Using Audience Response Technology to provide formative feedback on pharmacology performance for non-medical prescribing students--a preliminary evaluation.

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Mostyn, Alison; Meade, Oonagh; Lymn, Joanne S

2012-11-13

The use of anonymous audience response technology (ART) to actively engage students in classroom learning has been evaluated positively across multiple settings. To date, however, there has been no empirical evaluation of the use of individualised ART handsets and formative feedback of ART scores. The present study investigates student perceptions of such a system and the relationship between formative feedback results and exam performance. Four successive cohorts of Non-Medical Prescribing students (n=107) had access to the individualised ART system and three of these groups (n=72) completed a questionnaire about their perceptions of using ART. Semi-structured interviews were carried out with a purposive sample of seven students who achieved a range of scores on the formative feedback. Using data from all four cohorts of students, the relationship between mean ART scores and summative pharmacology exam score was examined using a non-parametric correlation. Questionnaire and interview data suggested that the use of ART enhanced the classroom environment, motivated students and promoted learning. Questionnaire data demonstrated that students found the formative feedback helpful for identifying their learning needs (95.6%), guiding their independent study (86.8%), and as a revision tool (88.3%). Interviewees particularly valued the objectivity of the individualised feedback which helped them to self-manage their learning. Interviewees' initial anxiety about revealing their level of pharmacology knowledge to the lecturer and to themselves reduced over time as students focused on the learning benefits associated with the feedback.A significant positive correlation was found between students' formative feedback scores and their summative pharmacology exam scores (Spearman's rho = 0.71, N=107, p<.01). Despite initial anxiety about the use of individualised ART units, students rated the helpfulness of the individualised handsets and personalised formative feedback highly

Using Audience Response Technology to provide formative feedback on pharmacology performance for non-medical prescribing students - a preliminary evaluation

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Mostyn Alison

2012-11-01

Full Text Available Abstract Background The use of anonymous audience response technology (ART to actively engage students in classroom learning has been evaluated positively across multiple settings. To date, however, there has been no empirical evaluation of the use of individualised ART handsets and formative feedback of ART scores. The present study investigates student perceptions of such a system and the relationship between formative feedback results and exam performance. Methods Four successive cohorts of Non-Medical Prescribing students (n=107 had access to the individualised ART system and three of these groups (n=72 completed a questionnaire about their perceptions of using ART. Semi-structured interviews were carried out with a purposive sample of seven students who achieved a range of scores on the formative feedback. Using data from all four cohorts of students, the relationship between mean ART scores and summative pharmacology exam score was examined using a non-parametric correlation. Results Questionnaire and interview data suggested that the use of ART enhanced the classroom environment, motivated students and promoted learning. Questionnaire data demonstrated that students found the formative feedback helpful for identifying their learning needs (95.6%, guiding their independent study (86.8%, and as a revision tool (88.3%. Interviewees particularly valued the objectivity of the individualised feedback which helped them to self-manage their learning. Interviewees’ initial anxiety about revealing their level of pharmacology knowledge to the lecturer and to themselves reduced over time as students focused on the learning benefits associated with the feedback. A significant positive correlation was found between students’ formative feedback scores and their summative pharmacology exam scores (Spearman’s rho = 0.71, N=107, p Conclusions Despite initial anxiety about the use of individualised ART units, students rated the helpfulness of the

Using Audience Response Technology to provide formative feedback on pharmacology performance for non-medical prescribing students - a preliminary evaluation

Science.gov (United States)

2012-01-01

Background The use of anonymous audience response technology (ART) to actively engage students in classroom learning has been evaluated positively across multiple settings. To date, however, there has been no empirical evaluation of the use of individualised ART handsets and formative feedback of ART scores. The present study investigates student perceptions of such a system and the relationship between formative feedback results and exam performance. Methods Four successive cohorts of Non-Medical Prescribing students (n=107) had access to the individualised ART system and three of these groups (n=72) completed a questionnaire about their perceptions of using ART. Semi-structured interviews were carried out with a purposive sample of seven students who achieved a range of scores on the formative feedback. Using data from all four cohorts of students, the relationship between mean ART scores and summative pharmacology exam score was examined using a non-parametric correlation. Results Questionnaire and interview data suggested that the use of ART enhanced the classroom environment, motivated students and promoted learning. Questionnaire data demonstrated that students found the formative feedback helpful for identifying their learning needs (95.6%), guiding their independent study (86.8%), and as a revision tool (88.3%). Interviewees particularly valued the objectivity of the individualised feedback which helped them to self-manage their learning. Interviewees’ initial anxiety about revealing their level of pharmacology knowledge to the lecturer and to themselves reduced over time as students focused on the learning benefits associated with the feedback. A significant positive correlation was found between students’ formative feedback scores and their summative pharmacology exam scores (Spearman’s rho = 0.71, N=107, pstudents rated the helpfulness of the individualised handsets and personalised formative feedback highly. The significant correlation between ART

Reduction of porcine circovirus type 2 (PCV2 viremia by a reformulated inactivated chimeric PCV1-2 vaccine-induced humoral and cellular immunity after experimental PCV2 challenge

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Seo Hwi

2012-10-01

Full Text Available Abstract Background The objective of the present study was to elucidate the humoral and cellular immune response mechanisms by which a reformulated inactivated chimeric PCV1-2 vaccine reduces the PCV2 viremia. Forty PCV2 seronegative 3-week-old pigs were randomly divided into the following four groups: vaccinated challenged (T01, vaccinated non-challenged (T02, non-vaccinated challenged (T03, and non-vaccinated non-challenged (T04 animals. The pigs in groups T01 and T02 were immunized with a reformulated inactivated chimeric PCV1-2 vaccine (Fostera™ PCV; Pfizer Animal Health administered as a 2.0 ml dose at 21 days of age. At 35 days of age (0 days post-challenge, the pigs in groups T01 and T03 were inoculated intranasally with 2 ml each of PCV2b. Results A reduction of PCV2 viremia coincided with the appearance of both PCV2-specific neutralizing antibodies (NA and interferon-γ-secreting cells (IFN-γ-SCs in the vaccinated animals. However, the presence of anti-PCV2 IgG antibodies did not correlate with the reduction of PCV2 viremia. Lymphocyte subset analysis indicated that the numbers of CD3+ and CD4+ cells increased in vaccinated animals but the numbers of CD4+ cells decreased transiently in non-vaccinated animals. The observation of a delayed type hypersensitivity response in only the vaccinated animals also supports a CD4+ cell-associated protective cellular immune response induced by the reformulated inactivated chimeric PCV1-2 vaccine. Conclusions The induction of PCV2-specific NA and IFN-γ-SCs, and CD4+ cells by the reformulated inactivated chimeric PCV1-2 vaccine is the important protective immune response leading to reduction of the PCV2 viremia and control of the PCV2 infection. To our knowledge this is the first demonstration of protective humoral and cellular immunity induced by the reformulated inactivated chimeric PCV1-2 vaccine and its effect on reduction of PCV2 viremia by vaccination.

Association between childhood maltreatment and non-medical prescription opioid use among Chinese senior high school students: The moderating role of gender.

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Lei, Yiling; Xi, Chuhao; Li, Pengsheng; Luo, Min; Wang, Wanxin; Pan, Siyuan; Gao, Xue; Xu, Yan; Huang, Guoliang; Deng, Xueqing; Guo, Lan; Lu, Ciyong

2018-08-01

Non-medical prescription opioid use (NMPOU) and childhood maltreatment are currently serious problems among adolescents worldwide, and childhood maltreatment may be associated with the increased rates of NMPOU. This study examined the specific associations between particular types of childhood maltreatment and lifetime NMPOU and assessed whether gender has a moderating effect on these associations. A 3-stage, stratified cluster, randomized sampling method was used to collect data from 11,194 high school students in Chongqing. The prevalence of the lifetime NMPOU among senior high school students in Chongqing was 7.7%. Physical abuse (AOR = 1.11, 95% CI = 1.07-1.14), emotional abuse (AOR = 1.05, 95% CI = 1.03-1.08), sexual abuse (AOR = 1.04, 95% CI = 1.01-1.07), physical neglect (AOR = 1.06, 95% CI = 1.04-1.09), and emotional neglect (AOR = 1.03, 95% CI = 1.02-1.04) were all positively associated with lifetime NMPOU. The moderating effects of gender on emotional abuse (P = 0.004) and sexual abuse (P = 0.019) were statistically significant in the adjusted model of lifetime NMPOU. According to the stratification analyses in which the male and female students were analyzed separately, female students who previously experienced emotional/sexual abuse had a higher prevalence of lifetime NMPOU. The study sample only contained school students and cross-sectional design limited our ability to make causal inferences. Childhood maltreatment was positively associated with lifetime NMPOU, and gender had a moderating effect on the associations between childhood maltreatment and lifetime NMPOU. Early identification of and intervention for childhood maltreatment victims, particularly female victims, may help reduce the lifetime risk of NMPOU. Copyright © 2018 Elsevier B.V. All rights reserved.

Primary care practice-based care management for chronically ill patients (PraCMan: study protocol for a cluster randomized controlled trial [ISRCTN56104508

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Baldauf Annika

2011-06-01

Full Text Available Abstract Background Care management programmes are an effective approach to care for high risk patients with complex care needs resulting from multiple co-occurring medical and non-medical conditions. These patients are likely to be hospitalized for a potentially "avoidable" cause. Nurse-led care management programmes for high risk elderly patients showed promising results. Care management programmes based on health care assistants (HCAs targeting adult patients with a high risk of hospitalisation may be an innovative approach to deliver cost-efficient intensified care to patients most in need. Methods/Design PraCMan is a cluster randomized controlled trial with primary care practices as unit of randomisation. The study evaluates a complex primary care practice-based care management of patients at high risk for future hospitalizations. Eligible patients either suffer from type 2 diabetes mellitus, chronic obstructive pulmonary disease, chronic heart failure or any combination. Patients with a high likelihood of hospitalization within the following 12 months (based on insurance data will be included in the trial. During 12 months of intervention patients of the care management group receive comprehensive assessment of medical and non-medical needs and resources as well as regular structured monitoring of symptoms. Assessment and monitoring will be performed by trained HCAs from the participating practices. Additionally, patients will receive written information, symptom diaries, action plans and a medication plan to improve self-management capabilities. This intervention is addition to usual care. Patients from the control group receive usual care. Primary outcome is the number of all-cause hospitalizations at 12 months follow-up, assessed by insurance claims data. Secondary outcomes are health-related quality of life (SF12, EQ5D, quality of chronic illness care (PACIC, health care utilisation and costs, medication adherence (MARS, depression

[Driving license of patients with epilepsy, management of their oral drugs and suppositories by non-medical professionals, and the role of pediatric neurologists].

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Ito, Masatoshi; Miyake, Shouta

2004-05-01

In June 2002, the following new driving regulations were enforced in Japan: 1. A person with epilepsy may be granted a driving license after a seizure-free period of two years. 2. A person with simple partial seizures that would not impair driving safety may be granted a driving license if no other seizures that may impair driving safety have occurred over a period of at least one year. 3. A person with seizures occurring only in sleep may be granted a driving license if no seizures have occurred in waking over a period of at least two years. 4. In case that the above requirements are going to be met within 6 months, driving should be prohibited for 6 months. 5. A person with epilepsy is recommended to apply for a license to drive heavy and/or public vehicles only after a seizure-free period of 5 years without medication. The committee for legal problems of the Japan Epilepsy Society proposed a guideline for non-medical teaching or caring professionals to give children with epilepsy antiepileptic medication or to insert suppositories, if needed, at schools or care institutions. The guideline indicated the following preconditions as important: 1. There must be a wish and consent of the patient or his/her family. 2. Drugs or suppositories are usually taken or used at home and regarded as a safe procedure. 3. Attending doctor should provide clear information about the use and risk of the medication or suppository. 4. Privacy of the patient should be protected. Pediatric neurologists are expected to play an important role on these issues.

Nurse consultants 10 years on: an insight to the role for nurse managers.

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Mullen, Chris; Gavin-Daley, Ann; Kilgannon, Helen; Swift, Juliette

2011-09-01

To evaluate the Non-Medical Consultant role in the North West of England. The objective was to identify the current number of Non-Medical Consultants, what they do and the impact of the role in practice. The Non-Medical Consultant role for nursing and midwifery was introduced in the UK in 2000 to provide better outcomes for patients by improving service and quality; strengthening clinical leadership; and providing a new career opportunity to help retain experienced and expert professionals in practice. A combined qualitative and quantitative design was adopted. This included desktop review of previous studies, a survey questionnaire to current consultants, focus group meetings with Non-Medical Consultants, sponsors and champions. The role is effective, flexible, responsive and outward facing both internal to the organization and externally on a local, regional and national basis. A key challenge for the Non-Medical Consultants was organizational understanding of the role. The small size of the Non-Medical Consultant workforce can limit individual organizations experience of establishing and supporting the role. Effective Non-Medical Consultants lead, drive and support quality improvement, increased productivity and service effectiveness. Other impacts include sharing and promoting best practice with colleagues, income generation and financial savings through service redesign and/or staff skill mix changes. Managerial issues identified may assist Nurse Managers seeking to introduce new consultant roles and/or support, and retain existing consultants to reach their full potential. 2011 Blackwell Publishing Ltd.

Association of knowledge of HIV and other factors with individuals' attitudes toward HIV infection: a national cross-sectional survey among the Japanese non-medical working population.

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Guoqin Wang

Full Text Available BACKGROUND: The stigma of and discrimination because of HIV has been described as the most important obstacle to prevention and treatment efforts. The purpose of this study was to investigate negative attitudes and prejudice toward HIV among the Japanese non-medical working population and to explore contributing factors. METHODS: An online anonymous nationwide survey involving approximately 3,000 individuals was conducted in Japan. Questions ranged from background information and HIV knowledge to individuals' attitudes towards HIV infection in the workplace. Descriptive statistics and logistic regression were applied for analysis. RESULTS: Thirty-three percent of participants feared transmission of HIV from infected colleagues, 34% tended to avoid contact with them and 40% had prejudiced opinions about HIV infection. Despite a relatively high level of knowledge of HIV/AIDS overall (11.9 ± 3.3 from 15 points, only 50% of individuals were aware of some issues. Greater knowledge was associated with less negative attitudes towards HIV infection (OR 0.39, 95% CI 0.31-0.48 for prejudiced opinion, high compared with low level of knowledge, whereas greater health consciousness was inversely related to attitude (OR 1.97, 95% CI 1.50-2.58 for prejudiced opinion, high compared with low health consciousness. CONCLUSION: Knowledge neutralizes peoples' negative attitudes towards HIV infection, whereas greater health consciousness may worsen them. Educational programs should balance knowledge with health consciousness to improve the efficacy of HIV interventions.

Alcohol screening and brief intervention in workplace settings and social services: A comparison of literature

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Bernd eSchulte

2014-10-01

Full Text Available BACKGROUND: The robust evidence base for the effectiveness of alcohol screening and brief interventions (ASBI in primary health care (PHC suggests a widespread expansion of ASBI in non-medical settings could be beneficial. Social service and criminal justice settings work frequently with persons with alcohol use disorders, and workplace settings can be an appropriate setting for the implementation of alcohol prevention programs, as a considerable part of their social interactions take place in this context. METHODS: Update of two systematic reviews on ASBI effectiveness in workplaces, social service and criminal justice settings. Review to identify implementation barriers and facilitators and future research needs of ASBI in nonmedical settings.RESULTS: We found a limited number of randomized controlled trials (RCTs in non-medical settings with an equivocal evidence of effectiveness of ASBI. In terms of barriers and facilitators to implementation, the heterogeneity of non-medical settings makes it challenging to draw overarching conclusions. In the workplace, employee concerns with regard to the consequences of self-disclosure appear to be key. For social services, the complexity of certain client needs suggest a stepped and carefully tailored approach is likely to be required.DISCUSSION: Compared to PHC, the reviewed settings are far more heterogeneous in terms of client groups, external conditions and the focus on substance use disorders. Thus, future research should try to systematize these differences, and consider their implications for the deliverability, acceptance and potential effectiveness of ASBI for different target groups, organisational frameworks and professionals.

[Brain activitivation of euthymic patients with Type I bipolar disorder in resting state Default Mode Network].

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Vargas, Cristian; Pineda, Julián; Calvo, Víctor; López-Jaramillo, Carlos

2014-01-01

As there are still doubts about brain connectivity in type I bipolar disorder (BID), resting-state functional magnetic resonance imaging (RS-fMRI) studies are necessary during euthymia for a better control of confounding factors. To evaluate the differences in brain activation between euthymic BID patients and control subjects using resting state- functional-magnetic resonance imaging (RS-fMRI), and to identify the lithium effect in these activations. A cross-sectional study was conducted on 21 BID patients (10 receiving lithium only, and 11 non-medicated) and 12 healthy control subjects, using RS fMRI and independent component analysis (ICA). Increased activation was found in the right hippocampus (P=.049) and posterior cingulate (P=.040) within the Default Mode Network (DMN) when BID and control group were compared. No statistically significant differences were identified between BID on lithium only therapy and non-medicated BID patients. The results suggest that there are changes in brain activation and connectivity in BID even during euthymic phase and mainly within the DMN network, which could be relevant in affect regulation. Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

A survey of awareness related to the use of antibiotics for dental issues among non-medical female university students in Riyadh, Saudi Arabia.

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Abu-Mostafa, Nedal A; Al-Mejlad, Najmah J; Al-Yami, Amal S; Al-Sakhin, Fatimah Z; Al-Mudhi, Shahad A

Inappropriate use of antibiotics may lead to adverse side effects. This cross-sectional survey aimed to investigate the knowledge and attitude of female non-medical students regarding the medical and dental use of antibiotics. Four hundred validated self-administered questionnaires were distributed in Princess Norah Bint-Abdurrahman University, Riyadh, Saudi Arabia. The questionnaire included questions about accessibility, attitude toward usage, efficacy, side effects, resistance, and usage for dental issues. Knowledge was estimated for every respondent by counting the correct answers, which were considered as points. The scores were categorized as poor, moderate, and high. Of the respondents, 77.8% answered they get antibiotics according to a doctor's prescription; however, 31% stops taking antibiotics when they feel well. Only 38.8% of respondents knew that antibiotics may cause allergic reactions while 59.8% believed the human body can be resistant to antibiotics. The percentages of answers related to dental issues were: antibiotics relieve dental pain (68.8%), antibiotics can be harmful for children's teeth (27.3%), antibiotics are best avoided in pregnancy (56.7%) and no need for antibiotics after scaling (33.8%), root canal treatment (16%), or simple extraction (40.3%). Of respondents, 68% had poor scores about antibiotics efficacy, side effects, and resistance while 86.8% had poor scores related to dental problems. This study noticed a bad attitude related to antibiotics usage, with many misconceptions and poor knowledge. Moreover, the necessity of antibiotics for treatment of dental disease or after dental procedures was totally unclear for the respondents. Community campaigns are recommended every university semester to educate students about the indications, efficacy, and side effects of antibiotics. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

High School Sports Participation and Substance Use: Differences by Sport, Race, and Gender

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Denham, Bryan E.

2014-01-01

Drawing on data gathered in the 2009 Monitoring the Future study of American youth, and controlling for race and noncompetitive exercise frequency, this research examined the explanatory effects of competitive sports participation on alcohol consumption and marijuana use as well as the nonmedical use of prescription pain relievers among American…

PET-CT in oncological patients: analysis of informal care costs in cost-benefit assessment.

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Orlacchio, Antonio; Ciarrapico, Anna Micaela; Schillaci, Orazio; Chegai, Fabrizio; Tosti, Daniela; D'Alba, Fabrizio; Guazzaroni, Manlio; Simonetti, Giovanni

2014-04-01

The authors analysed the impact of nonmedical costs (travel, loss of productivity) in an economic analysis of PET-CT (positron-emission tomography-computed tomography) performed with standard contrast-enhanced CT protocols (CECT). From October to November 2009, a total of 100 patients referred to our institute were administered a questionnaire to evaluate the nonmedical costs of PET-CT. In addition, the medical costs (equipment maintenance and depreciation, consumables and staff) related to PET-CT performed with CECT and PET-CT with low-dose nonenhanced CT and separate CECT were also estimated. The medical costs were 919.3 euro for PET-CT with separate CECT, and 801.3 euro for PET-CT with CECT. Therefore, savings of approximately 13% are possible. Moreover, savings in nonmedical costs can be achieved by reducing the number of hospital visits required by patients undergoing diagnostic imaging. Nonmedical costs heavily affect patients' finances as well as having an indirect impact on national health expenditure. Our results show that PET-CT performed with standard dose CECT in a single session provides benefits in terms of both medical and nonmedical costs.

Uso não-médico de medicamentos psicoativos entre escolares do ensino fundamental e médio no Sul do Brasil Non-medical use of psychoactive medicines among elementary and high school students in Southern Brazil

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Tatiane da Silva Dal Pizzol

2006-01-01

Full Text Available O objetivo do presente estudo é investigar a prevalência de uso não-médico de medicamentos entre escolares da rede de ensino público e privado de Passo Fundo, Rio Grande do Sul, Brasil, e sua distribuição em relação a fatores sócio-demográficos. Por meio de um delineamento transversal, foi aplicado um questionário de autopreenchimento a 5.057 estudantes a partir da quinta série do ensino fundamental até o terceiro ano do ensino médio. O questionário continha perguntas sobre o uso, sem receita médica, de anfetamínicos, ansiolíticos, barbitúricos, anticolinérgicos, opiáceos, orexígenos e anabolizantes. Da amostra, 7,7% consumiram ansiolíticos alguma vez na vida, 6,4% consumiram anfetamínicos, 2,2%, anabolizantes, e 1,1%, barbitúricos. Estudantes do sexo feminino apresentaram maior consumo de ansiolíticos e anfetamínicos, enquanto que o consumo de anabolizantes foi maior no sexo masculino. O padrão de consumo de medicamentos psicoativos é semelhante ao observado em adultos, sugerindo a necessidade de inclusão de crianças e adolescentes nas campanhas educativas para prevenção do uso indevido de medicamentos.The objective of this study is to assess the prevalence of and risk factors for the non-medical use of psychoactive medicines among students at public and private schools of Passo Fundo, Southern Brazil. A cross-sectional study was carried out using a questionnaire administered to 5,057 students from the 5th grade of elementary school to the 3rd year of high school. The questionnaire contained questions about the use of amphetamines, tranquilizers, barbiturates, anticholinergics, opioids, appetite stimulants, and anabolic steroids. Of the sample total, 7.7% had consumed tranquilizers sometime during their lives, 6.4% had used amphetamines, 2.2% had used anabolic steroids, and 1.1% had used barbiturates. Female students reported significantly greater consumption of tranquilizers and amphetamines, while anabolic

Efficacy of Moringa oleifera leaf powder as a hand-washing product: a crossover controlled study among healthy volunteers.

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Torondel, Belen; Opare, David; Brandberg, Bjorn; Cobb, Emma; Cairncross, Sandy

2014-02-14

Moringa oleifera is a plant found in many tropical and subtropical countries. Many different uses and properties have been attributed to this plant, mainly as a nutritional supplement and as a water purifier. Its antibacterial activity against different pathogens has been described in different in vitro settings. However the potential effect of this plant leaf as a hand washing product has never been studied. The aim of this study is to test the efficacy of this product using an in vivo design with healthy volunteers. The hands of fifteen volunteers were artificially contaminated with Escherichia coli. Moringa oleifera leaf powder was tested as a hand washing product and was compared with reference non-medicated liquid soap using a cross over design following an adaptation of the European Committee for Standardization protocol (EN 1499). In a second part of tests, the efficacy of the established amount of Moringa oleifera leaf powder was compared with an inert powder using the same protocol. Application of 2 and 3 g of dried Moringa oleifera leaf powder (mean log10-reduction: 2.44 ± 0.41 and 2.58 ± 0.34, respectively) was significantly less effective than the reference soap (3.00 ± 0.27 and 2.99 ± 0.26, respectively; p Moringa oleifera (2 and 3 g) but using a wet preparation, was also significantly less effective than reference soap (p Moringa oleifera powder in dried or wet preparation (mean log10-reduction: 2.70 ± 0.27 and 2.91 ± 0.11, respectively) compared with reference soap (2.97 ± 0.28). Application of calcium sulphate inert powder was significantly less effective than the 4 g of Moringa oleifera powder (p Moringa oleifera powder in dried and wet application had the same effect as non-medicated soap when used for hand washing. Efficacious and available hand washing products could be useful in developing countries in controlling pathogenic organisms that are transmitted through contaminated hands.

Why healthcare workers give prelacteal feeds.

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Akuse, R M; Obinya, E A

2002-08-01

Because prelacteal feeds can adversely affect breastfeeding, UNICEF/WHO discourage their use unless medically indicated. The study was carried out to determine the proportion of healthcare workers who routinely give prelacteal feeds, and their reasons for doing so; further, to determine whether any differences exist between medically and non-medically trained healthcare workers in their administration of prelacteal feeds. Survey. Primary, secondary and tertiary health facilities in Kaduna township Nigeria. Of 1100 healthcare workers sampled, 747 (68%) responded. Of these 80% had received medical training, 20% had not. Use of a pretested validated questionnaire. Large proportions of both medical and non-medically trained healthcare workers stated they routinely give prelacteal feeds (doctors, 68.2%; nurses, 70.2%; and non-medical, 73.6%). However their reasons for doing so differed significantly (P=0.00001). Nurses gave mainly for perceived breast milk insufficiency, doctors for prevention of dehydration, hypoglycaemia and neonatal jaundice and non-medical staff to prepare the gastrointestinal tract for digestion and to quench thirst. Most healthcare workers (medical and non-medical) routinely and unnecessarily give prelacteal feeds. Therefore training and retraining programmes in lactation management are necessary and must include non-medical staff. These programmes, while emphasizing the danger of giving prelacteal feeds, must deal with the misconceptions of each group. Deliberate efforts have to be made to incorporate clinical training in breastfeeding in curricula of Schools of Medicine and Nursing.

Information Needs of Cancer Patients and Perception of Impact of the Disease, of Self-Efficacy, and Locus of Control.

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Keinki, C; Seilacher, E; Ebel, M; Ruetters, D; Kessler, I; Stellamanns, J; Rudolph, I; Huebner, J

2016-09-01

The aim of our study was to investigate the relationship between information needs and cancer patients' perceptions of the impact of the disease, self-efficacy, and locus of control. Using a standardized questionnaire, we obtained data from patients who attended a series of lectures. The questionnaire included questions on their information needs, sources of information, satisfaction with information, and short questionnaires on self-efficacy, perception of the disease, and locus of control of reinforcement. Data was obtained from 185 patients. Our results showed that the sources of information that were most often used were physicians (84 %), print media (68 %), and the Internet (59 %); online fora (7.5 %), non-medical practitioners (9.7 %), and telephone-based counseling (8.6 %) were only used by a minority. Patients with a high perception of their own control over the disease more often used any source of information available to them and were more often interested in acquiring additional information. Higher self-efficacy was significantly associated with the need for information on all topics. Patients with a higher external locus of control significantly more often used sources of information and had significantly more need for additional information. By contrast, there were no associations with an internal locus of control. Neither external nor internal locus of control showed any associations with satisfaction with information. Information needs seem to be higher in patients with a high external locus of control and low self-efficacy. Physicians, other professionals, and institutions that provide information may take these relationships into consideration for tailoring their services to patients.

Student Drug Use.

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Nowlis, Helen H.

This paper discusses the nature and extent of student drug use, its meaning and significance, society's response to it, and some of the problems resulting from efforts to control it. Drugs are any substance which by its chemical nature affects the structure or function of the living organism. Abuse refers to any use of a non-medically approved…

A league of their own: demographics, motivations and patterns of use of 1,955 male adult non-medical anabolic steroid users in the United States

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Darkes Jack

2007-10-01

Full Text Available Abstract Background Rule violations among elite-level sports competitors and tragedies among adolescents have largely defined the issue of non-medical anabolic-androgenic steroid (NMAAS use for the public and policy makers. However, the predominant and oft-ignored segment of the NMAAS community exists in the general population that is neither participating in competitive sports nor adolescent. A clearer profile of NMAAS users within the general population is an initial step in developing a full understanding of NMAAS use and devising appropriate policy and interventions. This survey sought to provide a more comprehensive profile of NMAAS users by accessing a large sample of user respondents from around the United States. Methods U.S.-based male NMAAS users (n = 1955 were recruited from various Internet websites dedicated to resistance training activities and use of ergogenic substances, mass emails, and print media to participate in a 291-item web-based survey. The Internet was utilized to provide a large and geographically diverse sample with the greatest degree of anonymity to facilitate participation. Results The majority of respondents did not initiate AAS use during adolescence and their NMAAS use was not motivated by athletics. The typical user was a Caucasian, highly-educated, gainfully employed professional approximately 30 years of age, who was earning an above-average income, was not active in organized sports, and whose use was motivated by increases in skeletal muscle mass, strength, and physical attractiveness. These findings question commonly held views of the typical NMAAS user and the associated underlying motivations. Conclusion The focus on "cheating" athletes and at risk youth has led to ineffective policy as it relates to the predominant group of NMAAS users. Effective policy, prevention or intervention should address the target population(s and their reasons for use while utilizing their desire for responsible use and

Immune responses of a chimaeric protein vaccine containing Mycoplasma hyopneumoniae antigens and LTB against experimental M. hyopneumoniae infection in pigs.

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Marchioro, Silvana B; Sácristan, Rubén Del Pozo; Michiels, Annelies; Haesebrouck, Freddy; Conceição, Fabricio R; Dellagostin, Odir A; Maes, Dominiek

2014-08-06

A recombinant chimaeric protein containing three Mycoplasma hyopneumoniae antigens (C-terminal portion of P97, heat shock protein P42, and NrdF) fused to an adjuvant, the B subunit of heat-labile enterotoxin of Escherichia coli (LTB), was used to immunize pigs against enzootic pneumonia. The systemic and local immune responses, as well as the efficacy of the chimaeric protein in inducing protection against experimental M. hyopneumoniae infection were evaluated. In total, 60 male piglets, purchased from a M. hyopneumoniae-free herd, at 4 weeks of age were randomly allocated to six different experimental groups of 10 animals each: recombinant chimaeric protein by intramuscular (IM) (1) or intranasal (IN) (2) administration, commercial bacterin by IM administration (3), and the adjuvant LTB by IM (4, control group A) or IN (5, control group B) administration. All groups were immunized at 24 and 38 days of age and challenged at 52 days of age. The sixth group that was not challenged was used as the negative control (IN [n=5] or IM [n=5] administration of the LTB adjuvant). Compared with the non-challenged group, administration of the chimaeric protein induced significant (Phyopneumoniae infection in pigs. This lack of effectiveness points towards the need for further studies to improve the efficacy of this subunit-based vaccine approach. Copyright © 2014 Elsevier Ltd. All rights reserved.

An Examination of Prescription Stimulant Misuse and Psychological Variables among Sorority and Fraternity College Populations

Science.gov (United States)

Dussault, Crystal L.; Weyandt, Lisa L.

2013-01-01

Objective: The objective of this study was to examine nonmedical stimulant use among fraternity/sorority members and nonmembers and whether psychological variables (e.g., internal restlessness, depression, anxiety, and stress) were related to nonmedical stimulant use. Method: The sample consisted of 1,033 undergraduate students from five…

The altered complexity of cardiovascular regulation in depressed patients

International Nuclear Information System (INIS)

Schulz, Steffen; Voss, Andreas; Koschke, Mandy; Bär, Karl-Jürgen

2010-01-01

Major depressive disorders (MDD) are associated with an increased risk for cardiovascular morbidity and mortality. Even if it is known that MDD are accompanied by an autonomic dysbalance with increased sympathetic and/or reduced parasympathetic activity, to date only limited information is available about the degree and complexity of cardiovascular regulation. The aim of this study was to investigate the influence of MDD on the autonomous nervous system and cardiovascular complexity by means of linear and nonlinear indices from heart rate and blood pressure variability (HRV, BPV). From 57 non-medicated patients and 57 matched healthy controls with respect to age and gender HRV and BPV in time and frequency domain, symbolic dynamics, compression entropy, multiscale entropy, detrended fluctuation analysis, Poincaré plot analysis and baroreflex sensitivity were analysed from 30 min short-term recordings. Complexity indices from nonlinear dynamics demonstrated considerable changes in autonomous regulation due to MDD. For the first time we could show that non-medicated depressed patients who were matched with respect to age and gender reveal a significantly changed short-term as well as long-term complexity of cardiovascular regulation. These results suggest substantial changes in autonomic control probably due to a change of interactions between different physiological control loops in MDD

Benefits and Burdens of Participation in a Longitudinal Clinical Trial

Science.gov (United States)

Lazovski, Jaime; Losso, Marcelo; Krohmal, Benjamin; Emanuel, Ezekiel J.; Grady, Christine; Wendler, David

2010-01-01

systematic data on the impact that longitudinal clinical trials have on patient participants are needed to ensure that all the risks and potential benefits of participating in clinical research are properly evaluated and disclosed. Recognizing the lack of systematic data on this topic, we surveyed 582 individuals from Argentina, Brazil, and Thailand who were participating in the ESPRIT study, a Phase III randomized trial of interleukin-2 in HIV disease. Respondents were asked about the benefits and burdens of participating in ESPRIT using a self-administered survey. We found that 91% of respondents in the IL-2 treatment arm and 79% in the no IL-2 control arm reported medical benefits from their participation. In addition, 68% in the IL-2 treatment arm and 60% of the no IL-2 controls reported non-medical benefits. Thirteen percent of the IL-2 respondents and 5% of the non-IL2 respondents reported problems with their jobs due to study participation. Given that respondents, including those in the control arm, reported medical and non-medical benefits and burdens from their research participation, investigators and review committees should be aware of and respond to the potential for research participants to experience benefits and burdens that are unrelated to the intervention being tested. PMID:19754238

Trends in use of non-medical radiation sources in Slovenia

International Nuclear Information System (INIS)

Giacomelli, M.; Cesarek, J.; Osojnik, I.

2007-01-01

Slovenian Nuclear Safety Administration is the regulatory authority competent also for administrative control in the fields of radiation practices and use of radiation sources in industry and research, with exception in medicine and veterinary medicine. Prior to the adoption of the Act on Protection against Ionizing Radiation and Nuclear Safety the responsible authority was the Health Inspectorate of Republic of Slovenia. The article presents an overview of the use of radiation sources in Slovenia, in industry, research and education. Analysis of the data from abovementioned regulators shall examine trends in use in recent years as number of sources and organizations, and according to the type of their intended use. (author)

Rumors about cancer: content, sources, coping, transmission, and belief.

Science.gov (United States)

DiFonzo, Nicholas; Robinson, Nicole M; Suls, Jerry M; Rini, Christine

2012-01-01

Using a sense-making and threat management framework in rumor psychology, the authors used an exploratory web survey (n = 169) to query members of online cancer discussion groups about informal cancer statements heard from nonmedical sources (i.e., cancer rumors). Respondents perceived that rumors helped them cope. Dread rumors exceeded wish rumors; secondary control (control through emotional coping) rumors outnumbered primary control (direct action) rumors. Rumor content focused on cancer lethality, causes, and suffering. Rumors came primarily from family or friends in face-to-face conversations. Respondents discussed rumors with medical personnel primarily for fact-finding purposes, but with nonmedical people for altruistic, emotional coping, or relationship enhancement motives. Transmitters (vs. nontransmitters) considered rumors to be more important, were more anxious, and felt rumors helped them cope better, but did not believe them more strongly or feel that they were less knowledgeable about cancer. Most respondents believed the rumors; confidence was based on trust in family or friends (disregarding source nonexpertise) and concordance with beliefs, attitudes, and experience. Results point toward the fruitfulness of using rumor theory to guide research on cancer rumors and suggest that rumors help people achieve a sense of emotional control for dreaded cancer outcomes, inform the social construction of cancer, and highlight the continuing importance of nonelectronic word of mouth.

75 FR 29677 - PLMR Licensing; Frequency Coordination and Eligibility Issues

Science.gov (United States)

2010-05-27

... in the portions of the 1427-1432 MHz band where non- medical telemetry has primary status. We take... free of harmful interference. The band 1427-1432 MHz is shared between medical and non-medical telemetry operations. Generally, WMTS has primary status in the lower half of the band, and non-medical...

Economic Costs of Patients Attending the Prevention of Mother-to- Child Transmission of HIV/AIDS (PMTCT Services in Ethiopia: Urban-Rural Settings

Directory of Open Access Journals (Sweden)

Elias Asfaw Zegeye

2016-08-01

Full Text Available Economic analyses of patients’ costs are pertinent to improve effective healthcare services including the prevention of mother-to-child HIV/AIDS transmission (PMTCT. This study assessed the direct and non-direct medical costs borne by pregnant women attending PMTCT services in urban (high-HIV prevalence and rural (low-HIV prevalence settings, in Ethiopia. Patient-level direct medical costs and direct non-medical data were collected from HIV-positive pregnant women in six regions. The cost estimation was classified as direct medical (service fee, drugs and laboratory and direct non-medical (food, transportation and accommodation. The mean direct medical expense per patient per year was Ethiopian birr (ETB 746 (US$ 38 in the urban settings, as compared to ETB 368 (US$ 19 in the rural settings. On average, a pregnant woman from urban and rural catchments incurred direct non-medical costs of ETB 6,435 (US$ 327 and ETB 2,154 (US$ 110 per year, respectively. On average, non-medical costs of friend/relative/guardian were ETB 2,595 (US$ 132 and ETB 2,919 (US$ 148.39 in the urban and rural settings, respectively. Although the PMTCT service is provided free of charge, HIV-positive pregnant women and infant pairs still face a substantial amount of out-of-pocket spending due to direct medical and non-medical costs.

[Knowledge and attitudes toward smoke-free law among smoking and non-smoking medical students].

Science.gov (United States)

Zielińska-Danch, Wioleta; Goniewicz, Maciej Ł; Koszowski, Bartosz; Leszczyńska, Joanna; Czogała, Jan; Szołtysek-Bołdys, Izabela; Antosiewicz, Beata; Sobczak, Andrzej

2010-01-01

Tobacco smoking is common among various social groups. There is still high prevalence of smoking among health care professionals. The aim of the study was to assess knowledge about smoke-free law in public places in Poland among smoking and nonsmoking students of selected medical university. We surveyed 50 students of one medical university aged 23 +/- 2 years. Control group consisted with 61 students of other universities located in the same region aged 23 +/- 3 years. We developed a new survey to assess students knowledge about smoke-free regulations and their implementations in various public places. Smoking status was verified with exhaled carbon monoxide levels (COex). 57% off all surveyed students declared being familiar with smoke-free law. However, we detected a significant difference between the knowledge of medical vs. nonmedical students (76% vs. 41%, p < 0.05). The knowledge about smoke-free law in Poland among students is not sufficient, especially among nonmedical students.

The Coast Guard Proceedings of the Marine Safety and Security Council. Volume 72, Number 4, Winter 2015-2016

Science.gov (United States)

2016-04-13

National Drug Threat Assessment reported that the annual economic cost of controlled prescription drug non-medical use (use beyond that of...scenario: On a clear Tuesday eve- ning, an outbound small coastal freight ship collides with an inbound offshore supply vessel while navigating a bend...NMCProceedings@uscg.mil Website: www.uscg.mil/proceedings Safety Management Systems Waterways: America’s Economic Engine Recreational Boating Safety i

Nasogastric tube placement with video-guided laryngoscope: A manikin simulator study.

Science.gov (United States)

Lee, Xiao-Lun; Yeh, Li-Chun; Jin, Yau-Dung; Chen, Chun-Chih; Lee, Ming-Ho; Huang, Ping-Wun

2017-08-01

This study aimed to investigate video-guided laryngoscopy for nasogastric tube placement. This was an observational comparative study performed in a hospital. The participants included volunteers from the medical staff (physicians and nurses) experienced with nasogastric intubation, and non-medical staff (medical students, pharmacists and emergent medical technicians) with knowledge of nasogastric intubation but lacking procedural experience. Medical and non-medical hospital staff performed manual, laryngoscope-assisted and video-guided laryngoscope nasogastric intubation both in the presence and in the absence of an endotracheal tube, using a manikin. Nasogastric intubation times were compared between groups and methods. Using the video-guided laryngoscope resulted in a significantly shorter intubation time compared to the other 2 methods, both with and without an endotracheal tube, for the medical and non-medical staff alike (all p guided laryngoscope without endotracheal intubation, direct laryngoscope with endotracheal intubation and video-guided laryngoscope with endotracheal intubation compared to manual intubation without endotracheal intubation (0.49, 0.63 and 0.72 vs. 5.63, respectively, p ≤ 0.008). For non-medical staff, nasogastric intubation time was significantly shorter using video-guided laryngoscope without endotracheal intubation, direct laryngoscope with endotracheal intubation and video-guided laryngoscope with endotracheal intubation compared to manual intubation without endotracheal intubation (1.67, 1.58 and 0.95 vs. 6.9, respectively, p ≤ 0.002). And mean nasogastric intubation time for video-guided laryngoscope endotracheal intubation was significantly shorter for medical staff than for non-medical staff (0.49 vs. 1.67 min, respectively, p = 0.041). Video-guided laryngoscope reduces nasogastric intubation time compared to manual and direct laryngoscope intubation, which promotes a consistent technique when performed by

Euthanasia: A Controversial Entity Among Students of Karachi.

Science.gov (United States)

Kumar, Ameet; Naqvi, Syeda; Giyanwani, Pirthvi Raj; Yousuf, Fareeha; Masnoon, Aaliya; Bai, Kiran; Kumar, Deepak

2017-07-24

Background A serene death may be achieved through skilled and compassionate care, as well as by the dying person's own sense of having lived a righteous life. The purpose of this study is to acquire information about students' knowledge and understanding of euthanasia. Materials and Methods Four hundred and fifty-six students from four classes of two institutions with similar demographic characteristics were included in this cross-sectional study. A questionnaire adapted from a study of 'Gruber, et al.' was distributed among the respondents after obtaining a verbal informed consent. The questionnaire had two parts, first dealing with demographics of respondents, and in the second part students were given different situations and asked about their decision in that particular setting to understand their opinion about euthanasia. Results There were 31.7% medical students and 12.9% non-medical students in favor to provide complete medical information (p < 0.001) while 59.2% non-medical students thought that complete information should be given to a patient if any iatrogenic incident occurred. Same favored by 33.7% of medical students (p < 0.001). The majority of medical students (84.5%) felt that cardiopulmonary resuscitation (CPR) must always be provided (p < 0.001) and this was acceptable more among females (p = 0.001). Furthermore, medical students (57.6%) were more in favor of continuing maximum medical treatment including CPR than non-medical students (42.9%, p = 0.003). A total of 83% non-medical students and 46% medical students found euthanasia an acceptable practice. Conclusion Results show a significant difference in perception of medical and non-medical students regarding euthanasia. Non-medical students are more in favor of euthanasia than medical students. Also, it is observed that males seem to be more inclined towards euthanasia while females are more in favor to provide maximum medical treatment.

Career choices in health care: is nursing a special case? A content analysis of survey data.

Science.gov (United States)

Miers, Margaret E; Rickaby, Caroline E; Pollard, Katherine C

2007-09-01

As demand for nurses and other health professionals continues to outstrip supply it is important to understand what motivates individuals to join a non-medical health profession. The objectives of this study were to investigate students' reasons for choosing a particular nursing specialism, midwifery or other non-medical health profession, and to compare motivation factors across professions, gender, age, level of award, prior qualifications, prior experience and over time. A prospective follow-up study collected survey responses at the beginning and end of pre-qualifying professional programmes. The study took place in one large United Kingdom faculty. The study participants were 775 first-year students undertaking non-medical health professional programmes and 393 qualifying students. An open-ended question was included in a self-completed questionnaire administered at entry and at qualification. Content analysis identified themes. Altruism was the most frequently cited reason for wishing to join a non-medical health profession, followed by personal interest/abilities, professional values/rewards, and prior experience of the area. Students entering nursing were less likely to cite an altruistic motivation than those entering other non-medical health professions (chi(2)=21.61, df=1, pvalues/rewards (chi(2)=20.38, df=8, p=0.009). Students on degree level programmes were more likely to report altruism than those on diploma level courses (chi(2)=17.37, df=1, pvalues/rewards (chi(2)=6.67, p=0.010) decreased over time. Findings suggest that although a service orientation remains a key factor in choosing nursing, students also look for a career which matches their interests and attributes, as well as offering professional values and rewards. Nursing may be in danger of losing service orientated recruits to other non-medical health professions.

Ethics, Ethical Human Research and Human Research Ethics Committees

Science.gov (United States)

Lindorff, Margaret

2010-01-01

Non-medical research involves the same issues of justice, beneficence, and respect for persons that apply to non-medical research. It also may involve risk of harm to participants, and conflicts of interest for researchers. It is therefore not possible to argue that such research should be exempt from ethical review. This paper argues that…

75 FR 19277 - PLMR Licensing; Frequency Coordination and Eligibility Issues

Science.gov (United States)

2010-04-14

... band (1427-1429.5 MHz), and non-medical telemetry in the upper half of the band (1429.5-1432 MHz). Non... secondary basis on those portions of the 1427-1432 MHz shared band where non-medical telemetry is primary...-medical telemetry has primary status. Some WMTS operations in the portions of the 1427-1432 MHz band where...

Rationale and design of the Miami Healthy Heart Initiative: a randomized controlled study of a community health worker intervention among Latino patients with poorly controlled diabetes

Directory of Open Access Journals (Sweden)

Carrasquillo O

2014-02-01

Full Text Available Olveen Carrasquillo,1,2 Elizabeth Patberg,1 Yisel Alonzo,1 Hua Li,2 Sonjia Kenya1 1Department of Medicine, 2Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL, USA Background: Type 2 diabetes mellitus disproportionately affects the Latino community. Latinos with diabetes are also less likely to have adequate control of cardiovascular risk factors such as cholesterol and blood pressure. Community health workers (CHWs are increasingly being used to address various health disparity conditions, including diabetes. However, evidence of their effectiveness from randomized controlled trials is limited. Methods: The Miami Health Heart Initiative is a randomized controlled trial of 300 Latino patients with diabetes. Patients with hemoglobin A1c (HbA1c ≥8.0% were recruited from Miami-Dade's public hospital system. At baseline, all patients underwent phlebotomy, physical examination, and a structured 90-minute research interview. They were then randomized to either usual care or a CHW intervention called Cariño. For participants in the Cariño arm of the study, CHW services included assistance with nonmedical social services, health education, and patient navigation in which the CHWs serve as a bridge between patients and the health care system. These services were delivered through home visits, phone calls, and group visits. At 12 months, all subjects had a follow-up examination. The primary outcomes at 1 year are changes in systolic blood pressure, low-density lipoprotein, and HbA1c. Secondary outcomes include medication adherence, medication intensification, diabetes self-efficacy, physical activity, and self-reported fruit and vegetable intake. Discussion: The Miami Healthy Heart Initiative is one of the first rigorously conducted randomized controlled trials to provide evidence on the impact of CHWs on diabetes intermediate outcomes among Latinos. If the data support our primary hypotheses, the study would lend added

Non-medical exposures - Ethical concerns

International Nuclear Information System (INIS)

O'Reilly, G.

2009-01-01

The scope of the Medical Exposure Directive (MED), 97/43/Euratom (Council Directive 97/43/EURATOM, on the health protection of individuals against the dangers of ionising radiation in relation to medical exposures. OJ L 180 of 09.07.1997), is such that it includes not only those exposures which are part of the normal diagnosis and treatment of patients but also exposures for occupational health surveillance, health-screening programmes, research and medico-legal exposures. This is the first time that radiation protection legislation has tried to deal explicitly with the issue of medico-legal exposures in a European Directive. However, it has done so in the context of a Directive whose primary focus is the protection of patients undergoing diagnostic or therapeutic medical exposures. This may not be an appropriate framework for medico-legal exposures. In considering medico-legal exposures, a significant number of ethical considerations arise. The MED may not adequately take account of these matters and in fact may not be a suitable legal instrument for dealing with them. This paper looks specifically at the issues surrounding medico-legal exposures and considers whether or not the current system provides adequate protection for the individuals exposed. (authors)

Training Older Adults to Use Tablet Computers: Does It Enhance Cognitive Function?

Science.gov (United States)

Chan, Micaela Y; Haber, Sara; Drew, Linda M; Park, Denise C

2016-06-01

Recent evidence shows that engaging in learning new skills improves episodic memory in older adults. In this study, older adults who were computer novices were trained to use a tablet computer and associated software applications. We hypothesize that sustained engagement in this mentally challenging training would yield a dual benefit of improved cognition and enhancement of everyday function by introducing useful skills. A total of 54 older adults (age 60-90) committed 15 hr/week for 3 months. Eighteen participants received extensive iPad training, learning a broad range of practical applications. The iPad group was compared with 2 separate controls: a Placebo group that engaged in passive tasks requiring little new learning; and a Social group that had regular social interaction, but no active skill acquisition. All participants completed the same cognitive battery pre- and post-engagement. Compared with both controls, the iPad group showed greater improvements in episodic memory and processing speed but did not differ in mental control or visuospatial processing. iPad training improved cognition relative to engaging in social or nonchallenging activities. Mastering relevant technological devices have the added advantage of providing older adults with technological skills useful in facilitating everyday activities (e.g., banking). This work informs the selection of targeted activities for future interventions and community programs. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America.

THE INFLUENCE OF COMBINATION NON-MEDICAL TREATMENT INCLUDING FUNCTIONAL PROGRAMMED ELECTRICAL STIMULATION ON THE CLINICAL AND INSTRUMENTAL PARAMETERS IN PATIENTS WITH CEREBRAL PALSY WITH SPASTIC DIPLEGIA

Directory of Open Access Journals (Sweden)

V. V. Eliseev

2015-01-01

Full Text Available Background: Cerebral palsy is the leading cause of physical disability in pediatric  age. The search for new methods and improvement of old rehabil- itation techniques is ongoing, due to low efficacy of the latter. Aim: To assess the efficacy of a func- tional programmed electrical muscle stimulation as a part  of combination treatment of patients with cerebral palsy in the form of spastic diplegia. Materials and methods: We analyzed the results of treatment of 71 children with cerebral palsy and spastic diplegia, who had  been  randomized  into two groups  depending on the type of treatment. In  the  first group,  the  patients  (n = 38 received a course of functional programmed electric stim- ulation  in combination with  other  non-medical treatment  methods.  The  second   group   (n = 33 underwent a usual  course  of electrical  stimula- tion in combination with non-medical  treatment, similar to that  in the first group. The third group (control   included   41   children   without    cere- bral palsy. Clinical and  instrumental parameters were  assessed  in all study  participants. Results: After the course of combination treatment in the group  1, the  tonus  of m. gastrocnemius was de- creased significantly by 41%, that of the posterior group  of femur muscles by 43%, adductor group of femur muscles by 36%. In the group  2, the re- spective parameters decreased by 24, 21 and 21%. Muscle power  endurance was  increased  signifi- cantly in patients of both groups: that of long back extensors by 12.5 and 6.2 sec, of m. rectus abdomi- nis by 10.6 sec and 5.2 sec, of gluteal muscles by 9.3 and 4.6 sec, of m. quadriceps  by 19.8 and 7.2 sec, of m. anterior  tibialis by 12.1 and 4.6 sec, respec- tively. After the  treatment, the  active movement volume in the large joints of lower extremities  in the group 1 patients  improved as follows: by 15.6° in hip joints, by 11.1° in knee joints and by

An inevitable wave of prescription drug monitoring programs in the context of prescription opioids: pros, cons and tensions

OpenAIRE

Islam, M Mofizul; McRae, Ian S

2014-01-01

Background In an effort to control non-medical use and/or medical abuse of prescription drugs, particularly prescription opioids, electronic prescription drug monitoring programs (PDMP) have been introduced in North-American countries, Australia and some parts of Europe. Paradoxically, there are simultaneous pressures to increase opioid prescribing for the benefit of individual patients and to reduce it for the sake of public health, and this pressure warrants a delicate balance of appropriat...

A Case of Nonthrombotic Pulmonary Embolism after Facial Injection of Hyaluronic Acid in an Illegal Cosmetic Procedure

OpenAIRE

Jang, Jong Geol; Hong, Kyung Soo; Choi, Eun Young

2014-01-01

Hyaluronic acid is widely used in medical procedures, particularly in cosmetic procedures administered by physicians or nonmedical personnel. The materials used for cosmetic procedures by physicians as well as illegally by non-medical personnel can cause nonthrombotic pulmonary embolism (NTPE). We report the case of a woman with acute respiratory failure, neurologic symptoms and petechiae after an illegal procedure of hyaluronic acid dermal filler performed by an unlicensed medical practition...

Individual intake and antiparasitic efficacy of free choice mineral containing fenbendazole for grazing steers.

Science.gov (United States)

Garossino, K C; Ralston, B J; Olson, M E; McAllister, T A; Milligan, D N; Genswein, B M A

2005-04-20

A 95-day study (June 25-September 27, 2001) was conducted using 120 steers (311.9+/-2.4 kg) randomly allocated to two treatments: (1) mineral containing 0.55% fenbendazole (FBZ) and (2) control, no FBZ in the mineral. Animals in the FBZ group were individually identified by an electronic tag that was read each time an animal attended the mineral feeder. The feeder was equipped with load cells that enabled individual mineral intakes to be estimated. The FBZ group was provided with non-medicated mineral during a 14-day adaptation period (July 23-August 5) and an 8-day post-medication period (September 17-24). The intake of FBZ was monitored for 14 days during each of the two treatment periods; August 6-19 and September 3-16, separated by a 14-day non-medicated period, August 20-September 2. Control animals had access to non-medicated mineral for the entire 95-day study period. All steers were grazed on alfalfa-grass pasture for the duration of the study and had free access to flocculated, filtered and chlorinated water via an automatic waterer. Fecal samples were collected from steers three times during the experiment July 23, August 27 and September 27, and analyzed for nematode eggs and Giardia sp. cysts. Seventy-five and 83% of the steers in the FBZ group visited the mineral feeder during the first and second treatment periods, respectively. Individual daily mineral and FBZ intake for the first and second treatment periods was 52.9+/-6.6g per day and 10.1+/-1.2mg/kg BW; 72.3+/-8.4 g per day and 11.8+/-1.4 mg/kg BW, respectively. FBZ animals were separated into three groups during each treatment period based on the recommended dose (RD) of FBZ (5 mg/kg/BW), those that received > the RD, those that received 50% RD and those that received 0.05) by FBZ as compared to controls in either treatment period. These results may be a reflection of Giardia re-infection occurring following treatment and highlight the need for variation in treatment regimes specifically targeted

Extracurricular activities of medical school applicants

Directory of Open Access Journals (Sweden)

Sang Hyun Kim

2016-06-01

Full Text Available Purpose: The purpose of this study was to investigate medical school applicants’ involvements in extracurricular activities including medical volunteering/community services, nonmedical community services, club activities, leadership role, and research. Methods: Extracurricular characteristics were compared for 448 applicants (223 males and 225 females who applied to Kangwon Medical School in 2013 to 2014. Frequency analysis, chi-square test, and simple correlation were conducted with the collected data. Results: The 448 applicants participated in medical volunteer/community services (15.3%, nonmedical community services (39.8%, club activities (22.9%, club officials (10%, and research (13.4%. On average, applicants from foreign universities participated in 0.9 medical volunteer/community service, 0.8 nonmedical community service, 1.7 club activities, and 0.6 research work. On the other hand, applicants from domestic universities reported 0.2 medical volunteer/community service, 1.0 nonmedical community service, 0.7 club activity, and 0.3 research. Conclusion: Involvement in extracurricular activities was extensive for medical school applicants. Participation in extracurricular activities differed between applicants from foreign and domestic universities. Females consistently reported greater participation in extracurricular activities than males. The data can be helpful for admission committees to recruit well-rounded applicants and compare between applicants with similar academic backgrounds.

Non medical factors associated with psychological disorders in cancer patients

International Nuclear Information System (INIS)

Iqbal, A.; Intikhab, K.; Saeed, K.

2002-01-01

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

Evaluation of an innovative hands-on anatomy-centered ultrasound curriculum to supplement graduate gross anatomy education.

Science.gov (United States)

Royer, Danielle F; Kessler, Ross; Stowell, Jeffrey R

2017-07-01

Ultrasound (US) can enhance anatomy education, yet is incorporated into few non-medical anatomy programs. This study is the first to evaluate the impact of US training in gross anatomy for non-medical students in the United States. All 32 master's students enrolled in gross anatomy with the anatomy-centered ultrasound (ACUS) curriculum were recruited. Mean Likert ratings on pre- and post-course surveys (100% response rates) were compared to evaluate the effectiveness of the ACUS curriculum in developing US confidence, and gauge its impact on views of US. Post-course, students reported significantly higher (P education and to students' future careers remained positive after the course. End-of-semester quiz performance (91% response rate) provided data on educational outcomes. The average score was 79%, with a 90% average on questions about distinguishing tissues/artifacts, demonstrating positive learning outcomes and retention. The anatomy-centered ultrasound curriculum significantly increased confidence with and knowledge of US among non-medical anatomy students with limited prior training. Non-medical students greatly value the contributions that US makes to anatomy education and to their future careers. It is feasible to enhance anatomy education outside of medical training by incorporating US. Anat Sci Educ 10: 348-362. © 2016 American Association of Anatomists. © 2016 American Association of Anatomists.

ABORSI DAN HAK ATAS PELAYANAN KESEHATAN: Sebuah Tinjauan Teologis, Yuridis, dan Medis

Directory of Open Access Journals (Sweden)

Aliba'ul Chusna

2016-02-01

Aliba’ul Chusna   Abstract: Abortion, at this contemporary era, is fiercely controversial issue for amount of people. Nevertheless, It is a health problem of so many society cause not only diseases but also mother’s death. Abortion is also supposed to be one of several factors for rising mother’s death in Indonesia. It happens because of cases; it can be medical or non-medical motive. Abortion which is medical motive is permitted for prerequisites. Otherwise Abortion which is non-medical motive such as sex harassment pregnancy is not permitted by both Islamic jurisprudence and legal law. But in fact, amount of abortion cases are due to non-medical motives. This paper tries to explore and describe abortion and its connection to health service rights.              Keywords: Aborsi, hak, pelayanan kesehatan

iPads, droids, and bugs: Infection prevention for mobile handheld devices at the point of care.

Science.gov (United States)

Manning, Mary Lou; Davis, James; Sparnon, Erin; Ballard, Raylene M

2013-11-01

Health care providers are increasingly using wireless media tablets, such as the Apple iPad, especially in the hospital setting. In the absence of specific tablet disinfection guidelines the authors applied what is known about the contamination of other nonmedical mobile communication devices to create a "common sense" bundle to guide wireless media tablet infection prevention practices. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

A situation analysis of psychiatrists in South Africa’s rural primary healthcare settings

Directory of Open Access Journals (Sweden)

Johannes H. De Kock

2017-05-01

Conclusions: Because of a lack of MH nurses and medical officers dedicated to MH in PRPHC facilities, recommendations are made that the current task shifting strategy be revisited to include more cadres of MH professionals with specialised psychopharmacological training, as non-medical prescribers at PRPHC level. It is advised that visiting psychiatrists and family physicians be involved in the construction of training and supervision programmes for non-medical prescribers at the primary healthcare level.

Cost-consequence analysis of multimodal interventions with environmental components for pediatric asthma in the state of Maryland.

Science.gov (United States)

Jassal, Mandeep S; Diette, Gregory B; Dowdy, David W

2013-08-01

Applied environmental strategies for asthma control are often expensive, but may save longer-term healthcare costs. Whether these savings outweigh additional costs of implementing these strategies is uncertain. We conducted a systematic review to estimate the expenditures and savings of environmental interventions for asthma in the state of Maryland. Direct costs included hospitalizations, emergency room, and clinic visits. Indirect expenditures included costs of lost work productivity and travel incurred during the usage of healthcare services. We used decision analysis, assuming a hypothetical cohort of the approximated 49,290 pediatric individuals in Maryland with persistent asthma, to compare costs and benefits of environmental asthma interventions against the standard of care (no intervention) from the societal perspective. Three interventions among nine articles met the inclusion criteria for the systematic review: 1) environmental education using medical professionals; 2) education using non-medical personnel; and 3) multi-component strategy involving education with non-medical personnel, allergen-impermeable covers, and pest management. All interventions were found to be cost-saving relative to the standard of care. Home environmental education using non-medical professionals yielded the highest net savings of $14.1 million (95% simulation interval (SI): $-.283 million, $19.4 million), while the multi-component intervention resulted in the lowest net savings of $8.1 million (95% SI: $-4.9 million, $15.9 million). All strategies were most sensitive to the baseline number of hospitalizations in those not receiving targeted interventions for asthma. Limited environmental reduction strategies for asthma are likely to be cost-saving to the healthcare system in Maryland and should be considered for broader scale-up in other economically similar settings.

Developing and Evaluating Medical Humanities Problem-Based Learning Classes Facilitated by the Teaching Assistants Majored in the Liberal Arts: A Longitudinal Crossover Study.

Science.gov (United States)

Tseng, Fen-Yu; Shieh, Jeng-Yi; Kao, Tze-Wah; Wu, Chau-Chung; Chu, Tzong-Shinn; Chen, Yen-Yuan

2016-02-01

Although medical humanities courses taught by teachers from nonmedical backgrounds are not unusual now, few studies have compared the outcome of medical humanities courses facilitated by physicians to that by teaching assistants majored in the liberal arts. The objectives of this study were to (1) analyze the satisfaction of medical students with medical humanities problem-based learning (PBL) classes facilitated by nonmedical teaching assistants (TAF) majored in the liberal arts, and those facilitated by the attending physicians (APF) and (2) examine the satisfaction of medical students with clinical medicine-related and clinical medicine-unrelated medical humanities PBL classes.A total of 123 medical students, randomly assigned to 16 groups, participated in this study. There were 16 classes in the course: 8 of them were TAF classes; and the others were APF classes. Each week, each group rotated from 1 subject of the 16 subjects of PBL to another subject. All of the 16 groups went through all the 16 subjects in the 2013 spring semester. We examined the medical students' satisfaction with each class, based on a rating score collected after each class was completed, using a scale from 0 (the lowest satisfaction) to 100 (the highest satisfaction). We also conducted multivariate linear regression analysis to examine the association between the independent variables and the students' satisfaction.Medical students were more satisfied with the TAF (91.35 ± 7.75) medical humanities PBL classes than APF (90.40 ± 8.42) medical humanities PBL classes (P = 0.01). Moreover, medical students were more satisfied with the clinical medicine-unrelated topics (92.00 ± 7.10) than the clinical medicine-related topics (90.36 ± 7.99) in the medical humanities PBL course (P = 0.01).This medical humanities PBL course, including nonmedical subjects and topics, and nonmedical teaching assistants from the liberal arts as class facilitators, was satisfactory. This

Developing and Evaluating Medical Humanities Problem-Based Learning Classes Facilitated by the Teaching Assistants Majored in the Liberal Arts

Science.gov (United States)

Tseng, Fen-Yu; Shieh, Jeng-Yi; Kao, Tze-Wah; Wu, Chau-Chung; Chu, Tzong-Shinn; Chen, Yen-Yuan

2016-01-01

Abstract Although medical humanities courses taught by teachers from nonmedical backgrounds are not unusual now, few studies have compared the outcome of medical humanities courses facilitated by physicians to that by teaching assistants majored in the liberal arts. The objectives of this study were to (1) analyze the satisfaction of medical students with medical humanities problem-based learning (PBL) classes facilitated by nonmedical teaching assistants (TAF) majored in the liberal arts, and those facilitated by the attending physicians (APF) and (2) examine the satisfaction of medical students with clinical medicine-related and clinical medicine-unrelated medical humanities PBL classes. A total of 123 medical students, randomly assigned to 16 groups, participated in this study. There were 16 classes in the course: 8 of them were TAF classes; and the others were APF classes. Each week, each group rotated from 1 subject of the 16 subjects of PBL to another subject. All of the 16 groups went through all the 16 subjects in the 2013 spring semester. We examined the medical students’ satisfaction with each class, based on a rating score collected after each class was completed, using a scale from 0 (the lowest satisfaction) to 100 (the highest satisfaction). We also conducted multivariate linear regression analysis to examine the association between the independent variables and the students’ satisfaction. Medical students were more satisfied with the TAF (91.35 ± 7.75) medical humanities PBL classes than APF (90.40 ± 8.42) medical humanities PBL classes (P = 0.01). Moreover, medical students were more satisfied with the clinical medicine-unrelated topics (92.00 ± 7.10) than the clinical medicine-related topics (90.36 ± 7.99) in the medical humanities PBL course (P = 0.01). This medical humanities PBL course, including nonmedical subjects and topics, and nonmedical teaching assistants from the liberal arts as class facilitators, was

An overiew of non medical prescribing across one strategic health authority: a questionnaire survey

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Courtenay Molly

2012-06-01

Full Text Available Abstract Background Over 50,000 non-medical healthcare professionals across the United Kingdom now have prescribing capabilities. However, there is no evidence available with regards to the extent to which non-medical prescribing (NMP has been implemented within organisations across a strategic health authority (SHA. The aim of the study was to provide an overview of NMP across one SHA. Methods NMP leads across one SHA were asked to supply the email addresses of NMPs within their organisation. One thousand five hundred and eighty five NMPs were contacted and invited to complete an on-line descriptive questionnaire survey, 883 (55.7% participants responded. Data was collected between November 2010 and February 2011. Results The majority of NMPs were based in primary care and worked in a team of 2 or more. Nurse independent supplementary prescribers were the largest group (590 or 68.6% compared to community practitioner prescribers (198 or 22.4%, pharmacist independent supplementary prescribers (35 or 4%, and allied health professionals and optometrist independent and/or supplementary prescribers (8 or 0.9%. Nearly all (over 90% of nurse independent supplementary prescribers prescribed medicines. Approximately a third of pharmacist independent supplementary prescribers, allied health professionals, and community practitioner prescribers did not prescribe. Clinical governance procedures were largely in place, although fewer procedures were reported by community practitioner prescribers. General practice nurses prescribed the most items. Factors affecting prescribing practice were: employer, the level of experience prior to becoming a non-medical prescriber, existence of governance procedures and support for the prescribing role (p  Conclusion NMP in this strategic health authority reflects national development of this relatively new role in that the majority of non-medical prescribers were nurses based in primary care, with fewer pharmacist and

An overiew of non medical prescribing across one strategic health authority: a questionnaire survey.

Science.gov (United States)

Courtenay, Molly; Carey, Nicola; Stenner, Karen

2012-06-01

Over 50,000 non-medical healthcare professionals across the United Kingdom now have prescribing capabilities. However, there is no evidence available with regards to the extent to which non-medical prescribing (NMP) has been implemented within organisations across a strategic health authority (SHA). The aim of the study was to provide an overview of NMP across one SHA. NMP leads across one SHA were asked to supply the email addresses of NMPs within their organisation. One thousand five hundred and eighty five NMPs were contacted and invited to complete an on-line descriptive questionnaire survey, 883 (55.7%) participants responded. Data was collected between November 2010 and February 2011. The majority of NMPs were based in primary care and worked in a team of 2 or more. Nurse independent supplementary prescribers were the largest group (590 or 68.6%) compared to community practitioner prescribers (198 or 22.4%), pharmacist independent supplementary prescribers (35 or 4%), and allied health professionals and optometrist independent and/or supplementary prescribers (8 or 0.9%). Nearly all (over 90%) of nurse independent supplementary prescribers prescribed medicines. Approximately a third of pharmacist independent supplementary prescribers, allied health professionals, and community practitioner prescribers did not prescribe. Clinical governance procedures were largely in place, although fewer procedures were reported by community practitioner prescribers. General practice nurses prescribed the most items. Factors affecting prescribing practice were: employer, the level of experience prior to becoming a non-medical prescriber, existence of governance procedures and support for the prescribing role (p < 0.001). NMP in this strategic health authority reflects national development of this relatively new role in that the majority of non-medical prescribers were nurses based in primary care, with fewer pharmacist and allied health professional prescribers. This

Clinical predictors of challenging atrioventricular node ablation procedure for rate control in patients with atrial fibrillation.

Science.gov (United States)

Polin, Baptiste; Behar, Nathalie; Galand, Vincent; Auffret, Vincent; Behaghel, Albin; Pavin, Dominique; Daubert, Jean-Claude; Mabo, Philippe; Leclercq, Christophe; Martins, Raphael P

2017-10-15

Atrioventricular node (AVN) ablation is usually a simple procedure but may sometimes be challenging. We aimed at identifying pre-procedural clinical predictors of challenging AVN ablation. Patients referred for AVN ablation from 2009 to 2015 were retrospectively included. Baseline clinical data, procedural variables and outcomes of AVN ablation were collected. A "challenging procedure" was defined 1) total radiofrequency delivery to get persistent AVN block≥400s, 2) need for left-sided arterial approach or 3) failure to obtain AVN ablation. 200 patients were included (71±10years). A total of 37 (18.5%) patients had "challenging" procedures (including 9 failures, 4.5%), while 163 (81.5%) had "non-challenging" ablations. In multivariable analysis, male sex (Odds ratio (OR)=4.66, 95% confidence interval (CI): 1.74-12.46), body mass index (BMI, OR=1.08 per 1kg/m 2 , 95%CI 1.01-1.16), operator experience (OR=0.40, 95%CI 0.17-0.94), and moderate-to-severe tricuspid regurgitation (TR, OR=3.65, 95%CI 1.63-8.15) were significant predictors of "challenging" ablations. The proportion as a function of number of predictors was analyzed (from 0 to 4, including male sex, operator inexperience, a BMI>23.5kg/m 2 and moderate-to-severe TR). There was a gradual increase in the risk of "challenging" procedure with the number of predictors by patient (No predictor: 0%; 1 predictor: 6.3%; 2 predictors: 16.5%; 3 predictors: 32.5%; 4 predictors: 77.8%). Operator experience, male sex, higher BMI and the degree of TR were independent predictors of "challenging" AVN ablation procedure. The risk increases with the number of predictors by patient. Copyright © 2017. Published by Elsevier B.V.

Efficacy of tiamulin as a growth promotant for growing swine.

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Cromwell, G L; Stahly, T S

1985-01-01

A study involving 244 pigs initially averaging 13 kg was conducted at two stations to evaluate tiamulin as a growth promotant for growing swine. In each experiment, four replicate pens of five (Exp. 1) or six (Exp. 2) pigs/pen were used to evaluate each treatment. In Exp. 1, pigs were fed 0, 11, 22 or 44 ppm tiamulin from 15 to 58 kg, then fed a nonmedicated control diet for the remainder of the experiment (to 95 kg). In Exp. 2, pigs were fed 0, 2.75, 5.5, 11 or 22 ppm tiamulin from 11 to 56 kg, followed by the nonmedicated control diet (to 95 kg). In each experiment, carbadox (55 ppm) was included as a positive control and was fed to an average weight of 35 kg, followed by the control diet. Averaged across all dietary levels, tiamulin resulted in a 14.1% improvement in gain and a 5.7% improvement in feed:gain ratio during the first 28 to 35 d of the experiment (to 30 kg). These improvements were slightly less than those resulting from the feeding of carbadox during the same period (21.5 and 6.9%, respectively). From 13 to 57 kg, pigs fed tiamulin gained 11.6% faster and 3.1% more efficiently than did controls. Over the entire experiment (13 to 95 kg), tiamulin-fed pigs gained 5.7% faster than did controls, even though the tiamulin was withdrawn at 57 kg body weight. Growth rate from 13 to 57 kg plateaued at the 11-ppm dietary level of tiamulin; whereas, feed:gain ratio plateaued at the 22-ppm level. The results indicate that tiamulin is an effective growth promotant for growing swine.

Co-infection of chickens with Eimeria praecox and Eimeria maxima does not prevent development of immunity to Eimeria maxima.

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Jenkins, M; Fetterer, R; Miska, K

2009-05-12

Previous studies revealed an ameliorating effect of Eimeria praecox on concurrent E. maxima infection, such that weight gain, feed conversion ratio, and intestinal lesions were nearly identical to uninfected or E. praecox-infected controls. The purpose of the present study was to determine if protective immunity against E. maxima challenge infection developed in chickens infected with both E. praecox and E. maxima. Day-old chickens were infected with 10(3)E. praecox, 10(3)E. maxima, or a mixture of 10(3)E. praecox and 10(3)E. maxima oocysts. Chickens were then challenged at 4 weeks of age with 5x10(4)E. praecox or 5x10(3)E. maxima oocysts and clinical signs of coccidiosis were assessed 7 days post-challenge. Relative to non-challenged controls, naïve chickens or chickens immunized with E. praecox displayed a 32-34% weight gain depression after challenge with 5x10(3)E. maxima oocysts. In contrast, chickens immunized with either E. maxima oocysts alone or a combination of E. praecox and E. maxima oocysts displayed complete protection against lower weight gain associated with E. maxima challenge. Also, protection against decreased feed conversion ratio and intestinal lesions was observed in single E. maxima- or dual E. maxima+E. praecox-immunized chickens. These findings indicate that co-infection of chickens with E. maxima and E. praecox does not prevent development of immunity against E. maxima or E. praecox challenge.

The effect of a diet with fructan-rich chicory roots on intestinal helminths and microbiota with special focus on Bifidobacteria and Campylobacter in piglets around weaning

DEFF Research Database (Denmark)

Jensen, Annette Nygaard; Mejer, Helene; Mølbak, Lars

2011-01-01

The restrictions on the use of antibiotic and anthelmintic treatments in organic pig farming necessitate alternative non-medical control strategies. Therefore, the antibiotic and parasite-reducing effect of a fructan-rich (prebiotic) diet of dried chicory was investigated in free-ranging piglets...... either chicory (30% dry matter) or a control diet. The effect of chicory on intestinal helminths, intestinal microbiota, especially Bifidobacteria and Campylobacter spp. and E. coli post-weaning diarrhoea was assessed. The weight gain of the piglets was not impaired significantly by chicory...... the time of weaning caused complex changes of the microbiota and parasite communities within the intestinal tract, and feeding piglets chicory may therefore serve as an animal-friendly strategy to control pathogens....

Nonmedical applications of a positron camera

International Nuclear Information System (INIS)

Hawkesworth, M.R.; Parker, D.J.; Fowles, P.; Crilly, J.F.; Jefferies, N.L.; Jonkers, G.

1991-01-01

The positron camera in the School on Physics and Space Research, University of Birmingham, is based on position-sensitive multiwire γ-ray detectors developed at the Rutherford Appleton Laboratory. The current characteristics of the camera are discussed with particular reference to its suitability for flow mapping in industrial subjects. The techniques developed for studying the dynamics of processes with time scales ranging from milliseconds to days are described, and examples of recent results from a variety of industrial applications are presented. (orig.)

Doctor shopping: a concept analysis.

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Worley, Julie; Hall, Joanne M

2012-01-01

Prescription drug abuse is a significant problem in the United States that poses a serious health risk to Americans and is therefore significant to the field of nursing. The prescription drugs that are designated in the United States as having abuse potential are called controlled or scheduled drugs. The most common types of abused prescription drugs are benzodiazepines prescribed for anxiety, opioids prescribed for pain, and stimulants prescribed for attention deficit disorder. These prescription drugs are abused by taking larger doses than prescribed for nonmedical use to achieve a high or euphoric feeling, or are sold illicitly for profit. In 2009, there were 2.4 million nonmedical users of prescription opioids in the United States. These prescription drugs are often obtained by seeing multiple prescribers, often under false pretenses or with complicity from the prescribers that leads to abuse and illicit sales. The term doctor shopping has been used not only to refer to this phenomenon but has also had other meanings throughout the past decades. Thus, concept analysis is the focus of this article for clarification using the Walker and Avant method. Health implications and suggestions for minimizing doctor shopping are included.

Social Contexts of Substance Use among U.S. High School Seniors: A Multi-Cohort National Study

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McCabe, Sean Esteban; West, Brady T.; Veliz, Philip; Frank, Kenneth A.; Boyd, Carol J.

2015-01-01

Purpose To determine the social contexts associated with past-year substance use (multiple substances, alcohol, marijuana, and nonmedical use of prescription opioids, stimulants and tranquilizers) among U.S. high school seniors. Methods A secondary analysis of nationally representative survey data from ten cohorts (2002-2011) of the Monitoring the Future study, including 24,809 high school seniors. Results The social contexts associated with past-year substance use varied considerably based on which substance was used. The most prevalent location for alcohol, marijuana, and polydrug use was at a party while nonmedical use of prescription stimulants, tranquilizers and opioids was most likely to occur at home. Most types of substance use occurred in the presence of other people with the exception of nonmedical use of prescription stimulants that was a more solitary behavior. Conclusions These exploratory findings indicate that prevention efforts may need to account for differences in social contexts between types of substances used. PMID:25156895

Investigating Measures of Social Context on 2 Population-Based Health Surveys, Hawaii, 2010-2012.

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Pobutsky, Ann M; Baker, Kathleen Kromer; Reyes-Salvail, Florentina

2015-12-17

Measures from the Social Context Module of the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System were used on 2 population-based health surveys in Hawaii to explicate the role of the nonmedical and social determinants of health; these measures were also compared with conventional socioeconomic status (SES) variables. Results showed that the self-reported SES vulnerabilities of food and housing insecurity are both linked to demographic factors and physical and mental health status and significant when controlling for the conventional measures of SES. The social context module indicators should be increasingly used so results can inform appropriate interventions for vulnerable populations.

The use of recombinant omega interferon therapy in canine atopic dermatitis: a double-blind controlled study.

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Carlotti, Didier Noël; Boulet, Marc; Ducret, Joël; Machicote, Gustavo; Jasmin, Pierre; Rème, Christophe A; Albouy, Maxime

2009-10-01

This double-blind controlled study assessed whether reduced doses of omega interferon (rFeIFN-omega) (Virbagen Omega) could improve the clinical signs of canine atopic dermatitis (CAD) over a 6-month period, in comparison with cyclosporin. Thirty-one dogs diagnosed with CAD were entered in the study. Complicating infections were treated prior to entry. Dogs received 10 injections of rFeIFN-omega (1-5 million units according to bodyweight) or placebo over 6 months, and placebo capsules or cyclosporin (5 mg/kg) once daily for 2 months and then twice weekly for 4 months in groups 1 and 2 respectively. Flea control, non-medicated shampooing and ear cleansing were performed regularly. If a bacterial infection or Malassezia overgrowth developed, it was treated with oral cephalexin or with 3% chlorhexidine shampoo respectively. Oral prednisolone was used before day 90 to relieve pruritus when required for humane reasons (1 mg/kg once daily for 7 days). The CADESI-03 and a pruritus index were evaluated on day (D) 0, D14, D35, D56, D90, D120 and D180. No significant difference was detected between the groups for the time courses of lesions or pruritus over 6 months. On D90, the proportions of dogs with > or =50% improvement of pruritus and lesion scores were 56% and 72% respectively with interferon, 75% and 75% respectively with cyclosporin. Five dogs from group 1 and two dogs from group 2 were withdrawn from the study for treatment failure. Both products were well tolerated. Treatment with rfeIFN-omega at low doses may help for the long-term management of CAD.

Acute skin toxicity-related, out-of-pocket expenses in patients with breast cancer treated with external beam radiotherapy: a descriptive, exploratory study.

Science.gov (United States)

Schnur, Julie B; Graff Zivin, Joshua; Mattson, David M K; Green, Sheryl; Jandorf, Lina H; Wernicke, A Gabriella; Montgomery, Guy H

2012-12-01

Acute skin toxicity is one of the most common side effects of breast cancer radiotherapy. To date, no one has estimated the nonmedical out-of-pocket expenses associated with this side effect. The primary aim of the present descriptive, exploratory study was to assess the feasibility of a newly developed skin toxicity costs questionnaire. The secondary aims were to: (1) estimate nonmedical out-of-pocket costs, (2) examine the nature of the costs, (3) explore potential background predictors of costs, and (4) explore the relationship between patient-reported dermatologic quality of life and expenditures. A total of 50 patients (mean age = 54.88, Stage 0-III) undergoing external beam radiotherapy completed a demographics/medical history questionnaire as well as a seven-item Skin Toxicity Costs (STC) questionnaire and the Skindex-16 in week 5 of treatment. Mean skin toxicity costs were $131.64 (standard error [SE] = $23.68). Most frequently incurred expenditures were new undergarments and products to manage toxicity. Education was a significant unique predictor of spending, with more educated women spending more money. Greater functioning impairment was associated with greater costs. The STC proved to be a practical, brief measure which successfully indicated specific areas of patient expenditures and need. Results reveal the nonmedical, out-of-pocket costs associated with acute skin toxicity in the context of breast cancer radiotherapy. To our knowledge, this study is the first to quantify individual costs associated with this treatment side effect, as well as the first to present a scale specifically designed to assess such costs. In future research, the STC could be used as an outcome variable in skin toxicity prevention and control research, as a behavioral indicator of symptom burden, or as part of a needs assessment.

Excluded from social security: rejections of disability pension applications in Norway 1998-2004.

Science.gov (United States)

Galaasen, Anders Mølster; Bruusgaard, Dag; Claussen, Bjørgulf

2012-03-01

Admission to disability pension (DP) in Norway, like most other countries, requires a medical condition as the main cause of income reduction. Still, a widespread assumption is that much of the recruitment to the programme is rather due to non-medical, mainly labour market factors. In this article, we study the grey zones between acceptance and rejection of DP applications, in light of the concept of marginalisation. From the total Norwegian population, aged 18-66 in 1998, we included all first-time applications for DP between 1998 and 2004. Logistic regressions of both application and application outcome were then performed, controlling for a range of socioeconomic variables and medical diagnosis. Medical diagnosis had the strongest impact on application outcome, together with the applicant's age. High rejection risk was found among applicants with complex musculoskeletal diagnoses, and also for complex psychiatric diagnoses as compared to well-defined ones. Persons having previously received social assistance more often applied for a DP and more often were rejected. The same is true, though on a lesser scale, for people with a weak affiliation to the labour market. The DP programme in Norway is to a large degree medically oriented, not only judicially but also in practice. Nevertheless, non-medical factors have a bearing on both application rates and application outcome. The control system seems to work in a way that excludes the most marginalised applicants, thus possibly contributing to further marginalisation of already disadvantaged groups.

The effect of sensory stimulation provided by family on arterial blood oxygen saturation in critical care patients.

Science.gov (United States)

Yousefi, Hojatollah; Naderi, Mojgan; Daryabeigi, Reza

2015-01-01

Stressors in the intensive care unit (ICU) impair patients' comfort, excite the stress response, and increase oxygen consumption in their body. Non-medical interventions are recommended by several studies as a treatment to improve comfort in the ICU patients. Sensory stimulation is one of the most important interventions. Since arterial blood oxygen saturation is an important index of patients' clinical and respiratory condition, this study aimed to investigate the effect of sensory stimulation provided by family on arterial blood oxygen saturation in critical care patients. This study is a clinical trial conducted on 64 patients hospitalized in the ICU wards of Al-Zahra and Kashani hospitals in Isfahan, Iran in 2012 and 2013. The patients were selected by simple sampling method and were randomly assigned to two groups (study and control). Patients' arterial blood oxygen saturations were measured 10 min before, immediately after, 10 min and 30 min after sensory stimulation in the study group, and simultaneously in the control group without any intervention. Repeated measures analysis of variance (ANOVA) showed a significant difference in the mean of arterial blood oxygen saturation levels 10 min before, immediately after, 10 min and 30 min after sensory stimulation in the study group (P 0.18). Application of sensory stimulations as a nursing and non-medical intervention by the family members improves comfort and increases the level of blood oxygen saturation in critical care patients.

Drug use and abuse: the ethical issues.

Science.gov (United States)

Almond, B

1992-01-01

Drug abuse is both a personal and a public issue, raising questions about individual rights and the boundaries of law, as well as about national sovereignty and international control. Ethical issues that arise under these headings may be related to certain broad ethical positions. The implications of adopting utilitarian assumptions may be contrasted with basing ethics on a theory of individual rights, closely related to a theory of human nature. Neither position justifies a libertarian presumption against control, for, first, an individual decision to expose one's mind and personality to the control of drugs cannot be ethically justified and, second, there are no ethical reasons, nor any compelling arguments from social and political theory, for decriminalizing non-medical drug use.

Assessing the contribution of prescribing in primary care by nurses and professionals allied to medicine: a systematic review of literature

Directory of Open Access Journals (Sweden)

Bhanbhro Sadiq

2011-12-01

Full Text Available Abstract Background Safe and timely access to effective and appropriate medication through primary care settings is a major concern for all countries addressing both acute and chronic disease burdens. Legislation for nurses and other professionals allied to medicine to prescribe exists in a minority of countries, with more considering introducing legislation. Although there is variation in the range of medicines permitted to be prescribed, questions remain as to the contribution prescribing by nurses and professionals allied to medicine makes to the care of patients in primary care and what is the evidence on which clinicians, commissioners of services and policy makers can consider this innovation. Methods A integrative review of literature on non-medical prescribing in primary care was undertaken guided by dimensions of health care quality: effectiveness, acceptability, efficiency and access. Results 19 papers of 17 empirical studies were identified which provided evidence of patient outcome of non medical prescribing in primary care settings. The majority were undertaken in the UK with only one each from the USA, Canada, Botswana and Zimbabwe. Only two studies investigated clinical outcomes of non-medical prescribing. Seven papers reported on qualitative designs and four of these had fewer than ten participants. Most studies reported that non medical prescribing was widely accepted and viewed positively by patients and professionals. Conclusions Primary health care is the setting where timely access to safe and appropriate medicines is most critical for the well-being of any population. The gradual growth over time of legislative authority and in the numbers of non-medical prescribers, particularly nurses, in some countries suggests that the acceptability of non-medical prescribing is based on the perceived value to the health care system as a whole. Our review suggests that there are substantial gaps in the knowledge base to help evidence

Evaluation of the efficacy and safety of a marine-derived Bacillus strain for use as an in-feed probiotic for newly weaned pigs.

Directory of Open Access Journals (Sweden)

Maria Luz Prieto

Full Text Available Forty eight individual pigs (8.7±0.26 kg weaned at 28±1 d of age were used in a 22-d study to evaluate the effect of oral administration of a Bacillus pumilus spore suspension on growth performance and health indicators. Treatments (n = 16 were: (1 non-medicated diet; (2 medicated diet with apramycin (200 mg/kg and pharmacological levels of zinc oxide (2,500 mg zinc/kg and (3 B. pumilus diet (non-medicated diet + 10(10 spores/day B. pumilus. Final body weight and average daily gain tended to be lower (P = 0.07 and feed conversion ratio was worsened (P<0.05 for the medicated treatment compared to the B. pumilus treatment. Ileal E. coli counts were lower for the B. pumilus and medicated treatments compared to the non-medicated treatment (P<0.05, perhaps as a result of increased ileal propionic acid concentrations (P<0.001. However, the medicated treatment reduced fecal (P<0.001 and cecal (P<0.05 Lactobacillus counts and tended to reduce the total cecal short chain fatty acid (SCFA concentration (P = 0.10. Liver weights were lighter and concentrations of liver enzymes higher (P<0.05 in pigs on the medicated treatment compared to those on the non-medicated or B. pumilus treatments. Pigs on the B. pumilus treatment had lower overall lymphocyte and higher granulocyte percentages (P<0.001 and higher numbers of jejunal goblet cells (P<0.01 than pigs on either of the other two treatments or the non-medicated treatment, respectively. However, histopathological examination of the small intestine, kidneys and liver revealed no abnormalities. Overall, the B. pumilus treatment decreased ileal E. coli counts in a manner similar to the medicated treatment but without the adverse effects on growth performance, Lactobacillus counts, cecal SCFA concentration and possible liver toxicity experienced with the medicated treatment.

Chronic variable stress in fathers alters paternal and social behavior but not pup development in the biparental California mouse (Peromyscus californicus).

Science.gov (United States)

Harris, Breanna N; de Jong, Trynke R; Yang, Vanessa; Saltzman, Wendy

2013-11-01

Stress and chronically elevated glucocorticoid levels have been shown to disrupt parental behavior in mothers; however, almost no studies have investigated corresponding effects in fathers. The present experiment tested the hypothesis that chronic variable stress inhibits paternal behavior and consequently alters pup development in the monogamous, biparental California mouse (Peromyscus californicus). First-time fathers were assigned to one of three experimental groups: chronic variable stress (CVS, n=8), separation control (SC, n=7), or unmanipulated control (UC, n=8). The CVS paradigm (3 stressors per day for 7 days) successfully stressed mice, as evidenced by increased baseline plasma corticosterone concentrations, increased adrenal mass, decreased thymus mass, and a decrease in body mass over time. CVS altered paternal and social behavior of fathers, but major differences were observed only on day 6 of the 7-day paradigm. At that time point, CVS fathers spent less time with their pairmate and pups, and more time autogrooming, as compared to UC fathers; SC fathers spent more time behaving paternally and grooming the female mate than CVS and UC fathers. Thus, CVS blocked the separation-induced increase in social behaviors observed in the SC fathers. Nonetheless, chronic stress in fathers did not appear to alter survival or development of their offspring: pups from the three experimental conditions did not differ in body mass gain over time, in the day of eye opening, or in basal or post-stress corticosterone levels. These results demonstrate that chronic stress can transiently disrupt paternal and social behavior in P. californicus fathers, but does not alter pup development or survival under controlled, non-challenging laboratory conditions. © 2013.

The use of chitosan-dextran gel shows anti-inflammatory, antibiofilm, and antiproliferative properties in fibroblast cell culture.

Science.gov (United States)

Paramasivan, Sathish; Jones, Damien; Baker, Leonie; Hanton, Lyall; Robinson, Simon; Wormald, Peter J; Tan, Lorwai

2014-01-01

Chitosan-dextran gel has been used as an antihemostatic agent and antiadhesive agent after endoscopic sinus surgery. Because Staphylococcus aureus biofilms have been implicated in recalcitrant chronic rhinosinusitis, this study aimed to further investigate the (i) anti-inflammatory, (ii) bacterial biofilm inhibition, (iii) antiproliferative effects, and (iv) wound-healing properties of chitosan and chitosan-dextran gel. Fibroblasts were isolated from human nasal tissue and were used to determine the effects of chitosan and chitosan-dextran gel on (i) cell proliferation, (ii) wound healing, (iii) inflammation in fibroblast cultures challenged with superantigens S. aureus enterotoxin B (SEB) and toxic shock syndrome toxin (TSST), and (iv) on S. aureus biofilms. Chitosan was highly effective at reducing IL-8 expression after TSST and SEB challenge. Chitosan was also effective at reducing IL-8 expression of nonchallenged fibroblasts showing its anti-inflammatory effects on fibroblasts in a diseased state. Chitosan-dextran gel showed strong antibiofilm properties at 50% (v/v) concentration in vitro. Dextran, on its own, showed antibiofilm properties at 1.25% (w/v) concentration. Chitosan, on its own, reduced proliferation of fibroblasts to 82% of control proliferation and chitosan-dextran gel reduced proliferation of the fibroblasts to 0.04% of control proliferation. Relative to the no treatment controls, chitosan-dextran gel significantly delayed the wound-healing rate over the first 48 hours of the experiment. Chitosan-dextran gel reduced fibroblast proliferation and wound-healing time, showing a possible mechanism of reducing adhesions in the postsurgical period. Chitosan reduced IL-8 levels, showing its anti-inflammatory properties. Chitosan-dextran gel and dextran treatment showed antibiofilm properties in our model.

The occupational risk of Helicobacter pylori infection among gastroenterologists and their assistants

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Costa José

2011-05-01

Full Text Available Abstract Background Helicobacter pylori is a widely spread bacterium that mainly inhabits the gastric mucosa and can lead to serious illnesses such as peptic ulcer disease, gastric carcinoma and gastric MALT lymphoma. The oral-oral route seems to be the main transmission route. The fact that endoscopes are contaminated after being used to perform a gastroscopy leads one to question whether gastroenterologists and endoscopy nurses and assistants run a higher risk of infection. Methods A systematic search for literature was conducted in the MEDLINE and EMBASE databases and further publications were found in reference lists of relevant articles. Epidemiological studies on the occupational exposure of endoscopy personnel were collected and their quality was assessed. Pooled effect estimates were identified in a meta-analysis. Results Of the 24 studies included in the analysis, 15 were considered to be methodologically good. Of these 15 studies, eight single studies showed a statistically significant increased risk of infection for gastroenterologists, and five for their assistants. Meta-analysis across all methodologically good studies found a statistically significant risk of 1.6 (95%CI 1.3-2.0 for doctors. The pooled effect estimates also indicated a statistically significant risk of Helicobacter pylori infection (RR 1.4; 95%CI 1.1-1.8 for assistants too. When studies are stratified by medical and non-medical control groups, statistically significant risks can only be recognised in the comparison with non-medical controls. Conclusions In summary, our results demonstrated an increased risk of Helicobacter pylori infection among gastroenterological personnel. However, the choice of control group is important for making a valid assessment of occupational exposure risks.

Fostering sustained energy behavior change and increasing energy literacy in a student housing energy challenge

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Brewer, Robert Stephen

We designed the Kukui Cup challenge to foster energy conservation and increase energy literacy. Based on a review of the literature, the challenge combined a variety of elements into an overall game experience, including: real-time energy feedback, goals, commitments, competition, and prizes. We designed a software system called Makahiki to provide the online portion of the Kukui Cup challenge. Energy use was monitored by smart meters installed on each floor of the Hale Aloha residence halls on the University of Hawai'i at Manoa campus. In October 2011, we ran the UH Kukui Cup challenge for the over 1000 residents of the Hale Aloha towers. To evaluate the Kukui Cup challenge, I conducted three experiments: challenge participation, energy literacy, and energy use. Many residents participated in the challenge, as measured by points earned and actions completed through the challenge website. I measured the energy literacy of a random sample of Hale Aloha residents using an online energy literacy questionnaire administered before and after the challenge. I found that challenge participants' energy knowledge increased significantly compared to non-challenge participants. Positive self-reported energy behaviors increased after the challenge for both challenge participants and non-participants, leading to the possibility of passive participation by the non-challenge participants. I found that energy use varied substantially between and within lounges over time. Variations in energy use over time complicated the selection of a baseline of energy use to compare the levels during and after the challenge. The best team reduced its energy use during the challenge by 16%. However, team energy conservation did not appear to correlate to participation in the challenge, and there was no evidence of sustained energy conservation after the challenge. The problems inherent in assessing energy conservation using a baseline call into question this common practice. My research has

Empathy, Sense of Power, and Personality: Do They Change During Pediatric Residency?

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Greenberg, Larrie; Agrawal, Dewesh; Toto, Regina; Blatt, Benjamin

2015-08-01

Empathy is a critical competency in medicine. Prior studies demonstrate a longitudinal decrease in empathy during residency; however, they have not included pediatric residents. The relations among the expression of empathy, sense of power (ability to influence other's behavior), and personality traits in residents also have not been addressed. Lastly, there are no data on how residents compare with the general nonmedical population in their expression of empathy. The purposes of our study were to assess whether empathy, sense of power, and personality type were statistically correlated; if resident empathy declines over time; and how resident empathy compares with that of nonmedical peers. In 2010, a cohort of individuals entering pediatric residency were given three validated survey instruments at the beginning of their first and third years of training to explore longitudinal changes in empathy, sense of power, and major personality traits. We found no decrease in resident empathy in 2 years of pediatric training, no changes in their sense of power, and no statistically significant correlation between empathetic tendencies and sense of power. When compared with the general nonmedical population, pediatric residents rated themselves higher in empathy. As expected, the two components of empathy (empathic concern and perspective taking) were moderately correlated. Of the major personality traits, only agreeableness showed significant correlation with empathy. Pediatric resident empathy did not decrease longitudinally, unlike studies in other residents. There was no inverse relation between self-perceptions of sense of power and empathy as is present in the business literature. Finally, pediatric resident empathy was significantly higher when compared with a general nonmedical population.

Past-year Prescription Drug Monitoring Program Opioid Prescriptions and Self-reported Opioid Use in an Emergency Department Population With Opioid Use Disorder.

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Hawk, Kathryn; D'Onofrio, Gail; Fiellin, David A; Chawarski, Marek C; O'Connor, Patrick G; Owens, Patricia H; Pantalon, Michael V; Bernstein, Steven L

2017-11-22

Despite increasing reliance on prescription drug monitoring programs (PDMPs) as a response to the opioid epidemic, the relationship between aberrant drug-related behaviors captured by the PDMP and opioid use disorder is incompletely understood. How PDMP data should guide emergency department (ED) assessment has not been studied. The objective was to evaluate a relationship between PDMP opioid prescription records and self-reported nonmedical opioid use of prescription opioids in a cohort of opioid-dependent ED patients enrolled in a treatment trial. PDMP opioid prescription records during 1 year prior to study enrollment on 329 adults meeting Diagnostic and Statistical Manual IV criteria for opioid dependence entering a randomized clinical trial in a large, urban ED were cross-tabulated with data on 30-day nonmedical prescription opioid use self-report. The association among these two types of data was assessed by the Goodman and Kruskal's gamma; a logistic regression was used to explore characteristics of participants who had PDMP record of opioid prescriptions. During 1 year prior to study enrollment, 118 of 329 (36%) patients had at least one opioid prescription (range = 1-51) in our states' PDMP. Patients who reported ≥15 of 30 days of nonmedical prescription opioid use were more likely to have at least four PDMP opioid prescriptions (20/38; 53%) than patients reporting 1 to 14 days (14/38, 37%) or zero days of nonmedical prescription opioid use (4/38, 11%; p = 0.002). Female sex and having health insurance were significantly more represented in the PDMP (p Medicine.

Response of testosterone and corticosterone plasma levels to the challenge of sibling competition: a study in common terns.

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Braasch, Alexander; Becker, Peter H; Groothuis, Ton G G

2014-08-01

The hormonal response to social challenges has been widely studied, however, most work focused on adult behavior in a reproductive context although developing animals also encounter important social challenges early in life. We studied the relationship between acute sibling competition and plasma corticosterone (CORT) and testosterone (T) in common tern (Sterna hirundo) chicks, a species whose young compete for access to food by scramble interactions. Blood samples were taken in nests with two and only one single chick both immediately after a feeding bout and in non-challenged controls. We found that T levels were lower in siblings challenged by a feeding bout as compared to controls, which may be explained by the fact that T suppresses begging behavior and is only elevated in response to territorial intrusion but not sibling competition in a related species. Singletons had, corrected for body condition, generally lower CORT levels than siblings suggesting that growing up with siblings creates a competitive environment in which high CORT levels are sustained irrespective of a social challenge. CORT levels were also negatively correlated with body condition and were higher in males than in females. The latter may be related to sex-specific food requirements and susceptibility to stress. Our results suggest a possible suppressive effect of acute sibling competition on T secretion, and a positive effect on CORT levels by longer term sibling competition. The degree to which these dynamics are related to begging or aggression, or both, needs further experimental work. Copyright © 2014 Elsevier Inc. All rights reserved.

[Changing surgical therapy because of clinical studies?].

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Schwenk, W; Haase, O; Müller, J M

2002-04-01

The randomised controlled clinical trial (RCT) is a powerful instrument to evaluate different therapeutic regimens. In a survey among 115 physicians visiting the 25th annual meeting of the Surgical Society of Berlin and Brandenburg, the RCT was judged to be very important when changes of therapeutic strategies are discussed. 90 % of all participants claimed to use data from RCTs in the clinical routine and 89 % would participate in such a trial. In official (e. g. discussions during coffee breaks at scientific meetings) or non-medical (e. g. non-scientific press or media) sources of information were assessed as irrelevant for decisions regarding therapeutic strategies. However, in contrast to this view laparoscopic cholecystectomy was introduced into clinical practice rapidly because patients informed by external (non-medical) sources preferred to be operated on with the "modern" technique. Clinical trials with a high level of evidence had no relevant influence on the rapid distribution of laparoscopic cholecystectomy. Controversial discussions concerning the extent of lymphadenectomy with gastric resection for carcinoma demonstrate that the value of excellent clinical RCTs is low if their results challenge a stable paradigma of the surgical scientific society. To allow a rational judgement, new surgical technologies should undergo a scientific gradual evaluation in agreement with the principles of evidence based medicine.

Applications of industrial computed tomography at Los Alamos Scientific Laboratory

International Nuclear Information System (INIS)

Kruger, R.P.; Morris, R.A.; Wecksung, G.W.

1980-01-01

A research and development program was begun three years ago at the Los Alamos Scientific Laboratory (LASL) to study nonmedical applications of computed tomography. This program had several goals. The first goal was to develop the necessary reconstruction algorithms to accurately reconstruct cross sections of nonmedical industrial objects. The second goal was to be able to perform extensive tomographic simulations to determine the efficacy of tomographic reconstruction with a variety of hardware configurations. The final goal was to construct an inexpensive industrial prototype scanner with a high degree of design flexibility. The implementation of these program goals is described

Health protection: communicable disease, public health and infection control educational programmes--a case study from the UK.

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El-Ansari, W; Privett, S

2005-04-01

The health protection (HP) landscape is changing. Issues related to infectious diseases in the context of global health are receiving the attention of world leaders and policy makers. In the UK, the national health policies resonate with such transformations, presenting a range of opportunities and challenges. The opportunities include the formation of a new national organisation dedicated to protecting the people's health and reducing the impact of infectious disease, the Health Protection Agency. The opportunities also include the opening of non-medical specialists's pathways in public health. The challenges represent the limited number of centres offering infection control education; the hospital focus and bias of the courses; new, resurgent and emerging infections; globalisation and travel; bacterial resistance; vaccine safety and coverage; bioterrorism; global response capacity; and visa restrictions. Within this context, this paper presents a case study of a HP educational programme at a British university in the south of England. It outlines the course design and philosophy, participants, recruitment, aims, descriptions and learning outcomes. A range of teething problems associated with the initiation and running of such programmes is considered. These include aspects related to the university, features associated with the modules, characteristics of the students, and other interconnected larger scale international issues. Some suggestions for the way forward are presented. Collectively, attention to the suggested measures can ensure that the processes that teaching programmes embrace to refine their content and delivery will equip tomorrow's professionals with the requisite HP knowledge and skills.

Loose regulation of medical marijuana programs associated with higher rates of adult marijuana use but not cannabis use disorder.

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Williams, Arthur Robin; Santaella-Tenorio, Julian; Mauro, Christine M; Levin, Frances R; Martins, Silvia S

2017-11-01

Most US states have passed medical marijuana laws (MMLs), with great variation in program regulation impacting enrollment rates. We aimed to compare changes in rates of marijuana use, heavy use and cannabis use disorder across age groups while accounting for whether states enacted medicalized (highly regulated) or non-medical mml programs. Difference-in-differences estimates with time-varying state-level MML coded by program type (medicalized versus non-medical). Multi-level linear regression models adjusted for state-level random effects and covariates as well as historical trends in use. Nation-wide cross-sectional survey data from the US National Survey of Drug Use and Health (NSDUH) restricted use data portal aggregated at the state level. Participants comprised 2004-13 NSDUH respondents (n ~ 67 500/year); age groups 12-17, 18-25 and 26+ years. States had implemented eight medicalized and 15 non-medical MML programs. Primary outcome measures included (1) active (past-month) marijuana use; (2) heavy use (> 300 days/year); and (3) cannabis use disorder diagnosis, based on DSM-IV criteria. Covariates included program type, age group and state-level characteristics throughout the study period. Adults 26+ years of age living in states with non-medical MML programs increased past-month marijuana use 1.46% (from 4.13 to 6.59%, P = 0.01), skewing towards greater heavy marijuana by 2.36% (from 14.94 to 17.30, P = 0.09) after MMLs were enacted. However, no associated increase in the prevalence of cannabis use disorder was found during the study period. Our findings do not show increases in prevalence of marijuana use among adults in states with medicalized MML programs. Additionally, there were no increases in adolescent or young adult marijuana outcomes following MML passage, irrespective of program type. Non-medical marijuana laws enacted in US states are associated with increased marijuana use, but only among adults aged 26+ years. Researchers and

Route of administration for illicit prescription opioids: a comparison of rural and urban drug users

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Havens Jennifer R

2010-10-01

Full Text Available Abstract Background Nonmedical prescription opioid use has emerged as a major public health concern in recent years, particularly in rural Appalachia. Little is known about the routes of administration (ROA involved in nonmedical prescription opioid use among rural and urban drug users. The purpose of this study was to describe rural-urban differences in ROA for nonmedical prescription opioid use. Methods A purposive sample of 212 prescription drug users was recruited from a rural Appalachian county (n = 101 and a major metropolitan area (n = 111 in Kentucky. Consenting participants were given an interviewer-administered questionnaire examining sociodemographics, psychiatric disorders, and self-reported nonmedical use and ROA (swallowing, snorting, injecting for the following prescription drugs: buprenorphine, fentanyl, hydrocodone, hydromorphone, methadone, morphine, OxyContin® and other oxycodone. Results Among urban participants, swallowing was the most common ROA, contrasting sharply with substance-specific variation in ROA among rural participants. Among rural participants, snorting was the most frequent ROA for hydrocodone, methadone, OxyContin®, and oxycodone, while injection was most common for hydromorphone and morphine. In age-, gender-, and race-adjusted analyses, rural participants had significantly higher odds of snorting hydrocodone, OxyContin®, and oxycodone than urban participants. Urban participants had significantly higher odds of swallowing hydrocodone and oxycodone than did rural participants. Notably, among rural participants, 67% of hydromorphone users and 63% of morphine users had injected the drugs. Conclusions Alternative ROA are common among rural drug users. This finding has implications for rural substance abuse treatment and harm reduction, in which interventions should incorporate methods to prevent and reduce route-specific health complications of drug use.

Characteristics of general practice care: What do senior citizens value? A qualitative study

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Verhaak Peter FM

2010-11-01

Full Text Available Abstract Background In view of the increasing number of senior citizens in our society who are likely to consult their GP with age-related health problems, it is important to identify and understand the preferences of this group in relation to the non-medical attributes of GP care. The aim of this study is to improve our understanding about preferences of this group of patients in relation to non-medical attributes of primary health care. This may help to develop strategies to improve the quality of care that senior citizens receive from their GP. Methods Semi-structured interviews (N = 13 with senior citizens (65-91 years in a judgement sample were recorded and transcribed verbatim. The analysis was conducted according to qualitative research methodology and the frame work method. Results Continuity of care providers, i.e. GP and practice nurses, GPs' expertise, trust, free choice of GP and a kind open attitude were highly valued. Accessibility by phone did not meet the expectations of the interviewees. The interviewees had difficulties with the GP out-of-office hours services. Spontaneous home visits were appreciated by some, but rejected by others. They preferred to receive verbal information rather than collecting information from leaflets. Distance to the practice and continuity of caregiver seemed to conflict for respondents. Conclusions Preferences change in the process of ageing and growing health problems. GPs and their co-workers should be also aware of the changing needs of the elderly regarding non-medical attributes of GP care. Meeting their needs regarding non-medical attributes of primary health care is important to improve the quality of care.

Culturally acceptable health care services for Saudi's elderly population: the decision-maker's perception.

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al-Shammari, S A; Felemban, F M; Jarallah, J S; Ali el-S; al-Bilali, S A; Hamad, J M

1995-01-01

This article reports on a study carried out in 1993 to elicit the opinions of decision makers (medical and non-medical) as to the types of facilities, locations and culturally acceptable levels of health care appropriate for the elderly in Saudi Arabia. In addition, the study sought to find out the procedures and likely constraints in the development of future health care services for the elderly. An opinion survey was carried out on a randomly selected sample of decision makers, drawn from: hospitals of 100-bed capacity or more; and, from directorates of education, agriculture, police, municipalities, commerce, transport and media, in each of the regions of Saudi Arabia. A predesigned Arabic questionnaire was completed by the respondents during February-April, 1993. Of the 244 respondents, the most important categories of elderly to be cared for were considered to be those with handicaps, the chronically ill, and those without family support. The non-medical decision makers gave higher scores to these alternatives than did the medical decision makers (P < 0.05). Use of the family home for elderly health care was rated as the most appropriate, followed by medical rehabilitation centres, and only then by hospitals. Non-medical respondents gave more emphasis on rehabilitation centres (P < 0.02). Medical respondents thought that primary care doctors (87.2%), physiotherapists (87.2%) and general nurses (78.2%) can adequately fulfil the needs of most elderly patients. In contrast, non-medical respondents demanded the presence of specialist doctors (72.3%), specialist nurses (78.9%), laboratory and X-ray facilities to run such services (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Societal costs and burden of otitis media in Portugal

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Speets AM

2011-04-01

Full Text Available Anouk Speets1, Judith Wolleswinkel1, Cristina Cardoso21Pallas health research and consultancy, Rotterdam, the Netherlands; 2GlaxoSmithKline, Algés, PortugalAbstract: This study aimed to estimate the resource consumption and societal impact of otitis media (OM in children younger than five years of age in Portugal. An Internet survey on generic childhood symptoms and diseases was administered to a sample of parents. This self-report survey had been previously implemented in other European countries. Medically confirmed OM was defined as symptoms of earache or “running ear” and/or a diagnosis of OM provided by a medical doctor. Direct medical, nonmedical, and indirect nonmedical costs were calculated for individual cases. Mean total costs per OM episode were estimated at €334. This corresponds to an estimated societal impact of 72 million €/year, of which 39% were indirect nonmedical costs. An epidemiological study should help to confirm the results of this study, and evaluate whether an intervention to reduce the occurrence and/or duration of OM may have an impact on societal costs and quality of life for affected families.Keywords: otitis media, costs, societal burden, Portugal

Marijuana Legalization and Parents' Attitudes, Use, and Parenting in Washington State.

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Kosterman, Rick; Bailey, Jennifer A; Guttmannova, Katarina; Jones, Tiffany M; Eisenberg, Nicole; Hill, Karl G; Hawkins, J David

2016-10-01

The recent legalization of nonmedical marijuana use in several U.S. states has unknown implications for those who are actively parenting. This study examined parents' reactions to marijuana legalization and changes in attitudes and behaviors over time. Data were from a gender-balanced, ethnically diverse sample of 395 parents in Washington State who were participating in the longitudinal Seattle Social Development Project. Participants were interviewed 15 times between 1985 (age 10) and 2014 (age 39). Adult nonmedical marijuana use was legalized in Washington in 2012 and retail outlets opened in 2014. Results showed (1) one third of parents incorrectly believed the legal age of nonmedical marijuana use to be 18; (2) significant increase in approval of adult marijuana use and decrease in perceived harm of regular use; (3) wide opposition to teen use and use around one's children; and (4) substantial increases in frequency of use and marijuana use disorder among parents who used. Despite increased acceptance and frequency of adult use, parents remain widely opposed to teen use but need facts and strategies for talking with their children about marijuana. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Systemic oxidatively generated DNA/RNA damage in clinical depression

DEFF Research Database (Denmark)

Jorgensen, Anders; Krogh, Jesper; Miskowiak, Kamilla

2013-01-01

oxidatively generated DNA and RNA damage, 8-oxo-7,8-dihydro-2-deoxyguanosine (8-oxodG) and 8-oxo-7,8-dihydroguanosine (8-oxoGuo), respectively, were determined in healthy controls (N=28), moderately depressed, non-medicated patients (N=26) and severely depressed patients eligible for electroconvulsive therapy...... for trend=0.004). The 8-oxoGuo excretion was further increased after clinically effective ECT compared with pre-ECT values (P=0.006). There were no differences in 8-oxodG excretion between the groups or pre- vs. post-ECT. LIMITATIONS: Small sample size and the inclusion of both unipolar and bipolar patients...

Medical Evaluation and Triage of the Agitated Patient: Consensus Statement of the American Association for Emergency Psychiatry Project BETA Medical Evaluation Workgroup

Science.gov (United States)

Nordstrom, Kimberly; Zun, Leslie S; Wilson, Michael P; MD, Victor Stiebel; Ng, Anthony T; Bregman, Benjamin; Anderson, Eric L

2012-01-01

Numerous medical and psychiatric conditions can cause agitation; some of these causes are life threatening. It is important to be able to differentiate between medical and nonmedical causes of agitation so that patients can receive appropriate and timely treatment. This article aims to educate all clinicians in nonmedical settings, such as mental health clinics, and medical settings on the differing levels of severity in agitation, basic triage, use of de-escalation, and factors, symptoms, and signs in determining whether a medical etiology is likely. Lastly, this article focuses on the medical workup of agitation when a medical etiology is suspected or when etiology is unclear. PMID:22461915

["No" for stacked young bodybuilders, "yes" for manthers: the biomedical discourse on anabolic steroids and health].

Science.gov (United States)

Moraes, Danielle Ribeiro de; Castiel, Luis David; Ribeiro, Ana Paula Pereira da Gama Alves

2015-06-01

The article addresses the use of anabolic androgenic steroids (AAS), synthetic drugs whose abuse has been characterized as a public health problem, operated in the opposition between "medical" and "non-medical" uses. A qualitative approach was used to analyze the text in 76 biomedical articles published from 2002 to 2012. The discourse shows a persistent ban on non-medically regulated use of AAS by young people, while the limits on clinically qualified use appear to expand among older people, even given the contradictions straining the argument on the prevention of health risks. Moralizing biopolitical stances appear, based on gender distinctions or under the aegis of criminalizing drug use.

Dietary l-threonine supplementation attenuates lipopolysaccharide-induced inflammatory responses and intestinal barrier damage of broiler chickens at an early age.

Science.gov (United States)

Chen, Yueping; Zhang, Hao; Cheng, Yefei; Li, Yue; Wen, Chao; Zhou, Yanmin

2018-06-01

This study was conducted to investigate the protective effects of l-threonine (l-Thr) supplementation on growth performance, inflammatory responses and intestinal barrier function of young broilers challenged with lipopolysaccharide (LPS). A total of 144 1-d-old male chicks were allocated to one of three treatments: non-challenged broilers fed a basal diet (control group), LPS-challenged broilers fed a basal diet without l-Thr supplementation and LPS-challenged broilers fed a basal diet supplemented with 3·0 g/kg l-Thr. LPS challenge was performed intraperitoneally at 17, 19 and 21 d of age, whereas the control group received physiological saline injection. Compared with the control group, LPS challenge impaired growth performance of broilers, and l-Thr administration reversed LPS-induced increase in feed/gain ratio. LPS challenge elevated blood cell counts related to inflammation, and pro-inflammatory cytokine concentrations in serum (IL-1β and TNF-α), spleen (IL-1β and TNF-α) and intestinal mucosa (jejunal interferon-γ (IFN-γ) and ileal IL-1β). The concentrations of intestinal cytokines in LPS-challenged broilers were reduced by l-Thr supplementation. LPS administration increased circulating d-lactic acid concentration, whereas it reduced villus height, the ratio between villus height and crypt depth and goblet density in both jejunum and ileum. LPS-induced decreases in jejunal villus height, intestinal villus height:crypt depth ratio and ileal goblet cell density were reversed with l-Thr supplementation. Similarly, LPS-induced alterations in the intestinal mRNA abundances of genes related to intestinal inflammation and barrier function (jejunal toll-like receptor 4, IFN- γ and claudin-3, and ileal IL-1 β and zonula occludens-1) were normalised with l-Thr administration. It can be concluded that l-Thr supplementation could attenuate LPS-induced inflammatory responses and intestinal barrier damage of young broilers.

Hartig' net formation of Tricholoma vaccinum-spruce ectomycorrhiza in hydroponic cultures.

Science.gov (United States)

Henke, Catarina; Jung, Elke-Martina; Kothe, Erika

2015-12-01

For re-forestation of metal-contaminated land, ectomycorrhizal trees may provide a solution. Hence, the study of the interaction is necessary to allow for comprehensive understanding of the mutually symbiotic features. On a structural level, hyphal mantle and the Hartig' net formed in the root apoplast are essential for plant protection and mycorrhizal functioning. As a model, we used the basidiomycete Tricholoma vaccinum and its host spruce (Picea abies). Using an optimized hydroponic cultivation system, both features could be visualized and lower stress response of the tree was obtained in non-challenged cultivation. Larger spaces in the apoplasts could be shown with high statistical significance. The easy accessibility will allow to address metal stress or molecular responses in both partners. Additionally, the proposed cultivation system will enable for other experimental applications like addressing flooding, biological interactions with helper bacteria, chemical signaling, or other biotic or abiotic challenges relevant in the natural habitat.

Cost of dengue and other febrile illnesses to households in rural Cambodia: a prospective community-based case-control study

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Margolis Harold S

2009-05-01

Full Text Available Abstract Background The average annual reported dengue incidence in Cambodia is 3.3/1,000 among children Methods In 2006, active fever surveillance was conducted among a cohort of 6,694 children aged ≤ 15 years in 16 villages in Kampong Cham province, Cambodia. Subsequently, a case-control study was performed by individually assigning one non-dengue febrile control from the cohort to each laboratory-confirmed dengue case. Parents of cases and controls were interviewed using a standardized questionnaire to determine household-level, illness-related expenditures for medical and non-medical costs, and estimated income loss (see Additional file 1. The household socio-economic status was determined and its possible association with health seeking behaviour and the ability to pay for the costs of a febrile illness. Additional File 1 2006 cost study survey questionnaire, Cambodia. the questionnaire represents the data collection instrument that was developed and used during the present study. Click here for file Results Between September and November 2006, a total of 60 household heads were interviewed: 30 with dengue-positive and 30 with dengue-negative febrile children. Mean total dengue-related costs did not differ from those of other febrile illnesses (31.5 vs. 27.2 US$, p = 0.44. Hospitalization almost tripled the costs of dengue (from 14.3 to 40.1 US$ and doubled the costs of other febrile illnesses (from 17.0 to 36.2 US$. To finance the cost of a febrile illness, 67% of households incurred an average debt of 23.5 US$ and higher debt was associated with hospitalization compared to outpatient treatment (US$ 23.1 vs. US$ 4.5, p Conclusion In Cambodia, dengue and other febrile illnesses pose a financial burden to households. A possible reason for a lower rate of hospitalization among children from poor households could be the burden of higher illness-related costs and debts.

Empathy as a function of clinical exposure--reading emotion in the eyes.

Directory of Open Access Journals (Sweden)

Cameron Handford

Full Text Available BACKGROUND: Evidence based largely on self-report data suggests that factors associated with medical education erode the critical human quality of empathy. These reports have caused serious concern among medical educators and clinicians and have led to changes in medical curricula around the world. This study aims to provide a more objective index of possible changes in empathy across the spectrum of clinical exposure, by using a behavioural test of empathic accuracy in addition to self-report questionnaires. Moreover, non-medical groups were used to control for maturation effects. METHODS: Three medical groups (N = 3×20 representing a spectrum of clinical exposure, and two non-medical groups (N = 2×20 matched for age, sex and educational achievements completed self-report measures of empathy, and tests of empathic accuracy and interoceptive sensitivity. RESULTS: Between-group differences in reported empathy related to maturation rather than clinical training/exposure. Conversely, analyses of the "eyes" test results specifically identified clinical practice, but not medical education, as the key influence on performance. The data from the interoception task did not support a link between visceral feedback and empathic processes. CONCLUSIONS: Clinical practice, but not medical education, impacts on empathy development and seems instrumental in maintaining empathetic skills against the general trend of declining empathic accuracy with age.

Barriers to and facilitators of compliance with clinic-based cervical cancer screening: population-based cohort study of women aged 23-60 years.

Science.gov (United States)

Östensson, Ellinor; Alder, Susanna; Elfström, K Miriam; Sundström, Karin; Zethraeus, Niklas; Arbyn, Marc; Andersson, Sonia

2015-01-01

This study aims to identify possible barriers to and facilitators of cervical cancer screening by (a) estimating time and travel costs and other direct non-medical costs incurred in attending clinic-based cervical cancer screening, (b) investigating screening compliance and reasons for noncompliance, (c) determining women's knowledge of human papillomavirus (HPV), its relationship to cervical cancer, and HPV and cervical cancer prevention, and (d) investigating correlates of HPV knowledge and screening compliance. 1510 women attending the clinic-based cervical cancer screening program in Stockholm, Sweden were included. Data on sociodemographic characteristics, time and travel costs and other direct non-medical costs incurred in attending (e.g., indirect cost of time needed for the screening visit, transportation costs, child care costs, etc.), mode(s) of travel, time, distance, companion's attendance, HPV knowledge, and screening compliance were obtained via self-administered questionnaire. Few respondents had low socioeconomic status. Mean total time and travel costs and direct non-medical cost per attendance, including companion (if any) were €55.6. Over half (53%) of the respondents took time off work to attend screening (mean time 147 minutes). A large portion (44%) of the respondents were noncompliant (i.e., did not attend screening within 1 year of the initial invitation), 51% of whom stated difficulties in taking time off work. 64% of all respondents knew that HPV vaccination was available; only 34% knew it was important to continue to attend screening following vaccination. Age, education, and income were the most important correlates of HPV knowledge and compliance; and additional factors associated with compliance were time off work, accompanying companion and HPV knowledge. Time and travel costs and other direct non-medical costs for clinic-based screening can be considerable, may affect the cost-effectiveness of a screening program, and may

[Preliminary analysis of total cost and life quality for elder patients with femoral neck fracture].

Science.gov (United States)

Liu, Haonan; He, Liang; Zhang, Guilin; Gong, Xiaofeng; Li, Ning

2015-09-01

To analyze the total cost and life quality of the femoral neck fracture patients who received different surgery and supplement comprehensive data of osteoporotic fracture. One hundred and five patients above 60-year old who were diagnosed femoral neck fracture and received operation in Department of Orthopedics ＆ Traumatology, Beijing Jishuitan Hospital were admitted into our study from August 2013 to December. According to the type of surgery there were 52 and 53 cases in internal fixation (IF) group and hemiarthroplasty (HA) group respectively. At first we collected the medical expense of the patients before and during hospitalization. And then the 1-year medical and non-medical expenses were collected by the cost diary ever 3 months after discharge. At the last follow-up we evaluated the life quality by the EuroQol-5 Dimensions (EQ-5D) and calculated the total cost. Outcome All the patients completed the operation successfully. No nonunion or delayed union cases in IF group, and no cases received revision surgery in both groups. The total average cost was 59 584.9 yuan including 79.1% medical cost and 20.9% non-medical cost. The primary treatment cost accounts for 84.1% of the medical cost. The cost for home care accounts for 90.7% of the non-medical care. The total and medical cost of IF group just account for 40.3% and 38.5% of the HA group and the non-medical showed no significant difference between the 2 groups (P>0.05). In addition the data of life quality and walking capability also showed no significant difference. The main cost for the femoral neck fracture is medical expense in 1-year follow-up. Both surgeries can provide satisfactory outcome, however IF may be more cost-effective compared to the HA because of the less total cost.

Does doctors’ workload impact supervision and ward activities of final-year students? A prospective study

Directory of Open Access Journals (Sweden)

Celebi Nora

2012-06-01

Full Text Available Abstract Background Hospital doctors face constantly increasing workloads. Besides caring for patients, their duties also comprise the education of future colleagues. The aim of this study was to objectively investigate whether the workload arising from increased patient care interferes with student supervision and is associated with more non-medical activities of final-year medical students. Methods A total of 54 final-year students were asked to keep a diary of their daily activities over a three-week period at the beginning of their internship in Internal Medicine. Students categorized their activities – both medical and non-medical - according to whether they had: (1 only watched, (2 assisted the ward resident, (3 performed the activity themselves under supervision of the ward resident, or (4 performed the activity without supervision. The activities reported on a particular day were matched with a ward specific workload-index derived from the hospital information system, including the number of patients treated on the corresponding ward on that day, a correction factor according to the patient comorbidity complexity level (PCCL, and the number of admissions and discharges. Both students and ward residents were blinded to the study question. Results A total of 32 diaries (59 %, 442 recorded working days were handed back. Overall, the students reported 1.2 ± 1.3 supervised, 1.8 ±1.6 medical and 3.6 ± 1.7 non-medical activities per day. The more supervised activities were reported, the more the number of reported medical activities increased (p  Conclusions There was a significant association between ward doctors’ supervision of students and the number of medical activities performed by medical students. The workload had no significant effect on supervision or the number of medical or non-medical activities of final-year students.

Carbadox has both temporary and lasting effects on the swine gut microbiota

Directory of Open Access Journals (Sweden)

Torey eLooft

2014-06-01

Full Text Available Antibiotics are used in livestock and poultry production to treat and prevent disease as well as to promote animal growth. Carbadox is an in-feed antibiotic that is widely used in swine production to prevent dysentery and to improve feed efficiency. The goal of this study was to characterize the effects of carbadox and its withdrawal on the swine gut microbiota. Six pigs (initially 3-weeks old received feed containing carbadox and six received unamended feed. After 3-weeks of continuous carbadox administration, all pigs were switched to a maintenance diet without carbadox. DNA was extracted from feces (n=142 taken before, during, and following (6-week withdrawal carbadox treatment. Phylotype analysis using 16S rRNA sequences showed the gradual development of the non-medicated swine gut microbiota over the 8-week study, and that the carbadox-treated pigs had significant differences in bacterial membership relative to non-medicated pigs. Enumeration of fecal Escherichia coli showed that a diet change concurrent with carbadox withdrawal was associated with an increase in the E. coli in the non-medicated pigs, suggesting that carbadox pretreatment prevented an increase of E. coli populations. In-feed carbadox caused striking effects within four days of administration, with significant alterations in both community structure and bacterial membership, notably a large relative increase in Prevotella populations in medicated pigs. Digital PCR was used to show that the absolute abundance of Prevotella was unchanged between the medicated and non-medicated pigs despite the relative increase shown in the phylotype analysis. Carbadox therefore caused a decrease in the abundance of other gut bacteria but did not affect the absolute abundance of Prevotella. The pending regulation on antibiotics used in animal production underscores the importance of understanding how they modulate the microbiota and impact animal health, which will inform the search for

Barriers to and facilitators of compliance with clinic-based cervical cancer screening: population-based cohort study of women aged 23-60 years.

Directory of Open Access Journals (Sweden)

Ellinor Östensson

Full Text Available This study aims to identify possible barriers to and facilitators of cervical cancer screening by (a estimating time and travel costs and other direct non-medical costs incurred in attending clinic-based cervical cancer screening, (b investigating screening compliance and reasons for noncompliance, (c determining women's knowledge of human papillomavirus (HPV, its relationship to cervical cancer, and HPV and cervical cancer prevention, and (d investigating correlates of HPV knowledge and screening compliance.1510 women attending the clinic-based cervical cancer screening program in Stockholm, Sweden were included. Data on sociodemographic characteristics, time and travel costs and other direct non-medical costs incurred in attending (e.g., indirect cost of time needed for the screening visit, transportation costs, child care costs, etc., mode(s of travel, time, distance, companion's attendance, HPV knowledge, and screening compliance were obtained via self-administered questionnaire.Few respondents had low socioeconomic status. Mean total time and travel costs and direct non-medical cost per attendance, including companion (if any were €55.6. Over half (53% of the respondents took time off work to attend screening (mean time 147 minutes. A large portion (44% of the respondents were noncompliant (i.e., did not attend screening within 1 year of the initial invitation, 51% of whom stated difficulties in taking time off work. 64% of all respondents knew that HPV vaccination was available; only 34% knew it was important to continue to attend screening following vaccination. Age, education, and income were the most important correlates of HPV knowledge and compliance; and additional factors associated with compliance were time off work, accompanying companion and HPV knowledge.Time and travel costs and other direct non-medical costs for clinic-based screening can be considerable, may affect the cost-effectiveness of a screening program, and may

What Do Patients Want to Know? Questions and Concerns Regarding Mammography Expressed Through Social Media.

Science.gov (United States)

Charlie, Abbas M; Gao, Yiming; Heller, Samantha L

2017-12-05

The purpose of this project is to identify questions and concerns patients have regarding breast cancer screening mammography to establish priorities in patient education and health care communication. A content analysis of posted questions (June 2010 to February 2017) containing the keywords mammogram and mammography was conducted on the social media question and answer website Quora (Quora Inc, Mountainview, California). Question topic, responses, and number of views were recorded. Comparisons were made by respondent type (medical professional or nonmedical professional) for screening recommendations and accompanying evidence. Descriptive statistics were employed to summarize the results. Overall, 197,620 views of mammography-related questions were identified, focused on 51 questions and 172 responses (51 of 172 [29.7%] by medical professionals [n = 25]; 121 of 172 [70.3%] by nonmedical professionals [n = 121]). Mammographic efficacy (16 of 51 [31.4%]) and screening guidelines (10 of 51 [19.6%]) were the most frequently queried topics. Overall, the majority of respondents were supportive of screening mammography. Most medical professionals recommended screening mammography starting at age 40, even after revisions in guidelines. Among nonmedical professionals, 4 of 22 (18.2%) were against screening mammography with less consensus regarding appropriate age of initial screen. Health society websites and journal articles were the most commonly referenced sources among medical and nonmedical professionals, respectively. A considerable interest in screening mammography guidelines and mammographic efficacy exists among users who seek health information on a social media question and answer website. Awareness of such platforms allows a unique opportunity for targeted health education and dissemination of accurate information, which may be able to reach a potentially untapped or hard-to-reach patient population. Copyright © 2017 American College of Radiology

Lovastatin protects against experimental plague in mice.

Directory of Open Access Journals (Sweden)

Saravanan Ayyadurai

Full Text Available BACKGROUND: Plague is an ectoparasite-borne deadly infection caused by Yersinia pestis, a bacterium classified among the group A bioterrorism agents. Thousands of deaths are reported every year in some African countries. Tetracyclines and cotrimoxazole are used in the secondary prophylaxis of plague in the case of potential exposure to Y. pestis, but cotrimoxazole-resistant isolates have been reported. There is a need for additional prophylactic measures. We aimed to study the effectiveness of lovastatin, a cholesterol-lowering drug known to alleviate the symptoms of sepsis, for plague prophylaxis in an experimental model. METHODOLOGY: Lovastatin dissolved in Endolipide was intraperitoneally administered to mice (20 mg/kg every day for 6 days prior to a Y. pestis Orientalis biotype challenge. Non-challenged, lovastatin-treated and challenged, untreated mice were also used as control groups in the study. Body weight, physical behavior and death were recorded both prior to infection and for 10 days post-infection. Samples of the blood, lungs and spleen were collected from dead mice for direct microbiological examination, histopathology and culture. The potential antibiotic effect of lovastatin was tested on blood agar plates. CONCLUSIONS/SIGNIFICANCE: Lovastatin had no in-vitro antibiotic effect against Y. pestis. The difference in the mortality between control mice (11/15; 73.5% and lovastatin-treated mice (3/15; 20% was significant (P<0.004; Mantel-Haenszel test. Dead mice exhibited Y. pestis septicemia and inflammatory destruction of lung and spleen tissues not seen in lovastatin-treated surviving mice. These data suggest that lovastatin may help prevent the deadly effects of plague. Field observations are warranted to assess the role of lovastatin in the prophylaxis of human plague.

Comparative efficacy of the Cognitive Behavioral Analysis System of Psychotherapy versus Supportive Psychotherapy for early onset chronic depression: design and rationale of a multisite randomized controlled trial

Science.gov (United States)

2011-01-01

Background Effective treatment strategies for chronic depression are urgently needed since it is not only a common and particularly disabling disorder, but is also considered treatment resistant by most clinicians. There are only a few studies on chronic depression indicating that traditional psycho- and pharmacological interventions are not as effective as in acute, episodic depression. Current medications are no more effective than those introduced 50 years ago whereas the only psychotherapy developed specifically for the subgroup of chronic depression, the Cognitive Behavioral Analysis System of Psychotherapy (CBASP), faired well in one large trial. However, CBASP has never been directly compared to a non-specific control treatment. Methods/Design The present article describes the study protocol of a multisite parallel-group randomized controlled trial in Germany. The purpose of the study is to estimate the efficacy of CBASP compared to supportive psychotherapy in 268 non-medicated early-onset chronically depressed outpatients. The intervention includes 20 weeks of acute treatment with 24 individual sessions followed by 28 weeks of continuation treatment with another 8 sessions. Depressive symptoms are evaluated 20 weeks after randomisation by means of the 24-item Hamilton Rating Scale of Depression (HRSD). Secondary endpoints are depressive symptoms after 12 and 48 weeks, and remission after 12, 20, and 48 weeks. Primary outcome will be analysed using analysis of covariance (ANCOVA) controlled for pre-treatment scores and site. Analyses of continuous secondary variables will be performed using linear mixed models. For remission rates, chi-squared tests and logistic regression will be applied. Discussion The study evaluates the comparative effects of a disorder-specific psychotherapy and a well designed non-specific psychological approach in the acute and continuation treatment phase in a large sample of early-onset chronically depressed patients. Trial

Deletion of the γ-Aminobutyric Acid Transporter 2 (GAT2 and SLC6A13) Gene in Mice Leads to Changes in Liver and Brain Taurine Contents*

Science.gov (United States)

Zhou, Yun; Holmseth, Silvia; Guo, Caiying; Hassel, Bjørnar; Höfner, Georg; Huitfeldt, Henrik S.; Wanner, Klaus T.; Danbolt, Niels C.

2012-01-01

The GABA transporters (GAT1, GAT2, GAT3, and BGT1) have mostly been discussed in relation to their potential roles in controlling the action of transmitter GABA in the nervous system. We have generated the first mice lacking the GAT2 (slc6a13) gene. Deletion of GAT2 (both mRNA and protein) neither affected growth, fertility, nor life span under nonchallenging rearing conditions. Immunocytochemistry showed that the GAT2 protein was predominantly expressed in the plasma membranes of periportal hepatocytes and in the basolateral membranes of proximal tubules in the renal cortex. This was validated by processing tissue from wild-type and knockout mice in parallel. Deletion of GAT2 reduced liver taurine levels by 50%, without affecting the expression of the taurine transporter TAUT. These results suggest an important role for GAT2 in taurine uptake from portal blood into liver. In support of this notion, GAT2-transfected HEK293 cells transported [3H]taurine. Furthermore, most of the uptake of [3H]GABA by cultured rat hepatocytes was due to GAT2, and this uptake was inhibited by taurine. GAT2 was not detected in brain parenchyma proper, excluding a role in GABA inactivation. It was, however, expressed in the leptomeninges and in a subpopulation of brain blood vessels. Deletion of GAT2 increased brain taurine levels by 20%, suggesting a taurine-exporting role for GAT2 in the brain. PMID:22896705

Thymus transcriptome reveals novel pathways in response to avian pathogenic Escherichia coli infection.

Science.gov (United States)

Sun, H; Liu, P; Nolan, L K; Lamont, S J

2016-12-01

Avian pathogenic Escherichia coli (APEC) can cause significant morbidity in chickens. The thymus provides the essential environment for T cell development; however, the thymus transcriptome has not been examined for gene expression in response to APEC infection. An improved understanding of the host genomic response to APEC infection could inform future breeding programs for disease resistance and APEC control. We therefore analyzed the transcriptome of the thymus of birds challenged with APEC, contrasting susceptible and resistant phenotypes. Thousands of genes were differentially expressed in birds of the 5-day post infection (dpi) challenged-susceptible group vs. 5 dpi non-challenged, in 5 dpi challenged-susceptible vs. 5 dpi challenged-resistant birds, as well as in 5 dpi vs. one dpi challenged-susceptible birds. The Toll-like receptor signaling pathway was the major innate immune response for birds to respond to APEC infection. Moreover, lysosome and cell adhesion molecules pathways were common mechanisms for chicken response to APEC infection. The T-cell receptor signaling pathway, cell cycle, and p53 signaling pathways were significantly activated in resistant birds to resist APEC infection. These results provide a comprehensive assessment of global gene networks and biological functionalities of differentially expressed genes in the thymus under APEC infection. These findings provide novel insights into key molecular genetic mechanisms that differentiate host resistance from susceptibility in this primary lymphoid tissue, the thymus. © The Author 2016. Published by Oxford University Press on behalf of Poultry Science Association.

Research and quality improvement experience and knowledge: a nursing survey.

Science.gov (United States)

Fox, Jolene; Bagley, Lisa; Day, Suzanne; Holleran, Renee; Handrahan, Diana

2011-07-01

To assess nursing staff's background and research and quality improvement (QI) experience. In this corporation, participation in research and QI is encouraged, but little is known about nurses' experiences. A web-based survey was distributed. Nursing staffs from an academic/teaching medical centre and other intra-corporation non-academic facilities were compared. Respondents included: 148 (52.9%) medical centre and 132 (47.1%) non-medical centre subjects. Medical centre respondents had a higher proportion previously engaged in research, currently engaged in research and previously engaged in QI. Productivity (grant, published and presented) was low for both groups but statistically lower for the non-medical centre group. Medical centre employees used research resources more often than the non-medical centre. Time was the most frequently mentioned barrier to participation in research and QI initiatives. A moderate proportion of respondents had research and QI experience, yet productivity and use of resources was low. Nurses at non-academically focused facilities were in most need of assistance. Familiarizing nurses with resources and providing protected time may increase productivity. Developing an infrastructure to support nursing research is a worthy goal. Information about interest and experience of nurses can aid management in determining how to focus financial resources. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.

The influence of generic substitution on the content of patient-pharmacist communication in Swedish community pharmacies.

Science.gov (United States)

Olsson, Erika; Wallach-Kildemoes, Helle; Ahmed, Ban; Ingman, Pontus; Kaae, Susanne; Kälvemark Sporrong, Sofia

2017-08-01

The objective was to study the relationship between the length and content of patient-pharmacist communication in community pharmacies, and generic substitution. The study was conducted in six community pharmacies in Sweden. Non-participant observations with audio recordings and short structured interviews were conducted. Out of 32 pharmacists 29 agreed to participate (90.6%), as did 282 out of 407 patients (69.3%). Logistic regression analysis was applied to calculate odds ratio for occurrence of generic substitution. Linear regression (β-coefficients) was applied to test for differences in time spent on different categories. In encounters where generic substitution occurred more time (19.2 s) was spent on non-medical (for instance administrative or economical) issues (P = 0.01, 95% confidence interval 4.8-33.6). However, the total time of the encounter was not significantly longer. The amount of time spent on non-medical issues increased with age of patient (age 60+: β, 33 s, P communicating on non-medical, but not on medical, issues. No extra time was spent on medical information for the groups normally overrepresented among those with low health literacy. This study suggests that pharmacists need to further embrace their role in promoting rational use of medicines, not least when generic substitution occurs. © 2016 Royal Pharmaceutical Society.

Is hypochondriasis a significant problem among polish adolescents? An attempt of assessment of severe form of health anxiety in polish population

Directory of Open Access Journals (Sweden)

Janusz Kocjan

2017-08-01

[Conclusions] The study provides evidence about moderate intensification of health anxiety among polish adolescent. Health anxiety level was significantly higher among medical students versus non-medical students group.

Stanford Workshop on Surgical Simulation

National Research Council Canada - National Science Library

Salisbury, Kenneth

2001-01-01

.... We were particularly interested in medical applications including simulation-based training, skills assessment and planning, as well as other non-medical domains where real-time interactivity is needed...

42 CFR 498.2 - Definitions.

Science.gov (United States)

2010-10-01

...) An entity approved by CMS to furnish outpatient diabetes self-management training. (12) End-stage...) Home health agency (HHA). (vii) Hospice. (viii) Religious nonmedical health care institution (RNHCI...

Efficacy of a Multicomponent Positive Psychology Self-Help Intervention: Study Protocol of a Randomized Controlled Trial

Science.gov (United States)

Drossaert, Constance HC; Pieterse, Marcel E; Walburg, Jan A; Bohlmeijer, Ernst T

2015-01-01

Background Positive psychology interventions have been found to enhance well-being and decrease clinical symptomatology. However, it is still unknown how flourishing can also be increased. Although multicomponent interventions seem to be necessary for this purpose, different formats can be used. A cost-effective approach could be a positive psychology-based self-help book with tailored email support to reach large target groups and to prevent dropout. Objective This study will evaluate the efficacy of a comprehensive multicomponent self-help intervention with or without email support on well-being and flourishing, and will seek to determine the working mechanisms underlying the intervention. Methods In this 3-armed, parallel, randomized controlled trial, 396 participants with low or moderate levels of well-being and without clinical symptomatology will be randomly assigned to (1) a self-help book condition with weekly email support, (2) a self-help book condition without email support but with a weekly information email, or (3) a waiting list control condition. Online measurements will be assessed at baseline, at post-test (3 months after baseline), and at 6 and 12 months after baseline. Results The primary outcomes are well-being and flourishing (ie, high levels of well-being). Secondary outcomes are the well-being components included in the intervention: positive emotion, use of strengths, optimism, self-compassion, resilience, and positive relations. Other measures include depressive and anxiety symptoms, personality traits, direct medical and non-medical costs, life-events, and client satisfaction. Conclusions This study will add knowledge to the efficacy and cost-effectiveness of a multicomponent positive psychology intervention. We will also explore who can benefit most from this intervention. If the intervention is found to be effective, our results will be especially relevant for public mental health services, governments, and primary care. Trial

Space hvac-systems need careful maintenance; Operators are responsible. Raumlufttechnische Anlagen beduerfen der sorgfaeltigen Wartung; Betreiber stehen in der Verantwortung

Energy Technology Data Exchange (ETDEWEB)

Mertz, G

1992-01-01

Regular expert maintenance of ventilation and air-conditioning systems is absolutely necessary among others to avoid health damages (Legionnaires' disease). In hospitals the risk of bacteria distribution is avoided by two or three-step filtration. In case of air-conditioning systems in non-medical areas supply air has to be filtered at least once. Moreover regular maintenance and control of the hygienic conditions of all systems is absolutely necessary. With ultraviolet disinfection in humidifying systems an effective disinfection at least of drinking water can be attained by keeping to certain limits. Filtering devices are also important for the removal of pollutants from air. (BWI)

A randomised controlled trial of a cognitive behavioural intervention for men who have hot flushes following prostate cancer treatment (MANCAN: trial protocol

Directory of Open Access Journals (Sweden)

Yousaf Omar

2012-06-01

Full Text Available Abstract Background This randomised controlled trial (RCT aims to evaluate the effectiveness of a guided self-help cognitive behavioural intervention to alleviate problematic hot flushes (HF and night sweats (NS in men who are undergoing prostate cancer treatment. The trial and the self-help materials have been adapted from a previous RCT, which showed that a cognitive behavioural intervention reduced the self-reported problem-rating of hot flushes in women with menopausal symptoms, and in women undergoing breast cancer treatment. We hypothesize that guided self-help will be more effective than usual care in reducing HF/NS problem-rating at post treatment assessment. Methods/Design Seventy men who are undergoing treatment for prostate cancer and who have been experiencing more than ten HF/NS weekly for over a month are recruited into the trial from urology clinics in London. They are randomly allocated to either a four-week self-help cognitive behavioural therapy (CBT treatment or to their usual care (control group. The treatment includes information and discussion about hot flushes and night sweats in the context of prostate cancer, monitoring and modifying precipitants, relaxation and paced respiration, stress management, cognitive therapy for unhelpful thoughts and beliefs, managing sleep and night sweats, and advice on maintaining these changes. Prior to randomisation, men attend a clinical interview, undergo 24-48-hour sternal skin conductance monitoring, and complete pre-treatment questionnaires (e.g., problem-rating and frequency of hot flushes and night sweats; quality of life; mood; hot flush beliefs and behaviours. Post-treatment measures (sternal skin conductance and the above questionnaires are collected four-six weeks later, and again at a six-month follow-up. Discussion MANCAN is the first randomised controlled trial of cognitive behavioural therapy for HF/NS for men that measures both self-reported and physiologically indexed

Brain-Computer Interfaces : Beyond Medical Applications

NARCIS (Netherlands)

Erp, J.B.F. van; Lotte, F.; Tangermann, M.

2012-01-01

Brain-computer interaction has already moved from assistive care to applications such as gaming. Improvements in usability, hardware, signal processing, and system integration should yield applications in other nonmedical areas.

Critical review of Compton imaging

International Nuclear Information System (INIS)

Guzzardi, R.; Licitra, G.

1987-01-01

This paper reviews the basic aspects, problems, and applications of Compton imaging including those related to nonmedical applications. The physics and technology at the base of this specific methodology are analyzed and the relative differences and merits with respect to other imaging techniques, using ionizing radiations, are reviewed. The basic Compton imaging approaches, i.e., point-by-point, line-by-line, and plane-by-plane, are analyzed. Specifically, physical design and technological aspects are reviewed and discussed. Furthermore, the most important clinical applications of the different methods are presented and discussed. Finally, possibilities and applications of the Compton imaging method to other nonmedical fields, as in the case of the important area of object defects recognition, are analyzed and reviewed. 56 references

Ethical Dilemmas for Oocyte Donations: Slippery Slope for Conflicts of Interest.

Science.gov (United States)

Tulay, Pinar

2016-01-01

Oocyte donations have increased with improvements in oocyte cryopreservation procedures in recent years. Women with medical conditions that require chemotherapy or radiotherapy have begun to opt for oocyte cryo¬preservation prior to their treatment or to enroll in an oocyte donation program. Alternatively, some women apply for "third-party" oocyte donation programs for nonmedical reasons such as delayed childbearing. Although society seems to accept oocyte donations for medical reasons, it appears that there are still some moral issues surrounding nonmedical oocyte donations. In this review, the ethical aspects of oocyte donations and donors' perspectives are discussed. With developing technologies, the genetic screening of donors has expanded to include diseases. This review explores the ethical issues involved in genetic screening of gamete donors.

New measures of mental state and behavior based on data collected from sensors, smartphones, and the Internet.

Science.gov (United States)

Glenn, Tasha; Monteith, Scott

2014-12-01

With the rapid and ubiquitous acceptance of new technologies, algorithms will be used to estimate new measures of mental state and behavior based on digital data. The algorithms will analyze data collected from sensors in smartphones and wearable technology, and data collected from Internet and smartphone usage and activities. In the future, new medical measures that assist with the screening, diagnosis, and monitoring of psychiatric disorders will be available despite unresolved reliability, usability, and privacy issues. At the same time, similar non-medical commercial measures of mental state are being developed primarily for targeted advertising. There are societal and ethical implications related to the use of these measures of mental state and behavior for both medical and non-medical purposes.

Medical Evaluation and Triage of the Agitated Patient: Consensus Statement of the American Association for Emergency Psychiatry Project BETA Medical Evaluation Workgroup

Directory of Open Access Journals (Sweden)

Kimberly Nordstrom

2012-04-01

Full Text Available Numerous medical and psychiatric conditions can cause agitation, some of these causes are life threatening. It is important to be able to differentiate between medical and non-medical causes of agitation so that patients can receive appropriate and timely treatment. This article aims to educate all clinicians in non-medical settings, such as mental health clinics, and medical settings on the differing levels of severity in agitation, basic triage, use of de-escalation, and factors, symptoms, and signs in determining whether a medical etiology is likely. Lastly, this article focuses on the medical workup of agitation when a medical etiology is suspected or when etiology is unclear. [West J Emerg Med. 2012;13(1:3–10.

Dietary quality as a non-medical health input

DEFF Research Database (Denmark)

Burggraf, Christine; Teuber, Ramona; Glauben, Thomas

2016-01-01

The aim of this inquiry is to provide a comprehensive theoretical framework, which describes the demand for dietary quality. In our dietary health investment model, we consider the health investment character of dietary choices as well as the intertemporal health-taste trade-off. Additionally, a ...

Non-medical exposure to radioiodines and thyroid cancer

International Nuclear Information System (INIS)

Hindie, Elif; Leenhardt, Laurence; Aurengo, Andre; Vitaux, Francoise; Colas-Linhart, Nicole; Bok, B.; Grosclaude, Pascale; Galle, Pierre

2002-01-01

The Chernobyl accident, which occurred 32 years after the accidental exposure of Marshall islanders, resulted in the exposure of neighbouring populations to a mixture of iodine isotopes and in an increased incidence of thyroid cancer. The highest thyroid doses were received by the youngest age groups. This review describes the existing evidence, and examines factors that may have increased the risk. It also stresses problems with contemporary thyroid measurements, and the lack of information on the sensitivity of the thyroid to short-lived iodine isotopes and iodine-131. Practical considerations for nuclear physicians, epidemiologists and thyroidologists are discussed in the light of this major accident. (orig.)

28 CFR 570.42 - Non-medical escorted trips.

Science.gov (United States)

2010-07-01

... member of an inmate's immediate family. For purposes of this rule, immediate family refers to mother, father, brother, sister, spouse, children, step-parents, and foster parents. (2) Non-emergency, non... persons (e.g., attending physician, hospital staff, funeral home staff, family members, U.S. Probation...

Non-medical exposure to radioiodines and thyroid cancer

Energy Technology Data Exchange (ETDEWEB)

Hindie, Elif [Service de Medecine Nucleaire, Hopital Saint-Antoine, Assistance Publique-Hopitaux de Paris (France); Leenhardt, Laurence; Aurengo, Andre [Service de Medecine Nucleaire, Hopital de la Pitie-Salpetriere, Assistance Publique-Hopitaux de Paris (France); Vitaux, Francoise [Service de Medecine Nucleaire, CHI Le Raincy-Montfermeil (France); Colas-Linhart, Nicole; Bok, B. [Service de Medecine Nucleaire, Hopital Beaujon, Assistance Publique-Hopitaux de Paris, 100 avenue du General Leclerc, 92110 Clichy (France); Grosclaude, Pascale [Reseau Francais des Registres de Cancers, Toulouse (France); Galle, Pierre [Service de Physique et Chimie Biologiques, Ecole Nationale Veterinaire d' Alfort (France)

2002-08-01

The Chernobyl accident, which occurred 32 years after the accidental exposure of Marshall islanders, resulted in the exposure of neighbouring populations to a mixture of iodine isotopes and in an increased incidence of thyroid cancer. The highest thyroid doses were received by the youngest age groups. This review describes the existing evidence, and examines factors that may have increased the risk. It also stresses problems with contemporary thyroid measurements, and the lack of information on the sensitivity of the thyroid to short-lived iodine isotopes and iodine-131. Practical considerations for nuclear physicians, epidemiologists and thyroidologists are discussed in the light of this major accident. (orig.)

Adverse health effects of non-medical cannabis use.

Science.gov (United States)

Hall, Wayne; Degenhardt, Louisa

2009-10-17

For over two decades, cannabis, commonly known as marijuana, has been the most widely used illicit drug by young people in high-income countries, and has recently become popular on a global scale. Epidemiological research during the past 10 years suggests that regular use of cannabis during adolescence and into adulthood can have adverse effects. Epidemiological, clinical, and laboratory studies have established an association between cannabis use and adverse outcomes. We focus on adverse health effects of greatest potential public health interest-that is, those that are most likely to occur and to affect a large number of cannabis users. The most probable adverse effects include a dependence syndrome, increased risk of motor vehicle crashes, impaired respiratory function, cardiovascular disease, and adverse effects of regular use on adolescent psychosocial development and mental health.

Non-Medical Management of Raynaud’s Disease,

Science.gov (United States)

1981-06-29

initial cold exposure (p< .01). -This therapy offers a practical alternative to traditional treatments with drugs or sympathectomy, without unwarranted...cold and emotional upset; the use of tranquilizers and vasoail. t ing drugs ; or in extreme cases, sympathectomy. 4 There is controversy as to whether the...Disease 3 Pavlovian conditioning is an alternative method of counter-conditioning the autonomic nervous system. Research has shown that vasoconstriction and

Computer-Assisted Visual Search/Decision Aids as a Training Tool for Mammography

National Research Council Canada - National Science Library

Nodine, Calvin

2000-01-01

.... In the first two years we carried out two experiments. The first equated experience by comparing perceptual skills of expert radiologists with lay people searching non-medical pictorial scenes for hidden targets...

Radiation-emitting Electronic Product Codes

Data.gov (United States)

U.S. Department of Health & Human Services — This database contains product names and associated information developed by the Center for all products, both medical and non-medical, which emit radiation. It...

78 FR 45205 - Agency Information Collection Activities: Proposed Collection; Comment Request

Science.gov (United States)

2013-07-26

... ``test innovative payment and service delivery models to reduce program expenditures. . .while preserving... facilities, home health agencies, providers of home health care, hospices, religious nonmedical health care...) and Supporting Regulations [[Page 45206

Gender Differences in Emergency Department Visits and Detox Referrals for Illicit and Nonmedical Use of Opioids.

Science.gov (United States)

Ryoo, Hyeon-Ju; Choo, Esther K

2016-05-01

Visits to the emergency department (ED) for use of illicit drugs and opioids have increased in the past decade. In the ED, little is known about how gender may play a role in drug-related visits and referrals to treatment. This study performs gender-based comparison analyses of drug-related ED visits nationwide. We performed a cross-sectional analysis with data collected from 2004 to 2011 by the Drug Abuse Warning Network (DAWN). All data were coded to capture major drug categories and opioids. We used logistic regression models to find associations between gender and odds of referral to treatment programs. A second set of models were controlled for patient "seeking detox," or patient explicitly requesting for detox referral. Of the 27.9 million ED visits related to drug use in the DAWN database, visits by men were 2.69 times more likely to involve illicit drugs than visits by women (95% CI [2.56, 2.80]). Men were more likely than women to be referred to detox programs for any illicit drugs (OR 1.12, 95% CI [1.02-1.22]), for each of the major illicit drugs (e.g., cocaine: OR 1.27, 95% CI [1.15-1.40]), and for prescription opioids (OR 1.30, 95% CI [1.17-1.43]). This significant association prevailed after controlling for "seeking detox." Women are less likely to receive referrals to detox programs than men when presenting to the ED regardless of whether they are "seeking detox." Future research may help determine the cause for this gender-based difference and its significance for healthcare costs and health outcomes.

Effect of a Grain Extract on Certain Digestive Physiological Indicators in Early Weaned Rabbits

Directory of Open Access Journals (Sweden)

Melinda Kovács

2009-01-01

Full Text Available The effect of a non-medicated diet with or without a grain extract feed additive (benzoquinones as main active ingredients on the growth of rabbits and certain physiological indicators of the digestive tract was examined. One-day-old rabbits of average birth weight were distributed into litters of eight, and these litters were randomly divided into three groups (21-22 litters/group. The control group (Group C received a basal diet. The diet fed to rabbits of Group IM, was supplemented with a feed additive containing natural basic ingredients (Immunovet-HBM, 1 kg/t; the diet fed to Group M was medicated (tiamulin, oxytetracycline and diclazuril. Three days prior to kindling and up to weaning at 21 days of age of the pups, the does were fed one of the three diets ad libitum. Young rabbits were allowed to consume the same diets beside their mother’s milk before weaning. Significant (p p p < 0.05 higher in the C and IM group than in M rabbits. The proportion of butyric acid was lower than that of propionic acid even on the 42nd day in Group M. From the results of this study it is clear that the early weaning of rabbits can be accomplished by the use of a non-medicated diet without any decrease in weight gain. In our study the grain extract feed additive exerted a beneficial effect by increasing the pancreatic enzyme activity and maintaining a better VFA ratio.

In-feed antibiotic effects on the swine intestinal microbiome

Science.gov (United States)

Looft, Torey; Johnson, Timothy A.; Allen, Heather K.; Bayles, Darrell O.; Alt, David P.; Stedtfeld, Robert D.; Sul, Woo Jun; Stedtfeld, Tiffany M.; Chai, Benli; Cole, James R.; Hashsham, Syed A.; Tiedje, James M.; Stanton, Thad B.

2012-01-01

Antibiotics have been administered to agricultural animals for disease treatment, disease prevention, and growth promotion for over 50 y. The impact of such antibiotic use on the treatment of human diseases is hotly debated. We raised pigs in a highly controlled environment, with one portion of the littermates receiving a diet containing performance-enhancing antibiotics [chlortetracycline, sulfamethazine, and penicillin (known as ASP250)] and the other portion receiving the same diet but without the antibiotics. We used phylogenetic, metagenomic, and quantitative PCR-based approaches to address the impact of antibiotics on the swine gut microbiota. Bacterial phylotypes shifted after 14 d of antibiotic treatment, with the medicated pigs showing an increase in Proteobacteria (1–11%) compared with nonmedicated pigs at the same time point. This shift was driven by an increase in Escherichia coli populations. Analysis of the metagenomes showed that microbial functional genes relating to energy production and conversion were increased in the antibiotic-fed pigs. The results also indicate that antibiotic resistance genes increased in abundance and diversity in the medicated swine microbiome despite a high background of resistance genes in nonmedicated swine. Some enriched genes, such as aminoglycoside O-phosphotransferases, confer resistance to antibiotics that were not administered in this study, demonstrating the potential for indirect selection of resistance to classes of antibiotics not fed. The collateral effects of feeding subtherapeutic doses of antibiotics to agricultural animals are apparent and must be considered in cost-benefit analyses. PMID:22307632

Cost-effectiveness of CBT, SSRI, and CBT+SSRI in the treatment for panic disorder.

Science.gov (United States)

van Apeldoorn, F J; Stant, A D; van Hout, W J P J; Mersch, P P A; den Boer, J A

2014-04-01

The objective of this study was to assess the cost-effectiveness of three empirically supported treatments for panic disorder with or without agoraphobia: cognitive behavioral therapy (CBT), pharmacotherapy using a selective serotonin reuptake inhibitor (SSRI), or the combination of both (CBT+SSRI). Cost-effectiveness was examined based on the data from a multicenter randomized controlled trial. The Hamilton Anxiety Rating Scale was selected as a primary health outcome measure. Data on costs from a societal perspective (i.e., direct medical, direct non-medical, and indirect non-medical costs) were collected in the study sample (N=150) throughout a 24-month period in which patients received active treatment during the first twelve months and were seen twice for follow-up in the next twelve months. Total costs were largely influenced by costs of the interventions and productivity losses. The mean total societal costs were lower for CBT as compared to SSRI and CBT+SSRI. Costs of medication use were substantial for both SSRI and CBT+SSRI. When examining the balance between costs and health outcomes, both CBT and CBT+SSRI led to more positive outcomes than SSRI. Cognitive behavioral therapy is associated with the lowest societal costs. Cognitive behavioral therapy and CBT+SSRI are more cost-effective treatments for panic disorder with or without agoraphobia as compared to SSRI only. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Recommendations service for chronic disease patient in multimodel sensors home environment.

Science.gov (United States)

Hussain, Maqbool; Ali, Taqdir; Khan, Wajahat Ali; Afzal, Muhammad; Lee, Sungyoung; Latif, Khalid

2015-03-01

With advanced technologies in hand, there exist potential applications and services built around monitoring activities of daily living (ADL) of elderly people at nursing homes. Most of the elderly people in these facilities are suffering from different chronic diseases such as dementia. Existing technologies are mainly focusing on non-medication interventions and monitoring of ADL for addressing loss of autonomy or well-being. Monitoring and managing ADL related to cognitive behaviors for non-medication intervention are very effective in improving dementia patients' conditions. However, cognitive functions of patients can be improved if appropriate recommendations of medications are delivered at a particular time. Previously we developed the Secured Wireless Sensor Network Integrated Cloud Computing for Ubiquitous-Life Care (SC(3)). SC(3) services were limited to monitoring ADL of elderly people with Alzheimer's disease and providing non-medication recommendations to the patient. In this article, we propose a system called the Smart Clinical Decision Support System (CDSS) as an integral part of the SC(3) platform. Using the Smart CDSS, patients are provided with access to medication recommendations of expert physicians. Physicians are provided with an interface to create clinical knowledge for medication recommendations and to observe the patient's condition. The clinical knowledge created by physicians as the knowledge base of the Smart CDSS produces recommendations to the caregiver for medications based on each patient's symptoms.

[BETWEEN USAGE AND POLEMIC, AN ARGUMENT IN FAVOUR OF CLARIFYING THE TERMINOLOGY FOR PREIMPLANTATION GENETIC DIAGNOSIS].

Science.gov (United States)

Côté, Stéphanie; Ravitsky, Vardit; Hamet, Pavel; Bouffard, Chantal

2015-12-01

Over 30 years ago, preimplantation genetic diagnosis (PGD) was developed to help couples at risk of transmitting a serious genetic disease to their offspring. Today, the range of medical and non-medical uses of PGD has expanded considerably and some raise much controversy. This is the case, for example, with In-Vitro Fertilization to select embryos as 'saviour siblings' or to screen for susceptibility and predisposition to late onset diseases or conditions of variable penetrance. The situation is even more problematic in the case of sex selection or selection of traits that are culturally valued or discredited (such as deafness, behavioral traits, or height). The debate surrounding PGD has been employing terms to describe these particular uses that have contributed to a focus on the negative effects, thus preventing a distinction between the abuses and the benefits of this reproductive technology. In this context, this paper proposes a terminological clarification that would allow distinguishing medical and non-medical use and, therefore, the issues relevant to each. A more accurate and less generic nomenclature could prevent a conflation of different levels of ethical, clinical and social issues under the single term 'PGD'. For the vast majority of medical uses, we propose to keep: 'preimplantation genetic diagnosis (PGD)', which emphasizes that it is a genetic diagnosis. For non-medical uses, we suggest: 'preimplantation genetic trait selection (PGTS)'.

9 CFR 2.31 - Institutional Animal Care and Use Committee (IACUC).

Science.gov (United States)

2010-01-01

... nonmedical care of the animals will be directed by the attending veterinarian or other scientist trained and... with a list of proposed activities to be reviewed. Written descriptions of all proposed activities that...

How to hold an ethical pox party.

Science.gov (United States)

Jamrozik, Euzebiusz

2018-04-01

Pox parties are a controversial alternative to vaccination for diseases such as chickenpox. Such parties involve parents infecting non-immune children by exposing them to a contagious child. If successful, infection will usually lead to immunity, thus preventing infection later in life, which, for several vaccine-preventable diseases, is more severe than childhood infection. Some may consider pox parties more morally objectionable than opting out of vaccination through non-medical exemptions. In this paper, I argue that this is not the case. Pox parties involve immediate risk of harm for children and reduce future harms, whereas opting out of vaccination places children at long-term risk of harms that increase with time, at least for some pathogens. Regarding harm to others through onward transmission of infection, this can be easily prevented in the case of pox parties-given the relatively controlled timing of infection-by quarantining attendees after the party, whereas opting out of vaccination involves risks to others that are more difficult to control. I defend three criteria for an ethical pox party: (1) that the disease is sufficiently low risk, (2) that parents consent to their child's attendance and (3) that children exposed to infection are quarantined and isolated appropriately. I argue that, if these criteria are met, pox parties are morally preferable to non-vaccination; such parties involve less risk to non-consenting others and, for some pathogens in some cases, even involve less risk for the children who participate. Thus, policies that permit non-medical exemption to vaccination should also permit ethical pox parties. Alternatively, if pox parties are not permitted, then vaccination should be mandated for those without medical contraindication. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Psychological and support interventions to reduce levels of stress, anxiety or depression on women's subsequent pregnancy with a history of miscarriage: an empty systematic review.

Science.gov (United States)

San Lazaro Campillo, Indra; Meaney, Sarah; McNamara, Karen; O'Donoghue, Keelin

2017-09-07

The aim of this systematic review was to assess the effect of interventions to reduce stress in pregnant women with a history of miscarriage. A systematic review of randomised controlled trials (RCTs). A total of 13 medical, psychological and social electronic databases were searched from January 1995 to April 2016 including PUBMED, CENTRAL, Web of Science and EMBASE. This review focused on women in their subsequent pregnancy following miscarriage. All published RCTs which assessed the effect of non-medical interventions such as counselling or support interventions on psychological and mental health outcomes such as stress, anxiety or depression when compared with a control group were included. Stress, anxiety or depression had to be measured at least preintervention and postintervention. This systematic review found no RCT which met our initial inclusion criteria. Of the 4140 titles screened, 17 RCTs were identified. All of them were excluded. One RCT, which implemented a caring-based intervention, included pregnant women in their subsequent pregnancy; however, miscarriage was analysed as a composite variable among other pregnancy losses such as stillbirth and neonatal death. Levels of perceived stress were measured by four RCTs. Different types of non-medical interventions, time of follow-up and small sample sizes were found. Cohort studies and RCTs in non-pregnant women suggest that support and psychological interventions may improve pregnant women's psychological well-being after miscarriage. This improvement may reduce adverse pregnancy-related outcomes in subsequent pregnancies. However, this review found no RCTs which met our criteria. There is a need for targeted RCTs that can provide reliable and conclusive results to determine effective interventions for this vulnerable group. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly

The economic burden of angina on households in South Asia.

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Alam, Khurshid; Mahal, Ajay

2014-02-19

Globally, an estimated 54 million people have angina, 16 million of whom are from the WHO South-East Asia region. Despite the increasing burden of cardiovascular disease (CVD) in South Asia, there is no evidence of an economic burden of angina on households in this region. We investigated the economic burden of angina on households in South Asia. We applied a novel propensity score matching approach to assess the economic burden of angina on household out-of-pocket (OOP) health spending, borrowing or selling assets, non-medical consumption expenditure, and employment status of angina-affected individual using nationally representative World Health Survey data from Bangladesh, India, Nepal and Sri Lanka collected during 2002-2003. We used multiple matching methods to match households where the respondent reported symptomatic or diagnosed angina with control households with similar propensity scores. Angina-affected households had significantly higher OOP health spending per person in the four weeks preceding the survey than matched controls, in Bangladesh (I$1.94, p = 0.04), in Nepal (I$4.68, p = 0.03) and in Sri Lanka (I$1.99, p finance OOP health expenses in Bangladesh (6%, p = 0.03), India (8.20%, p < 0.01) and Sri Lanka (7.80%, p = 0.01). However, impoverishment, non-medical consumption expenditure and employment status of the angina-affected individual remained mostly unaffected. We adjusted our estimates for comorbidities, but limitations on comorbidity data in the WHS mean that our results may be upwardly biased. Households that had the respondent reporting angina in South Asia face an economic burden of OOP health expenses (primarily on drugs and other outpatient expenses), and tend to rely on borrowing or selling assets. Our analysis underscores the need to protect South Asian households from the financial burden of CVD.

78 FR 17744 - Social Security Ruling, SSR 13-2p; Titles II and XVI: Evaluating Cases Involving Drug Addiction...

Science.gov (United States)

2013-03-22

...The Social Security Administration published a document in the Federal Register on February 20, 2013. (78 FR 11939). On page 11940, in the first column, under the ``CITATIONS'' section, replace the period after 1614(a) with a comma, and remove the additional space between 416.927 and the comma. On page 11941, in the ``DAA Evaluation Process'' chart, in step 6 b, add a period after ``material''. On page 11942, in the second column, under section e. i., first bullet, add a space between ``20'' and ``CFR''. On page 11943, footnote 19, replace ``20 CFR 404.1527(e) and 416.927(e)'' with the correct reference which is ``20 CFR 404.1527(d) and 416.927(d)''. On page 11943, footnote 20, replace ``20 CFR 404.1527(f) and 416.927(f)'' with the correct reference which is ``20 CFR 404.1527(e) and 416.927(e)''. On page 11944, first column, question 8. ``What evidence do we need in cases involving DAA?'', a., italicize the subheading ``General'', and in the first sentence add a period at the end of the sentence. On page 11944, second column, under c. i., third sentence, hyphenate ``nonmedical'' to read ``non-medical''. On page 11944, third column, under c. ii, third sentence, delete ``the'' before ``well''. On page 11944, third column, under d. i., first sentence, hyphenate ``nonmedical'' to read ``non-medical''. On page 11944, footnote 22, replace ``404.928'' with ``404.1528''. On page 11945, second column, c. iii., second sentence, remove the extra space after ``abstinence'' and before the period. On page 11946, second column, first bullet, replace the semi-colon with a period. On page 11946, second column, under ``15. How should adjudicators consider Federal district and circuit court decisions about DAA?'', first sentence, replace ``20 CFR 404.1585 and 416.985'' with ``20 CFR 404.985 and 416.1485'', and under a., italicize the subheading ``General''.

Insight, psychopathology, explanatory models and outcome of schizophrenia in India: a prospective 5-year cohort study

Directory of Open Access Journals (Sweden)

Johnson Shanthi

2012-09-01

Full Text Available Abstract Background The sole focus of models of insight on bio-medical perspectives to the complete exclusion of local, non-medical and cultural constructs mandates review. This study attempted to investigate the impact of insight, psychopathology, explanatory models of illness on outcome of first episode schizophrenia. Method Patients diagnosed to have DSM IV schizophrenia (n = 131 were assessed prospectively for insight, psychopathology, explanatory models of illness at baseline, 6, 12 and 60 months using standard instruments. Multiple linear and logistic regression and generalized estimating equations (GEE were employed to assess predictors of outcome. Results We could follow up 95 (72.5% patients. Sixty-five of these patients (68.4% achieved remission. There was a negative relationship between psychosis rating and insight scores. Urban residence, fluctuating course of the initial illness, and improvement in global functioning at 6 months and lower psychosis rating at 12 months were significantly related to remission at 5 years. Insight scores, number of non-medical explanatory models and individual explanatory models held during the later course of the illness were significantly associated with outcome. Analysis of longitudinal data using GEE showed that women, rural residence, insight scores and number of non-medical explanatory models of illness held were significantly associated with BPRS scores during the study period. Conclusions Insight, the disease model and the number of non-medical model positively correlated with improvement in psychosis arguing for a complex interaction between the culture, context and illness variables. These finding argue that insight and explanatory models are secondary to psychopathology, course and outcome of the illness. The awareness of mental illness is a narrative act in which people make personal sense of the many challenges they face. The course and outcome of the illness, cultural context

Medical leadership, a systematic narrative review: do hospitals and healthcare organisations perform better when led by doctors?

Science.gov (United States)

Clay-Williams, Robyn; Ludlow, Kristiana; Testa, Luke; Li, Zhicheng; Braithwaite, Jeffrey

2017-09-24

Despite common assumptions that doctors are well placed to lead hospitals and healthcare organisations, the peer-reviewed literature contains little evidence on the performance of doctors in leadership roles in comparison with that of non-medical managers. To determine whether there is an association between the leader's medical background and management performance in terms of organisational performance or patient outcomes. We searched for peer-reviewed, English language studies using Medline, Embase and Emerald Management between 2005 and 2017. We included quantitative, qualitative and mixed method empirical studies on the performance of senior healthcare managers where participants were described as doctors or leaders and where comparative performance data were provided on non-medical leaders. Studies without full text available, or no organisational, leadership behaviour or patient measures, were excluded. The search, conducted in Medline (n=3395), Embase (n=1913) and Emerald Management (n=454) databases, yielded 3926 entries. After the application of inclusion and exclusion criteria, 16 studies remained. Twelve studies found that there were positive differences between medical and non-medical leaders, and eight studies correlated those findings with hospital performance or patient outcomes. Six studies examined the composition of boards of directors; otherwise, there were few common areas of investigation. Five inter-related themes emerged from a narrative analysis: the impact of medical leadership on outcomes; doctors on boards; contribution of qualifications and experience; the medical leader as an individual or part of a team and doctors transitioning into the medical leadership role. A modest body of evidence supports the importance of including doctors on organisational governing boards. Despite many published articles on the topic of whether hospitals and healthcare organisations perform better when led by doctors, there were few empirical studies that

Gender Differences in Emergency Department Visits and Detox Referrals for Illicit and Nonmedical Use of Opioids

Directory of Open Access Journals (Sweden)

Hyeon-Ju Ryoo

2016-05-01

Full Text Available Introduction: Visits to the emergency department (ED for use of illicit drugs and opioids have increased in the past decade. In the ED, little is known about how gender may play a role in drug-related visits and referrals to treatment. This study performs gender-based comparison analyses of drug-related ED visits nationwide. Methods: We performed a cross-sectional analysis with data collected from 2004 to 2011 by the Drug Abuse Warning Network (DAWN. All data were coded to capture major drug categories and opioids. We used logistic regression models to find associations between gender and odds of referral to treatment programs. A second set of models were controlled for patient “seeking detox,” or patient explicitly requesting for detox referral. Results: Of the 27.9 million ED visits related to drug use in the DAWN database, visits by men were 2.69 times more likely to involve illicit drugs than visits by women (95% CI [2.56, 2.80]. Men were more likely than women to be referred to detox programs for any illicit drugs (OR 1.12, 95% CI [1.02-1.22], for each of the major illicit drugs (e.g., cocaine: OR 1.27, 95% CI [1.15-1.40], and for prescription opioids (OR 1.30, 95% CI [1.17-1.43]. This significant association prevailed after controlling for “seeking detox.” Conclusion: Women are less likely to receive referrals to detox programs than men when presenting to the ED regardless of whether they are “seeking detox.” Future research may help determine the cause for this gender-based difference and its significance for healthcare costs and health outcomes.

Diseases and conditions falsely linked with “nylon teeth” myth: a ...

African Journals Online (AJOL)

The health care workers less likely linked nylon teeth with ... some instances, they invent methods to cure and/or prevent the children's .... (dentist + medical doctor + nurse + pharmacist) and non-medics (teacher + peasant + traditional healer).

Donation FAQs

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... however you can Daughter's dying wish became mother's motivation Be The Match Blog Stories Anna, transplant recipient ... or by the patient's medical insurance, as are travel expenses and other non-medical costs. The only ...

Reflecting on Jesus' teaching on forgiveness from a positive ...

African Journals Online (AJOL)

In its quest for a non-medical, pro-health approach to psychotherapy, positive psychology ... Deridda, Wolterstorff]); (4) the (perceived) positive role of forgiveness in psychotherapy; (5) the 'techniques' or method ... AJOL African Journals Online.

audit of cases presenting at the out patient department of a district ...

African Journals Online (AJOL)

Administrator

patients who came for outpatient consultation were recruited into the study. RESULTS: 1636 adults ... technicians, and three pharmacy technicians. Other non-medical ... female surgical ward and an emergency room. It has been suggested ...

Methicillin-resistant Staphylococcus aureus nasal carriage between healthy students of medical and nonmedical universities.

Science.gov (United States)

Abroo, Soleiman; Hosseini Jazani, Nima; Sharifi, Yaeghob

2017-07-01

Methicillin-resistant Staphylococcus aureus (MRSA) is a challenge for public health, and community-acquired (CA) infections seem to be increasing among people in different areas. A total of 700 healthy student volunteers residing in dormitories of universities in Urmia, Iran, were enrolled in this study. After identification of the isolates, antibiotic susceptibility, presence of mecA and pvl genes, and staphylococcal cassette chromosome mec (SCCmec) typing were evaluated. Nasal screening identified 137 (19.6%) carriers of S aureus, and 18 (13.14%) were MRSA isolates. The antimicrobial susceptibility patterns of isolates revealed high resistance to penicillin (93.4%). All isolates were sensitive to vancomycin. The SCCmec typing showed that most MRSA strains belonged to SCCmec type IV (n = 14; 77.8%). Only 1 (5.56%) MRSA isolates carried the pvl gene. Our findings revealed the relatively high frequency of S aureus nasal carriers and the advent of multidrug resistance among these isolates. Most MRSA isolates were SCCmec type IV; the transfer of such MRSA strains from carriers to other individuals in crowded living conditions such as dormitories can act as a risk factor for outbreak of CA MRSA and is a serious threat for the study groups. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Growth performance and gastrointestinal responses of broiler chickens fed corn-soybean meal diet without or with exogenous epidermal growth factor upon challenge with Eimeria1

Science.gov (United States)

Kim, E.; Leung, H.; Akhtar, N.; Li, J.; Barta, J. R.; Wang, Y.; Yang, C.; Kiarie, E.

2017-01-01

Abstract Epidermal growth factor (EGF), a protein known for its mitogenic and anti-apoptotic effects was fed to broiler chickens to evaluate growth performance, gastrointestinal measurements, and apparent retention (AR) of components upon challenge with Eimeria. A total of 216, d old male broiler chicks (Ross 708) were placed in cages (6 birds/cage) and allocated to treatments. The treatments were: 1) control (Lactotobacilli lactis fermentation supernatant without EGF), 2) 80 μg of EGF/kg BW/d, and 3) 160 μg of EGF/kg BW/d. A basal antibiotic-free corn-soybean diet containing TiO2 was used. Birds were offered fresh feed with respective treatments on daily basis and had free access to drinking water for 14 d. On d 5, birds (6 replicates per treatment) were challenged with 1 mL of E. acervulina and E. maxima mixture via oral gavage and the other 6 replicates were given sham. Growth performance was measured in pre- (d 0 to 5) and post- (d 6 to 14) challenge periods. Two birds per cage were necropsied on d 10 for intestinal lesion scores and tissue samples for histomorphology and expression of select intestinal genes. Excreta samples for AR of components and oocyst shedding were taken d 10 to 13 and all birds were necropsied on d 14 for gastrointestinal weight. The EGF linearly (P Eimeria interaction (P > 0.05) on growth performance, AR of GE, and intestinal histomorphology; the main effects were such that Eimeria depressed (P Eimeria (P Eimeria challenged birds whilst no effect in non-challenged control. In conclusion, Eimeria challenge reduced growth performance and impaired gut function; EGF showed beneficial effects on growth pre-challenge and improved indices of gut function upon Eimeria challenge. PMID:28938785

Growth performance and gastrointestinal responses of broiler chickens fed corn-soybean meal diet without or with exogenous epidermal growth factor upon challenge with Eimeria.

Science.gov (United States)

Kim, E; Leung, H; Akhtar, N; Li, J; Barta, J R; Wang, Y; Yang, C; Kiarie, E

2017-10-01

Epidermal growth factor (EGF), a protein known for its mitogenic and anti-apoptotic effects was fed to broiler chickens to evaluate growth performance, gastrointestinal measurements, and apparent retention (AR) of components upon challenge with Eimeria. A total of 216, d old male broiler chicks (Ross 708) were placed in cages (6 birds/cage) and allocated to treatments. The treatments were: 1) control (Lactotobacilli lactis fermentation supernatant without EGF), 2) 80 μg of EGF/kg BW/d, and 3) 160 μg of EGF/kg BW/d. A basal antibiotic-free corn-soybean diet containing TiO2 was used. Birds were offered fresh feed with respective treatments on daily basis and had free access to drinking water for 14 d. On d 5, birds (6 replicates per treatment) were challenged with 1 mL of E. acervulina and E. maxima mixture via oral gavage and the other 6 replicates were given sham. Growth performance was measured in pre- (d 0 to 5) and post- (d 6 to 14) challenge periods. Two birds per cage were necropsied on d 10 for intestinal lesion scores and tissue samples for histomorphology and expression of select intestinal genes. Excreta samples for AR of components and oocyst shedding were taken d 10 to 13 and all birds were necropsied on d 14 for gastrointestinal weight. The EGF linearly (P Eimeria interaction (P > 0.05) on growth performance, AR of GE, and intestinal histomorphology; the main effects were such that Eimeria depressed (P Eimeria (P Eimeria challenged birds whilst no effect in non-challenged control. In conclusion, Eimeria challenge reduced growth performance and impaired gut function; EGF showed beneficial effects on growth pre-challenge and improved indices of gut function upon Eimeria challenge. © The Author 2017. Published by Oxford University Press on behalf of Poultry Science Association.

Effect of a direct-fed microbial (Primalac) on structure and ultrastructure of small intestine in turkey poults.

Science.gov (United States)

Rahimi, S; Grimes, J L; Fletcher, O; Oviedo, E; Sheldon, B W

2009-03-01

The effects of dietary supplementation of the direct-fed microbial (DFM) Primalac in mash or crumbled feed on histological and ultrastructural changes of intestinal mucosa was determined in 2 populations of poults; 1 with and 1 without a Salmonella spp. challenge. Three hundred thirty-six 1-d-old female Large White turkey poults were randomly distributed into 8 treatment groups with 6 replicates of 7 poults in each pen. The poults were placed on 1 of 4 dietary treatments in a 2 x 2 x 2 factorial arrangement (mash or crumble feed, with or without DFM, not-challenged or challenged at 3 d of age). The DFM groups were fed a Primalac-supplemented diet from d 1 until the last day of the experiment (d 21). At 3 d of age, 50% of the poults were challenged with 1 mL of 10(10) cfu/ mL of Salmonella spp. (Salmonella enterica serovar Typhimurium, Salmonella Heidelberg, and Salmonella Kentucky) by oral gavage. The inoculated poults were housed in a separate room from nonchallenged controls. Feed and water were provided ad libitum for all birds. At d 21, 1 poult per pen (total of 6 poults per treatment) was randomly selected and killed humanely by cervical dislocation. After necropsy, the small intestine was removed, and tissue samples from duodenum, jejunum, and ileum were taken for light and electron microscopic evaluation. The DFM birds showed increased goblet cell (GC) numbers, total GC area, GC mean size, mucosal thickness, and a greater number of segmented filamentous bacteria compared with controls. Changes in intestinal morphology as observed in this study support the concept that poultry gut health and function, and ultimately bird performance, can be improved by dietary supplementation with DFM products such as Primalac as used in this study.

Plastic Surgery Inclusion in the Undergraduate Medical Curriculum: Perception, Challenges, and Career Choice—A Comparative Study

Directory of Open Access Journals (Sweden)

M. Farid

2017-01-01

Full Text Available Objective. The undergraduate medical curriculum has been overcrowded with core learning outcomes with no formal exposure to plastic surgery. The aim of this study was to compare medical students from two educational settings for the basic understanding, preferred learning method, and factors influencing a career choice in plastic surgery. Design and Setting. A prospective cohort study based on a web-based anonymous questionnaire sent to final year medical students at Birmingham University (United Kingdom, McGill University (Canada, and a control group (non-medical staff. The questions were about plastic surgery: (1 source of information and basic understanding; (2 undergraduate curriculum inclusion and preferred learning methods; (3 factors influencing a career choice. A similar questionnaire was sent to non-medical staff (control group. The data was analysed based on categorical outcomes (Chi-square χ2 and level of significance p≤0.05. Results. Questionnaire was analysed for 243 students (Birmingham, n=171/332, 52% (McGill n=72/132, 54%. Birmingham students (14% considered the word “plastic” synonymous with “cosmetic” more than McGill students (4%, p<0.025. Teaching was the main source of knowledge for McGill students (39%, p<0.001 while Birmingham students and control group chose the media (70%, p<0.001. McGill students (67% more than Birmingham (49%, p<0.010 considered curriculum inclusion. The preferred learning method was lectures for McGill students (61%, p<0.01 but an optional module for Birmingham (61%. A similar proportion (18% from both student groups considered a career in plastic surgery. Conclusions. Medical students recognised the need for plastic surgery inclusion in the undergraduate curriculum. There was a difference for plastic surgery source of information, operations, and preferred method of learning for students. The study highlighted the urgent need to reform plastic surgery undergraduate teaching in

Standards of resuscitation during inter-hospital transportation: the effects of structured team briefing or guideline review - A randomised, controlled simulation study of two micro-interventions

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Christensen Erika F

2011-03-01

Full Text Available Abstract Background Junior physicians are sometimes sent in ambulances with critically ill patients who require urgent transfer to another hospital. Unfamiliar surroundings and personnel, time pressure, and lack of experience may imply a risk of insufficient treatment during transportation as this can cause the physician to loose the expected overview of the situation. While health care professionals are expected to follow complex algorithms when resuscitating, stress can compromise both solo-performance and teamwork. Aim To examine whether inter-hospital resuscitation improved with a structured team briefing between physician and ambulance crew in preparation for transfer vs. review of resuscitation guidelines. The effect parameters were physician team leadership (requesting help, delegating tasks, time to resuscitation key elements (chest compressions, defibrillation, ventilations, medication, or a combination of these termed "the first meaningful action", and hands-off ratio. Methods Participants: 46 physicians graduated within 5 years. Design: A simulation intervention study with a control group and two interventions (structured team briefing or review of guidelines. Scenario: Cardiac arrest during simulated inter-hospital transfer. Results Forty-six candidates participated: 16 (control, 13 (review, and 17 (team briefing. Reviewing guidelines delayed requesting help to 162 seconds, compared to 21 seconds in control and team briefing groups (p = 0.021. Help was not requested in 15% of cases; never requesting help was associated with an increased hands-off ratio, from 39% if the driver's assistance was requested to 54% if not (p Conclusion Neither review nor team briefing improved the time to resuscitation key elements. Review led to an eight-fold increase in the delay to requesting help. The association between never requesting help and an increased hands-off ratio underpins the importance of prioritising available resources. Other medical

Studies of biochemistry and clinical biochemistry. Studies at sample medical schools in 13 EU countries regarding biochemistry and clinical biochemistry teaching.

Science.gov (United States)

Stern, Petr; Sebesta, Ivan; Trnkova, Bohuslava; Zima, Tomas

2008-07-01

The study summarizes the results obtained during personal visits to 53 medical schools in the 13 original EU countries during 2004--2006. Data from the Czech Republic is shown for comparison. The possibilities of acquiring information from the websites of the medical schools in the local language and English are assessed. The admission process to medical schools and the organization of studies of medicine, dentistry, and non-medical healthcare fields are briefly characterized. Significant attention is paid to the forms of education in biochemistry and clinical (bio)chemistry in the medical study field. The position of these subjects in the studies of dentistry and non-medical healthcare fields is also noted. In addition, the course of subject exams is described. The methods of funding and postgraduate studies at the medical schools are also briefly addressed.

The influence of generic substitution on the content of patient-pharmacist communication in Swedish community pharmacies

DEFF Research Database (Denmark)

Olsson, Erika; Wallach-Kildemoes, Helle; Ahmed, Ban

2017-01-01

OBJECTIVES: The objective was to study the relationship between the length and content of patient-pharmacist communication in community pharmacies, and generic substitution. METHODS: The study was conducted in six community pharmacies in Sweden. Non-participant observations with audio recordings...... for differences in time spent on different categories. KEY FINDINGS: In encounters where generic substitution occurred more time (19.2 s) was spent on non-medical (for instance administrative or economical) issues (P = 0.01, 95% confidence interval 4.8-33.6). However, the total time of the encounter...... to those with only elementary school education. CONCLUSIONS: Occurrence of generic substitution was correlated with more time spent on communicating on non-medical, but not on medical, issues. No extra time was spent on medical information for the groups normally overrepresented among those with low health...

Altered balance in the autonomic nervous system in schizophrenic patients

DEFF Research Database (Denmark)

Nielsen, B M; Mehlsen, J; Behnke, K

1988-01-01

.05). Heart-rate response to inspiration was greater in non-medicated schizophrenics compared to normal subjects (P less than 0.05), whereas no difference was found between medicated and non-medicated schizophrenics. The results show that the balance in the autonomic nervous system is altered in schizophrenic...... patients with a hyperexcitability in both the sympathetic and the parasympathetic division. Our study has thus indicated a dysfunction in the autonomic nervous system per se and the previous interpretations of attentional orienting responses in schizophrenia is questioned. Medication with neuroleptics......The aim of the present study was to evaluate the autonomic nervous function in schizophrenic patients. Twenty-eight patients (29 +/- 6 years) diagnosed as schizophrenics and in stable medication were included, together with ten schizophrenic patients (25 +/- 5 years) who were unmedicated. Eleven...

Functional memory metals

International Nuclear Information System (INIS)

Dunne, D.P.

2000-01-01

The field of shape memory phenomena in metals and alloys has developed in a sporadic fashion from a scientific curiosity to a vigorously growing niche industry, over a period close to a full working lifetime. Memory metal research and development is replete with scientist and engineer 'true believers', who can finally feel content that their longstanding confidence in the potential of these unusual functional materials has not been misplaced. This paper reviews the current range of medical and non-medical systems and devices which are based on memory metals and attempts to predict trends in applications over the next decade. The market is dominated by Ni Ti alloys which have proved to exhibit the best and most reproducible properties for application in a wide range of medical and non-medical devices

Inhibition of toxinogenesis of type a Clostridium botulinum in beef using combined treatments

International Nuclear Information System (INIS)

Lasta, J.A.; Rodriguez, H.R.; Pensel, N.A.; Margaria, C.A.; Gallinger, M.M.; Artuso, C.A.; Masana, M.O.; Suarez-Rebollo, M.P.

1998-01-01

A shelf stable beef product was developed on the basis of combined treatments involving a reduction in water activity and using specific anti-microbial agents, thermal processing, vacuum packaging and irradiation. Beef foreshanks were cured, thermally processed and irradiated at 7.5 and 15 kGy. Sensory analysis and microbiological, chemical and lipid stability studies were carried out on the non-inoculated samples. In addition, challenge studies involving samples inoculated with 10 3 or 10 5 spores of Clostridium botulinum/g were performed. The samples challenged with 10 3 spores of C. botulinum and irradiated with 15 kGy did not show toxin production during a storage time of 8 months at 28 deg. C. The non-challenged samples showed low 2-thiobarbituric acid numbers and a significant decrease in residual nitrite during storage. Sensory studies carried out by a trained panel indicated that these samples developed some mild off-flavours, which diminished as the storage time increased, and showed good overall acceptance. Studies to introduce a further safety factor, by adding sodium propionate, are currently in progress. (author)

Genome Wide Analysis of Nucleotide-Binding Site Disease Resistance Genes in Brachypodium distachyon

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Shenglong Tan

2012-01-01

Full Text Available Nucleotide-binding site (NBS disease resistance genes play an important role in defending plants from a variety of pathogens and insect pests. Many R-genes have been identified in various plant species. However, little is known about the NBS-encoding genes in Brachypodium distachyon. In this study, using computational analysis of the B. distachyon genome, we identified 126 regular NBS-encoding genes and characterized them on the bases of structural diversity, conserved protein motifs, chromosomal locations, gene duplications, promoter region, and phylogenetic relationships. EST hits and full-length cDNA sequences (from Brachypodium database of 126 R-like candidates supported their existence. Based on the occurrence of conserved protein motifs such as coiled-coil (CC, NBS, leucine-rich repeat (LRR, these regular NBS-LRR genes were classified into four subgroups: CC-NBS-LRR, NBS-LRR, CC-NBS, and X-NBS. Further expression analysis of the regular NBS-encoding genes in Brachypodium database revealed that these genes are expressed in a wide range of libraries, including those constructed from various developmental stages, tissue types, and drought challenged or nonchallenged tissue.

Socio-demographic factors related to under-diagnosis of childhood asthma in Upper Silesia, Poland

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Jan E. Zejda

2017-06-01

Among non-medical determinants of undiagnosed asthma the age of a child plays a major role. Another factors of importance is the large distance between residence and health centre, and low parental attention at home.

Health rehabilitation-94

International Nuclear Information System (INIS)

Zotov, V.P.

1994-01-01

The reports are connected wit urgent problems of health rehabilitation. The experience of different non-medical complex actions on support and renewing of ChNPP personnel and Slavutich town inhabitants functional working capability is generalized

A randomized controlled trial of directive and nondirective smoking cessation coaching through an employee quitline

Directory of Open Access Journals (Sweden)

Walton Sumner

2016-07-01

Full Text Available Abstract Background Telephone quitlines can help employees quit smoking. Quitlines typically use directive coaching, but nondirective, flexible coaching is an alternative. Call-2-Quit used a worksite-sponsored quitline to compare directive and nondirective coaching modes, and evaluated employee race and income as potential moderators. Methods An unblinded randomized controlled trial compared directive and nondirective telephone coaching by trained laypersons. Participants were smoking employees and spouses recruited through workplace smoking cessation campaigns in a hospital system and affiliated medical school. Coaches were four non-medical women trained to use both coaching modes. Participants were randomized by family to coaching mode. Participants received up to 7 calls from coaches who used computer assisted telephone interview software to track topics and time. Outcomes were reported smoking abstinence for 7 days at last contact, 6 or 12 months after coaching began. Both worksites implemented new tobacco control policies during the study. Results Most participants responded to an insurance incentive introduced at the hospital. Call-2-Quit coached 518 participants: 22 % were African-American; 45 % had incomes below $30,000. Income, race, and intervention did not affect coaching completion rates. Cessation rates were comparable with directive and nondirective coaching (26 % versus 30 % quit, NS. A full factorial logistic regression model identified above median income (odds ratio = 1.8, p = 0.02, especially among African Americans (p = 0.04, and recent quit attempts (OR = 1.6, p = 0.03 as predictors of cessation. Nondirective coaching was associated with high cessation rates among subgroups of smokers reporting income above the median, recent quit attempts, or use of alternative therapies. Waiting up to 4 weeks to start coaching did not affect cessation. Of 41 highly addicted or depressed smokers who had never quit

A randomized controlled trial of directive and nondirective smoking cessation coaching through an employee quitline.

Science.gov (United States)

Sumner, Walton; Walker, Mark S; Highstein, Gabrielle R; Fischer, Irene; Yan, Yan; McQueen, Amy; Fisher, Edwin B

2016-07-11

Telephone quitlines can help employees quit smoking. Quitlines typically use directive coaching, but nondirective, flexible coaching is an alternative. Call-2-Quit used a worksite-sponsored quitline to compare directive and nondirective coaching modes, and evaluated employee race and income as potential moderators. An unblinded randomized controlled trial compared directive and nondirective telephone coaching by trained laypersons. Participants were smoking employees and spouses recruited through workplace smoking cessation campaigns in a hospital system and affiliated medical school. Coaches were four non-medical women trained to use both coaching modes. Participants were randomized by family to coaching mode. Participants received up to 7 calls from coaches who used computer assisted telephone interview software to track topics and time. Outcomes were reported smoking abstinence for 7 days at last contact, 6 or 12 months after coaching began. Both worksites implemented new tobacco control policies during the study. Most participants responded to an insurance incentive introduced at the hospital. Call-2-Quit coached 518 participants: 22 % were African-American; 45 % had incomes below $30,000. Income, race, and intervention did not affect coaching completion rates. Cessation rates were comparable with directive and nondirective coaching (26 % versus 30 % quit, NS). A full factorial logistic regression model identified above median income (odds ratio = 1.8, p = 0.02), especially among African Americans (p = 0.04), and recent quit attempts (OR = 1.6, p = 0.03) as predictors of cessation. Nondirective coaching was associated with high cessation rates among subgroups of smokers reporting income above the median, recent quit attempts, or use of alternative therapies. Waiting up to 4 weeks to start coaching did not affect cessation. Of 41 highly addicted or depressed smokers who had never quit more than 30 days, none quit. Nondirective

FastStats: Mental Health

Science.gov (United States)

... Women’s Health State and Territorial Data Reproductive Health Contraceptive Use Infertility Reproductive Health Notice Regarding FastStats Mobile ... Use of Selected Nonmedication Mental Health Services by Adolescent Boys and Girls With Serious Emotional or Behavioral ...

Sex differences in objective measures of sleep in post-traumatic stress disorder and healthy control subjects.

Science.gov (United States)

Richards, Anne; Metzler, Thomas J; Ruoff, Leslie M; Inslicht, Sabra S; Rao, Madhu; Talbot, Lisa S; Neylan, Thomas C

2013-12-01

A growing literature shows prominent sex effects for risk for post-traumatic stress disorder and associated medical comorbid burden. Previous research indicates that post-traumatic stress disorder is associated with reduced slow wave sleep, which may have implications for overall health, and abnormalities in rapid eye movement sleep, which have been implicated in specific post-traumatic stress disorder symptoms, but most research has been conducted in male subjects. We therefore sought to compare objective measures of sleep in male and female post-traumatic stress disorder subjects with age- and sex-matched control subjects. We used a cross-sectional, 2 × 2 design (post-traumatic stress disorder/control × female/male) involving83 medically healthy, non-medicated adults aged 19-39 years in the inpatient sleep laboratory. Visual electroencephalographic analysis demonstrated that post-traumatic stress disorder was associated with lower slow wave sleep duration (F(3,82)  = 7.63, P = 0.007) and slow wave sleep percentage (F(3,82)  = 6.11, P = 0.016). There was also a group × sex interaction effect for rapid eye movement sleep duration (F(3,82)  = 4.08, P = 0.047) and rapid eye movement sleep percentage (F(3,82)  = 4.30, P = 0.041), explained by greater rapid eye movement sleep in post-traumatic stress disorder females compared to control females, a difference not seen in male subjects. Quantitative electroencephalography analysis demonstrated that post-traumatic stress disorder was associated with lower energy in the delta spectrum (F(3,82)  = 6.79, P = 0.011) in non-rapid eye movement sleep. Slow wave sleep and delta findings were more pronounced in males. Removal of post-traumatic stress disorder subjects with comorbid major depressive disorder, who had greater post-traumatic stress disorder severity, strengthened delta effects but reduced rapid eye movement effects to non-significance. These findings support previous evidence that post

Comparative Assessment of Three Approaches of Teaching Nonmedically Trained Persons in the Handling of Supraglottic Airways: A Randomized Controlled Trial.

Science.gov (United States)

Hensel, Mario; Schmidbauer, Willi; Benker, Michael; Schmieder, Paula; Kerner, Thoralf

2017-03-01

The use of supraglottic airways has been recommended in combat trauma airway management. To ensure an adequate airway management on the battlefield, suitable training concepts are sought to efficiently teach as many soldiers as possible. Our aim was to compare three approaches of teaching laypersons in the handling of supraglottic airways in a mannequin model. In this prospective randomized blinded study, 285 military service men without any medical background were divided into three groups and trained in the use of the Laryngeal Mask Airway Supreme (LMA) and the Laryngeal Tube Disposable (LT-D). The first group received a theoretical lecture, the second group was shown an instruction video, and the third group underwent a practical training. Immediately after instruction participants were asked to place the supraglottic airway and ventilate the mannequin within 60 seconds. The entire test was repeated 3 months later. Test results were evaluated with regard to success rate, insertion time, ability to judge the correct placement, and degree of difficulty. Practical training showed the highest success rate when placing supraglottic airways immediately after the instruction (lecture: 68%, video: 74%, training: 94%); (training vs. lecture and training vs. video, p training: 78%); (training vs. lecture, p = 0.019 and training vs. video, p = 0.025). Immediately after the instruction practical training was also superior in terms of insertion time, ability to judge the correct placement, and the self-rated degree of difficulty (p place a supraglottic airway immediately following minimal instruction and after 3 months as well. Study participants achieved the best results after practical training followed by video presentation and finally lecture regardless of the airway device used. There are two possible reasons why practical training is the superior method. Firstly, the success is tied to more time spent with the learners. Secondly, practical training seems to be the best teaching method for various types of learners such as visual, auditory, reading/writing, and kinesthetic type. In addition the results of our study show that the LT-D is an ideal supraglottic airway in the hands of people inexperienced in airway management. In conclusion, our results show that practical training is the superior instruction method compared to theoretical lecture and presentation of an instruction video. Nevertheless, the presentation of an instruction video is a promising approach of teaching a maximum number of laypersons with minimal effort to correctly place supraglottic airways. To optimize the success rate of such a concept LT-Ds instead of LMAs should be used for airway management. The presented concepts hold promise for combat as well as for civilian emergency medicine. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

Efficacy of Medication and Nonmedication Methods on Working Memory of Children With Attention Deficit and Hyperactivity Disorder

Directory of Open Access Journals (Sweden)

Ahmadpanah

2015-05-01

Full Text Available Background Working memory is the ability to keep and manipulate information in a short time. Children with attention deficit and hyperactivity disorder (ADHD are among the people suffering from deficiency in the active memory, and this deficiency has been attributed to the problem of frontal lobe. This study utilized a new approach with suitable tasks and methods for training active memory and assessment of its effects. Objectives This study aimed to investigate the effectiveness of medicinal and behavioral therapies on working memory of children with attention deficit and hyperactivity disorder. Patients and Methods The children participating in this study were 7 - 15 years old, and were diagnosed with ADHD by the psychiatrist and psychologist based on DSM-IV criteria. The intervention group comprised 8 boys and 6 girls with the average age of 11 (± 2 years, and the control group comprised 2 girls and 5 boys with an average age of 11.4 (± 3. Three children in the test group and 2 in the control group were under medicinal therapy. Results Training of working memory significantly improved the performance in nontrained areas as visual-spatial working memory as well as the performance in Raven progressive tests which are a perfect example of nonverbal, complicated reasoning tasks. Conclusions The performance of working memory improved through training, and these trainings extended to other areas of cognition functions not receiving any training. Trainings resulted in the improvement of performance in the tasks related to prefrontal area. They had also a positive and significant impact on the movement activities of hyperactive children.

KNOWLEDGE AND AWARENESS REGARDING BIOMEDICAL WASTE MANAGEMENT AMONG EMPLOYEES OF A TERTIARY CARE HOSPITAL

Directory of Open Access Journals (Sweden)

Manoj Bansal

2013-03-01

Results: The score was highest for medical and least for non-medical staff. Conclusion: The present study concludes that regular training programs should be organized about the guidelines and rules of biomedical waste management at all level.

An assessment of psychological stress and symptomatology for didactic phase physician assistant students.

Science.gov (United States)

Childers, William A; May, Ryan K; Ball, Natalie

2012-01-01

The purpose of this study was to assess the amount of psychological stress experienced by didactic phase, physician assistant (PA) students. The Symptom Checklist-90-R (SCL-90-R) survey was administered to 81 students in 2011 during the first two didactic phase semesters at two PA programs. Using ANOVA and t-tests, several variables were analyzed for significance. The SCL-90-R results portray that a significant proportion of the students from both programs reported elevated levels of stress during the first and second semester of the didactic year. Although several significant levels were noted throughout this study, it is not known how these scores from PA students would compare to other medical and/or nonmedical graduate students. Additional studies of stress from both medical and nonmedical graduate students would be beneficial for comparison to PA students.

Ultrastructural observation of the airways of recovered and susceptible pigs after inoculation with Mycoplasma hyopneumoniae

Directory of Open Access Journals (Sweden)

Irigoyen Luiz Francisco

1998-01-01

Full Text Available To determine the morphological differences in the epithelium of the airways of recovered and susceptible pigs after Mycoplasma hyopneumoniae challenge, twenty-four 4-week-old M. hyopneumoniae-free pigs were intratracheally inoculated with 107ccu/ml of a pure low-passaged culture of the P5722-3 strain of M. hyopneumoniae challenge material. Eight pigs (group I were challenged at the beginning of the experiment and rechallenged 3 months later. Group II pigs were also challenged at the beginning of the experiment and necropsied 3 months later. Group III pigs were challenged at the same time as the rechallenge of group I pigs. Eight nonchallenged pigs served as controls (group IV. Three days after the second challenge of group I and the first challenge of group III, and every 3 and 4 days thereafter, two pigs from each group were euthanatized by electrocution and necropsied. Samples of bronchi and lung tissue were examined using light and electron microscopy (SEM and TEM. Macroscopic lesions were observed in the lungs of all group III pigs (average = 4.74% and were characterized by purple-red areas of discoloration and increased firmness affecting the cranioventral aspect of the lungs. Macroscopic lesions of pneumonia in groups I and II were minimal (less than 1%. There were no gross lesions of pneumonia in control (group IV pigs. Microscopic lesions were characterized by hyperplasia of the peribronchial lymphoid tissue and mild neutrophilic infiltrates in alveoli. Electron microscopy showed patchy areas with loss of cilia and presence of leukocytes and mycoplasmas in bronchi of susceptible pigs (group III. The bronchial epithelium of rechallenged (group I, recovered (group II, and control (group IV pigs was ultrastructurally similar indicating recovery of the former two groups. Although mycoplasmas were seen among cilia, a second challenge on pigs of group I did not produce another episode of the disease nor did it enhance morphological changes

Potential spillover educational effects of cancer-related direct-to-consumer advertising on cancer patients' increased information seeking behaviors: results from a cohort study.

Science.gov (United States)

Tan, Andy S L

2014-06-01

Spillover effects of exposure to direct-to-consumer advertising (DTCA) of cancer treatments on patients' general inquiry about their treatments and managing their illness are not well understood. This study examines the effects of cancer patients' exposure to cancer-related DTCA on subsequent health information seeking behaviors from clinician and non-clinician sources (lay media and interpersonal contacts). Using a longitudinal survey design over 3 years, data was collected from cancer survivors diagnosed with colorectal, breast, or prostate cancer who were randomly sampled from the Pennsylvania Cancer Registry. Study outcome measures include patients' information engagement with their clinicians and information seeking from non-medical sources about cancer treatment and quality of life issues, measured in the second survey. The predictor variable is the frequency of exposure to cancer-related DTCA since diagnosis, measured at the round 1 survey. The analyses utilized lagged-weighted multivariate regressions and adjusted for round 1 levels of patient-clinician engagement, information seeking from nonmedical sources, and confounders. Exposure to cancer-related DTCA is associated with increased levels of subsequent patient-clinician information engagement (B = .023, 95% CI = .005-.040, p = .012), controlling for confounders. In comparison, exposure to DTCA is marginally significant in predicting health information seeking from non-clinician sources (B = .009, 95% CI = -.001-.018, p = .067). Cancer-related DTCA has potentially beneficial spillover effects on health information seeking behaviors among cancer patients. Exposure to DTCA predicts (a little) more patient engagement with their physicians.

Potential Spillover Educational Effects Of Cancer-Related Direct-To-Consumer Advertising On Cancer Patients’ Increased Information Seeking Behaviors: Results From A Cohort Study

Science.gov (United States)

Tan, Andy SL

2014-01-01

Spillover effects of exposure to direct-to-consumer advertising (DTCA) of cancer treatments on patients’ general inquiry about their treatments and managing their illness are not well understood. This study examines the effects of cancer patients’ exposure to cancer-related DTCA on subsequent health information seeking behaviors from clinician and non-clinician sources (lay media and interpersonal contacts). Using a longitudinal survey design over three years, data was collected from cancer survivors diagnosed with colorectal, breast, or prostate cancer who were randomly sampled from the Pennsylvania Cancer Registry. Study outcome measures include patients’ information engagement with their clinicians and information seeking from non-medical sources about cancer treatment and quality of life issues, measured in the second survey. The predictor variable is the frequency of exposure to cancer-related DTCA since diagnosis, measured at the round 1 survey. The analyses utilized lagged weighted multivariate regressions and adjusted for round 1 levels of patient-clinician engagement, information seeking from non-medical sources, and confounders. Exposure to cancer-related DTCA is associated with increased levels of subsequent patient-clinician information engagement (B=.023, 95%CI=.005 to .040, p=.012), controlling for confounders. In comparison, exposure to DTCA is marginally significant in predicting health information seeking from non-clinician sources (B=.009, 95%CI=−.001 to .018, p=.067). Cancer-related DTCA has potentially beneficial spillover effects on health information seeking behaviors among cancer patients. Exposure to DTCA predicts (a little) more patient engagement with their physicians. PMID:24254248

Products for Security Screening of People

Science.gov (United States)

... for Non-Medical Radiation Applications, administered by the Health Physics Society (HPS), published the current version of the ... took place during the October 1, 2003 meeting. Health Risks from Exposure ... Applied Physics Laboratory, Assessment for TSA, October 2009 and revised ...

Costs of Nine Common Mental Disorders:Implications for Curative and Preventive Psychiatry

NARCIS (Netherlands)

Smit, H.F.E.; Cuijpers, P.; Oostenbrink, J.; Batelaan, N.M.; de Graaf, R.; Beekman, A.J.

2006-01-01

BACKGROUND: Mental disorders are highly prevalent and are associated with substantial disease burden, but their economic costs have been relatively less well researched. Moreover, few cost-of-illness studies used population-based psychiatric surveys for estimating direct medical, direct non-medical

Key Facts about the Uninsured Population

Science.gov (United States)

... 52%) of debt collections actions that appear on consumer credit reports in the United States 40 and contribute to ... medical- bills- survey/ 40 Consumer Financial Protection Bureau, “Consumer Credit Reports: A Study of Medical and Non-Medical Collections.” ( ...

Caregiver Stress

Science.gov (United States)

... Home health care services, such as nursing or physical therapy Nonmedical home care services, such as housekeeping, cooking, ... the impact of disease duration . European Journal of Physical and Rehabilitation ... Journal of Geriatric Psychiatry, 13 (9), 795–801. Godbout, J. P., & ...

Citations of respiratory diseases in Niger State, Nigeria

African Journals Online (AJOL)

The state is naturally endowed with both savannah and tropical rainforest vegetations. There are ...... Non-medical ethno-botanical uses of plant (e.g. food, fiber, ritual and spiritual uses: * Local Plant Name(s) ..... [10] WHO web sites. Links for an ...

Classification of Clinically Relevant Microorganisms in Non-Medical Environments

National Research Council Canada - National Science Library

Bowers, Daniel

2004-01-01

.... He named them Staphylococcus aureus because of their golden color. S. aureus remains one of the most important pathogens in clinical settings largely due to the rapidity of its evolutionary response to treatment...

The impact of human immunodeficiency virus (HIV) infection on quality of life in a multiracial South African population.

Science.gov (United States)

O'Keefe, E A; Wood, R

1996-04-01

We set out to document quality of life in South African HIV subjects, using the Medical Outcomes Survey (MOS) SF-36 instrument, and to determine whether this was affected by race, gender or clinical stage of disease. A cross-sectional survey of 134 HIV outpatients (42 White, 49 Mixed race, 43 Black) and 114 healthy non-medical hospital personnel (36 White, 37 Mixed race, 42 Black) was carried out at a referral centre for HIV patients in the Western Cape region of South Africa. Scores on eight scales measuring different aspects of quality of life were calculated. Black female controls scored significantly lower on all scales (p impacts early on all aspects of quality of life and that this impact is largely independent of racial origin.

Risk of burnout among early career mental health professionals.

Science.gov (United States)

Volpe, U; Luciano, M; Palumbo, C; Sampogna, G; Del Vecchio, V; Fiorillo, A

2014-01-01

Burnout is a stress-related syndrome that often affects mental health professionals (MHPs) and may have serious consequences on personal well-being as well as on the quality of provided psychiatric care. Established literature shows a high risk to develop burnout among MHPs. Few data are available on the incidence and on the clinical implications of the burnout syndrome in the early phases of MHP professional career. We confirmed the presence of burnout among early career MHPs: early career psychiatrists showed a lower sense of personal accomplishment, while non-medical MHPs tended to have more depersonalization and suffered from higher levels of depression. Specific programmes to identify the presence of the burnout syndrome and to cope with it should be taught within mental health training curricula. Burnout is a stress-related syndrome that often affects professionals working in emotionally loaded and highly interpersonal environments. Mental health professionals (MHPs) are long known to be at high risk to develop the burnout syndrome, but this has rarely been investigated in professionals in an early phase of career. The aim of the present study was to evaluate the presence of the burnout syndrome and of depressive symptoms among early career psychiatrists and 'non-medical' MHPs. One hundred MHPs (including 50 psychiatrists and 50 non-medical MHPs) were screened for the presence of burnout and depression, with the Maslach Burnout Inventory and the Beck Depression Inventory - revised, respectively. The relationships of burnout with socio-demographical and professional characteristics were also explored. We confirmed the presence of burnout among both groups of early career MHPs, but psychiatrists had a significantly higher degree of emotional exhaustion and a lower sense of personal accomplishment, while non-medical MHPs adopted more frequently depersonalization as a coping strategy and had higher scores for depression, which is associated with higher level of

Economic burden to primary informal caregivers of hospitalized older adults in Mexico: a cohort study.

Science.gov (United States)

López-Ortega, Mariana; García-Peña, Carmen; Granados-García, Víctor; García-González, José Juan; Pérez-Zepeda, Mario Ulises

2013-02-08

The burden of out of pocket spending for the Mexican population is high compared to other countries. Even patients insured by social security institutions have to face the cost of health goods, services or nonmedical expenses related to their illness. Primary caregivers, in addition, experience losses in productivity by taking up responsibilities in care giving activities. This situation represents a mayor economic burden in an acute care setting for elderly population. There is evidence that specialized geriatric services could represent lower overall costs in these circumstances and could help reduce these burdens.The aim of this study was to investigate economic burden differences in caregivers of elderly patients comparing two acute care services (Geriatric and Internal Medicine). Specifically, economic costs associated with hospitalization of older adults in these two settings by evaluating health care related out of pocket expenditures (OOPE), non-medical OOPE and indirect costs. A comparative analysis of direct and indirect costs in hospitalised elderly patients (60-year or older) and their primary informal caregivers in two health care settings, using a prospective cohort was performed. Economic burden was measured by out of pocket expenses and indirect costs (productivity lost) due to care giving activities. The analysis included a two-part model, the first one allowing the estimation of the probability of observing any health care related and non-medical OOPE; and the second one, the positive observations or expenditures. A total of 210 subjects were followed during their hospital stay. Of the total number of subjects 95% reported at least one non-medical OOPE, being daily transportation the most common expense. Regarding medical OOPE, medicines were the most common expense, and the mean numbers of days without income were 4.12 days. Both OOPE and indirect costs were significantly different between type of services, with less overall economic burden to

Health care expenditure for hospital-based delivery care in Lao PDR

Directory of Open Access Journals (Sweden)

Douangvichit Daovieng

2012-01-01

Full Text Available Abstract Background Delivery by a skilled birth attendant (SBA in a hospital is advocated to improve maternal health; however, hospital expenses for delivery care services are a concern for women and their families, particularly for women who pay out-of-pocket. Although health insurance is now implemented in Lao PDR, it is not universal throughout the country. The objectives of this study are to estimate the total health care expenses for vaginal delivery and caesarean section, to determine the association between health insurance and family income with health care expenditure and assess the effect of health insurance from the perspectives of the women and the skilled birth attendants (SBAs in Lao PDR. Methods A cross-sectional study was carried out in two provincial hospitals in Lao PDR, from June to October 2010. Face to face interviews of 581 women who gave birth in hospital and 27 SBAs was carried out. Both medical and non-medical expenses were considered. A linear regression model was used to assess influencing factors on health care expenditure and trends of medical and non-medical expenditure by monthly family income stratified by mode of delivery were assessed. Results Of 581 women, 25% had health care insurance. Health care expenses for delivery care services were significantly higher for caesarean section (270 USD than for vaginal delivery (59 USD. After adjusting for the effect of hospital, family income was significantly associated with all types of expenditure in caesarean section, while it was associated with non-medical and total expenditures in vaginal delivery. Both delivering women and health providers thought that health insurance increased the utilisation of delivery care. Conclusions Substantially higher delivery care expenses were incurred for caesarean section compared to vaginal delivery. Three-fourths of the women who were not insured needed to be responsible for their own health care payment. Women who had higher family

Cost of Illness of Chronic Hepatitis B Infection in Vietnam

NARCIS (Netherlands)

Tu, Hong Anh T.; Woerdenbag, Herman J.; Riewpaiboon, Arthorn; Kane, Sumit; Le, Diep M.; Postma, Maarten J.; Li, Shu Chuen

2012-01-01

To estimate the total financial burden of chronic hepatitis B virus (HBV) infection for Vietnam by quantifying the direct medical, the direct nonmedical, and indirect costs among patients with various stages of chronic HBV infection. Direct medical cost data were retrieved retrospectively from

Male circumcision does not result in inferior perceived male sexual function - a systematic review

DEFF Research Database (Denmark)

Shabanzadeh, Daniel Mønsted; Düring, Signe; Frimodt-Møller, Cai

2016-01-01

-B). Following non-medical circumcision, no inferior sexual function was reported (A-B). Following medical circumcision, most outcomes were comparable (B); however, problems in obtaining an orgasm were increased (C) and erectile dysfunction was reported with inconsistency (D). A younger age at circumcision...

Medication-overuse headache

DEFF Research Database (Denmark)

Westergaard, Maria Lurenda; Munksgaard, Signe Bruun; Bendtsen, Lars

2016-01-01

and nonmedical treatments, and limiting acute symptomatic medication. Stress reduction and lifestyle interventions may support the change towards rational pain medication use. Support, follow up, and education are needed to help patients through the detoxification period. There is fertile ground for research...

Order of 28 April 1989 fixing the categories of products not subject to the new article R5235 of the Public Health Code in implementation of paragraph eight b and c of that article

International Nuclear Information System (INIS)

1989-05-01

This Order establishes the categories of products containing radioelements with a low specific activity or having a limited radiotoxicity which are exempted from the licensing regime for artificial radioelements for non-medical or other uses or which do not concern human biology [fr

24 CFR 700.105 - Definitions.

Science.gov (United States)

2010-04-01

... must be mobile. The mobility requirement does not exclude persons in wheelchairs or those requiring mobility devices.) (2) Each of the Activities of Daily Living noted in paragraph (1) of this definition... non-medical supervision, wellness programs, preventive health screening, monitoring of medication...

Job satisfaction of practice assistants in general practice in Germany: an observational study

NARCIS (Netherlands)

Goetz, K.; Campbell, S.; Broge, B.; Brodowski, M.; Steinhaeuser, J.; Wensing, M.; Szecsenyi, J.

2013-01-01

BACKGROUND: Job satisfaction of practice staff is important for optimal health care delivery and for minimizing the turnover of non-medical professions. OBJECTIVE: To document the job satisfaction of practice assistants in German general practice and to explore associations between job satisfaction,

Current state of knowledge, beliefs, and attitudes toward organ transplantation among academic students in Poland and the potential means for altering them.

Science.gov (United States)

Nowak, E; Pfitzner, R; Koźlik, P; Kozynacka, A; Durajski, L; Przybyłowski, P

2014-10-01

Students manifest a high level of social commitment. Improving their knowledge and developing more positive attitudes toward organ transplantation may increase the number of organ donations. This study was an assessment of the knowledge and attitudes toward organ transplantation among young people in Poland, with an overview of current beliefs and potential methods for improving transplantology awareness. The study included 400 medical students and 400 nonmedical students from public universities in Kraków, Poland. Data were collected by using an anonymous questionnaire examining demographic factors and transplantology issues. Despite the overall positive attitude toward transplantology among academic students in Poland, the state of knowledge of the nonmedical population remains relatively low. The most important issues for social education to focus on are the role of presumed consent and brain death diagnosis, actual hazards of living donations, recipient qualification criteria, and the attitudes of religious authorities. The overall level of knowledge and the number of positive attitudes were significantly higher among medical students than among nonmedical students, proving that formal educational programs are more efficient than the more accessible but less reliable sources of knowledge. Introduction of transplantology issues in schools and churches, promoting the positive outcomes of organ transplantation rather than negating false beliefs, and eliminating misleading information from the media may significantly increase young people's knowledge and result in more positive attitudes toward transplantology in a society-wide fashion. This outcome could create a favorable background for introducing an opt-in system of consent for organ donation.

A systematic review on the effectiveness of physical and rehabilitation interventions for chronic non-specific low back pain

NARCIS (Netherlands)

M. van Middelkoop (Marienke); S.M. Rubinstein (Sidney); T. Kuijpers (Ton); A.P. Verhagen (Arianne); R.W.J.G. Ostelo (Raymond); B.W. Koes (Bart); M.W. van Tulder (Maurits)

2011-01-01

textabstractLow back pain (LBP) is a common and disabling disorder in western society. The management of LBP comprises a range of different intervention strategies including surgery, drug therapy, and non-medical interventions. The objective of the present study is to determine the effectiveness of

77 FR 74018 - Agency Information Collection Activities: Proposed Collection; Comment Request

Science.gov (United States)

2012-12-12

... Rehabilitation Act of 1973, as amended in 1998, and removal of the beneficiary's health insurance claim number..., the ABN is delivered by Part B paid physicians, providers (including institutional providers like... Religious Non-medical Health Care Institutions paid under Part A. Other Medicare institutional providers...

A state-level analysis of the economic impacts of medical tourism in Malaysia

NARCIS (Netherlands)

Klijs, J.; Ormond, M.E.; Mainil, T.; Peerlings, J.H.M.; Heijman, W.J.M.

2016-01-01

In Malaysia, a country that ranks among the world's most recognised medical tourism destinations, medical tourism is identified as a potential economic growth engine for both medical and non-medical sectors. A state-level analysis of economic impacts is important, given differences between states in

Hydrogen peroxide as pre-treatment stressor in experimental immer-sion challenge of rainbow trout fry with Flavobacterium psychrophilum

DEFF Research Database (Denmark)

Henriksen, Maya Maria Mihályi; Madsen, Lone; Dalsgaard, Inger

2012-01-01

. Non-medical therapeutic substances are routinely used against pathogens in aquacultures, including copper sulphate, chloramine-T, sodium carbonates, sodium chloride, formalin and hydrogen peroxide (H2O2). One of the more successful immersion models used formalin as a stressor, but a less harmful...

Medically-enhanced normality

DEFF Research Database (Denmark)

Møldrup, Claus; Traulsen, Janine Morgall; Almarsdóttir, Anna Birna

2003-01-01

Objective: To consider public perspectives on the use of medicines for non-medical purposes, a usage called medically-enhanced normality (MEN). Method: Examples from the literature were combined with empirical data derived from two Danish research projects: a Delphi internet study and a Telebus...

Psychologists' right to prescribe – should prescribing privileges be ...

African Journals Online (AJOL)

Current changes in legislation regarding prescription rights increase the possibility of non-medical practitioners being authorised to presctibe medication. There has been ongoing debate about granting psychologists in South Africa a limited right to prescribe (RTP) psychotropic medication. The main reasons advanced for ...

Imaging of serotonin transporters and its blockade by citalopram in patients with major depression using a novel SPECT ligand [123I]-ADAM

International Nuclear Information System (INIS)

Herold, N.; Amthauer, H.; Luedemann, L.; Bruhn, H.; Felix, R.; Plotkin, M.; Uebelhack, K.; Franke, L.; Uebelhack, R.

2006-01-01

We studied the midbrain SERT availability in patients with major depression and assessed the relation of SERT occupancy by citalopram to the treatment response. 21 non-medicated patients with major depression and 13 healthy controls were examined by [ 123 I]-ADAM SPECT. The midbrain SERT availability (SERT V3'') was calculated using individual MRI scans. In 13/21 patients SPECT was repeated 7 days after oral medication with citalopram (10 mg/day). We found no significant difference in the mean midbrain SERT availability between the studied patients with major depression and healthy controls (0.86 ± 0.27 vs. 0.71 ± 0.44, p = 0.069). The mean SERT occupancy accounted to 61 %. The degree of SERT blockade by citalopram did not correlate with the reduction in HAMD total score. Treatment with low-dosed citalopram caused individually variable occupancy of the midbrain-SERT and a rapid clinical improvement in 54 % of the investigated patients. (author)

Current status of securing Category 1 and 2 radioactive sources in Taiwan

Energy Technology Data Exchange (ETDEWEB)

Cheng, Y-F.; Tsai, C-H. [Atomic Energy Council of Executive Yuan of Taiwan (China)

2014-07-01

For enhancing safe and secure management of Category 1 and 2 radioactive sources against theft or unauthorized removal, AEC (Atomic Energy Council) of Taiwan have been regulating the import/export of the sources ever since 2005, in compliance with the IAEA's (International Atomic Energy Agency) 'Guidance on the Import and Export of Radioactive Sources'. Furthermore in consulting the IAEA Nuclear Security Series No.11 report, administrative regulations on the program of securing the sources have been embodied into AECL's regulatory system since 2012, for the purpose of enforcing medical and non-medical licensees and industrial radiographers to establish their own radioactive source security programs. Regulations require that security functions such as access control, detection, delay, response and communication and security management measures are to be implemented within the programs. This paper is to introduce the current status in implementing the security control measures in Taiwan. (author)

Logo-autobiography and its effectiveness on depressed Korean immigrant women.

Science.gov (United States)

Cho, Sunhee; Bernstein, Kunsook S; Roh, Soonhee; Chen, Daniel C

2013-01-01

This study aimed to explore the effectiveness of logo-autobiography (LA) as a therapeutic modality for Korean immigrant women suffering from depression and perceiving their lives as meaningless. A nonrandomized quasi-experimental study was conducted with pretest, posttest, and a 4-week follow-up test. Forty subjects--20 with antidepressants and 20 without--were divided quarterly and assigned to the experimental group and the control group. The experimental group reported a significant lower score on depressive symptoms (F = 6.832, p = .013; F = 19.800, p ≤ .001) and a higher score on meaning of life (F = 12.294, p = .001; F = 12.232, p = .001) than did the control group immediately after completing the LA and a 4-week follow-up. The LA was more effective for the subjects in the nonmedication group than in the medication group. In conclusion, LA is effective in reducing depressive symptoms and increasing a sense of meaning in life among Korean immigrant women suffering from depression.

Milk fat globule membrane coating of large lipid droplets in the diet of young mice prevents body fat accumulation in adulthood.

Science.gov (United States)

Baars, Annemarie; Oosting, Annemarie; Engels, Eefje; Kegler, Diane; Kodde, Andrea; Schipper, Lidewij; Verkade, Henkjan J; van der Beek, Eline M

2016-06-01

Epidemiological studies have demonstrated protective effects of breast-feeding on childhood obesity. Differences between human milk and infant milk formula (IMF) in dietary lipid structure may contribute to this effect. In our mouse model, feeding a diet containing large lipid droplets coated with phospholipids (PL) (Nuturis®; PL of milk fat globule membrane (MFGM) fraction origin) in early life protected against excessive body fat accumulation following a diet challenge in adult life. We now set out to determine the relevance of increased droplet size and/or MFGM lipid droplet coating to the observed anti-obesogenic effects in adult life. From day 16 to 42, male mouse pups were exposed to diets with small (S) or large (L) lipid droplets (0·3 v. 2·9 µm average mode diameter, respectively), either without MFGM or with MFGM coating around the lipid droplet, resulting in four groups: S (control diet), L, Scoating and Lcoating (Nuturis® IMF diet). Mice were subsequently challenged with a Western-style diet until dissection at postnatal day 98. A non-challenged group served as reference (REF). We repeatedly determined body composition between postnatal day 42 and 98. At day 98 plasma and gene expression measurements were performed. Only the Nuturis® IMF diet (Lcoating) in early life containing MFGM-coated large lipid droplets reduced body fat mass to a level comparable with the REF group. These data support the notion that the structural aspects of lipids in human milk, for example, both lipid droplet size as well as the MFGM coating, may contribute to its reported protective effect against obesity in later life.

Meta-analytical study of productive and nutritional interactions of mycotoxins in broilers.

Science.gov (United States)

Andretta, I; Kipper, M; Lehnen, C R; Hauschild, L; Vale, M M; Lovatto, P A

2011-09-01

A meta-analysis was carried out to study the association of mycotoxins with performance, productive indices, and organ weights in broilers. Ninety-eight papers published between 1980 and 2009 were used, totaling 1,401 diets and 37,371 animals. Meta-analysis followed 3 sequential analyses: graphical, correlation, and variance-covariance. The mycotoxin presence in diets reduced (P mycotoxins with the greatest effect on feed intake and bird growth, reducing (P mycotoxin concentration in diets and the animal age at challenge were the variables that more improved the coefficient of determination for equations to estimate mycotoxin effect on weight gain. The mycotoxin effect on growth proved to be greater in young poultry. The residual analysis revealed that 65% of the variation in weight gain was explained by feed intake. The variation in weight gain of challenged broilers in relation to nonchallenged broilers was also influenced by ingestion of nutrients such as protein and methionine. Mortality was 8.8 and 2.8 times greater (P Mycotoxins also increased (P Mycotoxins influenced broiler performance, productive indices, and organ weights. However, the magnitude of the effects varied with type and concentration of mycotoxin, animal age, and nutritional factors.

Deep sequencing-based transcriptome analysis of chicken spleen in response to avian pathogenic Escherichia coli (APEC infection.

Directory of Open Access Journals (Sweden)

Qinghua Nie

Full Text Available Avian pathogenic Escherichia coli (APEC leads to economic losses in poultry production and is also a threat to human health. The goal of this study was to characterize the chicken spleen transcriptome and to identify candidate genes for response and resistance to APEC infection using Solexa sequencing. We obtained 14422935, 14104324, and 14954692 Solexa read pairs for non-challenged (NC, challenged-mild pathology (MD, and challenged-severe pathology (SV, respectively. A total of 148197 contigs and 98461 unigenes were assembled, of which 134949 contigs and 91890 unigenes match the chicken genome. In total, 12272 annotated unigenes take part in biological processes (11664, cellular components (11927, and molecular functions (11963. Summing three specific contrasts, 13650 significantly differentially expressed unigenes were found in NC Vs. MD (6844, NC Vs. SV (7764, and MD Vs. SV (2320. Some unigenes (e.g. CD148, CD45 and LCK were involved in crucial pathways, such as the T cell receptor (TCR signaling pathway and microbial metabolism in diverse environments. This study facilitates understanding of the genetic architecture of the chicken spleen transcriptome, and has identified candidate genes for host response to APEC infection.

Transposition of the basic safety standards. Potential impact on French laws and regulations

Energy Technology Data Exchange (ETDEWEB)

Godet, J.L.; Perrin, M.M.; Saad, N.; Bardelay, C. [Autorite de Surete Nucleaire (ASN), Paris (France)

2013-07-01

The new proposal for a Council Directive laying down basic safety standards for protection against the dangers arising from exposure to ionising radiation is about to be adopted. Member States shall bring into force the laws, regulations and administrative provisions necessary to comply with this Directive within 4 years after adoption of the final text. As far as France is concerned, these evolutions will mainly impact the labour code (for occupational issues) and the public health code for both legal and regulatory requirements. The most significant improvements of the current version of the project are the introduction of graded approach to regulatory control and the enhancement of requirements for protection against natural radiation sources (in particular exposure to radon and naturally occurring radioactive material). This project also aims at achieving a better harmonisation between Member States for topics such as the organization of radiation protection for workers, the justification of medical devices and non-medical imaging exposure situations. ASN has already identified major issues for the transposition of the Directive concerning both French laws and regulations. Main topics should concern the impact of ICRP terminology (planned exposure situation, existing exposure situation versus lasting exposure situation, reference level versus maximum activity level for exposure to radon..) and the extension of both justification and optimisation principles to new activities involving natural radiation sources, such as industries processing naturally occurring radioactive material. Furthermore, France will have to decide whether it will adjust some positions about the prohibition of nonmedical imaging exposures and the release of materials from regulatory control according to generic values. Indeed, the project mentions the possibility to introduce derogations to those major principles. Finally, and according to the graded approach, the project introduces a new

Influences on anatomical knowledge: The complete arguments

NARCIS (Netherlands)

Bergman, E.M.; Verheijen, I.W.; Scherpbier, A.J.J.A.; Vleuten, C.P.M. van der; Bruin, A.B. De

2014-01-01

Eight factors are claimed to have a negative influence on anatomical knowledge of medical students: (1) teaching by nonmedically qualified teachers, (2) the absence of a core anatomy curriculum, (3) decreased use of dissection as a teaching tool, (4) lack of teaching anatomy in context, (5)

Emergency Contraception: A Wareness And Knowledge Among ...

African Journals Online (AJOL)

A cross sectional descriptive survey of awareness and knowledge of emergency contraception among medical/paramedical and non-medical workers was carried out in the National Hospital Abuja, Nigeria. Most of the hospital workers were not aware of emergency contraceptive methods. 59.9% were not aware of ...

75 FR 19340 - Wireless Technologies, Devices, and Services

Science.gov (United States)

2010-04-14

... that use radio only for their internal operations, utilities, transportation entities, and medical... authorize WMTS systems to operate on a secondary basis on those portions of the 1427-1432 MHz shared band where non-medical telemetry is primary, and commenters disagree regarding whether the rules should be...

Doctor in the lead: balancing between two worlds

NARCIS (Netherlands)

Witman, Yolande; Smid, Gerhard A. C.; Meurs, Pauline L.; Willems, Dick L.

2011-01-01

The article examines the leadership of department heads in a university hospital in day-to-day practice. These 'doctors in the lead' bridge the medical and the management world in the hospital organization. They are better able to influence their colleagues' clinical activities than a non-medical

A pill for every ill?

OpenAIRE

Buhagiar, Marc

2015-01-01

In the US, non-medical use of prescription drugs is second only to marijuana. Marc Buhagiar meets up with Prof. Marilyn Clark to investigate just how dangerous this problem is around Europe. Illustrations by Sonya Hallett. http://www.um.edu.mt/think/a-pill-for-every-ill/

The use of non-medical/alternative treatment in multiple sclerosis. A 5 year follow-up study

DEFF Research Database (Denmark)

Stenager, Egon; Stenager, E N; Knudsen, Lone

1995-01-01

Forty-nine patients (22 males, 27 females) were examined and interviewed with 5 years interval in order to determine the extent of the use of non-medical (alternative) treatment and whether the use influenced the natural course of multiple sclerosis (MS). Using clinical course, Kurtzke Disability...

A Trial of Piracetam in Two Subgroups of Students with Dyslexia Enrolled in Summer Tutoring.

Science.gov (United States)

Ackerman, Peggy T.; And Others

1991-01-01

Fifty-three children (ages 9-13) with dyslexia completed a summer tutoring program that emphasized word-building skills. Children who received piracetam (a purportedly memory-enhancing drug) did not improve more than nonmedicated children in any aspect of reading. Children subtyped as "phonetic" improved significantly more in…

Problems of Hemophilia and the Role of the Rehabilitation Counselor.

Science.gov (United States)

Carrai, Edward B.; Handford, H. Allen

1983-01-01

Because of the multiple problems associated with hemophilia, optimal treatment is usually provided in a comprehensive care setting by a team of medical and nonmedical professionals. The rehabilitation counselor contributes expertise to that of other team members in development and implementation of an individual rehabilitation plan for…

Safety and efficiency of prehospital pain management with fentanyl administered by emergency medical technicians

DEFF Research Database (Denmark)

Nielsen, Niels Dalsgaard; Brogaard, Kjeld; Dahl, Michael

2007-01-01

minor, and were not treated with naloxone.   Conclusions: Our results suggest that non-medical personnel safely can administer IV fentanyl to selected groups of patients with a satisfactory result in terms of a considerable reduction in pain score and an acceptable rate of negative coincident events....

Cognitive-emotional sensitization contributes to wind-up-like pain in phantom limb pain patients

DEFF Research Database (Denmark)

Vase, Lene; Nikolajsen, Lone; Christensen, Bente

2011-01-01

). Catastrophizing accounted for 35% of the variance in phantom limb pain (p=0.001) independently of anxiety and depression. Catastrophizing was also positively associated with wind-up-like pain in non-medicated patients (p=0.015), but not to pain thresholds. These findings suggest that cognitive-emotional...

Annual Costs of Care for Pediatric Irritable Bowel Syndrome, Functional Abdominal Pain, and Functional Abdominal Pain Syndrome

NARCIS (Netherlands)

Hoekman, Daniël R.; Rutten, Juliette M. T. M.; Vlieger, Arine M.; Benninga, Marc A.; Dijkgraaf, Marcel G. W.

2015-01-01

To estimate annual medical and nonmedical costs of care for children diagnosed with irritable bowel syndrome (IBS) or functional abdominal pain (syndrome; FAP/FAPS). Baseline data from children with IBS or FAP/FAPS who were included in a multicenter trial (NTR2725) in The Netherlands were analyzed.

A systematic review on the effectiveness of physical and rehabilitation interventions for chronic non-specific low back pain

NARCIS (Netherlands)

van Middelkoop, M.; Rubinstein, S.M.; Kuijpers, T.; Verhagen, A.P.; Ostelo, R.W.J.G.; Koes, B.W.; van Tulder, M.W.

Low back pain (LBP) is a common and disabling disorder in western society. The management of LBP comprises a range of different intervention strategies including surgery, drug therapy, and non-medical interventions. The objective of the present study is to determine the effectiveness of physical and

30 CFR 50.20-6 - Criteria-MSHA Form 7000-1, Section C.

Science.gov (United States)

2010-07-01

... swallowed; the chemical or non-ionizing radiation which irritated the skin; or in cases of strains or..., frostbite and effects of exposure to low temperatures; caisson disease; effects of ionizing radiation (radon daughters, non-medical, non-therapeutic X-rays, radium); effects of nonionizing radiation (welding flash...

Public opinions about human enhancement can enhance the expert-only debate. A review study

NARCIS (Netherlands)

Dijkstra, Anne M.; Schuijff, Mirjam

2016-01-01

Human enhancement, the non-medical use of biomedical technologies to improve the human body or performance beyond their ‘natural’ limitations, is a growing trend. At the same time, the use of these technologies has societal consequences. In societal debates about human enhancement, however, it is

The Impact of Alzheimer's Disease on the Chinese Economy

Directory of Open Access Journals (Sweden)

Marcus R. Keogh-Brown

2016-02-01

Interpretation: Health and macroeconomic models predict an unfolding 2011–2050 Chinese AD epidemic with serious macroeconomic consequences. Significant investment in research and development (medical and non-medical is warranted and international researchers and national authorities should therefore target development of effective AD treatment and prevention strategies.

45 CFR 234.70 - Protective payments for the aged, blind, or disabled.

Science.gov (United States)

2010-10-01

..., administrator or fiscal agent of a nursing home, or social care, medical or nonmedical institution, except for... disabled. 234.70 Section 234.70 Public Welfare Regulations Relating to Public Welfare OFFICE OF FAMILY ASSISTANCE (ASSISTANCE PROGRAMS), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN...

[Delegation yes, substitution no!].

Science.gov (United States)

Schroeder, A

2014-08-01

The aging of society leads on the one hand to increasing case numbers and on the other hand to a reduction in the number of physicians available for patient treatment. The delegation and substitution of medical duties as a tried and tested method is increasingly being recommended in order to compensate for the lack of physicians. The Berufsverband der Deutschen Urologen (BDU, Professional Association of German Urologists) supports the guiding principle of the Bundesärztekammer (Federal Medical Council) of "delegation yes, substitution no" and rejects a substitution of medical duties by non-medical academic health personnel. Against the background of the demographic changes, the increasing need for treatment and the current deficiency of junior physicians, a more extensive inclusion of well-qualified and experienced non-medical personnel by the delegation of medically responsible duties (medical scope of practice) can be an appropriate measure to maintain a good medical service in practices, hospitals and nursing homes.

Comparing interventions for selective mutism: a pilot study.

Science.gov (United States)

Manassis, Katharina; Tannock, Rosemary

2008-10-01

To examine the outcome within 6 to 8 months of medical and nonmedical intervention for children with severe selective mutism (SM). Children with SM (n = 17) and their mothers, seen in a previous study, attended follow-up appointments with a clinician. Obtained by maternal report were: treatment received, current diagnosis (based on semi-structured interview), speech in various environments, and global improvement. An independent clinician also rated global functioning. The diagnosis of SM persisted in 16 children, but significant symptomatic improvement was evident in the sample. All children had received school consultations. Children who had been treated with selective serotonin reuptake inhibitors (SSRI) (n = 10) showed greater global improvement, improvement in functioning, and improvement in speech outside the family than children who were unmedicated (n = 7). No differences were evident for children receiving and not receiving additional nonmedical intervention. The findings suggest the potential benefit of SSRI treatment in severe SM, but randomized comparative treatment studies are indicated.

EFFECTIVENESS OF RUQYAH SYAR’IYYAH ON PHYSICAL DISEASE TREATMENT IN RIAU PROVINCE

Directory of Open Access Journals (Sweden)

Adynata Adynata

2016-12-01

Full Text Available Ruqyah Syar’iyyah is one of Sunnah Prophet Muhammad in treating diseases and disorders syaithan, that is by reciting Al-Qur’an verses and praying. Most Muslims understand that ruqyah Syar’iyyah is only effectively treat non-medical disease or illness caused by psychiatric disorders and jin, whereas medical illness to be treated by medical means, Though al-Qur’an Surat al-Isra’ verses 82 mentions that al-Qur’an is as a bidder (a cure and a mercy for believers without distinction of medications for non-medical or medical illness. Based on the research of writer in 2015, there are two methods ruqyah Syar’iyyah in Riau Province, which is manual method and practical Qur’anic Healing method. In fact, there are many chronic medical illnesses cannot be treated by doctors, but these diseases can be treated and cured by ruqyah without being accompanied by medication. Thus, ruqyah Syar’iyyah is not only effectively treat mental illness, but also effectively treat medical ailments

Verification of radiodynamic therapy by medical linear accelerator using a mouse melanoma tumor model.

Science.gov (United States)

Takahashi, Junko; Murakami, Mami; Mori, Takashi; Iwahashi, Hitoshi

2018-02-09

Combined treatment with 5-aminolevulinic acid (5-ALA) and X-rays improves tumor suppression in vivo. This is because the accumulated protoporphyrin IX from 5-ALA enhances the generation of ROS by the X-ray irradiation. In the present study, a high-energy medical linear accelerator was used instead of a non-medical low energy X-ray irradiator, which had been previously used. Tumor-bearing mice implanted with B16-BL6 melanoma cells were treated with fractionated doses of irradiation (in total, 20 or 30 Gy), using two types of X-ray irradiator after 5-ALA administration. Suppression of tumor growth was enhanced with X-ray irradiation in combination with 5-ALA treatment compared with X-ray treatment alone, using both medical and non-medical X-ray irradiators. 5-ALA has been used clinically for photodynamic therapy. Thus, "radiodynamic therapy", using radiation from medical linacs as a physical driving force, rather than the light used in photodynamic therapy, may have potential clinical applications.

[A sense of responsibility in health personnel as a cause of work-related stress].

Science.gov (United States)

Nedić, Olesja; Jocić, Neda; Filipović, Danka; Solak, Zdravko

2002-01-01

Job stress is a great problem in developed countries of the world, but in Yugoslavia, it is increased due to additional reasons associated with economic crisis in the society. Health services and health workers are in particularly difficult conditions. The aim of this paper was to examine sources and causes of job stress in health workers. The research was undertaken among health workers treated at Health Centre "Hospital" in Novi Sad. The study group included health workers--doctors, nurses and laboratory workers, and the control group included the rest of non-medical staff. Adapted Siegrist questionnaire was used. Three factors were examined: extrinsic efforts (disturbances at work, sense of great job responsibility and the need for overtime work); intrinsinc efforts (major criticism, thinking about the job from the early morning, getting nervous because of minor problems, discontentment because of unsolved problems at work, relaxation at home and so on), and low reward (respect from the superiors and colleagues, support and security at workplace). Answers were scored indicating intensity (high, moderate, low, not at all). Statistic analysis included testing the level of significance in health workers in relation to non-medical staff (t test and Fisher's exact test). Applying the scoring system it has been established that health workers are exposed to greater job stress, great sense of very high job responsibility and frequent overtime work (p stress increases absenteeism, reduces work productivity, causes higher expenses of medical treatment, rehabilitation and staff retraining. It is of great importance to identify factors which cause job dissatisfaction in order to decrease them to the lowest level. High sense of responsibility in health workers is a course of job stress.

Self-regulation theory: applications to medical education: AMEE Guide No. 58.

Science.gov (United States)

Sandars, John; Cleary, Timothy J

2011-01-01

Self-regulation theory, as applied to medical education, describes the cyclical control of academic and clinical performance through several key processes that include goal-directed behaviour, use of specific strategies to attain goals, and the adaptation and modification to behaviours or strategies to optimise learning and performance. Extensive research across a variety of non-medical disciplines has highlighted differences in key self-regulation processes between high- and low-achieving learners and performers. Structured identification of key self-regulation processes can be used to develop specific remediation approaches that can improve performance in academic and complex psycho-motor skills. General teaching approaches that are guided by a self-regulation perspective can also enhance academic performance. Self-regulation theory offers an exciting potential for improving academic and clinical performance in medical education.

Actigraphic and parental reports of sleep difficulties in children with attention-deficit/hyperactivity disorder

DEFF Research Database (Denmark)

Hvolby, Allan; Jørgensen, Jan; Bilenberg, Niels

2008-01-01

OBJECTIVES: To describe actigraphically detected and parent-reported sleep problems in nonmedicated children with attention-deficit/hyperactivity disorder (ADHD); to clarify whether or not comorbid oppositional defiant disorder contributes to sleep difficulties; and to compare objectively measured...... subjects. Average sleep onset latencies were 26.3 minutes in the ADHD group, 18.6 minutes in the psychiatric control group, and 13.5 minutes in the healthy reference group. There was no apparent relationship between sleep problems and comorbid oppositional defiant disorder. We found discrepancies between...... the objectively measured sleep variables and those reported by parents, who overestimated sleep onset latency. CONCLUSIONS: The results of this study allow us to conclude that some children with ADHD have impaired sleep that cannot be referred to comorbid oppositional defiant disorder. However, it is important...

Standard First Aid Training Course. Naval Education and Training Command Rate Training Manual.

Science.gov (United States)

Naval Education and Training Command, Washington, DC.

This first aid manual is designed to serve as basic first aid instructional materials for all nonmedical naval personnel. Chapters are included on the following topics: basic life support, hemorrhage, shock, wounds, injuries, drug abuse, poisoning, common medical emergencies, NBC (nuclear, biological, chemical) agent casualties, and rescue and…

Differences in abuse potential of ADHD drugs measured by contrasting poison centre and therapeutic use data

DEFF Research Database (Denmark)

Jensen, Louise; Pagsberg, Anne Katrine; Dalhoff, Kim Peder

2015-01-01

.018), but not the enquiries/sale relationship. The proportion of exposures motivated by recreational drug use was significantly lower for ATX (19%) than that for MPH (40%) (p = 0.038). DISCUSSION AND CONCLUSION: These results suggest that ATX is used by adults for non-medical purposes including recreational use...

New regulations in the German Radiation Protection Ordinance. What do the changes mean?; Neues in der Strahlenschutzverordnung. Was bringt die Aenderung?

Energy Technology Data Exchange (ETDEWEB)

Bickel, Angela [Wiederaufarbeitungsanlage Karlsruhe Rueckbau- und Entsorgungs-GmbH, Eggenstein-Leopoldshafen (Germany); Fehringer, Franz [Berufsgenossenschaft Energie Textil Elektro, Koeln (Germany). Inst. fuer Strahlenschutz; Feldmann, Ulrike [Wirtschaftsverband Kernbrennstoff-Kreislauf und Kerntechnik e.V., Berlin (Germany)] [and others

2012-11-01

Since November 1{sup st} 2011, several new regulations have become effective in the Radiation Protection Ordinance, that are described here first as a general overview and then in more detail. The first part of the contribution compiles the non-medical and the second one the medical applications. (orig.)

Parental and Professional Beliefs on the Treatment and Management of ADHD

Science.gov (United States)

Dryer, Rachel; Kiernan, Michael J.; Tyson, Graham A.

2012-01-01

Objective: This study examined parental and professional beliefs about the efficacy of various treatment strategies for ADHD. Method: Parents of children with and without ADHD and seven medical and nonmedical professional groups (N = 673) completed a questionnaire examining their beliefs about the efficacy of various treatment regimes. Results:…

7 CFR 1944.252 - Definitions.

Science.gov (United States)

2010-01-01

... location to another for activities such as going to the doctor and shopping, but must be mobile. The mobility requirement does not exclude persons in wheelchairs or those requiring mobility devices.) (2) Each... services described in section 802(k)(16). Under this Program, health-related services mean non-medical...

Feasibility of Providing Sexually Transmitted Infection Testing and Treatment in Off-Campus, Nonclinic Settings for Adolescents Enrolled in a School-Based Research Project

Science.gov (United States)

Chacko, Mariam R.; Markham, Christine; Thiel, Melanie; Crandall, Stacy M.; Peskin, Melissa F.; Shegog, Ross; Tortolero, Susan

2014-01-01

Background: This study examined the acceptability and feasibility of using a biological outcome measure to evaluate a school-based sexuality education program. Confidential field-delivered sexually transmitted infection (STI) testing by nonmedical field staff and STI treatment by medically trained field staff was assessed in off-campus and…

Circumscribing the Body Politic : Circumcision, Religious Freedom and Identity in Europe

NARCIS (Netherlands)

McIvor, Méadhbh

2018-01-01

In February 2018, Icelandic Member of Parliament Silja Dögg Gunnarsdóttir made international news by proposing a bill that would criminalise the circumcision of male children for non-medical reasons. The bill, which is supported by the ruling Progressive Party and Left-Green coalition, has sparked

Developing the Clinical Psychomotor Skills of Musculoskeletal Sonography Using a Multimedia DVD: A Pilot Study

Science.gov (United States)

Thoirs, Kerry; Coffee, Jane

2012-01-01

Sonographers are medical or non-medical health professionals in the radiology field who skilfully manipulate ultrasound equipment to produce images that are used to diagnose medical conditions and abnormalities. This technique is also becoming popular amongst the wider community in other medical specialities and allied health professionals, due to…

Prevalence of malaria and typhoid co-infections in University of ...

African Journals Online (AJOL)

Mixed infection of malaria caused by Plasmodium species and typhoid fever caused by Salmonella species is often observed in areas where malaria is endemic, and the infection with Salmonella species has been considered by some medical and non-medical personnels to be associated with the malaria parasite infection ...

Resource consumption and costs in Dutch patients with Type 2 diabetes mellitus. Results from 29 general practices

NARCIS (Netherlands)

Redekop, WK; Koopmanschap, MA; Rutten, GEHM; Wolffenbuttel, BHR; Stolk, RP; Niessen, LW

Aims The aims of this study were to estimate the costs incurred by Dutch patients with Type 2 diabetes, examine which patient and/or treatment characteristics are associated with costs, and estimate the medical and non-medical costs of patients with Type 2 diabetes in The Netherlands. Methods

Correlates of use of alcohol mixed with energy drinks among youth across 10 US metropolitan areas.

Science.gov (United States)

Khan, Shivani R; Cottler, Linda B; Striley, Catherine W

2016-06-01

Predictors of use of alcohol mixed with energy drinks (AmED) among youth have been understudied. The current analyses investigated the prevalence of and correlates for use of AmED among alcohol users from a national study of stimulant use among youth. The National Monitoring of Adolescent Prescription Stimulants Study (N-MAPSS) assessed behaviors and risk factors for stimulant use from 11,048 youth, 10-18 years of age recruited from entertainment venues across 10 US cities. Of the four cross sections, two had questions on having alcohol mixed with energy drinks (AmED) in the past 30 days along with sociodemographic characteristics, current tobacco and marijuana use and current nonmedical use of prescription opioids, anxiolytics, and stimulants. Only 13 to18 year olds and those who reported alcohol use were included in the analyses. Overall, 28.4% (1392 out of 4905) of the 13 to18 year olds reported past 30-day alcohol use. Among alcohol users, 27% reported having alcohol mixed with energy drinks in the past 30 days. Multivariate logistic regression indicated that use of AmED was significantly associated with tobacco and marijuana use and nonmedical use of prescription stimulants. Underage drinking is common among youth and more than a quarter of these drinkers use AmED. Use of AmED is significantly associated with tobacco and marijuana use and nonmedical use of prescription stimulants. Drug and alcohol intervention programs should educate on the risks of AmED, as the same population is at high-risk for use of AmED and alcohol/drug use. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The economic burden of cancer in Korea in 2009.

Science.gov (United States)

Kim, So Young; Park, Jong-Hyock; Kang, Kyoung Hee; Hwang, Inuk; Yang, Hyung Kook; Won, Young-Joo; Seo, Hong-Gwan; Lee, Dukhyoung; Yoon, Seok-Jun

2015-01-01

Cancer imposes a significant economic burden on individuals, families and society. The purpose of this study was to estimate the economic burden of cancer using the healthcare claims and cancer registry data in Korea in 2009. The economic burden of cancer was estimated using the prevalence data where patients were identified in the Korean Central Cancer Registry. We estimated the medical, non-medical, morbidity and mortality cost due to lost productivity. Medical costs were calculated using the healthcare claims data obtained from the Korean National Health Insurance (KNHI) Corporation. Non-medical costs included the cost of transportation to visit health providers, costs associated with caregiving for cancer patients, and costs for complementary and alternative medicine (CAM). Data acquired from the Korean National Statistics Office and Ministry of Labor were used to calculate the life expectancy at the time of death, age- and gender-specific wages on average, adjusted for unemployment and labor force participation rate. Sensitivity analysis was performed to derive the current value of foregone future earnings due to premature death, discounted at 3% and 5%. In 2009, estimated total economic cost of cancer amounted to $17.3 billion at a 3% discount rate. Medical care accounted for 28.3% of total costs, followed by non-medical (17.2%), morbidity (24.2%) and mortality (30.3%) costs. Given that the direct medical cost sharply increased over the last decade, we must strive to construct a sustainable health care system that provides better care while lowering the cost. In addition, a comprehensive cancer survivorship policy aimed at lower caregiving cost and higher rate of return to work has become more important than previously considered.

Risk of preeclampsia after gestational exposure to selective serotonin reuptake inhibitors and other antidepressants: A study from The Norwegian Mother and Child Cohort Study.

Science.gov (United States)

Lupattelli, Angela; Wood, Mollie; Lapane, Kate; Spigset, Olav; Nordeng, Hedvig

2017-10-01

To describe the risk of early- and late-onset preeclampsia across pregnancies exposed to antidepressants and to evaluate the impact of timing and length of gestational exposure to antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), on preeclampsia. The Norwegian Mother and Child Cohort, a prospective population-based study, and the Medical Birth Registry of Norway provided information on antidepressant exposure, depression, and anxiety symptoms in pregnancy, preeclampsia diagnoses, and important covariates. Within a pregnancy cohort of depressed women, we compared the risk of late-onset preeclampsia between SSRI-exposed and nonmedicated pregnancies using marginal structural models (weighted) and modified Poisson regression models. Of the 5887 pregnancies included, 11.1% were exposed at any time before week 34 to SSRIs, 1.3% to serotonin-norepinephrine reuptake inhibitors, 0.4% to tricyclic antidepressants, and 0.5% to other antidepressants. The risks of early- and late-onset preeclampsia by exposure status in pregnancy were 0.3% and 3.6% (nonmedicated), 0.4% and 3.7% (SSRIs), 1.5% and 4.1% (serotonin-norepinephrine reuptake inhibitors), and 7.1% and 10.0% (tricyclic antidepressants). Compared with nonmedicated pregnancies, SSRI-exposed in mid and late gestation had adjusted relative risks for late-onset mild preeclampsia of 0.76 (95% confidence interval, 0.38-1.53) and 1.56 (0.71-3.44) (weighted models), respectively. There was no association between SSRI exposure in pregnancy and severe late-onset preeclampsia. We have provided evidence that SSRI use in early and midpregnancy does not substantially increase the risk of late-onset preeclampsia. © 2017 The Authors. Pharmacoepidemiology & Drug Safety published by John Wiley & Sons Ltd.

The economic burden of fracture patients with osteoporosis in western China.

Science.gov (United States)

Qu, B; Ma, Y; Yan, M; Wu, H-H; Fan, L; Liao, D-F; Pan, X-M; Hong, Z

2014-07-01

To study the cost of osteoporotic fracture in China, we performed a prospective study and compared the costs of the disease in referral patients with fractures in three of the most common sites. Our results indicated that the economic burden of osteoporotic fracture to both Chinese patients and the nation is heavy. This paper aims to study the cost of osteoporotic fracture in China and thus to provide essential information about the burden of this disease to individuals and society. This prospective observational data collection study assessed the cost related to hip, vertebral, and wrist fracture 1 year after the fracture based on a patient sample consisting of 938 men and women. Information was collected using patient records, registry sources, and patient interviews. Both direct medical, direct non-medical, and indirect non-medical costs were considered. The annual total costs were highest in hip fracture patients (renminbi, RMB 27,283 or USD 4,330, with confidence interval (RMB 25715, 28851)), followed by patients with vertebral fracture (RMB 21,474 or USD 3,409, with confidence interval (RMB 20082, 22866)) and wrist fracture (RMB 8,828 or USD 1,401, with confidence interval (RMB 7829, 9827)). The direct medical care costs averaged approximately RMB 17,007 per year per patient, of which inpatient costs, drugs, and investigations accounted for the majority of the costs. Nonmedical direct costs were much less compared to direct healthcare costs and averaged approximately RMB 1,846. These results indicate that the economic burden of osteoporotic fracture to both Chinese patients and China was heavy, and the proportion of the costs in China demonstrated many similar features and some significant differences compared to other countries.

The incidence and economic burden of injuries in Jiangxi, China.

Science.gov (United States)

Fang, X; Zeng, G; Linnan, H W; Jing, R; Zhu, X; Corso, P; Liu, P; Linnan, M

2016-09-01

This study estimated the incidence, direct medical and non-medical costs, and productivity losses due to morbidity and mortality across multiple strata for injuries that occurred in Jiangxi, China. Cross-sectional study. Data came from the Jiangxi injury survey, a provincially-representative, population-based sample of 100,010 households. The major economic costs of injuries were divided into direct costs and indirect costs. Direct costs encompass medical costs and direct non-medical costs. Indirect costs refer to the productivity losses due to injury-related morbidity and mortality. In 2005, about one of 18 residents in Jiangxi, China, experienced an injury. Overall, fall, animal bite, and road traffic crash (RTC) injuries accounted for more than 66% of all injuries, while fall, RTC, drowning, and self-harm injuries accounted for 80% of fatal injuries. Average cost per case for a fatal injury was 163,389 RMB ($20,171) for lost productivity and 2800 RMB ($346) in direct medical & non-medical costs. A non-fatal injury resulting in hospitalisation or permanent disability on average caused 5221 RMB ($643) in direct costs and 18,437 RMB ($2276) in lost productivity and, an additional loss of three school days. A non-hospitalised non-fatal injury on average caused 303 ($37) RMB in direct costs and 491 RMB ($61) in lost productivity and, an additional loss of 0.5 school days. The unequivocal evidence of the substantial health and financial burden of injuries indicates to Chinese policy makers that more research and efforts are needed to find efficacious and cost-effective interventions targeting injury. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Affluence as a predictor of vaccine refusal and underimmunization in California private kindergartens.

Science.gov (United States)

McNutt, Louise-Anne; Desemone, Cristina; DeNicola, Erica; El Chebib, Hassan; Nadeau, Jessica A; Bednarczyk, Robert A; Shaw, Jana

2016-03-29

Non-medical vaccine exemption rates in California private schools far exceed those of public schools, but little is known about specific factors which may be associated with high exemption rates in private schools. The percent of personal-belief exemptions (PBEs) among California public and private kindergartens were computed for 2000-2001 to 2014-2015 academic years. For the 2014-2015 academic year, a random sample of private schools was selected to investigate associations between kindergarten characteristics (tuition amount, religious affiliation) and vaccine profile (non-medical vaccine exemptions, vaccine coverage). The proportion of private kindergartens reporting 5% or more children with PBEs increased from 9% (2000-2001) to 34% (2013-2014), followed by a small decrease in 2014-2015 (31%). Overall, 93.7% (565/605) of kindergartens sampled in 2014-2015 had data available. Very high PBE levels (>20%) were seen among secular and non-Catholic, Christian kindergartens but not Roman Catholic, Jewish or Islamic kindergartens. However, the majority of schools at all tuition levels had fewer than 5% of children with a PBE. Kindergartens with an annual tuition of $10,000 or more were over twice as likely to have 20% or more children with PBEs than kindergartens with a lower tuition (ptuitions of $10,000 or more were 39% compared to 22% for less expensive kindergartens (pprivate kindergartens had 95% coverage of the MMR (49%) and pertussis-containing vaccines (51%). School-entry vaccination requirements are critical to preventing outbreaks of vaccine preventable diseases in the US. Nonmedical exemptions increased between the 2000-2001 and 2014-2015 academic years and appear to be associated with affluence, raising social justice concerns. Copyright © 2015 Elsevier Ltd. All rights reserved.

Adolescent context of exposure to prescription opioids and substance use disorder symptoms at age 35: A national longitudinal study

Science.gov (United States)

McCabe, Sean Esteban; Veliz, Philip; Schulenberg, John E.

2016-01-01

The objective of this study was to examine the association of context of prescription opioid exposure (i.e., medical and/or nonmedical) in adolescence with the subsequent risk of nonmedical use of prescription opioids (NMUPO) and substance use disorder (SUD) symptoms at age 35. Multiple cohorts of nationally representative probability samples of U.S. high school seniors (n = 4072) were surveyed via self-administered questionnaires and followed longitudinally from adolescence (modal age 18, graduating classes 1976–1996) to age 35 (1993–2013). Main outcome measures were past-year NMUPO and SUD symptoms. The medical and nonmedical use of prescription opioids during adolescence was significantly associated with NMUPO at age 35. Relative to no prescription opioid exposure, medical use of prescription opioids without any history of NMUPO during adolescence was not associated with SUD symptoms at age 35. In contrast, compared with no prescription opioid exposure during adolescence, the adjusted odds ratios (AORs) associated with SUD symptoms at age 35 were greater among those with a history of both medical use of prescription opioids and NMUPO during adolescence, AOR = 1.49 (95% confidence interval [CI], 1.13–1.97); and among those who reported NMUPO only, AOR = 2.61 (95% CI, 1.88–3.61). The findings indicate medical use of prescription opioids without any history of NMUPO in adolescence is not associated with SUD symptoms at age 35 while any NMUPO in adolescence predicts SUD symptoms at age 35. Screening instruments and preventative intervention programs to reduce NMUPO and SUDs must account for the context associated with prescription opioid exposure during adolescence. PMID:27227693

Value connotations, perspectives and self-perception.

NARCIS (Netherlands)

van der Pligt, J.; Eiser, J.R.

1983-01-01

Reports 2 studies in which Ss rated statements concerning the nonmedical use of drugs before rating their own attitude on the issue. In Study 1, 185 high school and 73 university students rated their attitude on 4 scales chosen to manipulate the value connotations of the response language, as well

The Feasibility of E-Learning Implementation in an Iranian University

Science.gov (United States)

Mirzamohammadi, M. H.

2017-01-01

The present research aimed to investigate the feasibility of e-learning implementation in an Iranian comprehensive university (included medical and non-medical fields) to provide appropriate solutions in this regard. To achieve this objective, seven research questions were formed. Surveying method was applied for data collection in this study.…

Gendered Uncertainty and Variation in Physicians' Decisions for Coronary Heart Disease: The Double-Edged Sword of "Atypical Symptoms"

Science.gov (United States)

Welch, Lisa C.; Lutfey, Karen E.; Gerstenberger, Eric; Grace, Matthew

2012-01-01

Nonmedical factors and diagnostic certainty contribute to variation in clinical decision making, but the process by which this occurs remains unclear. We examine how physicians' interpretations of patient sex-gender affect diagnostic certainty and, in turn, decision making for coronary heart disease. Data are from a factorial experiment of 256…

Over-the-Counter Data's Impact on Educators' Data Analysis Accuracy

Science.gov (United States)

Rankin, Jenny Grant

2013-01-01

There is extensive research on the benefits of making data-informed decisions, but research also contains evidence many educators incorrectly interpret student data. Meanwhile, the types of detailed labeling on over-the-counter medication have been shown to improve use of "non"-medication products, as well. However, data systems most…

Cultural Literacy of Fourth-Year Medical Students.

Science.gov (United States)

King, Charles R.

1988-01-01

A survey of fourth-year students in obstetrics at one medical school confirmed the absence of a liberal undergraduate education and indicated their failure to acquire cultural knowledge during their premedical and medical education. Knowledge deficits extended beyond the humanities to nonmedical sciences and the history and philosophy of medicine.…

Requirements for use of nonmedical x-ray generators at SLAC

International Nuclear Information System (INIS)

Busick, D.D.

1984-09-01

The risks associated with use of x-ray equipment have long been recognized. While the relative frequency of x-ray damage is small, machine produced x-rays and large radiography sources continue to account for a large percentage of preventable radiation injuries reported worldwide. The intent of this report is to formalize SLAC's radiation safety program as it applies to radiation producing equipment (diffraction, fluorescence analysis and nondestructive testing). It does not apply to the two-mile linac, experimental areas or other x-ray producing equipment directly related to the high energy physics program. 4 refs., 3 figs., 1 tab

Nonmedical application of computed tomography to power capacitor quality assesment

International Nuclear Information System (INIS)

Kruger, R.P.

1981-01-01

Present research and development efforts at Los Alamos Scientific Laboratory require the design and use of high-efficiency rapid-discharge energy storage capacitors for laser isotope separation and plasma physics programs. In these applications, capacitors are subjected to electrical, mechanical, thermal, and other environmental stresses. These stresses cause the dielectric constant to change due to gasification from arcing at nonsoldering connections, which produce a chemical reduction of the dielectric material. This effectively limits the lifetime of the capacitor. The programs mentioned above require capacitors with a multikilohertz frequency response at a current of tens of kiloamperes and a voltage of at least 100 kV. The lifetime of such capacitors should exceed 10 10 charge/discharge cycles. Such capacitors do not presently exist. The exploration of new capacitor designs will require the use of both electrical functional tests and tests that show the changes in internal physical structure as the capacitor is repeatedly stressed by the charge/discharge cycle. The integration of electrical and structural tests throughout the life cycle of a candidate capacitor makes it imperative that the structural integrity tests be nondestructive. Computed tomography (CT) makes this integration possible. The work reported here is the result of a pilot project designed to show the potential use of CT for this application. This work includes visualization of material defects using both a layered sequence of conventional tomographic slices and orthogonal multiangular pseudoradiographs generated from these slices

Economic evaluation of zinc and copper use in treating acute diarrhea in children: A randomized controlled trial

Directory of Open Access Journals (Sweden)

Dhande Leena A

2003-08-01

Full Text Available Abstract Background The therapeutic effects of zinc and copper in reducing diarrheal morbidity have important cost implications. This health services research study evaluated the cost of treating a child with acute diarrhea in the hospital, the impact of micronutrient supplementation on the mean predicted costs and its cost-effectiveness as compared to using only standard oral rehydration solution (ORS, from the patient's and government's (providers perspective. Methods Children aged 6 months to 59 months with acute diarrhea were randomly assigned to receive either the intervention or control. The intervention was a daily dose of 40 mg of zinc sulfate and 5 mg of copper sulfate powder dissolved in a liter of standard ORS (n = 102. The control was 50 mg of standard ORS powder dissolved in a liter of standard ORS (n = 98. The cost measures were the total mean cost of treating acute diarrhea, which included the direct medical, the direct non-medical and the indirect costs. The effectiveness measures were the probability of diarrhea lasting ≤ 4 days, the disability adjusted life years (DALYs and mortality. Results The mean total cost of treating a child with acute diarrhea was US $14 of which the government incurred an expenditure of 66%. The factors that increased the total were the number of stools before admission (p = 0.01, fever (p = 0.01, increasing grade of dehydration (p = 0.00, use of antibiotics (p = 0.00, use of intra-venous fluids (p = 0.00, hours taken to rehydrate a child (p = 0.00, the amount of oral rehydration fluid used (p = 0.00, presence of any complications (p = 0.00 and the hospital stay (p = 0.00. The supplemented group had a 8% lower cost of treating acute diarrhea, their cost per unit health (diarrhea lasting ≤ 4 days was 24% less and the incremental cost-effectiveness ratio indicated cost savings (in Rupees with the intervention [-452; 95%CI (-11306, 3410]. However these differences failed to reach conventional levels

Characteristics of general practice care: what do senior citizens value? A qualitative study.

NARCIS (Netherlands)

Berkelmans, P.G.J.; Berendsen, A.J.; Verhaak, P.F.M.; Meer, K. van der

2010-01-01

Background: In view of the increasing number of senior citizens in our society who are likely to consult their GP with age-related health problems, it is important to identify and understand the preferences of this group in relation to the non-medical attributes of GP care. The aim of this study is

The Debreather: A Report on Euthanasia and Suicide Assistance Using Adapted Scuba Technology

Science.gov (United States)

Ogden, Russel D.

2010-01-01

In response to the general prohibition of euthanasia and assisted suicide, some right-to-die activists have developed non-medical methods to covertly hasten death. One such method is a "debreather," a closed system breathing device that laypersons can use to induce hypoxia for persons seeking euthanasia or assisted suicide. This article presents…

Characteristics of general practice care : What do senior citizens value? A qualitative study

NARCIS (Netherlands)

Berkelmans, P. (Ine) G. J.; Berendsen, Annette J.; Verhaak, Peter F. M.; van der Meer, Klaas

2010-01-01

Background: In view of the increasing number of senior citizens in our society who are likely to consult their GP with age-related health problems, it is important to identify and understand the preferences of this group in relation to the non-medical attributes of GP care. The aim of this study is

[The benefits of foot reflexology in nursing homes].

Science.gov (United States)

Simonnet, Karine

2012-01-01

Massages, following the foot reflexology method, were given to patients in a nursing home suffering from Alzheimer's disease or related disorders. A methodical assessment, on a small sample of patients, showed a significant reduction in neuropsychiatric manifestations, opening up new perspectives for non-medication based therapy for the care of elderly dependent people.

Dating Violence and Substance Use among Ethnically Diverse Adolescents

Science.gov (United States)

Temple, Jeff R.; Freeman, Daniel H., Jr.

2011-01-01

Teen dating violence is a serious public health concern with numerous and long-lasting consequences. Although alcohol and drug use have been associated with dating violence, little is known about the role of specific substances, especially the use of club drugs and the nonmedical use of prescription drugs. Thus, the authors examined the…

Perceptions, knowledge, attitudes and practices for the prevention and control of lymphatic filariasis in Conakry, Republic of Guinea.

Science.gov (United States)

Kouassi, Bernard L; Barry, Aboulaye; Heitz-Tokpa, Kathrin; Krauth, Stefanie J; Goépogui, Andre; Baldé, Mamadou S; Barry, Oumar; Niamey, Marie L; Bockarie, Moses J; Koudou, Benjamin G; Utzinger, Jürg

2018-03-01

Little is known about the perceptions, attitudes and practices of lymphatic filariasis in Conakry, Republic of Guinea. Yet, such knowledge is important for an optimal design and implementation of setting-specific prevention and control measures. We conducted a cross-sectional study using a mixed methods approach. Qualitative data related to people's general experience with lymphatic filariasis, their perception of the causes of the disease, the onset of elephantiasis, care-seeking behaviour and the socioeconomic impact of lymphatic filariasis were collected through in-depth interviews with 85 respondents. Quantitative data related to strategies for prevention and the knowledge of the causes of the disease were collected by interviewing 429 people. A total of 514 individuals (313 females and 201 males), aged 10-84 years, participated. Most participants were well aware of lymphatic filariasis and they recognized the disease mainly by its disfiguring manifestation, collectively termed "elephantiasis" or "leg-swelling disease". Morbidity patterns due to filarial infection showed an increase with age (from 30 to 50 years) independent of sex. Most patients with lymphatic filariasis abandoned their jobs (73.9%) or sought other work (21.7%). The main perceived causes of acquiring lymphatic filariasis were of supernatural origin (as stated by 8.7% of patients and 5.7% of healthy subjects), while mosquito bites were mentioned by fewer participants (4.3% of patients and 4.2% of healthy subjects). A number of other causes were reported that relate to both medical and non-medical conceptions. The study also identified socioeconomic impairments and stigmatization due to elephantiasis. Taken together, community perception of lymphatic filariasis in Conakry is influenced by sociocultural conceptions. Appropriate health education campaigns aimed at enhancing community understanding of the transmission of lymphatic filariasis are required to increase the success of mass drug

Impact of medical treatment on lung diffusion capacity in elderly patients with heart failure. Baseline characteristics and 1-year follow up after medical treatment

DEFF Research Database (Denmark)

Petersen, Claus Leth; Kjaer, Andreas

2005-01-01

treatment (baseline) and after 1 year of treatment with diuretics and ACE-inhibitors/angiotensin-II receptor antagonists. Age- and gender-matched healthy volunteers were included as control group. RESULTS: (mean+/-S.E.M.): K(CO) at baseline was 0.95+/-0.06 and 1.25+/-0.04 mmol/min x kPa/l in HF patients......AIM: The aim of this investigation was (1) to study the effect of untreated chronic heart failure (CHF) on alveolar membrane diffusion capacity (transfer coefficient, K(CO)) in elderly patients and (2) to study the impact of the standard regime of medical treatment with diuretics and ACE......-inhibitor/angiotensin-II receptor antagonists on K(CO) in these patients. METHODS: Non-medicated patients (except for diuretics) with symptoms of heart failure (NYHA II-III) and echocardiographically estimated left ventricular ejection fraction (LVEF)

Positron computed tomography studies: potential use in neuro-psychiatric disorders

International Nuclear Information System (INIS)

Yamasaki, T.; Tateno, Y.; Shishido, F.

1982-01-01

Since November 1979 positron computed tomography (PCT) have been performed to study subjects in a variety of states and varied disorders, using 13 NH 3 , 11 CO and 18 F-2-fluorodeoxyglucose ( 18 FDG) at the National Institute of Radiological Sciences, Japan. In neuro-psychiatric studies, normal volunteers and patients including schizophrenia, affective disorders, Alzheimer's disease, Huntigton's chorea were studied. Tomographic images were analyzed by visual observation and activity counting in regions selected. In degenerative disorder group, 18 FDG revealed decreased accumulation in target areas, whereas in functional psychosis group both in medicating patients and in non-medicated patients, positron images were basically similar to normal controls. Especially in a patient with Huntington's chorea, 18 FDG accumulation in striatal region was markedly decreased without significant change in the same region on X-ray CT and 13 NH 3 PCT

Severe forms of fibromyalgia with acute exacerbation of pain: costs, comorbidities, and length of stay in inpatient care

Directory of Open Access Journals (Sweden)

Romeyke T

2017-06-01

Full Text Available Tobias Romeyke,1,2 Elisabeth Noehammer,1 Hans Christoph Scheuer,2 Harald Stummer1,3 1Institute for Management and Economics in Health Care, University of Health Sciences, Medical Informatics and Technology (UMIT, Hall in Tirol, Austria; 2Waldhausklinik Deuringen, Acute Hospital for Internal Medicine, Pain Therapy, Complementary, and Individualized Patient-Centered Medicine, Stadtbergen, Germany; 3Institute for Management and Innovation in Healthcare, University Schloss Seeburg, Seekirchen/Wallersee, Austria Background and purpose: As a disease of the musculoskeletal system, fibromyalgia is becoming increasingly important, because of the direct and indirect costs to health systems. The purpose of this study of health economics was to obtain information about staff costs differentiated by service provider, and staff and material costs of the nonmedical infrastructure in inpatient care.Patients and methods: This study looked at 263 patients who received interdisciplinary inpatient treatment for severe forms of fibromyalgia with acute exacerbation of pain between 2011 and 2014. Standardized cost accounting and an analysis of additional diagnoses were performed.Results: The average cost per patient was €3,725.84, with staff and material costs of the nonmedical infrastructure and staff costs of doctors and nurses accounting for the highest proportions of the costs. Each fibromyalgia patient had an average of 6.1 additional diagnoses.Conclusion: Severe forms of fibromyalgia are accompanied by many concomitant diseases and associated with both high clinical staff costs and high medical and nonmedical infrastructure costs. Indication-based cost calculations provide important information for health policy and hospital managers if they include all elements that incur costs in both a differentiated and standardized way. Keywords: fibromyalgia, DRG, cost, length of stay, comorbidities, interdisciplinary care, inpatient care, musculoskeletal, pain

Assessing bias against overweight individuals among nursing and psychology students: an implicit association test.

Science.gov (United States)

Waller, Tabitha; Lampman, Claudia; Lupfer-Johnson, Gwen

2012-12-01

To determine the implicit or unconscious attitudes of Nursing and Psychology majors towards overweight individuals in medical and non-medical contexts. Obesity is a leading health concern today, which impacts both physical and psychological health. Overweight individuals confront social biases in many aspects of their lives including health care. Examining the views of Nursing and Psychology students may reveal implicit attitudes towards overweight individuals that may lead to prejudiced behaviours. A mixed design experiment with one between-subjects variable (student major: Nursing or Psychology) and one within-subjects variable (condition: congruent or incongruent) was used to assess implicit attitudes in two convenience samples of Nursing and Psychology students. A computerised implicit association test was used to determine implicit attitudes towards overweight individuals in medical and non-medical contexts. A total of 90 students from Nursing (n= 45) and Psychology (n = 45) were recruited to complete an implicit association test. Reaction times in milliseconds between the congruent trials (stereotype consistent) and incongruent trials (stereotype inconsistent) were compared with determine adherence to social stereotypes or weight bias. A statistically significant implicit bias towards overweight individuals was detected in both subject groups and in both target settings (medical vs. non-medical). Stronger weight bias was found when the stimulus targets were female than male. Findings from this study expand understanding of the implicit attitudes and social biases of Nursing and Psychology students. The views held by these future healthcare professionals may negatively impact patient care. Providing education and support to overweight individuals is central to Nursing practice in a society struggling to manage obesity. Negative stereotypes or beliefs about these individuals may result in poor patient care. Therefore, nurses and other healthcare professionals

The personal financial burden of chronic rhinosinusitis: A Canadian perspective.

Science.gov (United States)

Yip, Jonathan; Vescan, Allan D; Witterick, Ian J; Monteiro, Eric

2017-07-01

Previous studies describe the financial burden of chronic rhinosinusitis (CRS) from the perspective of third-party payers, but, to our knowledge, none analyze the costs borne by patients (i.e., out-of-pocket expenses [OOPE]). Furthermore, this burden has not been previously investigated in the context of a publicly funded health care system. The purpose of this study was to characterize the financial impact of CRS on patients, specifically by evaluating its associated OOPEs and the perceived financial burden. The secondary aim was to determine the factors predictive of OOPEs and perceived burden. Patients with CRS at a tertiary care sinus center completed a self-administered questionnaire that assessed their socioeconomic characteristics, disease-specific quality of life (22-item Sino-Nasal Outcome Test [SNOT-22]), workdays missed due to CRS, perceived financial burden, and direct medical and nonmedical OOPEs over a 12-month period. Total OOPEs were calculated from the sum of direct medical and nonmedical OOPEs. Regression analyses determined factors predictive of OOPEs and the perceived burden. A total of 84 patients completed the questionnaires. After accounting for health insurance coverage and the median direct medical, direct nonmedical, and total OOPEs per patient over a 12-month period were Canadian dollars (CAD) $336.00 (2011) [U.S. $339.85], CAD $129.87 [U.S. $131.86], and CAD $607.10 [U.S. $614.06], respectively. CRS resulted in an average of 20.6 workdays missed over a 12-month period. Factors predictive of a higher financial burden included younger age, a greater number of previous sinus surgeries, financial burden and consider counseling them on strategies to offset expenses, including obtaining travel grants, using telemedicine for follow-up assessments, providing drug samples, and streamlining diagnostic testing with medical visits.

Integrating care for individuals with FASD: results from a multi-stakeholder symposium.

Science.gov (United States)

Masotti, Paul; Longstaffe, Sally; Gammon, Holly; Isbister, Jill; Maxwell, Breann; Hanlon-Dearman, Ana

2015-10-05

Fetal Alcohol Spectrum Disorder (FASD) has a significant impact on communities and systems such as health, education, justice and social services. FASD is a complex neurodevelopmental disorder that results in permanent disabilities and associated service needs that change across affected individuals' lifespans. There is a degree of interdependency among medical and non-medical providers across these systems that do not frequently meet or plan a coordinated continuum of care. Improving overall care integration will increase provider-specific and system capacity, satisfaction, quality of life and outcomes. We conducted a consensus generating symposium comprised of 60 experts from different stakeholder groups: Allied & Mental Health, Education, First Nations & Métis Health, Advocates, Primary Care, Government Health Policy, Regional FASD Coordinators, Social Services, and Youth Justice. Research questions addressed barriers and solutions to integration across systems and group-specific and system-wide research priorities. Solutions and consensus on prioritized lists were generated by combining the Electronic Meeting System approach with a modified 'Nominal Group Technique'. FASD capacity (e.g., training, education, awareness) needs to be increased in both medical and non-medical providers. Outcomes and integration will be improved by implementing: multidisciplinary primary care group practice models, FASD system navigators/advocates, and patient centred medical homes. Electronic medical records that are accessible to multiple medical and non-medical providers are a key tool to enhancing integration and quality. Eligibility criteria for services are a main barrier to integration across systems. There is a need for culturally and community-specific approaches for First Nations communities. There is a need to better integrate care for individuals and families living with FASD. Primary Care is well positioned to play a central and important role in facilitating and

A randomised controlled trial of a cognitive behavioural intervention for women who have menopausal symptoms following breast cancer treatment (MENOS 1: Trial protocol

Directory of Open Access Journals (Sweden)

Hellier Jennifer

2011-01-01

of medical services measure at six months post-randomisation. Discussion MENOS 1 is the first randomised controlled trial of cognitive behavioural therapy for hot flushes and night sweats that measures both self-reported and physiologically indexed symptoms. The results will inform future clinical practice by developing an evidence-based, non-medical treatment, which can be delivered by trained health professionals. Trial Registration Current Controlled Trials ISRCTN13771934

Perspectives on Health among Adult Users of Illicit Stimulant Drugs in Rural Ohio

Science.gov (United States)

Siegal, Harvey A.; Draus, Paul J.; Carlson, Robert G.; Falck, Russel S.; Wang, Jichuan

2006-01-01

Context: Although the nonmedical use of stimulant drugs such as cocaine and methamphetamine is increasingly common in many rural areas of the United States, little is known about the health beliefs of people who use these drugs. Purpose: This research describes illicit stimulant drug users' views on health and health-related concepts that may…

The Misuse of Prescription Opioids: A Threat for Europe?

NARCIS (Netherlands)

van Amsterdam, Jan; van den Brink, Wim

2015-01-01

In the the past two decades the medical use of prescription opioids (POs), in particular oxycodone, increased up to 14-fold in the U.S. and Canada. The high consumption of these pain relievers also led to non-medical use and abuse of these substances which in turn resulted in a dramatic increase in

Knowledge, attitude and practice of female genital mutilation among ...

African Journals Online (AJOL)

McRoy

International Journal of Medicine and Biomedical Research. Volume 2 Issue 1 January – April 2013 www.ijmbr.com ... female genital organs for non-medical reasons.[1] The various terms emerged in an attempt to balance varying .... cannot be said to be a done deal in Bayelsa state. Of greater concern is the fact that health.

The Role of Ultrasound in Graduate Anatomy Education: Current State of Integration in the United States and Faculty Perceptions

Science.gov (United States)

Royer, Danielle F.

2016-01-01

Ultrasound (US) is increasingly taught in medical schools, where it has been shown to be a valuable adjunct to anatomy training. To determine the extent of US training in nonmedical anatomy programs, and evaluate anatomists' perceptions on the role of US in anatomy education, an online survey was distributed to faculty in anatomy Master's and…

Injection of Vaseline under Penis Skin for the Purpose of Penis Augmentation

OpenAIRE

Karakan, Tolga; Ersoy, Erim; Hasçiçek, Metin; Özgür, Berat Cem; Özcan, Serkan; Aydın, Arif

2012-01-01

Penile foreign body injection is an uncommon entity produced by penile paraffin, mineral oil, and vaseline injections for the purpose of penile enlargement. Generally, penile subcutaneous and glandular injections for penile augmentation are performed by a nonmedical person, under unacceptable conditions. It will be an aim to share our experiences about penile vaseline injection.

Injection of Vaseline under Penis Skin for the Purpose of Penis Augmentation.

Science.gov (United States)

Karakan, Tolga; Ersoy, Erim; Hasçiçek, Metin; Ozgür, Berat Cem; Ozcan, Serkan; Aydın, Arif

2012-01-01

Penile foreign body injection is an uncommon entity produced by penile paraffin, mineral oil, and vaseline injections for the purpose of penile enlargement. Generally, penile subcutaneous and glandular injections for penile augmentation are performed by a nonmedical person, under unacceptable conditions. It will be an aim to share our experiences about penile vaseline injection.

Relationship Between Broiler Body Weights, Eimeria maxima Gross Lesion Scores, and Microscores in Three Anticoccidial Sensitivity Tests.

Science.gov (United States)

Barrios, Miguel A; Da Costa, Manuel; Kimminau, Emily; Fuller, Lorraine; Clark, Steven; Pesti, Gene; Beckstead, Robert

2017-06-01

Anticoccidial sensitivity tests (ASTs) serve to determine the efficacy of anticoccidial drugs against Eimeria field isolates in a controlled laboratory setting. The most commonly measured parameters are body weight gain, feed conversion ratio, gross intestinal lesion scores, and mortality. Due to the difficulty in reliably scoring gross lesion scores of Eimeria maxima , microscopic analysis of intestinal scrapings (microscores) can be used in the field to indicate the presence of this particular Eimeria. The goal of this study was to determine the relationship between E. maxima microscores and broiler body weights and gross E. maxima lesion scores in three ASTs. Day-old broiler chicks were raised for 12 days on a standard corn-soy diet. On Day 12, chicks were placed in Petersime batteries and treatment diets were provided. There were six birds per pen, four pens per treatment, and 12 treatments, for a total of 288 chicks per AST. The treatments were as follows: 1) nonmedicated, noninfected; 2) nonmedicated, infected; 3) lasalocid, infected; 4) salinomycin, infected; 5) diclazuril, infected; 6) monensin, infected; 7) decoquinate, infected; 8) narasin + nicarbazin, infected; 9) narasin, infected; 10) nicarbazin, infected; 11) robenidine, infected; and 12) zoalene, infected. On Day 14, chicks were challenged with an Eimeria field isolate by oral gavage. On Day 20, broilers were weighed, and gross lesion scores and microscores were classified from 0 to 4 depending on the severity of the gross lesion scores and E. maxima microscores. Data from three trials using different field isolates were statistically analyzed using a logarithmic regression model. There was no relationship (P = 0.1224) between microscores and body weight gain. There was a positive relationship between microscores and gross lesion scores (P = 0.004). However, there was also an interaction between isolate and treatment (P Eimeria or the amount of E. maxima in the inoculum.

Cost-of-illness analysis of type 2 diabetes mellitus in Iran.

Directory of Open Access Journals (Sweden)

Mehdi Javanbakht

Full Text Available Diabetes is a worldwide high prevalence chronic progressive disease that poses a significant challenge to healthcare systems. The aim of this study is to provide a detailed economic burden of diagnosed type 2 diabetes mellitus (T2DM and its complications in Iran in 2009 year.This is a prevalence-based cost-of-illness study focusing on quantifying direct health care costs by bottom-up approach. Data on inpatient hospital services, outpatient clinic visits, physician services, drugs, laboratory test, education and non-medical cost were collected from two national registries. The human capital approach was used to calculate indirect costs separately in male and female and also among different age groups.The total national cost of diagnosed T2DM in 2009 is estimated at 3.78 billion USA dollars (USD including 2.04±0.28 billion direct (medical and non-medical costs and indirect costs of 1.73 million. Average direct and indirect cost per capita was 842.6±102 and 864.8 USD respectively. Complications (48.9% and drugs (23.8% were main components of direct cost. The largest components of medical expenditures attributed to diabetes's complications are cardiovascular disease (42.3% of total Complications cost, nephropathy (23% and ophthalmic complications (14%. Indirect costs include temporarily disability (335.7 million, permanent disability (452.4 million and reduced productivity due to premature mortality (950.3 million.T2DM is a costly disease in the Iran healthcare system and consume more than 8.69% of total health expenditure. In addition to these quantified costs, T2DM imposes high intangible costs on society in terms of reduced quality of life. Identification of effective new strategies for the control of diabetes and its complications is a public health priority.

Socio-demographic factors related to under-diagnosis of childhood asthma in Upper Silesia, Poland.

Science.gov (United States)

Zejda, Jan E; Farnik, Małgorzata; Smółka, Irena; Lawson, Joshua; Brożek, Grzegorz M

2017-06-07

Introduction. The presented study of 4,535 children aged 7-17 years in the Upper Silesian region of Poland yielded 186 cases of previously known asthma, and 44 children with newly diagnosed asthma. The aim of the presented study was to identify non-medical factors that could explain why children with a newly established diagnosis ('undiagnosed asthma') had not been diagnosed in the past. Materials and method. The study was performed according to a case-control design. Parents of the children answered questionnaires on socio-economic status and family-related factors. Statistical determinants of undiagnosed asthma were explored using raw (OR) and logistic odds ratios with their 95% confidence intervals (logOR, 95%CI). Results. Children with undiagnosed asthma were younger compared to the group with previously known asthma (11.3±2.1 vs. 12.6±2.5 years; p=0.0008). Newly diagnosed cases were more frequent in children who had less parental attention (less than 1 hour/day spent by parent with child - OR=4.36; 95%CI: 1.76-10.81) and who were not registered with specialized health care (OR=2.20; 95%CI: 0.95-5.06). Results of logistic regression analysis suggest that under-diagnosis of asthma is related to age below 12 years - logOR = 3.59 (95%CI: 1.28-10.36), distance to a health centre > 5 km - logOR = 3.45 (95%CI: 1.05-11.36), time spent with child Conclusion. Among non-medical determinants of undiagnosed asthma the age of a child plays a major role. Another factors of importance is the large distance between residence and health centre, and low parental attention at home.

Statewide Quality Improvement Initiative to Reduce Early Elective Deliveries and Improve Birth Registry Accuracy.

Science.gov (United States)

Kaplan, Heather C; King, Eileen; White, Beth E; Ford, Susan E; Fuller, Sandra; Krew, Michael A; Marcotte, Michael P; Iams, Jay D; Bailit, Jennifer L; Bouchard, Jo M; Friar, Kelly; Lannon, Carole M

2018-04-01

To evaluate the success of a quality improvement initiative to reduce early elective deliveries at less than 39 weeks of gestation and improve birth registry data accuracy rapidly and at scale in Ohio. Between February 2013 and March 2014, participating hospitals were involved in a quality improvement initiative to reduce early elective deliveries at less than 39 weeks of gestation and improve birth registry data. This initiative was designed as a learning collaborative model (group webinars and a single face-to-face meeting) and included individual quality improvement coaching. It was implemented using a stepped wedge design with hospitals divided into three balanced groups (waves) participating in the initiative sequentially. Birth registry data were used to assess hospital rates of nonmedically indicated inductions at less than 39 weeks of gestation. Comparisons were made between groups participating and those not participating in the initiative at two time points. To measure birth registry accuracy, hospitals conducted monthly audits comparing birth registry data with the medical record. Associations were assessed using generalized linear repeated measures models accounting for time effects. Seventy of 72 (97%) eligible hospitals participated. Based on birth registry data, nonmedically indicated inductions at less than 39 weeks of gestation declined in all groups with implementation (wave 1: 6.2-3.2%, Pinitiative, they saw significant decreases in rates of early elective deliveries as compared with wave 3 (control; P=.018). All waves had significant improvement in birth registry accuracy (wave 1: 80-90%, P=.017; wave 2: 80-100%, P=.002; wave 3: 75-100%, Pinitiative enabled statewide spread of change strategies to decrease early elective deliveries and improve birth registry accuracy over 14 months and could be used for rapid dissemination of other evidence-based obstetric care practices across states or hospital systems.

[Pharmacist as gatekeeper: combating medication abuse and dependence].

Science.gov (United States)

Shimane, Takuya

2013-01-01

  The nonmedical use of medications, including psychotropic drugs, is a growing health problem in Japan. According to a nationwide survey of mental hospitals, the proportion of patients with sedative (mainly benzodiazepine)-related disorders has more than doubled over the last decade. An association between psychotropic drug overdose and suicide risk has also been reported. Furthermore, over-the-counter drug abuse is still a serious problem in Japan. In recent years, pharmacists have been expected to act as gatekeepers, making timely identifications of suicide risk or substance abuse and directing these individuals to appropriate medical care facilities. In August 2012, the revised Comprehensive Suicide Measures Act identified pharmacists as one professional group that should act as gatekeepers. This article begins by reviewing the fundamental terms involved in understanding the nonmedical use of medications, including abuse, dependence, and intoxication. The current situation of substance abuse and dependence is then introduced through a summary of several epidemiological surveys conducted in Japan. Finally, the role of pharmacists as gatekeepers in preventing substance abuse and dependence on medications is discussed.

Consumer behavior in OTC medicines market.

Science.gov (United States)

Woźniak-Holecka, Joanna; Grajek, Mateusz; Siwozad, Karolina; Mazgaj, Kamila; Czech, Elzbieta

2012-01-01

Over-the-counter (OTC) drugs are pharmaceuticals sold without a medical prescription. The goal of the paper was to evaluate the awareness in the studied group of people concerning purchasing and usage of the OTC drugs. The essence of the research was to determine whether factors as: education, income, type and place of work influence purchase and use of OTC drugs. Four equal groups (100 people each) were studied by an anonymous questionnaire. Two occupational groups: nurses and people working outside the medical sector, and also 2 student groups--from medical and non-medical schools living in Silesia. Respondents answered 47 questions. Data received from the questionnaire were statistically analyzed by means of the Chi2 test (p drugs. The respondents mainly buy the medicines in pharmacies. People connected with medical sector more often take pharmacists' advice and opinion than people from non-medical sector. The majority of the respondents are not familiar with chemical composition of the OTC drugs they take. Among them medical staff and medical schools students are to be found.

KNOWLEDGE AND AWARENESS REGARDING BIOMEDICAL WASTE MANAGEMENT AMONG EMPLOYEES OF A TERTIARY CARE HOSPITAL

Directory of Open Access Journals (Sweden)

Manoj Bansal

2013-05-01

Full Text Available Background: A hospital is an establishment where the persons suffering with the variety of communicable and non communicable diseases are visiting to take medical care facilities. Hospitals and other healthcare establishments in India produce a significant quantity of waste, posing serious problems for its disposal, an issue that has received scant attention. Objective: To assess the level of knowledge regarding biomedical waste and its management among hospital personnel. Material and Methods: The present study was a cross sectional study carried out in a tertiary care hospital of Gwalior in year 2008. Medical, para-medical and non-medical personnel working at their current position for at least 6 months were included as study participants. Self made scoring system was used to categorize the participants as having Good, Average and Poor knowledge. Statistical Analysis: Percentage and Proportion were applied to interpret the result. Results: The score was highest for medical and least for non-medical staff. Conclusion: The present study concludes that regular training programs should be organized about the guidelines and rules of biomedical waste management at all level.

[Ethical Evaluation of Non-Therapeutic Male Circumcision].

Science.gov (United States)

İzgi, M Cumhur

2015-01-01

Elective circumcision for nonmedical reasons is a surgical approach which is historically long standing and accepted as the most performed procedure. The necessity of the procedure is usually for religious and traditional reasons alongside some medical ground related benefits to enable its social acceptability. The discussion of the subject from the aspect of ethics becomes necessary as there is no consensus about the benefits or harmfulness of nonmedical circumcision. Fundamental ethical discussions about circumcision, which contradicts legal acceptance criteria of any medical application, are related to the basic concepts of the existence of an individual such as sovereignty, the loss of bodily integrity, and privacy. The recent legal processes and the fact that the European Council and the American Academy of Pediatrics have put the issue on their agenda have increased the necessity of these ethical evaluations. The responsibility of consideration and evaluation of ethical permission of every circumcision procedure, besides discussing the necessity of circumcision for improvement and protection of health rests on the shoulders of the physicians because the dignity and intellectual identity of the profession require so.

Complementary and Alternative Medicine: A Clinical Study in 1,016 Hematology/Oncology Patients.

Science.gov (United States)

Hierl, Marina; Pfirstinger, Jochen; Andreesen, Reinhard; Holler, Ernst; Mayer, Stephanie; Wolff, Daniel; Vogelhuber, Martin

2017-01-01

Surveys state a widespread use of complementary and alternative medicine (CAM) in patients with malignant diseases. CAM methods might potentially interfere with the metabolization of tumor-specific therapy. However, there is little communication about CAM use in hematology/oncology patients between patients, CAM providers, and oncologists. A self-administered questionnaire was handed out to all patients attending to the hematology/oncology outpatient clinic of Regensburg University Hospital. Subsequently, a chart review of all CAM users was performed. Questionnaires of 1,016 patients were analyzed. Of these patients, 30% used CAM, preferably vitamins and micronutrients. Main information sources for CAM methods were physicians/nonmedical practitioners and friends/relatives. CAM therapies were provided mainly by licensed physicians (29%), followed by nonmedical practitioners (14%) and the patients themselves (13%). Although 62% of the CAM users agreed that the oncologist may know about their CAM therapy, a chart entry about CAM use was found only in 41%. CAM is frequently used by hematology/oncology patients. Systematic communication about CAM is essential to avoid possible drug interactions. © 2017 S. Karger AG, Basel.

Effects of in ovo supplementation of probiotics on performance and immunocompetence of broiler chicks to an Eimeria challenge.

Science.gov (United States)

Pender, C M; Kim, S; Potter, T D; Ritzi, M M; Young, M; Dalloul, R A

2016-11-30

Coccidiosis is regarded as the parasitic disease with the greatest economic impact on the poultry industry due to reduced performance and increased mortality. A study was conducted to investigate the effects of in ovo administration of probiotics on hatchability, performance, immune organ weights, and lesion scores in broiler chicks during a mixed Eimeria infection. At embryonic day 18, 210 eggs were injected with either sterile water or 1×10 6 cfu probiotic bacteria. On day 3 post-hatch, half of the chicks from each treatment group were challenged with a mixed inoculum of Eimeria acervulina, Eimeria maxima and Eimeria tenella. Measurements and tissue samples were taken on day of hatch (DOH) and days 3, 9 and 15. On day 9, 24 birds per treatment were scored for intestinal Eimeria lesions. No differences were seen among groups for hatchability as well as for body weight (BW), BW gain (BWG), or immune organ weights prior to the Eimeria challenge. On day 9, the non-challenged birds with probiotic supplementation had higher BW and BWG than the non-supplemented controls while no differences were seen among the challenged groups. On day 15, probiotic supplemented birds had improved BW compared to the non-supplemented birds as well as increased BWG from day 9 to 15. Bursa weight was not affected by treatment at any time point while spleen weight was greater in supplemented birds on day 15. Birds receiving the probiotic had significantly lower mortality than non-treated birds. Additionally, gross lesion severity was reduced due to probiotic supplementation in all intestinal segments evaluated. These results suggest that in ovo supplementation of probiotics may improve early performance and provide protection against a mixed Eimeria infection.

RACOON: a multiuser QoS design for mobile wireless body area networks.

Science.gov (United States)

Cheng, Shihheng; Huang, Chingyao; Tu, Chun Chen

2011-10-01

In this study, Random Contention-based Resource Allocation (RACOON) medium access control (MAC) protocol is proposed to support the quality of service (QoS) for multi-user mobile wireless body area networks (WBANs). Different from existing QoS designs that focus on a single WBAN, a multiuser WBAN QoS should further consider both inter-WBAN interference and inter-WBAN priorities. Similar problems have been studied in both overlapped wireless local area networks (WLANs) and Bluetooth piconets that need QoS supports. However, these solutions are designed for non-medical transmissions that do not consider any priority scheme for medical applications. Most importantly, these studies focus on only static or low mobility networks. Network mobility of WBANs will introduce unnecessary inter-network collisions and energy waste, which are not considered by these solutions. The proposed multiuser-QoS protocol, RACOON, simultaneously satisfies the inter WBAN QoS requirements and overcomes the performance degradation caused by WBAN mobility. Simulation results verify that RACOON provides better latency and energy control, as compared with WBAN QoS protocols without considering the inter-WBAN requirements.

The Debreather and NuTech: A Reply to Kleespies

Science.gov (United States)

Ogden, Russel D.

2010-01-01

This article responds to Phillip Kleespies's (2010/this issue) commentary on NuTech fieldworkers and their use of the debreather. Non-medical assistance with suicide raises legitimate concerns about accountability, public safety, and care for those who are suffering. Given that suicide is not a crime, an outcome of the NuTech movement may be that…

School Sports and Adolescent Steroid Use: National Trends and Race-Ethnic Variations

Science.gov (United States)

Hua, Lv; Braddock, Jomills Henry, II

2008-01-01

In the United States, it has been reported that 4% to 12% of male adolescents and 0.5% to 2.9% of female adolescents have used anabolic steroids to enhance sports performance or favorably alter body size. Although medical, legal, and ethical issues related to the nonmedical use of anabolic steroids have been widely publicized, a growing number of…

Toward a Rational View of Hallucinogenic Drugs.

Science.gov (United States)

McGlothlin, William H.

The enactment of California's "LSD Bill" is presented as an example of poor judgment in drug legislation on the state level. An appraisal of the nonmedical use of hallucinogens centering around the types of users, and the results of drug use, shows that the principal social impact of hallucinogens is on the personalities and values of the users.…

Anabolic Steroids: A Threat to Body and Mind. National Institute on Drug Abuse Research Report Series.

Science.gov (United States)

National Inst. on Drug Abuse (DHHS/PHS), Rockville, MD.

This report, based on findings of recent studies on the use of anabolic steroids in the United States, was written to educate the public about these drugs and the dangers of misusing them. It notes that the nonmedical use of anabolic/androgenic steroids among adolescents and young adults is of growing concern, with possibly as many as half a…

Injection of Vaseline under Penis Skin for the Purpose of Penis Augmentation

Directory of Open Access Journals (Sweden)

Tolga Karakan

2012-01-01

Full Text Available Penile foreign body injection is an uncommon entity produced by penile paraffin, mineral oil, and vaseline injections for the purpose of penile enlargement. Generally, penile subcutaneous and glandular injections for penile augmentation are performed by a nonmedical person, under unacceptable conditions. It will be an aim to share our experiences about penile vaseline injection.

Telerehabilitation to improve outcomes for people with stroke: study protocol for a randomised controlled trial

Directory of Open Access Journals (Sweden)

Saywell Nicola

2012-12-01

Full Text Available Abstract Background In New Zealand, around 45,000 people live with stroke and many studies have reported that benefits gained during initial rehabilitation are not sustained. Evidence indicates that participation in physical interventions can prevent the functional decline that frequently occurs after discharge from acute care facilities. However, on-going stroke services provision following discharge from acute care is often related to non-medical factors such as availability of resources and geographical location. Currently most people receive no treatment beyond three months post stroke. The study aims to determine if the Augmented Community Telerehabilitation Intervention (ACTIV results in better physical function for people with stroke than usual care, as measured by the Stroke Impact Scale, physical subcomponent. Methods/design This study will use a multi-site, two-arm, assessor blinded, parallel randomised controlled trial design. People will be eligible if they have had their first ever stroke, are over 20 and have some physical impairment in either arm or leg, or both. Following discharge from formal physiotherapy services (inpatient, outpatient or community, participants will be randomised into ACTIV or usual care. ACTIV uses readily available technology, telephone and mobile phones, combined with face-to-face visits from a physiotherapist over a six-month period, to help people with stroke resume activities they enjoyed before the stroke. The impact of stroke on physical function and quality of life will be assessed, measures of cost will be collected and a discrete choice survey will be used to measure preferences for rehabilitation options. These outcomes will be collected at baseline, six months and 12 months. In-depth interviews will be used to explore the experiences of people participating in the intervention arm of the study. Discussion The lack of on-going rehabilitation for people with stroke diminishes the chance of their