. We investigated the medical care expenditures of cases one year prior to committing suicide and conducted a case-control study using conditional logistic regression analysis after adjusting for age, gender, area of residence, and socioeconomic status. Results: Among the 4515 suicides motivated by non-illness-related causes, medical care expenditures increased in only the last 3 months prior to suicide in the adolescent group. In the younger group, the proportion of total medical expenditure for external injuries was higher than that in the older groups. Conditional logistic regression analysis showed significant associations with being a suicide completer and having a rural residence, low socioeconomic status, and high medical care expenditure. After stratification into the four age groups, a significant positive association with medical care expenditures and being a suicide completer was found in the adolescent and young adult groups, but no significant results were found in the elderly groups for both men and women. Conclusions: Younger adults who committed suicide motivated by non-illness-related causes had a higher proportion of external injuries and more medical care expenditures than their controls did. This reinforces the notion that suicide prevention strategies for young people with suicidal risk factors are needed.

  19. Prevalence of interpersonal trauma exposure and trauma-related disorders in severe mental illness

    Mauritz, Maria W.; Goossens, Peter J.J.; Draijer, Nel; Achterberg, Theo van

    2013-01-01

    Background: Interpersonal trauma exposure and trauma-related disorders in people with severe mental illness (SMI) are often not recognized in clinical practice.Objective: To substantiate the prevalence of interpersonal trauma exposure and trauma-related disorders in people with SMI.Methods: We conducted a systematic review of four databases (1980-2010) and then described and analysed 33 studies in terms of primary diagnosis and instruments used to measure trauma exposure and traumarelated dis...

  20. Method of relative comparison of the thermohydraulic efficiency of heat exchange intensification in channels of heat-exchange surfaces

    Dubrovskij, E.V.; Vasil'ev, V.Ya.

    2002-01-01

    One introduces a technique to compare relatively thermohydraulic efficiency of heat transfer intensification in channels of heat exchange surfaces of any design types. It is shown that one should compare thermohydraulic efficiency of heat exchange intensification as to the thermal power of heat exchangers and pressure losses in channels with turbulators and in polished channels of heat exchange surfaces on the basis of dimensions of heat exchangers, their heat exchange surfaces and at similar (as to Re numbers) modes of coolant flow [ru

  1. Hand hygiene instruction decreases illness-related absenteeism in elementary schools: a prospective cohort study

    Lau Claudia H

    2012-05-01

    Full Text Available Abstract Background Illness-related absences have been shown to lead to negative educational and economic outcomes. Both hand washing and hand sanitizer interventions have been shown to be effective in reducing illness-related absences. However, while the importance of hand hygiene in schools is clear, the role of instruction in use is less obvious. The purpose of this study was to compare absenteeism rates among elementary students given access to hand hygiene facilities versus students given both access and short repetitive instruction in use, particularly during influenza season when illness-related absences are at a peak. Methods A hand hygiene intervention was implemented from October to May during the 2009/2010 academic year, including peak flu season, in two Chicago Public Elementary Schools among students grades pre-kindergarten to eighth grade (ages 4–14. Classrooms were systematically assigned to an intervention or control group by grade (cluster design. Hand hygiene facilities (sanitizer and soap were made available to all students. Students in the intervention group also received short repetitive instruction in hand hygiene every 2 months. Only absences as a result of respiratory or gastrointestinal illness were used to establish illness-related absenteeism rates. Percent absent days were calculated and bivariate analyses were performed to compare percent absent days among students given access to hand hygiene facilities versus students given both access and instruction. Prior to the intervention, teachers’ perceptions of students’ hand hygiene were also evaluated. Teacher perceptions were analysed to describe attitudes and beliefs. Results Data were collected and analysed for 773 students reporting 1,886 absences during the study period (1.73% of total school days. Both the percent total absent days and percent illness-related absent days were significantly lower in the group receiving short instruction during flu season (P

  2. Gender-related differences in the human rights needs of patients with mental illness.

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

    2012-06-01

    Individuals with mental illness commonly experience human rights violations while seeking to meet their basic needs. There is lack of research in developing countries on gender-related differences in human rights needs. This study investigated gender differences in perceived human rights needs at the family and community levels in individuals with mental illness in India. This descriptive study surveyed 100 asymptomatic individuals with mental illness at a tertiary care center. Subject selection employed a random sampling method. Data were collected using face-to-face interviews based on a structured needs assessment questionnaire. Data were analyzed and interpreted using descriptive and inferential statistics. Subjects enjoyed a satisfactory level of fulfillment in the physical dimension of human rights needs, which included food, housing, and clothing. Men expressed lower satisfaction than women with perceived human rights needs fulfillment in the emotional dimension. This included fear of family members (χ = 9.419, p human rights needs fulfillment in social and ethical dimensions. The former included freedom to leave the home (χ = 11.277, p human rights needs of people with mental illness and that legislation must be strengthened to meet the human rights needs of this disadvantaged population.

  3. Under-recording of work-related injuries and illnesses: An OSHA priority.

    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.

  4. The impact of illness-related shame on psychological health and social relationships: Testing a mediational model in students with chronic illness.

    Trindade, Inês A; Duarte, Joana; Ferreira, Cláudia; Coutinho, Mariana; Pinto-Gouveia, José

    2018-01-26

    This study explores the impact of illness-related shame on the quality of social relationships and psychological health in chronic patients. We aimed to examine the roles of fear of receiving compassion from others and experiential avoidance as potential mediators of this relationship. Although some studies have demonstrated the negative impact of chronic illness-related shame on psychological functioning, the mechanisms that may underlie this link remain understudied. The sample was comprised by 115 college students, which had been diagnosed with at least 1 chronic illness. Participants completed self-report measures on an online platform. This study's design was cross-sectional. A path analysis was conducted using structural equation modelling. Results showed that the impact of illness-related shame on both psychological health (R 2  = .45) and the quality of social relationships (R 2  = .33) was fully accounted by fear of compassion from others and experiential avoidance. This model revealed an excellent fit. Fear of receiving compassion from others was the main mediator of the illness-related shame link with the quality of social relationships (β = -.22). The main mediator of the association between shame-related chronic illness and psychological health was experiential avoidance (β = -.21).This study shed light on possible psychological mechanisms linking feelings of shame associated with having a chronic condition and impaired social relationships and mental health. On one hand, resisting feelings of compassion and care from others and, on the other hand, avoiding difficult internal experiences and situations that might trigger them seem to underlie the impact of shame on psychological and social functioning in chronic patients. Copyright © 2018 John Wiley & Sons, Ltd.

  5. A Cross-Sectional Study of Heat Wave-Related Knowledge, Attitude, and Practice among the Public in the Licheng District of Jinan City, China.

    Li, Jing; Xu, Xin; Ding, Guoyong; Zhao, Yun; Zhao, Ruixia; Xue, Fuzhong; Li, Jing; Gao, Jinghong; Yang, Jun; Jiang, Baofa; Liu, Qiyong

    2016-06-29

    Knowledge, attitude, and practice (KAP) are three key components for reducing the adverse health impacts of heat waves. However, research in eastern China regarding this is scarce. The present study aimed to evaluate the heat wave-related KAP of a population in Licheng in northeast China. This cross-sectional study included 2241 participants. Data regarding demographic characteristics, KAP, and heat illnesses were collected using a structured questionnaire. Univariate analysis and unconditional logistic regression models were used to analyze the data. Most residents had high KAP scores, with a mean score of 12.23 (standard deviation = 2.23) on a 17-point scale. Urban women and participants aged 35-44 years had relatively high total scores, and those with high education levels had the highest total score. There was an increased risk of heat-related illness among those with knowledge scores of 3-5 on an 8-point scale with mean score of 5.40 (standard deviation = 1.45). Having a positive attitude toward sunstroke prevention and engaging in more preventive practices to avoid heat exposure had a protective interaction effect on reducing the prevalence of heat-related illnesses. Although the KAP scores were relatively high, knowledge and practice were lacking to some extent. Therefore, governments should further develop risk-awareness strategies that increase awareness and knowledge regarding the adverse health impact of heat and help in planning response strategies to improve the ability of individuals to cope with heat waves.

  6. A Cross-Sectional Study of Heat Wave-Related Knowledge, Attitude, and Practice among the Public in the Licheng District of Jinan City, China

    Jing Li

    2016-06-01

    Full Text Available Knowledge, attitude, and practice (KAP are three key components for reducing the adverse health impacts of heat waves. However, research in eastern China regarding this is scarce. The present study aimed to evaluate the heat wave-related KAP of a population in Licheng in northeast China. This cross-sectional study included 2241 participants. Data regarding demographic characteristics, KAP, and heat illnesses were collected using a structured questionnaire. Univariate analysis and unconditional logistic regression models were used to analyze the data. Most residents had high KAP scores, with a mean score of 12.23 (standard deviation = 2.23 on a 17-point scale. Urban women and participants aged 35–44 years had relatively high total scores, and those with high education levels had the highest total score. There was an increased risk of heat-related illness among those with knowledge scores of 3–5 on an 8-point scale with mean score of 5.40 (standard deviation = 1.45. Having a positive attitude toward sunstroke prevention and engaging in more preventive practices to avoid heat exposure had a protective interaction effect on reducing the prevalence of heat-related illnesses. Although the KAP scores were relatively high, knowledge and practice were lacking to some extent. Therefore, governments should further develop risk-awareness strategies that increase awareness and knowledge regarding the adverse health impact of heat and help in planning response strategies to improve the ability of individuals to cope with heat waves.

  7. Experiences of women with stress-related ill health in a therapeutic gardening program.

    Eriksson, Therese; Westerberg, Yvonne; Jonsson, Hans

    2011-12-01

    Stress-related ill health, e.g. burnout, is of great concern worldwide. Effective rehabilitation programs need to be developed and their therapeutic aspects understood. To explore and describe how women with stress-related ill health who are on sick leave experience the rehabilitation process in a therapeutic garden and how these experiences connect to their everyday lives. This longitudinal study used methods from grounded theory. Five women completed three semi-structured interviews at three weekly intervals during rehabilitation and one interview three months after. Data were analyzed using a constant comparative approach. A secure environment facilitated engagement in activities that provided feelings of enjoyment. These experiences inspired participants to add enjoyable activities in their everyday lives, contributing to occupational balance, despite worries of not be able to continue performing enjoyable activities. Implications. Effective rehabilitation programs need to focus on enjoyable activities in a protective environment to support achievement of occupational balance.

  8. Rehabilitation and everyday life in people with stress-related ill health

    Eriksson, Therese

    2012-01-01

    The overall aim was to explore and describe knowledge of the perceived occupational repertoire in people with stress-related ill health and their experiences from the rehabilitation process, with a specific focus on rehabilitation in a therapeutic garden and how the rehabilitation experiences are connecting with everyday life. Study I was a cross-sectional study that aimed to describe and compare how occupational gaps were reported in everyday occupations in a rehabilitation group of pe...

  9. Raising Awareness on Heat Related Mortality in Bangladesh

    Arrighi, J.; Burkart, K.; Nissan, H.

    2017-12-01

    Extreme heat is the leading cause of weather-related deaths in the United States and Europe, and was responsible for four of the ten deadliest natural disasters worldwide in 2015. Near the tropics, where hot weather is considered the norm, perceived heat risk is often low, but recent heat waves in South Asia have caught the attention of the health community, policy-makers and the public. In a recent collaboration between the Red Cross Red Crescent Climate Centre, Columbia University and BBC Media Action the effects of extreme heat in Bangladesh were analyzed and the findings were subsequently used as a basis to raise awareness about the impacts of extreme heat on the most vulnerable, to the general public. Analysis of excess heat in Bangladesh between 2003 and 2007 showed that heatwaves occur between April and June with most extreme heat events occurring in May. Between 2003 and 2007 it is estimated that an average of 1500 people died per year due to heatwaves lasting three days or longer, with an eight-day heatwave in 2005 resulting in a minimum of 3,800 excess deaths. Utilizing these findings BBC Media Action launched an online communications campaign in May 2017 ultimately reaching approximately 3.9 million people with information on reducing the impacts of extreme heat. This presentation will highlight key findings from the study of heat related mortality in Bangladesh as well as highlight the benefit of collaboration between scientists and communicators for increasing awareness about the effects of extreme heat on the most vulnerable.

  10. Occupation and work-related ill-health in UK construction workers.

    Stocks, S J; Turner, S; McNamee, R; Carder, M; Hussey, L; Agius, R M

    2011-09-01

    Construction workers are at increased risk of work-related ill-health (WRI) worldwide. To compare the incidence of medically reported WRI in occupations within the UK construction industry according to job title. We calculated standardized incidence rate ratios (SRRs) using WRI cases for individual job titles returned to The Health and Occupation Reporting network by clinical specialists and UK population denominators. We counted frequencies of reported causal exposures or tasks reported by clinical specialists, occupational physicians and general practitioners. We found significantly increased incidence of WRI compared with other workers in the same major Standard Occupational Classification, i.e. workers with similar levels of qualifications, training, skills and experience, for skin neoplasia in roofers (SRR 6.3; 95% CI: 3.1-13.1), painters and decorators (2.1; 95% CI: 1.2-3.6) and labourers in building and woodworking trades (labourers, 6.6; 95% CI: 3.2-13.2); contact dermatitis in metal workers (1.4; 95% CI: 1.1-1.7) and labourers (1.6; 95% CI: 1.1-2.3); asthma in welders (3.8; 95% CI: 2.8-5.0); musculoskeletal disorders in welders (1.7; 95% CI: 1.1-2.8), road construction operatives (6.1; 95% CI: 3.8-9.6) and labourers (2.5; 95% CI: 1.7-3.7); long latency respiratory disease (mesothelioma, pneumoconiosis, lung cancer, non-malignant pleural disease) in pipe fitters (4.5; 95% CI: 3.2-6.2), electrical workers (2.7; 95% CI: 2.4-3.2), plumbing and heating engineers (2.3; 95% CI: 1.9-2.7), carpenters and joiners (2.7; 95% CI: 2.3-3.1), scaffolders (12; 95% CI: 8-18) and labourers (3.3; 95% CI: 2.6-4.1). UK construction industry workers have significantly increased risk of WRI. These data in individual construction occupations can be used to inform appropriate targeting of occupational health resources.

  11. Developing a relativities approach to valuing the prevention of non-fatal work-related accidents and ill health.

    Karnon, Jonathan; Tsuchiya, Aki; Dolan, Paul

    2005-11-01

    The aim of the current explorative study is to define and test a process for the valuation of the benefits associated with the prevention of non-fatal work-related accidents and ill health. A relativities approach is adopted, and monetary values for the prevention of three forms of work-related illness are estimated. The approach involves describing relevant attributes of alternative events (accidents or occurrences of ill health), their causes, the characteristics of the relevant working population, and the number of events that are avoidable, and asking respondents to make pair wise choices between alternatives options for prevention. Indirect monetary valuations are obtained against a peg event for which a reliable valuation exists (road deaths).A series of discussion groups were held to identify relevant factors affecting potential valuations and to test the presentation of information. The predicted magnitude of responses for three-case study events (and road deaths) was estimated in a pilot study. These preliminary stages informed the final survey instrument that described five attributes in addition to a statement of the event and occupation, and the likely intervention effect, which was administered by post. Based on a small sample, the results show that virtually all respondents passed the inserted consistency test. The median respondent altered their choice according to the number of events avoided for all three comparisons, such that the estimated valuations appear sensible. Potential amendments are suggested, but the general relativities approach warrants further investigation for the valuation of non-fatal work-related accidents and ill health.

  12. No duty owed to the relatives of a victim of a person with mental illness.

    Scott, Russ

    2015-08-01

    To review the case of an acutely psychotic person who was discharged into the care of a friend whom he killed later the same day, and to consider the reasoning of the High Court in the subsequent negligence action of the victim's relatives. By a narrow interpretation, the High Court found that the exercise of the powers and duties in relation to the involuntary detention of a mentally ill person as prescribed by the Mental Health Act were inconsistent with a common law duty of care to another person or the relatives of another person. © The Royal Australian and New Zealand College of Psychiatrists 2015.

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

    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.

  14. Relations between heat exchange and Rényi divergences

    Wei, Bo-Bo

    2018-04-01

    In this work, we establish an exact relation which connects the heat exchange between two systems initialized in their thermodynamic equilibrium states at different temperatures and the Rényi divergences between the initial thermodynamic equilibrium state and the final nonequilibrium state of the total system. The relation tells us that the various moments of the heat statistics are determined by the Renyi divergences between the initial equilibrium state and the final nonequilibrium state of the global system. In particular the average heat exchange is quantified by the relative entropy between the initial equilibrium state and the final nonequilibrium state of the global system. The relation is applicable to both finite classical systems and finite quantum systems.

  15. [Metabolic control in the critically ill patient an update: hyperglycemia, glucose variability hypoglycemia and relative hypoglycemia].

    Pérez-Calatayud, Ángel Augusto; Guillén-Vidaña, Ariadna; Fraire-Félix, Irving Santiago; Anica-Malagón, Eduardo Daniel; Briones Garduño, Jesús Carlos; Carrillo-Esper, Raúl

    Metabolic changes of glucose in critically ill patients increase morbidity and mortality. The appropriate level of blood glucose has not been established so far and should be adjusted for different populations. However concepts such as glucose variability and relative hypoglycemia of critically ill patients are concepts that are changing management methods and achieving closer monitoring. The purpose of this review is to present new data about the management and metabolic control of patients in critical areas. Currently glucose can no longer be regarded as an innocent element in critical patients; both hyperglycemia and hypoglycemia increase morbidity and mortality of patients. Protocols and better instruments for continuous measurement are necessary to achieve the metabolic control of our patients. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  16. Estimating the costs of work-related accidents and ill-health: An analysis of European data sources

    Heuvel, S. van den; Zwaan, L. van der; Dam, L. van; Oude Hengel, K.M.; Eekhout, I.; Emmerik, M.L. van; Oldenburg, C.; Brück, C.; Janowski, P.; Wilhelm, C.

    2017-01-01

    This report presents the results of a survey of national and international data sources on the costs of work-related injuries, illnesses and deaths. The aim was to evaluate the quality and comparability of different sources as a first step towards estimating the costs of accidents and ill-health at

  17. The relation of illness perceptions to stress, depression, and fatigue in patients with chronic lymphocytic leukaemia.

    Westbrook, Travis D; Maddocks, Kami; Andersen, Barbara L

    2016-07-01

    Chronic lymphocytic leukaemia (CLL) is the most prevalent adult leukaemia and is incurable. The course and treatment of CLL is unique and characterised by repeated cycles of treatment, stable disease and relapse. Utilising a Self-Regulatory Model framework, we examined the relationship between patients' illness perceptions and cancer-specific stress, depressive symptoms and fatigue. Our aim was to test illness perceptions as predictors of these outcomes when variance due to disease and treatment variables was controlled. Data were collected on 147 patients with relapsed/refractory CLL as they entered a phase II clinical trial of an investigational medication at a university affiliated, National Cancer Institute designated comprehensive cancer center. Cancer-specific stress, depressive symptoms and fatigue interference. . Hierarchical multiple regression was used. Consequences and emotional representation were related to all outcomes (ps stress (p fatigue interference (p stress, depressive symptoms and fatigue interference in relapsed/refractory CLL. Interventions targeted at restructuring maladaptive illness perceptions may have clinical benefit in this population.

  18. Fermentation products as feed additives mitigate some ill-effects of heat stress in pigs.

    Kumar, S; Bass, B E; Bandrick, M; Loving, C L; Brockmeier, S L; Looft, T; Trachsel, J; Madson, D M; Thomas, M; Casey, T A; Frank, J W; Stanton, T B; Allen, H K

    2017-01-01

    Heat stress (HS) may result in economic losses to pig producers across the USA and worldwide. Despite significant advancements in management practices, HS continues to be a challenge. In this study, an in-feed antibiotic (carbadox, CBX) and antibiotic alternatives ( [XPC], and [SGX] fermentation products) were evaluated in a standard pig starter diet as mitigations against the negative effects of HS in pigs. A total of 100 gilts were obtained at weaning (6.87 ± 0.82 kg BW, 19.36 ± 0.72 d of age) and randomly assigned to dietary treatments (2 rooms/treatment, 2 pens/room, 6 to 7 pigs/pen). After 4 wk of dietary acclimation, half of the pigs in each dietary group (1 room/dietary treatment) were exposed to repeated heat stress conditions (RHS; daily cycles of 19 h at 25°C and 5 h at 40°C, repeated for 9 d), and the remaining pigs were housed at constant thermal neutral temperature (25°C, [NHS]). Pigs subjected to RHS had elevated skin surface temperature ( treatment. Independent of diet, RHS pigs had significantly shorter ( stress resulted in decreased villus height to crypt depth ratio (V:C) in pigs fed with control diet with no added feed additive (NON) and CBX diets at d 3, whereas the pigs fed diets containing XPC or SGX showed no decrease. Transcriptional expression of genes involved in cellular stress (, , , ), tight junction integrity (, , ), and immune response (, , and ) were measured in the ileum mucosa. Pigs in all dietary treatments subjected to RHS had significantly higher ( natural killer () cell numbers or NK cell lytic activity. In conclusion, pigs subjected to RHS had decreased performance, and supplementation with fermentation products in the feed (XPC and SGX) protected pigs from injury to the jejunum mucosa.

  19. Exertional heat illness incidence and on-site medical team preparedness in warm weather.

    Hosokawa, Yuri; Adams, William M; Belval, Luke N; Davis, Robert J; Huggins, Robert A; Jardine, John F; Katch, Rachel K; Stearns, Rebecca L; Casa, Douglas J

    2018-03-29

    To investigate the influence of estimated wet bulb globe temperature (WBGT) and the International Institute of Race Medicine (IIRM) activity modification guidelines on the incidence of exertional heat stroke (EHS) and heat exhaustion (HEx) and the ability of an on-site medical team to treat those afflicted. Medical records of EHS and HEx patients over a 17-year period from the New Balance Falmouth Road Race were examined. Climatologic data from nearby weather stations were obtained to calculate WBGT with the Australian Bureau of Meteorology (WBGT A ) and Liljegren (WBGT L ) models. Incidence rate (IR) of EHS, HEx, and combined total of EHS and HEx (COM) were calculated, and linear regression analyses were performed to assess the relationship between IR and WBGT A or WBGT L . One-way ANOVA was performed to compare differences in EHS, HEx, and COM incidence to four alert levels in the IIRM guidelines. Incidence of EHS, HEx, and COM was 2.12, 0.98, and 3.10 cases per 1000 finishers. WBGT A explained 48, 4, and 46% of the variance in EHS, HEx, and COM IR; WBGT L explained 63, 13, and 69% of the variance in EHS, HEx, and COM IR. Main effect of WBGT A and WBGT L on the alert levels were observed in EHS and COM IR (p < 0.05). The cumulative number of EHS patients treated did not exceed the number of cold water immersion tubs available to treat them. EHS IR increased as WBGT and IIRM alert level increased, indicating the need for appropriate risk mitigation strategies and on-site medical treatment.

  20. Exertional heat illness incidence and on-site medical team preparedness in warm weather

    Hosokawa, Yuri; Adams, William M.; Belval, Luke N.; Davis, Robert J.; Huggins, Robert A.; Jardine, John F.; Katch, Rachel K.; Stearns, Rebecca L.; Casa, Douglas J.

    2018-03-01

    To investigate the influence of estimated wet bulb globe temperature (WBGT) and the International Institute of Race Medicine (IIRM) activity modification guidelines on the incidence of exertional heat stroke (EHS) and heat exhaustion (HEx) and the ability of an on-site medical team to treat those afflicted. Medical records of EHS and HEx patients over a 17-year period from the New Balance Falmouth Road Race were examined. Climatologic data from nearby weather stations were obtained to calculate WBGT with the Australian Bureau of Meteorology (WBGTA) and Liljegren (WBGTL) models. Incidence rate (IR) of EHS, HEx, and combined total of EHS and HEx (COM) were calculated, and linear regression analyses were performed to assess the relationship between IR and WBGTA or WBGTL. One-way ANOVA was performed to compare differences in EHS, HEx, and COM incidence to four alert levels in the IIRM guidelines. Incidence of EHS, HEx, and COM was 2.12, 0.98, and 3.10 cases per 1000 finishers. WBGTA explained 48, 4, and 46% of the variance in EHS, HEx, and COM IR; WBGTL explained 63, 13, and 69% of the variance in EHS, HEx, and COM IR. Main effect of WBGTA and WBGTL on the alert levels were observed in EHS and COM IR (p < 0.05). The cumulative number of EHS patients treated did not exceed the number of cold water immersion tubs available to treat them. EHS IR increased as WBGT and IIRM alert level increased, indicating the need for appropriate risk mitigation strategies and on-site medical treatment.

  1. An implicit measure of associations with mental illness versus physical illness: response latency decomposition and stimuli differential functioning in relation to IAT order of associative conditions and accuracy.

    Mannarini, Stefania; Boffo, Marilisa

    2014-01-01

    The present study aimed at the definition of a latent measurement dimension underlying an implicit measure of automatic associations between the concept of mental illness and the psychosocial and biogenetic causal explanatory attributes. To this end, an Implicit Association Test (IAT) assessing the association between the Mental Illness and Physical Illness target categories to the Psychological and Biologic attribute categories, representative of the causal explanation domains, was developed. The IAT presented 22 stimuli (words and pictures) to be categorized into the four categories. After 360 university students completed the IAT, a Many-Facet Rasch Measurement (MFRM) modelling approach was applied. The model specified a person latency parameter and a stimulus latency parameter. Two additional parameters were introduced to denote the order of presentation of the task associative conditions and the general response accuracy. Beyond the overall definition of the latent measurement dimension, the MFRM was also applied to disentangle the effect of the task block order and the general response accuracy on the stimuli response latency. Further, the MFRM allowed detecting any differential functioning of each stimulus in relation to both block ordering and accuracy. The results evidenced: a) the existence of a latency measurement dimension underlying the Mental Illness versus Physical Illness - Implicit Association Test; b) significant effects of block order and accuracy on the overall latency; c) a differential functioning of specific stimuli. The results of the present study can contribute to a better understanding of the functioning of an implicit measure of semantic associations with mental illness and give a first blueprint for the examination of relevant issues in the development of an IAT.

  2. Work-related injuries and illnesses reported by World Trade Center response workers and volunteers.

    Perritt, Kara R; Herbert, Robin; Levin, Stephen M; Moline, Jacqueline

    2011-12-01

    In 2002, the Mount Sinai Center for Occupational and Environmental Medicine, with support from the National Institute for Occupational Safety and Health (NIOSH), began coordinating the World Trade Center (WTC) Worker and Volunteer Medical Screening Program (MSP) to monitor the health of qualified WTC responders. Enrolled participants were offered a clinical examination; interviewed to collect medical, mental health, and exposure information; and requested to complete a self-administered medical questionnaire. The objective of this study was to better understand work-related injuries and illnesses sustained on-site by WTC responders. A descriptive analysis of select data from the MSP self-administered medical questionnaire was conducted. Data collected July 2002 through April 2004 from MSP participants enrolled at the Mount Sinai clinic were reviewed using univariate statistical techniques. Records from 7,810 participants were analyzed, with most participants associated with either the construction industry (n = 2,623, 34%) or law enforcement (n = 2,036, 26%). Approximately a third of the participants (n = 2,486, 32%) reported at least one injury or illness requiring medical treatment that was sustained during WTC work/volunteer activities. Of the total 4,768 injuries/illnesses reported by these participants, respiratory complaints were most common (n = 1,350, 28%), followed by traumatic injuries excluding eye injuries (n = 961, 20%), eye injuries/ailments (n = 709, 15%), chest pain (n = 375, 8%), headaches (n = 359, 8%), skin conditions (n = 178, 4%), and digestive system conditions (n = 163, 3%). Participants reported that 36% of injuries/illnesses were treated off-site and 29% were treated on-site, with the remaining not specifying treatment location. Off-site treatment was prevalent for respiratory complaints, psychological stress, and chest pain. On-site treatment was predominate for eye injuries/ailments and traumatic injuries excluding eye injuries. Study

  3. Linking Excessive Heat with Daily Heat-Related Mortality over the Coterminous United States

    Quattrochi, Dale A.; Crosson, William L.; Al-Hamdan, Mohammad Z.; Estes, Maurice G., Jr.

    2014-01-01

    In the United States, extreme heat is the most deadly weather-related hazard. In the face of a warming climate and urbanization, which contributes to local-scale urban heat islands, it is very likely that extreme heat events (EHEs) will become more common and more severe in the U.S. This research seeks to provide historical and future measures of climate-driven extreme heat events to enable assessments of the impacts of heat on public health over the coterminous U.S. We use atmospheric temperature and humidity information from meteorological reanalysis and from Global Climate Models (GCMs) to provide data on past and future heat events. The focus of research is on providing assessments of the magnitude, frequency and geographic distribution of extreme heat in the U.S. to facilitate public health studies. In our approach, long-term climate change is captured with GCM outputs, and the temporal and spatial characteristics of short-term extremes are represented by the reanalysis data. Two future time horizons for 2040 and 2090 are compared to the recent past period of 1981- 2000. We characterize regional-scale temperature and humidity conditions using GCM outputs for two climate change scenarios (A2 and A1B) defined in the Special Report on Emissions Scenarios (SRES). For each future period, 20 years of multi-model GCM outputs are analyzed to develop a 'heat stress climatology' based on statistics of extreme heat indicators. Differences between the two future and the past period are used to define temperature and humidity changes on a monthly time scale and regional spatial scale. These changes are combined with the historical meteorological data, which is hourly and at a spatial scale (12 km) much finer than that of GCMs, to create future climate realizations. From these realizations, we compute the daily heat stress measures and related spatially-specific climatological fields, such as the mean annual number of days above certain thresholds of maximum and minimum air

  4. Altered cortical expression of GABA-related genes in schizophrenia: illness progression vs developmental disturbance.

    Hoftman, Gil D; Volk, David W; Bazmi, H Holly; Li, Siyu; Sampson, Allan R; Lewis, David A

    2015-01-01

    Schizophrenia is a neurodevelopmental disorder with altered expression of GABA-related genes in the prefrontal cortex (PFC). However, whether these gene expression abnormalities reflect disturbances in postnatal developmental processes before clinical onset or arise as a consequence of clinical illness remains unclear. Expression levels for 7 GABA-related transcripts (vesicular GABA transporter [vGAT], GABA membrane transporter [GAT1], GABAA receptor subunit α1 [GABRA1] [novel in human and monkey cohorts], glutamic acid decarboxylase 67 [GAD67], parvalbumin, calretinin, and somatostatin [previously reported in human cohort, but not in monkey cohort]) were quantified in the PFC from 42 matched pairs of schizophrenia and comparison subjects and from 49 rhesus monkeys ranging in age from 1 week postnatal to adulthood. Levels of vGAT and GABRA1, but not of GAT1, messenger RNAs (mRNAs) were lower in the PFC of the schizophrenia subjects. As previously reported, levels of GAD67, parvalbumin, and somatostatin, but not of calretinin, mRNAs were also lower in these subjects. Neither illness duration nor age accounted for the levels of the transcripts with altered expression in schizophrenia. In monkey PFC, developmental changes in expression levels of many of these transcripts were in the opposite direction of the changes observed in schizophrenia. For example, mRNA levels for vGAT, GABRA1, GAD67, and parvalbumin all increased with age. Together with published reports, these findings support the interpretation that the altered expression of GABA-related transcripts in schizophrenia reflects a blunting of normal postnatal development changes, but they cannot exclude a decline during the early stages of clinical illness. © The Author 2013. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  5. Self-defining memories related to illness and their integration into the self in patients with schizophrenia.

    Berna, Fabrice; Bennouna-Greene, Mehdi; Potheegadoo, Jevita; Verry, Paulina; Conway, Martin A; Danion, Jean-Marie

    2011-08-30

    Although schizophrenia alters the sense of personal identity, little is known about the impact of illness-related autobiographical events on patients' self-representation. We investigated self-defining memories (SDM) in 24 patients with schizophrenia and 24 controls to explore how illness-related SDM were integrated into the self at both the cognitive (how participants are able to give a meaning to past events: meaning making) and affective levels (how participants can re-experience past negative events as less negative: redemption and benefaction effects). We found that 26% of freely recalled SDM referred to their illness in patients. Further, while meaning making was impaired in patients for both illness-related and other SDM, illness-related SDM were characterized by a higher redemption and benefaction effects than other SDM. Our results highlight that despite a reduced ability to give a meaning to illness-related episodes, emotional processing seems to allow these events to become positively integrated into patients' life stories. This study provides new findings about the construction of the self in relation to psychotic episodes in patients with schizophrenia. We discuss clinical implications of our results that are helpful to guide cognitive interventions. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  6. Pesticide-related illness reported to and diagnosed in Primary Care: implications for surveillance of environmental causes of ill-health

    Mann Vera

    2009-07-01

    Full Text Available Abstract Background In Great Britain (GB, data collected on pesticide associated illness focuses on acute episodes such as poisonings caused by misuse or abuse. This study aimed to investigate the extent and nature of pesticide-related illness presented and diagnosed in Primary Care and the feasibility of establishing a routine monitoring system. Methods A checklist, completed by General Practitioners (GP for all patients aged 18+ who attended surgery sessions, identified patients to be interviewed in detail on exposures and events that occurred in the week before their symptoms appeared. Results The study covered 59320 patients in 43 practices across GB and 1335 detailed interviews. The annual incidence of illness reported to GPs because of concern about pesticide exposure was estimated to be 0.04%, potentially 88400 consultations annually, approximately 1700 per week. The annual incidence of consultations where symptoms were diagnosed by GPs as likely to be related to pesticide exposure was 0.003%, an annual estimate of 6630 consultations i.e. about 128 per week. 41% of interviewees reported using at least one pesticide at home in the week before symptoms occurred. The risk of having symptoms possibly related to pesticide exposure compared to unlikely was associated with home use of pesticides after adjusting for age, gender and occupational pesticide exposure (OR = 1.88, 95% CI 1.51 – 2.35. Conclusion GP practices were diverse and well distributed throughout GB with similar symptom consulting patterns as in the Primary Care within the UK. Methods used in this study would not be feasible for a routine surveillance system for pesticide related illness. Incorporation of environmental health into Primary Care education and practice is needed.

  7. Taste Reward Circuitry Related Brain Structures Characterize Ill and Recovered Anorexia Nervosa and Bulimia Nervosa

    Frank, Guido K.; Shott, Megan E.; Hagman, Jennifer O.; Mittal, Vijay A.

    2013-01-01

    Objective The pathophysiology of the eating disorder anorexia nervosa remains obscure, but structural brain alterations could be functionally important biomarkers. Here we assessed taste pleasantness and reward sensitivity in relation to brain structure, which might be related to food avoidance commonly seen in eating disorders. Method We used structural magnetic resonance brain imaging to study gray and white matter volumes in individuals with restricting type currently ill (n = 19) or recovered-anorexia nervosa (n = 24), bulimia nervosa (n= 19) and healthy control women (n=24). Results All eating disorder groups showed increased gray matter volume of the medial orbitofrontal cortex (gyrus rectus). Manually tracing confirmed larger gyrus rectus volume, and predicted taste pleasantness across all groups. The analyses also indicated other morphological differences between diagnostic categories: Ill and recovered-anorexia nervosa had increased right, while bulimia nervosa had increased left antero-ventral insula gray matter volumes compared to controls. Furthermore, dorsal striatum volumes were reduced in recovered-anorexia and bulimia nervosa, and predicted sensitivity to reward in the eating disorder groups. The eating disorder groups also showed reduced white matter in right temporal and parietal areas when compared to healthy controls. Notably, the results held when controlling for a range of covariates (e.g., age, depression, anxiety, medications). Conclusion Brain structure in medial orbitofrontal cortex, insula and striatum is altered in eating disorders and suggests altered brain circuitry that has been associated with taste pleasantness and reward value. PMID:23680873

  8. Using Action Research to prevent work-related illness among rubber farmers in Northeastern Thailand.

    Sena, Wijitra; Nilvarangkul, Kessarawan; Saranrittichai, Kesinee; Smith, John F; Phajan, Teerasak; Seetangkham, Sansanee

    2018-06-10

    This research aimed to enhance self-care among rubber farmers for preventing work-related illness. The project used Action Research's four phase iterative process: fact-finding to understand the problems, action planning, action plan implementation, and evaluation and reflection on action plan impacts. Sixty-six participants (46 rubber farmers and 20 community stakeholders) were purposively recruited from two villages in the top 10 rubber producing provinces in Northeastern Thailand. Demographic and work-related illness data were collected in face-to-face structured interviews, Focus group interviews and participant observations were used to collect data in each project phase. Night group meetings were held throughout the research phases. The intervention included training workshops and establishing a community health education team for ongoing farmer support. Results showed improved farmer self-care behaviors and establishment of a community health education team to encourage farmers to care for themselves properly. Community nurses, other health personnel, and the Thai government can build on initiatives like this to strengthen occupational health and safety practices and services policy for rubber farmers. © 2018 Wiley Periodicals, Inc.

  9. Schizophrenia and dissociation: Its relation with severity, self-esteem and awareness of illness.

    Justo, Ania; Risso, Alicia; Moskowitz, Andrew; Gonzalez, Anabel

    2018-03-07

    This article describes the conclusions of an investigation done with 120 Spanish patients: the finding of a new psychopathological profile within a subgroup of patients suffering from schizophrenia. The patients were evaluated through different questionnaires about sociodemographic data, traumatic events, the severity index (both clinical and psychopathological), self-esteem and consciousness of the illness. From the scores obtained on a scale of dissociative experiences, they were classified into two groups: high dissociative symptomatology or HD, and low dissociative symptomatology or LD. The HD group contained 44 patients (36.7% of the total population). The groups LD and HD show meaningful differences with respect to dissociative symptomatology levels, general psychopathology and level of traumatic events suffered. The percentage of patients with low self-esteem was higher in group HD than in group LD (M=25.52 front 28.76 of group LD; t (118)=2.94, p=.00). In addition, the group HD was more conscious of having a mental disorder, of the beneficial effects of medication and of the social consequences of their illness: F (1)=10.929, p=.001; ƞ2pt=0.083; 1-β=0.907. The results show the existence of a subgroup of schizophrenic patients with higher levels of dissociation and trauma that were related with higher levels of symptomatology, lower self-esteem and higher consciousness of the illness, building a population of higher severity in which it would make sense to implement coadjutant treatments specifically oriented to these variables and, in addition, opening a therapeutic possibility for the patients with refractory schizophrenia. Copyright © 2018 Elsevier B.V. All rights reserved.

  10. The impact of experiential avoidance on the relations between illness representations, pain catastrophising and pain interference in chronic pain.

    Karademas, Evangelos C; Karekla, Maria; Flouri, Magdalini; Vasiliou, Vasilis S; Kasinopoulos, Orestis; Papacostas, Savvas S

    2017-12-01

    The aim of this study was to examine the effects of experiential avoidance (EA) on the indirect relationship of chronic pain patients' illness representations to pain interference, through pain catastrophising Design and main outcome measure: The sample consisted of 162 patients diagnosed with an arthritis-related or a musculoskeletal disorder. The effects of EA on the pathway between illness representations, pain catastrophising and pain interference were examined with PROCESS, a computational tool for SPSS Results: After controlling for patient and illness-related variables and pain severity, the 'illness representations-pain catastrophising-pain interference' pathway was interrupted at the higher levels of EA. The reason was that, at the high levels of EA, either the relation of illness representations to pain catastrophising or the relation of pain catastrophising to pain interference was not statistically significant. The findings indicate that EA is not a generalised negative response to highly aversive conditions, at least as far as the factors examined in this study are concerned. EA may rather reflect a coping reaction, the impact of which depends on its specific interactions with the other aspects of the self-regulation mechanism. At least in chronic pain, EA should become the focus of potential intervention only when its interaction with the illness-related self-regulation mechanism results in negative outcomes.

  11. Urban Heat Island Effect Actions - Neighborhood Data

    Louisville Metro Government — The urban heat island effect — defined as the difference in temperature between the core of Louisville and its suburbs — contributes to heat-related illnesses and...

  12. MR imaging of the central nervous system in diving-related decompression illness

    Reuter, M.; Hutzelmann, A.; Steffens, J.C.; Heller, M.; Fritsch, G.

    1997-01-01

    Purpose: This investigation was conducted to determine whether MR imaging showed cerebral or spinal damage in acute diving-related decompression illness, a term that includes decompressions sickness (DCS) and arterial gas embolism (AGE). Material and Methods: A total of 16 divers with dysbaric injuries were examined after the initiation of therapeutic recompression. Their injuries comprised: neurological DCS II n=8; AGE n=7; combined cerebral-AGE/spinal-DCS n=1. T1- and T2-weighted images of the brain were obtained in 2 planes. In addition, the spinal cord was imaged in 7 subjects. The imaging findings were correlated with the neurological symptoms. Results: MR images of the head showed ischemic cerebrovascular lesions in 6/8 patients with AGE but showed focal hyperintensities in only 2/8 divers with DCS. Spinal-cord involvement was detected in 1/7 examinations, which was the combined cerebral-AGE/spinal-DCS case. There was agreement between the locations of the documented lesions and the clinical manifestations. Conclusion: MR readily detects cerebral damage in AGE but yields low sensitivity in DCS. A negative MR investigation cannot rule out AGE or DCS. However, MR is useful in the examination of patients with decompression illness. (orig.)

  13. Creating the final conversations scale: a measure of end-of-life relational communication with terminally ill individuals.

    Generous, Mark Alan; Keeley, Maureen P

    2014-01-01

    Final conversations (FCs) are defined as the communicative interactions, both verbal and nonverbal, that occur between terminally ill patients and relational partners. In this study, the "Final Conversations Scale" was developed and tested. A total of 152 participants that had engaged in final conversations with individuals that were terminally ill completed the newly developed instrument. Factor analysis produced a five-factor structure, including: messages of spirituality/religion; expressions of love; proactive difficult relationship talk; everyday communication; and talk about illness/death. Participants' perceptions of the relational closeness and difficulty with the deceased significantly influenced the individuals' recalled frequency of FCs messages. Practical and scholarly implications focus on the needs of the family members regarding their communication with terminally ill individuals, as well as directions for future research with the FCs Scale.

  14. Visual event-related potentials as markers of hyperarousal in Gulf War Illness: evidence against a stress-related etiology

    Tillman, Gail D.; Calley, Clifford S.; Green, Timothy A.; Buhl, Virginia I.; Biggs, Melanie M.; Spence, Jeffrey S.; Briggs, Richard W.; Haley, Robert W.; Kraut, Michael A.; Hart, John

    2012-01-01

    An exaggerated response to emotional stimuli is among the many symptoms widely reported by veterans of the 1991 Persian Gulf War. These symptomologies have been attributed to damage and dysfunction associated with deployment-related exposures. We collected event-related potential data from 22 veterans meeting Haley criteria for Gulf War (GW) Syndromes 1-3 and from 8 matched GW veteran controls, who were deployed but not symptomatic, while they performed a visual three-condition oddball task where images authenticated to be associated with the 1991 Persian Gulf War were the distractor stimuli. Hyperarousal reported by ill veterans was significantly greater than that by control veterans, but this was not paralleled by higher amplitude P3a in their ERP responses to GW-related distractor stimuli. Whereas previous studies of PTSD patients have shown higher amplitude P3b responses to target stimuli that are placed amid trauma-related nontarget stimuli, ill veterans in this study showed P3b amplitudes to target stimuli—placed amid GW-related nontarget stimuli—that were significantly lower than those of the control group. Hyperarousal scores reliably predicted P3b, but not P3a, amplitudes. Although many factors may contribute to P3b amplitude differences—most notably depression and poor sleep quality, symptoms that are prevalent in the GW syndrome groups—our findings in context of previous studies on this population are consistent with the contention that dysfunction in cholinergic and dopaminergic neurotransmitter systems, and in white matter and basal ganglia may be contributing to impairments in GW veterans. PMID:23149040

  15. Social differences in illness and health-related exclusion from the labour market in Denmark from 1987 to 1994

    Lissau, I; Rasmussen, N K; Hesse, N M

    2001-01-01

    employed and non-employed people, indicating a health-related exclusion from the labour market. This may explain why, in 1994, smaller occupational class differences were found in the prevalence of long-standing illness among employed people compared with the findings in 1987, whereas the health...... differences remained in the different educational groups. Women above 54 years of age with basic education only and long-standing illness have the highest odds ratio of permanent exclusion from the labour market....

  16. heat-induced biological changes as heat tolerance indices related to growth performance in buffaloes

    Kaldes, M.Z.N.

    2004-01-01

    the main objective of this study was to predict new heat tolerance indices related to hot summer growth performance, depending on heat - induced changes in some physiological and biochemical parameters of young water buffalo calves. the present study was carried out on 8 egyptian male buffalo calves of 6 months old and 106.8 kg mean body weight (B W), and on the same animals of 12 months old and 179.5 kg mean B W. the animals were maintained in a climatic chamber of the egyptian atomic energy authority. the animals were maintained in metabolic cages inside a climatic chamber for 3 weeks under mild climate (20-24 c and 50-60% Rh, equivalent to 62-72 THI) for 6 hours daily as adjustment period,followed by 5 and 7 days in the 6- and 12-month old calves, respectively at the same climatic conditions as a control period.this was followed by 6 hours of acute heat exposure period (33-43 c and 40-60% Rh, equivalent to 85-93 Thi), then by chronic heat exposure period of the same climatic conditions for 5 and 7 days in the 6- and 12- month old calves, respectively.Rectal temperature (RT) and respiration rate (RR) were estimated daily, whereas BW was estimated at the beginning and the end of each exposure period

  17. How multiple sclerosis is related to animal illness, stress and diabetes

    Warren, S.A.; Warren, K.G.; Greenhill, S.; Paterson, M.

    1982-02-15

    At the University of Alberta's multiple sclerosis research clinic 100 patients with multiple sclerosis were matched to control patients for age, sex, race and zone of residence before the age of 15 years. Case and control subjects were interviewed and information was collected by questionnaire on factors that might play a role in the development of multiple sclerosis. The only factors found to be significantly associated with the development of this disorder were a history of leisure time spent in physical activities before the onset of symptoms, exposure to animal illness -- specifically canine distemper -- and a history of severe or prolonged emotional stress. The study also confirmed a familial predisposition to multiple sclerosis and suggested a relation between the disorder and a personal or family history of diabetes mellitus.

  18. Ethics and the compensation of immigrant workers for work-related injuries and illnesses.

    Gravel, Sylvie; Vissandjée, Bilkis; Lippel, Katherine; Brodeur, Jean-Marc; Patry, Louis; Champagne, François

    2010-10-01

    This paper examines the compensation process for work-related injuries and illnesses by assessing the trajectories of a sample of immigrant and non-immigrant workers (n = 104) in Montreal. Workers were interviewed to analyze the complexity associated with the compensation process. Experts specialized in compensation issues assessed the difficulty of the interviewees' compensation process. Immigrant workers faced greater difficulties with medical, legal, and administrative issues than non-immigrants did. While immigrant workers' claim forms tended to be written more often by employers or friends (58% vs. 8%), the claims were still more often contested by employers (64% vs. 24%). Immigrant workers were less likely to obtain a precise diagnosis (64% vs. 42%) and upon returning to work were more likely to face sub-optimal conditions. Such results throw into relief issues of ethics and equity in host societies that are building their economy with migrant workers.

  19. Indirect, out-of-pocket and medical costs from influenza-related illness in young children.

    Ortega-Sanchez, Ismael R; Molinari, Noelle-Angelique M; Fairbrother, Gerry; Szilagyi, Peter G; Edwards, Kathryn M; Griffin, Marie R; Cassedy, Amy; Poehling, Katherine A; Bridges, Carolyn; Staat, Mary Allen

    2012-06-13

    Studies have documented direct medical costs of influenza-related illness in young children, however little is known about the out-of-pocket and indirect costs (e.g., missed work time) incurred by caregivers of children with medically attended influenza. To determine the indirect, out-of-pocket (OOP), and direct medical costs of laboratory-confirmed medically attended influenza illness among young children. Using a population-based surveillance network, we evaluated a representative group of children aged accounting databases, and follow-up interviews with caregivers. Outcome measures included work time missed, OOP expenses (e.g., over-the-counter medicines, travel expenses), and direct medical costs. Costs were estimated (in 2009 US Dollars) and comparisons were made among children with and without high risk conditions for influenza-related complications. Data were obtained from 67 inpatients, 121 ED patients and 92 outpatients with laboratory-confirmed influenza. Caregivers of hospitalized children missed an average of 73 work hours (estimated cost $1456); caregivers of children seen in the ED and outpatient clinics missed 19 ($383) and 11 work hours ($222), respectively. Average OOP expenses were $178, $125 and $52 for inpatients, ED-patients and outpatients, respectively. OOP and indirect costs were similar between those with and without high risk conditions (p>0.10). Medical costs totaled $3990 for inpatients and $730 for ED-patients. Out-of-pocket and indirect costs of laboratory-confirmed and medically attended influenza in young children are substantial and support the benefits of vaccination. Published by Elsevier Ltd.

  20. Work-related ill-health: Republic of Ireland, Northern Ireland, Great Britain 2005-2012.

    Money, A; Carder, M; Noone, P; Bourke, J; Hayes, J; Turner, S; Agius, R

    2015-01-01

    Data on work-related ill-health (WRIH) in the Republic of Ireland is inconsistent. To compare the incidence of WRIH in the Republic of Ireland (ROI), Northern Ireland (NI) and Great Britain (GB) reported by clinical specialists in skin and respiratory medicine and by specialist occupational physicians (OPs). Analysis of data reported to three surveillance schemes in The Health and Occupation Research (THOR) network in ROI and corresponding UK schemes. Contact dermatitis was the most frequently reported skin disease in the three areas. Asthma was the most frequently-reported respiratory disease in the ROI, while asbestos-related cases predominate in GB and NI. Mental health disorders, followed by musculoskeletal disorders were reported most frequently by OPs. Annual average incidence rates for skin disease were 2 per 100000 employed (95% confidence interval [CI] 1.9-2.8) in the ROI and 7 per 100000 for GB (95% CI 4.8-9.4). Unadjusted incidence rates for respiratory disease were 1 (95% CI 0.3-1) and 8 (95% CI 6.1-10.7) per 100000 in the ROI and GB, respectively; adjusted for reporter non-response, these figures increased to 15 (95% CI 11.3-19.6) and 32 (95% CI 28.4-35.6) per 100000 respectively. This is the first paper to include THOR data on WRIH from the ROI, NI and GB. Consistent and dedicated data collection in the ROI via the THOR schemes is viable and important in the light of a deficit of occupational ill-health data. Sustained efforts to improve participation are underway. © The Author 2014. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  1. Simple exercise test for the prediction of relative heat tolerance

    Kenney, W.L.; Lewis, D.A.; Anderson, R.K.; Kamon, E.

    1986-01-01

    A medical screening exercise test is presented which accurately predicts relative heat tolerance during work in very hot environments. The test consisted of 15-20 min of exercise at a standard absolute intensity of about 600 kcal/hr (140W) with the subject wearing a vapor-barrier suit. Five minutes after the subject exercised, recovery heart rate was measured. When this heart rate is used, a physiological limit (+/- approximately 5 min) can be predicted with 95% confidence for the most intense work-heat conditions found in nuclear power stations. In addition, site health and safety personnel can establish qualification criteria for work on hot jobs, based on the test results. The test as developed can be performed in an office environment with the use of a minimum of equipment by personnel with minimal expertise and training. Total maximal test duration is about 20-25 min per person and only heart rate need be monitored (simple pulse palpation will suffice). Test modality is adaptable to any ergometer, the most readily available and least expensive of which is bench-stepping. It is recommended that this test be available for use for those persons who, based upon routine medical examination or past history, are suspected of being relatively heat intolerant

  2. Videogame-Related Illness and Injury: A Review of the Literature and Predictions for Pokémon GO!

    Pourmand, Ali; Lombardi, Kevin; Kuhl, Evan; O'Connell, Francis

    2017-02-01

    Reports of videogame-related illness and injury soon emerged in the literature with the inception of videogame systems and subsequent development of novel gaming platforms and technologies. In an effort to better detail the impacts of these phenomena and provide recommendations for injury prevention as it relates to Pokémon Go and the larger world of augmented reality games, we conducted an extensive systems-based review of past trends in videogame-related illness and injury from the literature. A literature review using PubMed, Medline, and PsycInfo databases with search terms "Pokémon GO," "videogame injuries," "augmented reality injuries," and "Nintendo Injury" was performed. The search was limited to the English language, and the Boolean were used to combine the search terms. The literature search yielded 359 peer-reviewed articles, 44 of which met the study criteria and included in the review. Seventeen additional popular press reports detailing injuries related to Pokémon Go were also incorporated. Videogame-related injuries and illness include both physical trauma as well as psychological and behavioral disorder with unique patterns of injury and illness linked to specific gaming platforms. As videogames become increasingly advanced and immersive, they expose players to unique and often more serious injury and illness. Augmented reality games, such as Pokémon GO, are the next step in the evolution of this trend and likely portend a future in which many pathologic processes may become increasingly common.

  3. Prevalence of interpersonal trauma exposure and trauma-related disorders in severe mental illness

    Maria W. Mauritz

    2013-04-01

    Full Text Available Background: Interpersonal trauma exposure and trauma-related disorders in people with severe mental illness (SMI are often not recognized in clinical practice. Objective: To substantiate the prevalence of interpersonal trauma exposure and trauma-related disorders in people with SMI. Methods: We conducted a systematic review of four databases (1980–2010 and then described and analysed 33 studies in terms of primary diagnosis and instruments used to measure trauma exposure and trauma-related disorders. Results: Population-weighted mean prevalence rates in SMI were physical abuse 47% (range 25–72%, sexual abuse 37% (range 24–49%, and posttraumatic stress disorder (PTSD 30% (range 20–47%. Compared to men, women showed a higher prevalence of sexual abuse in schizophrenia spectrum disorder, bipolar disorder, and mixed diagnosis groups labelled as having SMI. Conclusions: Prevalence rates of interpersonal trauma and trauma-related disorders were significantly higher in SMI than in the general population. Emotional abuse and neglect, physical neglect, complex PTSD, and dissociative disorders have been scarcely examined in SMI.

  4. Prevalence of interpersonal trauma exposure and trauma-related disorders in severe mental illness.

    Mauritz, Maria W; Goossens, Peter J J; Draijer, Nel; van Achterberg, Theo

    2013-01-01

    Interpersonal trauma exposure and trauma-related disorders in people with severe mental illness (SMI) are often not recognized in clinical practice. To substantiate the prevalence of interpersonal trauma exposure and trauma-related disorders in people with SMI. We conducted a systematic review of four databases (1980-2010) and then described and analysed 33 studies in terms of primary diagnosis and instruments used to measure trauma exposure and trauma-related disorders. Population-weighted mean prevalence rates in SMI were physical abuse 47% (range 25-72%), sexual abuse 37% (range 24-49%), and posttraumatic stress disorder (PTSD) 30% (range 20-47%). Compared to men, women showed a higher prevalence of sexual abuse in schizophrenia spectrum disorder, bipolar disorder, and mixed diagnosis groups labelled as having SMI. Prevalence rates of interpersonal trauma and trauma-related disorders were significantly higher in SMI than in the general population. Emotional abuse and neglect, physical neglect, complex PTSD, and dissociative disorders have been scarcely examined in SMI.

  5. Improvements in or relating to devices for conducting excess heat away from heat sources

    Cooke-Yarborough, E.H.

    1976-01-01

    Reference is made to radioisotope powered heat engines. Should such an engine stop working for any reason the radioisotope heat source will continue to generate heat, and this may cause overheating and possible damage to the engine as well as the heat source. A device is described for conducting excess heat from the heat source to a heat sink but which in normal operation of the engine will impede heat conduction and so reduce thermal losses. The device may be used to support and/or locate the heat source. Constructional and operational details are given. (U.K.)

  6. Illness of the Mind or Illness of the Spirit? Mental Health-Related Conceptualization and Practices of Older Iranian Immigrants

    Martin, Shadi Sahami

    2009-01-01

    The purpose of this qualitative phenomenological study was to explore whether the way mental health is conceptualized by older Iranian immigrants can influence their mental health-related practices. In-depth interviews were conducted with 15 Iranians who had immigrated to the United States after the age of 50. The findings from this study revealed…

  7. Effectiveness of contact-based education for reducing mental illness-related stigma in pharmacy students.

    Patten, Scott B; Remillard, Alfred; Phillips, Leslie; Modgill, Geeta; Szeto, Andrew Ch; Kassam, Aliya; Gardner, David M

    2012-12-05

    A strategy for reducing mental illness-related stigma in health-profession students is to include contact-based sessions in their educational curricula. In such sessions students are able to interact socially with a person that has a mental illness. We sought to evaluate the effectiveness of this strategy in a multi-centre study of pharmacy students. The study was a randomized controlled trial conducted at three sites. Because it was necessary that all students receive the contact-based sessions, the students were randomized either to an early or late intervention, with the late intervention group not having participated in the contact-based education at the time when the primary outcome was assessed. The primary outcome, stigma, was assessed using an attitudes scale called the Opening Minds Survey for Health Care Providers (OMS-HC). We initially confirmed that outcomes were homogeneous across study centres, centre by group interaction, p = 0.76. The results were pooled across the three study centres. A significant reduction in stigma was observed in association with the contact-based sessions (mean change 4.3 versus 1.5, t=2.1, p=0.04). The effect size (Cohen's d) was 0.45. A similar reduction was seen in the control group when they later received the intervention. Contact-based education is an effective method of reducing stigma during pharmacy education. These results add to a growing literature confirming the effectiveness of contact-based strategies for stigma reduction in health profession trainees.

  8. Effectiveness of contact-based education for reducing mental illness-related stigma in pharmacy students

    Patten Scott B

    2012-12-01

    Full Text Available Abstract Background A strategy for reducing mental illness-related stigma in health-profession students is to include contact-based sessions in their educational curricula. In such sessions students are able to interact socially with a person that has a mental illness. We sought to evaluate the effectiveness of this strategy in a multi-centre study of pharmacy students. Methods The study was a randomized controlled trial conducted at three sites. Because it was necessary that all students receive the contact-based sessions, the students were randomized either to an early or late intervention, with the late intervention group not having participated in the contact-based education at the time when the primary outcome was assessed. The primary outcome, stigma, was assessed using an attitudes scale called the Opening Minds Survey for Health Care Providers (OMS-HC. Results We initially confirmed that outcomes were homogeneous across study centres, centre by group interaction, p = 0.76. The results were pooled across the three study centres. A significant reduction in stigma was observed in association with the contact-based sessions (mean change 4.3 versus 1.5, t=2.1, p=0.04. The effect size (Cohen’s d was 0.45. A similar reduction was seen in the control group when they later received the intervention. Conclusions Contact-based education is an effective method of reducing stigma during pharmacy education. These results add to a growing literature confirming the effectiveness of contact-based strategies for stigma reduction in health profession trainees.

  9. Dissimilary in patients' and spouses' representations of chronic illness: exploration of relations to patient adaptation.

    Heijmans, M.; Ridder, D. de; Bensing, J.

    1999-01-01

    In this cross-sectional study, the illness representations of patients suffering from Chronic Fatigue Syndrome (n=49) and Addison's Disease (n=52) and those of their spouses were compared. Couples generally held similar views with regard to the dimensions of illness identity and cause but disagreed

  10. Time trends for injuries and illness, and their relation to performance in the National Basketball Association.

    Podlog, Leslie; Buhler, Craig F; Pollack, Harvey; Hopkins, Paul N; Burgess, Paul R

    2015-05-01

    To survey injury/illness in the National Basketball Association over a 25-year period and examine the relationship of injury/illness to team performance. A retrospective correlational design. Trends were examined in reported numbers of players injured/ill during a season and games missed due to injury/illness from seasons ending in 1986 through 2005. This period was compared to years 2006-2010, when NBA teams were allowed to increase the total number of players on the team from 12 to 15. There was a highly significant trend (pBasketball Association up until the expansion of team size in 2006. Following 2006, team expansion was positively associated with decreased injury/illness rates. The latter finding suggests the importance of maintaining a healthy roster with respect to winning outcomes. Copyright © 2014 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  11. Mechanics/heat-transfer relation for particulate materials

    Campbell, C.S.; Wang, D.G.; Rahman, K.

    1991-11-01

    The original goal of this study was to try and understand the relationship between the thermal and mechanical properties of particulate flows. Two situations were examined. The first is a study of the effects of simple shear flows, as a embryonic flow type on the apparent thermal conductivity and apparent viscosity of a dry granular flow. The second study involved fluidized beds. The original idea was to try and relate the heat transfer behavior of a fluidized bed to the particle pressure,'' the forces by only the particle phase of the two-phase mixture. (VC)

  12. Mechanics/heat-transfer relation for particulate materials. Final report

    Campbell, C.S.; Wang, D.G.; Rahman, K.

    1991-11-01

    The original goal of this study was to try and understand the relationship between the thermal and mechanical properties of particulate flows. Two situations were examined. The first is a study of the effects of simple shear flows, as a embryonic flow type on the apparent thermal conductivity and apparent viscosity of a dry granular flow. The second study involved fluidized beds. The original idea was to try and relate the heat transfer behavior of a fluidized bed to the ``particle pressure,`` the forces by only the particle phase of the two-phase mixture. (VC)

  13. Attitudes and beliefs about mental illness among relatives of patients with schizophrenia

    Ajak Manguak Agau

    2017-08-01

    Full Text Available Background: Schizophrenia is a mental disease with inability to differentiate real from unreal. In many African cultures a traditional view on mental disease results in stigma, negative attitudes, and ignorance of the patient and their symptoms. Objective: To explore the different attitudes and beliefs amongst relatives of patients having schizophrenia. Method: Cross-sectional survey among relatives of patients with schizophrenia treated at Butabika Mental Hospital, Kampala, Uganda. Results: A total of 44 were included. 30% believed schizophrenia to be a brain disease, 32% thought the cause was supernatural. The majority (80% thought that schizophrenia can be treated and preferably in hospitals (91%; 66% felt the best way to reduce schizophrenia was to pray to God, and many stated that being with the patients (73% or letting them be part of the community (80% was good ways of helping the patients. Conclusion: Beliefs about supernatural causes of schizophrenia and stigmatizing are still present in Uganda. However among participants many had positive attitude towards letting the patients be part of community. Education of the communities could be a way of improving the awareness of mental disorders and the role that the community play in recovery from mental illness.

  14. Event-Related Potential Patterns Associated with Hyperarousal in Gulf War Illness Syndrome Groups

    Tillman, Gail D.; Calley, Clifford S.; Green, Timothy A.; Buhl, Virginia I.; Biggs, Melanie M.; Spence, Jeffrey S.; Briggs, Richard W.; Haley, Robert W.; Hart, John; Kraut, Michael A.

    2012-01-01

    An exaggerated response to emotional stimuli is one of several symptoms widely reported by veterans of the 1991 Persian Gulf War. Many have attributed these symptoms to post-war stress; others have attributed the symptoms to deployment-related exposures and associated damage to cholinergic, dopaminergic, and white matter systems. We collected event-related potential (ERP) data from 20 veterans meeting Haley criteria for Gulf War Syndromes 1–3 and from 8 matched Gulf War veteran controls, who were deployed but not symptomatic, while they performed an auditory three-condition oddball task with gunshot and lion roar sounds as the distractor stimuli. Reports of hyperarousal from the ill veterans were significantly greater than those from the control veterans; different ERP profiles emerged to account for their hyperarousability. Syndromes 2 and 3, who have previously shown brainstem abnormalities, show significantly stronger auditory P1 amplitudes, purported to indicate compromised cholinergic inhibitory gating in the reticular activating system. Syndromes 1 and 2, who have previously shown basal ganglia dysfunction, show significantly weaker P3a response to distractor stimuli, purported to indicate dysfunction of the dopaminergic contribution to their ability to inhibit distraction by irrelevant stimuli. All three syndrome groups showed an attenuated P3b to target stimuli, which could be secondary to both cholinergic and dopaminergic contributions or disruption of white matter integrity. PMID:22691951

  15. Time trends in the incidence of work-related mental ill-health and musculoskeletal disorders in the UK.

    Carder, Melanie; McNamee, Roseanne; Turner, Susan; Hodgson, John Timothy; Holland, Fiona; Agius, Raymond M

    2013-05-01

    To determine UK trends (from 1996 to 2009) in incidence of work-related mental ill-health and musculoskeletal disorders, for all industry as well as for health and social care employees. Second, to investigate whether there may have been a recent shift from a physical to psychological perspective in how patients present their illness by comparing reporting trends for back pain and 'other work stress'. Multilevel models were used to investigate changes in incidence of work-related illness, as diagnosed by specialist physicians. The dependent variable comprised case reports to The Health and Occupation Research network. Comparisons were made between medical specialties, industry (health and social care vs all other employees), gender and diagnosis. Trends for Occupational Physicians' (OP) reporting mental ill-health (average annual increase +3.7% (95% CI +2.2% to +5.2%)) differed significantly (phealth and social care employees. A fall in incidence of musculoskeletal disorders for OPs of -5.8% (95% CI -7.3% to -4.3%) and rheumatologists' reporting -6.6% (95% CI -8.3% to -4.8%) was found, with little variation by gender or industry. Within health and social care, an increase in incidence of 'other work stress' was accompanied by a similar decrease in 'spine/back pain'. The evidence presented is consistent with a shift in the presentation of ill-health from a physical to psychological perspective, although changes in hazards, prevention measures and physician awareness should also be considered as explanations.

  16. [Do Attachment Styles of Mentally Ill Parents Impact on the Health-related Quality of Life of their Children?].

    Wiegand-Grefe, Silke; Bomba, Franziska; Tönnies, Sven; Bullinger, Monika; Plass, Angela

    2016-01-01

    Do Attachment Styles of Mentally Ill Parents Impact on the Health-related Quality of Life of their Children? Parents with a mental disorder often display a problematic attachment style which may impact on their children's health related quality of life (HrQoL). The current study cross-sectionally examines attachment styles (BEPE) in mentally ill parents with underage children (n = 62) and the effect of attachment on their children's HrQoL (KINDL-R). Results show that secure attachment is less represented in parents with a mental health condition than in a healthy reference group. Within the clinical sample, children of mentally ill parents with a secure attachment style exhibit a higher HrQoL than children of mentally ill parents with ambivalent or avoidant attachment styles. These findings indicate not only that problematic attachment styles frequently occur in families with a mentally ill parent, but also suggest that this negatively affects the children's HrQoL. Appropriate interventions should include attachment oriented concepts.

  17. The relation of near-infrared spectroscopy with changes in peripheral circulation in critically ill patients

    Lima, Alexandre; van Bommel, Jasper; Sikorska, Karolina; van Genderen, Michel; Klijn, Eva; Lesaffre, Emmanuel; Ince, Can; Bakker, Jan

    2011-01-01

    We conducted this observational study to investigate tissue oxygen saturation during a vascular occlusion test in relationship with the condition of peripheral circulation and outcome in critically ill patients. Prospective observational study. Multidisciplinary intensive care unit in a university

  18. Perspectives on care and communication involving incurably ill Turkish and Moroccan patients, relatives and professionals: a systematic literature review

    de Graaff, F.M.; Mistiaen, P.; Devillé, W.L.J.M.; Francke, A.L.

    2012-01-01

    Background Our aim was to obtain a clearer picture of the relevant care experiences and care perceptions of incurably ill Turkish and Moroccan patients, their relatives and professional care providers, as well as of communication and decision-making patterns at the end of life. The ultimate

  19. Perspectives on care and communication involving incurably ill Turkish and Moroccan patients, relatives and professionals: a systematic literature review

    de Graaff, F.M.; Mistiaen, P.; Deville, W.L.; Francke, A.L.

    2012-01-01

    Abstract. Background: Our aim was to obtain a clearer picture of the relevant care experiences and care perceptions of incurably ill Turkish and Moroccan patients, their relatives and professional care providers, as well as of communication and decision-making patterns at the end of life. The

  20. Perspectives on care and communication involving incurably ill Turkish and Moroccan patients, relatives and professionals: a systematic literature review.

    Graaff, F.M. de; Mistiaen, P.; Devillé, W.L.J.M.; Francke, A.L.

    2012-01-01

    Background: Our aim was to obtain a clearer picture of the relevant care experiences and care perceptions of incurably ill Turkish and Moroccan patients, their relatives and professional care providers, as well as of communication and decision-making patterns at the end of life. The ultimate

  1. Commonly asked questions by critically ill patients relatives in Arabic countries

    Tayseer Zaytoun

    2017-04-01

    Full Text Available Background: Relatives often lack important information about intensive care unit patients. Research on ways to improve family satisfaction in the ICU has become a crucial point in ICU quality improvement research. Objective: The aim of this study is to develop and analyze a list of commonly asked questions from relatives of patients in the intensive care unit in Arabic countries. This list might help families to determine which questions they want to ask and help them in decision-making process in emergency situations of their critically ill relatives. Methods: This study was a prospective double center study. It took place in the ICUs of two hospitals in Arabic countries: Egypt and Kingdom of Saudi Arabia. Alexandria University Main Hospital in Egypt and the ICU of King Fahad specialist Hospital in Dammam in Saudi Arabia. Data collection was done by reporting of Questions asked by the relatives of ICU patients during daily interview. The list of questions generated was checked to identify questions that could be eliminated. The remaining questions were categorized into 9 different groups: diagnosis, treatment, prognosis, comfort, patient interaction, family, mortality, post-ICU management and other questions. WE ranked the questions in the preliminary list through ICU staff, patients families and the patient themselves. Results: 115 Health care professional (34 physicians and 81 nurses participated in the data collection, the questions recorded were 2240 questions. It was found that about 1750 questions (78.12% were duplicated or not clear. The remaining 490 questions were classified into different categories. The same 115 Health care professional (34 physicians and 81 nurses who shared in the collection of data also shared in the ranking of the questions. 128 first degree relatives shared in the evaluation of the relevance of questions as well as 62 patients after they have been cured and before their discharge from ICU.A list was created

  2. Providing care to relatives with mental illness: reactions and distress among primary informal caregivers.

    Chang, Sherilyn; Zhang, Yunjue; Jeyagurunathan, Anitha; Lau, Ying Wen; Sagayadevan, Vathsala; Chong, Siow Ann; Subramaniam, Mythily

    2016-03-25

    The responsibility of caring for relatives with mental illness often falls on the family members. It has been reported that the reactions to or consequences of providing care are what rendered the role of a caregiver challenging and hence a source of distress. This present study thus aimed to identify socio-demographic correlates of caregiving experiences using the Caregiver Reaction Assessment (CRA) and to examine the associations between reactions to caregiving and psychological distress. A total of 350 caregivers with relatives seeking outpatient care at a tertiary psychiatric hospital were recruited for this study. Distress among caregivers was assessed using the Patient Health Questionnaire (PHQ-9). The CRA was administered to measure reactions from caregiving in four domains including impact on schedule and health (ISH), impact on finance (IF), lack of family support (LFS) and caregiver esteem (CE). Participants also completed a questionnaire that asked for their socio-demographic information. Multivariable linear regression analysis was first used with domains of CRA as outcome variables and socio-demographic variables as predictors in the models. The next set of multivariable linear regression analysis tested for the association between CRA domains and distress with CRA domain scores as outcome variables and PHQ-9 score as predictor, controlling for socio-demographic variables. Socio-demographic correlates of CRA domains identified were age, education, employment, income and ethnicity. Domain scores of CRA were significantly associated with PHQ-9 score even after controlling for socio-demographic variables. A higher distress score was associated with greater impact felt in the domain of ISH (β = 0.080, P social care support in these domains may help to address caregiver distress.

  3. Development of a symptoms questionnaire for complex regional pain syndrome and potentially related illnesses: the Trauma Related Neuronal Dysfunction Symptoms Inventory

    Collins, S.; van Hilten, J.J.; Marinus, J.J.; Zuurmond, W.W.A.; de Lange, J.J.; Perez, R.S.G.M.

    2008-01-01

    Collins S, van Hilten JJ, Marinus J, Zuurmond WW, de Lange JJ, Perez RS. Development of a symptoms questionnaire for complex regional pain syndrome and potentially related illnesses: the Trauma Related Neuronal Dysfunction Symptoms Inventory. Objective: To develop a questionnaire to evaluate

  4. The impact of sport related stressors on immunity and illness risk in team-sport athletes.

    Keaney, Lauren C; Kilding, Andrew E; Merien, Fabrice; Dulson, Deborah K

    2018-06-19

    Elite team-sport athletes are frequently exposed to stressors that have the potential to depress immunity and increase infection risk. Therefore, the purpose of this review is to describe how team-sport stressors impact upon immune responses, along with exploring whether alterations in these markers have the potential to predict upper respiratory tract illness symptoms. Narrative review. Salivary secretory immunoglobulin A (SIgA) and T-cell markers have been shown to predict infection risk in individual endurance athletes. Papers discussing the impact of team-sport stressors on SIgA and T-cells were discussed in the review, studies discussing other aspects of immunity were excluded. Journal articles were sourced from PubMed, Web of science and Scopus. Key search terms included team-sport athletes, stressors, immunity, T-cells, cytokines, SIgA and upper respiratory illness. Most team-sport stressors appear to increase risk for illness. An association between reduced SIgA and increased illness incidence has been demonstrated. Intensive training and competition periods have been shown to reduce SIgA, however, it is less clear how additional stressors including extreme environmental conditions, travel, psychological stress, sleep disturbance and poor nutrition affect immune responses. Monitoring SIgA may provide an assessment of a team-sport athletes risk status for developing upper respiratory tract symptoms, however there is currently not enough evidence to suggest SIgA alone can predict illness. Team-sport stressors challenge immunity and it is possible that the combination of stressors could have a compounding effect on immunodepression and infection risk. Given that illness can disrupt training and performance, further research is required to better elucidate how stressors individually and collectively influence immunity and illness. Copyright © 2018 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  5. Measuring illness insight in patients with alcohol-related cognitive dysfunction using the Q8 questionnaire: a validation study

    Walvoort, Serge JW; van der Heijden, Paul T; Kessels, Roy PC; Egger, Jos IM

    2016-01-01

    Aim Impaired illness insight may hamper treatment outcome in patients with alcohol-related cognitive deficits. In this study, a short questionnaire for the assessment of illness insight (eg, the Q8) was investigated in patients with Korsakoff’s syndrome (KS) and in alcohol use disorder (AUD) patients with mild neurocognitive deficits. Methods First, reliability coefficients were computed and internal structure was investigated. Then, comparisons were made between patients with KS and patients with AUD. Furthermore, correlations with the Dysexecutive Questionnaire (DEX) were investigated. Finally, Q8 total scores were correlated with neuropsychological tests for processing speed, memory, and executive function. Results Internal consistency of the Q8 was acceptable (ie, Cronbach’s α =0.73). The Q8 items represent one factor, and scores differ significantly between AUD and KS patients. The Q8 total score, related to the DEX discrepancy score and scores on neuropsychological tests as was hypothesized, indicates that a higher degree of illness insight is associated with a higher level of cognitive functioning. Conclusion The Q8 is a short, valid, and easy-to-administer questionnaire to reliably assess illness insight in patients with moderate-to-severe alcohol-related cognitive dysfunction. PMID:27445476

  6. Heat exposure and socio-economic vulnerability as synergistic factors in heat-wave-related mortality

    Rey, Gregoire; Fouillet, Anne; Bessemoulin, Pierre; Frayssinet, Philippe; Dufour, Anne; Jougla, Eric; Hemon, Denis

    2009-01-01

    Heat waves may become a serious threat to the health and safety of people who currently live in temperate climates. It was therefore of interest to investigate whether more deprived populations are more vulnerable to heat waves. In order to address the question on a fine geographical scale, the spatial heterogeneity of the excess mortality in France associated with the European heat wave of August 2003 was analysed. A deprivation index and a heat exposure index were used jointly to describe the heterogeneity on the Canton scale (3,706 spatial units). During the heat wave period, the heat exposure index explained 68% of the extra-Poisson spatial variability of the heat wave mortality ratios. The heat exposure index was greater in the most urbanized areas. For the three upper quintiles of heat exposure in the densely populated Paris area, excess mortality rates were twofold higher in the most deprived Cantons (about 20 excess deaths/100,000 people/day) than in the least deprived Cantons (about 10 excess deaths/100,000 people/day). No such interaction was observed for the rest of France, which was less exposed to heat and less heterogeneous in terms of deprivation. Although a marked increase in mortality was associated with heat wave exposure for all degrees of deprivation, deprivation appears to be a vulnerability factor with respect to heat-wave-associated mortality.

  7. The Sports-Related Injuries and Illnesses in Paralympic Sport Study (SRIIPSS): a study protocol for a prospective longitudinal study.

    Fagher, Kristina; Jacobsson, Jenny; Timpka, Toomas; Dahlström, Örjan; Lexell, Jan

    2016-01-01

    Paralympic sport provides sporting opportunities for athletes with a disability, with the Paralympic Games as the main event. Participation in sport is, however, associated with a significant risk for sustaining injuries and illnesses. Our knowledge of sports-related injuries and illnesses in Paralympic sport is very limited and there are no large-scale epidemiological cohort studies. The purpose here is to present a protocol for a prospective longitudinal study: The Sports-Related Injuries and Illnesses in Paralympic Sport Study (SRIIPSS). An argument-based method for investigation of design problems was used to structure the study protocol. The primary requirement of the protocol is to allow prospective studies over time and include exposure to both training and competition. To reflect the complexity of Paralympic sport with athletes' pre-existing impairments, use of assistive equipment, pain and other and medical issues, it is required that the data collection system is specifically adapted to Paralympic sport. To allow the collection of data, at the same time as there is limited access to coaches and medical personnel, it is advantageous that data can be collected online directly from the athletes. Based on this a self-report athlete monitoring system will be developed, where the athletes can enter data weekly via their mobile phones or lap-tops. Data will be collected from around 100 Swedish Paralympic athletes for approximately 1 year, which will allow us to i) prospectively estimate the annual incidence of sports-related injuries and illnesses and ii) explore risk factors and mechanisms for sustaining sports-related injuries and illnesses based on athlete exposure and training loads. For effective implementation of injury and illness prevention measures, comprehensive epidemiological knowledge is required. This study will be the first prospective longitudinal self-report study of sports-related injuries and illnesses in Paralympic sport over a longer period

  8. Measuring illness insight in patients with alcohol-related cognitive dysfunction using the Q8 questionnaire: a validation study

    Walvoort SJW

    2016-07-01

    Full Text Available Serge JW Walvoort,1–3 Paul T van der Heijden,3,4 Roy PC Kessels,1,2,5 Jos IM Egger1–3,6 1Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray, 2Donders Institute for Brain, Cognition and Behaviour, 3Behavioural Science Institute, Radboud University, Nijmegen, 4Reinier van Arkel Mental Health Institute, ‘s-Hertogenbosch, 5Department of Medical Psychology, Radboud University Medical Center, Nijmegen, 6Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray, the Netherlands Aim: Impaired illness insight may hamper treatment outcome in patients with alcohol-related cognitive deficits. In this study, a short questionnaire for the assessment of illness insight (eg, the Q8 was investigated in patients with Korsakoff’s syndrome (KS and in alcohol use disorder (AUD patients with mild neurocognitive deficits. Methods: First, reliability coefficients were computed and internal structure was investigated. Then, comparisons were made between patients with KS and patients with AUD. Furthermore, correlations with the Dysexecutive Questionnaire (DEX were investigated. Finally, Q8 total scores were correlated with neuropsychological tests for processing speed, memory, and executive function. Results: Internal consistency of the Q8 was acceptable (ie, Cronbach’s α =0.73. The Q8 items represent one factor, and scores differ significantly between AUD and KS patients. The Q8 total score, related to the DEX discrepancy score and scores on neuropsychological tests as was hypothesized, indicates that a higher degree of illness insight is associated with a higher level of cognitive functioning. Conclusion: The Q8 is a short, valid, and easy-to-administer questionnaire to reliably assess illness insight in patients with moderate-to-severe alcohol-related cognitive dysfunction. Keywords: illness insight, anosognosia, alcohol use disorder, Korsakoff

  9. Belonging and doing: important factors for satisfaction with sexual relations as perceived by people with persistent mental illness.

    Eklund, Mona; Ostman, Margareta

    2010-07-01

    It is increasingly acknowledged that satisfaction with sexual relations forms an important aspect of people's lives, but little is known of factors associated with this phenomenon among people with mental illness. This study aimed to investigate how demographic, social, clinical, and health-related factors were related to satisfaction with sexual relations. Patients with persistent mental illness (N = 103), recruited from an outpatient unit, were assessed regarding the target variables. No clinical variable, and only one demographic factor, namely being a cohabitant, was found to be important to satisfaction with sexual relations. Several social factors, pertaining to how everyday occupations were valued and how the social network was perceived, were shown to be of importance. General quality of life, but not self-rated health or interviewer-assessed psychopathology, was also important for satisfaction with sexual relations. A multivariate analysis showed that the most significant factor for satisfaction with sexual relations was how everyday activities were valued, and being a cohabitant explained some additional variation. Previous research indicates that the mental health care services largely neglect sexual problems among people with mental illness, and the findings may provide additional knowledge that may be used in the support of this target group.

  10. Elicitation of cognitions related to HIV risk behaviors in persons with mental illnesses: implications for prevention.

    Tennille, Julie; Solomon, Phyllis; Fishbein, Martin; Blank, Michael

    2009-01-01

    An important step in research using the Theory of Reasoned Action and Theory of Planned Behavior (TRA/TPB) is conducting an elicitation process to identify topic and population specific cognitions. This study explored HIV risk behaviors in persons with mental illnesses and introduces findings from focus groups conducted during the development phase of an HIV primary and secondary prevention intervention study. Researchers held four focus groups with persons with mental illnesses focused on HIV risks and condom use. Participants discussed sexual side effects of psychotropic medications as a potential cause of both medication non-adherence and HIV risk behaviors. The intersection of these two issues is specific to this population. We conclude with the recommendation that HIV primary and secondary prevention intervention for persons with mental illnesses must incorporate the promotion of healthy sexuality, including attention to sexual side effects of psychotropic medications.

  11. Cadherin-related Family Member 3 Genetics and Rhinovirus C Respiratory Illnesses

    Bønnelykke, Klaus; Coleman, Amaziah T; Evans, Michael D

    2018-01-01

    Background Experimental evidence suggests that CDHR3 is a receptor for rhinovirus-C (RV-C), and a missense variant in this gene (rs6967330) is associated with childhood asthma with severe exacerbations. Objective To determine whether rs6967330 influences RV-C infections and illnesses in early...... childhood. Methods We studied associations between rs6967330 and respiratory infections and illnesses in the COPSAC2010 and COAST birth cohorts, where respiratory infections were monitored prospectively for the first 3 years of life. Nasal samples were collected during acute infections in both cohorts...

  12. A spatial analysis of heat stress related emergency room visits in rural Southern Ontario during heat waves.

    Bishop-Williams, Katherine E; Berke, Olaf; Pearl, David L; Kelton, David F

    2015-08-06

    In Southern Ontario, climate change may have given rise to an increasing occurrence of heat waves since the year 2000, which can cause heat stress to the general public, and potentially have detrimental health consequences. Heat waves are defined as three consecutive days with temperatures of 32 °C and above. Heat stress is the level of discomfort. A variety of heat stress indices have been proposed to measure heat stress (e.g., the heat stress index (HSI)), and has been shown to predict increases in morbidity and/or mortality rates in humans and other species. Maps visualizing the distribution of heat stress can provide information about related health risks and insight for control strategies. Information to inform heat wave preparedness models in Ontario was previously only available for major metropolitan areas. Hospitals in communities of fewer than 100,000 individuals were recruited for a pilot study by telephone. The number of people visiting the emergency room or 24-hour urgent care service was collected for a total of 27 days, covering three heat waves and six 3-day control periods from 2010-2012. The heat stress index was spatially predicted using data from 37 weather stations across Southern Ontario by geostatistical kriging. Poisson regression modeling was applied to determine the rate of increased number of emergency room visits in rural hospitals with respect to the HSI. During a heat wave, the average rate of emergency room visits was 1.11 times higher than during a control period (IRR = 1.11, CI95% (IRR) = (1.07,1.15), p ≤ 0.001). In a univariable model, HSI was not a significant predictor of emergency room visits, but when accounting for the confounding effect of a spatial trend polynomial in the hospital location coordinates, a one unit increase in HSI predicted an increase in daily emergency rooms visits by 0.4% (IRR = 1.004, CI95%(IRR) = (1.0005,1.007), p = 0.024) across the region. One high-risk cluster and no low risk

  13. Attitudes toward mental illness in adults by mental illness-related factors and chronic disease status: 2007 and 2009 Behavioral Risk Factor Surveillance System.

    Kobau, Rosemarie; Zack, Matthew M

    2013-11-01

    We examined how attitudes toward mental illness treatment and its course differ by serious psychological distress, mental illness treatment, chronic disease, and sociodemographic factors using representative state-based data. Using data from jurisdictions supporting the Behavioral Risk Factor Surveillance System's Mental Illness and Stigma Module (35 states, the District of Columbia, and Puerto Rico), we compared adjusted proportions of adults agreeing that "Treatment can help people with mental illness lead normal lives" (treatment effectiveness) and that "People are generally caring and sympathetic to people with mental illness" (supportive environment), by demographic characteristics, serious psychological distress, chronic disease status, and mental illness treatment. Attitudes regarding treatment effectiveness and a supportive environment for people with mental illness varied within and between groups. Most adults receiving mental illness treatment agreed that treatment is effective. Fewer adults with serious psychological distress than those without such distress agreed that treatment is effective. Fewer of those receiving treatment, those with psychological distress, and those with chronic disease perceived the environment as supportive. These data can be used to target interventions for population subgroups with less favorable attitudes and for surveillance.

  14. Illness perceptions and mood states are associated with injury-related outcomes in athletes

    van Wilgen, C. Paul; Kaptein, Ad A.; Brink, Michel S.

    2010-01-01

    Background. Athletes have to cope adequately with the consequences of their injury in order to return into sports as soon as possible. Besides the physical characteristics of the injury, illness perceptions and emotional responses impact the behavioural responses to the injury. Purpose. To apply

  15. Clinical Characteristics Related to Severity of Sexual Abuse: A Study of Seriously Mentally Ill Youth.

    McClellan, Jon; And Others

    1995-01-01

    Variables associated with sexual abuse were examined among youth, ages 5 through 18, with severe mental illness. Review of 499 patient records revealed abuse as an isolated event in 62 cases, intermittent abuse in 61 cases, and chronic abuse in 150. Sexual abuse was associated with inappropriate sexual behaviors, substance abuse, and posttraumatic…

  16. Diagnostic accuracy of emergency nurse practitioners versus physicians related to minor illnesses and injuries

    van der Linden, Christien; Reijnen, Resi; de Vos, Rien

    2010-01-01

    Our objectives were to determine the incidence of missed injuries and inappropriately managed cases in patients with minor injuries and illnesses and to evaluate diagnostic accuracy of the emergency nurse practitioners (ENPs) compared with junior doctors/senior house officers (SHOs). In a

  17. Heat stress related dairy cow mortality during heat waves and control periods in rural Southern Ontario from 2010-2012.

    Bishop-Williams, Katherine E; Berke, Olaf; Pearl, David L; Hand, Karen; Kelton, David F

    2015-11-27

    Heat stress is a physiological response to extreme environmental heat such as heat waves. Heat stress can result in mortality in dairy cows when extreme heat is both rapidly changing and has a long duration. As a result of climate change, heat waves, which are defined as 3 days of temperatures of 32 °C or above, are an increasingly frequent extreme weather phenomenon in Southern Ontario. Heat waves are increasing the risk for on-farm dairy cow mortality in Southern Ontario. Heat stress indices (HSIs) are generally based on temperature and humidity and provide a relative measure of discomfort which can be used to predict increased risk of on-farm dairy cow mortality. In what follows, the heat stress distribution was described over space and presented with maps. Similarly, on-farm mortality was described and mapped. The goal of this study was to demonstrate that heat waves and related HSI increases during 2010-2012 were associated with increased on-farm dairy cow mortality in Southern Ontario. Mortality records and farm locations for all farms registered in the CanWest Dairy Herd Improvement Program in Southern Ontario were retrieved for 3 heat waves and 6 three-day control periods from 2010 to 2012. A random sample of controls (2:1) was taken from the data set to create a risk-based hybrid design. On-farm heat stress was estimated using data from 37 weather stations and subsequently interpolated across Southern Ontario by geostatistical kriging. A Poisson regression model was applied to assess the on-farm mortality in relation to varying levels of the HSI. For every one unit increase in HSI the on-farm mortality rate across Southern Ontario increases by 1.03 times (CI95% (IRR) = (1.025,1.035); p = ≤ 0.001). With a typical 8.6 unit increase in HSI from a control period to a heat wave, mortality rates are predicted to increase by 1.27 times. Southern Ontario was affected by heat waves, as demonstrated by high levels of heat stress and increased on-farm mortality

  18. Interpretation of illness in cancer survivors is associated with health-related variables and adaptive coping styles

    Fischer Julia

    2009-01-01

    Full Text Available Abstract Background A patient's interpretation of illness may have an influence on the choice of coping strategies and decision making. We intended to analyze the meaning German cancer survivors would attribute to their disease, and investigated intercorrelations between the respective interpretations, health-related variables and adaptive coping strategies. Methods In an anonymous cross-sectional survey, we analyzed the interpretations of disease (according to Lipowski's eight 'meaning of illness' categories in 387 patients with cancer (81% breast cancer. To make statements about their conceptual relationships with health-related variables, we correlated the 8 items of the 'Interpretation of Illness' questionnaire (IIQ with health-related quality of life, anxiety/depression, fatigue, life satisfaction, and adaptive coping strategies. Results Most cancer survivors regarded their disease as a challenge (52%, others as value (38% or even an interruption of life (irreparable loss; 35%; weakness/failure (5% and punishment (3% were rated the lowest. The fatalistic negative interpretations 'interruption/loss' and 'enemy/threat' were inversely correlated with mental health-related quality of life and life satisfaction, and positively with an escape-avoidance strategy, depression and anxiety. In contrast, positive disease interpretations (i.e., 'challenge' and 'value' correlated only with adaptive coping strategies. Physical health correlated with none of the disease interpretations. Conclusion Despite conceptual limitations, the 8-item schema could be regarded as a useful screening approach to identify patients at risk for reduced psychosocial functioning.

  19. Antisocial personality disorder and borderline symptoms are differentially related to impulsivity and course of illness in bipolar disorder.

    Swann, Alan C; Lijffijt, Marijn; Lane, Scott D; Steinberg, Joel L; Moeller, F Gerard

    2013-06-01

    Interactions between characteristics of bipolar and Axis II cluster B disorders are clinically and diagnostically challenging. Characteristics associated with personality disorders may be dimensional aspects of bipolar disorder. We investigated relationships among antisocial personality disorder (ASPD) or borderline personality disorder symptoms, impulsivity, and course of illness in bipolar disorder. Subjects with bipolar disorder were recruited from the community. Diagnosis was by structured clinical interview for DSM-IV (SCID-I and -II), psychiatric symptom assessment by the change version of the schedule for affective disorders and schizophrenia (SADS-C), severity of Axis II symptoms by ASPD and borderline personality disorder SCID-II symptoms, and impulsivity by the Barratt impulsiveness scale (BIS-11). ASPD and borderline symptoms were not related to clinical state or affective symptoms. Borderline symptoms correlated with BIS-11 impulsivity scores, and predicted history of suicide attempts independently of the relationship to impulsivity. ASPD symptoms were more strongly related to course of illness, including early onset, frequent episodes, and substance-related disorders. These effects persisted after allowance for gender and substance-use disorder history. Personality disorder symptoms appear to be dimensional, trait-like characteristics of bipolar disorder. ASPD and Borderline symptoms are differentially related to impulsivity and course of illness. Copyright © 2012 Elsevier B.V. All rights reserved.

  20. "Helping my neighbour is like giving a loan…" -the role of social relations in chronic illness in rural Uganda.

    Amurwon, Jovita; Hajdu, Flora; Yiga, Dominic Bukenya; Seeley, Janet

    2017-11-09

    Understanding individuals' experience of accessing care and tending to various other needs during chronic illness in a rural context is important for health systems aiming to increase access to healthcare and protect poor populations from unreasonable financial hardship. This study explored the impact on households of access to free healthcare and how they managed to meet needs during chronic illness. Rich data from the life stories of individuals from 22 households in rural south-western Uganda collected in 2009 were analysed. The data revealed that individuals and households depend heavily on their social relations in order to meet their needs during illness, including accessing the free healthcare and maintaining vital livelihood activities. The life stories illustrated ways in which households draw upon social relations to achieve the broader social protection necessary to prevent expenses becoming catastrophic, but also demonstrated the uncertainty in relying solely on informal relations. Improving access to healthcare in a rural context greatly depends on broader social protection. Thus, the informal social protection that already exists in the form of strong reciprocal social relations must be acknowledged, supported and included in health policy planning.

  1. Antisocial Personality Disorder and Borderline Symptoms are Differentially Related to Impulsivity and Course of Illness in Bipolar Disorder

    Swann, Alan C.; Lijffijt, Marijn; Lane, Scott D.; Steinberg, Joel L.; Moeller, F. Gerard

    2012-01-01

    Background Interactions between characteristics of bipolar and Axis II cluster B disorders are clinically and diagnostically challenging. Characteristics associated with personality disorders may be dimensional aspects of bipolar disorder. We investigated relationships among antisocial personality disorder (ASPD) or borderline personality disorder symptoms, impulsivity, and course of illness in bipolar disorder. Methods Subjects with bipolar disorder were recruited from the community. Diagnosis was by Structured Clinical Interview for DSM-IV (SCID-I and –II), psychiatric symptom assessment by the Change version of the Schedule for Affective Disorders and Schizophrenia (SADS-C), severity of axis II symptoms by ASPD and borderline personality disorder SCID-II symptoms, and impulsivity by the Barratt Impulsiveness Scale (BIS-11). Results ASPD and borderline symptoms were not related to clinical state or affective symptoms. Borderline symptoms correlated with BIS-11 impulsivity scores, and predicted history of suicide attempts independently of the relationship to impulsivity. ASPD symptoms were more strongly related to course of illness, including early onset, frequent episodes, and substance-related disorders. These effects persisted after allowance for gender and substance-use disorder history. Conclusions Personality disorder symptoms appear to be dimensional, trait-like characteristics of bipolar disorder. ASPD and Borderline symptoms are differentially related to impulsivity and course of illness. PMID:22835849

  2. Relating the construction and maintenance of maternal ill-health in rural Indonesia

    Lucia D'Ambruoso

    2012-08-01

    Full Text Available Estimates suggest that over 350,000 deaths and more than 20 million severe disabilities result from the complications of pregnancy, childbirth or its management each year. Death and disability occur predominately among disadvantaged women in resource-poor settings and are largely preventable with adequate delivery care. This paper presents the substantive findings and policy implications from a programme of PhD research, of which the overarching objective was to assess quality of, and access to, care in obstetric emergencies. Three critical incident audits were conducted in two rural districts on Java, Indonesia: a confidential enquiry, a verbal autopsy survey, and a community-based review. The studies examined cases of maternal mortality and severe morbidity from the perspectives of local service users and health providers. A range of inter-related determining factors was identified. When unexpected delivery complications occurred, women and families were often uninformed, unprepared, found care unavailable, unaffordable, and many relied on traditional providers. Midwives in villages made important contributions by stabilising women and facilitating referrals but were often scarce in remote areas and lacked sufficient clinical competencies and payment incentives to treat the poor. Emergency transport was often unavailable and private transport was unreliable and incurred costs. In facilities, there was a reluctance to admit poorer women and those accepted were often admitted to ill-equipped, under-staffed wards. As a result, referrals between hospitals were also common. Otherwise, social health insurance, designed to reduce financial barriers, was particularly problematic, constraining quality and access within and outside facilities. Health workers and service users provided rich and explicit assessments of care and outcomes. These were used to develop a conceptual model in which quality and access are conceived of as social processes

  3. At what level of heat load are age-related impairments in the ability to dissipate heat evident in females?

    Jill M Stapleton

    Full Text Available Studies have reported that older females have impaired heat loss responses during work in the heat compared to young females. However, it remains unclear at what level of heat stress these differences occur. Therefore, we examined whole-body heat loss [evaporative (HE and dry heat loss, via direct calorimetry] and changes in body heat storage (∆Hb, via direct and indirect calorimetry in 10 young (23±4 years and 10 older (58±5 years females matched for body surface area and aerobic fitness (VO2peak during three 30-min exercise bouts performed at incremental rates of metabolic heat production of 250 (Ex1, 325 (Ex2 and 400 (Ex3 W in the heat (40°C, 15% relative humidity. Exercise bouts were separated by 15 min of recovery. Since dry heat gain was similar between young and older females during exercise (p=0.52 and recovery (p=0.42, differences in whole-body heat loss were solely due to HE. Our results show that older females had a significantly lower HE at the end of Ex2 (young: 383±34 W; older: 343±39 W, p=0.04 and Ex3 (young: 437±36 W; older: 389±29 W, p=0.008, however no difference was measured at the end of Ex1 (p=0.24. Also, the magnitude of difference in the maximal level of HE achieved between the young and older females became greater with increasing heat loads (Ex1=10.2%, Ex2=11.6% and Ex3=12.4%. Furthermore, a significantly greater ∆Hb was measured for all heat loads for the older females (Ex1: 178±44 kJ; Ex2: 151±38 kJ; Ex3: 216±25 kJ, p=0.002 relative to the younger females (Ex1: 127±35 kJ; Ex2: 96±45 kJ; Ex3: 146±46 kJ. In contrast, no differences in HE or ∆Hb were observed during recovery (p>0.05. We show that older habitually active females have an impaired capacity to dissipate heat compared to young females during exercise-induced heat loads of ≥325 W when performed in the heat.

  4. Nutrition in Relation to Diseases and Heat stress in Poultry

    S Das

    Full Text Available Different diseases conditions and stress factors are responsible for high morbidity and mortality of present day poultry. Nutritional strategy and proper feed formulation with specific dietary regimen can combat this up to a certain extent. The incidence of various infectious diseases, nervous disorders and metabolic disorders can be minimized through proper feed regimen. There is a stiff competition and restrictions in the global market of poultry products which can be addressed with proper management of emerging and important diseases with economic productions and quality poultry products free of elements detrimental to human health. Researchers have made efforts to prevent such damage to poultry and poultry product through dietary manipulations. Heat stress can lead to a reduction in the defense mechanisms of birds or to a relative state of immunosuppression. The health status of the poultry is facing new challenges today which can be suitably addressed by the right scientific and advanced nutritional manoeuvres and make the poultry farming more profitable and presentable in the global market. [Vet. World 2011; 4(9.000: 429-432

  5. Health-related quality of life in patients with hepatocellular carcinoma: the mediation effects of illness perceptions and coping.

    Fan, Sheng-Yu; Eiser, Christine; Ho, Ming-Chih; Lin, Cheng-Yao

    2013-06-01

    The aims of this study were to explore health-related quality of life (HRQOL) in patients with hepatocellular carcinoma (HCC). We report the following: (1) differences in HRQOL between patients with HCC and the general population; (2) significant physical and psychological predictors of HRQOL; and (3) mediation effects of illness perceptions and coping on HRQOL. Patients with HCC (n = 286) from Taiwan completed standardized measures of HRQOL, illness perception (cognitive representations, emotional representations and illness comprehensibility) and coping (emotion-oriented and problem-orientation coping). Demographic and physical variables were also collected. Patients with HCC had worse global HRQOL, physical, role, cognitive and social functioning, but better emotional functioning than the general population. Physical variables and cognitive representation were significant predictors of global HRQOL, physical functioning and emotional functioning. Cognitive representation mediated the relationships between physical variables and global HRQOL, physical functioning and emotional functioning, but coping only mediated the relationship between cognitive representation and global HRQOL. The results suggest that physical variables have direct effects on global HRQOL and physical functioning, but there were also partial mediations through cognitive representation. The effect of physical variables on emotional functioning was mediated through cognitive and emotional representations. Patients with better performance status and positive illness perceptions tended to report better HRQOL, but those with negative illness perceptions and who used more emotion-oriented coping had worse HRQOL. Limitations of the work associated with use of theory and measures developed in Europe and the US are discussed, as are the clinical implications for patients with HCC. Copyright © 2012 John Wiley & Sons, Ltd.

  6. Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) Symptom Severity: Stress Management Skills are Related to Lower Illness Burden.

    Lattie, Emily G; Antoni, Michael H; Fletcher, Mary Ann; Czaja, Sara; Perdomo, Dolores; Sala, Andreina; Nair, Sankaran; Fu, Shih Hua; Penedo, Frank J; Klimas, Nancy

    2013-01-01

    The onset of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) typically involves reductions in activities of daily living and social interactions (jointly referred to as "illness burden"). Emotional distress has been linked to increased reported symptoms, and stress management skills have been related to lower fatigue severity in CFS patients. Symptom severity and illness burden are highly correlated. The ability to manage stress may attenuate this relationship, allowing individuals to feel less burdened by the illness independent of the severity of their symptoms. This study aimed to evaluate if perceived stress management skills affect illness burden via emotional distress, independent of ME/CFS symptom severity. A total of 117 adults with ME/CFS completed measures of perceived stress management skills, emotional distress, ME/CFS symptom severity and illness burden. Regression analyses revealed that greater perceived stress management skills related to less social and fatigue-related illness burden, via lower emotional distress. This relationship existed independent of the association of symptom severity on illness burden, and was stronger among those not currently employed. Ability to manage stress is associated with a lower illness burden for individuals with ME/CFS. Future studies should evaluate the efficacy of psychosocial interventions in lowering illness burden by targeting stress management skills.

  7. Heat transfer phenomena related to the boiling crisis

    Groenveld, D.C.

    1981-03-01

    This report contains a state-of-the-art review of critical heat flux (CHF) and post-CHF heat transfer. Part I reviews the mechanisms controlling the boiling crisis. The observed parametric trends of the CHF in a heat flux controlled system are discussed in detail, paying special attention to parameters pertaining to nuclear fuel. The various methods of predicting the critical power are described. Part II reviews the published information on transition boiling and film boiling heat transfer under forced convective conditions. Transition boiling data were found to be available only within limited ranges of conditions. The data did not permit the derivation of a correlation; however, the parametric trends were isolated from these data. (author)

  8. Laser application of heat pipe technology in energy related programs

    Carbone, R.J.

    1975-01-01

    The design and operating parameters for a heat pipe laser utilizing metal vapors are proposed. The laser would be applied to laser induced fusion, laser induced chemistry, laser isotope separation, and power transport using optical beams. (U.S.)

  9. Accounting for adaptation and intensity in projecting heat wave-related mortality.

    Wang, Yan; Nordio, Francesco; Nairn, John; Zanobetti, Antonella; Schwartz, Joel D

    2018-02-01

    How adaptation and intensity of heat waves affect heat wave-related mortality is unclear, making health projections difficult. We estimated the effect of heat waves, the effect of the intensity of heat waves, and adaptation on mortality in 209 U.S. cities with 168 million people during 1962-2006. We improved the standard time-series models by incorporating the intensity of heat waves using excess heat factor (EHF) and estimating adaptation empirically using interactions with yearly mean summer temperature (MST). We combined the epidemiological estimates for heat wave, intensity, and adaptation with the Coupled Model Intercomparison Project Phase 5 (CMIP5) multi-model dataset to project heat wave-related mortality by 2050. The effect of heat waves increased with its intensity. Adaptation to heat waves occurred, which was shown by the decreasing effect of heat waves with MST. However, adaptation was lessened as MST increased. Ignoring adaptation in projections would result in a substantial overestimate of the projected heat wave-related mortality (by 277-747% in 2050). Incorporating the empirically estimated adaptation into projections would result in little change in the projected heat wave-related mortality between 2006 and 2050. This differs regionally, however, with increasing mortality over time for cities in the southern and western U.S. but decreasing mortality over time for the north. Accounting for adaptation is important to reduce bias in the projections of heat wave-related mortality. The finding that the southern and western U.S. are the areas that face increasing heat-related deaths is novel, and indicates that more regional adaptation strategies are needed. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Not sick enough: Experiences of carers of people with mental illness negotiating care for their relatives with mental health services.

    Olasoji, M; Maude, P; McCauley, K

    2017-08-01

    WHAT IS KNOWN ON THE SUBJECT?: Existing literature provides insight into the general experience of carers of people with a mental illness. Previous studies have found that carers experience a range of emotions when looking after their relatives with a mental illness. However, experiences of carers as they engage with the healthcare system is largely absent from the literature. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This paper identified the experiences of carers when their relatives are experiencing a crisis or acutely unwell. Carers found themselves in the middle between mental health services and their relatives. Strategies employed by carers to ensure their relatives receive adequate care were identified from this study. This paper identified how carers needed to become more assertive in order to receive adequate care for their relatives, and this finding has implications for any future carer education. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The participants identified the need to work more collaboratively with carers of people with a mental illness as they seek treatment for their relatives in order to achieve better health outcomes for the patients. Improved health service engagement of carers was seen by participants to assist them to better care for their relative. The study also found that there needs to be a clearer definition as to what constitutes mental health crisis and how carers are able to intervene during this period. Services could provide clear information concerning crisis services and in particular triage. Aim The literature reporting experiences of relatives of people with mental illness regarding their interactions with mental health services identifies many commonalities. However, the actual experience of carers engaging the services and understanding healthcare systems remains a gap in the literature. The aim of this study was to explore the experiences of carers (of people with a severe mental illness) in a major area mental health

  11. Words about body and soul: social representations relating to health and illness.

    Åsbring, Pia

    2012-11-01

    The purpose was to examine a sample of Stockholm residents' social representations of their physical and mental health and ill-health. Four open-ended questions were answered by 1240 people between 18-80 years. A thematic analysis revealed nine aspects of health: physical, lifestyle, psychological, social, recreational, work and study, treatment, other and multifactorial aspects. Some cross-cutting themes were described to have an impact on health: empowerment, health-conscious lifestyle, life balance and life perspective. A key result is the interdependence between physical and mental health that was described by the respondents.

  12. Surveillance of Travel-Related Mosquito-borne Illness in Rhode Island.

    Alang, Neha; Glavis-Bloom, Justin; Alexander-Scott, Nicole; Mermel, Leonard A; Mileno, Maria D

    2016-07-01

    Malaria and Dengue are some of the common infections occurring in persons traveling to countries endemic for these infections. Chinkungunya virus infection is another illness that can occur in people who have travelled to areas endemic for chikungunya virus infection. Herein we report cases of malaria, dengue, and chikungunya in Newport Hospital, The Miriam Hospital and Rhode Island Hospital between January 1, 2010 and December 31, 2014. [Full article available at http://rimed.org/rimedicaljournal-2016-07.asp, free with no login].

  13. Entransy analysis of irreversible heat pump using Newton and Dulong–Petit heat transfer laws and relations with its performance

    Açıkkalp, Emin

    2014-01-01

    Highlights: • Entransy analysis was made for irreversible heat pump. • Newton and Dulong–Petit heat transfer laws were used. • Entransy dissipations were defined and determined. • Relations between entransy and other thermodynamic parameters were determined. - Abstract: An irreversible heat pump was investigated via entransy analysis and performance criteria. In the analyses, two different convective heat transfer laws were applied to the considered system: the Newton and Dulong–Petit heat transfer laws. The irreversibilities in the system are the result of a finite heat transfer rate, a heat leak and internal irreversibilities, including friction, turbulence etc. In this study, a thermodynamic analysis was performed in detail, and the numerical solutions were used for the conducted analysis. The maximum entransy dissipation (critical points) ranges from 18436.7 kW K to 18855.3 kW K according to y for Newton’s law; however, there is no maximum point for the Dulon–Petit law. It can be concluded from this study that entransy should be used among the basic thermodynamic criteria

  14. Influenza A (H1N1pdm09)-Related Critical Illness and Mortality in Mexico and Canada, 2014.

    Dominguez-Cherit, Guillermo; De la Torre, Alethse; Rishu, Asgar; Pinto, Ruxandra; Ñamendys-Silva, Silvio A; Camacho-Ortiz, Adrián; Silva-Medina, Marco Antonio; Hernández-Cárdenas, Carmen; Martínez-Franco, Michel; Quesada-Sánchez, Alejandro; López-Gallegos, Guadalupe Celia; Mosqueda-Gómez, Juan L; Rivera-Martinez, Norma E; Campos-Calderón, Fernando; Rivero-Sigarroa, Eduardo; Hernández-Gilsoul, Thierry; Espinosa-Pérez, Lourdes; Macías, Alejandro E; Lue-Martínez, Dolores M; Buelna-Cano, Christian; Ramírez-García Luna, Ana-Sofía; Cruz-Ruiz, Nestor G; Poblano-Morales, Manuel; Molinar-Ramos, Fernando; Hernandez-Torre, Martin; León-Gutiérrez, Marco Antonio; Rosaldo-Abundis, Oscar; Baltazar-Torres, José Ángel; Stelfox, Henry T; Light, Bruce; Jouvet, Philippe; Reynolds, Steve; Hall, Richard; Shindo, Nikki; Daneman, Nick; Fowler, Robert A

    2016-10-01

    The 2009-2010 influenza A (H1N1pdm09) pandemic caused substantial morbidity and mortality among young patients; however, mortality estimates have been confounded by regional differences in eligibility criteria and inclusion of selected populations. In 2013-2014, H1N1pdm09 became North America's dominant seasonal influenza strain. Our objective was to compare the baseline characteristics, resources, and treatments with outcomes among critically ill patients with influenza A (H1N1pdm09) in Mexican and Canadian hospitals in 2014 using consistent eligibility criteria. Observational study and a survey of available healthcare setting resources. Twenty-one hospitals, 13 in Mexico and eight in Canada. Critically ill patients with confirmed H1N1pdm09 during 2013-2014 influenza season. None. The main outcome measures were 90-day mortality and independent predictors of mortality. Among 165 adult patients with H1N1pdm09-related critical illness between September 2013 and March 2014, mean age was 48.3 years, 64% were males, and nearly all influenza was community acquired. Patients were severely hypoxic (median PaO2-to-FIO2 ratio, 83 mm Hg), 97% received mechanical ventilation, with mean positive end-expiratory pressure of 14 cm H2O at the onset of critical illness and 26.7% received rescue oxygenation therapy with prone ventilation, extracorporeal life support, high-frequency oscillatory ventilation, or inhaled nitric oxide. At 90 days, mortality was 34.6% (13.9% in Canada vs 50.5% in Mexico, p Mexico (odds ratio, 7.76 [95% CI, 2.02-27.35]). ICUs in Canada generally had more beds, ventilators, healthcare personnel, and rescue oxygenation therapies. Influenza A (H1N1pdm09)-related critical illness still predominantly affects relatively young to middle-aged patients and is associated with severe hypoxemic respiratory failure. The local critical care system and available resources may be influential determinants of patient outcome.

  15. The Relation between Heat strain and hydration status among

    Somayeh Bolghanabadi

    2016-12-01

    Full Text Available Introduction: during the physical activity in hot environments, sweating with evaporation, the important physiological response of the body  increases which can be lead to dehydration . Long-term water shortages could adversely affect vital organs. The aim of this study was to determine heat stress and dehydration status of workers in hot workplaces. Methods: This cross sectional study was done on 90 workers of workers in sugar factory which were exposed to heat. Heart rate and oral temperature were respectively measured using a heart rate meter and an oral thermometer. WBGT index was recorded and the HSSI questionnaire was completed simultaneously, in order to assess dehydration level was measured of refractometer. Data obtained from this study were analyzed using compare means and t-test, paired t-test tests by SPSS 20 software Results: Heat stress exceeded the national and international recommended limits based on the WBGT index in 44% of cases of workstations. According to this study, 8.5% of our population had some degree of dehydration.63.4% of them were significantly dehydrated (urine SG>1.020 and 28% of them were severely dehydrated (urine SG>1.030 and the mean specific gravity was 1.025±0.043 The correlations between heat strains, Urine Density and heat stress including oral temperature, heart rate were significant(p<0.05. Conclusion: A high percentage of the study population had some degree of dehydration that based on the results is worrying. It seems that planning in order to control of heat stresses by replace drinking is necessary.

  16. Losses related to everyday occupations for adults affected by mental illness.

    Baker, Amy Elizabeth Zanker; Procter, Nicholas Gerard

    2014-07-01

    This paper presents findings from a larger study that explored losses from mental illness. Losses associated with occupations--a key theme from this participatory action research study--are the focus of this paper. Semi-structured in-depth interviews were carried out with 16 people who had been diagnosed with a mental illness and attended a community mental health centre. Interviews were transcribed verbatim and thematically analysed, guided by processes proposed by Dey. Numerous losses influenced participants' ability to initiate or engage in daily occupations. Some losses perpetuated further loss, at times with profound consequences, such as the loss of a house following a loss of work. Engaging in chosen occupations was often described as a longer-term goal or something participants did infrequently, due to losses such as motivation, energy, or normal sleeping patterns. The desire to work and participate in everyday occupations was emphasized and its benefits highlighted, despite previous difficulties. Implications for occupational therapists include the importance of exploring, validating, and responding to losses when these are shared, and being aware of and striving to support people experiencing losses in the areas of work, motivation, sleep patterns, and energy, which were perceived as especially challenging for participants in this study.

  17. [The Intentions Affecting the Medical Decision-Making Behavior of Surrogate Decision Makers of Critically Ill Patients and Related Factors].

    Su, Szu-Huei; Wu, Li-Min

    2018-04-01

    The severity of diseases and high mortality rates that typify the intensive care unit often make it difficult for surrogate decision makers to make decisions for critically ill patients regarding whether to continue medical treatments or to accept palliative care. To explore the behavioral intentions that underlie the medical decisions of surrogate decision makers of critically ill patients and the related factors. A cross-sectional, correlation study design was used. A total of 193 surrogate decision makers from six ICUs in a medical center in southern Taiwan were enrolled as participants. Three structured questionnaires were used, including a demographic datasheet, the Family Relationship Scale, and the Behavioral Intention of Medical Decisions Scale. Significantly positive correlations were found between the behavioral intentions underlying medical decisions and the following variables: the relationship of the participant to the patient (Eta = .343, p = .020), the age of the patient (r = .295, p medical decisions of the surrogate decision makers, explaining 13.9% of the total variance. In assessing the behavioral intentions underlying the medical decisions of surrogate decision makers, health providers should consider the relationship between critical patients and their surrogate decision makers, patient age, the length of ICU stay, and whether the patient has a pre-signed advance healthcare directive in order to maximize the effectiveness of medical care provided to critically ill patients.

  18. Heat shock proteins in relation to heat stress tolerance of creeping bentgrass at different N levels.

    Wang, Kehua; Zhang, Xunzhong; Goatley, Mike; Ervin, Erik

    2014-01-01

    Heat stress is a primary factor causing summer bentgrass decline. Changes in gene expression at the transcriptional and/or translational level are thought to be a fundamental mechanism in plant response to environmental stresses. Heat stress redirects protein synthesis in higher plants and results in stress protein synthesis, particularly heat shock proteins (HSPs). The goal of this work was to analyze the expression pattern of major HSPs in creeping bentgrass (Agrostis stolonifera L.) during different heat stress periods and to study the influence of nitrogen (N) on the HSP expression patterns. A growth chamber study on 'Penn-A4' creeping bentgrass subjected to 38/28°C day/night for 50 days, was conducted with four nitrate rates (no N-0, low N-2.5, medium N-7.5, and high N-12.5 kg N ha-1) applied biweekly. Visual turfgrass quality (TQ), normalized difference vegetation index (NDVI), photochemical efficiency of photosystem II (Fv/Fm), shoot electrolyte leakage (ShEL), and root viability (RV) were monitored, along with the expression pattern of HSPs. There was no difference in measured parameters between treatments until week seven, except TQ at week five. At week seven, grass at medium N had better TQ, NDVI, and Fv/Fm accompanied by lower ShEL and higher RV, suggesting a major role in improved heat tolerance. All the investigated HSPs (HSP101, HSP90, HSP70, and sHSPs) were up-regulated by heat stress. Their expression patterns indicated cooperation between different HSPs and their roles in bentgrass thermotolerance. In addition, their production seems to be resource dependent. This study could further improve our understanding about how different N levels affect bentgrass thermotolerance.

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

    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.

  20. Impacts of extreme heat on emergency medical service calls in King County, Washington, 2007-2012: relative risk and time series analyses of basic and advanced life support.

    Calkins, Miriam M; Isaksen, Tania Busch; Stubbs, Benjamin A; Yost, Michael G; Fenske, Richard A

    2016-01-28

    Exposure to excessive heat kills more people than any other weather-related phenomenon, aggravates chronic diseases, and causes direct heat illness. Strong associations between extreme heat and health have been identified through increased mortality and hospitalizations and there is growing evidence demonstrating increased emergency department visits and demand for emergency medical services (EMS). The purpose of this study is to build on an existing regional assessment of mortality and hospitalizations by analyzing EMS demand associated with extreme heat, using calls as a health metric, in King County, Washington (WA), for a 6-year period. Relative-risk and time series analyses were used to characterize the association between heat and EMS calls for May 1 through September 30 of each year for 2007-2012. Two EMS categories, basic life support (BLS) and advanced life support (ALS), were analyzed for the effects of heat on health outcomes and transportation volume, stratified by age. Extreme heat was model-derived as the 95th (29.7 °C) and 99th (36.7 °C) percentile of average county-wide maximum daily humidex for BLS and ALS calls respectively. Relative-risk analyses revealed an 8 % (95 % CI: 6-9 %) increase in BLS calls, and a 14 % (95 % CI: 9-20 %) increase in ALS calls, on a heat day (29.7 and 36.7 °C humidex, respectively) versus a non-heat day for all ages, all causes. Time series analyses found a 6.6 % increase in BLS calls, and a 3.8 % increase in ALS calls, per unit-humidex increase above the optimum threshold, 40.7 and 39.7 °C humidex respectively. Increases in "no" and "any" transportation were found in both relative risk and time series analyses. Analysis by age category identified significant results for all age groups, with the 15-44 and 45-64 year old age groups showing some of the highest and most frequent increases across health conditions. Multiple specific health conditions were associated with increased risk of an EMS call including abdominal

  1. The application of the European heat wave of 2003 to Korean cities to analyze impacts on heat-related mortality

    Greene, J. Scott; Kalkstein, Laurence S.; Kim, Kyu Rang; Choi, Young-Jean; Lee, Dae-Geun

    2016-02-01

    The goal of this research is to transpose the unprecedented 2003 European excessive heat event to six Korean cities and to develop meteorological analogs for each. Since this heat episode is not a model but an actual event, we can use a plausible analog to assess the risk of increasing heat on these cities instead of an analog that is dependent on general circulation (GCM) modeling or the development of arbitrary scenarios. Initially, the 2003 summer meteorological conditions from Paris are characterized statistically and these characteristics are transferred to the Korean cites. Next, the new meteorological dataset for each Korean city is converted into a daily air mass calendar. We can then determine the frequency and character of "offensive" air masses in the Korean cities that are historically associated with elevated heat-related mortality. One unexpected result is the comparative severity of the very hot summer of 1994 in Korea, which actually eclipsed the 2003 analog. The persistence of the offensive air masses is considerably greater for the summer of 1994, as were dew point temperatures for a majority of the Korean cities. For all the Korean cities but one, the summer of 1994 is associated with more heat-related deaths than the analog summer, in some cases yielding a sixfold increase over deaths in an average summer. The Korean cities appear less sensitive to heat-related mortality problems during very hot summers than do large eastern and Midwestern US cities, possibly due to a lesser summer climate variation and efficient social services available during extreme heat episodes.

  2. Review of Epidemiological Studies of Drinking-Water Turbidity in Relation to Acute Gastrointestinal Illness.

    De Roos, Anneclaire J; Gurian, Patrick L; Robinson, Lucy F; Rai, Arjita; Zakeri, Issa; Kondo, Michelle C

    2017-08-17

    Turbidity has been used as an indicator of microbiological contamination of drinking water in time-series studies attempting to discern the presence of waterborne gastrointestinal illness; however, the utility of turbidity as a proxy exposure measure has been questioned. We conducted a review of epidemiological studies of the association between turbidity of drinking-water supplies and incidence of acute gastrointestinal illness (AGI), including a synthesis of the overall weight of evidence. Our goal was to evaluate the potential for causal inference from the studies. We identified 14 studies on the topic (distinct by region, time period and/or population). We evaluated each study with regard to modeling approaches, potential biases, and the strength of evidence. We also considered consistencies and differences in the collective results. Positive associations between drinking-water turbidity and AGI incidence were found in different cities and time periods, and with both unfiltered and filtered supplies. There was some evidence for a stronger association at higher turbidity levels. The studies appeared to adequately adjust for confounding. There was fair consistency in the notable lags between turbidity measurement and AGI identification, which fell between 6 and 10 d in many studies. The observed associations suggest a detectable incidence of waterborne AGI from drinking water in the systems and time periods studied. However, some discrepant results indicate that the association may be context specific. Combining turbidity with seasonal and climatic factors, additional water quality measures, and treatment data may enhance predictive modeling in future studies. https://doi.org/10.1289/EHP1090.

  3. A biometeorology study of climate and heat-related morbidity in Phoenix from 2001 to 2006

    Golden, Jay S.; Hartz, Donna; Brazel, Anthony; Luber, George; Phelan, Patrick

    2008-07-01

    Heat waves kill more people in the United States than hurricanes, tornadoes, earthquakes, and floods combined. Recently, international attention focused on the linkages and impacts of human health vulnerability to urban climate when Western Europe experienced over 30,000 excess deaths during the heat waves of the summer of 2003—surpassing the 1995 heat wave in Chicago, Illinois, that killed 739. While Europe dealt with heat waves, in the United States, Phoenix, Arizona, established a new all-time high minimum temperature for the region on July 15, 2003. The low temperature of 35.5°C (96°F) was recorded, breaking the previous all-time high minimum temperature record of 33.8°C (93°F). While an extensive literature on heat-related mortality exists, greater understanding of influences of heat-related morbidity is required due to climate change and rapid urbanization influences. We undertook an analysis of 6 years (2001 2006) of heat-related dispatches through the Phoenix Fire Department regional dispatch center to examine temporal, climatic and other non-spatial influences contributing to high-heat-related medical dispatch events. The findings identified that there were no significant variations in day-of-week dispatch events. The greatest incidence of heat-related medical dispatches occurred between the times of peak solar irradiance and maximum diurnal temperature, and during times of elevated human comfort indices (combined temperature and relative humidity).

  4. Avoided heat-related mortality through climate adaptation strategies in three US cities.

    Stone, Brian; Vargo, Jason; Liu, Peng; Habeeb, Dana; DeLucia, Anthony; Trail, Marcus; Hu, Yongtao; Russell, Armistead

    2014-01-01

    Heat-related mortality in US cities is expected to more than double by the mid-to-late 21st century. Rising heat exposure in cities is projected to result from: 1) climate forcings from changing global atmospheric composition; and 2) local land surface characteristics responsible for the urban heat island effect. The extent to which heat management strategies designed to lessen the urban heat island effect could offset future heat-related mortality remains unexplored in the literature. Using coupled global and regional climate models with a human health effects model, we estimate changes in the number of heat-related deaths in 2050 resulting from modifications to vegetative cover and surface albedo across three climatically and demographically diverse US metropolitan areas: Atlanta, Georgia, Philadelphia, Pennsylvania, and Phoenix, Arizona. Employing separate health impact functions for average warm season and heat wave conditions in 2050, we find combinations of vegetation and albedo enhancement to offset projected increases in heat-related mortality by 40 to 99% across the three metropolitan regions. These results demonstrate the potential for extensive land surface changes in cities to provide adaptive benefits to urban populations at risk for rising heat exposure with climate change.

  5. Avoided heat-related mortality through climate adaptation strategies in three US cities.

    Brian Stone

    Full Text Available Heat-related mortality in US cities is expected to more than double by the mid-to-late 21st century. Rising heat exposure in cities is projected to result from: 1 climate forcings from changing global atmospheric composition; and 2 local land surface characteristics responsible for the urban heat island effect. The extent to which heat management strategies designed to lessen the urban heat island effect could offset future heat-related mortality remains unexplored in the literature. Using coupled global and regional climate models with a human health effects model, we estimate changes in the number of heat-related deaths in 2050 resulting from modifications to vegetative cover and surface albedo across three climatically and demographically diverse US metropolitan areas: Atlanta, Georgia, Philadelphia, Pennsylvania, and Phoenix, Arizona. Employing separate health impact functions for average warm season and heat wave conditions in 2050, we find combinations of vegetation and albedo enhancement to offset projected increases in heat-related mortality by 40 to 99% across the three metropolitan regions. These results demonstrate the potential for extensive land surface changes in cities to provide adaptive benefits to urban populations at risk for rising heat exposure with climate change.

  6. Work-related discrimination and change in self-stigma among people with mental illness during supported employment.

    Rüsch, Nicolas; Nordt, Carlos; Kawohl, Wolfram; Brantschen, Elisabeth; Bärtsch, Bettina; Müller, Mario; Corrigan, Patrick W; Rössler, Wulf

    2014-12-01

    The relationship of work-related discrimination to the change in self-stigma and stigma stress was assessed among supported employment participants in Switzerland. Self-stigma and the cognitive appraisal of mental illness stigma as a stressor were measured at baseline among supported employment participants (N=116). These variables and work-related discrimination in the past year were assessed one year later (N=96). Compared with participants who did not find employment (N=30), those who worked without experiencing discrimination (N=25) had lower levels of self-stigma and stigma stress at one year. Among those who worked and reported work-related discrimination (N=38), these measures did not decrease significantly. Experiencing discrimination at work may determine whether employment has positive effects in terms of self-stigma and stigma stress among individuals with mental illness. Interventions to reduce discrimination in work settings and to improve coping resources of these individuals could augment the positive effects of supported employment.

  7. Anomalies and other concerns related to the critical heat flux

    Groeneveld, D.C.

    2009-01-01

    This paper summarizes various unusual trends in the critical heat flux (CHF) that have been observed experimentally in tubes. They include the following: Occurrence of a minimum in the CHF vs. quality (X) curve at high flows - leading to an initial upstream CHF occurrence in uniformly heated tubes. This phenomenon has been observed at high flows in both water and Freon. Occurrence of a limiting quality region on the CHF vs. X curve where the CHF drops by 30 - 90% for a nearly constant quality. This is thought to correspond to the boundary between the entrainment-controlled and the deposition-controlled region and causes problems for prediction methods of the form CHF=f(X). Impact of flow obstructions on the occurrence of upstream CHF and the limiting quality region. The additional mixing by grid spacers or bundle appendages results in a more homogeneous phase distribution, thus diminishing the effects of flow regime/heat transfer regime transitions responsible for the above unusual CHF trends. This will lead to a more gradually decreasing CHF vs. X curve. Absence of a CHF temperature excursion at high flows and high qualities - this is found to be caused by a change in slope of the transition boiling part of the boiling curve from a negative value (usual trend that results in a dryout temperature excursion) to a positive slope. Gradual disappearance of the sharp temperature excursion at CHF when increasing the pressure towards and beyond the critical pressure - no drastic change is observed in the shape of the axial temperature distribution of a heated tube experiencing CHF or heat transfer deterioration, when, for constant mass flux and inlet temperature, the pressure is gradually increased from subcritical to supercritical. CHF fluid-to-fluid modeling: differences in CHF behavior at certain conditions between refrigerants and water at equivalent conditions. The mechanisms responsible for these trends and the implications for predicting CHF for bundle geometries

  8. Humanizing the impostor: object relations and illness equations in the neonatal intensive care unit.

    Landzelius, Kyra Marie

    2003-03-01

    In this paper I explore a seemingly mundane and inconsequential act--that of placing dolls and stuffed animals into newborns' incubator machines, in what I dub a kind of "teddy bear diplomacy," whereby mothers ornament their babies' high tech life-support prostheses with commonplace toys and trinkets. Using hospital ethnography and maternal interviews, I probe the psychodynamic significations of these ornamenting acts, which aspire to domesticate, animate and even humanize the incubator, itself a cyborg womb that displaces maternal purpose and problematizes bonding. The stress triggered by a high-risk infant and the double bind imposed by the therapeutic protocol lead me to here examine the intersubjectivity of illness in mothers' comorbidity and satellite syndromes. I argue that teddy bears and like artifacts serve as countertransitional objects to materially symbolize and perform the imagined mother-child dyad. Moreover, as autopoetic devices in the metamorphosis of maternal identity, they may empower a mother's vicarious participation in her child's healing, and thereby work towards closure of her own intersubjective afflictions.

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

    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.)

  10. Ill or just old? Towards a conceptual framework of the relation between ageing and disease

    Westendorp Rudi GJ

    2003-12-01

    Full Text Available Abstract Background Is this person ill or just old? This question reflects the pondering mind of a doctor while interpreting the complaints of an elderly person who seeks his help. Many doctors think that ageing is a non-disease. Accordingly, various attempts have been undertaken to separate pathological ageing from normal ageing. However, the existence of a normal ageing process distinct from the pathological processes causing disease later in life can be questioned. Discussion Ageing is the accumulation of damage to somatic cells, leading to cellular dysfunction, and culminates in organ dysfunction and an increased vulnerability to death. Analogously, chronic diseases initiate early in life and their development is slow before they become clinically apparent and culminate in disability or death. The definition of disease is also subject to current opinions and scientific understanding and usually, it is an act of individual creativity when physical changes are recognised as symptoms of a new disease. New diseases, however, are only rarely really new. Most new diseases have gone undiagnosed because their signs and symptoms escaped recognition or were interpreted otherwise. Many physical changes in the elderly that are not yet recognised as a disease are thus ascribed to normal ageing. Therefore, the distinction between normal ageing and disease late in life seems in large part arbitrary. Summary We think that normal ageing cannot be separated from pathological processes causing disease later in life, and we propose that the distinction is avoided.

  11. Anomalies and other concerns related to the critical heat flux

    Groeneveld, D.C., E-mail: thermal@magma.ca [Researcher Emeritus, Chalk River Laboratories, Atomic Energy of Canada Ltd, Chalk River (Canada) and University of Ottawa, Department of Mechanical Engineering, Ottawa (Canada)

    2011-11-15

    This paper summarizes various unusual trends in the critical heat flux (CHF) that have been observed experimentally in tubes or bundle subassemblies. They include the following: Bullet Occurrence of a minimum in the CHF vs. quality (X) curve at high flows - leading to an initial upstream CHF occurrence in uniformly heated channels. This phenomenon has been observed at high flows in both water and Freon. Bullet Occurrence of a limiting quality region on the CHF vs. X curve where the CHF drops by 30-90% for a nearly constant quality. This is thought to correspond to the boundary between the entrainment controlled and the deposition controlled region and causes problems for prediction methods of the form CHF = f(X). Bullet Impact of flow obstructions on the occurrence of upstream CHF and the limiting quality region. The additional mixing by grid spacers or bundle appendages results in a more homogeneous phase distribution, and diminishes the effects of flow regime/heat transfer regime transitions responsible for some of the unusual CHF trends, and results in a more gradually decreasing CHF vs. X curve. Bullet Absence of a CHF temperature excursion at high flows and high qualities - this is found to be caused by a change in slope of the transition boiling part of the boiling curve from a negative value (usual trend that results in a temperature excursion) to a positive slope. Bullet Gradual disappearance of the sharp temperature excursion at CHF when increasing the pressure towards and beyond the critical pressure - no drastic change is observed in the axial temperature distribution of a heated tube experiencing CHF when, for constant mass flux and inlet temperature, the pressure is gradually increased from subcritical to supercritical. Bullet CHF fluid-to-fluid modelling: differences in CHF trends at certain conditions between refrigerants and water at equivalent conditions. The mechanisms responsible for these trends and the implications for bundle geometries are

  12. Family caregivers' narratives of mental health treatment usage processes by their Latino adult relatives with serious and persistent mental illness.

    Marquez, Jorge A; Ramírez García, Jorge I

    2013-06-01

    Family caregivers' views and experiences related to treatment usage processes by their adult relatives with serious and persistent mental illness (SPMI) were empirically examined in a sample of Latino caregivers (n = 17) who were users of services at the National Alliance on Mental Illness (NAMI) in a predominantly Latino- (80%) and Mexican-descent large city in the Southwest United States. We conducted a stability check of qualitative findings with a second sample of Latino caregivers with no exposure to NAMI (n = 15). Overall, the combined sample (N = 32) compared similarly with larger samples of Latino adults and caregivers in quantitative measures of acculturation, familism, caregiver stigma, and depression symptoms. Together, caregivers' stigma and cultural beliefs, such as vergüenza (shame), use of folk healers, and lack of insurance, were major reported barriers to service usage. Family support (and lack of) for treatment also weighed heavily as a facilitator (and a barrier) of service usage, thus highlighting the complexity of family relationship contexts. Substantial portions of caregivers reported that treatment initiation was prompted by psychiatric hospitalization (50%), and that positive experiences with service providers were influential in treatment retention (72%). Given the high levels of family involvement reported among Latino caregivers, the findings underscore the potential role of family caregivers in treatment engagement and retention. Future research is needed that examines family caregivers' role in treatment with models that consider the interplay between cultural background, family level relationships, and service system contexts. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  13. Pursuing minimally disruptive medicine: disruption from illness and health care-related demands is correlated with patient capacity.

    Boehmer, Kasey R; Shippee, Nathan D; Beebe, Timothy J; Montori, Victor M

    2016-06-01

    Chronic conditions burden patients with illness and treatments. We know little about the disruption of life by the work of dialysis in relation to the resources patients can mobilize, that is, their capacity, to deal with such demands. We sought to determine the disruption of life by dialysis and its relation to patient capacity to cope. We administered a survey to 137 patients on dialysis at an academic medical center. We captured disruption from illness and treatment, and physical, mental, personal, social, financial, and environmental aspects of patient capacity using validated scales. Covariates included number of prescriptions, hours spent on health care, existence of dependents, age, sex, and income level. On average, patients reported levels of capacity and disruption comparable to published levels. In multivariate regression models, limited physical, financial, and mental capacity were significantly associated with greater disruption. Patients in the top quartile of disruption had lower-than-expected physical, financial, and mental capacity. Our sample generally had capacity comparable to other populations and may be able to meet the demands imposed by treatment. Those with reduced physical, financial, and mental capacity reported higher disruption and represent a vulnerable group that may benefit from innovations in minimally disruptive medicine. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  14. Mental Illness-Related Stigma in Canadian Military and Civilian Populations: A Comparison Using Population Health Survey Data.

    Weeks, Murray; Zamorski, Mark A; Rusu, Corneliu; Colman, Ian

    2017-07-01

    This study sought to compare the prevalence and impacts of mental illness-related stigma among Canadian Armed Forces personnel and Canadian civilians. Data were from two highly comparable, population-based, cross-sectional surveys of Canadian military personnel and Canadian civilians: the 2013 Canadian Forces Mental Health Survey (N=6,696) and the 2012 Canadian Community Health Survey-Mental Health (N=25,113), respectively. Perceived stigma was assessed among those who reported care seeking for a mental health problem in the past 12 months. Follow-up questions assessed the impact of stigma in various domains. Modified Poisson regression and linear regression were used to examine population differences (military versus civilian) in terms of care seeking, stigma, and stigma impact, with adjustments for sociodemographic characteristics and the need for care. Military personnel were significantly more likely than civilians to have perceived stigma (adjusted prevalence ratio [PR]=1.70, 95% confidence interval [CI]=1.11-2.60). Stigma had a greater impact on military personnel, particularly in terms of work or school life (b=1.01, CI=.57-1.47). However, military personnel were also significantly more likely than civilians to have sought care (PR=1.86, CI=1.53-2.25). Military personnel reported a disproportionate amount of mental illness-related stigma, compared with Canadian civilians, and a greater impact of stigma. Nevertheless, military personnel were more likely to seek care, pointing to a complex relationship between stigma and care seeking in the military.

  15. Health-related quality of life in multiple sclerosis: role of cognitive appraisals of self, illness and treatment.

    Wilski, Maciej; Tasiemski, Tomasz

    2016-07-01

    Health-related quality of life (HRQoL) is considered an important measure of treatment and rehabilitation outcomes in multiple sclerosis (MS) patients. In this study, we used multivariate regression analysis to examine the role of cognitive appraisals, adjusted for clinical, socioeconomic and demographic variables, as correlates of HRQoL in MS. The cross-sectional study included 257 MS patients, who completed Multiple Sclerosis Impact Scale, Generalized Self-Efficacy Scale, Rosenberg Self-Esteem Scale, Brief Illness Perception Questionnaire, Treatment Beliefs Scale, Actually Received Support Scale (a part of Berlin Social Support Scale) and Socioeconomic Resources Scale. Demographic and clinical characteristics of the participants were collected with a self-report survey. Correlation and regression analyses were conducted to determine associations between the variables. Five variables, illness identity (β = 0.29, p ≤ 0.001), self-esteem (β = -0.22, p ≤ 0.001), general self-efficacy (β = -0.21, p ≤ 0.001), disability subgroup "EDSS" (β = 0.14, p = 0.006) and age (β = 0.12, p = 0.012), were significant correlates of HRQoL in MS. These variables explained 46 % of variance in the dependent variable. Moreover, we identified correlates of physical and psychological dimensions of HRQoL. Cognitive appraisals, such as general self-efficacy, self-esteem and illness perception, are more salient correlates of HRQoL than social support, socioeconomic resources and clinical characteristics, such as type and duration of MS. Therefore, interventions aimed at cognitive appraisals may also improve HRQoL of MS patients.

  16. PURCHASING BEHAVIOUR RELATED TO HEATING SYSTEMS IN GERMANY WITH SPECIAL CONSIDERATION OF CONSUMERS' ECOLOGICAL ATTITUDES

    Decker, Thomas; Zapilko, Marina; Menrad, Klaus

    2010-01-01

    The decision for buying a heating system is a long-term one, as many different aspects have an influence on this choice which were analyzed in a Germany-wide, written survey. The respondents (only owners of a private house) had to answer questions about their attitude towards e.g. economic, convenience or ecological aspects related to heating systems and the respective combustibles. Using a multinomial logistic regression model the choice of the heating system is mainly explained by ecologica...

  17. Heat transfers and related effects in supercritical fluids

    Zappoli, Bernard; Garrabos, Yves

    2015-01-01

    This book investigates the unique hydrodynamics and heat transfer problems that are encountered in the vicinity of the critical point of fluids. Emphasis is given on weightlessness conditions, gravity effects and thermovibrational phenomena. Near their critical point, fluids indeed obey universal behavior and become very compressible and expandable. Their comportment, when gravity effects are suppressed, becomes quite unusual. The problems that are treated in this book are of interest to students and researchers interested in the original behavior of near-critical fluids as well as to engineers that have to manage supercritical fluids. A special chapter is dedicated to the present knowledge of critical point phenomena. Specific data for many fluids are provided, ranging from cryogenics (hydrogen) to high temperature (water). Basic information in statistical mechanics, mathematics and measurement techniques is also included. The basic concepts of fluid mechanics are given for the non-specialists to be able to ...

  18. Device-related infections in critically ill patients. Part II: Prevention of ventilator-associated pneumonia and urinary tract infections.

    Di Filippo, A; De Gaudio, A R

    2003-12-01

    Device utilization in critically ill patients is responsible for a high risk of complications such as catheter-related bloodstream infections (CRBSI), ventilator-associated pneumonia (VAP) and urinary tract infections (UTI). In this article we will review the current status of data regarding the prevention of VAP and UTI. The results of the more recent (5 years) randomized controlled trials are reviewed and discussed. General recommendations include staff education and use of a surveillance program with a restrictive antibiotic policy. Adequate time must be allowed for hand washing and barrier precautions must always be used during device manipulation. Specific measures for VAP prevention are: 1) use of multi-use, closed-system suction catheters; 2) no routine change of the breathing circuit; 3) lubrication of the cuff of the endotracheal tube (ET) with a water-soluble gel; 4) maintenance of patient in semi-recumbent position to improve chest physiotherapy in intubated patients. Specific measures for UTI prevention include: 1) use of a catheter-valve instead of a standard drainage system; 2) use of a silver-alloy, hydro gel-coated latex urinary catheter instead of uncoated catheters. Biofilm represents a new variable: the capacity of bacteria to organize a biofilm on a device surface can explain the difficulty in preventing and eradicating an infection in a critically ill patient. More clinical trials are needed to verify the efficacy of prevention measures of ICU infections.

  19. Entropic Constitutive Relation and Modeling for Fourier and Hyperbolic Heat Conductions

    Shu-Nan Li

    2017-12-01

    Full Text Available Most existing phenomenological heat conduction models are expressed by temperature and heat flux distributions, whose definitions might be debatable in heat conductions with strong non-equilibrium. The constitutive relations of Fourier and hyperbolic heat conductions are here rewritten by the entropy and entropy flux distributions in the frameworks of classical irreversible thermodynamics (CIT and extended irreversible thermodynamics (EIT. The entropic constitutive relations are then generalized by Boltzmann–Gibbs–Shannon (BGS statistical mechanics, which can avoid the debatable definitions of thermodynamic quantities relying on local equilibrium. It shows a possibility of modeling heat conduction through entropic constitutive relations. The applicability of the generalizations by BGS statistical mechanics is also discussed based on the relaxation time approximation, and it is found that the generalizations require a sufficiently small entropy production rate.

  20. Determination of susceptibility to heat-related disorders and prevention methods among agriculture workers

    2012-01-01

    Conclusion: According to the results, agriculture workers based on their age distribution, education, body mass index, health knowledge, drug use and incidence of chronic diseases, are very vulnerable to heat-related disorders. Therefore, training on recognizing the early signs and doing control measures as essential element in heat stress prevention should be seriously considered.

  1. Environmental microbiology as related to planetary quarantine. [synergetic effect of heat and radiation

    Pflug, I. J.

    1973-01-01

    The mechanistic basis of the synergetic effect of combined heat and radiation on microbial destruction was analyzed and results show that radiation intensity, temperature, and relative humidity are the determining factors. Dry heat resistance evaluation for selected bacterial spore crops indicates that different strains of Bacillus stearothermophilus demonstrate marked differences in resistance. Preliminary work to determine the effects of storage time, suspending medium, storage temperature and spore crop cleaning procedures on dry heat survival characteristics of Bacillus subtilis var. Niger, and dry heat resistance of natural microflora in soil particles is also reported.

  2. Work-related heat stress concerns in automotive industries: a case study from Chennai, India.

    Ayyappan, Ramalingam; Sankar, Sambandam; Rajkumar, Paramasivan; Balakrishnan, Kalpana

    2009-11-11

    Work-related heat stress assessments, the quantification of thermal loads and their physiological consequences have mostly been performed in non-tropical developed country settings. In many developing countries (many of which are also tropical), limited attempts have been made to create detailed job-exposure profiles for various sectors. We present here a case study from Chennai in southern India that illustrates the prevalence of work-related heat stress in multiple processes of automotive industries and the efficacy of relatively simple controls in reducing prevalence of the risk through longitudinal assessments. We conducted workplace heat stress assessments in automotive and automotive parts manufacturing units according to the protocols recommended by NIOSH, USA. Sites for measurements included indoor locations with process-generated heat exposure, indoor locations without direct process-generated heat exposure and outdoor locations. Nearly 400 measurements of heat stress were made over a four-year period at more than 100 locations within eight units involved with automotive or automotive parts manufacturing in greater Chennai metropolitan area. In addition, cross-sectional measurements were made in select processes of glass manufacturing and textiles to estimate relative prevalence of heat stress. Results indicate that many processes even in organised large-scale industries have yet to control heat stress-related hazards adequately. Upwards of 28% of workers employed in multiple processes were at risk of heat stress-related health impairment in the sectors assessed. Implications of longitudinal baseline data for assessing efficacy of interventions as well as modelling potential future impacts from climate change (through contributions from worker health and productivity impairments consequent to increases in ambient temperature) are described. The study re-emphasises the need for recognising heat stress as an important occupational health risk in both formal

  3. Treating the Illness: The School Practitioner's Response to Health-Related Student Death and Children's Grief

    Jimerson, Shane R.; Miller, David N.

    2008-01-01

    Although childhood death from health-related disorders has decreased dramatically in the United States due largely to advances in medical technology, it is an unfortunate fact of life that children can and do die from medical and health-related problems. A possible role for school psychologists in dealing with this situation is providing direct…

  4. Near-Real-Time Surveillance of Illnesses Related to Shellfish Consumption in British Columbia: Analysis of Poison Center Data.

    Wan, Victoria; McIntyre, Lorraine; Kent, Debra; Leong, Dennis; Henderson, Sarah B

    2018-02-23

    Data from poison centers have the potential to be valuable for public health surveillance of long-term trends, short-term aberrations from those trends, and poisonings occurring in near-real-time. This information can enable long-term prevention via programs and policies and short-term control via immediate public health response. Over the past decade, there has been an increasing use of poison control data for surveillance in the United States, Europe, and New Zealand, but this resource still remains widely underused. The British Columbia (BC) Drug and Poison Information Centre (DPIC) is one of five such services in Canada, and it is the only one nested within a public health agency. This study aimed to demonstrate how DPIC data are used for routine public health surveillance in near-real-time using the case study of its alerting system for illness related to consumption of shellfish (ASIRCS). Every hour, a connection is opened between the WBM software Visual Dotlab Enterprise, which holds the DPIC database, and the R statistical computing environment. This platform is used to extract, clean, and merge all necessary raw data tables into a single data file. ASIRCS automatically and retrospectively scans a 24-hour window within the data file for new cases related to illnesses from shellfish consumption. Detected cases are queried using a list of attributes: the caller location, exposure type, reasons for the exposure, and a list of keywords searched in the clinical notes. The alert generates a report that is tailored to the needs of food safety specialists, who then assess and respond to detected cases. The ASIRCS system alerted on 79 cases between January 2015 and December 2016, and retrospective analysis found 11 cases that were missed. All cases were reviewed by food safety specialists, and 58% (46/79) were referred to designated regional health authority contacts for follow-up. Of the 42% (33/79) cases that were not referred to health authorities, some were

  5. Microbial air quality in mass transport buses and work-related illness among bus drivers of Bangkok Mass Transit Authority.

    Luksamijarulkul, Pipat; Sundhiyodhin, Viboonsri; Luksamijarulkul, Soavalug; Kaewboonchoo, Orawan

    2004-06-01

    The air quality in mass transport buses, especially air-conditioned buses may affect bus drivers who work full time. Bus numbers 16, 63, 67 and 166 of the Seventh Bus Zone of Bangkok Mass Transit Authority were randomly selected to investigate for microbial air quality. Nine air-conditioned buses and 2-4 open-air buses for each number of the bus (36 air-conditioned buses and 12 open-air buses) were included. Five points of in-bus air samples in each studied bus were collected by using the Millipore A ir Tester Totally, 180 and 60 air samples collected from air-conditioned buses and open-air buses were cultured for bacterial and fungal counts. The bus drivers who drove the studied buses were interviewed towards histories of work-related illness while working. The results revealed that the mean +/- SD of bacterial counts in the studied open-air buses ranged from 358.50 +/- 146.66 CFU/m3 to 506 +/- 137.62 CFU/m3; bus number 16 had the highest level. As well as the mean +/- SD of fungal counts which ranged from 93.33 +/- 44.83 CFU/m3 to 302 +/- 294.65 CFU/m3; bus number 166 had the highest level. Whereas, the mean +/- SD of bacterial counts in the studied air-conditioned buses ranged from 115.24 +/- 136.01 CFU/m3 to 244.69 +/- 234.85 CFU/m3; bus numbers 16 and 67 had the highest level. As well as the mean +/- SD of fungal counts which rangedfrom 18.84 +/- 39.42 CFU/m3 to 96.13 +/- 234.76 CFU/m3; bus number 166 had the highest level. When 180 and 60 studied air samples were analyzed in detail, it was found that 33.33% of the air samples from open-air buses and 6.11% of air samples from air-conditioned buses had a high level of bacterial counts (> 500 CFU/m3) while 6.67% of air samples from open-air buses and 2.78% of air samples from air-conditioned buses had a high level of fungal counts (> 500 CFU/m3). Data from the history of work-related illnesses among the studied bus drivers showed that 91.67% of open-air bus drivers and 57.28% of air-conditioned bus drivers had

  6. Analysis of needs of the critically ill relatives and critical care professional's opinion.

    Sánchez-Vallejo, A; Fernández, D; Pérez-Gutiérrez, A; Fernández-Fernández, M

    2016-12-01

    To describe the needs of the families of patients admitted to the Intensive Care Unit (ICU) and the opinion of ICU professionals on aspects related to the presence of patient relatives in the unit. A prospective descriptive study was carried out between March and June 2015. Polyvalent ICU of León University Healthcare Complex (Spain). Two samples of volunteers were studied: one comprising the relatives emotionally closest to the primarily non-surgical patients admitted to the Unit for over 48hours, and the other composed of ICU professionals with over three months of experience in the ICU. One self-administered questionnaire was delivered to each relative and another to each professional. Sociodemographic data were collected. The variables in the questionnaire for relatives comprised the information received, closeness to the patient, safety of care, the support received, and comfort. In turn, the questionnaire for professionals addressed empathy and professional relationship with the family, visiting policy, and the effect of the family upon the patient. A total of 59% of the relatives (35/61) answered the questionnaire. Of these subjects, 91.4% understood the information received, though 49.6% received no information on nursing care. A total of 82.9% agreed with the visiting policy applied (95.2% were patient offspring; P<.05). Participation on the part of the professionals in turn reached 76.3% (61/80). A total of 59.3% would flexibilize the visiting policy, and 78.3% considered that the family afforded emotional support for the patient, with no destabilizing effect. On the other hand, 62.3% routinely informed the family, and 88% considered training in communication skills to be needed. Information was adequate, though insufficient in relation to nursing care. The professionals pointed to the need for training in communication skills. Copyright © 2016 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  7. Molecular genetic models related to schizophrenia and psychotic illness: heuristics and challenges.

    O'Tuathaigh, Colm M P; Desbonnet, Lieve; Moran, Paula M; Kirby, Brian P; Waddington, John L

    2011-01-01

    Schizophrenia is a heritable disorder that may involve several common genes of small effect and/or rare copy number variation, with phenotypic heterogeneity across patients. Furthermore, any boundaries vis-à-vis other psychotic disorders are far from clear. Consequently, identification of informative animal models for this disorder, which typically relate to pharmacological and putative pathophysiological processes of uncertain validity, faces considerable challenges. In juxtaposition, the majority of mutant models for schizophrenia relate to the functional roles of a diverse set of genes associated with risk for the disorder or with such putative pathophysiological processes. This chapter seeks to outline the evidence from phenotypic studies in mutant models related to schizophrenia. These have commonly assessed the degree to which mutation of a schizophrenia-related gene is associated with the expression of several aspects of the schizophrenia phenotype or more circumscribed, schizophrenia-related endophenotypes; typically, they place specific emphasis on positive and negative symptoms and cognitive deficits, and extend to structural and other pathological features. We first consider the primary technological approaches to the generation of such mutants, to include their relative merits and demerits, and then highlight the diverse phenotypic approaches that have been developed for their assessment. The chapter then considers the application of mutant phenotypes to study pathobiological and pharmacological mechanisms thought to be relevant for schizophrenia, particularly in terms of dopaminergic and glutamatergic dysfunction, and to an increasing range of candidate susceptibility genes and copy number variants. Finally, we discuss several pertinent issues and challenges within the field which relate to both phenotypic evaluation and a growing appreciation of the functional genomics of schizophrenia and the involvement of gene × environment interactions.

  8. Heat pulse analysis in JET and relation to local energy transport models

    Haas, J.C.M. de; Lopes Cardozo, N.J.; Han, W.; Sack, C.; Taroni, A.

    1989-01-01

    The evolution of a perturbation T e of the electron temperature depends on the linearised expression of the heat flux q e and may be not simply related to the local value of the electron heat conductivity χ e . It is possible that local heat transport models predicting similar temperature profiles and global energy confinement properties, imply a different propagation of heat pulses. We investigate here this possibility for the case of two models developed at JET. We also present results obtained at JET on a set of discharges covering the range of currents from 2 to 5 MA. Only L-modes, limiter discharges are considered here. Experimental results on the scaling of χ HP , the value of χ e related to heat pulse propagation, are compared with those of χ HP derived from the models. (author) 7 refs., 2 figs., 2 tabs

  9. Going ill to work--what personal circumstances, attitudes and work-related factors are associated with sickness presenteeism?

    Hansen, C. D.; Andersen, JH

    2008-01-01

    The aim of this study is to assess the impact of a broad range of possible factors relating to work, personal circumstances and attitudes towards sickness absence on a person's decision to go to work despite feeling ill, a phenomenon that has been termed sickness presence (SP), or 'presenteeism...... period. This means that SP is just as prevalent a phenomenon as sickness absence. Many of the results from earlier studies of SP were replicated and new factors were discovered: for example time pressure (having a supervisory role and/or working more than 45 h per week) and relationship with colleagues...... (measured by working in a small company, having non-standard hours and degree of cooperation) both increase the likelihood of SP. However, personal circumstances and attitudes, e.g. treating work as home (cf. Hochschild's thesis) and being over-committed to work, were also found to lead to higher levels...

  10. Understanding men's health and illness: a gender-relations approach to policy, research, and practice.

    Schofield, T; Connell, R W; Walker, L; Wood, J F; Butland, D L

    2000-05-01

    Men's health has emerged as an important public concern that may require new kinds of healthcare interventions and increased resources. Considerable uncertainty and confusion surround prevailing understandings of men's health, particularly those generated by media debate and public policy, and health research has often operated on oversimplified assumptions about men and masculinity. A more useful way of understanding men's health is to adopt a gender-relations approach. This means examining health concerns in the context of men's and women's interactions with each other, and their positions in the larger, multidimensional structure of gender relations. Such an approach raises the issue of differences among men, which is a key issue in recent research on masculinity and an important health issue. The gender-relations approach offers new ways of addressing practical issues of healthcare for men in college environments.

  11. Intra-household relations and treatment decision-making for childhood illness: a Kenyan case study.

    Molyneux, C S; Murira, G; Masha, J; Snow, R W

    2002-01-01

    This study, conducted on the Kenyan coast, assesses the effect of intra-household relations on maternal treatment-seeking. Rural and urban Mijikenda mothers' responses to childhood fevers in the last 2 weeks (n=317), and to childhood convulsions in the previous year (n=43), were documented through survey work. The intra-household relations and decision-making dynamics surrounding maternal responses were explored through in-depth individual and group interviews, primarily with women (n=223). Responses to convulsions were more likely than responses to fevers to include a healer consultation (p<0.0001), and less likely to include the purchase of over-the-counter medications (p<0.0001). Mothers received financial or advisory assistance from others in 71% (n=236) of actions taken outside the household in response to fevers. In-depth interviews suggested that general agreement on appropriate therapy results in relatively few intra-household conflicts over the treatment of fevers. Disputes over perceived cause and appropriate therapy of convulsions, however, highlighted the importance of age, gender and relationship to household head in intra-household relations and treatment decision-making. Although mothers' treatment-seeking preferences are often circumscribed by these relations, a number of strategies can be drawn upon to circumvent 'inappropriate' decisions, sometimes with implications for future household responses to similar syndromes. The findings highlight the complexity of intra-household relations and treatment decision-making dynamics. Tentative implications for interventions aimed at improving the home management of malaria, and for further research, are presented.

  12. Relationship between stress and pain in work-related upper extremity disorders: the hidden role of chronic multisymptom illnesses.

    Clauw, Daniel J; Williams, David A

    2002-05-01

    Pain and fatigue are commonly associated with work-related upper extremity disorders. Occasionally these symptoms persist beyond a reasonable healing period. One potential explanation for prolonged symptom expression is the concurrent development of a stress-mediated illness or CMI (Chronic Multi-Symptom Illness). In such a scenario, the chronic regional pain and other symptoms that the individual is experiencing would be attributable to the CMI rather than to tissue damage or a biomechanical dysfunction of the upper-extremity. This article critically reviews the case definitions of the new class of CMI disorders and evaluates the existing evidence supporting centrally mediated physiological changes (e.g., sensory hypervigilance, dysautonomia) that manifest as symptoms of pain and fatigue in some individuals experiencing chronic stressors. While explanations for prolonged pain and fatigue have historically focused on mechanisms involving peripheral pathology or psychiatric explanations, ample evidences support the role of altered Central Nervous System function in accounting for symptom manifestation in CMI. A model is presented that unites seemingly disparate findings across numerous investigations and provides a framework for understanding how genetics, triggering events, stressors, and early life events can affect CNS activity. Resultant symptom expression (e.g., pain and fatigue) from central dysregulation would be expected to occur in a subset of individuals in the population, including a subset of individuals with work-related upper extremity disorders. Thus when symptoms such as pain and fatigue persist beyond a reasonable period, consideration of CMI and associated assessment and interventions focused on central mechanisms may be worthwhile.

  13. Heat-related deaths among California residents, May-September, 2000-2009.

    California Environmental Health Tracking Program — This dataset contains counts, rates, and confidence intervals of heat-related deaths among California residents for the years 2000-2009. These data are stratified by...

  14. Diabetes-related distress over the course of illness: results from the Diacourse study.

    Kasteleyn, M.J.; Vries, L. de; Puffelen, A.L. van; Schellevis, F.G.; Rijken, M.; Vos, R.C.; Rutten, G.E.H.M.

    2015-01-01

    Aims To investigate the relationship between diabetes duration and diabetes-related distress and to examine the impact of micro- and macrovascular complications and blood glucose-lowering treatment on this relationship. Methods We conducted a cross-sectional study in people with Type 2 diabetes who

  15. Relation of Symptom-Induced Impairment with Other Illness Parameters in Clinic-Referred Youth

    Gadow, Kenneth D.; Kaat, Aaron J.; Lecavalier, Luc

    2013-01-01

    Objective: To examine the relation of caregiver ratings of psychiatric symptom-induced impairment with number and severity of symptoms and informant agreement in consecutive child psychiatry outpatient referrals. Methods: Parents and teachers completed a broadband "DSM-IV"-referenced rating scale with disorder-specific impairment for 636…

  16. Causal Beliefs and Effects upon Mental Illness Identification Among Chinese Immigrant Relatives of Individuals with Psychosis

    Yang, Lawrence H.; Wonpat-Borja, Ahtoy J.

    2011-01-01

    Identifying factors that facilitate treatment for psychotic disorders among Chinese-immigrants is crucial due to delayed treatment use. Identifying causal beliefs held by relatives that might predict identification of ‘mental illness’ as opposed to other ‘indigenous labels’ may promote more effective mental health service use. We examine what effects beliefs of ‘physical causes’ and other non-biomedical causal beliefs (‘general social causes’, and ‘indigenous Chinese beliefs’ or culture-speci...

  17. Travel-related illness at a tertiary care hospital in Osaka, Japan

    Hadano,Yoshiro; Shirano,Michinori; Goto,Tetsushi

    2016-01-01

    Yoshiro Hadano, Michinori Shirano, Tetsushi Goto Center for Infectious Diseases, Osaka City General Hospital, Osaka, Japan Abstract: We analyzed the travel-related health problems in persons returning to Japan from overseas. Data were extracted retrospectively for all patients visiting the infectious diseases department of Osaka City General Hospital, Osaka, Japan, between July 2012 and September 2013. There were 209 sick returning travelers during the period of the study. ...

  18. Needs of relatives of critically ill patients in an academic hospital in Chile.

    Padilla-Fortunatti, C; Rojas-Silva, N; Amthauer-Rojas, M; Molina-Muñoz, Y

    To identify the importance of the needs of family members of patients in an intensive care unit (ICU). Descriptive, comparative and cross-sectional study based on a secondary data analysis of 251 relatives of ICU patients at a university hospital in Santiago, Chile. Using non-random sampling, the 'Critical Care Family Needs Inventory' was used to establish the family needs, as well as a sociodemographic questionnaire that included: age, gender, educational level, patient relationship and previous ICU experience. A descriptive statistical analysis, Student's T test and ANOVA were performed. The most important family needs related to the dimensions of 'security' (mean=3.90) and 'information' (mean=3.76), while those of minor importance with 'support' (mean=3.09). In the latter, differences were observed at an older age (P<.05), an educational level (P<.001) and relationship with the patient (P<.05). The most relevant needs for family members in the ICU are related to safety and information. Less important needs are influenced by certain sociodemographic variables. Identifying the degree of importance of family needs will allow the health team to improve its relationship with families in ICUs. Copyright © 2017 Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC). Publicado por Elsevier España, S.L.U. All rights reserved.

  19. Projecting Future Heat-Related Mortality under Climate Change Scenarios: A Systematic Review

    Barnett, Adrian Gerard; Wang, Xiaoming; Vaneckova, Pavla; FitzGerald, Gerard; Tong, Shilu

    2011-01-01

    Background: Heat-related mortality is a matter of great public health concern, especially in the light of climate change. Although many studies have found associations between high temperatures and mortality, more research is needed to project the future impacts of climate change on heat-related mortality. Objectives: We conducted a systematic review of research and methods for projecting future heat-related mortality under climate change scenarios. Data sources and extraction: A literature search was conducted in August 2010, using the electronic databases PubMed, Scopus, ScienceDirect, ProQuest, and Web of Science. The search was limited to peer-reviewed journal articles published in English from January 1980 through July 2010. Data synthesis: Fourteen studies fulfilled the inclusion criteria. Most projections showed that climate change would result in a substantial increase in heat-related mortality. Projecting heat-related mortality requires understanding historical temperature–mortality relationships and considering the future changes in climate, population, and acclimatization. Further research is needed to provide a stronger theoretical framework for projections, including a better understanding of socioeconomic development, adaptation strategies, land-use patterns, air pollution, and mortality displacement. Conclusions: Scenario-based projection research will meaningfully contribute to assessing and managing the potential impacts of climate change on heat-related mortality. PMID:21816703

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

    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.

  1. CONVECTIVE HEAT EXCHANGE ON THE LATERAL SURFACE OF A RELATIVELY LONG CYCLONE CHAMBER

    E. N. Saburov

    2016-01-01

    Full Text Available The high-turbulent swirling flows of heat carrier that are created by a cyclone chamber are used in industry. They make it possible to intensify processes of heat and mass exchange. The results of an experimental study of convective heat transfer on the lateral surface of the active volume of a relatively long cyclone chamber considerably exceeding the length of the chambers that were used in previously performed studies are presented and analyzed in the article. Air supply in the swirler of the chamber was performed tangentially from diametrically opposite sides of the two input channels. The gas outlet was implemented from the opposite end. The heat transfer by convection to the swirling air flow was studied by the method of changing the state of aggregation of a heating agent – condensation of slightly superheated steam. Collecting condensate from the working section was made through a water seal for maintaining a constant pressure calorimeter. The amount of heat transferred during experiment was determined by weight of the collected condensate. The specific features of influence of geometrical characteristics of cyclone chamber on intensity of heat exchange are considered. In the experiments we varied the relative diameter of the outlet port of the chamber dвых and the relative area of the input channels fвх. Segmental construction of the chamber made it possible to move a calorimeter on its length. The local heat transfer coefficient was determined for various values of the dimensionless longitudinal coordinate z coinciding with the axis of the chamber, and counted from the back end of the swirler. The estimated equations of heat transfer obtained during the research are presented and recommended for use in practice of engineering. The considered problem is of an interest from the point of view of further research of aerodynamics and of convective heat transfer in a highly swirling flow cyclone devices, in order to improve the

  2. Life expectancy impacts due to heating energy utilization in China: Distribution, relations, and policy implications.

    Wang, Shaobin; Luo, Kunli

    2018-01-01

    The relation between life expectancy and energy utilization is of particular concern. Different viewpoints concerned the health impacts of heating policy in China. However, it is still obscure that what kind of heating energy or what pattern of heating methods is the most related with the difference of life expectancies in China. The aim of this paper is to comprehensively investigate the spatial relations between life expectancy at birth (LEB) and different heating energy utilization in China by using spatial autocorrelation models including global spatial autocorrelation, local spatial autocorrelation and hot spot analysis. The results showed that: (1) Most of heating energy exhibit a distinct north-south difference, such as central heating supply, stalks and domestic coal. Whereas spatial distribution of domestic natural gas and electricity exhibited west-east differences. (2) Consumption of central heating, stalks and domestic coal show obvious spatial dependence. Whereas firewood, natural gas and electricity did not show significant spatial autocorrelation. It exhibited an extinct south-north difference of heat supply, stalks and domestic coal which were identified to show significant positive spatial autocorrelation. (3) Central heating, residential boilers and natural gas did not show any significant correlations with LEB. While, the utilization of domestic coal and biomass showed significant negative correlations with LEB, and household electricity shows positive correlations. The utilization of domestic coal in China showed a negative effect on LEB, rather than central heating. To improve the solid fuel stoves and control consumption of domestic coal consumption and other low quality solid fuel is imperative to improve the public health level in China in the future. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Stigma Related Avoidance in People Living with Severe Mental Illness (SMI): Findings of an Integrative Review.

    Abiri, Sadat; Oakley, Linda Denise; Hitchcock, Mary E; Hall, Amanda

    2016-04-01

    The purpose of this integrative review is to synthesize primary evidence of the impact of internalized stigma on avoidance in adult community treatment patients living with SMI. A keyword database search of articles published through 2015 yielded 21 papers and a total of 4256 patients. Our analyses found that stigmatizing beliefs associated with avoidance are related to significant loss of self-esteem. Factors generally thought to reduce stigma internalized as self-stigmatizing beliefs, such as improved insight, increased self-awareness, and psycho-education to improve stigma coping skills, do not appear to improve self-esteem.

  4. The Concept of Travel Medicine and the Actual Situation of Travel-Related Illnesses.

    Tunalı, Varol; Turgay, Nevin

    2017-06-01

    Travel medicine defines all diseases and medical situations that are related to travel. Travel medicine comprises infectious diseases, traumas, altitude sickness, sun burns, embolisms, jet lag, and many more travel-related situations. With the increasing possibility and ease of travel, the number of people who have travelled internationally has exceeded 1.13 billion in 2014, and the revenues of international travel have exceeded 1.25 trillion dollars. With every passing day, international travels are shifting toward the developing countries and to more exotic regions of the world, and travelers tend to be more adventurous and daring, thereby increasing risky behaviors during travels. Traveling plays an important role in transmitting infections such as Zika virus infection, Ebola, avian flu, severe acute respiratory syndrome, Chikungunya, and dengue fever and is the principal reason for the epidemics of these types of infections on a global scale. With this background, we suggest that travel medicine is an important but "neglected" medical discipline as the discipline of Parasitology itself like most parasitic diseases.

  5. Heat-Related Mortality in a Warming Climate: Projections for 12 U.S. Cities

    Elisaveta P. Petkova

    2014-10-01

    Full Text Available Heat is among the deadliest weather-related phenomena in the United States, and the number of heat-related deaths may increase under a changing climate, particularly in urban areas. Regional adaptation planning is unfortunately often limited by the lack of quantitative information on potential future health responses. This study presents an assessment of the future impacts of climate change on heat-related mortality in 12 cities using 16 global climate models, driven by two scenarios of greenhouse gas emissions. Although the magnitude of the projected heat effects was found to differ across time, cities, climate models and greenhouse pollution emissions scenarios, climate change was projected to result in increases in heat-related fatalities over time throughout the 21st century in all of the 12 cities included in this study. The increase was more substantial under the high emission pathway, highlighting the potential benefits to public health of reducing greenhouse gas emissions. Nearly 200,000 heat-related deaths are projected to occur in the 12 cities by the end of the century due to climate warming, over 22,000 of which could be avoided if we follow a low GHG emission pathway. The presented estimates can be of value to local decision makers and stakeholders interested in developing strategies to reduce these impacts and building climate change resilience.

  6. Heat-Related Mortality in a Warming Climate: Projections for 12 U.S. Cities

    Petkova, Elisaveta P.; Bader, Daniel A.; Anderson, G. Brooke; Horton, Radley M.; Knowlton, Kim; Kinney, Patrick L.

    2014-01-01

    Heat is among the deadliest weather-related phenomena in the United States, and the number of heat-related deaths may increase under a changing climate, particularly in urban areas. Regional adaptation planning is unfortunately often limited by the lack of quantitative information on potential future health responses. This study presents an assessment of the future impacts of climate change on heat-related mortality in 12 cities using 16 global climate models, driven by two scenarios of greenhouse gas emissions. Although the magnitude of the projected heat effects was found to differ across time, cities, climate models and greenhouse pollution emissions scenarios, climate change was projected to result in increases in heat-related fatalities over time throughout the 21st century in all of the 12 cities included in this study. The increase was more substantial under the high emission pathway, highlighting the potential benefits to public health of reducing greenhouse gas emissions. Nearly 200,000 heat-related deaths are projected to occur in the 12 cities by the end of the century due to climate warming, over 22,000 of which could be avoided if we follow a low GHG emission pathway. The presented estimates can be of value to local decision makers and stakeholders interested in developing strategies to reduce these impacts and building climate change resilience.

  7. The relation of intrinsic religiousness to the subjective health of Greek medical inpatients: the mediating role of illness-related coping.

    Karademas, Evangelos C; Petrakis, Charoula

    2009-08-01

    A large number of studies suggest a significant beneficial relationship between religiousness and many health indicators. The aim of this study was to (1) examine the association between intrinsic religiousness and subjective health in a sample of medical inpatients; (2) examine the mediating role of illness-related coping. A cross-sectional design was employed. Participants were 128 inpatients suffering from a coronary artery disease, cancer, or a renal disease. Intrinsic religiousness was found to be uncorrelated to psychological symptoms or self-rated health. Weak to modest positive correlations were noticed with wishful thinking, emotional reactions, and palliative coping. These coping strategies were also found to mediate the relationship to subjective health measures. Results suggest a weak, indirect, and negative relation of intrinsic religiousness to participants' subjective health. Situational, assessment, and conceptual factors may underlie the discrepancy between these findings and research supporting the health benefits of religiousness.

  8. Impact of obesity on health-related quality of life in patients with chronic illness.

    Katz, D A; McHorney, C A; Atkinson, R L

    2000-11-01

    To determine the association between overweight and obesity and health-related quality of life (HRQOL) in patients with chronic conditions typical of those seen in general medical practice, after accounting for the effects of depression and medical comorbidities. Cross-sectional analysis of data from the Medical Outcomes Study. Offices of physicians practicing family medicine, internal medicine, endocrinology, cardiology, and psychiatry in three U.S. cities. We surveyed 2,931 patients with chronic medical and psychiatric conditions. The patients completed a self-administered questionnaire at enrollment and had complete data on height and weight. Body mass index (BMI), chronic medical conditions, and depression were obtained by structured interview. Health-related quality of life was measured by the SF-36 Health Survey. Patients who were overweight (BMI 25.0-29.9 kg/m2), patients with class I obesity (BMI 30.0-34.9 kg/m2), and patients with class II-III obesity (BMI > or = 35 kg/m2) had significantly lower adjusted physical function scores (by 3.4, 7.8, and 13.8 points, respectively) compared with nonoverweight patients. Patients with class I and class II-III obesity also had significantly lower adjusted general health perceptions scores (by 2.8 and 4.4 points, respectively) and lower adjusted vitality scores (by 4.0 and 7.1 points, respectively), compared with nonoverweight patients. No significant differences between nonoverweight, overweight, and obese patients were observed for the mental health scale. Women with elevated BMI had significantly lower HRQOL scores compared with the scores of obese men in several domains. Additionally, blacks with elevated BMI had significantly lower scores than whites in several domains of HRQOL. Overweight and obesity have the largest association with physical function measures. Recent national standards, which have lowered the threshold for defining overweight, identify patients who are more likely to have clinically significant

  9. Heat flux from magmatic hydrothermal systems related to availability of fluid recharge

    Harvey, M. C.; Rowland, J.V.; Chiodini, G.; Rissmann, C.F.; Bloomberg, S.; Hernandez, P.A.; Mazot, A.; Viveiros, F.; Werner, Cynthia A.

    2015-01-01

    Magmatic hydrothermal systems are of increasing interest as a renewable energy source. Surface heat flux indicates system resource potential, and can be inferred from soil CO2 flux measurements and fumarole gas chemistry. Here we compile and reanalyze results from previous CO2 flux surveys worldwide to compare heat flux from a variety of magma-hydrothermal areas. We infer that availability of water to recharge magmatic hydrothermal systems is correlated with heat flux. Recharge availability is in turn governed by permeability, structure, lithology, rainfall, topography, and perhaps unsurprisingly, proximity to a large supply of water such as the ocean. The relationship between recharge and heat flux interpreted by this study is consistent with recent numerical modeling that relates hydrothermal system heat output to rainfall catchment area. This result highlights the importance of recharge as a consideration when evaluating hydrothermal systems for electricity generation, and the utility of CO2 flux as a resource evaluation tool.

  10. A three-tier phenotyping approach for hunting QTLs related to heat tolerance in bread wheat

    Sharma, Dew Kumari; Rosenqvist, Eva; Ottosen, Carl-Otto

    2014-01-01

    In the global climate change scenario, heatstress together with other abiotic stresses will remain an importantdeterminant of future food security. Wheat (Triticum aestivum L.) is the third most important crop, feeding about one third of the world population. Being a crop of temperate climate......, wheat is sensitive to heat stress, particularly at the reproductive phase. Heat tolerance is a complex trait. In the present study, a combined approach of physiological phenotyping and quantitative genetics was used to dissect the complex nature of heat tolerance into photosynthesis related traits......- with a top-to-bottom (forward) approach: Tier 1: Phenotyping: As a starting point,the quantification of heat tolerance was done by the chlorophyll fluorescence parameter, Fv/Fm, as a measure of maximum quantum efficiency of PSII photochemistry after heat stress treatment (40°C for 72h). This way...

  11. Mental Illness

    ... 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: ...

  12. Risk factors and outcome of transfusion-related acute lung injury in the critically ill: A nested case-control study

    Vlaar, Alexander P. J.; Binnekade, Jan M.; Prins, David; van Stein, Danielle; Hofstra, Jorrit J.; Schultz, Marcus J.; Juffermans, Nicole P.

    2010-01-01

    Objectives: To determine the incidence, risk factors, and outcome of transfusion-related acute lung injury in a cohort of critically ill patients. Design: In a retrospective cohort study, patients with transfusion-related acute lung injury were identified using the consensus criteria of acute lung

  13. Risk factors and outcome of transfusion-related acute lung injury in the critically ill : A nested case-control study

    Vlaar, Alexander P. J.; Binnekade, Jan M.; Prins, David; van Stein, Danielle; Hofstra, Jorrit J.; Schultz, Marcus J.; Juffermans, Nicole P.

    Objectives: To determine the incidence, risk factors, and outcome of transfusion-related acute lung injury in a cohort of critically ill patients. Design: In a retrospective cohort study, patients with transfusion-related acute lung injury were identified using the consensus criteria of acute lung

  14. Study of blood exposure-related mental health illness among clinical nurses.

    Xiong, Xiaojia; Li, Min; Jiang, Yongliang; Tong, Xindeng; Peng, Yanzhong

    2017-03-01

    Nurses are subjected to high amount of stress in the medical setting, and work-related stress often leads to mental problems. This study aims to investigate the mental health status of nurses exposed to blood through needlestick injuries. A total of 302 nurses working in the hospital of Guangdong, China, participated in this study. Out of the 302 nurses, 140 did not experience any needlestick injuries during the previous week, whereas 162 nurses experienced needlestick injuries. The General Health Questionnaire (GHQ)-28 Standardized Questionnaire, which uses physical, anxiety, social function, and depression subscales, was used in this study. No significant difference between nurses exposed to blood and nurses not exposed to blood was found in terms of gender, age, length of employment, and civil status (P > 0.05). Results from the GHQ-28 Standardized Questionnaire showed that 75.9% (123/162) of nurses exposed to blood were suspected to suffer from mental disorders, whereas 40% (56/140) of nurses not exposed to blood were suspected to suffer from mental disorders. The mean mental health scores of nurses exposed to blood and those not exposed were 8.73 ± 7.32 and 5.69 ± 5.70, respectively. From these results, we can conclude that blood exposure from needlestick injuries leads to higher prevalence of depression, anxiety, and stress symptoms in nurses. This finding highlights the importance of providing efficient, adequate, and appropriate support services after nurses are exposed to blood from needlestick injuries.

  15. Heat stress related dairy cow mortality during heat waves and control periods in rural Southern Ontario from 2010?2012

    Bishop-Williams, Katherine E.; Berke, Olaf; Pearl, David L.; Hand, Karen; Kelton, David F.

    2015-01-01

    Background Heat stress is a physiological response to extreme environmental heat such as heat waves. Heat stress can result in mortality in dairy cows when extreme heat is both rapidly changing and has a long duration. As a result of climate change, heat waves, which are defined as 3 days of temperatures of 32 ?C or above, are an increasingly frequent extreme weather phenomenon in Southern Ontario. Heat waves are increasing the risk for on-farm dairy cow mortality in Southern Ontario. Heat st...

  16. A family of related proteins is encoded by the major Drosophila heat shock gene family

    Wadsworth, S.C.

    1982-01-01

    At least four proteins of 70,000 to 75,000 molecular weight (70-75K) were synthesized from mRNA which hybridized with a cloned heat shock gene previously shown to be localized to the 87A and 87C heat shock puff sites. These in vitro-synthesized proteins were indistinguishable from in vivo-synthesized heat shock-induced proteins when analyzed on sodium dodecyl sulfate-polyacrylamide gels. A comparison of the pattern of this group of proteins synthesized in vivo during a 5-min pulse or during continuous labeling indicates that the 72-75K proteins are probably not kinetic precursors to the major 70K heat shock protein. Partial digestion products generated with V8 protease indicated that the 70-75K heat shock proteins are closely related, but that there are clear differences between them. The partial digestion patterns obtained from heat shock proteins from the Kc cell line and from the Oregon R strain of Drosophila melanogaster are very similar. Genetic analysis of the patterns of 70-75K heat shock protein synthesis indicated that the genes encoding at least two of the three 72-75K heat shock proteins are located outside of the major 87A and 87C puff sites

  17. Mortality related to acute illness and injury in rural Uganda: task shifting to improve outcomes.

    Stacey Chamberlain

    Full Text Available Due to the dual critical shortages of acute care and healthcare workers in resource-limited settings, many people suffer or die from conditions that could be easily treated if existing resources were used in a more timely and effective manner. In order to address this preventable morbidity and mortality, a novel emergency midlevel provider training program was developed in rural Uganda. This is the first study that assesses this unique application of a task-shifting model to acute care by evaluating the outcomes of 10,105 patients.Nurses participated in a two-year training program to become midlevel providers called Emergency Care Practitioners at a rural district hospital. This is a retrospective analysis of the Emergency Department's quality assurance database, including three-day follow-up data. Case fatality rates (CFRs are reported as the percentage of cases with a specific diagnosis that died within three days of their Emergency Department visit.Overall, three-day mortality was 2.0%. The most common diagnoses of patients who died were malaria (n=60, pneumonia (n=51, malnutrition (n=21, and trauma (n=18. Overall and under-five CFRs were as follows: malaria, 2.0% and 1.9%; pneumonia, 5.5% and 4.1%; and trauma, 1.2% and 1.6%. Malnutrition-related fatality (all cases <18 years old was 6.5% overall and 6.8% for under-fives.This study describes the outcomes of emergency patients treated by midlevel providers in a resource-limited setting. Our fatality rates are lower than previously published regional rates. These findings suggest this model of task-shifting can be successfully applied to acute care in order to address the shortage of emergency care services in similar settings as part of an integrated approach to health systems strengthening.

  18. ESBWR related passive decay heat removal tests in PANDA

    Huggenberger, M.; Aubert, C.; Bandurski, T.; Dreier, J.; Fischer, O.; Strassberger, H.J.; Yadigaroglu, G.

    1999-01-01

    A number of test series to investigate passive safety systems for the next generation of Light Water Reactors have been performed in the PANDA multi-purpose facility at the Paul Scherrer Institut (PSI). The large scale thermal-hydraulic test facility allows to investigate LWR containment phenomena and system behaviour. PANDA was first used to examine the Passive Containment Cooling System (PCCS) for the Simplified Boiling Water Reactor (SBWR). In 1996 new test series were initiated; all related to projects of the EC Fourth Framework Programme on Nuclear Fission Safety. One of these projects (TEPSS) is focused on the European Simplified Boiling Water Reactor (ESBWR). The ESBWR containment features and PCCS long-term post LOCA response were investigated in PANDA. The PCCS start-up was demonstrated, the effect of nitrogen hidden somewhere in the drywell and released later in the transient was simulated and the effect of light gases (helium) on the PCCS performance was investigated. Finally, the influence of low PCC pool levels on PCCS and containment performance was examined. The main findings were that the PCCS works as intended and shows generally a favorable and robust long-term post LOCA behaviour. The system starts working even under extreme conditions and trapped air released from the drywell later in the transient does only temporarily reduce the PCCS performance. The new PANDA test series provided an extensive data base which will contribute to further improve containment design of passive plants and allow for system code assessment in a wide parameter range. (author)

  19. Prevalence of travel related illness amongst a group of Chinese undergraduate students in Hong Kong.

    Abdullah AS, A M; Hedley, A J; Fielding, R

    2000-01-01

    Regional and global travel by Asian residents is increasing. Young people seeking new experiences through travel may be particularly at risk of a wide spectrum of health problems. This study assesses travel-associated health risks and examines the prevalence and likely impact of pretravel health advice among Chinese undergraduate students in Hong Kong. Year 1 and year 3 undergraduate students of the University of Hong Kong were surveyed during September to December 1996, using a structured self-administered questionnaire. A total of 1,067 subjects were required to give a power of 95% (p =.50+/-3%). Of 1,197 students (514 male and 680 female) surveyed, 52% had traveled outside Hong Kong at least once within the previous 12 months. Of these travelers (n = 578), 41% had developed one or more health problems, 7% had to consult a doctor and 2% needed hospitalization during travel, and 8% developed health problems within 2 weeks of returning for which they had to consult a doctor. Most (75%) took no pretravel health advice and 48% took no travel health precautions. About half (41%) of those who received advice received this from nonexpert sources. Those more likely to develop health problems were aged over 20 years (Odds Ratio, 1.49, 95% confidence interval, 1.06-2.10), in financial difficulties (1.60, 1.02-2.51), ever-smokers (1.69, 1.03-2.77), reporting poorer current health status (1.64, 1.04-2.57). Also, those who sought health advice from nonprofessional sources (2.13, 1.03-4.01) and took precautions (1.88, 1.33-2.63) were more likely to develop health problems. This study demonstrated that young Chinese adults, with the benefits of higher education, are potentially at risk of a variety of avoidable travel-related health problems. Taking pretravel health advice from nonprofessional sources was common among respondents, but taking precautions did not reduce health problems. The comprehensibility and effectiveness of the advice and appropriateness of precautions taken

  20. Costs of treating patients with schizophrenia who have illness-related crisis events

    Peng Xiaomei

    2008-08-01

    Full Text Available Abstract Background Relatively little is known about the relationship between psychosocial crises and treatment costs for persons with schizophrenia. This naturalistic prospective study assessed the association of recent crises with mental health treatment costs among persons receiving treatment for schizophrenia. Methods Data were drawn from a large multi-site, non-interventional study of schizophrenia patients in the United States, conducted between 1997 and 2003. Participants were treated at mental health treatment systems, including the Department of Veterans Affairs (VA hospitals, community mental health centers, community and state hospitals, and university health care service systems. Total costs over a 1-year period for mental health services and component costs (psychiatric hospitalizations, antipsychotic medications, other psychotropic medications, day treatment, emergency psychiatric services, psychosocial/rehabilitation group therapy, individual therapy, medication management, and case management were calculated for 1557 patients with complete medical information. Direct mental health treatment costs for patients who had experienced 1 or more of 5 recent crisis events were compared to propensity-matched samples of persons who had not experienced a crisis event. The 5 non-mutually exclusive crisis event subgroups were: suicide attempt in the past 4 weeks (n = 18, psychiatric hospitalization in the past 6 months (n = 240, arrest in the past 6 months (n = 56, violent behaviors in the past 4 weeks (n = 62, and diagnosis of a co-occurring substance use disorder (n = 413. Results Across all 5 categories of crisis events, patients who had a recent crisis had higher average annual mental health treatment costs than patients in propensity-score matched comparison samples. Average annual mental health treatment costs were significantly higher for persons who attempted suicide ($46,024, followed by persons with psychiatric hospitalization in

  1. Memory bias for emotional and illness-related words in patients with depression, anxiety and somatization disorders: an investigation with the directed forgetting task.

    Wingenfeld, Katja; Terfehr, Kirsten; Meyer, Björn; Löwe, Bernd; Spitzer, Carsten

    2013-01-01

    Memory bias to emotion- and illness-related information plays a prominent role in many mental disorders, particularly major depressive disorder, anxiety disorders and somatoform disorder. The current study aimed to investigate memory bias in different mental disorders by using neutral, emotionally valenced and illness-related word stimuli in a directed forgetting task. Seventy-eight inpatients from a university-based psychosomatic hospital participated in the study. The item method of the directed forgetting task was used, in which participants are instructed to either forget or remember each item immediately after it has been presented. Memory performance was tested with a free recall test. Overall, 36 words were presented - 6 from each of 6 categories: neutral, negative, positive, illness related ('somatoform'), depression related, and anxiety related. Three words of each category were to be remembered and 3 were to be forgotten. Independently of the patients' diagnoses, we found that most patients had relative difficulties remembering anxiety- and depression-related words, compared to neutral words, when they were instructed to remember them. By contrast, in the 'instructed forgetting' condition, patients showed deficits in the ability to forget illness-related stimuli relative to neutral material. These effects were unspecific with regard to diagnosis. The results in the 'instructed remembering' condition might be interpreted in the context of cognitive avoidance instead of a memory bias. In the 'instructed forgetting' condition, it appeared that illness-related words were more difficult to suppress compared to the other word types, which could explain the observed memory bias. Copyright © 2012 S. Karger AG, Basel.

  2. The role of work related self-efficacy in supported employment for people living with serious mental illnesses.

    Waynor, William R; Gill, Kenneth J; Gao, Ni

    2016-03-01

    This study tested whether higher work-related self-efficacy would predict the achievement of competitive employment in supported employment (SE) programs. N = 105 individuals were recruited from 5 state-funded SE programs in a Northeastern state. Participants were required to be unemployed and seeking employment to be eligible to enter the study. Research staff met with the individuals at baseline and collected demographic information and data on self-efficacy and psychiatric symptoms. For the follow-up assessment at 6 months, data were collected on participants, self-efficacy, psychiatric symptoms, and employment activity. Thirty-eight percent of the participants achieved competitive employment at the 6-month follow-up. However, self-efficacy was not a positive predictor of competitive employment. Surprisingly, 1 of the subscales, work-related social skills self-efficacy, was negatively associated with employment. These findings suggest that self-efficacy is not a predictor of competitive employment for individuals living with serious mental illness and receiving supported employment services. It appears that SE can be helpful for participants with a range of self-efficacy. (c) 2016 APA, all rights reserved).

  3. Differences in Heat-Related Mortality by Citizenship Status: United States, 2005-2014.

    Taylor, Ethel V; Vaidyanathan, Ambarish; Flanders, W Dana; Murphy, Matthew; Spencer, Merianne; Noe, Rebecca S

    2018-04-01

    To determine whether non-US citizens have a higher mortality risk of heat-related deaths than do US citizens. We used place of residence reported in mortality data from the National Vital Statistics System from 2005 to 2014 as a proxy for citizenship to examine differences in heat-related deaths between non-US and US citizens. Estimates from the US Census Bureau American Community Survey of self-reported citizenship status and place of birth provided the numbers for the study population. We calculated the standardized mortality ratio and relative risk for heat-related deaths between non-US and US citizens nationally. Heat-related deaths accounted for 2.23% (n = 999) of deaths among non-US citizens and 0.02% (n = 4196) of deaths among US citizens. The age-adjusted standardized mortality ratio for non-US citizens compared with US citizens was 3.4 (95% confidence ratio [CI] = 3.2, 3.6). This risk was higher for Hispanic non-US citizens (risk ratio [RR] = 3.6; 95% CI = 3.2, 3.9) and non-US citizens aged 18 to 24 years (RR = 20.6; 95% CI = 16.5, 25.7). We found an increased mortality risk among non-US citizens compared with US citizens for heat-related deaths, especially those younger and of Hispanic ethnicity.

  4. Imersão em água fria para o manejo da hipertermia severa Cold water immersion to the control of exertional heat illness

    Jacqueline de Paula Viveiros

    2009-08-01

    Full Text Available A incapacidade de dissipar o calor gerado pela atividade muscular prejudica o desempenho e aumenta a predisposição a lesões do organismo. A hipertermia severa induzida pelo esforço físico (HTE prejudica a saúde e está associada à morbidade e mortalidade de indivíduos em diferentes atividades ocupacionais e atléticas. Estudos sobre a eficiência de métodos de resfriamento corporal têm recomendado a imersão em água fria para o tratamento da HTE. Sua utilização nos minutos iniciais pós-hipertemia parece a melhor recomendação por reduzir o tempo no qual a temperatura central permanece elevada. A manutenção de infraestrutura necessária para a realização desse procedimento deve ser considerada em atividades físicas e condições ambientais nas quais os indivíduos estão mais suscetíveis ao acometimento da HTE. As taxas de resfriamento observadas através da imersão em água a diferentes temperaturas podem servir de referência para o controle da duração do procedimento. Esta revisão analisa a recomendação da imersão em água fria como procedimento de resfriamento corporal para o manejo da HTE.The incapacity of dissipating heat generated by muscular activity hampers performance and increases predisposition to physical injuries. Exertional heat illness (HTE harms health and is associated with morbidity and mortality of individuals in different occupational and athletic activities. Studies on the efficiency of body cooling methods have recommended cold-water immersion for the treatment of HTE. Its use in the initial minutes of post-hyperthermia seems to be the best recommendation to reduce the time central temperature remains high. Maintenance of the infrastructure needed to perform this procedure should be considered in physical activities and environmental conditions in which the individuals are more prone to HTE. The cooling rates observed through water immersion in different water temperatures may serve as reference

  5. Analysis of relations for heat transfer at the post-CHF regime

    Dorokhovich, S. L. [Obninsk State Techical Univ., Obninsk (Russian Federation); Kirillov, P. L. [Institute of Physics and Power Engineering, Obninsk (Russian Federation)

    2003-07-01

    Information about heat transfer rates in two-fluid flow at the post-CHF regime is important for analysis of accidents of water-cooled nuclear reactors as well as calculations of steam generators (liquid metal-water). It is complicate to create analytical methods because there is a variety of two-fluid flow regimes dictated by channel size, pressure, mass flow rate, heat flux, droplet spectrum, flow quality, other factors and, finally, by crisis type. At crisis in subcooled liquid or low quality two-phase flows Inverted Annular Film Boiling (IAFB) takes place when liquid flow is separated from the wall by a thin superheated vapor film. For dispersed flow crisis is usually related to drying a liquid film moving along the heated surface (wall). In both cases two-phase flow is thermodynamically nonequilibrium since the temperatures of phases (liquid and vapor) are different. The mean (at the rate of heat content) flow temperature is not the determining parameter. Different boundary conditions of experiment s uniform heat fluxes or 'hot' spots, are able to lead to different relations for the heat transfer coefficient. Last years the great number of semiempirical models were elaborated, that become more and more complicate. It is difficult to examine many parameters of the models. An agreement between final results and separate experimental data is not yet the evidence for the verity of extension while prerequisites taken in the models are often doubtful and hardly examined. Thus the correlations obtained from experimental data, for example, are used in practice. The analysis of relations for heat transfer at the Deteriorated Heat Transfer (DHT) regime, the comparison of relations with the data of look up tables made on the basis of the Institute of Physics and Power Engineering and Chalk River Laboratories experimental data banks are the objective of current report.

  6. Analysis of relations for heat transfer at the post-CHF regime

    Dorokhovich, S. L.; Kirillov, P. L.

    2003-01-01

    Information about heat transfer rates in two-fluid flow at the post-CHF regime is important for analysis of accidents of water-cooled nuclear reactors as well as calculations of steam generators (liquid metal-water). It is complicate to create analytical methods because there is a variety of two-fluid flow regimes dictated by channel size, pressure, mass flow rate, heat flux, droplet spectrum, flow quality, other factors and, finally, by crisis type. At crisis in subcooled liquid or low quality two-phase flows Inverted Annular Film Boiling (IAFB) takes place when liquid flow is separated from the wall by a thin superheated vapor film. For dispersed flow crisis is usually related to drying a liquid film moving along the heated surface (wall). In both cases two-phase flow is thermodynamically nonequilibrium since the temperatures of phases (liquid and vapor) are different. The mean (at the rate of heat content) flow temperature is not the determining parameter. Different boundary conditions of experiment s uniform heat fluxes or 'hot' spots, are able to lead to different relations for the heat transfer coefficient. Last years the great number of semiempirical models were elaborated, that become more and more complicate. It is difficult to examine many parameters of the models. An agreement between final results and separate experimental data is not yet the evidence for the verity of extension while prerequisites taken in the models are often doubtful and hardly examined. Thus the correlations obtained from experimental data, for example, are used in practice. The analysis of relations for heat transfer at the Deteriorated Heat Transfer (DHT) regime, the comparison of relations with the data of look up tables made on the basis of the Institute of Physics and Power Engineering and Chalk River Laboratories experimental data banks are the objective of current report

  7. How mental health literacy and experience of mental illness relate to stigmatizing attitudes and social distance towards people with depression or psychosis: A cross-sectional study.

    Svensson, Bengt; Hansson, Lars

    2016-01-01

    Background Evidence suggests that mental health literacy among the public is low, and stigmatizing attitudes are widespread. So far the effects of anti-stigma campaigns are small, and studies demonstrate that negative attitudes have been quite stable through recent decades. Aims To investigate the relationships between mental health literacy, experience of mental illness and stigmatizing attitudes/social distance towards people with depression or psychosis. Methods A cross-sectional study in which staff members from public services in Sweden (n = 1027) completed questionnaires covering demographic data, self-reported experience of mental illness, identification of a vignette for depression or psychosis, beliefs about helpful interventions for the illness presented in the vignette, and attitudes and social distance towards people with the illness. Results About 50% of participants could identify depression and less than 40% psychosis. A higher degree of mental health literacy was related to less stigma and social distance but mainly towards people with depression. A similar relationship was shown for having personal or family experience of mental illness and attitudes/social distance. Negative attitudes and social distance were significantly higher in all aspects measured towards a person with psychosis than a person with depression. Conclusions A higher degree of mental health literacy relates to more positive attitudes and less desire for social distance towards people with depression. The differences between depression and psychosis should be taken into account in anti-stigma interventions.

  8. [Development and validation of the Inventory of Needs in Memory Impairment (BIG-65): illness-related needs in people with cognitive impairment and dementia].

    Schmid, R; Eschen, A; Rüegger-Frey, B; Martin, M

    2013-06-01

    There is growing evidence that individuals with cognitive impairment and dementia require systematic assessment of needs for the selection of optimal treatments. Currently no valid instrument is applicable for illness-related need assessment in this growing population. The purpose of this study was to develop and validate a new instrument ("Bedürfnisinventar bei Gedächtnisstörungen", BIG-65) that systematically assesses illness-related needs. The development was based on an adequate theoretical framework and standardised procedural guidelines and validated to an appropriate sample of individuals attending a Swiss memory clinic (n = 83). The BIG-65 provides a comprehensive range of biopsychosocial and environmental needs items and offers a dementia-friendly structure for the assessment of illness-related needs. The BIG-65 has high face validity and very high test-retest reliability (rtt = 0,916). On average 3.5 (SD = 3.7) unmet needs were assessed. Most frequently mentioned needs were: "forget less" (50%), "better concentration" (23.2%), "information on illness" (20.7%), "information on treatments" (17.1%), "less worry", "less irritable", "improve mood", "improve orientation" (13.4% each). Needs profiles differed between patients with preclinical (subjective cognitive impairment, mild cognitive impairment) and clinical (dementia) diagnosis. The BIG-65 reliably assesses illness-related needs in individuals with moderate dementia. With decreasing cognitive functions or an MMSE cognitive impairment and dementia pursue individual strategies to stabilize their quality of life level. In addition to the assessment of objective illness symptoms the selection of optimal treatments may profit from a systematic needs assessment to optimally support patients in their individual quality of life strategies.

  9. Susceptibility to Heat-Related Fluid and Electrolyte Imbalance Emergency Department Visits in Atlanta, Georgia, USA

    Leila Heidari

    2016-10-01

    Full Text Available Identification of populations susceptible to heat effects is critical for targeted prevention and more accurate risk assessment. Fluid and electrolyte imbalance (FEI may provide an objective indicator of heat morbidity. Data on daily ambient temperature and FEI emergency department (ED visits were collected in Atlanta, Georgia, USA during 1993–2012. Associations of warm-season same-day temperatures and FEI ED visits were estimated using Poisson generalized linear models. Analyses explored associations between FEI ED visits and various temperature metrics (maximum, minimum, average, and diurnal change in ambient temperature, apparent temperature, and heat index modeled using linear, quadratic, and cubic terms to allow for non-linear associations. Effect modification by potential determinants of heat susceptibility (sex; race; comorbid congestive heart failure, kidney disease, and diabetes; and neighborhood poverty and education levels was assessed via stratification. Higher warm-season ambient temperature was significantly associated with FEI ED visits, regardless of temperature metric used. Stratified analyses suggested heat-related risks for all populations, but particularly for males. This work highlights the utility of FEI as an indicator of heat morbidity, the health threat posed by warm-season temperatures, and the importance of considering susceptible populations in heat-health research.

  10. Social differences in illness and health-related exclusion from the labour market in Denmark from 1987 to 1994

    Lissau, I; Rasmussen, N K; Hesse, N M

    2001-01-01

    , age, and gender with employment status. SUBJECTS AND METHODS: Self-reported information on illness, educational level, employment status, and occupational class was obtained in two nationally representative Danish health interview surveys in 1987 (n=4753) and 1994 (n=4668). RESULTS: There was a marked......-standing illness, only basic education, and above 55 years of age. CONCLUSION: In conclusion, the study showed that the prevalence of long-standing illness increased from the mid-1980s to the mid-1990s, whereas perceived health below good was unchanged. In 1994, there was a remarkable difference in health between...... differences remained in the different educational groups. Women above 54 years of age with basic education only and long-standing illness have the highest odds ratio of permanent exclusion from the labour market....

  11. Estrategia educativa para cuidadoras de familiares con enfermedad terminal Educational strategy for female care givers who attend terminally ill relatives

    Yamilé Benítez Lambert

    2011-10-01

    Full Text Available Se realizó una intervención educativa desde julio de 2008 hasta enero de 2010 en el Policlínico Docente "Ramón López Peña" de Santiago de Cuba para aplicar una estrategia capacitante sobre cuidados paliativos, dirigida a 24 mujeres encargadas de atender a igual número de familiares con enfermedad terminal. Antes de ser instruidas al efecto, la mayoría de las cuidadoras desconocían cómo controlar los síntomas en sus parientes y su propio estrés, carecían de preparación psicológica para enfrentar el duelo, no habían adquirido las habilidades comunicativas necesarias y muchas se mostraban insatisfechas con el apoyo profesional recibido, entre otros factores; sin embargo, los encuentros programados permitieron brindarles la orientación y el asesoramiento requeridos para asumir con seguridad y confianza el rol que debían desempeñar responsablemente en esa humana labor.An educational intervention was carried out from July, 2008 to January, 2010 at "Ramóm López Peña" Teaching Polyclinic in Santiago de Cuba in order to apply an effective strategy on hospice care so as to train 24 women in charge of attending the same number of terminally ill family members. Before the training, most of female care givers did not know how to control symptoms of their ill relatives, not even their own stress; they had no psychological training to face the challenge; they had not developed the necessary communicative skills; and most of them were not satisfied with the professional aid received; among other factors. However, the scheduled meetings allowed health workers to offer the required orientation and expert advice to these care givers so they could assume their roles with confidence and security taking into account they had to perform a human task with a lot of responsibility.

  12. Urbanization Level and Vulnerability to Heat-Related Mortality in Jiangsu Province, China.

    Chen, Kai; Zhou, Lian; Chen, Xiaodong; Ma, Zongwei; Liu, Yang; Huang, Lei; Bi, Jun; Kinney, Patrick L

    2016-12-01

    Although adverse effects of high temperature on mortality have been studied extensively in urban areas, little is known of the heat-mortality associations outside of cities. We investigated whether heat-mortality associations differed between urban and nonurban areas and how urbanicity affected the vulnerability to heat-related mortality. We first analyzed heat-related mortality risk in each of 102 counties in Jiangsu Province, China, during 2009-2013 using a distributed-lag nonlinear model. The county-specific estimates were then pooled for more urban (percentage of urban population ≥ 57.11%) and less urban (percentage of urban population risk comparing the 99th vs. 75th percentiles of temperature was 1.43 [95% posterior intervals (PI): 1.36, 1.50] in less urban counties and 1.26 (95% PI: 1.23, 1.30) in more urban counties. The heat effects on cardiorespiratory mortality followed a similar pattern. Higher education level and prevalence of air conditioning were significantly associated with counties having lower risks, whereas percentage of elderly people was significantly associated with increased risks. Our findings reveal that nonurban areas have significant heat-related mortality risks in Jiangsu, China. These results suggest the need for enhanced adaptation planning in Chinese nonurban areas under a changing climate. Citation: Chen K, Zhou L, Chen X, Ma Z, Liu Y, Huang L, Bi J, Kinney PL. 2016. Urbanization level and vulnerability to heat-related mortality in Jiangsu Province, China. Environ Health Perspect 124:1863-1869; http://dx.doi.org/10.1289/EHP204.

  13. A predictive model of Health Related Quality of life of parents of chronically ill children: the importance of care-dependency of their child and their support system

    Hatzmann, Janneke; Maurice-Stam, Heleen; Heymans, Hugo S. A.; Grootenhuis, Martha A.

    2009-01-01

    BACKGROUND: Parents of chronically ill children are at risk for a lower Health Related Quality of Life (HRQoL). Insight in the dynamics of factors influencing parental HRQoL is necessary for development of interventions. Aim of the present study was to explore the influence of demographic and

  14. Impact of Climate Change on Heat-Related Mortality in Jiangsu Province, China

    Chen, Kai; Horton, Radley M.; Bader, Daniel A.; Lesk, Corey; Jiang, Leiwen; Jones, Bryan; Zhou, Lian; Chen, Xiaodong; Bi, Jun; Kinney, Patrick L.

    2017-01-01

    A warming climate is anticipated to increase the future heat-related total mortality in urban areas. However, little evidence has been reported for cause-specific mortality or nonurban areas. Here we assessed the impact of climate change on heat-related total and cause-specific mortality in both urban and rural counties of Jiangsu Province, China, in the next five decades. To address the potential uncertainty in projecting future heat-related mortality, we applied localized urban- and nonurban-specific exposure response functions, six population projections including a no population change scenario and five Shared Socioeconomic Pathways (SSPs), and 42 temperature projections from 21 global-scale general circulation models and two Representative Concentration Pathways (RCPs). Results showed that projected warmer temperatures in 2016-2040 and 2041-2065 will lead to higher heat-related mortality for total non-accidental, cardiovascular, respiratory, stroke, ischemic heart disease (IHD), and chronic obstructive pulmonary disease (COPD) causes occurring annually during May to September in Jiangsu Province, China. Nonurban residents in Jiangsu will suffer from more excess heat-related cause-specific mortality in 2016-2065 than urban residents. Variations across climate models and RCPs dominated the uncertainty of heat-related mortality estimation whereas population size change only had limited influence. Our findings suggest that targeted climate change mitigation and adaptation measures should be taken in both urban and nonurban areas of Jiangsu Province. Specific public health interventions should be focused on the leading causes of death (stroke, IHD, and COPD), whose health burden will be amplified by a warming climate.

  15. Impact of climate change on heat-related mortality in Jiangsu Province, China.

    Chen, Kai; Horton, Radley M; Bader, Daniel A; Lesk, Corey; Jiang, Leiwen; Jones, Bryan; Zhou, Lian; Chen, Xiaodong; Bi, Jun; Kinney, Patrick L

    2017-05-01

    A warming climate is anticipated to increase the future heat-related total mortality in urban areas. However, little evidence has been reported for cause-specific mortality or nonurban areas. Here we assessed the impact of climate change on heat-related total and cause-specific mortality in both urban and rural counties of Jiangsu Province, China, in the next five decades. To address the potential uncertainty in projecting future heat-related mortality, we applied localized urban- and nonurban-specific exposure response functions, six population projections including a no population change scenario and five Shared Socioeconomic Pathways (SSPs), and 42 temperature projections from 21 global-scale general circulation models and two Representative Concentration Pathways (RCPs). Results showed that projected warmer temperatures in 2016-2040 and 2041-2065 will lead to higher heat-related mortality for total non-accidental, cardiovascular, respiratory, stroke, ischemic heart disease (IHD), and chronic obstructive pulmonary disease (COPD) causes occurring annually during May to September in Jiangsu Province, China. Nonurban residents in Jiangsu will suffer from more excess heat-related cause-specific mortality in 2016-2065 than urban residents. Variations across climate models and RCPs dominated the uncertainty of heat-related mortality estimation whereas population size change only had limited influence. Our findings suggest that targeted climate change mitigation and adaptation measures should be taken in both urban and nonurban areas of Jiangsu Province. Specific public health interventions should be focused on the leading causes of death (stroke, IHD, and COPD), whose health burden will be amplified by a warming climate. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Using Google Flu Trends data in forecasting influenza-like-illness related ED visits in Omaha, Nebraska.

    Araz, Ozgur M; Bentley, Dan; Muelleman, Robert L

    2014-09-01

    Emergency department (ED) visits increase during the influenza seasons. It is essential to identify statistically significant correlates in order to develop an accurate forecasting model for ED visits. Forecasting influenza-like-illness (ILI)-related ED visits can significantly help in developing robust resource management strategies at the EDs. We first performed correlation analyses to understand temporal correlations between several predictors of ILI-related ED visits. We used the data available for Douglas County, the biggest county in Nebraska, for Omaha, the biggest city in the state, and for a major hospital in Omaha. The data set included total and positive influenza test results from the hospital (ie, Antigen rapid (Ag) and Respiratory Syncytial Virus Infection (RSV) tests); an Internet-based influenza surveillance system data, that is, Google Flu Trends, for both Nebraska and Omaha; total ED visits in Douglas County attributable to ILI; and ILI surveillance network data for Douglas County and Nebraska as the predictors and data for the hospital's ILI-related ED visits as the dependent variable. We used Seasonal Autoregressive Integrated Moving Average and Holt Winters methods with3 linear regression models to forecast ILI-related ED visits at the hospital and evaluated model performances by comparing the root means square errors (RMSEs). Because of strong positive correlations with ILI-related ED visits between 2008 and 2012, we validated the use of Google Flu Trends data as a predictor in an ED influenza surveillance tool. Of the 5 forecasting models we have tested, linear regression models performed significantly better when Google Flu Trends data were included as a predictor. Regression models including Google Flu Trends data as a predictor variable have lower RMSE, and the lowest is achieved when all other variables are also included in the model in our forecasting experiments for the first 5 weeks of 2013 (with RMSE = 57.61). Google Flu Trends data

  17. Associations between illness duration and health-related quality of life in specified mental and physical chronic health conditions: results from a population-based survey.

    Busija, Lucy; Tan, Jeretine; Sanders, Kerrie M

    2017-10-01

    We compared health-related quality of life (HRQOL) in incident (≤1 year since diagnosis), mid-term (>1-5 years since diagnosis), and long-term (>5 years since diagnosis) cases of mental and physical chronic illness with the general population and assessed the modifying effects of age and gender on the association between HRQOL and illness duration. Data from the 2007 Australian National Health and Mental Wellbeing Survey were used. HRQOL was captured by the Assessment of Quality of Life Scale 4D. Multivariable linear regression analyses compared HRQOL of individuals with different duration of illnesses with those who did not have the condition of interest. The 8841 survey respondents were aged 16-85 years (median 43 years, 50.3% female). For the overall sample, worse HRQOL was associated with incident (P = 0.049) and mid-term (P = 0.036) stroke and long-term depression (P illness is most apparent in stroke and mental illness and differs between age groups.

  18. Age-related differences in the accuracy of web query-based predictions of influenza-like illness.

    Alexander Domnich

    Full Text Available Web queries are now widely used for modeling, nowcasting and forecasting influenza-like illness (ILI. However, given that ILI attack rates vary significantly across ages, in terms of both magnitude and timing, little is known about whether the association between ILI morbidity and ILI-related queries is comparable across different age-groups. The present study aimed to investigate features of the association between ILI morbidity and ILI-related query volume from the perspective of age.Since Google Flu Trends is unavailable in Italy, Google Trends was used to identify entry terms that correlated highly with official ILI surveillance data. All-age and age-class-specific modeling was performed by means of linear models with generalized least-square estimation. Hold-out validation was used to quantify prediction accuracy. For purposes of comparison, predictions generated by exponential smoothing were computed.Five search terms showed high correlation coefficients of > .6. In comparison with exponential smoothing, the all-age query-based model correctly predicted the peak time and yielded a higher correlation coefficient with observed ILI morbidity (.978 vs. .929. However, query-based prediction of ILI morbidity was associated with a greater error. Age-class-specific query-based models varied significantly in terms of prediction accuracy. In the 0-4 and 25-44-year age-groups, these did well and outperformed exponential smoothing predictions; in the 15-24 and ≥ 65-year age-classes, however, the query-based models were inaccurate and highly overestimated peak height. In all but one age-class, peak timing predicted by the query-based models coincided with observed timing.The accuracy of web query-based models in predicting ILI morbidity rates could differ among ages. Greater age-specific detail may be useful in flu query-based studies in order to account for age-specific features of the epidemiology of ILI.

  19. Management of ethical issues related to care of seriously ill dialysis patients in free-standing facilities.

    Song, Mi-Kyung; Hanson, Laura C; Gilet, Constance A; Jo, Minjeong; Reed, Teresa J; Hladik, Gerald A

    2014-09-01

    There are few data on the frequency and current management of clinical ethical issues related to care of seriously ill dialysis patients in free-standing dialysis facilities. To examine the extent of clinical ethical challenges experienced by care providers in free-standing facilities and their perceptions about how those issues are managed. A total of 183 care providers recruited from 15 facilities in North Carolina completed a survey regarding the occurrence and management of ethical issues in the past year. Care plan meetings were observed at four of the facilities for three consecutive months. Also, current policies and procedures at each of the facilities were reviewed. The two most frequently experienced challenges involved dialyzing frail patients with multiple comorbidities and caring for disruptive/difficult patients. The most common ways of managing ethical issues were discussions in care plan meetings (n = 47) or discussions with the clinic manager (n = 47). Although policies were in place to guide management of some of the challenges, respondents were often not aware of those policies. Also, although participants reported that ethical issues related to dialyzing undocumented immigrants were fairly common, no facility had a policy for managing this challenge. Participants suggested that all staff obtain training in clinical ethics and communication skills, facilities develop ethics teams, and there be clear policies to guide management of ethical challenges. The scope of ethical challenges was extensive, how these challenges were managed varied widely, and there were limited resources for assistance. Multifaceted efforts, encompassing endeavors at the individual, facility, organization, and national levels, are needed to support staff in improving the management of ethical challenges in dialysis facilities. Copyright © 2014 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  20. Injuries and illnesses in a cohort of elite youth alpine ski racers and the influence of biological maturity and relative age: a two-season prospective study

    Müller, Lisa; Hildebrandt, Carolin; Müller, Erich; Oberhoffer, Renate; Raschner, Christian

    2017-01-01

    Background Studies on injuries and illnesses involving youth ski racers younger than 15 years are lacking in the literature. The aim of this study was prospectively to assess the incidence, prevalence, and severity of traumatic and overuse injuries, as well as illnesses of elite youth ski racers with regard to sex, biological maturity status, and relative age. Subjects and methods A prospective, longitudinal cohort design was used to monitor the anthropometrics, training characteristics, traumatic and overuse injuries, and illnesses of 82 elite youth ski racers (51 males, 31 females, age 9–14 years) over 2 consecutive years. The exact training exposure (skiing and athletic) was recorded. Relative age and estimated biological maturity status were assessed. Results Relatively low injury incidence or prevalence (traumatic, 0.86/1,000 hours of training; overuse, 0.28/1,000 hours) and comparably high illness prevalence (2.4/athlete) were reported. The knee was the most commonly affected body part (traumatic injuries 36.5%, overuse injuries 82%). A high number of bone fractures were revealed (46%), while no stress fractures occurred; 66% of the illnesses were respiratory tract infections. No differences were found between males and females, the differing maturity groups, or relative age quartiles. Early-maturing athletes had comparably low traumatic and overuse-injury rates. Relatively younger athletes had low traumatic injury rates. Conclusion The injury-prevention measures implemented in the training process of youth ski racers seem to contribute to a low incidence of injury. Biological maturity status should be considered in the training process to prevent injuries in late-maturing athletes. PMID:28546774

  1. Heat index in migrant farmworker housing: implications for rest and recovery from work-related heat stress.

    Quandt, Sara A; Wiggins, Melinda F; Chen, Haiying; Bischoff, Werner E; Arcury, Thomas A

    2013-08-01

    Although the health risk to farmworkers of working in hot conditions is recognized, potential for excessive heat exposure in housing affecting rest and recovery has been ignored. We assessed heat index in common and sleeping rooms in 170 North Carolina farmworker camps across a summer and examined associations with time of summer and air conditioning use. We recorded dangerous heat indexes in most rooms, regardless of time or air conditioning. Policies to reduce heat indexes in farmworker housing should be developed.

  2. [Practices and interventions related to the work integration of people with a severe mental illness: work outcomes and avenues of research].

    Pachoud, B; Corbière, M

    2014-06-01

    Sustained work integration for people with a severe mental illness or handicap psychique in French (e.g., schizophrenia) is an important issue in our society today. Indeed, work is not only an essential factor in people's social integration but is also a stepping-stone toward recovery for this clientele. Well-defined programs and services related to work integration were developed and studied over the last three decades. Although the work integration of people with severe mental illness has been studied extensively in the Anglo-Saxon literature, the impact of these studies on the traditional beliefs and services in France remains uncertain. In terms of the scope of the studies so far, there has been an initial interest lasting over many years to uncover individual characteristics of people with severe mental illness which would best predict job tenure. Since, studies have been increasingly investigating various supports in order to facilitate the work integration process. These supports can be illustrated as direct supports or accommodations offered in the workplace, as needed, particularly when people with severe mental illness choose to disclose their mental disorder in the workplace. This awareness of the impact of the workplace environment on the work integration of people with a severe mental illness increases the need to find solutions and develop environmentally sensitive clinical strategies to overcome difficulties during the work integration. To illustrate this thematic, in this special issue, we have gathered together studies conducted in different countries but who share the focus on work integration of people with a severe mental illness. To reflect the advancement in this domain, this special issue is divided in three parts. The first part consists of the presentation of different types of vocational programs: supported employment programs, social firms, and hybrid models. Supported employment programs are very well documented in the specialised

  3. Exploring the stigma related experiences of family members of persons with mental illness in a selected community in the iLembe district, KwaZulu-Natal

    Celenkosini T. Nxumalo

    2017-10-01

    Purpose: To explore the stigma related experiences of family members of persons with mental illness in a selected community in the iLembe district of KwaZulu-Natal (KZN, in order to develop recommendations to help families cope with such stigma. Methods: This was a descriptive qualitative study; data was collected from a purposive sample of six family members, which resulted in data saturation. Semi-structured interview questions were used during data collection and content analysis using Creswell's (2009 method was done to analyse the data; resulting in the formation of themes and sub-themes which were supported by the participants' responses and existing literature. Results: Participants reported experiencing stigma from the community in the form of isolation, blame and exploitation, community neglect, as well as labelling and stereotyping. The majority of the participants reported using emotion-focused coping mechanisms to deal with the stigma they faced. Participants suggested that education of communities regarding the myths and facts about mental illness may help to curb the stigma faced by the family members of persons with mental illness. Conclusion: Based on the results of this study, it was recommended that a combination of coping strategies, together with the integration of public and private sector support, be used to holistically deal with family related stigma. It was found that ground level education and support to families is the key to curbing family related stigma of mental illness, local NGO's and the clinics would be instrumental in this area.

  4. Heat Islands

    EPA's Heat Island Effect Site provides information on heat islands, their impacts, mitigation strategies, related research, a directory of heat island reduction initiatives in U.S. communities, and EPA's Heat Island Reduction Program.

  5. Emergence of a fluctuation relation for heat in nonequilibrium Landauer processes

    Taranto, Philip; Modi, Kavan; Pollock, Felix A.

    2018-05-01

    In a generalized framework for the Landauer erasure protocol, we study bounds on the heat dissipated in typical nonequilibrium quantum processes. In contrast to thermodynamic processes, quantum fluctuations are not suppressed in the nonequilibrium regime and cannot be ignored, making such processes difficult to understand and treat. Here we derive an emergent fluctuation relation that virtually guarantees the average heat produced to be dissipated into the reservoir either when the system or reservoir is large (or both) or when the temperature is high. The implication of our result is that for nonequilibrium processes, heat fluctuations away from its average value are suppressed independently of the underlying dynamics exponentially quickly in the dimension of the larger subsystem and linearly in the inverse temperature. We achieve these results by generalizing a concentration of measure relation for subsystem states to the case where the global state is mixed.

  6. Case studies on heat stress related perceptions in different industrial sectors in southern India.

    Balakrishnan, Kalpana; Ramalingam, Ayyappan; Dasu, Venkatesan; Stephen, Jeremiah Chinnadurai; Sivaperumal, Mohan Raj; Kumarasamy, Deepan; Mukhopadhyay, Krishnendu; Ghosh, Santu; Sambandam, Sankar

    2010-11-29

    Linkages between thermal loads and its physiological consequences have been widely studied in non-tropical developed country settings. In many developing countries like India, despite the widespread recognition of the problem, limited attempts have been made to estimate health impacts related to occupational heat stress and fewer yet to link heat stress with potential productivity losses. This is reflected in the ubiquity of workplaces with limited or no controls to reduce exposures. As a prelude to understanding the feasibility of alternative interventions in different industrial sectors, we present case studies from 10 different industrial units in Tamil Nadu, Chennai, which describe perceptions of occupational heat stress among the workers and supervisors/management.Units were selected from among those who had previously requested an assessment of workplace heat stress exposure at select locations as part of routine industrial hygiene services provided by the investigators. Since the earlier measurements were performed in response to a management request, all units were revisited to generate a simple job and process profile using checklists in order to understand the overall heat exposure situation in the concerned unit. This was followed by a simple questionnaire administration to a small subsample of employees to evaluate the perceptions of workers and supervisors/management. Finally, we retrieved available quantitative data from previous measurements of heat stress at these units to correlate prevalence of exposures with respective perceptions.Results indicate that the existing level of controls may not be sufficient for managing work-related heat stress in any of the sectors studied, with wide variations in perceived risks. There was a noticeable disconnect between worker's perceptions and their ability to secure workplace improvements related to heat stress from the management. Wider availability of engineering and administrative controls in the industries

  7. Case studies on heat stress related perceptions in different industrial sectors in southern India

    Kalpana Balakrishnan

    2010-11-01

    Full Text Available Linkages between thermal loads and its physiological consequences have been widely studied in non-tropical developed country settings. In many developing countries like India, despite the widespread recognition of the problem, limited attempts have been made to estimate health impacts related to occupational heat stress and fewer yet to link heat stress with potential productivity losses. This is reflected in the ubiquity of workplaces with limited or no controls to reduce exposures. As a prelude to understanding the feasibility of alternative interventions in different industrial sectors, we present case studies from 10 different industrial units in Tamil Nadu, Chennai, which describe perceptions of occupational heat stress among the workers and supervisors/management.Units were selected from among those who had previously requested an assessment of workplace heat stress exposure at select locations as part of routine industrial hygiene services provided by the investigators. Since the earlier measurements were performed in response to a management request, all units were revisited to generate a simple job and process profile using checklists in order to understand the overall heat exposure situation in the concerned unit. This was followed by a simple questionnaire administration to a small subsample of employees to evaluate the perceptions of workers and supervisors/management. Finally, we retrieved available quantitative data from previous measurements of heat stress at these units to correlate prevalence of exposures with respective perceptions.Results indicate that the existing level of controls may not be sufficient for managing work-related heat stress in any of the sectors studied, with wide variations in perceived risks. There was a noticeable disconnect between worker's perceptions and their ability to secure workplace improvements related to heat stress from the management. Wider availability of engineering and administrative

  8. Perspectives on care and communication involving incurably ill Turkish and Moroccan patients, relatives and professionals: a systematic literature review.

    de Graaff, Fuusje M; Mistiaen, Patriek; Devillé, Walter Ljm; Francke, Anneke L

    2012-09-18

    Our aim was to obtain a clearer picture of the relevant care experiences and care perceptions of incurably ill Turkish and Moroccan patients, their relatives and professional care providers, as well as of communication and decision-making patterns at the end of life. The ultimate objective is to improve palliative care for Turkish and Moroccan immigrants in the Netherlands, by taking account of socio-cultural factors in the guidelines for palliative care. A systematic literature review was undertaken. The data sources were seventeen national and international literature databases, four Dutch journals dedicated to palliative care and 37 websites of relevant national and international organizations. All the references found were checked to see whether they met the structured inclusion criteria. Inclusion was limited to publications dealing with primary empirical research on the relationship between socio-cultural factors and the health or care situation of Turkish or Moroccan patients with an oncological or incurable disease. The selection was made by first reading the titles and abstracts and subsequently the full texts. The process of deciding which studies to include was carried out by two reviewers independently. A generic appraisal instrument was applied to assess the methodological quality. Fifty-seven studies were found that reported findings for the countries of origin (mainly Turkey) and the immigrant host countries (mainly the Netherlands). The central themes were experiences and perceptions of family care, professional care, end-of-life care and communication. Family care is considered a duty, even when such care becomes a severe burden for the main female family caregiver in particular. Professional hospital care is preferred by many of the patients and relatives because they are looking for a cure and security. End-of-life care is strongly influenced by the continuing hope for recovery. Relatives are often quite influential in end-of-life decisions, such

  9. Perspectives on care and communication involving incurably ill Turkish and Moroccan patients, relatives and professionals: a systematic literature review

    de Graaff Fuusje M

    2012-09-01

    Full Text Available Abstract Background Our aim was to obtain a clearer picture of the relevant care experiences and care perceptions of incurably ill Turkish and Moroccan patients, their relatives and professional care providers, as well as of communication and decision-making patterns at the end of life. The ultimate objective is to improve palliative care for Turkish and Moroccan immigrants in the Netherlands, by taking account of socio-cultural factors in the guidelines for palliative care. Methods A systematic literature review was undertaken. The data sources were seventeen national and international literature databases, four Dutch journals dedicated to palliative care and 37 websites of relevant national and international organizations. All the references found were checked to see whether they met the structured inclusion criteria. Inclusion was limited to publications dealing with primary empirical research on the relationship between socio-cultural factors and the health or care situation of Turkish or Moroccan patients with an oncological or incurable disease. The selection was made by first reading the titles and abstracts and subsequently the full texts. The process of deciding which studies to include was carried out by two reviewers independently. A generic appraisal instrument was applied to assess the methodological quality. Results Fifty-seven studies were found that reported findings for the countries of origin (mainly Turkey and the immigrant host countries (mainly the Netherlands. The central themes were experiences and perceptions of family care, professional care, end-of-life care and communication. Family care is considered a duty, even when such care becomes a severe burden for the main female family caregiver in particular. Professional hospital care is preferred by many of the patients and relatives because they are looking for a cure and security. End-of-life care is strongly influenced by the continuing hope for recovery. Relatives are

  10. Challenging mental health related stigma in China: Systematic review and meta-analysis. II. Interventions among people with mental illness.

    Xu, Ziyan; Huang, Fangfang; Kösters, Markus; Rüsch, Nicolas

    2017-09-01

    People with mental illness often face different types of mental illness stigma that may affect their lives, including perceived stigma, self-stigma, harmful coping strategies and poor quality of life. Although anti-stigma interventions for people with mental illness from Western countries have been identified by recent systematic reviews, their efficacy in China is unknown. This review evaluates the efficacy of anti-stigma interventions among people with mental illness in Mainland China, Hong Kong, Taiwan and Macau. A systematic search of 8 electronic databases in English and Chinese yielded 17 randomized and non-randomized controlled trials. Standardized mean differences (SMDs) were calculated wherever possible. Psychoeducation was the most commonly used intervention. SMDs were large and significant for perceived/experienced/anticipated stigma, self-prejudice and coping with stigma, as well as for depression and anxiety symptoms and quality of life. Both Cognitive Behavioral Therapy and psychoeducation had positive effects on perceived/experienced/anticipated stigma. The quality of studies was modest and heterogeneity across studies was high. Anti-stigma interventions demonstrated promise to reduce stigma's negative impact on people with mental illness in China, but more high-quality intervention research is needed. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  11. Do bullied children get Ill, or do Ill children get bullied? A prospective cohort study on the relationship between bullying and health-related symptoms

    Fekkes, M.; Pijpers, F.I.M.; Fredriks, A.M.; Vogels, T.; Verloove-Vanhorick, S.P.

    2006-01-01

    OBJECTIVES. A number of studies have shown that victimization from bullying behavior is associated with substantial adverse effects on physical and psychological health, but it is unclear which comes first, the victimization or the health-related symptoms. In our present study, we investigated

  12. Psychological distress and quality of life in lung cancer: the role of health-related stigma, illness appraisals and social constraints.

    Chambers, Suzanne K; Baade, Peter; Youl, Philippa; Aitken, Joanne; Occhipinti, Stefano; Vinod, Shalini; Valery, Patricia C; Garvey, Gail; Fong, Kwun M; Ball, David; Zorbas, Helen; Dunn, Jeff; O'Connell, Dianne L

    2015-11-01

    Health-related stigma is associated with negative psychological and quality of life outcomes in lung cancer patients. This study describes the impact of stigma on lung cancer patients' psychological distress and quality of life and explores the role of social constraints and illness appraisal as mediators of effect. A self-administered cross-sectional survey examined psychological distress and quality of life in 151 people (59% response rate) diagnosed with lung cancer from Queensland and New South Wales. Health-related stigma, social constraints and illness appraisals were assessed as predictors of adjustment outcomes. Forty-nine percent of patients reported elevated anxiety; 41% were depressed; and 51% had high global distress. Health-related stigma was significantly related to global psychological distress and quality of life with greater stigma and shame related to poorer outcomes. These effects were mediated by illness appraisals and social constraints. Health-related stigma appears to contribute to poorer adjustment by constraining interpersonal discussions about cancer and heightening feelings of threat. There is a need for the development and evaluation of interventions to ameliorate the negative effects of health-related stigma among lung cancer patients. © 2015 The Authors. Psycho-Oncology Published by John Wiley & Sons Ltd.

  13. Psychological distress and quality of life in lung cancer: the role of health‐related stigma, illness appraisals and social constraints

    Baade, Peter; Youl, Philippa; Aitken, Joanne; Occhipinti, Stefano; Vinod, Shalini; Valery, Patricia C.; Garvey, Gail; Fong, Kwun M.; Ball, David; Zorbas, Helen; Dunn, Jeff; O'Connell, Dianne L.

    2015-01-01

    Abstract Objective Health‐related stigma is associated with negative psychological and quality of life outcomes in lung cancer patients. This study describes the impact of stigma on lung cancer patients' psychological distress and quality of life and explores the role of social constraints and illness appraisal as mediators of effect. Methods A self‐administered cross‐sectional survey examined psychological distress and quality of life in 151 people (59% response rate) diagnosed with lung cancer from Queensland and New South Wales. Health‐related stigma, social constraints and illness appraisals were assessed as predictors of adjustment outcomes. Results Forty‐nine percent of patients reported elevated anxiety; 41% were depressed; and 51% had high global distress. Health‐related stigma was significantly related to global psychological distress and quality of life with greater stigma and shame related to poorer outcomes. These effects were mediated by illness appraisals and social constraints. Conclusions Health‐related stigma appears to contribute to poorer adjustment by constraining interpersonal discussions about cancer and heightening feelings of threat. There is a need for the development and evaluation of interventions to ameliorate the negative effects of health‐related stigma among lung cancer patients. © 2015 The Authors. Psycho‐Oncology Published by John Wiley & Sons Ltd. PMID:25920906

  14. Assessing heat-related health risk in Europe via the Universal Thermal Climate Index (UTCI)

    Di Napoli, Claudia; Pappenberger, Florian; Cloke, Hannah L.

    2018-03-01

    In this work, the potential of the Universal Thermal Climate Index (UTCI) as a heat-related health risk indicator in Europe is demonstrated. The UTCI is a bioclimate index that uses a multi-node human heat balance model to represent the heat stress induced by meteorological conditions to the human body. Using 38 years of meteorological reanalysis data, UTCI maps were computed to assess the thermal bioclimate of Europe for the summer season. Patterns of heat stress conditions and non-thermal stress regions are identified across Europe. An increase in heat stress up to 1 °C is observed during recent decades. Correlation with mortality data from 17 European countries revealed that the relationship between the UTCI and death counts depends on the bioclimate of the country, and death counts increase in conditions of moderate and strong stress, i.e., when UTCI is above 26 and 32 °C. The UTCI's ability to represent mortality patterns is demonstrated for the 2003 European heatwave. These findings confirm the importance of UTCI as a bioclimatic index that is able to both capture the thermal bioclimatic variability of Europe, and relate such variability with the effects it has on human health.

  15. Employer knowledge of federal requirements for recording work-related injuries and illnesses: Implications for occupational injury surveillance data.

    Wuellner, Sara; Phipps, Polly

    2018-05-01

    Accuracy of the Bureau of Labor Statistics Survey of Occupational Injuries and Illnesses (SOII) data is dependent on employer compliance with workplace injury and illness recordkeeping requirements. Characterization of employer recordkeeping can inform efforts to improve the data. We interviewed representative samples of SOII respondents from four states to identify common recordkeeping errors and to assess employer characteristics associated with limited knowledge of the recordkeeping requirements and non compliant practices. Less than half of the establishments required to maintain OSHA injury and illness records reported doing so. Few establishments knew to omit cases limited to diagnostic services (22%) and to count unscheduled weekend days as missed work (27%). No single state or establishment characteristic was consistently associated with better or worse record-keeping. Many employers possess a limited understanding of workplace injury recordkeeping requirements, potentially leading them to over-report minor incidents, and under-report missed work cases. © 2018 Wiley Periodicals, Inc.

  16. A 1-year follow-up study exploring the associations between perception of illness and health-related quality of life in persons with chronic obstructive pulmonary disease.

    Bonsaksen, Tore; Haukeland-Parker, Stacey; Lerdal, Anners; Fagermoen, May Solveig

    2014-01-01

    Chronic obstructive pulmonary disease (COPD) is a progressive respiratory disease with an increasing prevalence worldwide. Its potential consequences, including reduced function and reduced social participation, are likely to be associated with decreased health-related quality of life (HRQoL). However, illness perceptions and self-efficacy beliefs may also play a part in determining HRQoL in persons with COPD. The aim of this study was to explore the relationships between illness perceptions, self-efficacy, and HRQoL in a sample of persons with COPD in a longitudinal perspective. The context of the study was a patient education course from which the participants were recruited. Data concerning sociodemographic variables, social support, physical activity, illness perceptions, general self-efficacy, and HRQoL were collected before the course started and 1 year after completion. Linear regression was used in the analyses. The results showed that less consequences and less symptoms (identity) were associated with higher physical HRQoL (PCS) at baseline and at 1-year follow-up. Less emotional response was similarly associated with higher mental HRQoL (MCS) at both time points. Lower self-efficacy showed a borderline significant association with higher PCS at baseline, but was unrelated to MCS at both time points. Self-efficacy showed no influence on the associations between illness perceptions and HRQoL. In conclusion, the study showed that specific illness perceptions had a stable ability to predict HRQoL in persons with COPD, whereas self-efficacy did not. The associations between illness perceptions and HRQoL were not mediated by self-efficacy.

  17. The relative influence of body characteristics on humid heat stress response

    Havenith, G.; Luttikholt, V. G.; Vrijkotte, T. G.

    1995-01-01

    The present study was designed to determine the relative importance of individual characteristics such as maximal oxygen uptake (VO2max), adiposity, DuBois body surface area (AD), surface to mass ratio (AD: mass) and body mass, for the individual's reaction to humid heat stress. For this purpose 27

  18. A randomised controlled trial of repeated filmed social contact on reducing mental illness-related stigma in young adults.

    Koike, S; Yamaguchi, S; Ojio, Y; Ohta, K; Shimada, T; Watanabe, K; Thornicroft, G; Ando, S

    2018-04-01

    Public stigma alters attitudes towards people with mental illness, and is a particular concern for young people since most mental health problems occur in adolescence and young adulthood. However, little is known about the long-term effects of repeated filmed social contact (FSC) on reducing mental health-related stigma among young adults in the general population, compared with self-instructional Internet search (INS) and control interventions. This study is a parallel-group randomised controlled trial over 12 months conducted in Tokyo, Japan. A total of 259 university students (male n = 150, mean age = 20.0 years, s.d. = 1.2) were recruited from 20 colleges and universities between November 2013 and July 2014, without being provided information about the mental health-related survey or trial. Participants were assigned to one of three groups before completion of the baseline survey (FSC/INS/control = 89/83/87). The FSC group received a computer-based 30-min social contact film with general mental health education and five follow-up web-based FSCs at 2-month intervals. The INS group undertook a 30-min search for mental health-related information with five follow-up web-based reminders for self-instructional searches at 2-month intervals. The control group played PC games and had no follow-up intervention. The main outcome measures were the future (intended behaviour) domain of the Reported and Intended Behaviour Scale at 12 months after the intervention. Analysis was conducted in September 2015. At the 12-month follow-up, 218 participants completed the survey (84.1%, 75:70:73). The FSC group showed the greatest change at the 12-month follow-up (FSC: mean change 2.11 [95% CI 1.49, 2.73], INS: 1.04 [0.29, 1.80], control: 0.71 [0.09, 1.33]; FSC v. INS p = 0.037, FSC v. controls p = 0.004). No adverse events were reported during the follow-up period. FSC was more successful in reducing stigma at 12 months after intervention than INS or control interventions. FSC could

  19. RELATION OF DOCTORS AND PATIENTS TO TREATMENT OF THE ILLNESS AS SOCIAL AND PSYCHOLOGICAL PROBLEM (ON THE EXAMPLE OF TREATMENT OF AN ARTERIAL HYPERTENSION

    N. V. Fomina

    2016-01-01

    Full Text Available Article is devoted to the analysis of a problem of the attitude of patients and doctors to treatment of an illness from a position of medical and socio-psychological approaches on the example of the most widespread in population disease, which is very difficult to treat - an arterial hypertension. The article describes the features of the attitude to an illness of the men and women sick with an arterial hypertension. It is noted that despite the progress in medical technologies, the consciousness of the patient changes extremely slowly and he is still dependent on the doctor, waiting for his leading and guiding assistance. The possibility of purposeful impact of the doctor on development of a responsible position of the patient in relation to an illness and its treatment, and also ways of involvement of patients to adoption of the medical decision is discussed. As a result of empirical research it is established that the active attitude of the patient to an illness and its treatment (compliance with therapy is formed when the doctor is ready to build with him dialogical, the subject - the subject relations.

  20. Central sensitivity syndromes: a new paradigm and group nosology for fibromyalgia and overlapping conditions, and the related issue of disease versus illness.

    Yunus, Muhammad B

    2008-06-01

    To discuss the current terminologies used for fibromyalgia syndrome (FMS) and related overlapping conditions, to examine if central sensitivity syndromes (CSS) is the appropriate nosology for these disorders, and to explore the issue of disease versus illness. A literature search was performed through PubMed, Web of Science, and ScienceDirect using a number of keywords, eg, functional somatic syndromes, somatoform disorders, medically unexplained symptoms, organic and nonorganic, and diseases and illness. Relevant articles were then reviewed and representative ones cited. Terminologies currently used for CSS conditions predominantly represent a psychosocial construct and are inappropriate. On the other hand, CSS seems to be the logical nosology based on a biopsychosocial model. Such terms as "medically unexplained symptoms," "somatization," "somatization disorder," and "functional somatic syndromes" in the context of CSS should be abandoned. Given current scientific knowledge, the concept of disease-illness dualism has no rational basis and impedes proper patient-physician communication, resulting in poor patient care. The concept of CSS is likely to promote research, education, and proper patient management. CSS seems to be a useful paradigm and an appropriate terminology for FMS and related conditions. The disease-illness, as well as organic/non-organic dichotomy, should be rejected.

  1. Study on Spheroidization and Related Heat Treatments of Medium Carbon Alloy Steels

    Harisha S. R.

    2018-01-01

    Full Text Available The importance of medium carbon steels as engineering materials is reflected by the fact that out of the vast majority of engineering grade ferrous alloys available and used in the market today, a large proportion of them are from the family of medium carbon steels. Typically medium carbon steels have a carbon range of 0.25 to 0.65% by weight, and a manganese content ranging from 0.060 to 1.65% by weight. Medium carbon steels are more resistive to cutting, welding and forming as compared to low carbon steels. From the last two decades a number of research scholars reported the use of verity of heat treatments to tailor the properties of medium carbon steels. Spheroidizing is the novel industrial heat treatment employed to improve formability and machinability of medium/high carbon low alloy steels. This exclusive study covers procedure, the effects and possible outcomes of various heat treatments on medium carbon steels. In the present work, other related heat treatments like annealing and special treatments for property alterations which serve as pretreatments for spheroidizing are also reviewed. Medium carbon steels with property alterations by various heat treatment processes are finding increased responsiveness in transportation, aerospace, space, underwater along with other variegated fields. Improved tribological and mechanical properties consisting of impact resistance, stiffness, abrasion and strength are the main reasons for the increased attention of these steels in various industries. In the present scenario for the consolidation of important aspects of various heat treatments and effects on mechanical properties of medium carbons steel, a review of different research papers has been attempted. This review may be used as a guide to provide practical data for heat treatment industry, especially as a tool to enhance workability and tool life.

  2. Fitness-related differences in the rate of whole-body evaporative heat loss in exercising men are heat-load dependent.

    Lamarche, Dallon T; Notley, Sean R; Louie, Jeffrey C; Poirier, Martin P; Kenny, Glen P

    2018-01-01

    What is the central question of this study? Aerobic fitness modulates heat loss, but the heat-load threshold at which fitness-related differences in heat loss occur in young healthy men remains unclear. What is the main finding and its importance? We demonstrate using direct calorimetry that aerobic fitness modulates heat loss in a heat-load-dependent manner, with fitness-related differences occurring between young men who have low and high fitness when the heat load is ∼≥500 W. Although aerobic fitness has been known for some time to modulate heat loss, our findings define the precise heat-load threshold at which fitness-related differences occur. The effect of aerobic fitness (defined as rate of peak oxygen consumption) on heat loss during exercise is thought to be related to the level of heat stress. However, it remains unclear at what combined exercise and environmental (net) heat-load threshold these fitness-related differences occur. To identify this, we assessed whole-body heat exchange (dry and evaporative) by direct calorimetry in young (22 ± 3 years) men matched for physical characteristics with low (Low-fit; 39.8 ± 2.5 ml O 2  kg -1  min -1 ), moderate (Mod-fit; 50.9 ± 1.2 ml O 2  kg -1  min -1 ) and high aerobic fitness (High-fit; 62.0 ± 4.4 ml O 2  kg -1  min -1 ; each n = 8), during three 30 min bouts of cycling in dry heat (40°C, 12% relative humidity) at increasing rates of metabolic heat production of 300 (Ex1), 400 (Ex2) and 500 W (Ex3), each followed by a 15 min recovery period. Each group was exposed to a similar net heat load (metabolic plus ∼100 W dry heat gain; P = 0.83) during each exercise bout [∼400 (Ex1), ∼500 (Ex2) and ∼600 W (Ex3); P fit (Ex2, 466 ± 21 W; Ex3, 557 ± 26 W) compared with the Low-fit group (Ex2, 439 ± 22 W; Ex3, 511 ± 20 W) during Ex2 and Ex3 (P ≤ 0.03). Conversely, evaporative heat loss for the Mod-fit group did not differ from either the High-fit or Low

  3. Premorbid and illness-related social difficulties in eating disorders: an overview of the literature and treatment developments.

    Cardi, Valentina; Tchanturia, Kate; Treasure, Janet

    2018-01-17

    Social difficulties in eating disorders can manifest as predisposing traits and premorbid difficulties, and/or as consequences of the illness. Objective The aim of this paper is to briefly review the evidence for social problems in people with eating disorders and to consider the literature on treatments that target these features. Method A narrative review of the literature was conducted. Results People with eating disorders often manifest traits, such as shyness, increased tendency to submissiveness and social comparison, and problems with peer relationships before illness onset. Further social difficulties occur as the illness develops, including impaired social cognition and increased threat sensitivity. All relationships with family, peers and therapists are compromised by these effects. Thus, social difficulties are both risk and maintaining factors of eating disorders and are suitable targets for interventions. Several forms of generic treatments (e.g. interpersonal psychotherapy, cognitive analytic therapy, focal psychodynamic therapy) have an interpersonal focus and show some efficacy. Guided self-management based on the cognitive interpersonal model of the illness and directed to both individuals and support persons have been found to improve outcomes for all parties. Adjunctive treatments that focus on specific social difficulties, such as Cognitive Remediation and Emotion Skills Training and Cognitive Bias Modification have been shown to have promise. Conclusion More work is needed to establish whether these approaches can improve on the rather disappointing outcomes that are attained by currently used treatments for eating disorders. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  4. Outcomes Related to the Use of Frozen Plasma or Pooled Solvent/Detergent-Treated Plasma in Critically Ill Children

    Camazine, Maraya N; Karam, Oliver; Colvin, Ryan

    2017-01-01

    OBJECTIVE: To determine if the use of fresh frozen plasma/frozen plasma 24 hours compared to solvent detergent plasma is associated with international normalized ratio reduction or ICU mortality in critically ill children. DESIGN: This is an a priori secondary analysis of a prospective, observati......OBJECTIVE: To determine if the use of fresh frozen plasma/frozen plasma 24 hours compared to solvent detergent plasma is associated with international normalized ratio reduction or ICU mortality in critically ill children. DESIGN: This is an a priori secondary analysis of a prospective....... SETTING: One hundred one PICUs in 21 countries. PATIENTS: All critically ill children admitted to a participating unit were included if they received at least one plasma unit during six predefined 1-week (Monday to Friday) periods. All children were exclusively transfused with either fresh frozen plasma...... was independently associated with reduced ICU mortality (odds ratio, 0.40; 95% CI, 0.16-0.99; p = 0.05). CONCLUSIONS: Solvent detergent plasma use in critically ill children may be associated with improved survival. This hypothesis-generating data support a randomized controlled trial comparing solvent detergent...

  5. Reported incidence and precipitating factors of work-related stress and mental ill-health in the United Kingdom (1996-2001).

    Cherry, Nicola M; Chen, Yiqun; McDonald, J Corbett

    2006-09-01

    Work-related mental ill-health appears to be increasing. Population-based data on incidence are scarce but in the United Kingdom occupational physicians and psychiatrists report these conditions to voluntary surveillance schemes. To estimate the incidence of work-related stress and mental illness reported 1996-2001 by occupational physicians and 1999-2001 by psychiatrists. Estimated annual average incidence rates were calculated by sex, occupation and industry against appropriate populations at risk. An in-house coding scheme was used to classify and analyse data on precipitating events. An estimated annual average of 3,624 new cases were reported by psychiatrists, and 2,718 by occupational physicians; the rates were higher for men in reports based on the former and for women on the latter. Most diagnoses were of anxiety/depression or work-related stress, with post-traumatic stress accounting for approximately 10% of cases reported by psychiatrists. High rates of ill-health were seen among professional and associated workers and in those in personal and protective services. Factors (such as work overload) intrinsic to the job and issues with interpersonal relations were the most common causes overall. The steep increase in new cases of work-related mental ill-health reported by occupational physicians since 1996 may reflect a greater willingness by workers to seek help but may also signify an increasing dissonance between workers' expectations and the work environment. Greater expertise is needed to improve the workplace by adjustment of job demands, improvement of working relations, increasing workers' capacities and management of organizational change.

  6. Projected heat-related mortality under climate change in the metropolitan area of Skopje

    Gerardo Sanchez Martinez

    2016-05-01

    Full Text Available Abstract Background Excessive summer heat is a serious environmental health problem in Skopje, the capital and largest city of the former Yugoslav Republic of Macedonia. This paper attempts to forecast the impact of heat on mortality in Skopje in two future periods under climate change and compare it with a historical baseline period. Methods After ascertaining the relationship between daily mean ambient air temperature and daily mortality in Skopje, we modelled the evolution of ambient temperatures in the city under a Representative Concentration Pathway scenario (RCP8.5 and the evolution of the city population in two future time periods: 2026–2045 and 2081–2100, and in a past time period (1986–2005 to serve as baseline for comparison. We then calculated the projected average annual mortality attributable to heat in the absence of adaptation or acclimatization during those time windows, and evaluated the contribution of each source of uncertainty on the final impact. Results Our estimates suggest that, compared to the baseline period (1986–2005, heat-related mortality in Skopje would more than double in 2026–2045, and more than quadruple in 2081–2100. When considering the impact in 2081–2100, sampling variability around the heat–mortality relationship and climate model explained 40.3 and 46.6 % of total variability. Conclusion These results highlight the importance of a long-term perspective in the public health prevention of heat exposure, particularly in the context of a changing climate.

  7. Heat-related deaths in hot cities: estimates of human tolerance to high temperature thresholds.

    Harlan, Sharon L; Chowell, Gerardo; Yang, Shuo; Petitti, Diana B; Morales Butler, Emmanuel J; Ruddell, Benjamin L; Ruddell, Darren M

    2014-03-20

    In this study we characterized the relationship between temperature and mortality in central Arizona desert cities that have an extremely hot climate. Relationships between daily maximum apparent temperature (ATmax) and mortality for eight condition-specific causes and all-cause deaths were modeled for all residents and separately for males and females ages heat. For this condition-specific cause of death, the heat thresholds in all gender and age groups (ATmax = 90-97 °F; 32.2-36.1 °C) were below local median seasonal temperatures in the study period (ATmax = 99.5 °F; 37.5 °C). Heat threshold was defined as ATmax at which the mortality ratio begins an exponential upward trend. Thresholds were identified in younger and older females for cardiac disease/stroke mortality (ATmax = 106 and 108 °F; 41.1 and 42.2 °C) with a one-day lag. Thresholds were also identified for mortality from respiratory diseases in older people (ATmax = 109 °F; 42.8 °C) and for all-cause mortality in females (ATmax = 107 °F; 41.7 °C) and males Heat-related mortality in a region that has already made some adaptations to predictable periods of extremely high temperatures suggests that more extensive and targeted heat-adaptation plans for climate change are needed in cities worldwide.

  8. EUROPAEM EMF Guideline 2016 for the prevention, diagnosis and treatment of EMF-related health problems and illnesses.

    Belyaev, Igor; Dean, Amy; Eger, Horst; Hubmann, Gerhard; Jandrisovits, Reinhold; Kern, Markus; Kundi, Michael; Moshammer, Hanns; Lercher, Piero; Müller, Kurt; Oberfeld, Gerd; Ohnsorge, Peter; Pelzmann, Peter; Scheingraber, Claus; Thill, Roby

    2016-09-01

    major impact on the oxidative and nitrosative regulation capacity in affected individuals. This concept also may explain why the level of susceptibility to EMF can change and why the range of symptoms reported in the context of EMF exposures is so large. Based on our current understanding, a treatment approach that minimizes the adverse effects of peroxynitrite - as has been increasingly used in the treatment of multisystem illnesses - works best. This EMF Guideline gives an overview of the current knowledge regarding EMF-related health risks and provides recommendations for the diagnosis, treatment and accessibility measures of EHS to improve and restore individual health outcomes as well as for the development of strategies for prevention.

  9. Fitness-related differences in the rate of whole-body total heat loss in exercising young healthy women are heat-load dependent.

    Lamarche, Dallon T; Notley, Sean R; Poirier, Martin P; Kenny, Glen P

    2018-03-01

    What is the central question of this study? Aerobic fitness modulates heat loss, albeit the heat load at which fitness-related differences occur in young healthy women remains unclear. What is the main finding and its importance? We demonstrate using direct calorimetry that fitness modulates heat loss in a heat-load dependent manner, with differences occurring between young women of low and high fitness and matched physical characteristics when the metabolic heat load is at least 400 W in hot, dry conditions. Although fitness has been known for some time to modulate heat loss, our findings define the metabolic heat load at which fitness-related differences occur. Aerobic fitness has recently been shown to alter heat loss capacity in a heat-load dependent manner in young men. However, given that sex-related differences in heat loss capacity exist, it is unclear whether this response is consistent in women. We therefore assessed whole-body total heat loss in young (21 ± 3 years old) healthy women matched for physical characteristics, but with low (low-fit; 35.8 ± 4.5 ml O 2  kg -1  min -1 ) or high aerobic fitness (high-fit; 53.1 ± 5.1 ml O 2  kg -1  min -1 ; both n = 8; indexed by peak oxygen consumption), during three 30 min bouts of cycling performed at increasing rates of metabolic heat production of 250 (Ex1), 325 (Ex2) and 400 W (Ex3), each separated by a 15 min recovery, in hot, dry conditions (40°C, 11% relative humidity). Whole-body total heat loss (evaporative ± dry heat exchange) and metabolic heat production were measured using direct and indirect calorimetry, respectively. Body heat content was measured as the temporal summation of heat production and loss. Total heat loss did not differ during Ex1 (low-fit, 215 ± 16 W; high-fit, 231 ± 20 W; P > 0.05) and Ex2 (low-fit, 278 ± 15 W; high-fit, 301 ± 20 W; P > 0.05), but was lower in the low-fit (316 ± 21 W) compared with the high-fit women (359 ± 32

  10. The Summers 2003 and 2015 in South-West Germany: Heat Waves and Heat-Related Mortality in the Context of Climate Change

    Stefan Muthers

    2017-11-01

    Full Text Available After 2003, another hot summer took place in Western and Central Europe in 2015. In this study, we compare the characteristics of the two major heat waves of these two summers and their effect on the heat related mortality. The analysis is performed with focus on South-West Germany (Baden–Württemberg. With an additional mean summer mortality of +7.9% (2003 and +5.8% (2015 both years mark the top-two records of the summer mortality in the period 1968–2015. In each summer, one major heat wave contributed strongly to the excess summer mortality: In August 2003, daily mortality reached anomalies of +70% and in July 2015 maximum deviations of +56% were observed. The August 2003 heat wave was very long-lasting and characterized by exceptional high maximum and minimum temperatures. In July 2015, temperatures were slightly lower than in 2003, however, the high air humidity during the day and night, lead to comparable heat loads. Furthermore, the heat wave occurred earlier during the summer, when the population was less acclimated to heat stress. Using regional climate models we project an increasing probability for future 2003- and 2015-like heat waves already in the near future (2021–2050, with a 2015-like event occurring about every second summer. In the far future (2070–2099 pronounced increases with more than two 2015-like heat waves per summer are possible.

  11. A predictive model of Health Related Quality of life of parents of chronically ill children: the importance of care-dependency of their child and their support system.

    Hatzmann, Janneke; Maurice-Stam, Heleen; Heymans, Hugo S A; Grootenhuis, Martha A

    2009-07-28

    Parents of chronically ill children are at risk for a lower Health Related Quality of Life (HRQoL). Insight in the dynamics of factors influencing parental HRQoL is necessary for development of interventions. Aim of the present study was to explore the influence of demographic and disease related factors on parental HRQoL, mediated by employment, income, leisure time, holiday and emotional support in a comprehensive model. In a cross-sectional design, 543 parents of chronically ill children completed questionnaires. A conceptual model of parental HRQoL was developed. Structural equation modeling was performed to explore the relations in the conceptual model, and to test if the model fitted the data. The model fitted the data closely (CHISQ(14) = 11.37, p = 0.66; RMSEA = 0.0, 90%CI [0.00;0.034]. The effect of socio-demographic and medical data on HRQoL was mediated by days on holiday (MCS: beta = .21) and emotional support (PCS: beta = .14; MCS: beta = .28). Also, female gender (beta = -.10), age (beta = .10), being chronically ill as a parent (beta = -.34), and care dependency of the child (beta = -.14; beta = -.15) were directly related to parental HRQoL. The final model was slightly different from the conceptual model. Main factors explaining parental HRQoL seemed to be emotional support, care dependency, days on holiday and being chronically ill as a parent. Holiday and emotional support mediated the effect of demographic and disease-related factors on HRQoL. Hours of employment, leisure time and household income did not mediate between background characteristics and HRQoL, contrasting the hypotheses.

  12. A predictive model of Health Related Quality of life of parents of chronically ill children: the importance of care-dependency of their child and their support system

    Heymans Hugo SA

    2009-07-01

    Full Text Available Abstract Background Parents of chronically ill children are at risk for a lower Health Related Quality of Life (HRQoL. Insight in the dynamics of factors influencing parental HRQoL is necessary for development of interventions. Aim of the present study was to explore the influence of demographic and disease related factors on parental HRQoL, mediated by employment, income, leisure time, holiday and emotional support in a comprehensive model. Methods In a cross-sectional design, 543 parents of chronically ill children completed questionnaires. A conceptual model of parental HRQoL was developed. Structural equation modeling was performed to explore the relations in the conceptual model, and to test if the model fitted the data. Results The model fitted the data closely (CHISQ(14 = 11.37, p = 0.66; RMSEA = 0.0, 90%CI [0.00;0.034]. The effect of socio-demographic and medical data on HRQoL was mediated by days on holiday (MCS: β = .21 and emotional support (PCS: β = .14; MCS: β = .28. Also, female gender (β = -.10, age (β = .10, being chronically ill as a parent (β = -.34, and care dependency of the child (β = -.14; β = -.15 were directly related to parental HRQoL. Conclusion The final model was slightly different from the conceptual model. Main factors explaining parental HRQoL seemed to be emotional support, care dependency, days on holiday and being chronically ill as a parent. Holiday and emotional support mediated the effect of demographic and disease-related factors on HRQoL. Hours of employment, leisure time and household income did not mediate between background characteristics and HRQoL, contrasting the hypotheses.

  13. Mediation analysis of critical time intervention for persons living with serious mental illnesses: assessing the role of family relations in reducing psychiatric rehospitalization.

    Tomita, Andrew; Lukens, Ellen P; Herman, Daniel B

    2014-03-01

    Critical Time Intervention (CTI) is a time-limited care coordination intervention designed to reduce homelessness and other adverse outcomes for persons living with serious mental illness during the transition period between institutions and community living. This study assesses whether CTI improves the quality of family relationships between family members and individuals living with serious mental illness, and examines whether changes in quality of family relationship mediated the association between the intervention and psychiatric rehospitalization outcomes. This study utilizes data from a randomized controlled trial that assessed the effect of CTI in preventing homelessness. Following discharge from inpatient psychiatric treatment in New York City, 150 previously homeless persons living with serious mental illness were randomly assigned to receive usual services only or 9 months of CTI in addition to usual services. Findings from mixed-effects regression models indicated that those assigned to the CTI group reported greater frequency of family contact and greater improvement in satisfaction with family relations than the comparison group during the 18-month follow-up period. Mediation analysis revealed that greater improvement in satisfaction with family relations mediated the effect of CTI on psychiatric rehospitalization outcome, but only at a modest level. These findings suggest that a relatively brief but targeted intervention delivered at the point of hospital discharge may contribute to strengthening family relations and that improvement in perceived family relationship quality can contribute to a reduction in psychiatric rehospitalization.

  14. “Helping my neighbour is like giving a loan…” –the role of social relations in chronic illness in rural Uganda

    Jovita Amurwon

    2017-11-01

    Full Text Available Abstract Background Understanding individuals’ experience of accessing care and tending to various other needs during chronic illness in a rural context is important for health systems aiming to increase access to healthcare and protect poor populations from unreasonable financial hardship. This study explored the impact on households of access to free healthcare and how they managed to meet needs during chronic illness. Methods Rich data from the life stories of individuals from 22 households in rural south-western Uganda collected in 2009 were analysed. Results The data revealed that individuals and households depend heavily on their social relations in order to meet their needs during illness, including accessing the free healthcare and maintaining vital livelihood activities. The life stories illustrated ways in which households draw upon social relations to achieve the broader social protection necessary to prevent expenses becoming catastrophic, but also demonstrated the uncertainty in relying solely on informal relations. Conclusion Improving access to healthcare in a rural context greatly depends on broader social protection. Thus, the informal social protection that already exists in the form of strong reciprocal social relations must be acknowledged, supported and included in health policy planning.

  15. Longitudinal study of respiratory function and symptoms in a non-smoking group of long-term officially-acknowledged victims of pollution-related illness.

    Tanaka, Takako; Asai, Masaharu; Yanagita, Yorihide; Nishinakagawa, Tsuyoshi; Miyamoto, Naomi; Kotaki, Kenji; Yano, Yudai; Kozu, Ryo; Honda, Sumihisa; Senjyu, Hideaki

    2013-08-17

    Air pollution is known to be a leading cause of respiratory symptoms. Many cross-sectional studies reported that air pollution caused respiratory disease in Japanese individuals in the 1960s. Japan has laws regulating air pollution levels and providing compensation for victims of pollution-related respiratory disease. However, long-term changes in respiratory function and symptoms in individuals who were exposed to air pollution in the 1960s have not been well studied. This study aimed to investigate longitudinal respiratory function and symptoms in older, non-smoking, long-term officially-acknowledged victims of pollution-related illness. The study included 563 officially-acknowledged victims of pollution-related illness living in Kurashiki, Okayama who were aged ≥ 65 years in 2009. Data were retrospectively collected from yearly respiratory symptom questionnaires and spirometry examinations conducted from 2000 to 2009. Respiratory function declined significantly from 2000 to 2009 (p pollutants around 1970 resulted in a decrease in respiratory function and an increase in respiratory symptoms in the study population. From 2000 to 2009, the mean annual changes in respiratory function were within the normal range, even though the severity of dyspnea worsened. The changes in respiratory function and symptoms over the study period were probably due to aging. The laws governing air pollution levels and providing compensation for officially-acknowledged victims of pollution-related illness in Japan may be effective for respiratory disease cause by pollution.

  16. Molecular diagnostics of FUV and accretion-related heating in protoplanetary disks

    Adamkovics, Mate; Najita, Joan R.

    2017-10-01

    Emission lines from the terrestrial planet forming regions of disks are diagnostic of both the physical processes that heat the gas and the chemistry that determines the inventory of nebular material available during the epoch of planet formation. Interpreting emission spectra is informed by models of radiative, thermal, physical, and chemical processes, such as: (i) the radiation transfer of X-rays and FUV --- both continuum and Ly-alpha, (ii) direct and indirect heating processes such as the photoelectric effect and photochemical heating, (iii) heating related to turbulent processes and viscous dissipation, and (iv) gas phase chemical reaction kinetics. Many of these processes depend on a the spatial distribution of dust grains and their properties, which temporally evolve during the lifetime of the disk and the formation of planets. Studies of disks atmospheres often predict a layered structure of hot (a few thousand K) atomic gas overlying warm (a few hundred K) molecular gas, which is generally consistent with the isothermal slab emission models that are used to interpret emission spectra. However, detailed comparison between observed spectra and models (e.g., comparing the total columns and the radial extent of warm emitting species) is rare.We present results including the implementation of Ly-alpha scattering, which is an important part of the photochemical heating and FUV heating radiation budget. By including these processes we find a new component of the disk atmosphere; hot molecular gas at ~2000K within radial distances of ~0.5AU, which is consistent with observations of UV-fluorescent H2 emission (Ádámkovics, Najita & Glassgold, 2016). Constraining the most optimistic contribution of radiative heating mechanisms via X-rays and FUV together with a favorable comparison to observations, allows us to explore and evaluate additional heating mechanisms. We find that the total columns of warm (90-400K) emitting molecules such as CO, arising directly below

  17. A 1-year follow-up study exploring the associations between perception of illness and health-related quality of life in persons with chronic obstructive pulmonary disease

    Bonsaksen T

    2013-12-01

    Full Text Available Tore Bonsaksen,1 Stacey Haukeland-Parker,2 Anners Lerdal,3,4 May Solveig Fagermoen4,5 1Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway; 2Department of Physiotherapy, Østfold Hospital Trust, Fredrikstad, Norway; 3Research Department, Lovisenberg Diakonale Hospital, Oslo, Norway; 4Department of Nursing Science, Institute of Health and Society, University of Oslo, Oslo, Norway; 5Department of Gastroenterology, Division of Medicine, Oslo University Hospital, Oslo, Norway Abstract: Chronic obstructive pulmonary disease (COPD is a progressive respiratory disease with an increasing prevalence worldwide. Its potential consequences, including reduced function and reduced social participation, are likely to be associated with decreased health-related quality of life (HRQoL. However, illness perceptions and self-efficacy beliefs may also play a part in determining HRQoL in persons with COPD. The aim of this study was to explore the relationships between illness perceptions, self-efficacy, and HRQoL in a sample of persons with COPD in a longitudinal perspective. The context of the study was a patient education course from which the participants were recruited. Data concerning sociodemographic variables, social support, physical activity, illness perceptions, general self-efficacy, and HRQoL were collected before the course started and 1 year after completion. Linear regression was used in the analyses. The results showed that less consequences and less symptoms (identity were associated with higher physical HRQoL (PCS at baseline and at 1-year follow-up. Less emotional response was similarly associated with higher mental HRQoL (MCS at both time points. Lower self-efficacy showed a borderline significant association with higher PCS at baseline, but was unrelated to MCS at both time points. Self-efficacy showed no influence on the associations

  18. Searching for God: Illness-Related Mortality Threats and Religious Search Volume in Google in 16 Nations.

    Pelham, Brett W; Shimizu, Mitsuru; Arndt, Jamie; Carvallo, Mauricio; Solomon, Sheldon; Greenberg, Jeff

    2018-03-01

    We tested predictions about religiosity and terror management processes in 16 nations. Specifically, we examined weekly variation in Google search volume in each nation for 12 years (all weeks for which data were available). In all 16 nations, higher than usual weekly Google search volume for life-threatening illnesses (cancer, diabetes, and hypertension) predicted increases in search volume for religious content (e.g., God, Jesus, prayer) in the following week. This effect held up after controlling for (a) recent past and annual variation in religious search volume, (b) increases in search volume associated with religious holidays, and (c) variation in searches for a non-life-threatening illness ("sore throat"). Terror management threat reduction processes appear to occur across the globe. Furthermore, they may occur over much longer periods than those studied in the laboratory. Managing fears of death via religious belief regulation appears to be culturally pervasive.

  19. Can the Cancer-related Fatigue Case-definition Criteria Be Applied to Chronic Medical Illness? A Comparison between Breast Cancer and Systemic Sclerosis.

    Kwakkenbos, Linda; Minton, Ollie; Stone, Patrick C; Alexander, Susanna; Baron, Murray; Hudson, Marie; Thombs, Brett D

    2015-07-01

    Fatigue is a crucial determinant of quality of life across rheumatic diseases, but the lack of agreed-upon standards for identifying clinically significant fatigue hinders research and clinical management. Case definition criteria for cancer-related fatigue were proposed for inclusion in the International Classification of Diseases. The objective was to evaluate whether the cancer-related fatigue case definition performed equivalently in women with breast cancer and systemic sclerosis (SSc) and could be used to identify patients with chronic illness-related fatigue. The cancer-related fatigue interview (case definition criteria met if ≥ 5 of 9 fatigue-related symptoms present with functional impairment) was completed by 291 women with SSc and 278 women successfully treated for breast cancer. Differential item functioning was assessed with the multiple indicator multiple cause model. Items 3 (concentration) and 10 (short-term memory) were endorsed significantly less often by women with SSc compared with cancer, controlling for responses on other items. Omitting these 2 items from the case definition and requiring 4 out of the 7 remaining symptoms resulted in a similar overall prevalence of cancer-related fatigue in the cancer sample compared with the original criteria (37.4% vs 37.8%, respectively), with 97.5% of patients diagnosed identically with both definitions. Prevalence of chronic illness-related fatigue was 36.1% in SSc using 4 of 7 symptoms. The cancer-related fatigue criteria can be used equivalently to identify patients with chronic illness-related fatigue when 2 cognitive fatigue symptoms are omitted. Harmonized definitions and measurement of clinically significant fatigue will advance research and clinical management of fatigue in rheumatic diseases and other conditions.

  20. Incidence of Decompression Illness and Other Diving Related Medical Problems Amongst Royal Navy Divers 1995-1999

    1999-01-01

    conditions hypobares ou hyperbares ] To order the complete compilation report, use: ADA395680 The component part is provided here to allow users access to...following report: TITLE: Operational Medical Issues in Hypo-and Hyperbaric Conditions [les Questions medicales a caractere oprationel liees aux...Navy diving accidents, and with the assistance of the British Hyperbaric Association (BHA) all civilian cases of decompression illness treated by member

  1. Study of dissolution precipitation phenomena related to heat generated by underground disposal

    Fabriol, R.

    1987-01-01

    This study is composed of two parts developed in two separated volumes. The first part is a bibliographical research concerning the behaviour of waste analog elements during hydrothermal alteration in active geothermal fields. The second part is an experimental and theoretical simulation of dissolution-precipitation phenomena related to heat generated in the vicinity of a nuclear waste repository located in granitic formations. This work is part of the CEC project MIRAGE on natural geological migration systems [fr

  2. EUROPAEM EMF Guideline 2015 for the prevention, diagnosis and treatment of EMF-related health problems and illnesses.

    Belyaev, Igor; Dean, Amy; Eger, Horst; Hubmann, Gerhard; Jandrisovits, Reinhold; Johansson, Olle; Kern, Markus; Kundi, Michael; Lercher, Piero; Mosgöller, Wilhelm; Moshammer, Hanns; Müller, Kurt; Oberfeld, Gerd; Ohnsorge, Peter; Pelzmann, Peter; Scheingraber, Claus; Thill, Roby

    2015-01-01

    Chronic diseases and illnesses associated with unspecific symptoms are on the rise. In addition to chronic stress in social and work environments, physical and chemical exposures at home, at work, and during leisure activities are causal or contributing environmental stressors that deserve attention by the general practitioner as well as by all other members of the health care community. It seems certainly necessary now to take "new exposures" like electromagnetic field (EMF) into account. Physicians are increasingly confronted with health problems from unidentified causes. Studies, empirical observations, and patient reports clearly indicate interactions between EMF exposure and health problems. Individual susceptibility and environmental factors are frequently neglected. New wireless technologies and applications have been introduced without any certainty about their health effects, raising new challenges for medicine and society. For instance, the issue of so-called non-thermal effects and potential long-term effects of low-dose exposure were scarcely investigated prior to the introduction of these technologies. Common EMF sources include Wi-Fi access points, routers and clients, cordless and mobile phones including their base stations, Bluetooth devices, ELF magnetic fields from net currents, ELF electric fields from electric lamps and wiring close to the bed and office desk. On the one hand, there is strong evidence that long-term-exposure to certain EMF exposures is a risk factor for diseases such as certain cancers, Alzheimer's disease and male infertility. On the other hand, the emerging electromagnetic hypersensitivity (EHS) is more and more recognized by health authorities, disability administrators and case workers, politicians, as well as courts of law. We recommend treating EHS clinically as part of the group of chronic multisystem illnesses (CMI) leading to a functional impairment (EHS), but still recognizing that the underlying cause remains the

  3. Health-related behavior, profile of health locus of control and acceptance of illness in patients suffering from chronic somatic diseases.

    Konrad Janowski

    Full Text Available PURPOSE: The purpose of the study was to determine health-related behaviors, profile of health locus of control (HLC, and to assess the relationships between these constructs among patients suffering from chronic somatic diseases. MATERIAL AND METHODS: Three-hundred adult patients suffering from various chronic diseases participated in the study. The patients' mean age was 54.6 years (SD = 17.57. RESULTS: No statistically significant differences were found between the different clinical groups in health-related behavior, acceptance of illness, internal HLC or chance HLC. Patients with neurologic conditions showed slightly lower powerful others HLC than did some other clinical groups. Health-related behavior was significantly positively related to all three categories of HLC, with most prominent associations observed with powerful others HLC. Only one type of health-related behavior--preventive behavior--correlated significantly and negatively with acceptance of illness. Differences in the frequency of health-related behavior were also found due to gender (women showing more healthy nutritional habits than men, age (older subjects showing more frequent health-promoting behavior, education (higher education was associated with less frequent health-promoting behavior and marital status (widowed subjects reporting more frequent health-promoting behavior. CONCLUSIONS: Health-related behavior in patients with chronic diseases seems to be unrelated to a specific diagnosis; however it shows associations with both internal and external HLC. Sociodemographic factors are also crucial factors determining frequency of health-related behavior in such patients.

  4. Injuries and illnesses in a cohort of elite youth alpine ski racers and the influence of biological maturity and relative age: a two-season prospective study

    Müller L

    2017-05-01

    Full Text Available Lisa Müller,1 Carolin Hildebrandt,1,2 Erich Müller,3 Renate Oberhoffer,2 Christian Raschner1 1Department of Sport Science, University of Innsbruck, Innsbruck, Austria; 2Department of Sport and Health Science, Preventative Pediatrics, Technical University of Munich, Munich, Germany; 3Department of Sport Science and Kinesiology, University of Salzburg, Salzburg, Austria Background: Studies on injuries and illnesses involving youth ski racers younger than 15 years are lacking in the literature. The aim of this study was prospectively to assess the incidence, prevalence, and severity of traumatic and overuse injuries, as well as illnesses of elite youth ski racers with regard to sex, biological maturity status, and relative age.Subjects and methods: A prospective, longitudinal cohort design was used to monitor the anthropometrics, training characteristics, traumatic and overuse injuries, and illnesses of 82 elite youth ski racers (51 males, 31 females, age 9–14 years over 2 consecutive years. The exact training exposure (skiing and athletic was recorded. Relative age and estimated biological maturity status were assessed.Results: Relatively low injury incidence or prevalence (traumatic, 0.86/1,000 hours of training; overuse, 0.28/1,000 hours and comparably high illness prevalence (2.4/athlete were reported. The knee was the most commonly affected body part (traumatic injuries 36.5%, overuse injuries 82%. A high number of bone fractures were revealed (46%, while no stress fractures occurred; 66% of the illnesses were respiratory tract infections. No differences were found between males and females, the differing maturity groups, or relative age quartiles. Early-maturing athletes had comparably low traumatic and overuse-injury rates. Relatively younger athletes had low traumatic injury rates.Conclusion: The injury-prevention measures implemented in the training process of youth ski racers seem to contribute to a low incidence of injury. Biological

  5. Estimating the Influence of Housing Energy Efficiency and Overheating Adaptations on Heat-Related Mortality in the West Midlands, UK

    Jonathon Taylor

    2018-05-01

    Full Text Available Mortality rates rise during hot weather in England, and projected future increases in heatwave frequency and intensity require the development of heat protection measures such as the adaptation of housing to reduce indoor overheating. We apply a combined building physics and health model to dwellings in the West Midlands, UK, using an English Housing Survey (EHS-derived stock model. Regional temperature exposures, heat-related mortality risk, and space heating energy consumption were estimated for 2030s, 2050s, and 2080s medium emissions climates prior to and following heat mitigating, energy-efficiency, and occupant behaviour adaptations. Risk variation across adaptations, dwellings, and occupant types were assessed. Indoor temperatures were greatest in converted flats, while heat mortality rates were highest in bungalows due to the occupant age profiles. Full energy efficiency retrofit reduced regional domestic space heating energy use by 26% but increased summertime heat mortality 3–4%, while reduced façade absorptance decreased heat mortality 12–15% but increased energy consumption by 4%. External shutters provided the largest reduction in heat mortality (37–43%, while closed windows caused a large increase in risk (29–64%. Ensuring adequate post-retrofit ventilation, targeted installation of shutters, and ensuring operable windows in dwellings with heat-vulnerable occupants may save energy and significantly reduce heat-related mortality.

  6. [Psychiatric patients and relatives instruct German police officers - an anti-stigma project of "BASTA - the alliance for mentally ill people"].

    Wundsam, Kerstin; Pitschel-Walz, Gabi; Leucht, Stefan; Kissling, Werner

    2007-05-01

    Contact with police officers due to schizophrenia and resort to violence in such interactions is a common occurrence and represents a source for stigmatisation of mentally ill people. Aim of this project was to establish a program for police officers to reduce that stigma. The seminar was developed by a German anti-stigma organisation in cooperation with sociology teachers of the Bavarian police academy. Evaluations focussed on the police officers "social distance" and "negative stereotypes" towards mentally ill people. The personal contact between officers and the referees (patients, relatives, professionals) was the core of the seminar. Results of a debriefing after the pilot-project was overall positive. Evaluations in the renewal years showed significant improvement within the scale "social distance" (p stigma interventions.

  7. Heat-Related Deaths in Hot Cities: Estimates of Human Tolerance to High Temperature Thresholds

    Sharon L. Harlan

    2014-03-01

    Full Text Available In this study we characterized the relationship between temperature and mortality in central Arizona desert cities that have an extremely hot climate. Relationships between daily maximum apparent temperature (ATmax and mortality for eight condition-specific causes and all-cause deaths were modeled for all residents and separately for males and females ages <65 and ≥65 during the months May–October for years 2000–2008. The most robust relationship was between ATmax on day of death and mortality from direct exposure to high environmental heat. For this condition-specific cause of death, the heat thresholds in all gender and age groups (ATmax = 90–97 °F; 32.2‒36.1 °C were below local median seasonal temperatures in the study period (ATmax = 99.5 °F; 37.5 °C. Heat threshold was defined as ATmax at which the mortality ratio begins an exponential upward trend. Thresholds were identified in younger and older females for cardiac disease/stroke mortality (ATmax = 106 and 108 °F; 41.1 and 42.2 °C with a one-day lag. Thresholds were also identified for mortality from respiratory diseases in older people (ATmax = 109 °F; 42.8 °C and for all-cause mortality in females (ATmax = 107 °F; 41.7 °C and males <65 years (ATmax = 102 °F; 38.9 °C. Heat-related mortality in a region that has already made some adaptations to predictable periods of extremely high temperatures suggests that more extensive and targeted heat-adaptation plans for climate change are needed in cities worldwide.

  8. On the Operator ⨁Bk Related to Bessel Heat Equation

    Wanchak Satsanit

    2010-01-01

    Full Text Available We study the equation (∂/∂tu(x,t=c2⊕Bku(x,t with the initial condition u(x,0=f(x for x∈Rn+. The operator ⊕Bk is the operator iterated k-times and is defined by ⊕Bk=((∑i=1pBxi4-(∑j=p+1p+qBxi4k, where p+q=n is the dimension of the Rn+, Bxi=∂2/∂xi2+(2vi/xi(∂/∂xi, 2vi=2αi+1, αi>-1/2, i=1,2,3,…,n, and k is a nonnegative integer, u(x,t is an unknown function for (x,t=(x1,x2,…,xn,t∈Rn+×(0,∞, f(x is a given generalized function, and c is a positive constant. We obtain the solution of such equation, which is related to the spectrum and the kernel, which is so called Bessel heat kernel. Moreover, such Bessel heat kernel has interesting properties and also related to the kernel of an extension of the heat equation.

  9. Studies related to emergency decay heat removal in EBR-II

    Singer, R.M.; Gillette, J.L.; Mohr, D.; Tokar, J.V.; Sullivan, J.E.; Dean, E.M.

    1979-01-01

    Experimental and analytical studies related to emergency decay heat removal by natural circulation in the EBR-II heat transport circuits are described. Three general categories of natural circulation plant transients are discussed and the resultant reactor flow and temperature response to these events are presented. these categories include the following: (1) loss of forced flow from decay power and low initial flow rates; (2) reactor scram with a delayed loss of forced flow; and (3) loss of forced flow with a plant protective system activated scram. In all cases, the transition from forced to natural convective flow was smooth and the peak in-core temperature rises were small to moderate. Comparisons between experimental measurements in EBR-II and analytical predictions of the NATDEMO code are included

  10. Power Relative to Body Mass Best Predicts Change in Core Temperature During Exercise-Heat Stress.

    Gibson, Oliver R; Willmott, Ashley G B; James, Carl A; Hayes, Mark; Maxwell, Neil S

    2017-02-01

    Gibson, OR, Willmott, AGB, James, CA, Hayes, M, and Maxwell, NS. Power relative to body mass best predicts change in core temperature during exercise-heat stress. J Strength Cond Res 31(2): 403-414, 2017-Controlling internal temperature is crucial when prescribing exercise-heat stress, particularly during interventions designed to induce thermoregulatory adaptations. This study aimed to determine the relationship between the rate of rectal temperature (Trec) increase, and various methods for prescribing exercise-heat stress, to identify the most efficient method of prescribing isothermic heat acclimation (HA) training. Thirty-five men cycled in hot conditions (40° C, 39% R.H.) for 29 ± 2 minutes. Subjects exercised at 60 ± 9% V[Combining Dot Above]O2peak, with methods for prescribing exercise retrospectively observed for each participant. Pearson product moment correlations were calculated for each prescriptive variable against the rate of change in Trec (° C·h), with stepwise multiple regressions performed on statistically significant variables (p ≤ 0.05). Linear regression identified the predicted intensity required to increase Trec by 1.0-2.0° C between 20- and 45-minute periods and the duration taken to increase Trec by 1.5° C in response to incremental intensities to guide prescription. Significant (p ≤ 0.05) relationships with the rate of change in Trec were observed for prescriptions based on relative power (W·kg; r = 0.764), power (%Powermax; r = 0.679), rating of perceived exertion (RPE) (r = 0.577), V[Combining Dot Above]O2 (%V[Combining Dot Above]O2peak; r = 0.562), heart rate (HR) (%HRmax; r = 0.534), and thermal sensation (r = 0.311). Stepwise multiple regressions observed relative power and RPE as variables to improve the model (r = 0.791), with no improvement after inclusion of any anthropometric variable. Prescription of exercise under heat stress using power (W·kg or %Powermax) has the strongest relationship with the rate of change in

  11. Climate Regulation of Rearing-Related Buildings - Evaluating the Factors Related to the Energy Requirement of Heating/Cooling, and Analysis of Alternative Solutions

    Toth Laszló

    2017-10-01

    Full Text Available The most notable role in the energy usage of rearing-related buildings belongs to barn climate. For animals, one of the most important climate parameter is the temperature of the barn atmosphere. This can be kept in the proper interval by either heating or cooling. Apart from the operation of technological solutions, the need for airing barns must be taken into consideration. This means there are special technical requirements for airing. Also, they can cause significant energy losses. The temperature limit of heating is mainly influenced by the technological temperature related to keeping the animal in question, its acceptable differences, the heat loss of the barn, and the airing requirement. Energy sources applicable to heating can be traditional sources (coal, oil, gas, renewable sources (solar, biomass, wind, water, or geothermal energy, or transformed energy (electricity. As these have specific operation systems, they also mean further challenges in implementing efficient energy usage. The usage of heating energy can either be optimised by the rational usage of the heating system, or machinery explicitly made for reserving energy. Sparing heating energy via recuperative heating exchange may cut costs significantly, which we also proved in this research with actual calculations. However, we have to state that the efficient usage of heat exchangers requires that the internal and external temperatures differ greatly, which has a huge impact on heat recovery performance.

  12. To assess the relations between breast feeding and illness in children under two years of age with particular reference to respiratory tract infections

    Javed, N.; Zaidi, N.; Khan, M.A.

    2008-01-01

    The study was carried out to examine the relation between the breast feeding and morbidity as a result of respiratory illness and infection in the children less than two years of age. This is a prospective analysis of 131 children attending the outdoor paediatric department of Federal Government Services Hospital, Islamabad during the month of February 2006. A close ended pretested questionnaire was filled after taking informed consent from patient's parents. Out of total 131 enrolled cases (76 male and 55 female) 62 (47%) were breast fed; 56 (43%) bottle fed; while 13 (10%) had mix feeding. Among 38 children, having past history of respiratory tract infections episodes in last one month, only 04 (10%) were breast fed and remaining 34 (90%) were either bottle fed or had partial breast feeding. Out of 62 breast fed children, only 04 (6%) had recurrent episodes of respiratory tract infections, on the other hand out of 56 bottle fed 32 (57%) had previous history of respiratory illness. In our study there is a significant correlation between breast feeding and reduction in number of Respiratory tact infections episodes. Predominant breast feeding for at leas six months and partial breast feeding for up to one year may reduce the prevalence and subsequent morbidity of respiratory illness and infection in infancy. (author)

  13. Diarrheal Illness

    2011-08-30

    Dr. Steve Monroe, director of CDC’s Division of High-Consequence Pathogens and Pathology, discusses diarrheal illness, its causes, and prevention.  Created: 8/30/2011 by National Center for Emerging Zoonotic and Infectious Diseases (NCEZID).   Date Released: 8/31/2011.

  14. Heat-Related Mortality in India: Excess All-Cause Mortality Associated with the 2010 Ahmedabad Heat Wave

    Azhar, Gulrez Shah; Mavalankar, Dileep; Nori-Sarma, Amruta; Rajiva, Ajit; Dutta, Priya; Jaiswal, Anjali; Sheffield, Perry; Knowlton, Kim; Hess, Jeremy J.; Azhar, Gulrez Shah; Deol, Bhaskar; Bhaskar, Priya Shekhar; Hess, Jeremy; Jaiswal, Anjali; Khosla, Radhika; Knowlton, Kim; Mavalankar, Mavalankar; Rajiva, Ajit; Sarma, Amruta; Sheffield, Perry

    2014-01-01

    Introduction In the recent past, spells of extreme heat associated with appreciable mortality have been documented in developed countries, including North America and Europe. However, far fewer research reports are available from developing countries or specific cities in South Asia. In May 2010, Ahmedabad, India, faced a heat wave where the temperatures reached a high of 46.8°C with an apparent increase in mortality. The purpose of this study is to characterize the heat wave impact and assess the associated excess mortality. Methods We conducted an analysis of all-cause mortality associated with a May 2010 heat wave in Ahmedabad, Gujarat, India, to determine whether extreme heat leads to excess mortality. Counts of all-cause deaths from May 1–31, 2010 were compared with the mean of counts from temporally matched periods in May 2009 and 2011 to calculate excess mortality. Other analyses included a 7-day moving average, mortality rate ratio analysis, and relationship between daily maximum temperature and daily all-cause death counts over the entire year of 2010, using month-wise correlations. Results The May 2010 heat wave was associated with significant excess all-cause mortality. 4,462 all-cause deaths occurred, comprising an excess of 1,344 all-cause deaths, an estimated 43.1% increase when compared to the reference period (3,118 deaths). In monthly pair-wise comparisons for 2010, we found high correlations between mortality and daily maximum temperature during the locally hottest “summer” months of April (r = 0.69, pheat (May 19–25, 2010), mortality rate ratios were 1.76 [95% CI 1.67–1.83, pheat wave in Ahmedabad, Gujarat, India had a substantial effect on all-cause excess mortality, even in this city where hot temperatures prevail through much of April-June. PMID:24633076

  15. Heat-related mortality in India: excess all-cause mortality associated with the 2010 Ahmedabad heat wave.

    Gulrez Shah Azhar

    Full Text Available In the recent past, spells of extreme heat associated with appreciable mortality have been documented in developed countries, including North America and Europe. However, far fewer research reports are available from developing countries or specific cities in South Asia. In May 2010, Ahmedabad, India, faced a heat wave where the temperatures reached a high of 46.8 °C with an apparent increase in mortality. The purpose of this study is to characterize the heat wave impact and assess the associated excess mortality.We conducted an analysis of all-cause mortality associated with a May 2010 heat wave in Ahmedabad, Gujarat, India, to determine whether extreme heat leads to excess mortality. Counts of all-cause deaths from May 1-31, 2010 were compared with the mean of counts from temporally matched periods in May 2009 and 2011 to calculate excess mortality. Other analyses included a 7-day moving average, mortality rate ratio analysis, and relationship between daily maximum temperature and daily all-cause death counts over the entire year of 2010, using month-wise correlations.The May 2010 heat wave was associated with significant excess all-cause mortality. 4,462 all-cause deaths occurred, comprising an excess of 1,344 all-cause deaths, an estimated 43.1% increase when compared to the reference period (3,118 deaths. In monthly pair-wise comparisons for 2010, we found high correlations between mortality and daily maximum temperature during the locally hottest "summer" months of April (r = 0.69, p<0.001, May (r = 0.77, p<0.001, and June (r = 0.39, p<0.05. During a period of more intense heat (May 19-25, 2010, mortality rate ratios were 1.76 [95% CI 1.67-1.83, p<0.001] and 2.12 [95% CI 2.03-2.21] applying reference periods (May 12-18, 2010 from various years.The May 2010 heat wave in Ahmedabad, Gujarat, India had a substantial effect on all-cause excess mortality, even in this city where hot temperatures prevail through much of April-June.

  16. Heat-Related Hospitalizations in Older Adults: An Amplified Effect of the First Seasonal Heatwave

    Liss, Alexander; Wu, Ruiruo; Chui, Kenneth Kwan Ho; Naumova, Elena N.

    2017-01-01

    Older adults are highly vulnerable to the detriment of extreme weather. The rapid non-linear increase in heat-related morbidity is difficult to quantify, hindering the attribution of direct effects of exposure on severe health outcomes. We examine the effects of ambient temperatures on heat-related hospitalizations (HH) among the elderly in presence of strong seasonality and by assessing the effects caused by the first and subsequent seasonal heatwaves. We empirically derived the thresholds for a heatwave episode in Boston MSA based on 16 years of daily observations. We compared the health risks of heatwaves using the proposed and four alternative definitions. 701 cases of HH in older residents of Boston area were examined using harmonic regression models, designed to capture the non-linear effects of ambient temperatures and heatwave episodes when the night-time temperature is above 65.5 °F for 3 consecutive nights. The overall relative risk of HH associated with a heatwave episode was 6.9 [95%CI:4.8-9.8]. The relative risk of HH associated with the first heatwave increases up to 13.3 [95%CI:7.4-24.0]. The risk declined to 3.7 [95%CI:2.4-5.8] for the subsequent heatwave. Four other commonly used heatwave definitions confirmed these findings. Public health actions have to target the first heatwave to maximize the impact of preventive measures.

  17. An ecological time-series study of heat-related mortality in three European cities

    Russo Antonio

    2008-01-01

    Full Text Available Abstract Background Europe has experienced warmer summers in the past two decades and there is a need to describe the determinants of heat-related mortality to better inform public health activities during hot weather. We investigated the effect of high temperatures on daily mortality in three cities in Europe (Budapest, London, and Milan, using a standard approach. Methods An ecological time-series study of daily mortality was conducted in three cities using Poisson generalized linear models allowing for over-dispersion. Secular trends in mortality and seasonal confounding factors were controlled for using cubic smoothing splines of time. Heat exposure was modelled using average values of the temperature measure on the same day as death (lag 0 and the day before (lag 1. The heat effect was quantified assuming a linear increase in risk above a cut-point for each city. Socio-economic status indicators and census data were linked with mortality data for stratified analyses. Results The risk of heat-related death increased with age, and females had a greater risk than males in age groups ≥65 years in London and Milan. The relative risks of mortality (per °C above the heat cut-point by gender and age were: (i Male 1.10 (95%CI: 1.07–1.12 and Female 1.07 (1.05–1.10 for 75–84 years, (ii M 1.10 (1.06–1.14 and F 1.08 (1.06–1.11 for ≥85 years in Budapest (≥24°C; (i M 1.03 (1.01–1.04 and F 1.07 (1.05–1.09, (ii M 1.05 (1.03–1.07 and F 1.08 (1.07–1.10 in London (≥20°C; and (i M 1.08 (1.03–1.14 and F 1.20 (1.15–1.26, (ii M 1.18 (1.11–1.26 and F 1.19 (1.15–1.24 in Milan (≥26°C. Mortality from external causes increases at higher temperatures as well as that from respiratory and cardiovascular disease. There was no clear evidence of effect modification by socio-economic status in either Budapest or London, but there was a seemingly higher risk for affluent non-elderly adults in Milan. Conclusion We found broadly consistent

  18. Study on Relative COP Changes with Increasing Heat Input Temperatures of Double Effect Steam Absorption Chillers

    Abd Majid Mohd Amin

    2016-01-01

    Full Text Available Absorption chillers at cogeneration plants generate chilled water using steam supplied by heat recovery steam generators. The chillers are mainly of double effect type. The COP of double effect varies from 0.7 to 1.2 depending on operation and maintenance practices of the chillers. Heat input to the chillers during operations could have impact on the COP of the chillers. This study is on relative COP changes with increasing the heat input temperatures for a steam absorption chiller at a gas fueled cogeneration plant. Reversible COP analysis and zero order model were used for evaluating COP of the chiller for 118 days operation period. Results indicate increasing COP trends for both the reversible COP and zero model COP. Although the zero model COP are within the range of double effect absorption chiller, it is not so for the actual COP. The actual COP is below the range of normal double effect COP. It is recommended that economic replacement analysis to be undertaken to assess the feasibility either to repair or replace the existing absorption chiller.

  19. Regressed relations for forced convection heat transfer in a direct injection stratified charge rotary engine

    Lee, Chi M.; Schock, Harold J.

    1988-01-01

    Currently, the heat transfer equation used in the rotary combustion engine (RCE) simulation model is taken from piston engine studies. These relations have been empirically developed by the experimental input coming from piston engines whose geometry differs considerably from that of the RCE. The objective of this work was to derive equations to estimate heat transfer coefficients in the combustion chamber of an RCE. This was accomplished by making detailed temperature and pressure measurements in a direct injection stratified charge (DISC) RCE under a range of conditions. For each specific measurement point, the local gas velocity was assumed equal to the local rotor tip speed. Local physical properties of the fluids were then calculated. Two types of correlation equations were derived and are described in this paper. The first correlation expresses the Nusselt number as a function of the Prandtl number, Reynolds number, and characteristic temperature ratio; the second correlation expresses the forced convection heat transfer coefficient as a function of fluid temperature, pressure and velocity.

  20. Isolation and Suffering Related to Serious and Terminal Illness: Metaphors and Lessons From Albert Camus' Novel, The Plague.

    Tuffuor, Akosua N; Payne, Richard

    2017-09-01

    Health care providers have much to learn from Albert Camus' great novel, The Plague. The Plague tells the story of a bubonic plague epidemic through the lens of doctor-narrator Rieux. In addition to Rieux, this essay also focuses on the perspective of Father Paneloux, a Jesuit priest, who provides important religious commentary on the epidemic, before falling victim to it and dying. Camus' masterful engagement of the metaphor of isolation and its profound impact on suffering emphasizes the important role of community and spiritual perspectives of patients and providers in coping with serious illness, death, and dying. The Plague is relevant today, particularly given the challenges of distancing, alienation, and isolation imposed by not only disease but also by technology and clinical and administrative practices that have unintended consequences of incentivizing separation between patient and healer, thus engendering greater stress and suffering in both. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  1. Disaster-related injuries and illnesses treated by American Red Cross disaster health services during Hurricanes Gustav and Ike.

    Noe, Rebecca S; Schnall, Amy H; Wolkin, Amy F; Podgornik, Michelle N; Wood, April D; Spears, Jeanne; Stanley, Sharon A R

    2013-01-01

    To describe the injuries and illnesses treated by the American Red Cross (Red Cross) during Hurricanes Gustav and Ike disaster relief operations reported on a new Aggregate Morbidity Report Form. From August 28 to October 18, 2008, 119 Red Cross field service locations in Louisiana, Mississippi, Tennessee, and Texas addressed the healthcare needs of people affected by the hurricanes. From these locations, individual client visit data were retrospectively collated per site onto new 24-hour Aggregate Morbidity Report Forms. A total of 3863 clients were treated. Of the clients, 48% were girls and women and 44% were boys and men; 61% were 19 to 64 years old. Ninety-eight percent of the visits occurred in shelters. The reasons for half of the visits were acute illness and symptoms (eg, pain) and 16% were for routine follow-up care. The majority (65%) of the 2516 visits required treatment at a field location, although 34%, or 1296 visits, required a referral, including 543 healthcare facility transfers. During the hurricanes, a substantial number of displaced evacuees sought care for acute and routine healthcare needs. The capacity of the Red Cross to address the immediate and ongoing health needs of sheltered clients for an extended period of time is a critical resource for local public health agencies, which are often overwhelmed during a disaster. This article highlights the important role that this humanitarian organization fills, to decrease surge to local healthcare systems and to monitor health effects following a disaster. The Aggregate Morbidity Report Form has the potential to assist greatly in this role, and thus its utility for real-time reporting should be evaluated further.

  2. Relative risk of diabetes, dyslipidaemia, hypertension and the metabolic syndrome in people with severe mental illnesses: Systematic review and metaanalysis

    King Michael B

    2008-09-01

    Full Text Available Abstract Background Severe mental illnesses (SMI may be independently associated with cardiovascular risk factors and the metabolic syndrome. We aimed to systematically assess studies that compared diabetes, dyslipidaemia, hypertension and metabolic syndrome in people with and without SMI. Methods We systematically searched MEDLINE, EMBASE, CINAHL & PsycINFO. We hand searched reference lists of key articles. We employed three search main themes: SMI, cardiovascular disease, and each cardiovascular risk factor. We selected cross-sectional, case control, cohort or intervention studies comparing one or more risk factor in both SMI and a reference group. We excluded studies without any reference group. We extracted data on: study design, cardiovascular risk factor(s and their measurement, diagnosis of SMI, study setting, sampling method, nature of comparison group and data on key risk factors. Results Of 14592 citations, 134 papers met criteria and 36 were finally included. 26 reported on diabetes, 12 hypertension, 11 dyslipidaemia, and 4 metabolic syndrome. Most studies were cross sectional, small and several lacked comparison data suitable for extraction. Meta-analysis was possible for diabetes, cholesterol and hypertension; revealing a pooled risk ratio of 1.70 (1.21 to 2.37 for diabetes and 1.11 (0.91 to 1.35 of hypertension. Restricting SMI to schizophreniform illnesses yielded a pooled risk ratio for diabetes of 1.87 (1.68 to 2.09. Total cholesterol was not higher in people with SMI (Standardized Mean Difference -0.10 (-0.55 to 0.36 and there were inconsistent data on HDL, LDL and triglycerides with some, but not all, reporting lower levels of HDL cholesterol and raised triglyceride levels. Metabolic syndrome appeared more common in SMI. Conclusion Diabetes (but not hypertension is more common in SMI. Data on other risk factors were limited by poor quality or inconsistent research findings, but a small number of studies show greater prevalence

  3. Foodborne Illness

    He, Zhan; Liu, Xuan; Li, Renjie

    2008-01-01

    Foodborne illnesses are a significant public health challenge in the world. Preventing foodborne disease in meat processing is an essential point to insure food safety and quality. HACCP systems currently are used for food processor to identify food safety hazards and prevent food is contaminated. By the introducing HACCP system into China in 1990s, Chinese government and enterprises have took more attention to control and monitoring the flow of food to insure food quality in processors. Meat...

  4. Foodborne Illness

    1983-02-01

    contaminate different dietary constituents. These toxins may be of biologic origin (microbial. plant, or animal toxins) or they may be inorganic or...food mine if similar illness has occurred concomitantly poisoning for planning specific therapy, for esti- in companions or family members. Seek to...gin 4 to 8 hours after ingestion of the toxin and speciated botulinum immunoglobulin of equine include severe retching, vomiting, diarrhea, and

  5. An eHealth Application of Self-Reported Sports-Related Injuries and Illnesses in Paralympic Sport: Pilot Feasibility and Usability Study.

    Fagher, Kristina; Jacobsson, Jenny; Dahlström, Örjan; Timpka, Toomas; Lexell, Jan

    2017-11-29

    Sport participation is associated with a risk of sports-related injuries and illnesses, and Paralympic athletes' additional medical issues can be a challenge to health care providers and medical staff. However, few prospective studies have assessed sports-related injuries and illnesses in Paralympic sport (SRIIPS) over time. Advances in mobile phone technology and networking systems offer novel opportunities to develop innovative eHealth applications for collection of athletes' self-reports. Using eHealth applications for collection of self-reported SRIIPS is an unexplored area, and before initiation of full-scale research of SRIIPS, the feasibility and usability of such an approach needs to be ascertained. The aim of this study was to perform a 4-week pilot study and (1) evaluate the monitoring feasibility and system usability of a novel eHealth application for self-reported SRIIPS and (2) report preliminary data on SRIIPS. An eHealth application for routine collection of data from athletes was developed and adapted to Paralympic athletes. A 4-week pilot study was performed where Paralympic athletes (n=28) were asked to weekly self-report sport exposure, training load, general well-being, pain, sleep, anxiety, and possible SRIIPS. The data collection was followed by a poststudy use assessment survey. Quantitative data related to the system use (eg, completed self-reports, missing responses, and errors) were analyzed using descriptive statistics. The qualitative feasibility and usability data provided by the athletes were condensed and categorized using thematic analysis methods. The weekly response rate was 95%. The athletes were of the opinion that the eHealth application was usable and feasible but stated that it was not fully adapted to Paralympic athletes and their impairments. For example, it was difficult to understand how a new injury or illness should be identified when the impairment was involved. More survey items related to the impairments were

  6. An eHealth Application of Self-Reported Sports-Related Injuries and Illnesses in Paralympic Sport: Pilot Feasibility and Usability Study

    2017-01-01

    Background Sport participation is associated with a risk of sports-related injuries and illnesses, and Paralympic athletes’ additional medical issues can be a challenge to health care providers and medical staff. However, few prospective studies have assessed sports-related injuries and illnesses in Paralympic sport (SRIIPS) over time. Advances in mobile phone technology and networking systems offer novel opportunities to develop innovative eHealth applications for collection of athletes’ self-reports. Using eHealth applications for collection of self-reported SRIIPS is an unexplored area, and before initiation of full-scale research of SRIIPS, the feasibility and usability of such an approach needs to be ascertained. Objective The aim of this study was to perform a 4-week pilot study and (1) evaluate the monitoring feasibility and system usability of a novel eHealth application for self-reported SRIIPS and (2) report preliminary data on SRIIPS. Methods An eHealth application for routine collection of data from athletes was developed and adapted to Paralympic athletes. A 4-week pilot study was performed where Paralympic athletes (n=28) were asked to weekly self-report sport exposure, training load, general well-being, pain, sleep, anxiety, and possible SRIIPS. The data collection was followed by a poststudy use assessment survey. Quantitative data related to the system use (eg, completed self-reports, missing responses, and errors) were analyzed using descriptive statistics. The qualitative feasibility and usability data provided by the athletes were condensed and categorized using thematic analysis methods. Results The weekly response rate was 95%. The athletes were of the opinion that the eHealth application was usable and feasible but stated that it was not fully adapted to Paralympic athletes and their impairments. For example, it was difficult to understand how a new injury or illness should be identified when the impairment was involved. More survey items

  7. The role of secure attachment, empathic self-efficacy, and stress perception in causal beliefs related to mental illness – a cross-cultural study: Italy versus Israel

    Mannarini S

    2017-10-01

    Full Text Available Stefania Mannarini,1 Alisa Reikher,1 Sharon Shani,1 Inbal Shani-Zinovich2 1Department of Philosophy, Sociology, Education and Applied Psychology, Interdepartmental Center for Family Research, University of Padova, Padova, Italy; 2Department of Counseling and Human Development, Faculty of Education, University of Haifa, Mount Carmel, Haifa, Israel Background: Research suggests that “mental illness etiological beliefs” and attitudes toward mentally ill people are significantly related; it has also been demonstrated that adult attachment style and empathic self-efficacy affect such attitudes. Moreover, community or regional culture has a significant impact on etiology beliefs and attitudes toward the mentally sick. Materials and methods: We carried out this study in Italy and Israel among psychology students to compare two cultures in regards to causal beliefs of mental disorders and the roles that specific variables, such as secure attachment, empathic self-efficacy, and stress, play in etiological beliefs. The participants (N=305 were students who belonged to two universities: Padua (N=183 and Haifa (N=122. The Many Facet Rasch Model (MFRM was applied in a cross-cultural perspective to analyze the differential functioning of specific etiological beliefs in relation to the above mentioned variables; the effect of gender and religious beliefs was also entered in the MFRM. Results: The two cultures reacted differently to the biogenetic and psychosocial causal explanations of mental disorders: Israeli students endorsed the biogenetic causal beliefs model more frequently than the Italians. Among other findings, concerning the biogenetic model, the Italian students were predominantly males, who declared to be religious and reported lower levels of secure attachment than Israelis. On the other hand, the Israeli students who manifested a preference toward the biogenetic explanation were mostly females, who declared not to be religious and who

  8. Effect of the relative phase of the driving sources on heating of dual frequency capacitive discharges

    Ziegler, Dennis; Trieschmann, Jan; Mussenbrock, Thomas; Brinkmann, Ralf Peter

    2009-10-01

    The influence of the relative phase of the driving voltages on heating in asymmetric dual frequency capacitive discharges is investigated. Basis of the analysis is a recently published global model [1] extended by the possibility to freely adjust the phase angles between the driving voltages. In recent publications it was reported that nonlinear electron resonance heating (NERH) drastically enhances dissipation at moments of sheath collapse due to plasma series resonance (PSR) excitation [2]. This work shows that depending on the relative phase of the driving voltages, the total number and exact moments of sheath collapse can be influenced. In case of a collapse directly being followed by a second collapse ("double collapse") a substantial increase in dissipated power, well above the reported growth due to a single PSR excitation event per period, can be observed.[4pt] [1] D.,iegler, T.,ussenbrock, and R.,. Brinkmann, Phys. Plasmas 16, 023503 (2009)[0pt] [2] T.,ussenbrock, R.,. Brinkmann, M.,. Lieberman, A.,. Lichtenberg, and E. Kawamura, Phys. Rev. Lett. 101, 085004 (2008)

  9. Heat-related inpatient hospitalizations and emergency room visits among California residents, May-September, 2000-2010.

    California Environmental Health Tracking Program — This dataset contains case counts, rates, and confidence intervals of heat-related inpatient hospitalizations and ED visits among California residents for the years...

  10. Boundary conditions, energies and gravitational heat in general relativity (a classical analysis)

    Francaviglia, M; Raiteri, M

    2004-01-01

    The variation of the energy for a gravitational system is directly defined from the Hamiltonian field equations of general relativity. When the variation of the energy is written in a covariant form, it splits into two (covariant) contributions: one of them is the Komar energy, while the other is the so-called covariant ADM correction term. When specific boundary conditions are analysed one sees that the Komar energy is related to the gravitational heat while the ADM correction term plays the role of the Helmholtz free energy. These properties allow one to establish, inside a classical geometric framework, a formal analogy between gravitation and the laws governing the evolution of a thermodynamical system. The analogy applies to stationary spacetimes admitting multiple causal horizons as well as to AdS Taub-bolt solutions

  11. Radiation control report on intermediate heat exchanger replacement and related works

    Kanou, Y.; Yamanaka, T.; Sasajima, T.; Hoshiba, H.; Emori, S.; Shindou, K.

    2002-03-01

    The 13th periodical inspection of the experimental fast reactor JOYO is being made from Jun. 2000 to Jan. 2003. While this inspection, from the end of Oct. 2000 to Nov. 2001, the MK-III modification work on heat transport system was made in lower region of the reactor containment vessel in the reactor facility (under floor area). In the MK-III modification work, the works important to radiation control were the replacement of intermediate heat exchangers (IHXs) and fixtures, and the picking out of the surveillance material from primary heat transport piping carried out in the maintenance building. Because the working areas of these works were executed in small space around the complicated primary heat transport piping, workability was bad and dose rate from the corrosion products (CP) in piping or fixtures was high. In such condition, radiation control was performed mainly concerned about external exposure. The planted total external exposure of the IHX replacement and related works was 7135 man-mSv (target of total dose control: less than 5708 man-mSv, 80% of the plan), derived from special radiation work plants for segmental works, concerned about work procedure, number of workers, period of work, dose rate of working area and surface dose rate of equipments. The special radiation control organization was established for such long and large-scale work. The spatial organization held detailed discussion about radiation control of this work with the execution section and contractors appropriately, performance careful external/internal exposure control and surface contamination control and made efforts to reduce te external exposure thoroughly. As a result of these action, the total external exposure was 2386 man·mSv (≅33% of the plan, ≅42% of the target) and the maximum individual exposure were 24.7 mSv for staffs and 21.7mSv for contractors. The dose rate, surface contamination and air contamination while the works were kept under the control level with the

  12. Prevention of influenza-related illness in young infants by maternal vaccination during pregnancy [version 1; referees: 2 approved

    Marta C Nunes

    2018-01-01

    Full Text Available The influenza virus circulates yearly and causes global epidemics. Influenza infection affects all age groups and causes mild to severe illness, and young infants are at particular risk for serious disease. The most effective measure to prevent influenza disease is vaccination; however, no vaccine is licensed for use in infants younger than 6 months old. Thus, there is a crucial need for other preventive strategies in this high-risk age group. Influenza vaccination during pregnancy protects both the mothers and the young infants against influenza infection. Vaccination during pregnancy boosts the maternal antibodies and increases the transfer of immunoglobulin G from the mother to the fetus through the placenta, which confers protection against infection in infants too young to be vaccinated. Data from clinical trials and observational studies did not demonstrate adverse effects to the mother, the fetus, or the infant after maternal influenza vaccination. We present the current data on the effectiveness and safety of influenza vaccination during pregnancy in preventing disease in the young infant.

  13. Illness Identity in Adults with a Chronic Illness.

    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.

  14. Aging Will Amplify the Heat-related Mortality Risk under a Changing Climate: Projection for the Elderly in Beijing, China

    Li, Tiantian; Horton, Radley M.; Bader, Daniel A.; Zhou, Maigeng; Liang, Xudong; Ban, Jie; Sun, Qinghua; Kinney, Patrick L.

    2016-06-01

    An aging population could substantially enhance the burden of heat-related health risks in a warming climate because of their higher susceptibility to extreme heat health effects. Here, we project heat-related mortality for adults 65 years and older in Beijing China across 31 downscaled climate models and 2 representative concentration pathways (RCPs) in the 2020s, 2050s, and 2080s. Under a scenario of medium population and RCP8.5, by the 2080s, Beijing is projected to experience 14,401 heat-related deaths per year for elderly individuals, which is a 264.9% increase compared with the 1980s. These impacts could be moderated through adaptation. In the 2080s, even with the 30% and 50% adaptation rate assumed in our study, the increase in heat-related death is approximately 7.4 times and 1.3 times larger than in the 1980s respectively under a scenario of high population and RCP8.5. These findings could assist countries in establishing public health intervention policies for the dual problems of climate change and aging population. Examples could include ensuring facilities with large elderly populations are protected from extreme heat (for example through back-up power supplies and/or passive cooling) and using databases and community networks to ensure the home-bound elderly are safe during extreme heat events.

  15. On the use of wearable physiological monitors to assess heat strain during occupational heat stress.

    Notley, Sean R; Flouris, Andreas D; Kenny, Glen P

    2018-05-04

    Workers in many industries are required to perform arduous work in high heat stress conditions, which can lead to rapid increases in body temperature that elevate the risk of heat-related illness or even death. Traditionally, effort to mitigate work-related heat injury has been directed to the assessment of environmental heat stress (e.g., wet-bulb globe temperature), rather than the associated physiological strain responses (e.g., heart rate, skin and core temperatures). However, since a workers physiological response to a given heat stress is modified independently by inter-individual factors (e.g., age, sex, chronic disease, others) and intra-individual factors both within (e.g., medication use, fitness, acclimation and hydration state, others) and beyond a workers control (e.g., shift duration, illness, others), it becomes challenging to protect workers on an individual basis from heat-related injury without assessing those physiological responses. Recent advancements in wearable technology have made it possible to monitor one or more physiological indices of heat strain. Nonetheless, information on the utility of the wearable systems available for assessing occupational heat strain is unavailable. This communication is therefore directed at identifying the physiological indices of heat strain that may be quantified in the workplace and evaluating the wearable monitoring systems available for assessing those responses. Finally, emphasis is directed to the barriers associated with implementing these devices to assist in mitigating work-related heat injury. This information is fundamental for protecting worker health and could also be utilized to prevent heat illnesses in vulnerable people during leisure or athletic activities in the heat.

  16. The relative competitive positions of the alternative means for domestic heating

    Torekov, M.S.; Bahnsen, N.; Qvale, Einar Bjørn

    2007-01-01

    This study strives to clarify to what extent the improved insulation of new buildings affects the economically rational choice of heating supply. In the Danish context, natural gas furnaces show to be economically rational for the society only in few cases. District heating should be advocated only...... for areas with a high concentration of heat demand, primarily areas with apartment buildings. An increased use of heat pumps (HP) should be advocated as the ambient air HP show to be the cheapest of the individual heating systems-and in most cases cheaper than the collective heating systems. The taxation...

  17. Heat recovery apparatus

    McFarland, I.

    1987-01-01

    Heat transfer is a living science and technical advances are constantly being made. However, in many cases, progress is limited by the equipment that is available on the market, rather than by knowledge of the heat transfer process. A case in point is the design of economizers: in such equipment a small quantity of water (with a relatively good heat transfer coefficient) is heated by a large quantity of low-pressure gas (with an inherently low heat transfer coefficient). As a first step in design finned tubing is used to lessen the discrepancy in coefficients. From this point, it becomes apparent that the equipment consists of a small number of tubes (to maintain good velocity on the water side) of considerable length (to provide sufficient area). In the process industries the base pressure, though low, may be in the region of 0.5 bar, and there is no convenient flue in which to place the heat recovery coil. It is therefore contained in a flat-sided enclosure, which is ill-fitted to pressure containment and is therefore reinforced with a plethora of structural sections. Such inelegant construction is quite common in North America; in Europe, cylindrical containments of vast size have been supplied for the same purposes. The real shortcoming is a successful marriage of different disciplines to produce reliable and efficient heat transfer equipment suitably contained

  18. Mortality related to air pollution with the moscow heat wave and wildfire of 2010.

    Shaposhnikov, Dmitry; Revich, Boris; Bellander, Tom; Bedada, Getahun Bero; Bottai, Matteo; Kharkova, Tatyana; Kvasha, Ekaterina; Lezina, Elena; Lind, Tomas; Semutnikova, Eugenia; Pershagen, Göran

    2014-05-01

    Prolonged high temperatures and air pollution from wildfires often occur together, and the two may interact in their effects on mortality. However, there are few data on such possible interactions. We analyzed day-to-day variations in the number of deaths in Moscow, Russia, in relation to air pollution levels and temperature during the disastrous heat wave and wildfire of 2010. Corresponding data for the period 2006-2009 were used for comparison. Daily average levels of PM10 and ozone were obtained from several continuous measurement stations. The daily number of nonaccidental deaths from specific causes was extracted from official records. Analyses of interactions considered the main effect of temperature as well as the added effect of prolonged high temperatures and the interaction with PM10. The major heat wave lasted for 44 days, with 24-hour average temperatures ranging from 24°C to 31°C and PM10 levels exceeding 300 μg/m on several days. There were close to 11,000 excess deaths from nonaccidental causes during this period, mainly among those older than 65 years. Increased risks also occurred in younger age groups. The most pronounced effects were for deaths from cardiovascular, respiratory, genitourinary, and nervous system diseases. Continuously increasing risks following prolonged high temperatures were apparent during the first 2 weeks of the heat wave. Interactions between high temperatures and air pollution from wildfires in excess of an additive effect contributed to more than 2000 deaths. Interactions between high temperatures and wildfire air pollution should be considered in risk assessments regarding health consequences of climate change.

  19. Chronic Illness & Mental Health

    ... increased risk of cardiovascular disease, diabetes, stroke, and Alzheimer’s disease, for example. Research also suggests that people with depression are at higher risk for osteoporosis relative to others. The reasons are not yet clear. One factor with some of these illnesses is that many ...

  20. Foodborne Illness Retrospective

    2015-05-07

    Dr. Paul Mead and Dr. Peter Drotman discuss the historic October 1999 article, Food-related Illness and Death in the United States.  Created: 5/7/2015 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 5/7/2015.

  1. Dehydration, Heat Stroke, or Hyponatremia? The Recognition, Treatment, and Prevention of Hyponatremia Caused by High Exercise Outdoor Activities.

    Cochran, Brent

    Hyponatremia (severe sodium depletion) has symptoms similar to heat exhaustion and heat stroke and can easily be misdiagnosed. The number of wilderness users and extreme adventure activities has increased in recent years, and more cases are being diagnosed. Given that a 1993 study found that 1 in 10 cases of heat-related illnesses were…

  2. Health-related quality of life of young people with long-term illnesses before and after transfer from child to adult healthcare.

    While, A E; Heery, E; Sheehan, A M; Coyne, I

    2017-01-01

    The numbers of children with long-term illnesses surviving into adulthood and transferring from child to adult services has increased dramatically in the last 30 years. This study aimed to examine health-related quality of life pre- and post-transfer from child to adult healthcare for young people with three long-term illnesses. A total of 217 young people with cystic fibrosis, congenital heart defects or diabetes attending child and adult hospital services in Dublin, Ireland completed a questionnaire survey. Multiple linear regression was used to identify predictors of five dimensions of health-related quality of life pre- and post-transfer. Post-transfer young people with congenital heart disease and diabetes reported significantly lower physical well-being than their pre-transfer counterparts. Pre-transfer young people with cystic fibrosis reported significantly lower physical well-being than those with diabetes, but there was no significant difference post-transfer. Pre-transfer females reported lower scores than males on the Psychological Well-being and Autonomy and Parent Relation dimensions; however, these differences disappeared post-transfer. Higher maternal overprotection scores were associated with significantly lower scores on the Psychological Well-being, Autonomy and Parent Relation, and Social Support and Peers dimensions, regardless of transfer status. Disease group, gender and maternal overprotection were predictors of health-related quality of life pre- and post-transfer from child to adult healthcare. Transition programmes should promote self-management and discourage parental overprotection. © 2016 John Wiley & Sons Ltd.

  3. Severe vitamin D deficiency upon admission in critically ill patients is related to acute kidney injury and a poor prognosis.

    Zapatero, A; Dot, I; Diaz, Y; Gracia, M P; Pérez-Terán, P; Climent, C; Masclans, J R; Nolla, J

    2018-05-01

    To evaluate the prevalence of vitamin D deficiency in critically ill patients upon admission to an Intensive Care Unit (ICU) and its prognostic implications. A single-center, prospective observational study was carried out from January to November 2015. Patients were followed-up on until death or hospital discharge. The department of Critical Care Medicine of a university hospital. All adults admitted to the ICU during the study period, without known factors capable of altering serum 25(OH)D concentration. Determination of serum 25(OH)D levels within the first 24h following admission to the ICU. Prevalence and mortality at 28 days. The study included 135 patients, of which 74% presented deficient serum 25(OH)D levels upon admission to the ICU. Non-survivors showed significantly lower levels than survivors (8.14ng/ml [6.17-11.53] vs. 12ng/ml [7.1-20.30]; P=.04], and the serum 25(OH)D levels were independently associated to mortality (OR 2.86; 95% CI 1.05-7.86; P=.04]. The area under the ROC curve was 0.61 (95% CI 0.51-0.75), and the best cut-off point for predicting mortality was 10.9ng/ml. Patients with serum 25(OH)D<10.9ng/ml also showed higher acute kidney injury rates (13 vs. 29%; P=.02). Vitamin D deficiency is highly prevalent upon admission to the ICU. Severe Vitamin D deficiency (25[OH]D<10.9ng/ml) upon admission to the ICU is associated to acute kidney injury and mortality. Copyright © 2017 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  4. Heat shock protein 10 (Hsp10) in immune-related diseases: one coin, two sides

    Jia, Haibo; Halilou, Amadou I.; Hu, Liang; Cai, Wenqian; Liu, Jing; Huang, Bo

    2011-01-01

    Heat shock protein 10 (Hsp10) in eukaryotes, originally identified as a mitochondrial chaperone, now is also known to be present in cytosol, cell surface, extracellular space and peripheral blood. Functionally besides participating in mitochondrial protein folding in association with Hsp60, Hsp10 appears to be related to pregnancy, cancer and autoimmune inhibition. Hsp10 can be released to peripheral blood at very early time point of pregnancy and given another name called early pregnancy factor (EPF), which seems to play a critical role in developing a pregnant niche. In malignant disorders, Hsp10 is usually abnormally expressed in the cytosol of malignant cells and further released to extracellular space, resulting in tumor-promoting effect from various aspects. Furthermore, distinct from other heat shock protein members, whose soluble form is recognized as danger signal by immune cells and triggers immune responses, Hsp10 after release, however, is designed to be an inhibitory signal by limiting immune response. This review discusses how Hsp10 participates in various physiological and pathological processes from basic protein molecule folding to pregnancy, cancer and autoimmune diseases, and emphasizes how important the location is for the function exertion of a molecule. PMID:21969171

  5. Temperature and Heat-Related Mortality Trends in the Sonoran and Mojave Desert Region

    Polioptro F. Martinez-Austria

    2017-03-01

    Full Text Available Extreme temperatures and heat wave trends in five cities within the Sonoran Desert region (e.g., Tucson and Phoenix, Arizona, in the United States and Ciudad Obregon and San Luis Rio Colorado, Sonora; and Mexicali, Baja California, in Mexico and one city within the Mojave Desert region (e.g., Las Vegas, Nevada were assessed using field data collected from 1950 to 2014. Instead of being selected by watershed, the cities were selected because they are part of the same arid climatic region. The data were analyzed for maximum temperature increases and the trends were confirmed statistically using Spearman’s nonparametric test. Temperature trends were correlated with the mortality information related with extreme heat events in the region. The results showed a clear trend of increasing maximum temperatures during the months of June, July, and August for five of the six cities and statically confirmed using Spearman’s rho values. Las Vegas was the only city where the temperature increase was not confirmed using Spearman’s test, probably because it is geographically located outside of the Sonoran Desert or because of its proximity to the Hoover Dam. The relationship between mortality and temperature was analyzed for the cities of Mexicali, Mexico and Phoenix. Arizona.

  6. Calculation of the yearly energy performance of heating systems based on the European Building Energy Directive and related CEN Standards

    Olesen, Bjarne W.; de Carli, Michele

    2011-01-01

    According to the Energy Performance of Buildings Directive (EPBD) all new European buildings (residential, commercial, industrial, etc.) must since 2006 have an energy declaration based on the calculated energy performance of the building, including heating, ventilating, cooling and lighting syst......–20% of the building energy demand. The additional loss depends on the type of heat emitter, type of control, pump and boiler. Keywords: Heating systems; CEN standards; Energy performance; Calculation methods......According to the Energy Performance of Buildings Directive (EPBD) all new European buildings (residential, commercial, industrial, etc.) must since 2006 have an energy declaration based on the calculated energy performance of the building, including heating, ventilating, cooling and lighting...... systems. This energy declaration must refer to the primary energy or CO2 emissions. The European Organization for Standardization (CEN) has prepared a series of standards for energy performance calculations for buildings and systems. This paper presents related standards for heating systems. The relevant...

  7. Nutrition-related risk indexes and long-term mortality in noncritically ill inpatients who receive total parenteral nutrition (prospective multicenter study).

    Tapia, María José; Ocón, Julia; Cabrejas-Gómez, Carmen; Ballesteros-Pomar, María D; Vidal-Casariego, Alfonso; Arraiza-Irigoyen, Carmen; Olivares, Josefina; Conde-García, Ma Carmen; García-Manzanares, Álvaro; Botella-Romero, Francisco; Quílez-Toboso, Rosa P; Cabrerizo, Lucio; Rubio, Miguel A; Chicharro, Luisa; Burgos, Rosa; Pujante, Pedro; Ferrer, Mercedes; Zugasti, Ana; Petrina, Estrella; Manjón, Laura; Diéguez, Marta; Carrera, Ma José; Vila-Bundo, Anna; Urgelés, Juan Ramón; Aragón-Valera, Carmen; Sánchez-Vilar, Olga; Bretón, Irene; García-Peris, Pilar; Muñoz-Garach, Araceli; Márquez, Efren; del Olmo, Dolores; Pereira, José Luis; Tous, María C; Olveira, Gabriel

    2015-10-01

    Malnutrition in hospitalized patients is associated with an increased risk of death, in both the short and the long term. The purpose of this study was to determine which nutrition-related risk index predicts long-term mortality better (three years) in patients who receive total parenteral nutrition (TPN). This prospective, multicenter study involved noncritically ill patients who were prescribed TPN during hospitalization. Data were collected on Subjective Global Assessment (SGA), Nutritional Risk Index (NRI), Geriatric Nutritional Risk Index (GNRI), body mass index, albumin and prealbumin, as well as long-term mortality. Over the 1- and 3-year follow-up periods, 174 and 244 study subjects (28.8% and 40.3%) respectively, died. Based on the Cox proportional hazards survival model, the nutrition-related risk indexes most strongly associated with mortality were SGA and albumin (Nutrition and Metabolism. All rights reserved.

  8. Evaporative cooling: Effective latent heat of evaporation in relation to evaporation distance from the skin

    Havenith, G.; Bröde, P.; Hartog, E.A. den; Kuklane, K.; Holmer, I.; Rossi, R.M.; Richards, M.; Farnworth, B.; Wang, X.

    2013-01-01

    Calculation of evaporative heat loss is essential to heat balance calculations. Despite recognition that the value for latent heat of evaporation, used in these calculations, may not always reflect the real cooling benefit to the body, only limited quantitative data on this is available, which has

  9. Medical screening and evaluation for heat stress

    Kenney, L.W.

    1985-01-01

    Wide interindividual variation exists with respect to heat tolerance, making it difficult to predict individual responses. However, several general physical and physiological characteristics are associated with excessive strain and early exhaustion during work in the heat. Included among these correlates of heat intolerance are a medical history of heat illness, acclimation state, age, body composition and size, aerobic fitness level, hypertension, and drug and alcohol use. The approach of choice for medical evaluation for heat exposure is a two-stage evaluation. First, the examining physician should be encouraged to screen out those workers whose characteristics increase their risk of heat intolerance. Secondly, a short exercise test is proposed which accurately predicts relative heat tolerance across a working population. This test is recommended as an adjunct screening test at the examining physician's disgression

  10. Surgical nurses' work-related stress when caring for severely ill and dying patients in cancer after participating in an educational intervention on existential issues.

    Udo, Camilla; Danielson, Ella; Henoch, Ingela; Melin-Johansson, Christina

    2013-10-01

    The aim of this study was to describe surgical nurses' perceived work-related stress in the care of severely ill and dying patients with cancer after participating in an educational intervention on existential issues. This article reports a mixed methods pilot study of an education programme consisting of lectures and supervised discussions conducted in 2009-2010 in three surgical wards in a county hospital in Sweden. The concurrent data collections consisted of repeated interviews with eleven nurses in an educational group, and questionnaires were distributed to 42 nurses on four occasions. Directly after the educational intervention, the nurses described working under high time pressure. They also described being hindered in caring because of discrepancies between their caring intentions and what was possible in the surgical care context. Six months later, the nurses described a change in decision making, and a shift in the caring to make it more in line with their own intentions and patients' needs rather than the organizational structure. They also reported decreased feelings of work-related stress, decreased stress associated with work-load and feeling less disappointed at work. Results indicate that it may be possible to influence nurses' work-related stress through an educational intervention. According to nurses' descriptions, reflecting on their ways of caring for severely ill and dying patients, many of whom had cancer, from an existential perspective, had contributed to enhanced independent decision making in caring. This in turn appears to have decreased their feelings of work-related stress and disappointment at work. Copyright © 2013 Elsevier Ltd. All rights reserved.

  11. Diabetic status and the relation of the three domains of glycemic control to mortality in critically ill patients: an international multicenter cohort study.

    Krinsley, James S; Egi, Moritoki; Kiss, Alex; Devendra, Amin N; Schuetz, Philipp; Maurer, Paula M; Schultz, Marcus J; van Hooijdonk, Roosmarijn T M; Kiyoshi, Morita; Mackenzie, Iain M J; Annane, Djillali; Stow, Peter; Nasraway, Stanley A; Holewinski, Sharon; Holzinger, Ulrike; Preiser, Jean-Charles; Vincent, Jean-Louis; Bellomo, Rinaldo

    2013-03-01

    Hyperglycemia, hypoglycemia, and increased glycemic variability have each been independently associated with increased risk of mortality in critically ill patients. The role of diabetic status on modulating the relation of these three domains of glycemic control with mortality remains uncertain. The purpose of this investigation was to determine how diabetic status affects the relation of hyperglycemia, hypoglycemia, and increased glycemic variability with the risk of mortality in critically ill patients. This is a retrospective analysis of prospectively collected data involving 44,964 patients admitted to 23 intensive care units (ICUs) from nine countries, between February 2001 and May 2012. We analyzed mean blood glucose concentration (BG), coefficient of variation (CV), and minimal BG and created multivariable models to analyze their independent association with mortality. Patients were stratified according to the diagnosis of diabetes. Among patients without diabetes, mean BG bands between 80 and 140 mg/dl were independently associated with decreased risk of mortality, and mean BG bands>or=140 mg/dl, with increased risk of mortality. Among patients with diabetes, mean BG from 80 to 110 mg/dl was associated with increased risk of mortality and mean BG from 110 to 180 mg/dl with decreased risk of mortality. An effect of center was noted on the relation between mean BG and mortality. Hypoglycemia, defined as minimum BGor=20%, was independently associated with increased risk of mortality only among patients without diabetes. Derangements of more than one domain of glycemic control had a cumulative association with mortality, especially for patients without diabetes. Although hyperglycemia, hypoglycemia, and increased glycemic variability is each independently associated with mortality in critically ill patients, diabetic status modulates these relations in clinically important ways. Our findings suggest that patients with diabetes may benefit from higher glucose

  12. Health-related quality of life for pediatric emergency department febrile illnesses: an Evaluation of the Pediatric Quality of Life Inventory™ 4.0 generic core scales

    Stevens Molly W

    2009-01-01

    Full Text Available Abstract Objective We sought to assess the validity and short-term responsiveness of the Pediatric Quality of Life Inventory™ 4.0 Generic Core Scales (PedsQL™ for febrile illnesses evaluated in the pediatric emergency department (ED. Design Prospective cohort study of children 2–18 years discharged after ED evaluation for fever (≥ 38°C. Self-administered, parent-report of health-related quality of life (HRQOL was assessed using the PedsQL™ Acute Version, a validated HRQOL instrument. HRQOL was measured on ED presentation and at 7–10 day follow-up. At follow-up, duration of fever, child functional impairment, missed daycare/school, and disrupted family unit functioning, were assessed. Results Of 160 subjects enrolled, 97 (61% completed the study; mean follow-up was 8.7 days. Mean total HRQOL score on ED presentation was 76.4; mean follow-up score was 86.3. Compared to subjects that returned to baseline, statistically significant differences in HRQOL were noted for those with prolonged fever, child functional impairment, and relapse. Significant correlation was observed between HRQOL at follow-up and days of daycare/school missed (r = -0.35, p = .003 and days of family disruption (r = -0.43, p Conclusion The PedsQL™ appears to be a valid and responsive indicator of HRQOL for short-term febrile illnesses evaluated in the ED.

  13. Heat Stress Affects Pi-related Genes Expression and Inorganic Phosphate Deposition/Accumulation in Barley

    Pacak, Andrzej; Barciszewska-Pacak, Maria; Swida-Barteczka, Aleksandra

    2016-01-01

    Phosphorus (P) in plants is taken from soil as an inorganic phosphate (Pi) and is one of the most important macroelements in growth and development. Plants actively react to Pi starvation by the induced expression of Pi transporters, MIR399, MIR827, and miR399 molecular sponge - IPS1 genes...... and by the decreased expression of the ubiquitin-conjugating enzyme E2 (PHOSPHATE2 - PHO2) and Pi sensing and transport SPX-MFS genes. The PHO2 protein is involved in the degradation of Pi transporters PHT1;1 (from soil to roots) and PHO1 (from roots to shoots). The decreased expression of PHO2 leads to Pi....... In shoots, the PHO2 mRNA level is decreased, leading to an increased Pi level. We concluded that Pi homeostasis in barley during heat stress is maintained by dynamic changes in Pi-related genes expression....

  14. Correlates of Illness Severity in Infectious Mononucleosis

    John Odame

    2014-01-01

    Full Text Available INTRODUCTION: Understanding the spectrum and frequencies of Epstein-Barr virus (EBV complications and markers of illness severity in immunocompetent patients with primary EBV infection will inform management of patients with EBV-related illnesses.

  15. Diurnal variation in heat production related to some physical activities in laying hens.

    Li, Y Z; Ito, T; Yamamoto, S

    1991-09-01

    1. Heat production, standing and eating activities, and hourly food intake of 4 laying hens were observed simultaneously and the effects of activity and food intake on heat production were studied. 2. Average heat production during the dark period (20.00 to 06.00 h) was 18.9 kJ/kgW0.75 h which was 33% lower than that during the light period. About 76% of the light-dark difference in the rate of heat production was probably associated with activity and posture. 3. Standing time, which included a range of behavioural activities, occupied 90% of the light period and the increased rate of heat production associated with standing was estimated to be about 18% of daily heat production. 4. Eating time occupied 40% of the light period; the heat production associated with eating activity represented about 5% of daily heat production or 3% of ME intake. 5. Because the regression of heat production on time spent eating agreed with the regression of heat production on hourly food intake, it is suggested that the energy expenditure associated with ad libitum feeding can be estimated for hens from the regression of heat production on hourly food intake.

  16. Relations between the efficiency, power and dissipation for linear irreversible heat engine at maximum trade-off figure of merit

    Iyyappan, I.; Ponmurugan, M.

    2018-03-01

    A trade of figure of merit (\\dotΩ ) criterion accounts the best compromise between the useful input energy and the lost input energy of the heat devices. When the heat engine is working at maximum \\dotΩ criterion its efficiency increases significantly from the efficiency at maximum power. We derive the general relations between the power, efficiency at maximum \\dotΩ criterion and minimum dissipation for the linear irreversible heat engine. The efficiency at maximum \\dotΩ criterion has the lower bound \

  17. Embarrassment When Illness Strikes A Close Relative: A World Mental Health Survey Consortium Multi-Site Study

    Ahmedani, Brian K.; Kubiak, Sheryl Pimlott; Kessler, Ronald C.; de Graaf, Ron; Alonso, Jordi; Bruffaerts, Ronny; Zarkov, Zahari; Viana, Maria Carmen; Huang, Y.Q.; Hu, Chiyi; Posada-Villa, Jose A.; Lepine, Jean-Pierre; Angermeyer, Matthias C.; de Girolamo, Giovanni; Karam, Aimee N.; Medina-Mora, Maria Elena; Gureje, Oye; Ferry, Finola; Sagar, Rajesh; Anthony, James C.

    2014-01-01

    Background This global study seeks to estimate the degree to which a family member might feel embarrassed when a close relative is suffering from an alcohol, drug, or mental health condition (ADMC) versus a general medical condition (GMC). To date, most studies have considered embarrassment and stigma in society and internalized by the afflicted individual, but have not assessed family embarrassment in a large scale study. Method In 16 sites of the World Mental Health Surveys (WMHS), standardized assessments were completed including items on family embarrassment. Site matching was used to constrain local socially shared determinants of stigma-related feelings, enabling a conditional logistic regression model that estimates the embarrassment close relatives may hold in relation to family members affected by an ADMC, GMC, or both conditions. Results There was a statistically robust association such that subgroups with an ADMC-affected relative were more likely to feel embarrassed as compared to subgroups with a relative affected by a GMC (p<0.001), even with covariate adjustments for age and sex. Conclusions The pattern of evidence from this research is consistent with conceptual models for interventions that target individual- and family-level stigma-related feelings of embarrassment as might be part of the obstacles to effective early intervention and treatment for ADMC conditions. Macro-level interventions are underway, but micro-level interventions also may be required among family members, along with care for each person with an ADMC. PMID:23298443

  18. Aging Will Amplify the Heat-Related Mortality Risk Under a Changing Climate: Projection for the Elderly in Beijing, China

    Li, Tiantian; Horton, Radley M.; Bader, Daniel A.; Zhou, Maigeng; Liang, Xudong; Ban, Jie; Sun, Qinghua; Kinney, Patrick L.

    2016-01-01

    An aging population could substantially enhance the burden of heat-related health risks in a warming climate because of their higher susceptibility to extreme heat health effects. Here, we project heatrelated mortality for adults 65 years and older in Beijing China across 31 downscaled climate models and 2 representative concentration pathways (RCPs) in the 2020s, 2050s, and 2080s. Under a scenario of medium population and RCP8.5, by the 2080s, Beijing is projected to experience 14,401 heat-related deaths per year for elderly individuals, which is a 264.9% increase compared with the 1980s. These impacts could be moderated through adaptation. In the 2080s, even with the 30% and 50% adaptation rate assumed in our study, the increase in heat-related death is approximately 7.4 times and 1.3 times larger than in the 1980s respectively under a scenario of high population and RCP8.5. These findings could assist countries in establishing public health intervention policies for the dual problems of climate change and aging population. Examples could include ensuring facilities with large elderly populations are protected from extreme heat (for example through back-up power supplies and/or passive cooling) and using databases and community networks to ensure the home-bound elderly are safe during extreme heat events.

  19. Changes in relative fit of human heat stress indices to cardiovascular, respiratory, and renal hospitalizations across five Australian urban populations

    Goldie, James; Alexander, Lisa; Lewis, Sophie C.; Sherwood, Steven C.; Bambrick, Hilary

    2018-03-01

    Various human heat stress indices have been developed to relate atmospheric measures of extreme heat to human health impacts, but the usefulness of different indices across various health impacts and in different populations is poorly understood. This paper determines which heat stress indices best fit hospital admissions for sets of cardiovascular, respiratory, and renal diseases across five Australian cities. We hypothesized that the best indices would be largely dependent on location. We fit parent models to these counts in the summers (November-March) between 2001 and 2013 using negative binomial regression. We then added 15 heat stress indices to these models, ranking their goodness of fit using the Akaike information criterion. Admissions for each health outcome were nearly always higher in hot or humid conditions. Contrary to our hypothesis that location would determine the best-fitting heat stress index, we found that the best indices were related largely by health outcome of interest, rather than location as hypothesized. In particular, heatwave and temperature indices had the best fit to cardiovascular admissions, humidity indices had the best fit to respiratory admissions, and combined heat-humidity indices had the best fit to renal admissions. With a few exceptions, the results were similar across all five cities. The best-fitting heat stress indices appear to be useful across several Australian cities with differing climates, but they may have varying usefulness depending on the outcome of interest. These findings suggest that future research on heat and health impacts, and in particular hospital demand modeling, could better reflect reality if it avoided "all-cause" health outcomes and used heat stress indices appropriate to specific diseases and disease groups.

  20. Changes in relative fit of human heat stress indices to cardiovascular, respiratory, and renal hospitalizations across five Australian urban populations.

    Goldie, James; Alexander, Lisa; Lewis, Sophie C; Sherwood, Steven C; Bambrick, Hilary

    2018-03-01

    Various human heat stress indices have been developed to relate atmospheric measures of extreme heat to human health impacts, but the usefulness of different indices across various health impacts and in different populations is poorly understood. This paper determines which heat stress indices best fit hospital admissions for sets of cardiovascular, respiratory, and renal diseases across five Australian cities. We hypothesized that the best indices would be largely dependent on location. We fit parent models to these counts in the summers (November-March) between 2001 and 2013 using negative binomial regression. We then added 15 heat stress indices to these models, ranking their goodness of fit using the Akaike information criterion. Admissions for each health outcome were nearly always higher in hot or humid conditions. Contrary to our hypothesis that location would determine the best-fitting heat stress index, we found that the best indices were related largely by health outcome of interest, rather than location as hypothesized. In particular, heatwave and temperature indices had the best fit to cardiovascular admissions, humidity indices had the best fit to respiratory admissions, and combined heat-humidity indices had the best fit to renal admissions. With a few exceptions, the results were similar across all five cities. The best-fitting heat stress indices appear to be useful across several Australian cities with differing climates, but they may have varying usefulness depending on the outcome of interest. These findings suggest that future research on heat and health impacts, and in particular hospital demand modeling, could better reflect reality if it avoided "all-cause" health outcomes and used heat stress indices appropriate to specific diseases and disease groups.

  1. Inactivation of GABAA receptor is related to heat shock stress response in organism model Caenorhabditis elegans.

    Camargo, Gabriela; Elizalde, Alejandro; Trujillo, Xochitl; Montoya-Pérez, Rocío; Mendoza-Magaña, María Luisa; Hernandez-Chavez, Abel; Hernandez, Leonardo

    2016-09-01

    The mechanisms underlying oxidative stress (OS) resistance are not completely clear. Caenorhabditis elegans (C. elegans) is a good organism model to study OS because it displays stress responses similar to those in mammals. Among these mechanisms, the insulin/IGF-1 signaling (IIS) pathway is thought to affect GABAergic neurotransmission. The aim of this study was to determine the influence of heat shock stress (HS) on GABAergic activity in C. elegans. For this purpose, we tested the effect of exposure to picrotoxin (PTX), gamma-aminobutyric acid (GABA), hydrogen peroxide, and HS on the occurrence of a shrinking response (SR) after nose touch stimulus in N2 (WT) worms. Moreover, the effect of HS on the expression of UNC-49 (GABAA receptor ortholog) in the EG1653 strain and the effect of GABA and PTX exposure on HSP-16.2 expression in the TJ375 strain were analyzed. PTX 1 mM- or H2O2 0.7 mM-exposed worms displayed a SR in about 80 % of trials. GABA exposure did not cause a SR. HS prompted the occurrence of a SR as did PTX 1 mM or H2O2 0.7 mM exposure. In addition, HS increased UNC-49 expression, and PTX augmented HSP-16.2 expression. Thus, the results of the present study suggest that oxidative stress, through either H2O2 exposure or application of heat shock, inactivates the GABAergic system, which subsequently would affect the oxidative stress response, perhaps by enhancing the activity of transcription factors DAF-16 and HSF-1, both regulated by the IIS pathway and related to hsp-16.2 expression.

  2. Do single and partnered women with gynecologic cancer differ in types and intensities of illness- and treatment-related psychosocial concerns? A pilot study.

    de Groot, Janet M; Mah, Kenneth; Fyles, Anthony; Winton, Susan; Greenwood, Sarah; DePetrillo, Denny; Devins, Gerald M

    2007-09-01

    We compared the psychosocial and psychosexual concerns of single and partnered women with gynecologic cancer, since relationship status and psychosocial context are known to affect sexuality, a life domain commonly affected by this cancer. A cross-sectional convenience sample of 49 women (68% response), with ovarian (n=31), endometrial (n=12), and cervical (n=6) cancer, responded to a 72-item self-report Cancer Concerns Questionnaire and additional psychosocial questionnaires. Single (n=13) and partnered women (n=36) similarly reported prognosis as their highest concern, but single women (26% of the sample) reported that communication with the treatment team, treatment side effects, and prognosis were of greater salience to them than did partnered women. The latter group had greater sexuality and partner relationship concerns. These preliminary findings suggest that relationship status, whether partnered or single, influences current psychosocial concerns among women with gynecologic cancer, despite similar levels of illness- and treatment-related intrusions on important life domains.

  3. Taking cognizance of mental illness in schizophrenics and its association with crime and substance-related diagnoses.

    Munkner, R; Haastrup, S; Jørgensen, T; Andreasen, A H; Kramp, P

    2003-02-01

    To analyse how committed crimes and substance-related diagnoses are associated with the age on the first contact with the psychiatric hospital system and the age at diagnosing of schizophrenia among schizophrenics. In a register-based study including all Danes diagnosed with schizophrenia born after November 1, 1963, data on criminality, substance-related diagnoses and contacts with the psychiatric hospital system were analysed. Compared with the non-convicted schizophrenics the convicted were older on first contact with the psychiatric hospital system and older when the diagnosis of schizophrenia was first given. In contrast, having a substance-related diagnosis was associated with a younger age on first contact but did not influence the age at which the diagnosis of schizophrenia was given. It is important that both psychiatrists and the judicial system are aware of possible psychotic symptoms in criminal and abusing individuals to enable earlier detection and treatment.

  4. Illness perceptions among cancer survivors.

    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.

  5. Heat Stroke

    Mørch, Sofie Søndergaard; Andersen, Johnny Dohn Holmgren; Bestle, Morten Heiberg

    2017-01-01

    not diagnosed until several days after admittance; hence treatment with cooling was delayed. Both patients were admitted to the intensive care unit, where they were treated with an external cooling device and received treatment for complications. Both cases ended fatally. As global warming continues, more heat......Heat stroke is an acute, life-threatening emergency characterized clinically by elevated body temperature and central nervous system dysfunction. Early recognition and treatment including aggressive cooling and management of life-threatening systemic complications are essential to reduce morbidity...... and mortality. This case report describes two Danish patients diagnosed with heat stroke syndrome during a heat wave in the summer of 2014. Both patients were morbidly obese and had several predisposing illnesses. However since heat stroke is a rare condition in areas with temperate climate, they were...

  6. Taking cognizance of mental illness in schizophrenics and its association with crime and substance-related diagnoses

    Munkner, R; Haastrup, S; Jørgensen, T

    2003-01-01

    with schizophrenia born after November 1, 1963, data on criminality, substance-related diagnoses and contacts with the psychiatric hospital system were analysed. RESULTS: Compared with the non-convicted schizophrenics the convicted were older on first contact with the psychiatric hospital system and older when...... are aware of possible psychotic symptoms in criminal and abusing individuals to enable earlier detection and treatment....

  7. Taking cognizance of mental illness in schizophrenics and its association with crime and substance-related diagnoses

    Munkner, R; Haastrup, S; Jørgensen, T

    2003-01-01

    OBJECTIVE: To analyse how committed crimes and substance-related diagnoses are associated with the age on the first contact with the psychiatric hospital system and the age at diagnosing of schizophrenia among schizophrenics. METHOD: In a register-based study including all Danes diagnosed with sc...

  8. Taking cognizance of mental illness in schizophrenics and its association with crime and substance-related diagnoses

    Munkner, R; Haastrup, S; Jørgensen, T

    2003-01-01

    the diagnosis of schizophrenia was first given. In contrast, having a substance-related diagnosis was associated with a younger age on first contact but did not influence the age at which the diagnosis of schizophrenia was given. CONCLUSION: It is important that both psychiatrists and the judicial system...

  9. Adaptation to Climate Change: A Comparative Analysis of Modeling Methods for Heat-Related Mortality.

    Gosling, Simon N; Hondula, David M; Bunker, Aditi; Ibarreta, Dolores; Liu, Junguo; Zhang, Xinxin; Sauerborn, Rainer

    2017-08-16

    Multiple methods are employed for modeling adaptation when projecting the impact of climate change on heat-related mortality. The sensitivity of impacts to each is unknown because they have never been systematically compared. In addition, little is known about the relative sensitivity of impacts to "adaptation uncertainty" (i.e., the inclusion/exclusion of adaptation modeling) relative to using multiple climate models and emissions scenarios. This study had three aims: a ) Compare the range in projected impacts that arises from using different adaptation modeling methods; b ) compare the range in impacts that arises from adaptation uncertainty with ranges from using multiple climate models and emissions scenarios; c ) recommend modeling method(s) to use in future impact assessments. We estimated impacts for 2070-2099 for 14 European cities, applying six different methods for modeling adaptation; we also estimated impacts with five climate models run under two emissions scenarios to explore the relative effects of climate modeling and emissions uncertainty. The range of the difference (percent) in impacts between including and excluding adaptation, irrespective of climate modeling and emissions uncertainty, can be as low as 28% with one method and up to 103% with another (mean across 14 cities). In 13 of 14 cities, the ranges in projected impacts due to adaptation uncertainty are larger than those associated with climate modeling and emissions uncertainty. Researchers should carefully consider how to model adaptation because it is a source of uncertainty that can be greater than the uncertainty in emissions and climate modeling. We recommend absolute threshold shifts and reductions in slope. https://doi.org/10.1289/EHP634.

  10. Lung Microbiota Is Related to Smoking Status and to Development of Acute Respiratory Distress Syndrome in Critically Ill Trauma Patients.

    Panzer, Ariane R; Lynch, Susan V; Langelier, Chaz; Christie, Jason D; McCauley, Kathryn; Nelson, Mary; Cheung, Christopher K; Benowitz, Neal L; Cohen, Mitchell J; Calfee, Carolyn S

    2018-03-01

    Cigarette smoking is associated with increased risk of acute respiratory distress syndrome (ARDS) in patients after severe trauma; however, the mechanisms underlying this association are unknown. To determine whether cigarette smoking contributes to ARDS development after trauma by altering community composition of the lung microbiota. We studied the lung microbiota of mechanically ventilated patients admitted to the ICU after severe blunt trauma. To do so, we used 16S ribosomal RNA gene amplicon sequencing of endotracheal aspirate samples obtained on ICU admission (n = 74) and at 48 hours after admission (n = 30). Cigarette smoke exposure (quantified using plasma cotinine), ARDS development, and other clinical parameters were correlated with lung microbiota composition. Smoking status was significantly associated with lung bacterial community composition at ICU admission (P = 0.007 by permutational multivariate ANOVA [PERMANOVA]) and at 48 hours (P = 0.03 by PERMANOVA), as well as with significant enrichment of potential pathogens, including Streptococcus, Fusobacterium, Prevotella, Haemophilus, and Treponema. ARDS development was associated with lung community composition at 48 hours (P = 0.04 by PERMANOVA) and was characterized by relative enrichment of Enterobacteriaceae and of specific taxa enriched at baseline in smokers, including Prevotella and Fusobacterium. After severe blunt trauma, a history of smoking is related to lung microbiota composition, both at the time of ICU admission and at 48 hours. ARDS development is also correlated with respiratory microbial community structure at 48 hours and with taxa that are relatively enriched in smokers at ICU admission. The data derived from this pilot study suggest that smoking-related changes in the lung microbiota could be related to ARDS development after severe trauma.

  11. DEVELOPMENT OF THE HEAT PUMP MARKET IN POLAND IN RELATION TO NEW LEGAL REGULATIONS

    Anna Wachowicz-Pyzik

    2015-10-01

    Full Text Available Heat pump market in Poland is one of the most dynamically developing branches of renewable energy sources (RES. Installations using different types of low-temperature heat pumps are becoming more and more popular especially among owners of detached houses. The article presents the characteristics of the heat pump market in Poland in recent years. Most important changes introduced on 20 February 2015 in the Act on Renewable Energy Sources (Journal of Laws 2015 pos. 478, were discussed. Also future prospects associated with increased use of heat pumps installations in the face of new regulations were analyzed.

  12. Heat production of pig platelets in relation with glycolysis and respiration.

    Nanri, H; Minakami, S

    1983-01-01

    Heat production of pig platelets was measured on a flow microcalorimeter with simultaneous measurements of the oxygen consumption and metabolite change of the suspension. The heat production associated with the glycolytic reaction was estimated from the decrease in the heat production caused by the addition of sodium fluoride. The glycolytic heat production was about -75 kJ per mol of lactate formed, which is the sum of the enthalpy values for the conversion of glucose to lactic acid and that for the neutralization of the acid. The heat production due to the respiration was estimated from the heat production of the cells at various pH. The respiratory heat production was about -475 kJ per mol oxygen consumed, which agrees with the enthalpy change for the non-phosphorylating respiration of mitochondria or for the complete oxidation of glucose or fatty acids. The heat production of the cells increased by the alkalinization of the medium, and the increase of the heat production was parallel with the increase in the lactate formation.

  13. Increased extracellular heat shock protein 90α in severe sepsis and SIRS associated with multiple organ failure and related to acute inflammatory-metabolic stress response in children.

    Fitrolaki, Michaela-Diana; Dimitriou, Helen; Venihaki, Maria; Katrinaki, Marianna; Ilia, Stavroula; Briassoulis, George

    2016-08-01

    Mammalian heat-shock-protein (HSP) 90α rapidly responses to environmental insults. We examined the hypothesis that not only serum HSP72 but also HSP90α is increased in the systemic inflammatory response syndrome (SIRS), severe-sepsis (SS), and/or sepsis (S) compared to healthy children (H); we assessed HSP90α relation to (a) multiple organ system failure (MOSF) and (b) inflammatory-metabolic response and severity of illness.A total of 65 children with S, SS, or SIRS and 25 H were included. ELISA was used to evaluate extracellular HSP90α and HSP72, chemiluminescence interleukins (ILs), flow-cytometry neutrophil-CD64 (nCD64)-expression.HSP90α, along with HSP72, were dramatically increased among MOSF patients. Patients in septic groups and SIRS had elevated HSP90α compared to H (P stress, fever, outcome endpoints, and predicted mortality and inversely related to the low-LDL/low-HDL stress metabolic pattern.

  14. Alterations in brain structures related to taste reward circuitry in ill and recovered anorexia nervosa and in bulimia nervosa.

    Frank, Guido K; Shott, Megan E; Hagman, Jennifer O; Mittal, Vijay A

    2013-10-01

    The pathophysiology of anorexia nervosa remains obscure, but structural brain alterations could be functionally important biomarkers. The authors assessed taste pleasantness and reward sensitivity in relation to brain structure, which may be related to food avoidance commonly seen in eating disorders. The authors used structural MR imaging to study gray and white matter volumes in women with current restricting-type anorexia nervosa (N=19), women recovered from restricting-type anorexia nervosa (N=24), women with bulimia nervosa (N=19), and healthy comparison women (N=24). All eating disorder groups exhibited increased gray matter volume of the medial orbitofrontal cortex (gyrus rectus). Manual tracing confirmed larger gyrus rectus volume, and volume predicted taste pleasantness ratings across all groups. Analyses also indicated other morphological differences between diagnostic categories. Antero-ventral insula gray matter volumes were increased on the right side in the anorexia nervosa and recovered anorexia nervosa groups and on the left side in the bulimia nervosa group relative to the healthy comparison group. Dorsal striatum volumes were reduced in the recovered anorexia nervosa and bulimia nervosa groups and predicted sensitivity to reward in all three eating disorder groups. The eating disorder groups also showed reduced white matter in right temporal and parietal areas relative to the healthy comparison group. The results held when a range of covariates, such as age, depression, anxiety, and medications, were controlled for. Brain structure in the medial orbitofrontal cortex, insula, and striatum is altered in eating disorders and suggests altered brain circuitry that has been associated with taste pleasantness and reward value.

  15. The Burden of Illness Related to Chronic Obstructive Pulmonary Disease Exacerbations in Québec, Canada

    Tam Dang-Tan

    2017-01-01

    Full Text Available Background. Chronic obstructive pulmonary disease (COPD prevalence in Canada has risen over time. COPD-related exacerbations contribute to the increased health care utilization (HCU in this population. This study investigated the impact of exacerbations on COPD-related HCU. Methods. This retrospective observational cohort study used patient data from the Québec provincial health insurance databases. Eligible patients with a new HCU claim with a diagnostic billing for COPD during 2001–2010 were followed until March 31, 2011. Exacerbation rates and time to first exacerbation were assessed. Unadjusted analyses and multivariable models compared the rate of HCU by exacerbation classification (any [moderate/severe], moderate, or severe. Results. The exacerbation event rate in patients with an exacerbation was 34.3 events/100 patient-years (22.7 for moderate exacerbations and 11.6 for severe exacerbations. Median time to first exacerbation of any classification was 37 months. In unadjusted analyses, COPD-related HCU significantly increased with exacerbation severity. In the multivariable, HCU rates were significantly higher after exacerbation versus before exacerbation (p<0.01 for patients with an exacerbation or moderate exacerbations. For severe exacerbations, general practitioner, respiratory specialist, emergency room, and hospital visits were significantly higher after exacerbation versus before exacerbation (p<0.001. Conclusions. Exacerbations were associated with increased HCU, which was more pronounced for patients with severe exacerbations. Interventions to reduce the risk of exacerbations in patients with COPD may reduce disease burden.

  16. Serum BDNF levels in relation to illness severity, suicide attempts, and central serotonin activity in patients with major depressive disorder: a pilot study.

    Park, Young-Min; Lee, Bun-Hee; Um, Tae Hyun; Kim, Sollip

    2014-01-01

    The aim of this study was to test the hypothesis that serum levels of brain-derived neurotrophic factor (BDNF) are correlated with the loudness dependence of auditory evoked potentials (LDAEP). The question of whether there is a difference in BDNF levels between depressive patients according to their illness severity, history of suicide attempts, and central serotonin activity was also addressed. A sample of 51 patients who met the criteria for major depressive disorder following diagnosis using axis I of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders - text revision comprised the study subjects. The patients were stratified into two subgroups based on their illness severity, history of suicide attempts, and their LDAEP values. The LDAEP was evaluated by measuring the auditory event-related potentials, and serum BDNF was measured using blood sampling before beginning medication with serotonergic agents. There was no difference in serum BDNF levels between the two patient subgroups. The subgroup with moderate-to-severe depression (n = 16) was reanalyzed after stratifying it into two subgroups according to LDAEP and BDNF values (dichotomized at the medians into low and high). The high-LDAEP subgroup had higher serum BDNF levels and total Barratt Impulsiveness Scale score than the low-LDAEP subgroup (p = 0.03 and 0.036, respectively). Serum BDNF levels were positively correlated with LDAEP and total Beck Hopelessness Scale (BHS) score (r = 0.56, p = 0.025, and r = 0.59, p = 0.016, respectively). The high-BDNF subgroup had a higher LDAEP and total BHS score than the low-BDNF subgroup (p = 0.046 and p = 0.011, respectively). This is the first study to demonstrate a relationship between the BDNF level and LDAEP in Asian depressive patients. Intriguingly, the high-BDNF subgroup (divided according to illness severity) exhibited a more severe psychopathology on some psychometric rating scales, a finding that

  17. GOTHIC-IST 6.1b code validation exercises relating to heat removal by dousing and air coolers in CANDU containment

    Ramachandran, S.; Krause, M.; Nguyen, T.

    2003-01-01

    This paper presents validation results relating to the use of the GOTHIC containment analysis code for CANDU safety analysis. The validation results indicate that GOTHIC predicts heat removal by dousing and air cooler heat transfer with reasonable accuracy. (author)

  18. Modelling domestic stock energy use and heat-related health risk : a GIS-based bottom-up modelling approach

    Mavrogianni, A.; Davies, M. [Univ. College London, London (United Kingdom). Bartlett School of Graduate Studies; Chalabi, Z.; Wilkinson, P. [London School of Hygiene and Tropical Medecine, London (United Kingdom); Kolokotroni, M. [Brunel Univ., London (United Kingdom). School of Engineering Design

    2009-07-01

    Approximately 8 per cent of the carbon dioxide (CO{sub 2}) emissions produced in the United Kingdom are produced in London, one of the fastest growing cities worldwide. Based on the projected rates of population and economic growth, a 15 per cent increase of emissions is predicted. In addition to the national target to cut emissions by 80 per cent by 2050, the Mayor of London Climate Change Action Plan set a target to reduce London's CO{sub 2} emissions by 60 per cent by 2025. Significant carbon savings can be achieved in the building sector, particularly since 38 per cent of the total delivered energy in London is associated with domestic energy use. This paper demonstrated a systematic approach towards exploring the impact of urban built form and the combined effect of climate change and the urban heat island (UHI) phenomenon on the levels of domestic energy consumption and heat-related health risk in London. It presented work in progress on the development of a GIS-based energy consumption model and heat vulnerability index of the Greater London Area domestic stock. Comparison of the model output for 10 case study areas with topdown energy statistics revealed that the model successfully ranks areas based on their domestic space heating demand. The health module can be used to determine environments prone to higher risk of heat stress by investigating urban texture factors. A newly developed epidemiological model will be feed into the health module to examine the influence on risk of heat-related mortality of local urban built form characteristics. The epidemiological model is based on multi-variable analysis of deaths during heat wave and non-heat wave days. 29 refs., 1 tab., 7 figs.

  19. Benefits of Medical Home Care Reaching Beyond Chronically Ill Teens: Exploring Parent Health-Related Quality of Life.

    Chavez, Laura J; Grannis, Connor; Dolce, Millie; Chisolm, Deena J

    2018-03-15

    Caring for teens with special health care needs places physical and mental health burdens on parents, which can be exacerbated by the stresses of transitions to independence. Medical homes can improve teen transitions to greater self-management and reduce health care-related time and financial burdens for families. We examined the association between parent-reported teen medical home status and caregiver health-related quality of life (HRQOL). The study sample included parents or caregivers of teens with special health care needs aged 15 to 18 recruited from a pediatric Medicaid accountable care organization who participated in a survey (response rate, 40.5%). The primary outcome was parent HRQOL scores (0-100 points) measured using the Pediatric Quality of Life Inventory Family Impact Module. Medical home status was based on parent report of teen's health care meeting medical home criteria. Linear regression models were used to estimate HRQOL scores, adjusted for demographic characteristics, health literacy, and teen functional limitation. Among 488 parents, 27% reported their teen received care consistent with a medical home. Adjusted parent HRQOL scores were significantly higher among those whose teens had a medical home (74.40; 95% confidence interval, 71.31-77.48), relative to those whose teens did not (65.78; 95% confidence interval, 63.92-67.65). Medical home subscale analyses showed HRQOL scores had significant positive associations with family-centered care and coordinated care, but not other subscales. Teen medical home status was positively associated with caregiver HRQOL, suggesting that the medical home may benefit overall caregiver well-being. In particular, receiving care that was family centered and coordinated appeared to be the most beneficial. Copyright © 2018 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  20. An examination of flame shape related to convection heat transfer in deep-fuel beds

    Kara M. Yedinak; Jack D. Cohen; Jason M. Forthofer; Mark A. Finney

    2010-01-01

    Fire spread through a fuel bed produces an observable curved combustion interface. This shape has been schematically represented largely without consideration for fire spread processes. The shape and dynamics of the flame profile within the fuel bed likely reflect the mechanisms of heat transfer necessary for the pre-heating and ignition of the fuel during fire spread....

  1. Determination of Factors Related to Students' Understandings of Heat, Temperature and Internal Energy Concepts

    Gurcay, Deniz; Gulbas, Etna

    2018-01-01

    The purpose of this research is to investigate the relationships between high school students' learning approaches and logical thinking abilities and their understandings of heat, temperature and internal energy concepts. Learning Approach Questionnaire, Test of Logical Thinking and Three-Tier Heat, Temperature and Internal Energy Test were used…

  2. Are carer attitudes toward medications related to self-reported medication adherence amongst people with mental illness?

    Deane, Frank P; McAlpine, Elizabeth; Byrne, Mitchell K; Davis, Esther L; Mortimer, Christine

    2017-11-22

    Medication nonadherence among consumers with psychiatric disorders can significantly affect the health and wellbeing of the consumer and their family. Previous research has suggested that carers have an impact on consumer attitudes toward medication and adherence. Yet, how carer attitudes toward medication may be related to consumer attitudes and adherence has received little investigation. This exploratory study aimed to investigate the relationships between carer and consumer attitudes toward medication and consumer adherence behaviour. A cross-sectional survey assessing consumer and carer attitudes toward medication and consumer adherence was conducted amongst 42 consumer-carer dyads. Correlation analyses showed a positive association between consumer and carer attitudes toward medication and between consumer and carer attitudes with adherence. There was a general indication that the greater the difference between consumer and carer attitudes, the lower the level of adherence. Regression analyses revealed that while neither consumer nor carer attitudes were significant predictors of adherence, carer attitudes appeared to have a stronger role in adherence than consumer attitudes. These preliminary results highlight the importance of carer attitudes in relation to patient perceptions and behaviours toward medication, and thus the potential benefits of addressing both consumer and carer attitudes in any intervention for improving adherence. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Understanding and remediating social-cognitive dysfunctions in patients with serious mental illness using relational frame theory

    Annemieke eHendriks

    2016-02-01

    Full Text Available Impairments in social cognition and perspective-taking play an important role in the psychopathology and social functioning of individuals with social anxiety, autism or schizophrenia-spectrum disorders, among other clinical presentations. Perspective-taking has mostly been studied using the concept of Theory of Mind (ToM, which describes the sequential development of these skills in young children, as well as clinical populations experiencing perspective-taking difficulties. Several studies mention positive results of Theory of Mind based training programs, however, the precise processes involved in the achievement of these improvements are difficult to determine. Relational Frame Theory (RFT is a modern behavioural account of complex cognitive functions, and is argued to provide a more precise approach to the assessment and training of perspective-taking, among other relational skills. Results of RFT-based studies of perspective-taking in developmental and clinical settings are discussed. The development of training methods targeting perspective-taking deficits from an RFT point of view appears to provide promising applications for the enhancement of current treatments of people with social-cognitive dysfunctions.

  4. Understanding and Remediating Social-Cognitive Dysfunctions in Patients with Serious Mental Illness Using Relational Frame Theory.

    Hendriks, Annemieke L; Barnes-Holmes, Yvonne; McEnteggart, Ciara; De Mey, Hubert R A; Janssen, Gwenny T L; Egger, Jos I M

    2016-01-01

    Impairments in social cognition and perspective-taking play an important role in the psychopathology and social functioning of individuals with social anxiety, autism, or schizophrenia-spectrum disorders, among other clinical presentations. Perspective-taking has mostly been studied using the concept of Theory of Mind (ToM), which describes the sequential development of these skills in young children, as well as clinical populations experiencing perspective-taking difficulties. Several studies mention positive results of ToM based training programs; however, the precise processes involved in the achievement of these improvements are difficult to determine. Relational Frame Theory (RFT) is a modern behavioral account of complex cognitive functions, and is argued to provide a more precise approach to the assessment and training of perspective-taking, among other relational skills. Results of RFT-based studies of perspective-taking in developmental and clinical settings are discussed. The development of training methods targeting perspective-taking deficits from an RFT point of view appears to provide promising applications for the enhancement of current treatments of people with social-cognitive dysfunctions.

  5. Changes in health-related quality of life and quality of care among terminally ill cancer patients and survival prediction: Multicenter prospective cohort study.

    Lee, Myung Kyung; Lee, Woo Jin; Do, Young Rok; Lee, Keun Seok; Jung, Kyung Hae; Heo, Dae Seog; Kim, Sam Yong; Park, Sang Yoon; Jeong, Hyun Sik; Kang, Jung Hun; Kim, Si-Young; Park, Sook Ryun; Yun, Young Ho

    2015-08-01

    This study examined changes in health-related quality of life (HRQoL) and quality of care (QoC) as perceived by terminally ill cancer patients and a stratified set of HRQoL or QoC factors that are most likely to influence survival at the end of life (EoL). We administered questionnaires to 619 consecutive patients immediately after they were diagnosed with terminal cancer by physicians at 11 university hospitals and at the National Cancer Center in Korea. Subjects were followed up over 161.2 person-years until their deaths. We measured HRQoL using the core 30-item European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, and QoC using the Quality Care Questionnaire-End of Life (QCQ-EoL). We evaluated changes in HRQoL and QoC issues during the first three months after enrollment, performing sensitivity analysis by using data generated via four methods (complete case analysis, available case analysis, the last observation carried forward, and multiple imputation). Emotional and cognitive functioning decreased significantly over time, while dyspnea, constipation, and pain increased significantly. Dignity-conserving care, care by healthcare professionals, family relationships, and QCQ-EoL total score decreased significantly. Global QoL, appetite loss, and Eastern Cooperative Oncology Group Performance Status (ECOG-PS) scores were significantly associated with survival. Future standardization of palliative care should be focused on assessment of these deteriorated types of quality. Accurate estimates of the length of life remaining for terminally ill cancer patients by such EoL-enhancing factors as global QoL, appetite loss, and ECOG-PS are needed to help patients experience a dignified and comfortable death.

  6. Illness and determinants of health-related quality of life in a cross-sectional sample of schoolchildren in different weight categories

    Kesztyüs, Dorothea

    2014-01-01

    Full Text Available [english] Aim: To study associations between health-related quality of life (HRQoL, frequency of illness, and weight in primary school children in southern Germany. Methods: Data from baseline measurements of the outcome evaluation of a teacher based health promotion programme (“Join the Healthy Boat” were analysed. Parents provided information about their children’s HRQoL (KINDL, EQ5D-Y Visual Analogue Scale. The number of visits to a physician, children’s days of absence because of sickness, and parental days of absence from work due to their children’s illness during the last year of school/kindergarten were queried. Children’s weight status was determined by body mass index (BMI, central obesity by waist to height ratio (WHtR ≥0.5. Results: From 1,888 children (7.1±0.6 years, 7.8% were underweight, 82% had normal weight, 5.7% were overweight and 4.4% obese. 8.4% of all children were centrally obese. Bivariate analysis showed no significant differences for parental absence and visits to a physician in weight groups classified by BMI, but obese children had more sick days than non-obese. Centrally obese children differed significantly from the rest in the number of sick days and visits to a physician, but not in the frequency of parental absence. In regression analyses, central obesity correlated significantly with EQ5D-Y VAS, KINDL total score and the subscales of “psyche”, “family” and “friends”. BMI weight groups showed no significant associations. Conclusions: Central obesity but not BMI derived overweight and obesity is associated with HRQoL and visits to a physician in primary school children. Future studies should include WHtR. Preventive measures for children should focus on a reduction of or slowed increase in waist circumference.

  7. Control systems for condensing flue-gas coolers related to natural-gas-fired heating plants

    Krighaar, M.; Paulsen, O.

    1992-01-01

    A theoretical study is made of the enthalpy-efficiency for a water-cooled heat exchanger added to a natural gas-fired boiler. Under varying conditions of both water flow and temperature and flue-gas flow and temperature, both in condensing and non-condensing mode, the efficiency seems to be constant. The result is very useful for comparison between two different working conditions. The efficiency is used to calculate the savings achieved for a district heating plant by using a heat exchanger. The energy economic calculations are also helpful for estimating the most appropriate size of heat exchanger. The annual savings are calculated by means of data regarding heat production, flue gas temperature and water return temperature. The savings achieved by using different connection principles such as bypass, reheating and controlled water temperature are also calculated. (author)

  8. Improvements in or relating to transfer of heat to fluidized-solid beds

    1952-01-30

    A method is described for supplying heat to a dense turbulent mass of finely divided solids fluidized by an upwardly flowing gas to resemble a boiling liquid having a well-defined upper level, which comprises contacting the mass with the surface of a heat-transfer element heated by a fluid combustion mixture burning in contact with the surface, the surface separating the mass from the mixture, wherein the burning of the combustion mixture is localized in the heat-transfer element near the point of entry of the combustion mixture. A substantial temperature gradient is maintained along the path of the combustion mixture and combustion products through the heat-transfer element.

  9. Anxiety in Medically Ill Children/Adolescents

    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...

  10. Longitudinal spirometry among patients in a treatment program for community members with World Trade Center (WTC)-related illness

    Liu, Mengling; Qian, Meng; Cheng, Qinyi; Berger, Kenneth I.; Shao, Yongzhao; Turetz, Meredith; Kazeros, Angeliki; Parsia, Sam; Goldring, Roberta M.; Fernandez-Beros, Maria Elena; Marmor, Michael; Reibman, Joan

    2013-01-01

    Objective The course of lung function in community members exposed to World Trade Center (WTC) dust and fumes remains undefined. We studied longitudinal spirometry among patients in the WTC Environmental Health Center (WTCEHC) treatment program. Methods Observational study of 946 WTCEHC patients with repeated spirometry measures analyzed on the population as a whole and stratified by smoking status, initial spirometry pattern and WTC-related exposure category. Results Improvement in forced expiratory volume (FVC; 54.4 ml/year; 95% CI: 45.0-63.8) and forced expiratory volume in one second (FEV1; 36.8 ml/year; 95% CI: 29.3-44.3) was noted for the population as a whole. Heavy smokers did not improve. Spirometry changes differed depending on initial spirometry pattern and exposure category. Conclusions These data demonstrate spirometry improvement in select populations suggesting reversibility in airway injury and reinforcing the importance of continued treatment. PMID:22995806

  11. Campylobacter contamination and the relative risk of illness from organic broiler meat in comparison with conventional broiler meat

    Rosenquist, Hanne; Boysen, Louise; Krogh, Anne Louise

    2013-01-01

    Danish organic broiler meat, represented by carcasses sampled at the end of processing after chilling, was more frequently contaminated with thermotolerant Campylobacter spp. than conventional broiler carcasses; the yearly mean prevalence being 54.2% (CI: 40.9-67.5) for organic and 19.7% (CI: 14.......8-24.7) for conventional carcasses. Campylobacter jejuni was the most frequently isolated species. The difference in prevalence was obvious in all quarters of the year. Contamination of organic and conventional broiler carcasses was more likely to occur in the warmer summer months, in this case in the third quarter......, as also documented for conventional broiler flocks. When contaminated, the mean concentration of Campylobacter on neck skin samples of organic and conventional carcasses was not significantly different (P=0.428); 2.0±0.65log10cfu/g and 2.1±0.93log10cfu/g, respectively. Assessing the relative risk...

  12. Ill Health-Related Job Loss: A One-Year Follow-Up of 54,026 Employees.

    Dutheil, Frédéric; Naughton, Geraldine; Sindyga, Patricia; Lesage, François-Xavier

    2016-09-01

    The diagnoses of workers being unfit to work may be a relevant health indicator. Therefore, the aim of this study was to analyze the one-year incidence of an unfit to work diagnosis. This one-year prospective study included all workers undergoing annual work medical examination from occupational health services in Troyes, France. Twenty-one occupational physicians followed 54,026 employees. The all-cause incidence of being unfit to return to work was 0.772%. The two main causes of being unfit to work were musculoskeletal disorders (61%) and psychopathologies (24%). The relative risk (RR) of being unfit to work, independent of the cause, was higher when employees were aged over 50 years (RR = 2.51), and female (RR = 1.51). Prospective results from occupational physicians' medical records may provide significant and cost-effective directions to prioritize actions and target health promotion in the workplace.

  13. Evaluating penalized logistic regression models to predict Heat-Related Electric grid stress days

    Bramer, L. M.; Rounds, J.; Burleyson, C. D.; Fortin, D.; Hathaway, J.; Rice, J.; Kraucunas, I.

    2017-11-01

    Understanding the conditions associated with stress on the electricity grid is important in the development of contingency plans for maintaining reliability during periods when the grid is stressed. In this paper, heat-related grid stress and the relationship with weather conditions is examined using data from the eastern United States. Penalized logistic regression models were developed and applied to predict stress on the electric grid using weather data. The inclusion of other weather variables, such as precipitation, in addition to temperature improved model performance. Several candidate models and datasets were examined. A penalized logistic regression model fit at the operation-zone level was found to provide predictive value and interpretability. Additionally, the importance of different weather variables observed at different time scales were examined. Maximum temperature and precipitation were identified as important across all zones while the importance of other weather variables was zone specific. The methods presented in this work are extensible to other regions and can be used to aid in planning and development of the electrical grid.

  14. Age-related oxidative stress and antioxidant capacity in heat-stressed broilers.

    Del Vesco, A P; Khatlab, A S; Goes, E S R; Utsunomiya, K S; Vieira, J S; Oliveira Neto, A R; Gasparino, E

    2017-10-01

    We aimed to evaluate the effects of acute heat stress (HS) and age on the redox state in broilers aged 21 and 42 days. We evaluated the expression of genes related to antioxidant capacity, the production of hydrogen peroxide (H2O2), and the activity of antioxidant enzymes in the liver, as well as oxidative stress markers in the liver and plasma. The experiment had a completely randomized factorial design with two thermal environments (thermoneutral and HS, 38°C for 24 h) and two ages (21 and 42 days). Twenty-one-day-old animals exposed to HS showed the highest thioredoxin reductase 1 (TrxR1) (PAge influenced the expression of the thioredoxin (Trx) (P=0.0090), superoxide dismutase (SOD) (P=0.0194), glutathione reductase (GSR) (Page and environment on the liver content of Glutathione (GSH) (Page had higher plasma creatinine content (0.05 v. 0.01 mg/dl) and higher aspartate aminotransferase activity (546.50 v. 230.67 U/l) than chickens at 21 days of age. Our results suggest that under HS conditions, in which there is higher H2O2 production, 21-day-old broilers have greater antioxidant capacity than 42-day-old animals.

  15. Intravenous glucose intake independently related to intensive care unit and hospital mortality : an argument for glucose toxicity in critically ill patients

    van der Voort, PHJ; Feenstra, RA; Bakker, AJ; de Heide, L; Boerma, EC; van der Horst, ICC

    Objective It is assumed that the toxic effects of glucose play a role in the outcome of critically ill patients. We studied the impact of the amount of infused glucose as a determinant of mortality. Design A retrospective cohort study design was used as blood glucose levels in critically ill

  16. Using nature-based rehabilitation to restart a stalled process of rehabilitation in individuals with stress-related mental illness.

    Sahlin, Eva; Ahlborg, Gunnar; Tenenbaum, Artur; Grahn, Patrik

    2015-02-09

    After a period of decrease, sick leave in Sweden due to psychiatric diagnoses is on the increase. The lack of established rehabilitation programmes for patients with stress-related mental disorders (SRMD) has opened up for the use of garden/nature in a multimodal rehabilitation context (Nature-Based Rehabilitation, NBR). Region Västra Götaland (VGR) started an NBR to offer additional rehabilitation for its employees on long-term sick leave due to SRMD, where initial care had not been sufficient. The aim was to explore whether the mental health and well-being of NBR participants had improved at the end of the NBR and at three follow-ups, and to explore the development of sick leave and health care utilization according to the NBR model (n = 57) and an occupational health service (OHS) model (n = 45). Self-assessment instruments for measuring burnout, depression, anxiety and wellbeing, and data from regional and national registers were used. Results showed decreased scores on burnout, depression and anxiety, and increased well-being scores and significantly reduced health care utilization in the NBR group. A large movement from ordinary sickness benefit to rehabilitation benefit was observed, which was not observed in the OHS group. The two groups were in different rehabilitation phases, which limited comparisons. The results point to beneficial effects of using NBR for this patient group and for enhancing a stalled rehabilitation process.

  17. Assessment of potential zoonotic disease exposure and illness related to an annual bat festival--Idanre, Nigeria.

    Vora, Neil M; Osinubi, Modupe; Wallace, Ryan M; Aman-Oloniyo, Abimbola; Gbadegesin, Yemi H; Sebastian, Yennan Kerecvel; Saliman, Olugbon Abdullateef; Niezgoda, Mike; Davis, Lora; Recuenco, Sergio

    2014-04-18

    Bats provide vital ecologic services that humans benefit from, such as seed dispersal and pest control, and are a food source for some human populations. However, bats also are reservoirs for a number of high-consequence zoonoses, including paramyxoviruses, filoviruses, and lyssaviruses. The variety of viruses that bats harbor might be related to their evolutionary diversity, ability to fly large distances, long lifespans, and gregarious roosting behaviors. Every year a festival takes place in Idanre, Nigeria, in which males of all ages enter designated caves to capture bats; persons are forbidden from entering the caves outside of these festivities. Festival participants use a variety of techniques to capture bats, but protective equipment rarely is used, placing hunters at risk for bat scratches and bites. Many captured bats are prepared as food, but some are transported to markets in other parts of the country for sale as bushmeat. Bats also are presented to dignitaries in elaborate rituals. The health consequences of contact with these bats are unknown, but a number of viruses have been previously identified among Nigerian bats, including lyssaviruses, pegiviruses, and coronaviruses. Furthermore, the caves are home to Rousettus aegyptiacus bats, which are reservoirs for Marburg virus in other parts of Africa.

  18. Using Nature-Based Rehabilitation to Restart a Stalled Process of Rehabilitation in Individuals with Stress-Related Mental Illness

    Eva Sahlin

    2015-02-01

    Full Text Available After a period of decrease, sick leave in Sweden due to psychiatric diagnoses is on the increase. The lack of established rehabilitation programmes for patients with stress-related mental disorders (SRMD has opened up for the use of garden/nature in a multimodal rehabilitation context (Nature-Based Rehabilitation, NBR. Region Västra Götaland (VGR started an NBR to offer additional rehabilitation for its employees on long-term sick leave due to SRMD, where initial care had not been sufficient. The aim was to explore whether the mental health and well-being of NBR participants had improved at the end of the NBR and at three follow-ups, and to explore the development of sick leave and health care utilization according to the NBR model (n = 57 and an occupational health service (OHS model (n = 45. Self-assessment instruments for measuring burnout, depression, anxiety and wellbeing, and data from regional and national registers were used. Results showed decreased scores on burnout, depression and anxiety, and increased well-being scores and significantly reduced health care utilization in the NBR group. A large movement from ordinary sickness benefit to rehabilitation benefit was observed, which was not observed in the OHS group. The two groups were in different rehabilitation phases, which limited comparisons. The results point to beneficial effects of using NBR for this patient group and for enhancing a stalled rehabilitation process.

  19. Mental Illness Statistics

    ... 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 ...

  20. Relative contributions of microbial and infrastructure heat at a crude oil-contaminated site

    Warren, Ean; Bekins, Barbara A.

    2018-04-01

    Biodegradation of contaminants can increase the temperature in the subsurface due to heat generated from exothermic reactions, making temperature observations a potentially low-cost approach for determining microbial activity. For this technique to gain more widespread acceptance, it is necessary to better understand all the factors affecting the measured temperatures. Biodegradation has been occurring at a crude oil-contaminated site near Bemidji, Minnesota for 39 years, creating a quasi-steady-state plume of contaminants and degradation products. A model of subsurface heat generation and transport helps elucidate the contribution of microbial and infrastructure heating to observed temperature increases at this site. We created a steady-state, two-dimensional, heat transport model using previous-published parameter values for physical, chemical and biodegradation properties. Simulated temperature distributions closely match the observed average annual temperatures measured in the contaminated area at the site within less than 0.2 °C in the unsaturated zone and 0.4 °C in the saturated zone. The model results confirm that the observed subsurface heat from microbial activity is due primarily to methane oxidation in the unsaturated zone resulting in a 3.6 °C increase in average annual temperature. Another important source of subsurface heat is from the active, crude-oil pipelines crossing the site. The pipelines impact temperatures for a distance of 200 m and contribute half the heat. Model results show that not accounting for the heat from the pipelines leads to overestimating the degradation rates by a factor of 1.7, demonstrating the importance of identifying and quantifying all heat sources. The model results also highlighted a zone where previously unknown microbial activity is occurring at the site.

  1. Differential transcript induction of parsley pathogenesis-related proteins and of a small heat shock protein by ozone and heat shock

    Eckey-Kaltenbach, H.; Kiefer, E.; Grosskopf, E.; Ernst, D.; Sandermann, H. Jr

    1997-01-01

    Parsley (Petroselinum (crispum L.) is known to respond to pathogen attack by the synthesis of furanocoumarins and to UV irradiation by the synthesis of flavone glycosides whereas ozone treatment results in the induction of both pathways. A cDNA library from parsley plants was differentially screened using labelled reverse-transcribed poly(A)+ RNA isolated from ozone-treated parsley plants. This resulted in the isolation of 13 independent cDNA clones representing ozone-induced genes and of 11 cDNA clones representing ozone-repressed genes. DNA sequencing of several clones resulted in the identification of pathogenesis-related protein 1-3 (PR1-3), of a new member of PR1 cDNAs (PRI-4) and of a small heat shock protein (sHSP). Northern blot analyses showed a transient induction of the three mRNA species after ozone fumigation. In contrast, heat shock treatment of parsley plants resulted in an increase of sHSP mRNA whereas no increase for transcripts of PR1-3 and PR1-4 could be observed. This is the first characterized sHSP cDNA clone for plants induced by heat shock, as well as by oxidative stress caused by ozone. (author)

  2. Spatial patterns of heat-related cardiovascular mortality in the Czech Republic

    Urban, A.; Burkart, K.; Kyselý, J.; Schuster, Ch.; Plavcová, E.; Hanzlíková, Hana; Štěpánek, P.; Lakes, T.

    2016-01-01

    Roč. 13, č. 3 (2016), 284/1-284/19 ISSN 1660-4601 Institutional support: RVO:67985530 Keywords : heat stress * mortality * spatial differences Subject RIV: DG - Athmosphere Sciences, Meteorology Impact factor: 2.101, year: 2016

  3. Average Rate of Heat-Related Hospitalizations in 23 States, 2001-2010

    U.S. Environmental Protection Agency — This map shows the 2001–2010 average rate of hospitalizations classified as “heat-related” by medical professionals in 23 states that participate in CDC’s...

  4. Utilization of process heat from the HTR in the chemical and related industries

    Schad, M.; Didas, U.; Ebeling, F.; Kreutzkamp, G.; Renner, H.

    1988-12-01

    The wide introduction of the HTRI as heat and energy sources would be beneficial when the HTRI operating parameters were more suitable for flexible adaptation to the wide possible field of applications and requirements of the potential customer. Here of importance are: Guaranteed reliable, easily adaptable as well as effective process heat provision; a small HTRI size, under 100 MW if possible, for economic process plant operation never negatively influenced by the operational behaviour of the individual HTRI; avoidance of a secondary heat transfer circulation system for economic reasons by an extremely clean primary helium at all times and under all circumstances; greater flexibility in the HTRI helium inlet and outlet temperatures. Initially at least a helium inlet temperature of 300deg C or better 350deg C. At 250deg C too much heat is often offered in the low-temperature range which can in the main be used for domestic heating and power export only. The processes technically and economically interesting which could be provided with heat from the HTRI cover the field of mineral oil technology. Their process temperatures are below 600deg C, a temperature range demanding conventional technology. Thus, for this purpose it is only necessary to: Test the heat exchangers to be designed new; find the most effective combined plant concept in each case; carry out the necessary safety examinations into the combined operation of the two plant sections - HTRI and process plant. In addition, the market for the process heat supply in mineral oil technology has a considerable potential. (orig./GL)

  5. The relation of collector and storage tank size in solar heating systems

    Çomaklı, Kemal; Çakır, Uğur; Kaya, Mehmet; Bakirci, Kadir

    2012-01-01

    Highlights: ► A storage tank is used in many solar water heating systems for the storage of hot water. ► Using larger storage tanks decrease the efficiency and increases the cost of the system. ► The optimum tank size for the collector area is very important for economic solar heating systems. ► The optimum sizes of the collectors and the storage tank are determined. - Abstract: The most popular method to benefit from the solar energy is to use solar water heating systems since it is one of the cheapest way to benefit from the solar energy. The investment cost of a solar water heating system is very low, and the maintenance costs are nearly zero. Using the solar energy for solar water heating (SWH) technology has been greatly improved during the past century. A storage tank is used in many solar water heating systems for the conservation of heat energy or hot water for use when some need it. In addition, domestic hot water consumption is strongly variable in many buildings. It depends on the geographical situation, also on the country customs, and of course on the type of building usage. Above all, it depends on the inhabitants’ specific lifestyle. For that reason, to provide the hot water for consumption at the desirable temperature whenever inhabitants require it, there must be a good relevance between the collectors and storage tank. In this paper, the optimum sizes of the collectors and the storage tank are determined to design more economic and efficient solar water heating systems. A program has been developed and validated with the experimental study and environmental data. The environmental data were obtained through a whole year of operation for Erzurum, Turkey.

  6. Decompression illness - critical review

    C S Mohanty

    2015-01-01

    Full Text Available Decompression illness is caused by intravascular or extravascular bubbles that are formed as a result of reduction in environmental pressure (decompression. The term covers both arterial gas embolism, in which alveolar gas or venous gas emboli (via cardiac shunts or via pulmonary vessels are introduced into the arterial circulation, and decompression sickness, which is caused by in-situ bubble formation from dissolved inert gas. Both syndromes can occur in divers, compressed air workers, aviators, and astronauts, but arterial gas embolism also arises from iatrogenic causes unrelated to decompression. Risk of decompression illness is affected by immersion, exercise, and heat or cold. Manifestations range from itching and minor pain to neurological symptoms, cardiac collapse, and death. First-aid treatment is 1 0 0 % oxygen and definitive treatment is recompression to increased pressure, breathing 1 0 0 % oxygen. Adjunctive treatment, including fluid administration and prophylaxis against venous thromboembolism in paralysed patients, is also recommended Treatment is, in most cases, effective although residual deficits can remain in serious cases, even after several recompressions.

  7. Temperature Observation Time and Type Influence Estimates of Heat-Related Mortality in Seven U.S. Cities.

    Davis, Robert E; Hondula, David M; Patel, Anjali P

    2016-06-01

    Extreme heat is a leading weather-related cause of mortality in the United States, but little guidance is available regarding how temperature variable selection impacts heat-mortality relationships. We examined how the strength of the relationship between daily heat-related mortality and temperature varies as a function of temperature observation time, lag, and calculation method. Long time series of daily mortality counts and hourly temperature for seven U.S. cities with different climates were examined using a generalized additive model. The temperature effect was modeled separately for each hour of the day (with up to 3-day lags) along with different methods of calculating daily maximum, minimum, and mean temperature. We estimated the temperature effect on mortality for each variable by comparing the 99th versus 85th temperature percentiles, as determined from the annual time series. In three northern cities (Boston, MA; Philadelphia, PA; and Seattle, WA) that appeared to have the greatest sensitivity to heat, hourly estimates were consistent with a diurnal pattern in the heat-mortality response, with strongest associations for afternoon or maximum temperature at lag 0 (day of death) or afternoon and evening of lag 1 (day before death). In warmer, southern cities, stronger associations were found with morning temperatures, but overall the relationships were weaker. The strongest temperature-mortality relationships were associated with maximum temperature, although mean temperature results were comparable. There were systematic and substantial differences in the association between temperature and mortality based on the time and type of temperature observation. Because the strongest hourly temperature-mortality relationships were not always found at times typically associated with daily maximum temperatures, temperature variables should be selected independently for each study location. In general, heat-mortality was more closely coupled to afternoon and maximum

  8. Whole-genome transcriptional analysis of Escherichia coli during heat inactivation processes related to industrial cooking.

    Guernec, A; Robichaud-Rincon, P; Saucier, L

    2013-08-01

    Escherichia coli K-12 was grown to the stationary phase, for maximum physiological resistance, in brain heart infusion (BHI) broth at 37°C. Cells were then heated at 58°C or 60°C to reach a process lethality value \\[\\mathbf{\\left(}{{\\mathit{F}}^{\\mathit{o}}}_{\\mathbf{70}}^{\\mathbf{10}}\\mathbf{\\right)} \\] of 2 or 3 or to a core temperature of 71°C (control industrial cooking temperature). Growth recovery and cell membrane integrity were evaluated immediately after heating, and a global transcription analysis was performed using gene expression microarrays. Only cells heated at 58°C with F(o) = 2 were still able to grow on liquid or solid BHI broth after heat treatment. However, their transcriptome did not differ from that of bacteria heated at 58°C with F(o) = 3 (P value for the false discovery rate [P-FDR] > 0.01), where no growth recovery was observed posttreatment. Genome-wide transcriptomic data obtained at 71°C were distinct from those of the other treatments without growth recovery. Quantification of heat shock gene expression by real-time PCR revealed that dnaK and groEL mRNA levels decreased significantly above 60°C to reach levels similar to those of control cells at 37°C (P citE, glyS, oppB, and asd, whose expression was upregulated at 71°C, may be worth investigating as good biomarkers for accurately determining the efficiency of heat treatments, especially when cells are too injured to be enumerated using growth media.

  9. Uncertainty characterization of HOAPS 3.3 latent heat-flux-related parameters

    Liman, Julian; Schröder, Marc; Fennig, Karsten; Andersson, Axel; Hollmann, Rainer

    2018-03-01

    Latent heat flux (LHF) is one of the main contributors to the global energy budget. As the density of in situ LHF measurements over the global oceans is generally poor, the potential of remotely sensed LHF for meteorological applications is enormous. However, to date none of the available satellite products have included estimates of systematic, random, and sampling uncertainties, all of which are essential for assessing their quality. Here, the challenge is taken on by matching LHF-related pixel-level data of the Hamburg Ocean Atmosphere Parameters and Fluxes from Satellite (HOAPS) climatology (version 3.3) to in situ measurements originating from a high-quality data archive of buoys and selected ships. Assuming the ground reference to be bias-free, this allows for deriving instantaneous systematic uncertainties as a function of four atmospheric predictor variables. The approach is regionally independent and therefore overcomes the issue of sparse in situ data densities over large oceanic areas. Likewise, random uncertainties are derived, which include not only a retrieval component but also contributions from in situ measurement noise and the collocation procedure. A recently published random uncertainty decomposition approach is applied to isolate the random retrieval uncertainty of all LHF-related HOAPS parameters. It makes use of two combinations of independent data triplets of both satellite and in situ data, which are analysed in terms of their pairwise variances of differences. Instantaneous uncertainties are finally aggregated, allowing for uncertainty characterizations on monthly to multi-annual timescales. Results show that systematic LHF uncertainties range between 15 and 50 W m-2 with a global mean of 25 W m-2. Local maxima are mainly found over the subtropical ocean basins as well as along the western boundary currents. Investigations indicate that contributions from qa (U) to the overall LHF uncertainty are on the order of 60 % (25 %). From an

  10. Heat pumps

    Brodowicz, Kazimierz; Wyszynski, M L; Wyszynski

    2013-01-01

    Heat pumps and related technology are in widespread use in industrial processes and installations. This book presents a unified, comprehensive and systematic treatment of the design and operation of both compression and sorption heat pumps. Heat pump thermodynamics, the choice of working fluid and the characteristics of low temperature heat sources and their application to heat pumps are covered in detail.Economic aspects are discussed and the extensive use of the exergy concept in evaluating performance of heat pumps is a unique feature of the book. The thermodynamic and chemical properties o

  11. [Seasonal variation of soil heat conduction in a larch plantation and its relations to environmental factors].

    Wang, Wen-Jie; Cui, Song; Liu, Wei; Zu, Yuan-Gang; Sun, Wei; Wang, Hui-Min

    2008-10-01

    Based on a 3-year (2003-2005) observation of soil heat flux (SHF) in a larch (Larix gmelinii) plantation, the characteristics of soil heat conduction in the plantation and their relationships with environment factors were analyzed. The results showed that there was an obvious seasonal variation of SHF in different years and sampling sites. The SHF was positive from April to August and mostly negative from September to next March, with an almost balance between heat income and outcome at annual scale. Solar net radiation had significant effects on the SHF and soil heat conductance (k), and an obvious time-lag effect was found, with 4-5 hours' time-lag in winter and 2-3 hours' time-lag in summer. Based on the real-time measurement of SHF and soil temperature difference at the study sites, the k value was significantly higher in early spring (P 0.05). Therefore, when we use the observation data of soil temperature from weather stations to estimate soil heat flux, the k value in spring (from March to May) could induce a bias estimation.

  12. Is appreciation of written education about pain neurophysiology related to changes in illness perceptions and health status in patients with fibromyalgia?

    van Ittersum, M. W.; van Wilgen, C. P.; Groothoff, J. W.; van der Schans, C. P.

    2011-01-01

    Objective: To investigate the appreciation of written education about pain neurophysiology in patients with fibromyalgia (FM) and its effects on illness perceptions and perceived health status. Methods: A booklet explaining pain neurophysiology was sent to participants with FM. Appreciation was

  13. Is appreciation of written education about pain neurophysiology related to changes in illness perceptions and health status in patients with fibromyalgia?

    van Ittersum, Miriam; van Wilgen, C P; Groothoff, J W; van der Schans, C.P.

    2011-01-01

    OBJECTIVE: To investigate the appreciation of written education about pain neurophysiology in patients with fibromyalgia (FM) and its effects on illness perceptions and perceived health status. METHODS: A booklet explaining pain neurophysiology was sent to participants with FM. Appreciation was

  14. TRPA1 channels in Drosophila and honey bee ectoparasitic mites share heat sensitivity and temperature-related physiological functions

    Guangda Peng

    2016-10-01

    Full Text Available The transient receptor potential cation channel, subfamily A, member 1 (TRPA1 is conserved between many arthropods, and in some has been shown to function as a chemosensor for noxious compounds. Activation of arthropod TRPA1 channels by temperature fluctuations has been tested in only a few insect species, and all of them were shown to be activated by heat. The recent identification of chemosensitive TRPA1 channels from two honey bee ectoparasitic mite species (VdTRPA1 and TmTRPA1 have provided an opportunity to study the temperature-dependent activation and the temperature-associated physiological functions of TRPA1 channels in non-insect arthropods. We found that both mite TRPA1 channels are heat sensitive and capable of rescuing the temperature-related behavioral defects of a Drosophila melanogaster trpA1 mutant. These results suggest that heat-sensitivity of TRPA1 could be conserved between many arthropods despite its amino acid sequence diversity. Nevertheless, the ankyrin repeats (ARs 6 and 7 are well-conserved between six heat-sensitive arthropod TRPA1 channels and have critical roles for the heat activation of VdTRPA1.

  15. Cyanobacteria and Algae Blooms: Review of Health and Environmental Data from the Harmful Algal Bloom-Related Illness Surveillance System (HABISS) 2007–2011

    Backer, Lorraine C.; Manassaram-Baptiste, Deana; LePrell, Rebecca; Bolton, Birgit

    2015-01-01

    Algae and cyanobacteria are present in all aquatic environments. We do not have a good sense of the extent of human and animal exposures to cyanobacteria or their toxins, nor do we understand the public health impacts from acute exposures associated with recreational activities or chronic exposures associated with drinking water. We describe the Harmful Algal Bloom-related Illness Surveillance System (HABISS) and summarize the collected reports describing bloom events and associated adverse human and animal health events. For the period of 2007–2011, Departments of Health and/or Environment from 11 states funded by the National Center for Environmental Health (NCEH), Centers for Disease Control and Prevention contributed reports for 4534 events. For 2007, states contributed 173 reports from historical data. The states participating in the HABISS program built response capacity through targeted public outreach and prevention activities, including supporting routine cyanobacteria monitoring for public recreation waters. During 2007–2010, states used monitoring data to support196 public health advisories or beach closures. The information recorded in HABISS and the application of these data to develop a wide range of public health prevention and response activities indicate that cyanobacteria and algae blooms are an environmental public health issue that needs continuing attention. PMID:25826054

  16. The NDE1 genomic locus can affect treatment of psychiatric illness through gene expression changes related to microRNA-484.

    Bradshaw, Nicholas J; Ukkola-Vuoti, Liisa; Pankakoski, Maiju; Zheutlin, Amanda B; Ortega-Alonso, Alfredo; Torniainen-Holm, Minna; Sinha, Vishal; Therman, Sebastian; Paunio, Tiina; Suvisaari, Jaana; Lönnqvist, Jouko; Cannon, Tyrone D; Haukka, Jari; Hennah, William

    2017-11-01

    Genetic studies of familial schizophrenia in Finland have observed significant associations with a group of biologically related genes, DISC1 , NDE1 , NDEL1 , PDE4B and PDE4D , the 'DISC1 network'. Here, we use gene expression and psychoactive medication use data to study their biological consequences and potential treatment implications. Gene expression levels were determined in 64 individuals from 18 families, while prescription medication information has been collected over a 10-year period for 931 affected individuals. We demonstrate that the NDE1 SNP rs2242549 associates with significant changes in gene expression for 2908 probes (2542 genes), of which 794 probes (719 genes) were replicable. A significant number of the genes altered were predicted targets of microRNA-484 ( p = 3.0 × 10 -8 ), located on a non-coding exon of NDE1 Variants within the NDE1 locus also displayed significant genotype by gender interaction to early cessation of psychoactive medications metabolized by CYP2C19. Furthermore, we demonstrate that miR-484 can affect the expression of CYP2C19 in a cell culture system. Thus, variation at the NDE1 locus may alter risk of mental illness, in part through modification of miR-484, and such modification alters treatment response to specific psychoactive medications, leading to the potential for use of this locus in targeting treatment. © 2017 The Authors.

  17. The prevalence of heat-related cardiorespiratory symptoms: the vulnerable groups identified from the National FINRISK 2007 Study

    Näyhä, Simo; Rintamäki, Hannu; Donaldson, Gavin; Hassi, Juhani; Jousilahti, Pekka; Laatikainen, Tiina; Jaakkola, Jouni J. K.; Ikäheimo, Tiina M.

    2017-04-01

    The prevalence of heat-related cardiorespiratory symptoms among vulnerable groups is not well known. We therefore estimated the prevalence of heat-related cardiorespiratory symptoms among the Finnish population and their associations with social and individual vulnerability factors. The data came from the National FINRISK 2007 Study, in which 4007 men and women aged 25-74 answered questions on heat-related cardiorespiratory symptoms in the Oulu Cold and Heat Questionnaire 2007. Logistic regression was used to calculate odds ratios (ORs), their 95 % confidence intervals (CIs), and model-predicted prevalence figures. The prevalence of heat-related cardiorespiratory symptoms was 12 %. It increased with age, from 3 % at the age of 25 years to 28 % at the age of 75 years. The symptoms were associated with pre-existing lung (OR 3.93; CI 3.01-5.13) and cardiovascular diseases (OR 2.27; 1.78-2.89); being a pensioner (OR 2.91; 1.65-5.28), unemployed (OR 2.82; 1.47-5.48), or working in agriculture (OR 2.27; 1.14-4.46) compared with working in industry; having only basic vs academic education (OR 1.98; 1.31-3.05); being female (OR 1.94; 1.51-2.50); being heavy vs light alcohol consumer (OR 1.89; 1.02-3.32); undertaking hard vs light physical work (OR 1.48;1.06-2.07); and being inactive vs active in leisure time (OR 1.97; 1.39-2.81). The adjusted prevalence of symptoms showed a wide range of variation, from 3 to 61 % depending on sex, age, professional field, education, and pre-existing lung and cardiovascular diseases. In conclusion, heat-related cardiorespiratory symptoms are commonly perceived among people with pre-existing lung or cardiovascular disease, agricultural workers, unemployed, pensioners, and people having only basic education. This information is needed for any planning and targeting measures to reduce the burden of summer heat.

  18. An analysis of JET fast-wave heating and current drive experiments directly related to ITER

    Bhatnagar, V P; Eriksson, L; Gormezano, C; Jacquinot, J; Kaye, A; Start, D F.H. [Commission of the European Communities, Abingdon (United Kingdom). JET Joint Undertaking

    1994-07-01

    The ITER fast-wave system is required to serve a variety of purposes, in particular, plasma heating to ignition, current profile and burn control and eventually, in conjunction with other schemes, a central non-inductive current drive (CD) for the steady-state operation of ITER. The ICRF heating and current drive data that has been obtained in JET are analyzed in terms of dimensionless parameters, with a view to ascertaining its direct relevance to key ITER requirements. The analysis is then used to identify areas both in physics and technological aspects of ion-cyclotron resonance heating (ICRH) and CD that require further experimentation in ITER-relevant devices such as JET to establish the required data base. (authors). 12 refs., 8 figs.

  19. An analysis of JET fast-wave heating and current drive experiments directly related to ITER

    Bhatnagar, V.P.; Eriksson, L.; Gormezano, C.; Jacquinot, J.; Kaye, A.; Start, D.F.H.

    1994-01-01

    The ITER fast-wave system is required to serve a variety of purposes, in particular, plasma heating to ignition, current profile and burn control and eventually, in conjunction with other schemes, a central non-inductive current drive (CD) for the steady-state operation of ITER. The ICRF heating and current drive data that has been obtained in JET are analyzed in terms of dimensionless parameters, with a view to ascertaining its direct relevance to key ITER requirements. The analysis is then used to identify areas both in physics and technological aspects of ion-cyclotron resonance heating (ICRH) and CD that require further experimentation in ITER-relevant devices such as JET to establish the required data base. (authors). 12 refs., 8 figs

  20. Experimental investigation of thermal conduction and related phenomena in a laser heated plasma

    Gray, D.R.

    1979-02-01

    Thermal conduction in plasmas is of major importance especially in controlled nuclear fusion studies. Direct measurements are rare. When the temperature gradient in a plasma becomes large enough classical thermal conduction (Heat flux q = -kΔT) no longer applies and it is thought that q is limited to some fraction of the free streaming limit qsub(m). The main experiment is the heating of a z-pinch plasma by a fast rising, intense carbon dioxide laser pulse. Electron temperature and density in time and space are diagnosed by ruby laser scattering. The profiles obtained were consistent with a flux limited to approximately 3% of the free streaming limit. Ion acoustic turbulence is observed along the temperature gradient. It is shown that the observed turbulence level is consistent with the heat flux limitation. At electron densities > 10 17 cm -3 backscattered light is observed from the plasma whose growth rate implies that it is Brillouin scattered. (author)

  1. Individual and Public-Program Adaptation: Coping with Heat Waves in Five Cities in Canada

    Mustapha Alhassan

    2011-12-01

    Full Text Available Heat Alert and Response Systems (HARS are currently undergoing testing and implementation in Canada. These programs seek to reduce the adverse health effects of heat waves on human health by issuing weather forecasts and warnings, informing individuals about possible protections from excessive heat, and providing such protections to vulnerable subpopulations and individuals at risk. For these programs to be designed effectively, it is important to know how individuals perceive the heat, what their experience with heat-related illness is, how they protect themselves from excessive heat, and how they acquire information about such protections. In September 2010, we conducted a survey of households in 5 cities in Canada to study these issues. At the time of the survey, these cities had not implemented heat outreach and response systems. The study results indicate that individuals’ recollections of recent heat wave events were generally accurate. About 21% of the sample reported feeling unwell during the most recent heat spell, but these illnesses were generally minor. Only in 25 cases out of 243, these illnesses were confirmed or diagnosed by a health care professional. The rate at which our respondents reported heat-related illnesses was higher among those with cardiovascular and respiratory illnesses, was higher among younger respondents and bore no relationship with the availability of air conditioning at home. Most of the respondents indicated that they would not dismiss themselves as “not at risk” and that they would cope with excessive heat by staying in air conditioned environments and keeping well hydrated. Despite the absence of heat outreach and education programs in their city, our respondents at least a rough idea of how to take care of themselves. The presence of air conditioning and knowledge of cooling centers is location-specific, which provides opportunities for targeting HARS interventions.

  2. Individual and public-program adaptation: coping with heat waves in five cities in Canada.

    Alberini, Anna; Gans, Will; Alhassan, Mustapha

    2011-12-01

    Heat Alert and Response Systems (HARS) are currently undergoing testing and implementation in Canada. These programs seek to reduce the adverse health effects of heat waves on human health by issuing weather forecasts and warnings, informing individuals about possible protections from excessive heat, and providing such protections to vulnerable subpopulations and individuals at risk. For these programs to be designed effectively, it is important to know how individuals perceive the heat, what their experience with heat-related illness is, how they protect themselves from excessive heat, and how they acquire information about such protections. In September 2010, we conducted a survey of households in 5 cities in Canada to study these issues. At the time of the survey, these cities had not implemented heat outreach and response systems. The study results indicate that individuals' recollections of recent heat wave events were generally accurate. About 21% of the sample reported feeling unwell during the most recent heat spell, but these illnesses were generally minor. Only in 25 cases out of 243, these illnesses were confirmed or diagnosed by a health care professional. The rate at which our respondents reported heat-related illnesses was higher among those with cardiovascular and respiratory illnesses, was higher among younger respondents and bore no relationship with the availability of air conditioning at home. Most of the respondents indicated that they would not dismiss themselves as "not at risk" and that they would cope with excessive heat by staying in air conditioned environments and keeping well hydrated. Despite the absence of heat outreach and education programs in their city, our respondents at least a rough idea of how to take care of themselves. The presence of air conditioning and knowledge of cooling centers is location-specific, which provides opportunities for targeting HARS interventions.

  3. Is appreciation of written education about pain neurophysiology related to changes in illness perceptions and health status in patients with fibromyalgia?

    van Ittersum, M W; van Wilgen, C P; Groothoff, J W; van der Schans, C P

    2011-11-01

    To investigate the appreciation of written education about pain neurophysiology in patients with fibromyalgia (FM) and its effects on illness perceptions and perceived health status. A booklet explaining pain neurophysiology was sent to participants with FM. Appreciation was assessed with 10 questions addressing relevance (0-30) and reassurance (0-30). Illness perceptions, catastrophizing and health status were measured with the Revised Illness Perception Questionnaire (IPQ-R), the Pain Catastrophizing Scale (PCS) and the Fibromyalgia Impact Questionnaire (FIQ) at baseline (T0), after a 2-week control period (T1) and 6 weeks after the intervention (T2). Forty-one patients participated. Mean (SD) scores for relevance and reassurance were 21.6 (5.6) and 18.7 (5.7), respectively. Only illness coherence, emotional representations, pain and fatigue changed significantly between T0 and T2. Correlations between appreciation and changes in outcomes ranged between r=0.00 and r=0.34. Although a majority of subjects appreciated the written information, it did not have clinically relevant effects on illness perceptions, catastrophizing or impact of FM on daily life. Written education about pain neurophysiology is inadequate toward changing illness perceptions, catastrophizing or perceived health status of participants with FM; education should be incorporated into a broader multidisciplinary self-management program. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  4. Exercise Prevents Mental Illness

    Purnomo, K. I.; Doewes, M.; Giri, M. K. W.; Setiawan, K. H.; Wibowo, I. P. A.

    2017-03-01

    Multiple current studies show that neuroinflammation may contribute to mental illness such as depression, anxiety, and mood disorder. Chronic inflammation in peripheral tissues is indicated by the increase of inflammatory marker like cytokine IL-6, TNF-α, and IL-1β. Pro-inflammatory cytokine in peripheral tissues can reach brain tissues and activate microglia and it causes neuroinflammation. Psychological stress may led peripheral and central inflammation. Activated microglia will produce pro-inflammatory cytokine, ROS, RNS, and tryptophan catabolizes. This neuroinflammation can promote metabolism changes of any neurotransmitter, such as serotonin, dopamine, and glutamate that will influence neurocircuit in the brain including basal ganglia and anterior cingulated cortex. It leads to mental illness. Exercise give contribution to reduce tissue inflammation. When muscle is contracting in an exercise, muscle will produce the secretion of cytokine like IL-6, IL-1ra, and IL-10. It will react as anti-inflammation and influence macrophage, T cell, monosit, protein Toll-Like Receptor (TLR), and then reduce neuroinflammation, characterised by the decrease of pro-inflammatory cytokine and prevent the activation of microglia in the brain. The objective of the present study is to review scientific articles in the literature related to the contribution of exercise to prevent and ease mental illness.

  5. Spiritual Well-Being as a Component of Health-Related Quality of Life: The Functional Assessment of Chronic Illness Therapy—Spiritual Well-Being Scale (FACIT-Sp

    Jason M. Bredle

    2011-03-01

    Full Text Available The Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp-12 is a 12-item questionnaire that measures spiritual well-being in people with cancer and other chronic illnesses. Cancer patients, psychotherapists, and religious/spiritual experts provided input on the development of the items. It was validated with a large, ethnically diverse sample. It has been successfully used to assess spiritual well-being across a wide range of religious traditions, including those who identify themselves as “spiritual yet not religious.” Part of the larger FACIT measurement system that assesses multidimensional health related quality of life (HRQOL, the FACIT-Sp-12 has been translated and linguistically validated in 15 languages and has been used in dozens of studies examining the relationships among spiritual well-being, health, and adjustment to illness.

  6. Existence of a time-dependent heat flux-related ponderomotive effect

    Schamel, H.; Sack, C.

    1980-01-01

    The existence of a new ponderomotive effect associated with high-frequency waves is pointed out. It originates when time-dependency, mean velocities, or divergent heat fluxes are involved and it supplements the two effects known previously, namely, the ponderomotive force and fake heating. Two proofs are presented; the first is obtained by establishing the momentum equations generalized by including radiation effects and the second by solving the quasi-linear-type diffusion equation explicitly. For a time-dependent wave packet the solution exhibits a new contribution in terms of an integral over previous states. Owing to this term, the plasma has a memory which leads to a breaking of the time symmetry of the plasma response. The range, influenced by the localized wave packet, expands during the course of time due to streamers emanating from the wave active region. Perturbations, among which is the heat flux, are carried to remote positions and, consequently, the region accessible to wave heating is increased. The density dip appears to be less pronounced at the center, and its generation and decay are delayed. The analysis includes a self-consistent action of high-frequency waves as well as the case of traveling wave packets. In order to establish the existence of this new effect, the analytical results are compared with recent microwave experiments. The possibility of generating fast particles by this new ponderomotive effect is emphasized

  7. The relation between land-cover and the urban heat island in northeastern Puerto Rico

    David J.R. Murphy; Myrna Hall; Charles Hall; Gordon Heisler; Steve Stehman

    2007-01-01

    As development continues in Puerto Rico, forests and grasslands are being converted to impervious cover, changing the magnitude and geographic range of the Urban Heat Island (UHI). As part of the U.S. National Science Foundation Long Term Ecological Research Program, this study aims to quantify the various meteorological effects that urbanization may be imparting on...

  8. Validation of the All Patient Refined Diagnosis Related Group (APR-DRG) Risk of Mortality and Severity of Illness Modifiers as a Measure of Perioperative Risk.

    McCormick, Patrick J; Lin, Hung-Mo; Deiner, Stacie G; Levin, Matthew A

    2018-03-22

    The All Patient Refined Diagnosis Related Group (APR-DRG) is an inpatient visit classification system that assigns a diagnostic related group, a Risk of Mortality (ROM) subclass and a Severity of Illness (SOI) subclass. While extensively used for cost adjustment, no study has compared the APR-DRG subclass modifiers to the popular Charlson Comorbidity Index as a measure of comorbidity severity in models for perioperative in-hospital mortality. In this study we attempt to validate the use of these subclasses to predict mortality in a cohort of surgical patients. We analyzed all adult (age over 18 years) inpatient non-cardiac surgery at our institution between December 2005 and July 2013. After exclusions, we split the cohort into training and validation sets. We created prediction models of inpatient mortality using the Charlson Comorbidity Index, ROM only, SOI only, and ROM with SOI. Models were compared by receiver-operator characteristic (ROC) curve, area under the ROC curve (AUC), and Brier score. After exclusions, we analyzed 63,681 patient-visits. Overall in-hospital mortality was 1.3%. The median number of ICD-9-CM diagnosis codes was 6 (Q1-Q3 4-10). The median Charlson Comorbidity Index was 0 (Q1-Q3 0-2). When the model was applied to the validation set, the c-statistic for Charlson was 0.865, c-statistic for ROM was 0.975, and for ROM and SOI combined the c-statistic was 0.977. The scaled Brier score for Charlson was 0.044, Brier for ROM only was 0.230, and Brier for ROM and SOI was 0.257. The APR-DRG ROM or SOI subclasses are better predictors than the Charlson Comorbidity Index of in-hospital mortality among surgical patients.

  9. Validation of an uncertainty of illness scale adapted to use with Spanish emergency department patients and their accompanying relatives or friends.

    Ruymán Brito-Brito, Pedro; García-Tesouro, Esther; Fernández-Gutiérrez, Domingo Ángel; García-Hernández, Alfonso Miguel; Fernández-Gutiérrez, Raquel; Burillo-Putze, Guillermo

    2018-01-01

    To validate a Spanish adaptation of the Mishel Uncertainty of Illness Scale for use with emergency-department (ED) patients and their accompanying relatives or friends (the UIS-ED). We first developed a version of the questionnaire for Spanish ED situations. Next we assessed the content validity index for each of its items, revised it, and reassessed its face validity to produce a second version, which we then piloted in 20 hospital ED patients. A third revised version was then validated in a population of 320 adults (160 patients and 160 accompanying persons) who attended the ED between November 2015 and September 2016. The 12-item UIS-ED (60 points) was administered by 2 nurses while the patients and accompanying persons were in the ED. We gathered sociodemographic and clinical data as well as the subjects' perception about the information they were given. The mean (SD) uncertainty score among patients was 29 (11) points. Accompanying persons had a mean score of 36 (13) points. Factorial analysis confirmed the instrument's construct validity, finding that both dimensions of the original Mishel scale (complexity and ambiguity) were present in 6 items each. Factorial analysis explained 60% of the total variance in the patient version and 67% of the variance in the version for accompanying persons. Reliability statistics were good, with Cronbach's α values ranging from 0.912 to 0.938. Split-half reliability statistics ranged from 0.901 to 0.933. Correlations were significant in the analysis of convergent validity. The UIS-ED questionnaire may prove to be a simple, valid, and reliable way for assessing uncertainty in patients and their accompanying friends or relatives attending Spanish EDs.

  10. Cultural Variation in Implicit Mental Illness Stigma.

    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.

  11. Identifying heat-related deaths by using medical examiner and vital statistics data: Surveillance analysis and descriptive epidemiology - Oklahoma, 1990-2011.

    Johnson, Matthew G; Brown, Sheryll; Archer, Pam; Wendelboe, Aaron; Magzamen, Sheryl; Bradley, Kristy K

    2016-10-01

    Approximately 660 deaths occur annually in the United States associated with excess natural heat. A record heat wave in Oklahoma during 2011 generated increased interest concerning heat-related mortality among public health preparedness partners. We aimed to improve surveillance for heat-related mortality and better characterize heat-related deaths in Oklahoma during 1990-2011, and to enhance public health messaging during future heat emergencies. Heat-related deaths were identified by querying vital statistics (VS) and medical examiner (ME) data during 1990-2011. Case inclusion criteria were developed by using heat-related International Classification of Diseases codes, cause-of-death nomenclature, and ME investigation narrative. We calculated sensitivity and predictive value positive (PVP) for heat-related mortality surveillance by using VS and ME data and performed a descriptive analysis. During the study period, 364 confirmed and probable heat-related deaths were identified when utilizing both data sets. ME reports had 87% sensitivity and 74% PVP; VS reports had 80% sensitivity and 52% PVP. Compared to Oklahoma's general population, decedents were disproportionately male (67% vs. 49%), aged ≥65 years (46% vs. 14%), and unmarried (78% vs. 47%). Higher rates of heat-related mortality were observed among Blacks. Of 95 decedents with available information, 91 (96%) did not use air conditioning. Linking ME and VS data sources together and using narrative description for case classification allows for improved case ascertainment and surveillance data quality. Males, Blacks, persons aged ≥65 years, unmarried persons, and those without air conditioning carry a disproportionate burden of the heat-related deaths in Oklahoma. Published by Elsevier Inc.

  12. Illness perceptions and psychological distress associated with physical health-related quality of life in primary Sjögren's syndrome compared to systemic lupus erythematosus and rheumatoid arthritis.

    Kotsis, Konstantinos; Voulgari, Paraskevi V; Tsifetaki, Niki; Drosos, Alexandros A; Carvalho, André F; Hyphantis, Thomas

    2014-12-01

    Notwithstanding that psychological distress and illness perceptions are important in determining outcomes in rheumatic diseases, few studies investigated these variables in primary Sjögren's syndrome (pSS). We aimed to compare illness perceptions and psychological distress in patients with pSS, systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) and to test whether their associations with health-related quality of life (HRQoL) are similar in these groups of patients. In 57 patients with pSS, 75 with SLE and 199 with RA, we administered the Patient Health Questionnaire (PHQ-9), the Symptom Check-List and the Brief-Illness Perception Questionnaire to assess psychological variables and the World Health Organization Quality of Life Instrument, Short-Form to assess HRQoL. Hierarchical regression models determined the associations of psychological variables with HRQoL after adjusting for demographic variables and clinical parameters. The prevalence of clinically significant depressive symptoms (PHQ-9 ≥ 10) was 24.6 % in pSS, 29.3 % in SLE and 25.1 % in RA. Patients with pSS showed little understanding of their disease (comprehensibility) and attributed more symptoms to their illness (identity) compared with the other groups of patients. Illness perceptions and depressive symptoms were independently associated with physical HRQoL in a similar pattern in all three groups. In pSS, however, the patients' worries about the consequences of their illness was a stronger correlate of physical HRQoL than pain. These findings indicate that psychological factors are important correlates of HRQoL in these disease groups and encourage the design of psycho-educational therapies targeting disease-related cognitions in pSS in an attempt to improve patient's physical HRQoL.

  13. Use of geothermal heat for crop drying and related agricultural applications. Final report

    Gordon, T.J.; Wright, T.C.; Fein, E.; Munson, T.R.; Richmond, R.C.

    1978-03-01

    Observations led to the selection of the alfalfa dehydration industry for in-depth analysis of the application of moderate-temperature geothermal heat. Six geothermal heat exchanger/dryer configurations were examined. A low-temperature conveyor dryer using geothermal water to supply all required heat was chosen for site-specific analysis, the retrofitting of a large alfalfa dehydration plant within the Heber KGRA in the Imperial Valley, California. Even in the most favorable scenario--sharing a geothermal pipeline with the neighboring fertilizer plant--geothermal retrofitting would increase the price of the alfalfa ''dehy'' about 40 percent. The geothermal brine is estimated to cost $2.58/million Btu's compared with a 1977 natural gas cost of $1.15. Capital cost for heat exchangers and the new dryers is estimated at $3.3 million. The Heber plant appeared to offer the only good opportunity for geothermal retrofitting of an existing alfalfa dehydration plant. Construction of new plants at geothermal resource sites cannot be justified due to the uncertain state of the ''dehy'' industry. Use of geothermal heat for drying other crops may be much more promising. The potato dehydration industry, which is concentrated in the geothermal-rich Snake River Valley of Idaho, appears to offer good potential for geothermal retrofitting; about 4.7 x 10{sup 12}Btu's are used annually by plants within 50 miles of resources. Drying together at the geothermal wellhead several crops that have interlocking processing seasons and drying-temperature requirements may be quite attractive. The best ''multicrop drying center'' site identified was at Power Ranch Wells, Arizona; 34 other sites were defined. Agricultural processing applications other than drying were investigated briefly.

  14. Energy-related environmental and economic performance analysis of two different types of electrically heated student residence halls

    Amber, Khuram Pervez; Aslam, Muhammad Waqar

    2018-03-01

    Student residence halls occupy 26% of the total area of a typical university campus in the UK and are directly responsible for 24% of university's annual CO2 emissions. Based on five years measured data, this paper aims to investigate the energy-related environmental and economic performance of electrically heated residence halls in which space heating is provided by two different types of electric heaters, that is, panel heater (PHT) and storage heater (SHT). Secondly, using statistical and machine learning methods, the paper attempts to investigate the relationship between daily electricity consumption and five factors (ambient temperature, solar radiation, relative humidity, wind speed and type of day). Data analysis revealed that electricity consumption of both halls is mainly driven by ambient temperature only, whereas SHT residence has 39% higher annual electricity bill and emits 70% higher CO2 emissions on a per square metre basis compared to the PHT residence hall.

  15. Transport phenomena in solid oxide fuel cell electrodes focusing on heat transfer related to chemical reactions

    Navasa, M; Andersson, M; Yuan, J; Sundén, B

    2012-01-01

    Solid oxide fuel cells (SOFCs) are widely studied for their advantages especially at high temperatures. However, operating at high temperatures represents a high cost due to the strict requirements the materials are expected to fulfill. Thus, the main goal in SOFC research has been to decrease the operating temperature so that the range of available materials is widened and hence, the operating cost can be reduced. In this paper, the different heat sources that contribute to the cell energy balance are presented with strong emphasis on the chemical reactions that take place in SOFCs. The knowledge of which heat sources or sinks taking place and their locations within the SOFC can provide useful information for further design and efficiency improvements.

  16. Heat capacity of the white pine biocarbon preform and the related biocarbon/copper composite

    Smirnov, I. A.; Orlova, T. S.; Smirnov, B. I.; Wlosewicz, D. W.; Misiorek, H.; Jezowski, A.; Wilkes, T. E.; Faber, K. T.

    2009-11-01

    This paper reports on measurements in the 80-300-K temperature interval of the heat capacity at constant pressure C p ( T) of high-porosity amorphous white pine carbon preforms (biocarbon) prepared by pyrolysis (carbonization) at T carb = 1000 and 2400°C in an argon flow. The dependences C p ( T) for biocarbon/copper composites based on the carbon preforms obtained have also been determined. It is shown that the mixture rule holds for the composites, i.e., that C p ( T) of the composite is a sum of the heat capacities of the constituent materials taken in the corresponding ratios. Phonon mean free paths for the white pine carbon preforms prepared at T carb = 1000 and 2400°C have been calculated and used to estimate the size of the nanocrystallites contributing to formation of the carbon frameworks of these preforms.

  17. Fuel cycle related parametric study considering long lived actinide production, decay heat and fuel cycle performances

    Raepsaet, X.; Damian, F.; Lenain, R.; Lecomte, M.

    2001-01-01

    One of the very attractive HTGR reactor characteristics is its highly versatile and flexible core that can fulfil a wide range of diverse fuel cycles. Based on a GTMHR-600 MWth reactor, analyses of several fuel cycles were carried out without taking into account common fuel particle performance limits (burnup, fast fluence, temperature). These values are, however, indicated in each case. Fuel derived from uranium, thorium and a wide variety of plutonium grades has been considered. Long-lived actinide production and total residual decay heat were evaluated for the various types of fuel. The results presented in this papers provide a comparison of the potential and limits of each fuel cycle and allow to define specific cycles offering lowest actinide production and residual heat associated with a long life cycle. (author)

  18. Review of issues relating to enhancement of critical heat flux in nuclear reactors - 15220

    Hasan, S.M.K.; Chowdhury, M.A.Z.; Sarkar, M.A.R.

    2015-01-01

    Critical heat flux (CHF) is manifested by sharp reduction in