Using the Job Burden-Capital Model of Occupational Stress to Predict Depression and Well-Being among Electronic Manufacturing Service Employees in China

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Chao Wang

2016-08-01

Full Text Available Background: This study aimed to identify the association between occupational stress and depression-well-being by proposing a comprehensive and flexible job burden-capital model with its corresponding hypotheses. Methods: For this research, 1618 valid samples were gathered from the electronic manufacturing service industry in Hunan Province, China; self-rated questionnaires were administered to participants for data collection after obtaining their written consent. The proposed model was fitted and tested through structural equation model analysis. Results: Single-factor correlation analysis results indicated that coefficients between all items and dimensions had statistical significance. The final model demonstrated satisfactory global goodness of fit (CMIN/DF = 5.37, AGFI = 0.915, NNFI = 0.945, IFI = 0.952, RMSEA = 0.052. Both the measurement and structural models showed acceptable path loadings. Job burden and capital were directly associated with depression and well-being or indirectly related to them through personality. Multi-group structural equation model analyses indicated general applicability of the proposed model to basic features of such a population. Gender, marriage and education led to differences in the relation between occupational stress and health outcomes. Conclusions: The job burden-capital model of occupational stress-depression and well-being was found to be more systematic and comprehensive than previous models.

Using the Job Burden-Capital Model of Occupational Stress to Predict Depression and Well-Being among Electronic Manufacturing Service Employees in China.

Science.gov (United States)

Wang, Chao; Li, Shuang; Li, Tao; Yu, Shanfa; Dai, Junming; Liu, Xiaoman; Zhu, Xiaojun; Ji, Yuqing; Wang, Jin

2016-08-12

This study aimed to identify the association between occupational stress and depression-well-being by proposing a comprehensive and flexible job burden-capital model with its corresponding hypotheses. For this research, 1618 valid samples were gathered from the electronic manufacturing service industry in Hunan Province, China; self-rated questionnaires were administered to participants for data collection after obtaining their written consent. The proposed model was fitted and tested through structural equation model analysis. Single-factor correlation analysis results indicated that coefficients between all items and dimensions had statistical significance. The final model demonstrated satisfactory global goodness of fit (CMIN/DF = 5.37, AGFI = 0.915, NNFI = 0.945, IFI = 0.952, RMSEA = 0.052). Both the measurement and structural models showed acceptable path loadings. Job burden and capital were directly associated with depression and well-being or indirectly related to them through personality. Multi-group structural equation model analyses indicated general applicability of the proposed model to basic features of such a population. Gender, marriage and education led to differences in the relation between occupational stress and health outcomes. The job burden-capital model of occupational stress-depression and well-being was found to be more systematic and comprehensive than previous models.

Using the Job Burden-Capital Model of Occupational Stress to Predict Depression and Well-Being among Electronic Manufacturing Service Employees in China

Science.gov (United States)

Wang, Chao; Li, Shuang; Li, Tao; Yu, Shanfa; Dai, Junming; Liu, Xiaoman; Zhu, Xiaojun; Ji, Yuqing; Wang, Jin

2016-01-01

Background: This study aimed to identify the association between occupational stress and depression-well-being by proposing a comprehensive and flexible job burden-capital model with its corresponding hypotheses. Methods: For this research, 1618 valid samples were gathered from the electronic manufacturing service industry in Hunan Province, China; self-rated questionnaires were administered to participants for data collection after obtaining their written consent. The proposed model was fitted and tested through structural equation model analysis. Results: Single-factor correlation analysis results indicated that coefficients between all items and dimensions had statistical significance. The final model demonstrated satisfactory global goodness of fit (CMIN/DF = 5.37, AGFI = 0.915, NNFI = 0.945, IFI = 0.952, RMSEA = 0.052). Both the measurement and structural models showed acceptable path loadings. Job burden and capital were directly associated with depression and well-being or indirectly related to them through personality. Multi-group structural equation model analyses indicated general applicability of the proposed model to basic features of such a population. Gender, marriage and education led to differences in the relation between occupational stress and health outcomes. Conclusions: The job burden-capital model of occupational stress-depression and well-being was found to be more systematic and comprehensive than previous models. PMID:27529267

Burden of depressive disorders by country, sex, age, and year: findings from the global burden of disease study 2010.

Directory of Open Access Journals (Sweden)

Alize J Ferrari

2013-11-01

Full Text Available Depressive disorders were a leading cause of burden in the Global Burden of Disease (GBD 1990 and 2000 studies. Here, we analyze the burden of depressive disorders in GBD 2010 and present severity proportions, burden by country, region, age, sex, and year, as well as burden of depressive disorders as a risk factor for suicide and ischemic heart disease.Burden was calculated for major depressive disorder (MDD and dysthymia. A systematic review of epidemiological data was conducted. The data were pooled using a Bayesian meta-regression. Disability weights from population survey data quantified the severity of health loss from depressive disorders. These weights were used to calculate years lived with disability (YLDs and disability adjusted life years (DALYs. Separate DALYs were estimated for suicide and ischemic heart disease attributable to depressive disorders. Depressive disorders were the second leading cause of YLDs in 2010. MDD accounted for 8.2% (5.9%-10.8% of global YLDs and dysthymia for 1.4% (0.9%-2.0%. Depressive disorders were a leading cause of DALYs even though no mortality was attributed to them as the underlying cause. MDD accounted for 2.5% (1.9%-3.2% of global DALYs and dysthymia for 0.5% (0.3%-0.6%. There was more regional variation in burden for MDD than for dysthymia; with higher estimates in females, and adults of working age. Whilst burden increased by 37.5% between 1990 and 2010, this was due to population growth and ageing. MDD explained 16 million suicide DALYs and almost 4 million ischemic heart disease DALYs. This attributable burden would increase the overall burden of depressive disorders from 3.0% (2.2%-3.8% to 3.8% (3.0%-4.7% of global DALYs.GBD 2010 identified depressive disorders as a leading cause of burden. MDD was also a contributor of burden allocated to suicide and ischemic heart disease. These findings emphasize the importance of including depressive disorders as a public-health priority and implementing

The burden of mental disorders in the Eastern Mediterranean region, 1990-2015: findings from the global burden of disease 2015 study.

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2017-08-03

Mental disorders are among the leading causes of nonfatal burden of disease globally. We used the global burden of diseases, injuries, and risk factors study 2015 to examine the burden of mental disorders in the Eastern Mediterranean region (EMR). We defined mental disorders according to criteria proposed in the diagnostic and statistical manual of mental disorders IV and the 10th International Classification of Diseases. Mental disorders contributed to 4.7% (95% uncertainty interval (UI) 3.7-5.6%) of total disability-adjusted life-years (DALYs), ranking as the ninth leading cause of disease burden. Depressive disorders and anxiety disorders were the third and ninth leading causes of nonfatal burden, respectively. Almost all countries in the EMR had higher age-standardized mental disorder DALYs rates compared to the global level, and in half of the EMR countries, observed mental disorder rates exceeded the expected values. The burden of mental disorders in the EMR is higher than global levels, particularly for women. To properly address this burden, EMR governments should implement nationwide quality epidemiological surveillance of mental disorders and provide adequate prevention and treatment services.

The prevalence and burden of mental and substance use disorders in Australia: Findings from the Global Burden of Disease Study 2015.

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Ciobanu, Liliana G; Ferrari, Alize J; Erskine, Holly E; Santomauro, Damian F; Charlson, Fiona J; Leung, Janni; Amare, Azmeraw T; Olagunju, Andrew T; Whiteford, Harvey A; Baune, Bernhard T

2018-05-01

Timely and accurate assessments of disease burden are essential for developing effective national health policies. We used the Global Burden of Disease Study 2015 to examine burden due to mental and substance use disorders in Australia. For each of the 20 mental and substance use disorders included in Global Burden of Disease Study 2015, systematic reviews of epidemiological data were conducted, and data modelled using a Bayesian meta-regression tool to produce prevalence estimates by age, sex, geography and year. Prevalence for each disorder was then combined with a disorder-specific disability weight to give years lived with disability, as a measure of non-fatal burden. Fatal burden was measured as years of life lost due to premature mortality which were calculated by combining the number of deaths due to a disorder with the life expectancy remaining at the time of death. Disability-adjusted life years were calculated by summing years lived with disability and years of life lost to give a measure of total burden. Uncertainty was calculated around all burden estimates. Mental and substance use disorders were the leading cause of non-fatal burden in Australia in 2015, explaining 24.3% of total years lived with disability, and were the second leading cause of total burden, accounting for 14.6% of total disability-adjusted life years. There was no significant change in the age-standardised disability-adjusted life year rates for mental and substance use disorders from 1990 to 2015. Global Burden of Disease Study 2015 found that mental and substance use disorders were leading contributors to disease burden in Australia. Despite several decades of national reform, the burden of mental and substance use disorders remained largely unchanged between 1990 and 2015. To reduce this burden, effective population-level preventions strategies are required in addition to effective interventions of sufficient duration and coverage.

Oxidative stress and neurological disorders in relation to blood lead levels in children.

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Ahamed, M; Fareed, Mohd; Kumar, A; Siddiqui, W A; Siddiqui, M K J

2008-01-01

Oxidative stress plays a pivotal role in the pathogenesis of neurological disorders. Free radical generation appears to be the mode of lead toxicity. We evaluated the effects of blood lead levels on oxidative stress parameters in children suffering from neurological disorders. Thirty children (aged 3-12 years) with neurological disorders (cerebral palsy [n = 12], seizures [n = 11], and encephalopathy [n = 7]) were recruited in the study group. Sixty healthy children (aged 3-12 years) from similar socio-economic environments and not suffering from any chronic disease were taken as the controls. Blood lead levels and oxidant/antioxidant status were determined. Mean blood lead level was significantly higher while delta-aminolevulinic acid dehydratase (delta-ALAD) activity, a biomarker for lead exposure, was significantly lower in the study group as compared to the control group (P children with neurological disorders. Lead-induced oxidative stress as an underlying mechanism for neurological diseases in children warranted further investigation.

Fatigue as Presenting Symptom and a High Burden of Premature Ventricular Contractions Are Independently Associated With Increased Ventricular Wall Stress in Patients With Normal Left Ventricular Function.

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van Huls van Taxis, Carine F B; Piers, Sebastiaan R D; de Riva Silva, Marta; Dekkers, Olaf M; Pijnappels, Daniël A; Schalij, Martin J; Wijnmaalen, Adrianus P; Zeppenfeld, Katja

2015-12-01

High idiopathic premature ventricular contractions (PVC) burden has been associated with PVC-induced cardiomyopathy. Patients may be symptomatic before left ventricular (LV) dysfunction develops. N-terminal pro-B-type natriuretic peptide (NT-proBNP) and circumferential end-systolic wall stress (cESS) on echocardiography are markers for increased ventricular wall stress. This study aimed to evaluate the relation between presenting symptoms, PVC burden, and increased ventricular wall stress in patients with frequent PVCs and preserved LV function. Eighty-three patients (41 men; 49±15 years) with idiopathic PVCs and normal LV function referred for PVC ablation were included. Type of symptoms (palpitations, fatigue, and [near-]syncope), PVC burden on 24-hour Holter, NT-proBNP levels, and cESS on echocardiography were assessed before and 3 months after ablation. Sustained successful ablation was defined as ≥80% PVC burden reduction during follow-up. Patients were symptomatic for 24 months (Q1-Q3, 16-60); 73% reported palpitations, 47% fatigue, and 30% (near-)syncope. Baseline PVC burden was 23±13%, median NT-proBNP 92 pg/mL (Q1-Q3 50-156), and cESS 143±35 kdyne/cm(2). Fatigue was associated with higher baseline NT-proBNP and cESS (PFatigue was independently associated with a significantly larger reduction in NT-proBNP. In patients with nonsuccessful ablation, NT-proBNP and cESS remained unchanged. In patients with frequent PVCs and preserved LV function, fatigue was associated with higher baseline NT-proBNP and cESS, and with a significantly larger reduction in NT-proBNP after sustained successful ablation. These findings support a link between fatigue and PVC-induced increased ventricular wall stress, despite preserved LV function. © 2015 American Heart Association, Inc.

The effectiveness of telehealth care on caregiver burden, mastery of stress, and family function among family caregivers of heart failure patients: a quasi-experimental study.

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Chiang, Li-Chi; Chen, Wan-Chou; Dai, Yu-Tzu; Ho, Yi-Lwun

2012-10-01

Telehealth care was developed to provide home-based monitoring and support for patients with chronic disease. The positive effects on physical outcome have been reported; however, more evidence is required concerning the effects on family caregivers and family function for heart failure patients transitioning from the hospital to home. To evaluate the effectiveness of nursing-led transitional care combining discharge plans and telehealth care on family caregiver burden, stress mastery and family function in family caregivers of heart failure patients compared to those receiving traditional discharge planning only. This is a quasi-experimental study design. Sixty-three patients with heart failure were assessed for eligibility and invited to participate in either telehealth care or standard care in a medical centre from May to October 2010. Three families refused to participate in data collection. Thirty families who chose telehealth care after discharge from the hospital to home comprised the experimental group; the others families receiving discharge planning only comprised the comparison group. Telenursing specialist provided the necessary family nursing interventions by 24-h remote monitoring of patients' health condition and counselling by telephone, helping the family caregivers successfully transition from hospital to home. Data on caregiver burden, stress mastery and family function were collected before discharge from the hospital and one month later at home. Effects of group, time, and group×time interaction were analysed using Mixed Model in SPSS (17.0). Family caregivers in both groups had significantly lower burden, higher stress mastery, and better family function at one-month follow-up compared to before discharge. The total score of caregiver burden, stress mastery and family function was significantly improved for the family caregivers in the experimental group compared to the comparison group at posttest. Two subscales of family function

Development of a stress sensor based on the piezoelectric lead zirconate titanate for impact stress measurement

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Liu, Yiming; Xu, Bin; Li, Lifei; Li, Bing

2012-04-01

The measurement of stress of concrete structures under impact loading and other strong dynamic loadings is crucial for the monitoring of health and damage detection. Due to its main advantages including availability, extremely high rigidity, high natural frequency, wide measuring range, high stability, high reproducibility, high linearity and wide operating temperature range, piezoelectric (Lead Zirconate Titanate, PZT) ceramic materials has been a widely used smart material for both sensing and actuation for monitoring and control in engineering structures. In this paper, a kind of stress sensor based on piezoelectric ceramics for impact stress measuring of concrete structures is developed. Because the PZT is fragile, in order to employ it for the health monitoring of concrete structures, special handling and treatment should be taken to protect the PZT and to make it survive and work properly in concrete. The commercially available PZT patch with lead wires is first applied with an insulation coating to prevent water and moisture damage, and then is packaged by jacketing it by two small precasted cylinder concrete blocks with enough strength to form a smart aggregate (SA). The employed PZT patch has a dimension of 10mm x 10mm x 0.3mm. In order to calibrate the PZT based stress sensor for impact stress measuring, a dropping hammer was designed and calibration test on the sensitivity of the proposed transducer was carried out with an industry charge amplifier. The voltage output of the stress sensor and the impact force under different free falling heights and impact mass were recorded with a high sampling rate data acquisition system. Based on the test measurements, the sensibility of the PZT based stress sensor was determined. Results show that the output of the PZT based stress sensor is proportional to the stress level and the repeatability of the measurement is very good. The self-made piezoelectric stress sensor can be easily embedded in concrete and provide

Lead induced oxidative stress: beneficial effects of Kombucha tea.

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Dipti, P; Yogesh, B; Kain, A K; Pauline, T; Anju, B; Sairam, M; Singh, B; Mongia, S S; Kumar, G Ilavazhagan Devendra; Selvamurthy, W

2003-09-01

To evaluate the effect of oral administration of Kombucha tea (K-tea) on lead induced oxidative stress. Sprague Dawley rats were administered 1 mL of 3.8% lead acetate solution daily alone or in combination with K-tea orally for 45 d, and the antioxidant status and lipid peroxidation were evaluated. Oral administration of lead acetate to rats enhanced lipid peroxidation and release of creatine phosphokinase and decreased levels of reduced glutathione (GSH) and antioxidant enzymes (superoxide dismutase, SOD and glutathione peroxidase, GPx). Lead treatment did not alter humoral immunity, but inhibited DTH response when compared to the control. Lead administration also increased DNA fragmentation in liver. Oral administration of Kombucha tea to rats exposed to lead decreased lipid peroxidation and DNA damage with a concomitant increase in the reduced glutathione level and GPx activity. Kombucha tea supplementation relieved the lead induced immunosuppression to appreciable levels. The results suggest that K-tea has potent antioxidant and immunomodulating properties.

Assessing burden in families of critical care patients.

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Kentish-Barnes, Nancy; Lemiale, Virginie; Chaize, Marine; Pochard, Frédéric; Azoulay, Elie

2009-10-01

To provide critical care clinicians with information on validated instruments for assessing burden in families of critical care patients. PubMed (1979-2009). We included all quantitative studies that used a validated instrument to evaluate the prevalence of, and risk factors for, burden on families. We extracted the descriptions of the instruments used and the main results. Family burden after critical illness can be detected reliably and requires preventive strategies and specific treatments. Using simple face-to-face interviews, intensivists can learn to detect poor comprehension and its determinants. Instruments for detecting symptoms of anxiety, depression, or stress can be used reliably even by physicians with no psychiatric training. For some symptoms, the evaluation should take place at a distance from intensive care unit discharge or death. Experience with families of patients who died in the intensive care unit and data from the literature have prompted studies of bereaved family members and the development of interventions aimed at decreasing guilt and preventing complicated grief. We believe that burden on families should be assessed routinely. In clinical studies, using markers for burden measured by validated tools may provide further evidence that effective communication and efforts to detect and to prevent symptoms of stress, anxiety, or depression provide valuable benefits to families.

Household burden of chronic diseases in Ghana | Togoe | Ghana ...

African Journals Online (AJOL)

Conclusion: The relatively high direct cost of illness among households with person(s) living with NCDs and the associated high indirect burden of illness places undue stress on households. Research requires better measurement of the indirect burden with focus on the household. These findings suggest the necessity of ...

Overprotective social support leads to increased cardiovascular and subjective stress reactivity.

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Zniva, Richard; Pauli, Paul; Schulz, Stefan M

2017-02-01

Self-determination theory suggests that autonomy-enhancing social support helps individuals to perceive stressors as challenging rather than stressing. Overprotective support may reduce stress in the short-run but undermines autonomy, thus hampering stress-coping in the long run, particularly when social support is terminated. Heartrate, blood-pressure and ratings were examined in N=44 undergraduate students receiving autonomy support (calculation steps) or overprotection (solutions) from a close friend or no support for solving arithmetic tasks as well as during a subsequent stress-challenge (solving arithmetic tasks alone). Overprotection resulted in increased heartrate, diastolic blood-pressure, stress ratings, and decreased subjective control during stress-challenge. Autonomy support did not lead to unfavorable stress responding. The current findings are in line with assumptions derived from self-determination theory and indicate that autonomy support can help to prevent stress. Overprotection does not buffer stress and is associated with increased stress when discontinued. Copyright © 2016 Elsevier B.V. All rights reserved.

Effect of Glycine on Lead Mobilization, Lead-Induced Oxidative Stress, and Hepatic Toxicity in Rats

Directory of Open Access Journals (Sweden)

Yolanda Alcaraz-Contreras

2011-01-01

Full Text Available The effectiveness of glycine in treating experimental lead intoxication was examined in rats. Male Wistar rats were exposed to 3 g/L lead acetate in drinking water for 5 weeks and treated thereafter with glycine (100 and 500 mg/kg, orally once daily for 5 days or glycine (1000 mg/kg, orally once daily for 28 days. The effect of these treatments on parameters indicative of oxidative stress (glutathione and malondialdehyde levels, the activity of blood -aminolevulinic acid dehydratase, and lead concentration in blood, liver, kidney, brain, and bone were investigated. Liver samples were observed for histopathological changes. Glycine was found to be effective in (1 increasing glutathione levels; (2 reducing malondialdehyde levels; (3 decreasing lead levels in bone with the highest dose. However, glycine had no effect on lead mobilization when 100 and 500 mg/kg glycine were administered. In microscopic examination, glycine showed a protective effect against lead intoxication.

MicroRNA-target gene responses to lead-induced stress in cotton (Gossypium hirsutum L.).

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He, Qiuling; Zhu, Shuijin; Zhang, Baohong

2014-09-01

MicroRNAs (miRNAs) play key roles in plant responses to various metal stresses. To investigate the miRNA-mediated plant response to heavy metals, cotton (Gossypium hirsutum L.), the most important fiber crop in the world, was exposed to different concentrations (0, 25, 50, 100, and 200 µM) of lead (Pb) and then the toxicological effects were investigated. The expression patterns of 16 stress-responsive miRNAs and 10 target genes were monitored in cotton leaves and roots by quantitative real-time PCR (qRT-PCR); of these selected genes, several miRNAs and their target genes are involved in root development. The results show a reciprocal regulation of cotton response to lead stress by miRNAs. The characterization of the miRNAs and the associated target genes in response to lead exposure would help in defining the potential roles of miRNAs in plant adaptation to heavy metal stress and further understanding miRNA regulation in response to abiotic stress.

Relationships between appraisals of caregiver communication strategies and burden among spouses and adult children.

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Savundranayagam, Marie Y; Orange, J B

2011-11-01

The purpose of this study was to investigate the impact of caregivers' appraisals of the effectiveness of their own communication strategies on caregiver burden when caring for family members with Alzheimer's disease (AD). Family caregivers (N = 84) of participants with AD completed questionnaires appraising communication strategies, problem behaviors, and levels of three types of burden. Hierarchical linear regression models revealed that effective strategies and kinship status were significantly linked with stress burden, whereas effective strategies and problem behaviors were significantly related to relationship burden. Cognitive status of participants with AD significantly predicted objective burden. Caregivers who rated effective strategies as helpful were more likely to experience lower levels of stress and relationship burden. Findings provide preliminary support for understanding mechanisms by which the appraisals of communication strategies influence caregiver burden and justify testing empirically derived communication interventions.

Parasitism and Physiological Trade-Offs in Stressed Capybaras

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Eberhardt, Ayelen T.; Costa, Sebastián A.; Marini, M. Rocío; Racca, Andrea; Baldi, Cecilia J.; Robles, M. Rosario; Moreno, Pablo G.; Beldomenico, Pablo M.

2013-01-01

Parasites play a key role in regulating wildlife population dynamics, but their impact on the host appears to be context-dependent. Evidence indicates that a synergistic interaction between stress, host condition and parasites is implicated in this phenomenon, but more studies are needed to better understand this context-dependency. With the goal to assess the net effect of two types of chronic stress on various host-parasite interactions, we conducted an experiment in capybaras to evaluate the impact of food restriction and physical restraint on the infection intensity of specific gastrointestinal nematodes and coccidia, and how these stressors affected the growth, body condition, and some immuno-physiological parameters. Our hypothesis was that both forms of stress would result in an alteration in the host-parasite interactions, with deteriorated condition and reduced immunological investment leading to high parasite burdens and vice versa. Stressed capybaras had significantly higher coccidia infection intensities; but among individuals that were smaller, those stressed consistently showed lower helminth burdens than controls. Both stress treatments had a marked negative impact on growth and body condition, but concomitantly they had a significant positive effect on some components of the immune system. Our results suggest, on the one hand, that during prolonged periods of stress capybaras preventatively invest in some components of their immunity, such as innate humoural defenses and cells that combat helminths, which could be considered a stress-dependent prophylaxis. On the other hand, stress was found to cause greater infection intensities of protozoans but lower burdens of nematodes, indicating that the relationship between stress, physiological trade-offs and infection depends on the type of parasite in question. Moreover, both findings might be related in a causal way, as one of the immunological parameters enhanced in stressed capybaras is associated with

Checkpoint Kinase Rad53 Couples Leading- and Lagging-Strand DNA Synthesis under Replication Stress.

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Gan, Haiyun; Yu, Chuanhe; Devbhandari, Sujan; Sharma, Sushma; Han, Junhong; Chabes, Andrei; Remus, Dirk; Zhang, Zhiguo

2017-10-19

The checkpoint kinase Rad53 is activated during replication stress to prevent fork collapse, an essential but poorly understood process. Here we show that Rad53 couples leading- and lagging-strand synthesis under replication stress. In rad53-1 cells stressed by dNTP depletion, the replicative DNA helicase, MCM, and the leading-strand DNA polymerase, Pol ε, move beyond the site of DNA synthesis, likely unwinding template DNA. Remarkably, DNA synthesis progresses further along the lagging strand than the leading strand, resulting in the exposure of long stretches of single-stranded leading-strand template. The asymmetric DNA synthesis in rad53-1 cells is suppressed by elevated levels of dNTPs in vivo, and the activity of Pol ε is compromised more than lagging-strand polymerase Pol δ at low dNTP concentrations in vitro. Therefore, we propose that Rad53 prevents the generation of excessive ssDNA under replication stress by coordinating DNA unwinding with synthesis of both strands. Copyright © 2017 Elsevier Inc. All rights reserved.

Cultural differences are reflected in variables associated with carer burden in FTD: a comparison study between India and Australia

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Mekala, Shailaja; Alladi, Suvarna; Chandrasekar, Kammammettu; Fathima, Safiya; M.O.'Connor, Claire; McKinnon, Colleen; Hornberger, Michael; Piguet, Olivier; Hodges, John R.; Mioshi, Eneida

2013-01-01

There is great need to understand variables behind carer burden, especially in FTD. Carer burden is a complex construct, and its factors are likely to vary depending on the type of dementia, carer characteristics and cultural background. OBJECTIVE The present study aimed to compare profiles and severity of carer burden, depression, anxiety and stress in carers of FTD patients in India in comparison to Australia; to investigate which carer variables are associated with carer burden in each country. METHODS Data of 138 participants (69 dyads of carers-patients) from India and Australia (India, n=31; Australia, n=38). Carer burden was assessed with the short Zarit Burden Inventory; carer depression, anxiety and stress were measured with the Depression, Anxiety and Stress-21. Dementia severity was determined with the Frontotemporal Dementia Rating Scale (FTD-FRS), and a range of demographic variables regarding the carer and patient were also obtained. RESULTS Overall, levels of carer burden were not significantly different across India and Australia, despite more hours delivering care and higher dementia severity in India. Variables associated with burden, however, differed between countries, with carer depression, anxiety and stress strongly associated with burden in India. By contrast, depression, stress, and dementia severity were associated with burden in Australia. CONCLUSION This study demonstrated that variables associated with carer burden in FTD differ between cultures. Consequently, cultural considerations should be taken into account when planning for interventions to reduce burden. This study suggests that addressing carers' skills and coping mechanisms are likely to result in more efficacious outcomes than targeting patient symptoms alone. PMID:29213826

Prenatal maternal stress in relation to the effects of prenatal lead exposure on toddler cognitive development.

Science.gov (United States)

Zhou, Leilei; Xu, Jian; Zhang, Jinsong; Yan, Chonghuai; Lin, Yanfen; Jia, Yinan; Hu, Wenjing

2017-03-01

To evaluate the effects of maternal lead exposure during pregnancy on toddler cognitive development and the potential effect modification by maternal stress. We conducted a prospective birth-cohort study in Shanghai from 2010 to 2012 and investigated 225 mother-infant pairs. The mothers were recruited in mid-to-late pregnancy and children were followed up until 24-36 months old. A self-administered Symptom Checklist-90-Revised Scale (SCL-90-R) was used to assess maternal emotional stress during pregnancy. Maternal whole blood lead levels were measured during gestational weeks 28-36. The toddlers' cognitive levels were assessed using the Gesell Development Scale. Multiple linear regression models were established to explore the main effects of prenatal lead exposure on toddlers' cognitive abilities and the modifying effects of maternal stress. Covariate information was collected through interviews, questionnaires and medical records. The mean maternal blood lead concentration was 3.30 (95%CI: 3.05, 3.57) μg/dL. After adjusting for relevant confounders, no significant associations of maternal blood lead concentrations with toddlers' cognitive levels were observed in all five domains of the Gesell scale (P>0.05). However, the interaction between prenatal maternal blood lead and stress was significant in the domains of adaptive behavior, language and social behavior. When stratified by maternal stress levels, compared with non-significant associations (P>0.05) among low (P1-P75) prenatal stress group, adverse associations between maternal blood lead concentrations (log10-transformed) and toddlers' cognitive levels were observed among high (P75-P100) prenatal stress group in the domains of language (β=-33.82, 95%CI: -60.04, -7.59), social behavior (β=-41.00, 95%CI: -63.11, -18.89) and adaptive behavior (β=-17.93, 95%CI: -35.83, -0.03). Prenatal maternal stress may exacerbate the deleterious effects of prenatal exposure to lead on toddler cognitive development

High hydrostatic pressure leads to free radicals accumulation in yeast cells triggering oxidative stress.

Science.gov (United States)

Bravim, Fernanda; Mota, Mainã M; Fernandes, A Alberto R; Fernandes, Patricia M B

2016-08-01

Saccharomyces cerevisiae is a unicellular organism that during the fermentative process is exposed to a variable environment; hence, resistance to multiple stress conditions is a desirable trait. The stress caused by high hydrostatic pressure (HHP) in S. cerevisiae resembles the injuries generated by other industrial stresses. In this study, it was confirmed that gene expression pattern in response to HHP displays an oxidative stress response profile which is expanded upon hydrostatic pressure release. Actually, reactive oxygen species (ROS) concentration level increased in yeast cells exposed to HHP treatment and an incubation period at room pressure led to a decrease in intracellular ROS concentration. On the other hand, ethylic, thermic and osmotic stresses did not result in any ROS accumulation in yeast cells. Microarray analysis revealed an upregulation of genes related to methionine metabolism, appearing to be a specific cellular response to HHP, and not related to other stresses, such as heat and osmotic stresses. Next, we investigated whether enhanced oxidative stress tolerance leads to enhanced tolerance to HHP stress. Overexpression of STF2 is known to enhance tolerance to oxidative stress and we show that it also leads to enhanced tolerance to HHP stress. © FEMS 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The global burden of periodontal disease

DEFF Research Database (Denmark)

Petersen, Poul E; Ogawa, Hiroshi

2012-01-01

Chronic diseases are accelerating globally, advancing across all regions and pervading all socioeconomic classes. Unhealthy diet and poor nutrition, physical inactivity, tobacco use, excessive use of alcohol and psychosocial stress are the most important risk factors. Periodontal disease...... is a component of the global burden of chronic disease, and chronic disease and periodontal disease have the same essential risk factors. In addition, severe periodontal disease is related to poor oral hygiene and to poor general health (e.g. the presence of diabetes mellitus and other systemic diseases......). The present report highlights the global burden of periodontal disease: the ultimate burden of periodontal disease (tooth loss), as well as signs of periodontal disease, are described from World Health Organization (WHO) epidemiological data. High prevalence rates of complete tooth loss are found in upper...

The increasing burden of depression

Directory of Open Access Journals (Sweden)

Lépine J-P

2011-05-01

Full Text Available Jean-Pierre Lépine1, Mike Briley21Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris Unité INSERM 705 CNRS UMR 8206, Université Paris Diderot, Paris, France; 2NeuroBiz Consulting and Communication, Castres, FranceAbstract: Recent epidemiological surveys conducted in general populations have found that the lifetime prevalence of depression is in the range of 10% to 15%. Mood disorders, as defined by the World Mental Health and the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, have a 12-month prevalence which varies from 3% in Japan to over 9% in the US. A recent American survey found the prevalence of current depression to be 9% and the rate of current major depression to be 3.4%. All studies of depressive disorders have stressed the importance of the mortality and morbidity associated with depression. The mortality risk for suicide in depressed patients is more than 20-fold greater than in the general population. Recent studies have also shown the importance of depression as a risk factor for cardiovascular death. The risk of cardiac mortality after an initial myocardial infarction is greater in patients with depression and related to the severity of the depressive episode. Greater severity of depressive symptoms has been found to be associated with significantly higher risk of all-cause mortality including cardiovascular death and stroke. In addition to mortality, functional impairment and disability associated with depression have been consistently reported. Depression increases the risk of decreased workplace productivity and absenteeism resulting in lowered income or unemployment. Absenteeism and presenteeism (being physically present at work but functioning suboptimally have been estimated to result in a loss of $36.6 billion per year in the US. Worldwide projections by the World Health Organization for the year 2030 identify unipolar major depression as the leading cause of disease burden

Food-derived bioactive peptides on inflammation and oxidative stress.

Science.gov (United States)

Chakrabarti, Subhadeep; Jahandideh, Forough; Wu, Jianping

2014-01-01

Chronic diseases such as atherosclerosis and cancer are now the leading causes of morbidity and mortality worldwide. Inflammatory processes and oxidative stress underlie the pathogenesis of these pathological conditions. Bioactive peptides derived from food proteins have been evaluated for various beneficial effects, including anti-inflammatory and antioxidant properties. In this review, we summarize the roles of various food-derived bioactive peptides in inflammation and oxidative stress and discuss the potential benefits and limitations of using these compounds against the burden of chronic diseases.

The burden on informal caregivers of people with bipolar disorder.

Science.gov (United States)

Ogilvie, Alan D; Morant, Nicola; Goodwin, Guy M

2005-01-01

Caregivers of people with bipolar disorder may experience a different quality of burden than is seen with other illnesses. A better understanding of their concerns is necessary to improve the training of professionals working with this population. Conceptualizing caregiver burden in a conventional medical framework may not focus enough on issues important to caregivers, or on cultural and social issues. Perceptions of caregivers about bipolar disorder have important effects on levels of burden experienced. It is important to distinguish between caregivers' experience of this subjective burden and objective burden as externally appraised. Caregivers' previous experiences of health services may influence their beliefs about the illness. Caregiver burden is associated with depression, which affects patient recovery by adding stress to the living environment. The objective burden on caregivers of patients with bipolar disorder is significantly higher than for those with unipolar depression. Caregivers of bipolar patients have high levels of expressed emotion, including critical, hostile, or over-involved attitudes. Several measures have been developed to assess the care burden of patients with depressive disorders, but may be inappropriate for patients with bipolar disorder because of its cyclical nature and the stresses arising from manic and hypomanic episodes. Inter-episode symptoms pose another potential of burden in patients with bipolar disorder. Subsyndromal depressive symptoms are common in this phase of the illness, resulting in severe and widespread impairment of function. Despite the importance of assessing caregiver burden in bipolar disorder, relevant literature is scarce. The specific effects of mania and inter-episode symptoms have not been adequately addressed, and there is a lack of existing measures to assess burden adequately, causing uncertainty regarding how best to structure family interventions to optimally alleviate burden. The relatively few

High-anxious individuals show increased chronic stress burden, decreased protective immunity, and increased cancer progression in a mouse model of squamous cell carcinoma.

Directory of Open Access Journals (Sweden)

Firdaus S Dhabhar

Full Text Available In spite of widespread anecdotal and scientific evidence much remains to be understood about the long-suspected connection between psychological factors and susceptibility to cancer. The skin is the most common site of cancer, accounting for nearly half of all cancers in the US, with approximately 2-3 million cases of non-melanoma cancers occurring each year worldwide. We hypothesized that a high-anxious, stress-prone behavioral phenotype would result in a higher chronic stress burden, lower protective-immunity, and increased progression of the immuno-responsive skin cancer, squamous cell carcinoma. SKH1 mice were phenotyped as high- or low-anxious at baseline, and subsequently exposed to ultraviolet-B light (1 minimal erythemal dose (MED, 3 times/week, 10-weeks. The significant strengths of this cancer model are that it uses a normal, immunocompetent, outbred strain, without surgery/injection of exogenous tumor cells/cell lines, and produces lesions that resemble human tumors. Tumors were counted weekly (primary outcome, and tissues collected during early and late phases of tumor development. Chemokine/cytokine gene-expression was quantified by PCR, tumor-infiltrating helper (Th, cytolytic (CTL, and regulatory (Treg T cells by immunohistochemistry, lymph node T and B cells by flow cytometry, adrenal and plasma corticosterone and tissue vascular-endothelial-growth-factor (VEGF by ELISA. High-anxious mice showed a higher tumor burden during all phases of tumor development. They also showed: higher corticosterone levels (indicating greater chronic stress burden, increased CCL22 expression and Treg infiltration (increased tumor-recruited immuno-suppression, lower CTACK/CCL27, IL-12, and IFN-γ gene-expression and lower numbers of tumor infiltrating Th and CTLs (suppressed protective immunity, and higher VEGF concentrations (increased tumor angiogenesis/invasion/metastasis. These results suggest that the deleterious effects of high trait anxiety

Factors Underpinning Caregiver Burden in Frontotemporal Dementia Differ in Spouses and their Children

Science.gov (United States)

Kaizik, Cassandra; Caga, Jashelle; Camino, Julieta; O’Connor, Claire M.; McKinnon, Colleen; Oyebode, Jan R.; Piguet, Olivier; Hodges, John R.; Mioshi, Eneida

2017-01-01

The objectives of this observational study were to (1) compare spousal and child caregiver burden; (2) compare co-resident and live-out child caregiver burden; and (3) investigate factors influencing spousal and child caregiver burden. Data was collected from 90 caregivers of people with frontotemporal degeneration (FTD) recruited from the Frontotemporal Dementia Research Group (Frontier) at Neuroscience Research, Australia. Of this caregiver group, 43 were spousal caregivers and 47 were child caregivers. Caregiver burden and emotional state were evaluated using the short Zarit Burden Interview and the short version of the Depression, Anxiety and Stress Scale-21. The Social Network Index was applied to ascertain the social network of the caregiver, while the Intimate Bond Measure was used to evaluate the current quality of the relationship between the caregiver and the person with dementia. The Frontotemporal Dementia Rating Scale was used to assess severity of dementia. Spousal and child caregivers experienced similar levels of burden, depression, anxiety, and stress, regardless of disease severity. Co-resident child caregivers had smaller social networks and greater burden than live-out caregivers. Dementia severity was key in spousal caregiver burden, whereas caregiver depression was most important in child caregiver burden. Child and spousal caregivers of individuals with FTD share similar levels of burden, influenced by different factors. Future interventions need to account for these differences. PMID:28106550

Neural Circuits via Which Single Prolonged Stress Exposure Leads to Fear Extinction Retention Deficits

Science.gov (United States)

Knox, Dayan; Stanfield, Briana R.; Staib, Jennifer M.; David, Nina P.; Keller, Samantha M.; DePietro, Thomas

2016-01-01

Single prolonged stress (SPS) has been used to examine mechanisms via which stress exposure leads to post-traumatic stress disorder symptoms. SPS induces fear extinction retention deficits, but neural circuits critical for mediating these deficits are unknown. To address this gap, we examined the effect of SPS on neural activity in brain regions…

Burden of Respiratory Syncytial Virus Hospitalizations in Canada

Directory of Open Access Journals (Sweden)

Ian Mitchell

2017-01-01

Full Text Available Objective. To examine the socioeconomic burden of respiratory syncytial virus (RSV disease for Canadian infants hospitalized for the condition. Data and Methods. The descriptive study used data collected in Alberta, Canada, during 2 consecutive RSV seasons. Infants (<1 year of age were included if they had not received palivizumab and were hospitalized with a confirmed diagnosis of RSV. Hospitalization resource use and parental time burden, out-of-pocket costs, lost work productivity, and stress and anxiety were assessed. Results. 13.4% of all infants (n = 67 had intensive care unit (ICU admission, and average ICU stay for these infants was 6.5 days. Families had average out-of-pocket expenses of 736.69 Canadian dollars (CAD $, and the average time both parents spent in hospital was nearly 7 days (164.0 hours. For working parents (n = 43, average absenteeism was 49% and overall work impairment was 77.8%. Parents also exhibited significant parental stress (3.6 on the Parental Stressor Scale: 43.9 state anxiety and 36.9 trait anxiety scores. Conclusions. Results indicate a high burden associated with the hospitalization of an infant due to RSV disease in terms of resource use, time, productivity, costs, and stress, even among a population of infants not considered to be at risk for the condition.

Assessment of the toxic stress of lead on Clarias gariepinus (African ...

African Journals Online (AJOL)

6; 101 –104 (2003). Original article ... The toxic stress of lead on fish was tested employing a 96-hour bioassay test. The ... This work is therefore aimed at ... Water was changed every other day. .... like Sweden, Japan, Switzerland and.

The Global Burden of Cancer 2013

OpenAIRE

2015-01-01

Importance Cancer is among the leading causes of death worldwide. Current estimates of cancer burden in individual countries and regions are necessary to inform local cancer control strategies. Objective To estimate mortality, incidence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) for 28 cancers in 188 countries by sex from 1990 to 2013. Evidence Review The general methodology of the Global Burden of Disease (GBD) 2013 study was us...

Relationship between Mental Health and Burden among Primary Caregivers of Outpatients with Schizophrenia.

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Yu, Wenjun; Chen, Jia; Hu, Jize; Hu, JingChu

2018-01-24

There is growing recognition that caring for a patient with schizophrenia often results in high levels of perceived burden and poorer overall mental health for caregivers. A quantitative cross-sectional design and standardized instruments were used to collect data from 355 primary caregivers of adults in outpatient care with schizophrenia in China. Structural equation modeling was used to examine the association between caregiver burden and mental health among primary caregivers and whether this association is influenced by personality, coping style, and family functioning, based on a diathesis-stress perspective. Goodness-of-fit indices (χ 2 /df = 1.406, GFI = 0.919, CFI = 0.957, etc.) confirmed that the modified model fit the data well. In line with the diathesis-stress model, and with this study's hypotheses, we found that caregiver burden was significantly related to mental health outcomes directly. The final model showed that personality traits, coping style, and family function influenced the relationship between caregiver burden and mental health. The neuroticism personality traits have a direct effect on caregiver burden and family functioning in this sample. Coping style had a direct effect on the caregiver burden, and family functioning had a direct effect on the caregiver burden. Our final model about primary caregivers can be applied clinically to predict mental health outcomes from caregiver burden. © 2018 Family Process Institute.

Oxidative stress status, antioxidant metabolism and polypeptide patterns in Juncus maritimus shoots exhibiting differential mercury burdens in Ria de Aveiro coastal lagoon (Portugal).

Science.gov (United States)

Anjum, Naser A; Duarte, Armando C; Pereira, Eduarda; Ahmad, Iqbal

2014-05-01

This study assessed the oxidative stress status, antioxidant metabolism and polypeptide patterns in salt marsh macrophyte Juncus maritimus shoots exhibiting differential mercury burdens in Ria de Aveiro coastal lagoon at reference and the sites with highest, moderate and the lowest mercury contamination. In order to achieve these goals, shoot-mercury burden and the responses of representative oxidative stress indices, and the components of both non-glutathione- and glutathione-based H2O2-metabolizing systems were analyzed and cross-talked with shoot-polypeptide patterns. Compared to the reference site, significant elevations in J. maritimus shoot mercury and the oxidative stress indices such as H2O2, lipid peroxidation, electrolyte leakage and reactive carbonyls were maximum at the site with highest followed by moderate and the lowest mercury contamination. Significantly elevated activity of non-glutathione-based H2O2-metabolizing enzymes such as ascorbate peroxidase and catalase accompanied the studied damage-endpoint responses, whereas the activity of glutathione-based H2O2-scavenging enzymes glutathione peroxidase and glutathione sulfo-transferase was inhibited. Concomitantly, significantly enhanced glutathione reductase activity and the contents of both reduced and oxidized glutathione were perceptible in high mercury-exhibiting shoots. It is inferred that high mercury-accrued elevations in oxidative stress indices were obvious, where non-glutathione-based H2O2-decomposing enzyme system was dominant over the glutathione-based H2O2-scavenging enzyme system. In particular, the glutathione-based H2O2-scavenging system failed to coordinate with elevated glutathione reductase which in turn resulted into increased pool of oxidized glutathione and the ratio of oxidized glutathione-to-reduced glutathione. The substantiation of the studied oxidative stress indices and antioxidant metabolism with approximately 53-kDa polypeptide warrants further studies.

Chronic lead exposure induces cochlear oxidative stress and potentiates noise-induced hearing loss.

Science.gov (United States)

Jamesdaniel, Samson; Rosati, Rita; Westrick, Judy; Ruden, Douglas M

2018-08-01

Acquired hearing loss is caused by complex interactions of multiple environmental risk factors, such as elevated levels of lead and noise, which are prevalent in urban communities. This study delineates the mechanism underlying lead-induced auditory dysfunction and its potential interaction with noise exposure. Young-adult C57BL/6 mice were exposed to: 1) control conditions; 2) 2 mM lead acetate in drinking water for 28 days; 3) 90 dB broadband noise 2 h/day for two weeks; and 4) both lead and noise. Blood lead levels were measured by inductively coupled plasma mass spectrometry analysis (ICP-MS) lead-induced cochlear oxidative stress signaling was assessed using targeted gene arrays, and the hearing thresholds were assessed by recording auditory brainstem responses. Chronic lead exposure downregulated cochlear Sod1, Gpx1, and Gstk1, which encode critical antioxidant enzymes, and upregulated ApoE, Hspa1a, Ercc2, Prnp, Ccl5, and Sqstm1, which are indicative of cellular apoptosis. Isolated exposure to lead or noise induced 8-12 dB and 11-25 dB shifts in hearing thresholds, respectively. Combined exposure induced 18-30 dB shifts, which was significantly higher than that observed with isolated exposures. This study suggests that chronic exposure to lead induces cochlear oxidative stress and potentiates noise-induced hearing impairment, possibly through parallel pathways. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

[Occupational burdens in special educators working with intellectually disabled students].

Science.gov (United States)

Plichta, Piotr

2014-01-01

The article presents the results of psychosocial burdens in special educators (specialists in the field of oligophrenopedagogy) with intellectually disabled students. In theoretical part, specific context of occupational stress in special educators was introduced. Additionally, the need of broader research context regarding occupational stress and the risk of burnout in special educators working with intellectually disabled individuals were included. The results were obtained using Plichta and Pyzalski's Questionnaire of Occupational Burdens in Teaching (QOBT). The presented results are based on a research sample (N = 100) of special educators (female) teaching intellectually disabled students attending special schools in the city of Lódz. The obtained results were compared with the results coming from a large random sample of public school teachers working with non-intellectually disabled children from the Lodi voivodeship (N = 429) and referred to the norms of QOBT. The results show significant percentage of respondents obtaining high level of occupational burdens (conflict situations - 45%, organizational burdens - 31%, lack of work sense - 40%, global score - 40%). Seniority is not related to the level of burdens. Some significant differences concerning the level of occupational burdens between both groups of teachers were found. The study showed e.g. the strong need for supporting special educators in the workplace context and the need of implementing preventive and remedial measures at both individual and organizational levels (especially in terms of improving personal relationships in a workplace). Generally, the results show similarity of the stressors' ranking in special educators and school teachers working with non-intellectually disabled children.

Trunk and Shank Position Influences Patellofemoral Joint Stress in the Lead and Trail Limbs During the Forward Lunge Exercise.

Science.gov (United States)

Hofmann, Cory L; Holyoak, Derek T; Juris, Paul M

2017-01-01

Study Design Controlled laboratory study, repeated-measures design. Background The effects of trunk and shank position on patellofemoral joint stress of the lead limb have been well studied; however, the effects on the trail limb are not well understood. Objectives To test the hypothesis that trunk and shank position may influence patellofemoral joint stress in both limbs during the forward lunge exercise. Methods Patellofemoral kinetics were quantified from 18 healthy participants performing the lunge exercise with different combinations of trunk and shank positions (vertical or forward). A 2-by-3 (limb-by-lunge variation) repeated-measures analysis of variance was performed, using paired t tests for post hoc comparisons. Results The trail limb experienced greater total patellofemoral joint stress relative to the lead limb, regardless of trunk and shank position (Ppatellofemoral joint stress in the trail limb relative to the lead limb (Ppatellofemoral stress in the lead limb (Ppatellofemoral joint loading of both limbs during the forward lunge, with the trail limb generally experiencing greater total joint stress. Restricting forward translation of the lead-limb shank may reduce patellofemoral joint stress at the expense of increased stress in the trail limb. Technique recommendations should consider the demands imposed on both knees during this exercise. J Orthop Sports Phys Ther 2017;47(1):31-40. Epub 4 Nov 2016. doi:10.2519/jospt.2017.6336.

Stress corrosion cracking of the tubing materials for nuclear steam generators in an environment containing lead

International Nuclear Information System (INIS)

Kim, Kyung Mo; Kim, Uh Chul; Lee, Eun Hee; Hwang, Seong Sik

2004-01-01

Steam generator tube materials show a high susceptibility to stress corrosion cracking (SCC) in an environment containing lead species and some nuclear power plants currently have degradation problems associated with lead-induced stress corrosion cracking in a caustic solution. Effects of an applied potential on SCC is tested for middle-annealed Alloy 600 specimens since their corrosion potential can be changed when lead oxide coexists with other oxidizing species like copper oxide in the sludge. In addition, all the steam generator tubing materials used for nuclear power plants being operated and currently under construction in Korea are tested in a caustic solution with lead oxide. (author)

Economic burden of informal care attributable to stroke among those aged 65 years or older in China.

Science.gov (United States)

Joo, Heesoo; Liang, Di

2017-02-01

Stroke is a leading cause of disability in China, frequently resulting in the need for informal care. No information, however, is available on costs of informal care associated with stroke, required to understand the true cost of stroke in China. Using the 2011 China Health and Retirement Longitudinal Study, we identified 4447 respondents aged ≥65 years suitable for analyses, including 184 stroke survivors. We estimated the economic burden of informal care associated with stroke using a two-part model. The monthly number of hours of informal caregiving associated with stroke was 29.2 h/stroke survivor, and the average annual cost of informal care associated with stroke was 10,612 RMB per stroke survivor. The findings stress the necessity of proper interventions to prevent stroke and will be useful for estimating the economic burden of stroke.

Burden of diarrhea in the eastern mediterranean region, 1990-2013

NARCIS (Netherlands)

Khalil, Ibrahim; Colombara, Danny V.; Forouzanfar, Mohammad Hossein; Troeger, Christopher; Daoud, Farah; Moradi-Lakeh, Maziar; Bcheraoui, El Charbel; Rao, Puja C.; Afshin, Ashkan; Charara, Raghid; Abate, Kalkidan Hassen; Abd El Razek, Mohammed Magdy; Abd-Allah, Foad; Abu-Elyazeed, Remon; Kiadaliri, Aliasghar Ahmad; Akanda, Ali Shafqat; Akseer, Nadia; Alam, Khurshid; Alasfoor, Deena; Ali, Raghib; AlMazroa, Mohammad A.; Alomari, Mahmoud A.; Salem Al-Raddadi, Rajaa Mohammad; Alsharif, Ubai; Alsowaidi, Shirina; Altirkawi, Khalid A.; Alvis-Guzman, Nelson; Ammar, Walid; Antonio, Carl Abelardo T.; Asayesh, Hamid; Asghar, Rana Jawad; Atique, Suleman; Awasthi, Ashish; Bacha, Umar; Badawi, Alaa; Barac, Aleksandra; Bedi, Neeraj; Bekele, Tolesa; Bensenor, Isabela M.; Betsu, Balem Demtsu; Bhutta, Zulfiqar; Abdulhak, Bin Aref A.; Butt, Zahid A.; Danawi, Hadi; Dubey, Manisha; Endries, Aman Yesuf; Faghmous, Imad M.D.A.; Farid, Talha; Farvid, Maryam S.; Farzadfar, Farshad; Fereshtehnejad, Seyed Mohammad; Fischer, Florian; Anderson Fitchett, Joseph Robert; Gibney, Katherine B.; Mohamed Ginawi, Ibrahim Abdelmageem; Gishu, Melkamu Dedefo; Gugnani, Harish Chander; Gupta, Rahul; Hailu, Gessessew Bugssa; Hamadeh, Randah Ribhi; Hamidi, Samer; Harb, Hilda L.; Hedayati, Mohammad T.; Hsairi, Mohamed; Husseini, Abdullatif; Jahanmehr, Nader; Javanbakht, Mehdi; Beyene, Tariku; Jonas, Jost B.; Kasaeian, Amir; Khader, Yousef Saleh; Khan, Abdur Rahman; Khan, Ejaz Ahmad; Khan, Gulfaraz; Khoja, Tawfik Ahmed Muthafer; Kinfu, Yohannes; Kissoon, Niranjan; Koyanagi, Ai; Lal, Aparna; Abdul Latif, Asma Abdul; Lunevicius, Raimundas; Abd El Razek, Hassan Magdy; Majeed, Azeem; Malekzadeh, Reza; Mehari, Alem; Mekonnen, Alemayehu B.; Melaku, Yohannes Adama; Memish, Ziad A.; Mendoza, Walter; Misganaw, Awoke; Ibrahim Mohamed, Layla Abdalla; Nachega, Jean B.; Nguyen, Quyen Le; Nisar, Muhammad Imran; Peprah, Emmanuel Kwame; Platts-Mills, James A.; Pourmalek, Farshad; Qorbani, Mostafa; Rafay, Anwar; Rahimi-Movaghar, Vafa; Ur Rahman, Sajjad; Rai, Rajesh Kumar; Rana, Saleem M.; Ranabhat, Chhabi L.; Rao, Sowmya R.; Refaat, Amany H.; Riddle, Mark; Roshandel, Gholamreza; Ruhago, George Mugambage; Saleh, Muhammad Muhammad; Sanabria, Juan R.; Sawhney, Monika; Sepanlou, Sadaf G.; Setegn, Tesfaye; Sliwa, Karen; Sreeramareddy, Chandrashekhar T.; Sykes, Bryan L.; Tavakkoli, Mohammad; Tedla, Bemnet Amare; Terkawi, Abdullah S.; Ukwaja, Kingsley; Uthman, Olalekan A.; Westerman, Ronny; Wubshet, Mamo; Yenesew, Muluken A.; Yonemoto, Naohiro; Younis, Mustafa Z.; Zaidi, Zoubida; Sayed Zaki, El Maysaa; Rabeeah, Al Abdullah A.; Wang, Haidong; Naghavi, Mohsen; Vos, Theo; Lopez, Alan D.; Murray, Christopher J.L.; Mokdad, Ali H.

2016-01-01

Diarrheal diseases (DD) are leading causes of disease burden, death, and disability, especially in children in low-income settings. DD can also impact a child's potential livelihood through stunted physical growth, cognitive impairment, and other sequelae. As part of the Global Burden of Disease

Depressive and post-traumatic stress symptoms following termination of pregnancy in South African women: A longitudinal study measuring the effects of chronic burden, crisis support and resilience.

Science.gov (United States)

Subramaney, Ugasvaree; Wyatt, Gail Elizabeth; Williams, John K; Zhang, Muyu; Liu, Hong Hu; Chin, Dorothy

2015-11-01

Termination of pregnancy (TOP) remains a controversial issue, regardless of legislation. Access to services as well as psychological effects may vary across the world. To better understand the psychological effects of TOP, this study describes the circumstances of 102 women who underwent a TOP from two socioeconomic sites in Johannesburg, South Africa, one serving women with few economic resources and the other serving women with adequate resources. The relationship between demographic characteristics, resilience and symptoms of post-traumatic stress disorder (PTSD) and depression before, 1 month after and 3 months after the procedure was also examined. Time since TOP, age, chronic burden, resilience and the interaction of site with religion and site with chronic burden were significant. In addition, site differences were found for religion and chronic burden in predicting depression scores. Women from both sites had significant decreases in depression scores over time. The interaction of time with site was not significant. Higher chronic burden scores correlated with higher depression scores. No variables were significant in the bivariate analysis for PTSD. Resilience, religion and chronic burden emerge as significant variables in women undergoing a first-trimester TOP, and warrant further assessment in studies of this nature.

The mode of stress corrosion cracking in Ni-base alloys in high temperature water containing lead

International Nuclear Information System (INIS)

Hwang, S.S.; Kim, H.P.; Lee, D.H.; Kim, U.C.; Kim, J.S.

1999-01-01

The mode of stress corrosion cracking (SCC) in Ni-base alloys in high temperature aqueous solutions containing lead was studied using C-rings and slow strain rate testing (SSRT). The lead concentration, pH and the heat treatment condition of the materials were varied. TEM work was carried out to observe the dislocation behavior in thermally treated (TT) and mill annealed (MA) materials. As a result of the C-ring test in 1M NaOH+5000 ppm lead solution, intergranular stress corrosion cracking (IGSCC) was found in Alloy 600MA, whereas transgranular stress corrosion cracking (TGSCC) was found in Alloy 600TT and Alloy 690TT. In most solutions used, the SCC resistance increased in the sequence Alloy 600MA, Alloy 600TT and Alloy 690TT. The number of cracks that was observed in alloy 690TT was less than in Alloy 600TT. However, the maximum crack length in Alloy 690TT was much longer than in Alloy 600TT. As a result of the SSRT, at a nominal strain rate of 1 x 10 -7 /s, it was found that 100 ppm lead accelerated the SCC in Alloy 600MA (0.01%C) in pH 10 at 340 C. IGSCC was found in a 100 ppm lead condition, and some TGSCC was detected on the fracture surface of Alloy 600MA cracked in the 10000 ppm lead solution. The mode of cracking for Alloy 600 and Alloy 690 changed from IGSCC to TGSCC with increasing grain boundary carbide content in the material and lead concentration in the solution. IGSCC seemed to be retarded by stress relaxation around the grain boundaries, and TGSCC in the TT materials seemed to be a result of the crack blunting at grain boundary carbides and the enhanced Ni dissolution with an increase of the lead concentration. (orig.)

Occupational burdens in special educators working with intellectually disabled students

Directory of Open Access Journals (Sweden)

Piotr Plichta

2014-04-01

Full Text Available Background: The article presents the results of psychosocial burdens in special educators (specialists in the field of oligophrenopedagogy with intellectually disabled students. In theoretical part, specific context of occupational stress in special educators was introduced. Additionally, the need of broader research context regarding occupational stress and the risk of burnout in special educators working with intellectually disabled individuals were included. Material and Methods: The results were obtained using Plichta and Pyżalski's Questionnaire of Occupational Burdens in Teaching (QOBT. The presented results are based on a research sample (N = 100 of special educators (female teaching intellectually disabled students attending special schools in the city of Łódź. The obtained results were compared with the results coming from a large random sample of public school teachers working with non-intellectually disabled children from the Łodź voivodeship (N = 429 and referred to the norms of QOBT. Results: The results show significant percentage of respondents obtaining high level of occupational burdens (conflict situations - 45%, organizational burdens - 31%, lack of work sense - 40%, global score - 40%. Seniority is not related to the level of burdens. Some significant differences concerning the level of occupational burdens between both groups of teachers were found. Conclusions: The study showed e.g. the strong need for supporting special educators in the workplace context and the need of implementing preventive and remedial measures at both individual and organizational levels (especially in terms of improving personal relationships in a workplace. Generally, the results show similarity of the stressors' ranking in special educators and school teachers working with non-intellectually disabled children. Med Pr 2014;65(2:239–250

Beta-carotene reduces oxidative stress, improves glutathione metabolism and modifies antioxidant defense systems in lead-exposed workers

International Nuclear Information System (INIS)

Kasperczyk, Sławomir; Dobrakowski, Michał; Kasperczyk, Janusz; Ostałowska, Alina; Zalejska-Fiolka, Jolanta; Birkner, Ewa

2014-01-01

The aim of this study was to determine whether beta-carotene administration reduces oxidative stress and influences antioxidant, mainly glutathione-related, defense systems in workers chronically exposed to lead. The population consisted of two randomly divided groups of healthy male volunteers exposed to lead. Workers in the first group (reference group) were not administered any antioxidants, while workers in the second group (CAR group) were treated orally with 10 mg of beta-carotene once a day for 12 weeks. Biochemical analysis included measuring markers of lead-exposure and oxidative stress in addition to the levels and activities of selected antioxidants. After treatment, levels of malondialdehyde, lipid hydroperoxides and lipofuscin significantly decreased compared with the reference group. However, the level of glutathione significantly increased compared with the baseline. Treatment with beta-carotene also resulted in significantly decreased glutathione peroxidase activity compared with the reference group, while the activities of other glutathione-related enzymes and of superoxide dismutase were not significantly changed. However, the activities of glucose-6-phosphate dehydrogenase and catalase, as well as the level of alpha-tocopherol, were significantly higher after treatment compared with the baseline. Despite controversy over the antioxidant properties of beta-carotene in vivo, our findings showed reduced oxidative stress after beta-carotene supplementation in chronic lead poisoning. - Highlights: • Beta-carotene reduces oxidative stress in lead-exposed workers. • Beta-carotene elevates glutathione level in lead-exposed workers. • Beta-carotene administration could be beneficial in lead poisoning

Beta-carotene reduces oxidative stress, improves glutathione metabolism and modifies antioxidant defense systems in lead-exposed workers

Energy Technology Data Exchange (ETDEWEB)

Kasperczyk, Sławomir, E-mail: kaslav@mp.pl [Dept. of Biochemistry, School of Medicine with the Division of Dentistry, Medical University of Silesia, ul. Jordana 19, 41-808 Zabrze (Poland); Dobrakowski, Michał [Dept. of Biochemistry, School of Medicine with the Division of Dentistry, Medical University of Silesia, ul. Jordana 19, 41-808 Zabrze (Poland); Kasperczyk, Janusz [Dept. of Environmental Medicine and Epidemiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, ul. Jordana 19, 41-808 Zabrze (Poland); Ostałowska, Alina; Zalejska-Fiolka, Jolanta; Birkner, Ewa [Dept. of Biochemistry, School of Medicine with the Division of Dentistry, Medical University of Silesia, ul. Jordana 19, 41-808 Zabrze (Poland)

2014-10-01

The aim of this study was to determine whether beta-carotene administration reduces oxidative stress and influences antioxidant, mainly glutathione-related, defense systems in workers chronically exposed to lead. The population consisted of two randomly divided groups of healthy male volunteers exposed to lead. Workers in the first group (reference group) were not administered any antioxidants, while workers in the second group (CAR group) were treated orally with 10 mg of beta-carotene once a day for 12 weeks. Biochemical analysis included measuring markers of lead-exposure and oxidative stress in addition to the levels and activities of selected antioxidants. After treatment, levels of malondialdehyde, lipid hydroperoxides and lipofuscin significantly decreased compared with the reference group. However, the level of glutathione significantly increased compared with the baseline. Treatment with beta-carotene also resulted in significantly decreased glutathione peroxidase activity compared with the reference group, while the activities of other glutathione-related enzymes and of superoxide dismutase were not significantly changed. However, the activities of glucose-6-phosphate dehydrogenase and catalase, as well as the level of alpha-tocopherol, were significantly higher after treatment compared with the baseline. Despite controversy over the antioxidant properties of beta-carotene in vivo, our findings showed reduced oxidative stress after beta-carotene supplementation in chronic lead poisoning. - Highlights: • Beta-carotene reduces oxidative stress in lead-exposed workers. • Beta-carotene elevates glutathione level in lead-exposed workers. • Beta-carotene administration could be beneficial in lead poisoning.

A study on caregiver burden: stressors, challenges, and possible solutions.

Science.gov (United States)

Bialon, Laura Nelson; Coke, Sallie

2012-05-01

The purpose of this qualitative study was to explore factors impacting caregiver burden and to explore possible solutions for family caregivers of terminally ill patients. The majority of caregivers reported experiencing role conflict and inadequate stress management. Caregivers who worked outside the home, those who cared for two parents concurrently, those with the least amount of outside assistance, and caregivers who spent a longer period of time caregiving reported the highest levels of health problems and overall burden. Caregivers stated a need for more support from Hospice agencies, more education on caregiver training, and more public education about Hospice services. Faith played a positive role in alleviating caregiver burden. Early identification, intervention, education and coordination of services may help to alleviate caregiver burden, which will improve quality of life for both patient and caregiver.

Burden of gout in the Nordic region, 1990-2015: findings from the Global Burden of Disease Study 2015.

Science.gov (United States)

Kiadaliri, A A; Uhlig, T; Englund, M

2018-01-29

To explore the burden of gout in the Nordic region, with a population around 27 million in 2015 distributed across six countries. We used the findings of the 2015 Global Burden of Diseases study to report prevalence and disability associated with gout in the Nordic region. From 1990 to 2015, the number of prevalent gout cases rose by 30% to 252 967 [95% uncertainty interval (UI) 223 478‒287 288] in the Nordic region. In 2015, gout contributed to 7982 (95% UI 5431‒10 800) years lived with disability (YLDs) in the region, an increase of 29% (95% UI 24‒35%) from 1990. While the crude YLD rate of gout increased by 12.9% (95% UI 7.8‒18.1%) between 1990 and 2015, the age-standardized YLD rate remained stable. Gout was ranked as the 63rd leading cause of total YLDs in the region in 2015, with the highest rank in men aged 55-59 years (38th leading cause of YLDs). The corresponding rank at the global level was 94. Of 195 countries studied, four Nordic countries [Greenland (2nd), Iceland (12th), Finland (14th), and Sweden (15th)] were among the top 15 countries with the highest age-standardized YLD rate of gout. The burden of gout is rising in the Nordic region. Gout's contribution to the total burden of diseases in the region is more significant than the global average. Expected increases in gout burden owing to population growth and ageing call for stronger preventive and therapeutic strategies for gout management in Nordic countries.

Case report: heavy metal burden presenting as Bartter syndrome.

Science.gov (United States)

Crinnion, Walter J; Tran, Jessica Q

2010-12-01

Maternal transfer of heavy metals during fetal development or lactation possibly contributed to the clinical manifestations of Bartter syndrome and developmental delay in the offspring. An 11-month-old child diagnosed with Bartter syndrome and failure to thrive was treated concurrently for elevated metal burden while he was undergoing standard medical interventions. Treatment with body-weight doses of meso-2,3-dimercaptosuccinic acid (DMSA) reduced the body burden of lead, beryllium, copper, mercury, and cadmium at the three- and sixth-month follow-up tests. During the course of the six-month treatment, the patient gained 2.4 kg (5.2 lb) and grew approximately 9.5 cm (3.75 in). His weight shifted from significantly below the 5th percentile in weight to within the 5th percentile, and from below the 5th to within the 10th percentile for length. The child's acquisition of lead, beryllium, and copper correspond to his mother's history of stained glass assembly and occurred during fetal development or lactation, since there were no other identifiable sources that could have contributed to the heavy metal burden. Tests for known genetic mutations leading to Bartter syndrome were all negative. This case report highlights the potential benefit of DMSA for treatment of heavy metal body burden in infants who present with Bartter syndrome.

Subjective burden among spousal and adult-child informal caregivers of older adults : results from a longitudinal cohort study

NARCIS (Netherlands)

Oldenkamp, Marloes; Hagedoorn, Mariët; Slaets, Joris; Stolk, Ronald; Wittek, Rafael; Smidt, Nynke

2016-01-01

Background: Pressures on informal caregivers are likely to increase due to increasing life expectancy and health care costs, which stresses the importance of prevention of subjective burden. The present study examined the correlates of overall subjective burden and multiple burden dimensions among

Stress corrosion cracking susceptibility of steam generator tube materials in AVT (all volatile treatment) chemistry contaminated with lead

International Nuclear Information System (INIS)

Gomez Briceno, D.; Castano, M.L.; Garcia, M.S.

1996-01-01

Alloy 600 steam generator tubing has shown a high susceptibility to stress corrosion degradation at the operation conditions of pressurized water reactors. Several contaminants, such as lead, have been postulated as being responsible for producing the secondary side stress corrosion cracking that has occurred mainly at the location where these contaminants can concentrate. An extensive experimental work has been carried out in order to better understand the effects of lead on the stress corrosion cracking susceptibility of steam generator tube materials, namely Alloys 600, 690 and 800. This paper presents the experimental work conducted with a view to determining the influence of lead oxide concentration in AVT (all volatile treatment) conditions on the stress corrosion resistance of nickel alloys used in the fabrication of steam generator tubing. (orig.)

The Global Burden of Cancer 2013

NARCIS (Netherlands)

Fitzmaurice, C.; Geleijnse, J.M.; Naghavi, M.R.; et al.,

2015-01-01

Importance Cancer is among the leading causes of death worldwide. Current estimates of cancer burden in individual countries and regions are necessary to inform local cancer control strategies. Objective To estimate mortality, incidence, years lived with disability (YLDs), years of life lost (YLLs),

High Burden of Subclinical Lead Toxicity after Phase Out of Lead from Petroleum in Pakistan.

Science.gov (United States)

Majid, Hafsa; Khan, Aysha Habib; Khan, Nadeem Ullah; Siddiqui, Imran; Ghani, Farooq; Jafri, Lena

2017-12-01

To evaluate the frequency of subclinical lead toxicity. Cross-sectional study. Department of Pathology and Laboratory Medicine, The Aga Khan University Hospital, Karachi, from January 2011 to December 2014. Analysis of laboratory data for blood lead levels (BLL) was performed. Lead was tested by atomic absorption spectrometer. For all subjects, only initial test results were included while the results of repeated testing were excluded. Exemption was sought from institutional ethical review committee. BLL of 2-10 ug/dl and 10-70 ug/dl in children and adults, respectively were taken as subclinical lead toxicity. Amongst the total number of subjects tested (n=524), 26.5% (n=139) were children (lead level 16.9 ug/dl (36.1-4)] and lower level [4.2 ug/dl (6.8-2.6)] in children with lead levels while most had either subclinical (76%, n=106) or toxic lead levels (8%, n=11). In adults, (55%, n=212) subjects had desired lead levels, and 40% (n=154) and 4.99% (n=19) had subclinical and toxic lead levels. Presence of subclinical lead poisoning even after phasing out of lead petroleum in Pakistanis is alarming, especially in children. A national population-based study to determine the lead status and targeted intervention to identify potential sources is need of the time.

Energetic stress: The reciprocal relationship between energy availability and the stress response.

Science.gov (United States)

Harrell, C S; Gillespie, C F; Neigh, G N

2016-11-01

The worldwide epidemic of metabolic syndromes and the recognized burden of mental health disorders have driven increased research into the relationship between the two. A maladaptive stress response is implicated in both mental health disorders and metabolic disorders, implicating the hypothalamic-pituitary-adrenal (HPA) axis as a key mediator of this relationship. This review explores how an altered energetic state, such as hyper- or hypoglycemia, as may be manifested in obesity or diabetes, affects the stress response and the HPA axis in particular. We propose that changes in energetic state or energetic demands can result in "energetic stress" that can, if prolonged, lead to a dysfunctional stress response. In this review, we summarize the role of the hypothalamus in modulating energy homeostasis and then briefly discuss the relationship between metabolism and stress-induced activation of the HPA axis. Next, we examine seven mechanisms whereby energetic stress interacts with neuroendocrine stress response systems, including by glucocorticoid signaling both within and beyond the HPA axis; by nutrient-induced changes in glucocorticoid signaling; by impacting the sympathetic nervous system; through changes in other neuroendocrine factors; by inducing inflammatory changes; and by altering the gut-brain axis. Recognizing these effects of energetic stress can drive novel therapies and prevention strategies for mental health disorders, including dietary intervention, probiotics, and even fecal transplant. Copyright © 2015 Elsevier Inc. All rights reserved.

Burden of pediatric hepatitis C.

Science.gov (United States)

El-Shabrawi, Mortada Hassan; Kamal, Naglaa Mohamed

2013-11-28

Hepatitis C virus (HCV) is a major health burden infecting 170-210 million people worldwide. Additional 3-4 millions are newly-infected annually. Prevalence of pediatric infection varies from 0.05%-0.36% in the United States and Europe; up to 1.8%-5.8% in some developing countries. The highest prevalence occurs in Egypt, sub-Saharan Africa, Amazon basin and Mongolia. HCV has been present in some populations for several centuries, notably genotypes 1 and 2 in West Africa. Parenteral anti-schistosomal therapy practiced in the 1960s until the early 1980s had spread HCV infection throughout Egypt. Parenteral acquisition of HCV remains a major route for infection among Egyptian children. Insufficient screening of transfusions, unsterilized injection equipment and re-used needles and syringes continue to be major routes of HCV transmission in developing countries, whereas vertical transmission and adolescent high-risk behaviors (e.g., injection drug abuse) are the major routes in developed countries. The risk of vertical transmission from an infected mother to her unborn/newborn infant is approximately 5%. Early stages of HCV infection in children do not lead to marked impairment in the quality of life nor to cognitive, behavioral or emotional dysfunction; however, caregiver stress and family system strain may occur. HCV slowly progresses to serious complications as cirrhosis (1%-2%) and hepatocellular carcinoma (HCC) especially in the presence of risk factors as hemolytic anemias, obesity, treated malignancy, and concomitant human immune deficiency and/or hepatitis B virus co-infection. HCV vaccine remains elusive to date. Understanding the immune mechanisms in patients who successfully cleared the infection is essential for vaccine development. The pediatric standard of care treatment consists of pegylated interferon-α 2a or b plus ribavirin for 24-48 wk. The new oral direct acting antivirals, approved for adults, need further evaluation in children. Sustained

Burden of childhood-onset arthritis

Directory of Open Access Journals (Sweden)

Hassett Afton L

2010-07-01

Full Text Available Abstract Juvenile arthritis comprises a variety of chronic inflammatory diseases causing erosive arthritis in children, often progressing to disability. These children experience functional impairment due to joint and back pain, heel pain, swelling of joints and morning stiffness, contractures, pain, and anterior uveitis leading to blindness. As children who have juvenile arthritis reach adulthood, they face possible continuing disease activity, medication-associated morbidity, and life-long disability and risk for emotional and social dysfunction. In this article we will review the burden of juvenile arthritis for the patient and society and focus on the following areas: patient disability; visual outcome; other medical complications; physical activity; impact on HRQOL; emotional impact; pain and coping; ambulatory visits, hospitalizations and mortality; economic impact; burden on caregivers; transition issues; educational occupational outcomes, and sexuality. The extent of impact on the various aspects of the patients', families' and society's functioning is clear from the existing literature. Juvenile arthritis imposes a significant burden on different spheres of the patients', caregivers' and family's life. In addition, it imposes a societal burden of significant health care costs and utilization. Juvenile arthritis affects health-related quality of life, physical function and visual outcome of children and impacts functioning in school and home. Effective, well-designed and appropriately tailored interventions are required to improve transitioning to adult care, encourage future vocation/occupation, enhance school function and minimize burden on costs.

Psychological burden among women with polycystic ovarian syndrome in Oman: a case-control study.

Science.gov (United States)

Sulaiman, Maha Ah; Al-Farsi, Yahya M; Al-Khaduri, Maha M; Waly, Mostafa I; Saleh, Jumana; Al-Adawi, Samir

2017-01-01

Previous studies in Euro-American populations have shown that women with polycystic ovarian syndrome (PCOS) have increased levels of "psychological burden". While PCOS has been reported in Arab countries such as Oman, there is a dearth of studies of the occurrence of psychological burden among PCOS women in the Arab region. This study aimed to compare sociodemographic and clinical characteristics of PCOS women diagnosed with non-PCOS women and prevalence of severity of depression, anxiety and stress and to explore the association between PCOS and indices of psychological disturbances after adjusting for potential confounding factors. This hospital-based case-control study was conducted among women aged 16-49 years. The study included 52 women diagnosed with PCOS (as per Rotterdam 2003 criteria) and 60 control who were PCOS-free. The presence of psychological burden - depression, anxiety and stress - was quantified using Depression, Anxiety and Stress Scale-21 (DASS-21). The crude odds ratios (ORs) generated by logistic regression models indicated an increased risk of depression, anxiety and stress among women with PCOS compared to controls. The adjusted OR also indicated an increased risk of depression (OR =1.10; 95% confidence interval [CI] 0.50, 2.43), anxiety (OR =1.09; 95% CI 0.47, 2.52) and stress (OR =1.45; 95% CI 0.68, 3.12), However, no statistical differences were observed along the three psychological distresses ( p >0.05) between the two study groups. The study indicates that the presence of PCOS is associated with an increased risk of psychological burden. If this study will withstand further scrutiny, meeting psychological needs of such population would need to be contemplated.

Occupational burdens in special educators working with intellectually disabled students

OpenAIRE

Piotr Plichta

2014-01-01

Background: The article presents the results of psychosocial burdens in special educators (specialists in the field of oligophrenopedagogy) with intellectually disabled students. In theoretical part, specific context of occupational stress in special educators was introduced. Additionally, the need of broader research context regarding occupational stress and the risk of burnout in special educators working with intellectually disabled individuals were included. Material and Methods: The resu...

The psychosocial burden of psoriatic arthritis.

Science.gov (United States)

Husni, M Elaine; Merola, Joseph F; Davin, Sara

2017-12-01

To assess the psychosocial impact of psoriatic arthritis (PsA), describe how health-related quality of life (QoL) is affected in patients with PsA, discuss measures used to evaluate the psychosocial impact of PsA, and review studies examining the effect of therapy on QoL. A targeted review on the impact of PsA on QoL and the role of tailored psychosocial management in reducing the psychosocial burden of the disease was performed. PubMed literature searches were conducted using the terms PsA, psychosocial burden, QoL, and mood/behavioral changes. Articles were deemed relevant if they presented information regarding the psychosocial impact of PsA, methods used to evaluate these impacts, or ways to manage/improve management of PsA and its resulting comorbidities. The findings of this literature search are descriptively reviewed and the authors׳ expert opinion on their interpretation is provided. The psychosocial burden of PsA negatively affects QoL. Patients suffer from sleep disorders, fatigue, low-level stress, depression and mood/behavioral changes, poor body image, and reduced work productivity. Additionally, each patient responds to pain differently, depending on a variety of psychological factors including personality structure, cognition, and attention to pain. Strategies for evaluating the burdens associated with PsA and the results of properly managing patients with PsA are described. PsA is associated with a considerable psychosocial burden and new assessment tools, specific to PsA, have been developed to help quantify this burden in patients. Future management algorithms of PsA should incorporate appropriate assessment and management of psychological and physical concerns of patients. Furthermore, patients with PsA should be managed by a multidisciplinary team that works in coordination with the patient and their family or caregivers. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Lead and Hyperactivity: Lead Levels Among Hyperactive Children

Science.gov (United States)

David, Oliver J.; And Others

1977-01-01

In the study it is shown that within a group of 84 hyperactive children (4 to 11 years old) those for whom an organic etiology is present have lead burdens lower than in those for whom no apparent cause could be found. (Author/SBH)

The unrecognized burden of typhoid fever.

Science.gov (United States)

Obaro, Stephen K; Iroh Tam, Pui-Ying; Mintz, Eric Daniel

2017-03-01

Typhoid fever (TF), caused by Salmonella enterica serovar Typhi, is the most common cause of enteric fever, responsible for an estimated 129,000 deaths and more than 11 million cases annually. Although several reviews have provided global and regional TF disease burden estimates, major gaps in our understanding of TF epidemiology remain. Areas covered: We provide an overview of the gaps in current estimates of TF disease burden and offer suggestions for addressing them, so that affected communities can receive the full potential of disease prevention offered by vaccination and water, sanitation, and hygiene interventions. Expert commentary: Current disease burden estimates for TF do not capture cases from certain host populations, nor those with atypical presentations of TF, which may lead to substantial underestimation of TF cases and deaths. These knowledge gaps pose major obstacles to the informed use of current and new generation typhoid vaccines.

Estimates and 25-year trends of the global burden of disease attributable to ambient air pollution : an analysis of data from the Global Burden of Diseases Study 2015

NARCIS (Netherlands)

Cohen, Aaron J; Brauer, Michael; Burnett, Richard; Anderson, H Ross; Frostad, Joseph; Estep, Kara; Balakrishnan, Kalpana; Brunekreef, Bert|info:eu-repo/dai/nl/067548180; Dandona, Lalit; Dandona, Rakhi; Feigin, Valery; Freedman, Greg; Hubbell, Bryan; Jobling, Amelia; Kan, Haidong; Knibbs, Luke; Liu, Yang|info:eu-repo/dai/nl/411298119; Martin, Randall; Morawska, Lidia; Pope, C Arden; Shin, Hwashin; Straif, Kurt; Shaddick, Gavin; Thomas, Matthew; van Dingenen, Rita; van Donkelaar, Aaron; Vos, Theo; Murray, Christopher J L; Forouzanfar, Mohammad H

BACKGROUND: Exposure to ambient air pollution increases morbidity and mortality, and is a leading contributor to global disease burden. We explored spatial and temporal trends in mortality and burden of disease attributable to ambient air pollution from 1990 to 2015 at global, regional, and country

Effect of caregivers’ expressed emotion on the care burden and rehospitalization rate of schizophrenia

Directory of Open Access Journals (Sweden)

Wang X

2017-09-01

Full Text Available Xia Wang,1 Qiongni Chen,2 Min Yang1 1Xiangya School of Nursing, 2Nursing Department, Second Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China Background: This study assessed the effect of expressed emotion (EE among caregivers of schizophrenia patients on their care burden and the illness rehospitalization rate. Subjects and methods: A total of 64 schizophrenia patients hospitalized for the first time and their key caregivers were recruited. The Chinese version of the Camberwell Family Interview (CFI-CV was used to evaluate the EE of the key caregivers. A family burden questionnaire was used to evaluate the care burden. The patients’ rehospitalization rate and medication compliance were evaluated by the self-designated criteria. The data collection was carried out at the first meeting in the hospital, at 6 months and 12 months after hospital discharge by using the same instruments. Results: The subjective stress burden and subjective demand burden scores were higher in caregivers before and after discharge with statistical difference between the various observation time points (P<0.05. Significant differences were observed in the rehospitalization rate between patients with high medication adherence and low medication adherence at 12 months (P<0.01 and between patients with high expressed emotion (HEE and low expressed emotion (LEE; P<0.05. The rehospitalization rate in patients with HEE caregivers was higher than that in those with LEE caregivers. The subjective stress burden scores were statistically significant between HEE and LEE caregivers (P<0.05.Conclusion: HEE is a predictor of rehospitalization rate in schizophrenic patients. The burdens of care scores are high in caregivers of schizophrenic patients. The caregivers with HEE have a high score in burden of care compared with those with LEE. Keywords: expressed emotion, care burden, schizophrenia, rehospitalization rate, caregivers

Caregiver Burden Among Caregivers of Individuals With Severe Mental Illness: Testing the Moderation and Mediation Models of Resilience.

Science.gov (United States)

Mulud, Zamzaliza Abdul; McCarthy, Geraldine

2017-02-01

The association between the socio-demographic characteristics of caregivers, such as gender and caregiver burden, is well documented; however, the process underlying this relationship is poorly understood. Based on the stress process model, we designed a cross-sectional study to examine the mediating and moderating effect of resilience on the relationship between gender and caregiver burden. Caregivers of individuals with severe mental illness (n=201) were recruited in two psychiatric outpatient clinics in Malaysia. The relationship between the gender of the caregiver and caregiver burden was mediated by resilience, thus supporting the stress process model. The findings from the present research contribute to the growing evidence of the interaction between socio-demographic variables of caregivers and resilience, and caregiver burden. Copyright © 2016 Elsevier Inc. All rights reserved.

40 CFR 305.33 - Burden of presentation; burden of persuasion.

Science.gov (United States)

2010-07-01

... persuasion. 305.33 Section 305.33 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Hearing Procedure § 305.33 Burden of presentation; burden of persuasion. The Requestor has the burden of... justified. Accordingly, the Requestor bears the burdens of presentation and persuasion. Following the...

Evaluation of Foliar Spraying of Zinc and Calcium Fertilizers on Yield and Physiological Traits of Safflower under Lead Stress

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P Jamshidi

2017-10-01

Full Text Available Introduction In order to evaluate the effect of foliar spraying of zinc and calcium on yield and physiological traits of safflower under lead stress, a factorial experiment based on randomized complete block design was performed in Kerman agricultural and natural resource research and education center in 2014-2015 with three replications. The first factorial included three levels (control, and 0.5 and 1 μM lead spraying, whereas the second and third factorials were spraying zinc sulfate at three concentrations (zero, and 10 and 20 μM and spraying calcium chloride at two levels (zero and 20 μM, respectively. According to the results, grain yield, the 1000-grain weight, leaf dry weight, number of seeds per head, head weight and chlorophyll content decreased. On the other hand, a significant increase was observed in the activities of catalase and ascorbate peroxidase enzymes and amount of malondialdehyde in plants. Moreover, spraying zinc fertilizer in lead treatment resulted in a significant increase in activity of catalase enzyme, reduction of membrane lipid peroxidation, prevention of chlorophyll destruction and maintenance of grain yield. However, the effect of spraying calcium fertilize in lead treatment was only significant on chlorophyll content. According to the results of the research, it seems that spraying zinc fertilizer had more effects on improved growth of safflower under lead stress, compared to spraying calcium fertilizer. Therefore, in air pollution with heavy metals (lead, application of zinc sulfate fertilizer can be an effective approach to maintain the growth and production of plants. Among the various heavy metals, lead (Pb is a major anthropogenic pollutant that has been released to the environment since the industrial revolution and accumulated in different terrestrial and aquatic ecosystems These elements will transfer to leaves in polluted areas and will rapidly uptake and cause irreparable damages to the most

Predictor of increase in caregiver burden for disabled elderly at home.

Science.gov (United States)

Okamoto, Kazushi; Harasawa, Yuko

2009-01-01

In order to classify the caregivers at high risk of increase in their burden early, linear discriminant analysis was performed to obtain an effective discriminant model for differentiation of the presence or absence of increase in caregiver burden. The data obtained by self-administered questionnaire from 193 caregivers of frail elderly from January to February of 2005 were used. The discriminant analysis yielded a statistically significant function explaining 35.0% (Rc=0.59; d.f.=6; p=0.0001). The configuration indicated that the psychological predictors of change in caregiver burden with much perceived stress (1.47), high caregiver burden at baseline (1.28), emotional control (0.75), effort to achieve (-0.28), symptomatic depression (0.20) and "ikigai" (purpose in life) (0.18) made statistically significant contributions to the differentiation between no increase and increase in caregiver burden. The discriminant function showed a sensitivity of 86% and specificity of 81%, and successfully classified 83% of the caregivers. The function at baseline is a simple and useful method for screening of an increase in caregiver burden among caregivers for the frail elderly at home.

Measuring Burden of Diseases in a Rapidly Developing Economy: State of Qatar

Science.gov (United States)

Bener, Abdulbari; Zirie, Mahmoud A.; Kim, Eun-Jung; Buz, Rama Al; Zaza, Mouayyad; Al-Nufal, Mohammed; Basha, Basma; Hillhouse, Edward W; Riboli, Elio

2013-01-01

Background: The Global Burden of Disease (GBD) study has provided a conceptual and methodological framework to quantify and compare the health of populations. Aim: The objective of the study was to assess the national burden of disease in the population of Qatar using the disability-adjusted life year (DALYs) as a measure of disability. Methods: We adapted the methodology described by the World Health Organization for conducting burden of disease to calculate years of life lost due to premature mortality (YLL), years lived with disability (YLD) and disability adjusted life years (DALYs). The study was conducted during the period from November 2011 to October 2012. Results:: The study findings revealed that ischemic heart disease (11.8%) and road traffic accidents (10.3%) were the two leading causes of burden of diseases in Qatar in 2010. The burden of diseases among men (222.04) was found three times more than of women's (71.85). Of the total DALYs, 72.7% was due to non fatal health outcomes and 27.3% was due to premature death. For men, chronic diseases like ischemic heart disease (15.7%) and road traffic accidents (13.7%) accounted great burden and an important source of lost years of healthy life. For women, birth asphyxia and birth trauma (12.6%) and abortion (4.6%) were the two leading causes of disease burden. Conclusion:: The results of the study have shown that the national health priority areas should cover cardiovascular diseases, road traffic accidents and mental health. The burden of diseases among men was three times of women's. PMID:23445701

45 CFR 672.17 - Burden of presentation; burden of persuasion.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Burden of presentation; burden of persuasion. 672.17 Section 672.17 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION ENFORCEMENT AND HEARING PROCEDURES § 672.17 Burden of presentation; burden of persuasion. The...

ER Stress Inhibits Liver Fatty Acid Oxidation while Unmitigated Stress Leads to Anorexia-Induced Lipolysis and Both Liver and Kidney Steatosis

Directory of Open Access Journals (Sweden)

Diane DeZwaan-McCabe

2017-05-01

Full Text Available The unfolded protein response (UPR, induced by endoplasmic reticulum (ER stress, regulates the expression of factors that restore protein folding homeostasis. However, in the liver and kidney, ER stress also leads to lipid accumulation, accompanied at least in the liver by transcriptional suppression of metabolic genes. The mechanisms of this accumulation, including which pathways contribute to the phenotype in each organ, are unclear. We combined gene expression profiling, biochemical assays, and untargeted lipidomics to understand the basis of stress-dependent lipid accumulation, taking advantage of enhanced hepatic and renal steatosis in mice lacking the ER stress sensor ATF6α. We found that impaired fatty acid oxidation contributed to the early development of steatosis in the liver but not the kidney, while anorexia-induced lipolysis promoted late triglyceride and free fatty acid accumulation in both organs. These findings provide evidence for both direct and indirect regulation of peripheral metabolism by ER stress.

ER Stress Inhibits Liver Fatty Acid Oxidation while Unmitigated Stress Leads to Anorexia-Induced Lipolysis and Both Liver and Kidney Steatosis.

Science.gov (United States)

DeZwaan-McCabe, Diane; Sheldon, Ryan D; Gorecki, Michelle C; Guo, Deng-Fu; Gansemer, Erica R; Kaufman, Randal J; Rahmouni, Kamal; Gillum, Matthew P; Taylor, Eric B; Teesch, Lynn M; Rutkowski, D Thomas

2017-05-30

The unfolded protein response (UPR), induced by endoplasmic reticulum (ER) stress, regulates the expression of factors that restore protein folding homeostasis. However, in the liver and kidney, ER stress also leads to lipid accumulation, accompanied at least in the liver by transcriptional suppression of metabolic genes. The mechanisms of this accumulation, including which pathways contribute to the phenotype in each organ, are unclear. We combined gene expression profiling, biochemical assays, and untargeted lipidomics to understand the basis of stress-dependent lipid accumulation, taking advantage of enhanced hepatic and renal steatosis in mice lacking the ER stress sensor ATF6α. We found that impaired fatty acid oxidation contributed to the early development of steatosis in the liver but not the kidney, while anorexia-induced lipolysis promoted late triglyceride and free fatty acid accumulation in both organs. These findings provide evidence for both direct and indirect regulation of peripheral metabolism by ER stress. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Predictors of Caregiver Burden among Mothers of Children with Chronic Conditions

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Karina Javalkar

2017-05-01

Full Text Available Objective: The complex medical regimens of children and adolescents with chronic conditions can have a significant impact on families and households. Caregivers may experience burden, which can lead to negative health consequences and poor quality of life. The objective of this study was to determine child-related predictors and risk factors for caregiver burden among parents of children with chronic conditions. Methods: We distributed an institutional review board (IRB-approved, online cross-sectional survey to parents of children who attended the Victory Junction therapeutic camp. Parents provided information on child demographics, disease characteristics, and healthcare utilization. Parents also answered the adapted Zarit Burden Interview, which measured caregiver burden. Children completed scales about self-management and self-efficacy. Linear regression analyses determined how children’s disease characteristics, health utilization, and self-management skills were associated with caregiver burden. Results: We enrolled 150 mother-child dyads. The mean age of child participants was 12.23 years (±2.5, with an age range of 6 to 16 years. It was determined that children’s number of medicines and injections (β = 0.161, p = 0.047, a diagnosis of attention-deficit/hyperactivity disorder (ADHD in addition to the primary medical condition (β = 0.216, p = 0.008, frequent visits with a primary care provider (PCP (β = 0.209, p = 0.026 and emergency room (ER visits (β = 0.197, p = 0.038, and lower child self-efficacy (β = −0.241, p = 0.041 were predictors of increased caregiver burden. Conclusions: We identified risk factors for caregiver burden among mothers. Future studies should explore additional child-related characteristics as they relate to caregiver burden, and should determine if interventions for mothers of children with chronic conditions can lead to positive outcomes.

Child's organism's burden in radiological examinations in stomatology

International Nuclear Information System (INIS)

Stanko, V.; Uhlikova, Z.; Babor, L.

1979-01-01

Plastic holders were developed for fixing a photographic film in the patient's mouth in stomatological radiodiagnostic examinations of children. The holder serves to reduce the radiation burden of children. In addition, patient's gonads are protected with a shield, a lead apron or a cloth with a lead lining at least 1.5 mm thick. Also developed was a protective shield from a 2.0 mm lead sheet for intraoral examinations. The shield is to be installed in children stomatology offices. (H.S.)

Biosynthesis of vitamin C by yeast leads to increased stress resistance.

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Paola Branduardi

Full Text Available BACKGROUND: In industrial large scale bio-reactions micro-organisms are generally exposed to a variety of environmental stresses, which might be detrimental for growth and productivity. Reactive oxygen species (ROS play a key role among the common stress factors--directly--through incomplete reduction of O(2 during respiration, or indirectly--caused by other stressing factors. Vitamin C or L-ascorbic acid acts as a scavenger of ROS, thereby potentially protecting cells from harmful oxidative products. While most eukaryotes synthesize ascorbic acid, yeast cells produce erythro-ascorbic acid instead. The actual importance of this antioxidant substance for the yeast is still a subject of scientific debate. METHODOLOGY/PRINCIPAL FINDINGS: We set out to enable Saccharomyces cerevisiae cells to produce ascorbic acid intracellularly to protect the cells from detrimental effects of environmental stresses. We report for the first time the biosynthesis of L-ascorbic acid from D-glucose by metabolically engineered yeast cells. The amount of L-ascorbic acid produced leads to an improved robustness of the recombinant cells when they are subjected to stress conditions as often met during industrial fermentations. Not only resistance against oxidative agents as H(2O(2 is increased, but also the tolerance to low pH and weak organic acids at low pH is increased. CONCLUSIONS/SIGNIFICANCE: This platform provides a new tool whose commercial applications may have a substantial impact on bio-industrial production of Vitamin C. Furthermore, we propose S. cerevisiae cells endogenously producing vitamin C as a cellular model to study the genesis/protection of ROS as well as genotoxicity.

The Burden Attributable to Mental and Substance Use Disorders as Risk Factors for Suicide: Findings from the Global Burden of Disease Study 2010

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Ferrari, Alize J.; Norman, Rosana E.; Freedman, Greg; Baxter, Amanda J.; Pirkis, Jane E.; Harris, Meredith G.; Page, Andrew; Carnahan, Emily; Degenhardt, Louisa; Vos, Theo; Whiteford, Harvey A.

2014-01-01

Background The Global Burden of Disease Study 2010 (GBD 2010) identified mental and substance use disorders as the 5th leading contributor of burden in 2010, measured by disability adjusted life years (DALYs). This estimate was incomplete as it excluded burden resulting from the increased risk of suicide captured elsewhere in GBD 2010's mutually exclusive list of diseases and injuries. Here, we estimate suicide DALYs attributable to mental and substance use disorders. Methods Relative-risk estimates of suicide due to mental and substance use disorders and the global prevalence of each disorder were used to estimate population attributable fractions. These were adjusted for global differences in the proportion of suicide due to mental and substance use disorders compared to other causes then multiplied by suicide DALYs reported in GBD 2010 to estimate attributable DALYs (with 95% uncertainty). Results Mental and substance use disorders were responsible for 22.5 million (14.8–29.8 million) of the 36.2 million (26.5–44.3 million) DALYs allocated to suicide in 2010. Depression was responsible for the largest proportion of suicide DALYs (46.1% (28.0%–60.8%)) and anorexia nervosa the lowest (0.2% (0.02%–0.5%)). DALYs occurred throughout the lifespan, with the largest proportion found in Eastern Europe and Asia, and males aged 20–30 years. The inclusion of attributable suicide DALYs would have increased the overall burden of mental and substance use disorders (assigned to them in GBD 2010 as a direct cause) from 7.4% (6.2%–8.6%) to 8.3% (7.1%–9.6%) of global DALYs, and would have changed the global ranking from 5th to 3rd leading cause of burden. Conclusions Capturing the suicide burden attributable to mental and substance use disorders allows for more accurate estimates of burden. More consideration needs to be given to interventions targeted to populations with, or at risk for, mental and substance use disorders as an effective strategy for suicide

Burden of Diarrhea in the Eastern Mediterranean Region, 1990–2013: Findings from the Global Burden of Disease Study 2013

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Khalil, Ibrahim; Colombara, Danny V.; Forouzanfar, Mohammad Hossein; Troeger, Christopher; Daoud, Farah; Moradi-Lakeh, Maziar; El Bcheraoui, Charbel; Rao, Puja C.; Afshin, Ashkan; Charara, Raghid; Abate, Kalkidan Hassen; El Razek, Mohammed Magdy Abd; Abd-Allah, Foad; Abu-Elyazeed, Remon; Kiadaliri, Aliasghar Ahmad; Akanda, Ali Shafqat; Akseer, Nadia; Alam, Khurshid; Alasfoor, Deena; Ali, Raghib; AlMazroa, Mohammad A.; Alomari, Mahmoud A.; Al-Raddadi, Rajaa Mohammad Salem; Alsharif, Ubai; Alsowaidi, Shirina; Altirkawi, Khalid A.; Alvis-Guzman, Nelson; Ammar, Walid; Antonio, Carl Abelardo T.; Asayesh, Hamid; Asghar, Rana Jawad; Atique, Suleman; Awasthi, Ashish; Bacha, Umar; Badawi, Alaa; Barac, Aleksandra; Bedi, Neeraj; Bekele, Tolesa; Bensenor, Isabela M.; Betsu, Balem Demtsu; Bhutta, Zulfiqar; Bin Abdulhak, Aref A.; Butt, Zahid A.; Danawi, Hadi; Dubey, Manisha; Endries, Aman Yesuf; Faghmous, Imad D. A.; Farid, Talha; Farvid, Maryam S.; Farzadfar, Farshad; Fereshtehnejad, Seyed-Mohammad; Fischer, Florian; Fitchett, Joseph Robert Anderson; Gibney, Katherine B.; Ginawi, Ibrahim Abdelmageem Mohamed; Gishu, Melkamu Dedefo; Gugnani, Harish Chander; Gupta, Rahul; Hailu, Gessessew Bugssa; Hamadeh, Randah Ribhi; Hamidi, Samer; Harb, Hilda L.; Hedayati, Mohammad T.; Hsairi, Mohamed; Husseini, Abdullatif; Jahanmehr, Nader; Javanbakht, Mehdi; Jibat, Tariku; Jonas, Jost B.; Kasaeian, Amir; Khader, Yousef Saleh; Khan, Abdur Rahman; Khan, Ejaz Ahmad; Khan, Gulfaraz; Khoja, Tawfik Ahmed Muthafer; Kinfu, Yohannes; Kissoon, Niranjan; Koyanagi, Ai; Lal, Aparna; Latif, Asma Abdul Abdul; Lunevicius, Raimundas; El Razek, Hassan Magdy Abd; Majeed, Azeem; Malekzadeh, Reza; Mehari, Alem; Mekonnen, Alemayehu B.; Melaku, Yohannes Adama; Memish, Ziad A.; Mendoza, Walter; Misganaw, Awoke; Mohamed, Layla Abdalla Ibrahim; Nachega, Jean B.; Le Nguyen, Quyen; Nisar, Muhammad Imran; Peprah, Emmanuel Kwame; Platts-Mills, James A.; Pourmalek, Farshad; Qorbani, Mostafa; Rafay, Anwar; Rahimi-Movaghar, Vafa; Ur Rahman, Sajjad; Rai, Rajesh Kumar; Rana, Saleem M.; Ranabhat, Chhabi L.; Rao, Sowmya R.; Refaat, Amany H.; Riddle, Mark; Roshandel, Gholamreza; Ruhago, George Mugambage; Saleh, Muhammad Muhammad; Sanabria, Juan R.; Sawhney, Monika; Sepanlou, Sadaf G.; Setegn, Tesfaye; Sliwa, Karen; Sreeramareddy, Chandrashekhar T.; Sykes, Bryan L.; Tavakkoli, Mohammad; Tedla, Bemnet Amare; Terkawi, Abdullah S.; Ukwaja, Kingsley; Uthman, Olalekan A.; Westerman, Ronny; Wubshet, Mamo; Yenesew, Muluken A.; Yonemoto, Naohiro; Younis, Mustafa Z.; Zaidi, Zoubida; Zaki, Maysaa El Sayed; Al Rabeeah, Abdullah A.; Wang, Haidong; Naghavi, Mohsen; Vos, Theo; Lopez, Alan D.; Murray, Christopher J. L.; Mokdad, Ali H.

2016-01-01

Diarrheal diseases (DD) are leading causes of disease burden, death, and disability, especially in children in low-income settings. DD can also impact a child's potential livelihood through stunted physical growth, cognitive impairment, and other sequelae. As part of the Global Burden of Disease Study, we estimated DD burden, and the burden attributable to specific risk factors and particular etiologies, in the Eastern Mediterranean Region (EMR) between 1990 and 2013. For both sexes and all ages, we calculated disability-adjusted life years (DALYs), which are the sum of years of life lost and years lived with disability. We estimate that over 125,000 deaths (3.6% of total deaths) were due to DD in the EMR in 2013, with a greater burden of DD in low- and middle-income countries. Diarrhea deaths per 100,000 children under 5 years of age ranged from one (95% uncertainty interval [UI] = 0–1) in Bahrain and Oman to 471 (95% UI = 245–763) in Somalia. The pattern for diarrhea DALYs among those under 5 years of age closely followed that for diarrheal deaths. DALYs per 100,000 ranged from 739 (95% UI = 520–989) in Syria to 40,869 (95% UI = 21,540–65,823) in Somalia. Our results highlighted a highly inequitable burden of DD in EMR, mainly driven by the lack of access to proper resources such as water and sanitation. Our findings will guide preventive and treatment interventions which are based on evidence and which follow the ultimate goal of reducing the DD burden. PMID:27928080

Caregiver burden among relatives of patients with schizophrenia in Katsina, Nigeria

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Abdulkareem Jika Yusuf

2009-06-01

Full Text Available Objective: Caring for patients’ with schizophrenia leads to an enormous burden on the caregivers. However, the magnitude of this problem remains largely unknown in Sub-Saharan Africa. The objective of this study was to determine the burden of care giving among relatives of patients with schizophrenia. Materials and method: A total of 129 primary care-givers of patients with schizophrenia attending out-patient clinic of Katsina state Psychiatric Hospital were interviewed using a socio-demographic data collection sheet and Zarith Burden Interview (ZBI. Data obtained was analysed using Statistical Package for Social Sciences version 13. Results: The mean age of the respondents was 45.07±8.91. Majority of the caregivers are females. High level of burden was found in 47.3% of the respondents. The level of burden experienced was significantly associated with place of residence and family size. Conclusion: Schizophrenia is associated with high level of caregiver burden and effort should be made at alleviating this burden for better out come in both the patients and caregivers.

The Burden of Child Maltreatment Leading to Hospitalization in a Provincial Setting in Papua New Guinea.

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Rero, Allanie; Aipit, Jimmy; Yarong-Kote, Tina; Watch, Villa; Bolnga, John W; Vei, Robert; Morris, Marilyn; Lufele, Elvin; Laman, Moses

2016-08-01

Child maltreatment is prevalent globally. In Papua New Guinea (PNG), child maltreatment remains an under-reported problem. As part of a 10 month prospective observational study conducted at Modilon Hospital in PNG, we investigated the burden of child maltreatment in the form of sexual abuse, physical abuse and neglect, leading to hospitalization in children ≤14 years. Of 1061 screened admissions, 107 (10%) fulfilled the definition of child maltreatment. The in-hospital admission prevalence of sexual abuse was 5.7% [60 of 1061; 95% confidence interval (CI): 4.4-7.3]. Neglect accounted for 3.4% (36 of 1061; 95% CI: 2.4-4.7) of admissions, while physical abuse accounted for 1.0% (11 of 1061; 95% CI: 0.6-1.9). Mortality was highest in the neglected group, with severe acute malnutrition accounting for 89% of deaths. Improved awareness, establishment of appropriate channels for addressing child maltreatment and enforcement of child protection laws in PNG and other epidemiologically similar settings are urgently needed. © The Author [2016]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

National mortality burden due to communicable, non-communicable, and other diseases in Ethiopia, 1990-2015: findings from the Global Burden of Disease Study 2015.

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Misganaw, Awoke; Haregu, Tilahun N; Deribe, Kebede; Tessema, Gizachew Assefa; Deribew, Amare; Melaku, Yohannes Adama; Amare, Azmeraw T; Abera, Semaw Ferede; Gedefaw, Molla; Dessalegn, Muluken; Lakew, Yihunie; Bekele, Tolesa; Mohammed, Mesoud; Yirsaw, Biruck Desalegn; Damtew, Solomon Abrha; Krohn, Kristopher J; Achoki, Tom; Blore, Jed; Assefa, Yibeltal; Naghavi, Mohsen

2017-01-01

Ethiopia lacks a complete vital registration system that would assist in measuring disease burden and risk factors. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015) estimates to describe the mortality burden from communicable, non-communicable, and other diseases in Ethiopia over the last 25 years. GBD 2015 mainly used cause of death ensemble modeling to measure causes of death by age, sex, and year for 195 countries. We report numbers of deaths and rates of years of life lost (YLL) for communicable, maternal, neonatal, and nutritional (CMNN) disorders, non-communicable diseases (NCDs), and injuries with 95% uncertainty intervals (UI) for Ethiopia from 1990 to 2015. CMNN causes of death have declined by 65% in the last two-and-a-half decades. Injury-related causes of death have also decreased by 70%. Deaths due to NCDs declined by 37% during the same period. Ethiopia showed a faster decline in the burden of four out of the five leading causes of age-standardized premature mortality rates when compared to the overall sub-Saharan African region and the Eastern sub-Saharan African region: lower respiratory infections, tuberculosis, HIV/AIDS, and diarrheal diseases; however, the same could not be said for ischemic heart disease and other NCDs. Non-communicable diseases, together, were the leading causes of age-standardized mortality rates, whereas CMNN diseases were leading causes of premature mortality in 2015. Although lower respiratory infections, tuberculosis, and diarrheal disease were the leading causes of age-standardized death rates, they showed major declines from 1990 to 2015. Neonatal encephalopathy, iron-deficiency anemia, protein-energy malnutrition, and preterm birth complications also showed more than a 50% reduction in burden. HIV/AIDS-related deaths have also decreased by 70% since 2005. Ischemic heart disease, hemorrhagic stroke, and ischemic stroke were among the top causes of premature mortality and age

Lead exposure from lead pellets: age-related accumulation in mute swans

Energy Technology Data Exchange (ETDEWEB)

Eskildsen, J.; Grandjean, P.

1984-05-01

In a cross-sectional study of adult swans and their successfully fledged young in Ringkobing Fjord, West Jutland, Denmark, 128 venous blood samples were taken during the moulting period and analyzed for lead. While the juveniles generally showed blood lead levels below 15 micrograms/100 ml (median, 11 micrograms/100 ml), the values were significantly higher in adults (median, 25 micrograms/100 ml). Adult females showed slightly higher levels than did adult males. None of the birds examined showed signs of acute lead toxicity, and increased blood levels in adults may reflect increased lead body burdens from previous ingestion of lead shot as gizzard stones.

Study design and protocol for a culturally adapted cognitive behavioral stress and self-management intervention for localized prostate cancer: The Encuentros de Salud study.

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Penedo, Frank J; Antoni, Michael H; Moreno, Patricia I; Traeger, Lara; Perdomo, Dolores; Dahn, Jason; Miller, Gregory E; Cole, Steve; Orjuela, Julian; Pizarro, Edgar; Yanez, Betina

2018-06-14

Almost 2.8 million men in the U.S. are living with prostate cancer (PC), accounting for 40% of all male cancer survivors. Men diagnosed with prostate cancer may experience chronic and debilitating treatment side effects, including sexual and urinary dysfunction, pain and fatigue. Side effects can be stressful and can also lead to poor psychosocial functioning. Prior trials reveal that group-based cognitive behavioral stress and self-management (CBSM) is effective in reducing stress and mitigating some of these symptoms, yet little is known about the effects of culturally-translated CBSM among Spanish-speaking men with PC. This manuscript describes the rationale and study design of a multi-site, randomized controlled trial to determine whether participation in a culturally adapted cognitive behavioral stress management (C-CBSM) intervention leads to significantly greater reductions in symptom burden and improvements in health-related quality of life relative to participation in a non-culturally adapted cognitive behavioral stress management (CBSM) intervention. Participants (N = 260) will be Spanish-speaking Hispanic/Latino men randomized to the standard, non-culturally adapted CBSM intervention (e.g., cognitive behavioral strategies, stress management, and health maintenance) or the culturally adapted C-CBSM intervention (e.g., content adapted to be compatible with Hispanic/Latino cultural patterns and belief systems, meanings, values and social context) for 10 weeks. Primary outcomes (i.e., disease-specific symptom burden and health-related quality of life) will be assessed across time. We hypothesize that a culturally adapted C-CBSM intervention will be more efficacious in reducing symptom burden and improving health-related quality of life among Hispanic/Latino men when compared to a non-culturally adapted CBSM intervention. Copyright © 2017. Published by Elsevier Inc.

Caregiver burden in Alzheimer's disease patients in Spain.

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Peña-Longobardo, Luz María; Oliva-Moreno, Juan

2015-01-01

Alzheimer's disease constitutes one of the leading causes of burden of disease, and it is the third leading disease in terms of economic and social costs. To analyze the burden and problems borne by informal caregivers of patients who suffer from Alzheimer's disease in Spain. We used the Survey on Disabilities, Autonomy and Dependency to obtain information on the characteristics of disabled people with Alzheimer's disease and the individuals who provide them with personal care. Additionally, statistical multivariate analyses using probit models were performed to analyze the burden placed on caregivers in terms of health, professional, and leisure/social aspects. 46% of informal caregivers suffered from health-related problems as a result of providing care, 90% had leisure-related problems, and 75% of caregivers under 65 years old admitted to suffering from problems related to their professional lives. The probability of a problem arising for an informal caregiver was positively associated with the degree of dependency of the person cared for. In the case of caring for a greatly dependent person, the probability of suffering from health-related problems was 22% higher, the probability of professional problems was 18% higher, and there was a 10% greater probability of suffering from leisure-related problems compared to non-dependents. The results show a part of the large hidden cost for society in terms of problems related to the burden lessened by the caregivers. This information should be a useful tool for designing policies focused toward supporting caregivers and improving their welfare.

Caregiver burden in Alzheimer-type dementia and psychosis: A comparative study from India.

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Sinha, P; Desai, N G; Prakash, O; Kushwaha, S; Tripathi, C B

2017-04-01

Caregiver burden in dementia is an important area of research. Providing care for a relative can be a potent source of chronic stress and can have deleterious consequences for both the physical and emotional health of caregivers. This study aims to evaluate the burden of care in caregivers of patients with Alzheimer-type dementia and compare it with elderly psychosis; and to also study the factors that influence burden of care in Alzheimer's dementia. Thirty-two caregiver-patient dyads of Alzheimer-type dementia were compared with thirty-two caregiver-patient dyads of psychosis. Cognitive assessment, abilities to perform activities of daily living and severity of dementia was assessed in the patients. Zarit Burden Interview was used to study the caregiver burden in both groups. The mean burden score in dementia caregivers was high at 47.7, whereas the mean burden score for elderly psychosis caregivers was lesser at 33.6, and this difference in mean burden scores was found to be statistically significant. Spouses had the highest mean burden scores of 53.48. Caregiver burden in dementia was positively correlated with cognitive impairment and inability to carry out ADLs. Presence of psychological distress in caregivers was also an indicator for greater caregiver burden in dementia. The study revealed that dementia carries a greater caregiver burden when compared with elderly patients with psychosis. Innovative interventions are needed to remove burden from caregiving, making it a meaningful practice integral to the Indian society. Copyright © 2017 Elsevier B.V. All rights reserved.

Correlates of caregiver burden among family caregivers of older Korean Americans.

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Casado, Banghwa; Sacco, Paul

2012-05-01

Despite the rapid growth of older ethnic minority populations, knowledge is limited about informal caregiving among these groups. Our aim was to identify correlates of caregiver burden among family caregivers of older Korean Americans (KAs). A cross-sectional survey collected data from 146 KA caregivers. Using a modified stress-appraisal model, we examined background and context characteristics (caregiver sex, relationship to care recipient, college education, English proficiency, time in caregiving role, family support network, friend support network), a primary stressor (care recipient functional dependency), a primary appraisal (caregiving hours), and resources (family agreement, care management self-efficacy, service use self-efficacy) as potential correlates of caregiver burden. Interactions between the primary stressor, primary appraisal, and resources were also tested. Being female and the care recipient's spouse were associated with higher burden. Conversely, a larger family support network, greater family agreement, and greater care management self-efficacy were associated with lower burden. A significant interaction was detected between functional dependency and family agreement; higher levels of family agreement moderated the association between care recipient functional dependency and caregiver burden. Interventions to reduce caregiver burden in KA caregivers may be more effective if they include approaches specifically designed to build family support, improve family agreement, and increase caregivers' self-efficacy.

The Global Burden of Road Injury: Its Relevance to the Emergency Physician

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Sharon Chekijian

2014-01-01

Full Text Available Background. Road traffic crash fatalities in the United States are at the lowest level since 1950. The reduction in crash injury burden is attributed to several factors: public education and prevention programs, traffic safety policies and enforcement, improvements in vehicle design, and prehospital services coupled with emergency and acute trauma care. Globally, the disease burden of road traffic injuries is rising. In 1990, road traffic injuries ranked ninth in the ten leading causes of the global burden of disease. By 2030, estimates show that road traffic injuries will be the fifth leading causes of death in the world. Historically, emergency medicine has played a pivotal role in contributing to the success of the local, regional, and national traffic safety activities focused on crash and injury prevention. Objective. We report on the projected trend of the global burden of road traffic injuries and fatalities and describe ongoing global initiatives to reduce road traffic morbidity and mortality. Discussion. We present key domains where emergency medicine can contribute through international collaboration to address global road traffic-related morbidity and mortality. Conclusion. International collaborative programs and research offer important opportunities for emergency medicine physicians to make a meaningful impact on the global burden of disease.

Psychological Stressors and Burden of Medical Conditions in Older Adults: A Psychosomatic Approach

Directory of Open Access Journals (Sweden)

Arash Mani

2009-12-01

Full Text Available "n  "n  "nObjective: "nIn geriatric practice, the impact of psychological distress on health status has been undermined due to ageism, atypical presentation and less tendency to report negative affect among elderly people. Few studies have examined the impact of psychological stressors on medical burden in older adults. The current study has investigated the correlation of psychological distress and burden of medical conditions in a sample of older people .     "n  "n  "nMethod: A convenient study sample of 120 elderly subjects was recruited from the places where there was greater chance for the elderly people to attend. Data were collected by a trained research assistant using perceived stress scale, cumulative illness rating scale, geriatric depressive scale and a demographic questionnaire.     "n  "n  "nResults: "nOur participants perceived more level of stress than the average for their age. In the current study, the burden of medical condition was significantly correlated with the level of perceived stress(r = .197, p = .044. Moreover, in regression analysis, perceived stress was the strongest predictor for physical health morbidity (R2 =.049, significant f= .03.     "n  "n  "nConclusions: "nThe result of this study suggested that the psychological stressors contribute to poor health outcome in older adults ; the area that is usually overlooked due to ageism and its physiological related changes. The medical practitioners should consider the psychological distress as a part of etiological factors implicating in health morbidity among their aged patients.

Burden of emergency conditions and emergency care utilization: New estimates from 40 countries

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Chang, Cindy Y.; Abujaber, Samer; Reynolds, Teri A.; Camargo, Carlos A.; Obermeyer, Ziad

2016-01-01

Objective To estimate the global and national burden of emergency conditions, and compare them to emergency care utilization rates. Methods We coded all 291 Global Burden of Disease 2010 conditions into three categories to estimate emergency burden: conditions that, if not addressed within hours to days of onset, commonly lead to serious disability or death; conditions with common acute decompensations that lead to serious disability or death; and non-emergencies. Emergency care utilization rates were obtained from a systematic literature review on emergency care facilities in low- and middle-income countries (LMICs), supplemented by national health system reports. Findings All 15 leading causes of death and DALYs globally were conditions with potential emergent manifestations. We identified 41 facility-based reports in 23 countries, 12 of which were in LMICs; data for 17 additional countries were obtained from national or regional reports on emergency utilization. Burden of emergency conditions was the highest in low-income countries, with median DALYs of 47,728 per 100,000 population (IQR 45,253-50,085) in low-income, 25,186 (IQR 21,982-40,480) in middle-income, and 15,691 (IQR 14,649-16,382) in high-income countries. Patterns were similar using deaths to measure burden and excluding acute decompensations from the definition of emergency conditions. Conversely, emergency utilization rates were the lowest in low-income countries, with median 8 visits per 1,000 population (IQR 6-10), 78 (IQR 25-197) in middle-income, and 264 (IQR 177-341) in high-income countries. Conclusion Despite higher burden of emergency conditions, emergency utilization rates are substantially lower in LMICs, likely due to limited access to emergency care. PMID:27334758

Effects of variations in cadmium and lead levels in river sediments on local foods and body burden of local residents in non-polluted areas in Japan.

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Ikeda, Masayuki; Watanabe, Takao; Ohashi, Fumiko; Shimbo, Shinichiro

2010-03-01

This study was initiated to examine if variations in the concentrations of cadmium (Cd) and lead (Pb) in water environment may affect metal levels in local foods and body burden of local residents in non-polluted areas in Japan. Two nationwide databases have been made available on concentrations of Cd in locally harvested brown rice and of Cd and Pb in sediments in local river beds. These data were combined with published data on metal concentrations in polished rice, food duplicates, and blood and urine from the residents. Cd in river sediments correlated significantly with those in brown rice, food duplicates, blood, and urine. Cd in food duplicates correlated with Cd in rice. In contrast, Pb concentrations in the river sediments either did not correlate or correlated only weakly with Pb in biological materials or food duplicates. Possible implication of the different behavior between Cd and Pb regarding the intensity of correlation was discussed with reference to the different routes of exposure to the elements. In conclusions, the Cd body burden on local residents in Japan is significantly influenced by Cd levels in water in the general environment, whereas water-borne Pb did not show clear correlation with the Pb body burden.

Psychometric properties of Persian version of the Caregiver Burden Scale in Iranian caregivers of patients with spinal cord injury.

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Farajzadeh, Ata; Akbarfahimi, Malahat; Maroufizadeh, Saman; Rostami, Hamid Reza; Kohan, Amir Hassan

2018-02-01

To investigate the psychometric properties of the Persian version of Caregiver Burden Scale (CBS) in caregivers of patients with spinal cord injury. This is a cross-sectional study. After a forward-backward translation, the CBS was administered to 110 caregivers of patients with spinal cord injury (men = 60, women = 50). Factor structure was evaluated by confirmatory factor analysis. The Internal consistency and test-retest reliability of the CBS were examined using Cronbach's α and the intraclass correlation coefficient, respectively. Construct validity was assessed by examining the relationship among CBS and the World Health Organization Quality of Life, and the Beck Depression Inventory. The results of confirmatory factor analysis provided support for a five-factor model of CBS. All subscales of CBS revealed acceptable internal consistency (0.698-0.755), except for environment subscale (0.559). The CBS showed adequate test-retest reliability for its subscales (0.745-0.900). All subscales of CBS significantly correlated with both Beck Depression Inventory and World Health Organization Quality of Life, confirming construct validity. The Persian version of the CBS is a valid and reliable measure for assessing burden of care in caregivers of patients with spinal cord injury. Implications for Rehabilitation Spinal cord injury leads to depression, high levels of stress and diminished quality of life due to the high physical, emotional, and social burdens in caregivers. Persian version of the Caregiver Burden Scale is a valid and reliable tool for assessing burden in Iranian caregivers of patients with spinal cord injury.

[Coping and subjective burden in primary caregivers of dependent elderly relatives in Andalusia, Spain].

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Pérez-Cruz, Margarita; Muñoz-Martínez, M Ángeles; Parra-Anguita, Laura; Del-Pino-Casado, Rafael

To analyse the relationship between the type of coping and subjective burden in caregivers of dependent elderly relatives in Andalusia (Spain). Cross-sectional study. Primary Health Care (autonomous community of Andalusia, Spain). A convenience sample of 198 primary caregivers of dependent elderly relatives. Coping (Brief COPE), subjective burden (caregiver stress index), objective burden (functional capacity [Barthel Index], cognitive impairment [Pfeiffer Test], behavioural problems of the care recipient [Neuropsychiatric Inventory], and caregivers' dedication to caring), gender and kinship. Most caregivers were women (89.4%), daughters of the care recipient (57.1%), and shared home with him/her (69.7%). On controlling for objective burden, gender and kinship, it was found that subjective burden was positively associated with dysfunctional coping (β=0.28; P<.001) and negatively with emotion-focused coping (β=-0.25; P=.001), while no association was found with problem-focused coping. Dysfunctional coping may be a risk factor for subjective burden, and emotion-focused coping may be a protective factor for that subjective burden regardless of the objective burden, and gender and kinship of the caregivers. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

The State of stress in the Sanford Underground Research Facility (SURF) in Lead South Dakota

Energy Technology Data Exchange (ETDEWEB)

Lee, Moo Y. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

2016-10-01

As a part of the U.S. Department of Energy (DOE) SubTER (Subsurface Technology and Engineering Research, Development and Demonstration) initiative, University of Wisconsin- Madison, Sandia National Laboratories, and Lawrence Berkeley National Laboratory conducted the Permeability (k) and Induced Seismicity Management for Energy Technologies (kISMET) project. The objectives of the project are to define the in situ status of stress in the Sanford Underground Research Facility (SURF) in Lead, South Dakota and to establish the relations between in situ stress and induced fracture through hydraulically stimulating the fracture. (SURF) in Lead, South Dakota. In situ tests are conducted in a 7.6 cm diameter and 100 long vertical borehole located in the 4850 Level West Access Drift near Davies Campus of SURF (Figure 1). The borehole is located in the zone of Precambrian Metamorphic Schist.

Identification and Functional Analysis of MicroRNAs and Their Targets in Platanus acerifolia under Lead (Pb) Stress

OpenAIRE

Yuanlong Wang; Zhenli Zhao; Minjie Deng; Rongning Liu; Suyan Niu; Guoqiang Fan

2015-01-01

MicroRNAs (miRNAs) play important regulatory roles in development and stress responses in plants. Lead (Pb) is a non-essential element that is highly toxic to living organisms. Platanus acerifolia is grown as a street tree in cities throughout temperate regions for its importance in improving the urban ecological environment. MiRNAs that respond to abiotic stresses have been identified in plants; however, until now, the influence of Pb stress on P. acerifolia miRNAs has not been reported. To ...

Decreased MORF leads to prolonged endoplasmic reticulum stress in periodontitis-associated chronic inflammation.

Science.gov (United States)

Xue, Peng; Li, Bei; An, Ying; Sun, Jin; He, Xiaoning; Hou, Rui; Dong, Guangying; Fei, Dongdong; Jin, Fang; Wang, Qintao; Jin, Yan

2016-11-01

The association between inflammation and endoplasmic reticulum (ER) stress has been described in many diseases. However, if and how chronic inflammation governs the unfolded protein response (UPR) and promotes ER homeostasis of chronic inflammatory disease remains elusive. In this study, chronic inflammation resulted in ER stress in mesenchymal stem cells in the setting of periodontitis. Long-term proinflammatory cytokines induced prolonged ER stress and decreased the osteogenic differentiation of periodontal ligament stem cells (PDLSCs). Interestingly, we showed that chronic inflammation decreases the expression of lysine acetyltransferase 6B (KAT6B, also called MORF), a histone acetyltransferase, and causes the upregulation of a key UPR sensor, PERK, which lead to the persistent activation of the UPR in PDLSCs. Furthermore, we found that the activation of UPR mediated by MORF in chronic inflammation contributes to the PERK-related deterioration of the osteogenic differentiation of PDLSCs both in vivo and in vitro. Taken together, our results suggest that chronic inflammation compromises UPR function through MORF-mediated-PERK transcription, which is a previously unrecognized mechanism that contributes to impaired ER function, prolonged ER stress and defective osteogenic differentiation of PDLSCs in periodontitis.

The Spanish Burden of Disease 2010: Neurological, mental and substance use disorders.

Science.gov (United States)

Lara, Elvira; Garin, Noé; Ferrari, Alize J; Tyrovolas, Stefanos; Olaya, Beatriz; Sànchez-Riera, Lidia; Whiteford, Harvey A; Haro, Josep Maria

2015-01-01

We used data from the Global Burden of Disease, Injuries, and Risk Factors Study 2010 to report on the burden of neuropsychiatric disorders in Spain. The summary measure of burden used in the study was the disability-adjusted life-year (DALY), which sums of the years of life lost due to premature mortality (YLLs) and the years lived with disability (YLDs). DALYs were adjusted for comorbidity and estimated with 95% uncertainty intervals. The burden of neuropsychiatric disorders accounted for 18.4% of total all-cause DALYs generated in Spain for 2010. Within this group, the top five leading causes of DALYs were: depressive disorders, Alzheimer's disease, migraine, substance-use disorders, and anxiety disorder, which accounted for 70.9% of all DALYs due to neuropsychiatric disorders. Neurological disorders represented 5.03% of total all cause YLLs, whereas mental and substance-use disorders accounted for 0.8%. Mental and substance-use disorders accounted for 22.4% of total YLDs, with depression being the most disabling disorder. Neurological disorders represented 8.3% of total YLDs. Neuropsychiatric disorders were one of the leading causes of disability in 2010. This finding contributes to our understanding of the burden of neuropsychiatric disorders in the Spanish population and highlights the importance of prioritising neuropsychiatric disorders in the Spanish public health system. Copyright © 2014 SEP y SEPB. Published by Elsevier España. All rights reserved.

Stress proteins and oxidative damage in a renal derived cell line exposed to inorganic mercury and lead

International Nuclear Information System (INIS)

Stacchiotti, Alessandra; Morandini, Fausta; Bettoni, Francesca; Schena, Ilaria; Lavazza, Antonio; Grigolato, Pier Giovanni; Apostoli, Pietro; Rezzani, Rita; Aleo, Maria Francesca

2009-01-01

A close link between stress protein up-regulation and oxidative damage may provide a novel therapeutic tool to counteract nephrotoxicity induced by toxic metals in the human population, mainly in children, of industrialized countries. Here we analysed the time course of the expression of several heat shock proteins, glucose-regulated proteins and metallothioneins in a rat proximal tubular cell line (NRK-52E) exposed to subcytotoxic doses of inorganic mercury and lead. Concomitantly, we used morphological and biochemical methods to evaluate metal-induced cytotoxicity and oxidative damage. In particular, as biochemical indicators of oxidative stress we detected reactive oxygen species (ROS) and nitrogen species (RNS), total glutathione (GSH) and glutathione-S-transferase (GST) activity. Our results clearly demonstrated that mercury increases ROS and RNS levels and the expressions of Hsp25 and inducible Hsp72. These findings are corroborated by evident mitochondrial damage, apoptosis or necrosis. By contrast, lead is unable to up-regulate Hsp72 but enhances Grp78 and activates nuclear Hsp25 translocation. Furthermore, lead causes endoplasmic reticulum (ER) stress, vacuolation and nucleolar segregation. Lastly, both metals stimulate the over-expression of MTs, but with a different time course. In conclusion, in NRK-52E cell line the stress response is an early and metal-induced event that correlates well with the direct oxidative damage induced by mercury. Indeed, different chaperones are involved in the specific nephrotoxic mechanism of these environmental pollutants and work together for cell survival.

Metabolism of lead-210 in juvenile and adult rhesus monkeys (Macaca mulatta)

International Nuclear Information System (INIS)

Pounds, J.G.; Marlar, R.J.; Allen, J.R.

1978-01-01

Experiments were conducted measuring the gastrointestinal absorption and elimination of a single dose of lead-210 acetate in infant and adult rhesus monkeys. Urinary and fecal excretion of absorbed lead was followed for 23 days. Infant monkeys eliminated less and absorbed more orally administered lead. Adult animals excreted more absorbed lead in feces, while urinary excretion between adults and infants was similar. Increased absorption of administered lead and reduced fecal excretion of absorbed lead resulted in significantly greater body burden of lead-210 in infant animals. Blood lead values were increased in the infant animals, and were inversely correlated with body burden and percent absorption of ingested lead

Prospective study of the burden of rotavirus gastroenteritis in Danish children and their families

DEFF Research Database (Denmark)

Hoffmann, Thomas; Iturriza, Miren; Faaborg-Andersen, Jens

2011-01-01

This was the first study to characterize the total burden of rotavirus gastroenteritis (RVGE) at both hospital and general physician (GP) clinics in Denmark, and also the first to confirm rotavirus (RV) as the leading cause of acute gastroenteritis (GE) among children......This was the first study to characterize the total burden of rotavirus gastroenteritis (RVGE) at both hospital and general physician (GP) clinics in Denmark, and also the first to confirm rotavirus (RV) as the leading cause of acute gastroenteritis (GE) among children...

The combined effects of developmental lead and ethanol exposure on hippocampus dependent spatial learning and memory in rats: Role of oxidative stress.

Science.gov (United States)

Soleimani, Elham; Goudarzi, Iran; Abrari, Kataneh; Lashkarbolouki, Taghi

2016-10-01

Either developmental lead or ethanol exposure can impair learning and memory via induction of oxidative stress, which results in neuronal damage. we examined the effect of combined exposure with lead and ethanol on spatial learning and memory in offspring and oxidative stress in hippocampus. Rats were exposed to lead (0.2% in drinking water) or ethanol (4 g/kg) either individually or in combination in 5th day gestation through weaning. On postnatal days (PD) 30, rats were trained with six trials per day for 6 consecutive days in the water maze. On day 37, a probe test was done. Also, oxidative stress markers in the hippocampus were also evaluated. Results demonstrated that lead + ethanol co-exposed rats exhibited higher escape latency during training trials and reduced time spent in target quadrant, higher escape location latency and average proximity in probe trial test. There was significant decrease in superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) activities and increase of malondialdehyde (MDA) levels in hippocampus of animals co-exposed to lead and ethanol compared with their individual exposures. We suggest that maternal consumption of ethanol during lead exposure has pronounced detrimental effects on memory, which may be mediated by oxidative stress. Copyright © 2016. Published by Elsevier Ltd.

Biochemical effects of lead exposure on oxidative stress and antioxidant status of battery manufacturing workers of Western Maharashtra, India.

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Ghanwat, Ganesh Haribhau; Patil, Arun Jalindar; Patil, Jyotsna A; Kshirsagar, Mandakini S; Sontakke, Ajit; Ayachit, Ram Krishna

2016-03-01

Lead induces oxidative stress and alters the antioxidant status of population exposed to high lead levels, i.e. battery manufacturing workers. The aim of this study was to know the current scenario of blood lead (PbB) levels and their effect on the oxidative stress parameter, i.e. serum lipid peroxide (LP), and antioxidant parameters, such as red blood cell (RBC)-superoxide dismutase (SOD), RBC-catalase (CAT), plasma ceruloplasmin (CP), and serum nitrite, of battery manufacturing workers. Forty-three battery manufacturing workers from Western Maharashtra, India, with ages between 19 and 42 years, were selected as study group and compared with 38 age-matched, healthy male subjects (control group). From both group subjects, 10 mL of blood sample was drawn by puncturing the antecubital vein, and PbB, serum LP, RBC-SOD, RBC-CAT, plasma CP, and serum nitrite were estimated using standard methods. The PbB levels of the battery manufacturing workers were significantly higher (pworkers as compared with the control subjects. Despite modern techniques used to reduce lead exposure in battery manufacturing workers, PbB levels remain high, inducing oxidative stress and altering the antioxidant status of battery manufacturing workers.

Global and regional burden of stroke during 1990-2010

DEFF Research Database (Denmark)

Feigin, Valery L; Forouzanfar, Mohammad H; Krishnamurthi, Rita

2014-01-01

BACKGROUND: Although stroke is the second leading cause of death worldwide, no comprehensive and comparable assessment of incidence, prevalence, mortality, disability, and epidemiological trends has been estimated for most regions. We used data from the Global Burden of Diseases, Injuries, and Ri...

Disease burden of methylmercury in the German birth cohort 2014.

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Julia Lackner

Full Text Available This study aimed to estimate the disease burden of methylmercury for children born in Germany in the year 2014. Humans are mainly exposed to methylmercury when they eat fish or seafood. Prenatal methylmercury exposure is associated with IQ loss. To quantify this disease burden, we used Monte Carlo simulation to estimate the incidence of mild and severe mental retardation in children born to mothers who consume fish based on empirical data. Subsequently, we calculated the disease burden with the disability-adjusted life years (DALY-method. DALYs combine mortality and morbidity in one measure and quantify the gap between an ideal situation, where the entire population experiences the standard life expectancy without disease and disability, and the actual situation. Thus, one DALY corresponds to the loss of one year of life in good health. The methylmercury-induced burden of disease for the German birth cohort 2014 was an average of 14,186 DALY (95% CI 12,915-15,440 DALY. A large majority of the DALYs was attributed to morbidity as compared to mortality. Of the total disease burden, 98% were attributed to mild mental retardation, which only leads to morbidity. The remaining disease burden was a result of severe mental retardation with equal proportions of premature death and morbidity.

Genetically induced oxidative stress in mice causes thrombocytosis, splenomegaly and placental angiodysplasia that leads to recurrent abortion

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Takamasa Ishii

2014-01-01

Full Text Available Historical data in the 1950s suggests that 7%, 11%, 33%, and 87% of couples were infertile by ages 30, 35, 40 and 45, respectively. Up to 22.3% of infertile couples have unexplained infertility. Oxidative stress is associated with male and female infertility. However, there is insufficient evidence relating to the influence of oxidative stress on the maintenance of a viable pregnancy, including pregnancy complications and fetal development. Recently, we have established Tet-mev-1 conditional transgenic mice, which can express the doxycycline-induced mutant SDHCV69E transgene and experience mitochondrial respiratory chain dysfunction leading to intracellular oxidative stress. In this report, we demonstrate that this kind of abnormal mitochondrial respiratory chain-induced chronic oxidative stress affects fertility, pregnancy and delivery rates as well as causes recurrent abortions, occasionally resulting in maternal death. Despite this, spermatogenesis and early embryogenesis are completely normal, indicating the mutation's effects to be rather subtle. Female Tet-mev-1 mice exhibit thrombocytosis and splenomegaly in both non-pregnant and pregnant mice as well as placental angiodysplasia with reduced Flt-1 protein leading to hypoxic conditions, which could contribute to placental inflammation and fetal abnormal angiogenesis. Collectively these data strongly suggest that chronic oxidative stress caused by mitochondrial mutations provokes spontaneous abortions and recurrent miscarriage resulting in age-related female infertility.

Caregiver burden from caring for impaired elderly: a cross-sectional study in rural Lower Egypt

OpenAIRE

Salama, Rasha

2012-01-01

Background: increased life expectancy and an aging population have made home care for the elderly a major responsibility for families. Caring for a chronically ill or physically disabled person has been referred to as physically or emotionally stressful, placing the caregiver at a heightened risk of burden. This study aimed to identify factors related to caregiving burden among caregivers who care for their disabled older family members. Methods: a cross sectional descriptive study was conduc...

Role of ascorbic acid supplement in reducing oxidative stress and hepatotoxicity in lead intoxication

International Nuclear Information System (INIS)

Farooq, Y.; Hussain, M.M.; Aleem, S.B.

2013-01-01

Objective: The present study was conducted to measure the oxidative stress and hepatotoxicity in lead intoxicated sprague dawley rats with and without supplementation of ascorbic acid. Study Design: Randomized Control Trial. Place of Study: Physiology Department, Army Medical College, Rawalpindi. (From Oct 2007 to Sep 2008) Material and Methods: One hundred and five male rats (age, 90-120 days; weight 200 - 250 gm) were divided into three groups each having 35 rats. Rats of group 1 and group 2 were given weekly injections of sodium acetate (10 mg /kg body weight) and lead acetate (10 mg /kg body weight) respectively, whereas rats of group 3 were administered lead acetate(10 mg /kg body weight) through weekly injections and ascorbic acid in drinking water (500 mg/l). After 6 weeks, 4 ml of blood was drawn from each rat by cardiac puncture. The blood was allowed to clot and serum was separated for estimation of serum malondialdehyde (MDA) levels on spectrophotometer; and serum alanine aminotransferase (ALT) levels and aspartate aminotransferase (AST) levels on Merck Micorlab 200. Results: Lead intoxication of rats revealed that serum MDA levels were raised to 7.8 +- 0.48 micro mol/l (control, 3.2 +-0.39 micro mol/l), ALT levels to 76.26 +- 5.88 IU/l (control, 44.1 +- 3.26) and AST levels to 258.06 +- 13.30 IU/l (control, 156.2 +- 4.97). Ascorbic acid supplementation significantly lowered serum MDA levels (3.8 +- 0.34 micro mol/l), ALT levels (52.26 +-4.57 IU/l) and AST levels (188.13 +- 12.91 IU/l). Conclusion: Ascorbic acid supplementation ameliorates lead intoxication probably by reducing the oxidative stress, thus preventing the development of hepatotoxicity, but this amelioration is not equal to the control. (author)

Progranulin gene delivery reduces plaque burden and synaptic atrophy in a mouse model of Alzheimer's disease.

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Jackalina M Van Kampen

Full Text Available Progranulin (PGRN is a multifunctional protein that is widely expressed throughout the brain, where it has been shown to act as a critical regulator of CNS inflammation and also functions as an autocrine neuronal growth factor, important for long-term neuronal survival. PGRN has been shown to activate cell signaling pathways regulating excitoxicity, oxidative stress, and synaptogenesis, as well as amyloidogenesis. Together, these critical roles in the CNS suggest that PGRN has the potential to be an important therapeutic target for the treatment of various neurodegenerative disorders, particularly Alzheimer's disease (AD. AD is the leading cause of dementia and is marked by the appearance of extracellular plaques consisting of aggregates of amyloid-β (Aβ, as well as neuroinflammation, oxidative stress, neuronal loss and synaptic atrophy. The ability of PGRN to target multiple key features of AD pathophysiology suggests that enhancing its expression may benefit this disease. Here, we describe the application of PGRN gene transfer using in vivo delivery of lentiviral expression vectors in a transgenic mouse model of AD. Viral vector delivery of the PGRN gene effectively enhanced PGRN expression in the hippocampus of Tg2576 mice. This elevated PGRN expression significantly reduced amyloid plaque burden in these mice, accompanied by reductions in markers of inflammation and synaptic atrophy. The overexpression of PGRN was also found to increase activity of neprilysin, a key amyloid beta degrading enzyme. PGRN regulation of neprilysin activity could play a major role in the observed alterations in plaque burden. Thus, PGRN may be an effective therapeutic target for the treatment of AD.

EDXS and XRD Analyses of Coleus with Different Concentration Selenium Supplements Under Lead Stress

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QIN Hui-yuan

2014-04-01

Full Text Available In order to study the changes of the morphologies and element composition in Coleus hlumei Benth(Coleusroots and leaves under1.0 mmol·L-1 Pb2+ stress with selenium ( Setreatments, and to preliminarily investigate the relief mechanism of Se level on lead toxicity from the perspective of spectroscopy, Coleus was cultivated in nutrient solutions with different concentrations of Se. The results showed that the content of C, K and Ca elements in roots decreased, while 0, Mg, Al, Si, Fe and Pb elements increased under Pb stress with Se treatments. In addi-tion, the content of C, Mg, Al, Si, K, Ca and Fe elements in leaves decreased, while 0 and Cl elements increased. The element species and its contents in roots were changed obviously under Pb stress with Se treatments, and crystalline solid and crystal phase in roots were correspond-ingly changed.

40 CFR 179.91 - Burden of going forward; burden of persuasion.

Science.gov (United States)

2010-07-01

... persuasion. 179.91 Section 179.91 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED...; burden of persuasion. (a) The party whose request for an evidentiary hearing was granted has the burden... FFDCA has the burden of persuasion in the hearing on that issue, whether the proceeding concerns the...

Burden of Sexual Dysfunction.

Science.gov (United States)

Balon, Richard

2017-01-02

Similar to the burden of other diseases, the burden of sexual dysfunction has not been systematically studied. However, there is growing evidence of various burdens (e.g., economic, symptomatic, humanistic) among patients suffering from sexual dysfunctions. The burden of sexual dysfunction has been studied a bit more often in men, namely the burden of erectile dysfunction (ED), premature ejaculation (PE) and testosterone deficiency syndrome (TDS). Erectile dysfunction is frequently associated with chronic conditions such as cardiovascular disease, diabetes, and depression. These conditions could go undiagnosed, and ED could be a marker of those diseases. The only available report from the United Kingdom estimated the total economic burden of ED at £53 million annually in terms of direct costs and lost productivity. The burden of PE includes significant psychological distress: anxiety, depression, lack of sexual confidence, poor self-esteem, impaired quality of life, and interpersonal difficulties. Some suggest that increase in female sexual dysfunction is associated with partner's PE, in addition to significant interpersonal difficulties. The burden of TDS includes depression, sexual dysfunction, mild cognitive impairment, and osteoporosis. One UK estimate of the economic burden of female sexual dysfunctions demonstrated that the average cost per patient was higher than the per annum cost of ED. There are no data on burden of paraphilic disorders. The burden of sexual dysfunctions is underappreciated and not well studied, yet it is significant for both the patients and the society.

Neuropsychiatric Symptoms in Parkinson’s Disease Dementia Are Associated with Increased Caregiver Burden

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Yoon-Sang Oh

2015-01-01

Full Text Available Objective Neuropsychiatric symptoms are common in Parkinson’s disease dementia (PDD. Frequent and severe neuropsychiatric symptoms create high levels of distress for patients and caregivers, decreasing their quality of life. The aim of this study was to investigate neuropsychiatric symptoms that may contribute to increased caregiver burden in PDD patients. Methods Forty-eight PDD patients were assessed using the 12-item Neuropsychiatric Inventory (NPI to determine the frequency and severity of mental and behavioral problems. The Burden Interview and Caregiver Burden Inventory were used to evaluate caregiver burden. Results All but one patient showed one or more neuropsychiatric symptoms. The three most frequent neuropsychiatric symptoms were apathy (70.8% and anxiety (70.8%, followed by depression (68.7%. More severe neuropsychiatric symptoms were significantly correlated with increased caregiver burden. The domains of delusion, hallucination, agitation and aggression, anxiety, irritability and lability, and aberrant motor behavior were associated with caregiver stress. After controlling for age and other potential confounding variables, total NPI score was significantly associated with caregiver burden. Conclusions The results of this study confirm that neuropsychiatric symptoms are frequent and severe in patients with PDD and are associated with increased caregiver distress. A detailed evaluation and management of neuropsychiatric symptoms in PDD patients appears necessary to improve patient quality of life and reduce caregiver burden.

MAPK pathway activation by chronic lead-exposure increases vascular reactivity through oxidative stress/cyclooxygenase-2-dependent pathways

Energy Technology Data Exchange (ETDEWEB)

Simões, Maylla Ronacher, E-mail: yllars@hotmail.com [Dept. of Physiological Sciences, Federal University of Espirito Santo, Vitória, ES CEP 29040-091 (Brazil); Department of Pharmacology, Universidad Autonoma de Madrid, Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Madrid (Spain); Aguado, Andrea [Department of Pharmacology, Universidad Autonoma de Madrid, Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Madrid (Spain); Fiorim, Jonaína; Silveira, Edna Aparecida; Azevedo, Bruna Fernandes; Toscano, Cindy Medice [Dept. of Physiological Sciences, Federal University of Espirito Santo, Vitória, ES CEP 29040-091 (Brazil); Zhenyukh, Olha; Briones, Ana María [Department of Pharmacology, Universidad Autonoma de Madrid, Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Madrid (Spain); Alonso, María Jesús [Dept. of Biochemistry, Physiology and Molecular Genetics, Universidad Rey Juan Carlos, Alcorcón (Spain); Vassallo, Dalton Valentim [Dept. of Physiological Sciences, Federal University of Espirito Santo, Vitória, ES CEP 29040-091 (Brazil); Health Science Center of Vitória-EMESCAM, Vitória, ES CEP 29045-402 (Brazil); Salaices, Mercedes, E-mail: mercedes.salaices@uam.es [Department of Pharmacology, Universidad Autonoma de Madrid, Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Madrid (Spain)

2015-03-01

Chronic exposure to low lead concentration produces hypertension; however, the underlying mechanisms remain unclear. We analyzed the role of oxidative stress, cyclooxygenase-2-dependent pathways and MAPK in the vascular alterations induced by chronic lead exposure. Aortas from lead-treated Wistar rats (1st dose: 10 μg/100 g; subsequent doses: 0.125 μg/100 g, intramuscular, 30 days) and cultured aortic vascular smooth muscle cells (VSMCs) from Sprague Dawley rats stimulated with lead (20 μg/dL) were used. Lead blood levels of treated rats attained 21.7 ± 2.38 μg/dL. Lead exposure increased systolic blood pressure and aortic ring contractile response to phenylephrine, reduced acetylcholine-induced relaxation and did not affect sodium nitroprusside relaxation. Endothelium removal and L-NAME left-shifted the response to phenylephrine more in untreated than in lead-treated rats. Apocynin and indomethacin decreased more the response to phenylephrine in treated than in untreated rats. Aortic protein expression of gp91(phox), Cu/Zn-SOD, Mn-SOD and COX-2 increased after lead exposure. In cultured VSMCs lead 1) increased superoxide anion production, NADPH oxidase activity and gene and/or protein levels of NOX-1, NOX-4, Mn-SOD, EC-SOD and COX-2 and 2) activated ERK1/2 and p38 MAPK. Both antioxidants and COX-2 inhibitors normalized superoxide anion production, NADPH oxidase activity and mRNA levels of NOX-1, NOX-4 and COX-2. Blockade of the ERK1/2 and p38 signaling pathways abolished lead-induced NOX-1, NOX-4 and COX-2 expression. Results show that lead activation of the MAPK signaling pathways activates inflammatory proteins such as NADPH oxidase and COX-2, suggesting a reciprocal interplay and contribution to vascular dysfunction as an underlying mechanisms for lead-induced hypertension. - Highlights: • Lead-exposure increases oxidative stress, COX-2 expression and vascular reactivity. • Lead exposure activates MAPK signaling pathway. • ROS and COX-2 activation by

In vivo x-ray fluorescence of bone lead in the study of human lead metabolism: Serum lead, whole blood lead, bone lead, and cumulative exposure

International Nuclear Information System (INIS)

Cake, K.M.; Chettle, D.R.; Webber, C.E.; Gordon, C.L.

1995-01-01

Traditionally, clinical studies of lead's effect on health have relied on blood lead levels to indicate lead exposure. However, this is unsatisfactory because blood lead levels have a half-life of approximately 5 weeks, and thus reflect recent exposure. Over 90% of the lead body burden is in bone, and it is thought to have a long residence time, thus implying that measurements of bone lead reflect cumulative exposure. So, measurements of bone lead are useful in understanding the long-term health effects of lead. Ahlgren reported the first noninvasive measurements of bone lead in humans, where γ-rays from 57 Co were used to excite the K series x-rays of lead. The lead detection system at McMaster University uses a 109 Cd source which is positioned at the center of the detector face (HPGe) and a near backscatter (∼160 degrees) geometry. This arrangement allows great flexibility, since one can sample lead in a range of different bone sites due to a robust normalization technique which eliminates the need to correct for bone geometry, thickness of overlying tissue, and other related factors. The effective radiation dose to an adult during an x-ray fluorescence bone lead measurement is extremely low, being 35 nSv. This paper addresses the issue of how bone, whole blood, and serum lead concentrations can be related in order to understand a person's lead exposure history

Prenatal stress, prematurity and asthma

Science.gov (United States)

Medsker, Brock; Forno, Erick; Simhan, Hyagriv; Celedón, Juan C.

2016-01-01

Asthma is the most common chronic disease of childhood, affecting millions of children in the U.S. and worldwide. Prematurity is a risk factor for asthma, and certain ethnic or racial minorities such as Puerto Ricans and non-Hispanic Blacks are disproportionately affected by both prematurity and asthma. In this review, we examine current evidence to support maternal psychosocial stress as a putative link between prematurity and asthma, while also focusing on disruption of the hypothalamic-pituitary-adrenal (HPA) axis and immune responses as potential underlying mechanisms for stress-induced “premature asthma”. Prenatal stress may not only cause abnormalities in the HPA axis but also epigenetic changes in the fetal glucocorticoid receptor gene (NR3C1), leading to impaired glucocorticoid metabolism. Moreover, maternal stress can alter fetal cytokine balance, favoring Th2 (allergic) immune responses characteristic of atopic asthma: IL-6, which has been associated with premature labor, can promote Th2 responses by stimulating production of IL-4 and IL-13. Given a link among stress, prematurity, and asthma, future research should include birth cohorts aimed at confirming and better characterizing “premature asthma”. If confirmed, clinical trials of prenatal maternal stress reduction would be warranted to reduce the burden of these common co-morbidities. While awaiting the results of such studies, sound policies to prevent domestic and community violence (e.g. from firearms) are justified, not only by public safety but also by growing evidence of detrimental effects of violence-induced stress on psychiatric and somatic health. PMID:26676148

The influence of lead on stress corrosion cracking of steam generator tubing

International Nuclear Information System (INIS)

Ryan Curtis Wolfe

2015-01-01

Lead (Pb) is present at low concentrations on the secondary side of steam generators, but is known to accumulate in steam generator sludge and become concentrated in crevices and cracks. Pb is known to have played a role in the degradation of Alloy 600MA tubing, necessitating the replacement of those steam generators. There is new evidence which indicates that Pb has also played a role in the stress corrosion cracking (SCC) of Alloy 600TT. Furthermore. laboratory testing indicates that advanced tubing alloys such as Alloy 690TT and Alloy 800NG area also susceptible to this attack. In response to these vulnerabilities, utilities are attempting to manufacture tubing using processes which will impart optimal corrosion resistance, fabricate and operate SG's to minimize stress in the tubing, undertake efforts to identify and remove the sources of Pb, reduce the existing inventory of Pb using chemical or mechanical cleaning processes, and maintain rigorous chemistry controls. Research is warranted to qualify chemical methods to mitigate PbSCC that may be observed in service. This presentation will review work performed through the Electric Power Research Institute (EPRI) to address the issue of Pb-assisted stress corrosion cracking of steam generator tubing. (author)

Original Research Characterising cancer burden and quality of care ...

African Journals Online (AJOL)

Cancer burden at two palliative care clinics in Malawi 130 ... Cancer is a leading cause of mortality and morbidity worldwide. ... Health Organization (WHO) defines palliative care as an .... period, patients aged 15 years ..... GLOBOCAN 2012 ... Young People: A Case Series of 109 Cases and Review of the Literature.

Burden of diseases in poor resource countries: meeting the ...

African Journals Online (AJOL)

In Tanzania morbidity due to HIV/AIDS, tuberculosis and malaria leads to ... Key words: HIV/AIDS, malaria, tuberculosis, burden, poverty, research. Introduction ... children and women in particular, die without ever accessing ... 1990s in Tanzania show a mixed picture despite .... percent of the country is highly endemic for the.

A step forward for understanding the morbidity burden in Guinea: a national descriptive study

Directory of Open Access Journals (Sweden)

Hu Guoqing

2011-06-01

Full Text Available Abstract Background Little evidence on the burden of disease has been reported about Guinea. This study was conducted to demonstrate the morbidity burden in Guinea and provide basic evidence for setting health priorities. Methods A retrospective descriptive study was designed to present the morbidity burden of Guinea. Morbidity data were extracted from the National Health Statistics Report of Guinea of 2008. The data are collected based on a pyramid of facilities which includes two national hospitals (teaching hospitals, seven regional hospitals, 26 prefectural hospitals, 8 communal medical centers, 390 health centers, and 628 health posts. Morbidity rates were calculated to measure the burden of non-fatal diseases. The contributions of the 10 leading diseases were presented by sex and age group. Results In 2008, a total of 3,936,599 cases occurred. The morbidity rate for males was higher than for females, 461 versus 332 per 1,000 population. Malaria, respiratory infections, diarrheal diseases, helminthiases, and malnutrition ranked in the first 5 places and accounted for 74% of the total burden, respectively having a rate of 148, 64, 33, 32, and 14 per 1,000 population. The elderly aged 65+ had the highest morbidity rate (611 per 1,000 population followed by working-age population (458 per 1,000 population and children (396 per 1,000 population while the working-age population aged 25-64 contributed the largest part (39% to total cases. The sex- and age-specific spectrum of morbidity burden showed a similar profile except for small variations. Conclusion Guinea has its unique morbidity burden. The ten leading causes of morbidity burden, especially for malaria, respiratory infections, diarrheal diseases, helminthiases, and malnutrition, need to be prioritized in Guinea.

Perceived stress in dental practice.

Science.gov (United States)

Pop-Jordanova, Nada; Radojkova-Nikolovska, Vera; Markovska-Simoska, Silvana

2013-01-01

Stress is a normal physiological response to events that make us feel threatened, or upset our balance in some way. In medicine, it is known that stress, as an emotional state, can be a trigger for many psychosomatic disorders. Work stress and burnout are considered to be serious professional risks in dentistry. The dentist should be aware of these stressors and attempt to manage them in order to avoid becoming occupationally dissatisfied. On the other hand, the other common characteristic of modern life is a growing burden of different chronic diseases. Periodontal disease is one of the two most important oral diseases contributing to the global burden of chronic disease. The aim of this study was to assess the perceived stress in patients with periodontal pathologies, and to compare it with the stress in doctors-dentists and students of dentistry as future professionals. Our study confirmed the presence of significant stress in all three groups of examinees (patients, doctors, and students). Surprisingly, the obtained PSQ scores are similar in the examined groups. In addition, no differences between perceived stress in males and females have been found. There is a minimal positive correlation between age and obtained scores. However, stress must be evaluated as a risk factor both for professionals or for chronic dental patients and some response measures must be undertaken.

Beyond co-pays and out-of-pocket costs: perceptions of health-related financial burden in managing asthma among African American women.

Science.gov (United States)

Patel, Minal R; Nelson, Belinda W; Id-Deen, Effat; Caldwell, Cleopatra H

2014-12-01

The purpose of this study was to define perceptions of health-related financial burden based on the views of individuals who report these perceptions through qualitative approaches. Four focus groups were conducted in Southeast Michigan with 26 African American women with asthma, recruited based on maximum variation sampling procedures. A semi-structured interview was employed by facilitators. Coded transcripts were analyzed for themes regarding dimensions of the meaning of financial burden. Major domains of financial burden identified included (1) high out-of-pocket expenses; (2) lost wages from exacerbations, inability to maintain a stable job and stress from making decisions about taking a sick day or coming to work; (3) transport costs; (4) both costs and stress of managing insurance eligibility and correcting erroneous bills. Greater awareness of factors that add to perceptions of financial burden might better equip researchers to develop interventions to help care teams manage such concerns with their patients.

A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010.

Science.gov (United States)

Lim, Stephen S; Vos, Theo; Flaxman, Abraham D; Danaei, Goodarz; Shibuya, Kenji; Adair-Rohani, Heather; Amann, Markus; Anderson, H Ross; Andrews, Kathryn G; Aryee, Martin; Atkinson, Charles; Bacchus, Loraine J; Bahalim, Adil N; Balakrishnan, Kalpana; Balmes, John; Barker-Collo, Suzanne; Baxter, Amanda; Bell, Michelle L; Blore, Jed D; Blyth, Fiona; Bonner, Carissa; Borges, Guilherme; Bourne, Rupert; Boussinesq, Michel; Brauer, Michael; Brooks, Peter; Bruce, Nigel G; Brunekreef, Bert; Bryan-Hancock, Claire; Bucello, Chiara; Buchbinder, Rachelle; Bull, Fiona; Burnett, Richard T; Byers, Tim E; Calabria, Bianca; Carapetis, Jonathan; Carnahan, Emily; Chafe, Zoe; Charlson, Fiona; Chen, Honglei; Chen, Jian Shen; Cheng, Andrew Tai-Ann; Child, Jennifer Christine; Cohen, Aaron; Colson, K Ellicott; Cowie, Benjamin C; Darby, Sarah; Darling, Susan; Davis, Adrian; Degenhardt, Louisa; Dentener, Frank; Des Jarlais, Don C; Devries, Karen; Dherani, Mukesh; Ding, Eric L; Dorsey, E Ray; Driscoll, Tim; Edmond, Karen; Ali, Suad Eltahir; Engell, Rebecca E; Erwin, Patricia J; Fahimi, Saman; Falder, Gail; Farzadfar, Farshad; Ferrari, Alize; Finucane, Mariel M; Flaxman, Seth; Fowkes, Francis Gerry R; Freedman, Greg; Freeman, Michael K; Gakidou, Emmanuela; Ghosh, Santu; Giovannucci, Edward; Gmel, Gerhard; Graham, Kathryn; Grainger, Rebecca; Grant, Bridget; Gunnell, David; Gutierrez, Hialy R; Hall, Wayne; Hoek, Hans W; Hogan, Anthony; Hosgood, H Dean; Hoy, Damian; Hu, Howard; Hubbell, Bryan J; Hutchings, Sally J; Ibeanusi, Sydney E; Jacklyn, Gemma L; Jasrasaria, Rashmi; Jonas, Jost B; Kan, Haidong; Kanis, John A; Kassebaum, Nicholas; Kawakami, Norito; Khang, Young-Ho; Khatibzadeh, Shahab; Khoo, Jon-Paul; Kok, Cindy; Laden, Francine; Lalloo, Ratilal; Lan, Qing; Lathlean, Tim; Leasher, Janet L; Leigh, James; Li, Yang; Lin, John Kent; Lipshultz, Steven E; London, Stephanie; Lozano, Rafael; Lu, Yuan; Mak, Joelle; Malekzadeh, Reza; Mallinger, Leslie; Marcenes, Wagner; March, Lyn; Marks, Robin; Martin, Randall; McGale, Paul; McGrath, John; Mehta, Sumi; Mensah, George A; Merriman, Tony R; Micha, Renata; Michaud, Catherine; Mishra, Vinod; Mohd Hanafiah, Khayriyyah; Mokdad, Ali A; Morawska, Lidia; Mozaffarian, Dariush; Murphy, Tasha; Naghavi, Mohsen; Neal, Bruce; Nelson, Paul K; Nolla, Joan Miquel; Norman, Rosana; Olives, Casey; Omer, Saad B; Orchard, Jessica; Osborne, Richard; Ostro, Bart; Page, Andrew; Pandey, Kiran D; Parry, Charles D H; Passmore, Erin; Patra, Jayadeep; Pearce, Neil; Pelizzari, Pamela M; Petzold, Max; Phillips, Michael R; Pope, Dan; Pope, C Arden; Powles, John; Rao, Mayuree; Razavi, Homie; Rehfuess, Eva A; Rehm, Jürgen T; Ritz, Beate; Rivara, Frederick P; Roberts, Thomas; Robinson, Carolyn; Rodriguez-Portales, Jose A; Romieu, Isabelle; Room, Robin; Rosenfeld, Lisa C; Roy, Ananya; Rushton, Lesley; Salomon, Joshua A; Sampson, Uchechukwu; Sanchez-Riera, Lidia; Sanman, Ella; Sapkota, Amir; Seedat, Soraya; Shi, Peilin; Shield, Kevin; Shivakoti, Rupak; Singh, Gitanjali M; Sleet, David A; Smith, Emma; Smith, Kirk R; Stapelberg, Nicolas J C; Steenland, Kyle; Stöckl, Heidi; Stovner, Lars Jacob; Straif, Kurt; Straney, Lahn; Thurston, George D; Tran, Jimmy H; Van Dingenen, Rita; van Donkelaar, Aaron; Veerman, J Lennert; Vijayakumar, Lakshmi; Weintraub, Robert; Weissman, Myrna M; White, Richard A; Whiteford, Harvey; Wiersma, Steven T; Wilkinson, James D; Williams, Hywel C; Williams, Warwick; Wilson, Nicholas; Woolf, Anthony D; Yip, Paul; Zielinski, Jan M; Lopez, Alan D; Murray, Christopher J L; Ezzati, Majid; AlMazroa, Mohammad A; Memish, Ziad A

2012-12-15

Quantification of the disease burden caused by different risks informs prevention by providing an account of health loss different to that provided by a disease-by-disease analysis. No complete revision of global disease burden caused by risk factors has been done since a comparative risk assessment in 2000, and no previous analysis has assessed changes in burden attributable to risk factors over time. We estimated deaths and disability-adjusted life years (DALYs; sum of years lived with disability [YLD] and years of life lost [YLL]) attributable to the independent effects of 67 risk factors and clusters of risk factors for 21 regions in 1990 and 2010. We estimated exposure distributions for each year, region, sex, and age group, and relative risks per unit of exposure by systematically reviewing and synthesising published and unpublished data. We used these estimates, together with estimates of cause-specific deaths and DALYs from the Global Burden of Disease Study 2010, to calculate the burden attributable to each risk factor exposure compared with the theoretical-minimum-risk exposure. We incorporated uncertainty in disease burden, relative risks, and exposures into our estimates of attributable burden. In 2010, the three leading risk factors for global disease burden were high blood pressure (7·0% [95% uncertainty interval 6·2-7·7] of global DALYs), tobacco smoking including second-hand smoke (6·3% [5·5-7·0]), and alcohol use (5·5% [5·0-5·9]). In 1990, the leading risks were childhood underweight (7·9% [6·8-9·4]), household air pollution from solid fuels (HAP; 7·0% [5·6-8·3]), and tobacco smoking including second-hand smoke (6·1% [5·4-6·8]). Dietary risk factors and physical inactivity collectively accounted for 10·0% (95% UI 9·2-10·8) of global DALYs in 2010, with the most prominent dietary risks being diets low in fruits and those high in sodium. Several risks that primarily affect childhood communicable diseases, including unimproved

Global, Regional, and National Burden of Cardiovascular Diseases for 10 Causes, 1990 to 2015

DEFF Research Database (Denmark)

Roth, Gregory A; Johnson, Catherine; Abajobir, Amanuel

2017-01-01

BACKGROUND: The burden of cardiovascular diseases (CVDs) remains unclear in many regions of the world. OBJECTIVES: The GBD (Global Burden of Disease) 2015 study integrated data on disease incidence, prevalence, and mortality to produce consistent, up-to-date estimates for cardiovascular burden......-income countries. Ischemic heart disease was the leading cause of CVD health lost globally, as well as in each world region, followed by stroke. As SDI increased beyond 0.25, the highest CVD mortality shifted from women to men. CVD mortality decreased sharply for both sexes in countries with an SDI >0...... be used to guide policymakers who are focused on reducing the overall burden of noncommunicable disease and achieving specific global health targets for CVD....

Determining tissue-lead levels in large game mammals harvested with lead bullets: human health concerns.

Science.gov (United States)

Tsuji, L J S; Wainman, B C; Jayasinghe, R K; VanSpronsen, E P; Liberda, E N

2009-04-01

Recently, the use of lead isotope ratios has definitively identified lead ammunition as a source of lead exposure for First Nations people, but the isotope ratios for lead pellets and bullets were indistinguishable. Thus, lead-contaminated meat from game harvested with lead bullets may also be contributing to the lead body burden; however, few studies have determined if lead bullet fragments are present in big game carcasses. We found elevated tissue-lead concentrations (up to 5,726.0 microg/g ww) in liver (5/9) and muscle (6/7) samples of big game harvested with lead bullets and radiographic evidence of lead fragments. Thus, we would advise that the tissue surrounding the wound channel be removed and discarded, as this tissue may be contaminated by lead bullet fragments.

[Predictive value of Hodgkin's lymphoma tumor burden in present].

Science.gov (United States)

Kulyova, S A; Karitsky, A P

2014-01-01

Today approximately 70% of patients with Hodgkin lymphoma can be cured with the combined-modality therapy. Tumor burden, the importance of which was demonstrated 15 years ago for the first time, is a powerful prognostic factor. Data of literature of representations on predictive value of Hodgkin's lymphoma tumor burden are shown in the article. The difficult immunological relations between tumor cells and reactive ones lead to development of the main symptoms. Nevertheless, the collective sign of tumor burden shows the greatest influence on survival and on probability of resistance, which relative risk can be predicted on this variable and treatment program. Patients with bulky disease need escalated therapy with high-dose chemotherapy. Integration into predictive models of the variable will change an expected contribution of clinical and laboratory parameters in the regression analyses constructed on patients with Hodgkin's lymphoma. Today the role of diagnostic functional methods, in particular a positron emission tomography, for metabolic active measurement is conducted which allows excluding a reactive component.

Estimating the burden of antimicrobial resistance: a systematic literature review.

Science.gov (United States)

Naylor, Nichola R; Atun, Rifat; Zhu, Nina; Kulasabanathan, Kavian; Silva, Sachin; Chatterjee, Anuja; Knight, Gwenan M; Robotham, Julie V

2018-01-01

Accurate estimates of the burden of antimicrobial resistance (AMR) are needed to establish the magnitude of this global threat in terms of both health and cost, and to paramaterise cost-effectiveness evaluations of interventions aiming to tackle the problem. This review aimed to establish the alternative methodologies used in estimating AMR burden in order to appraise the current evidence base. MEDLINE, EMBASE, Scopus, EconLit, PubMed and grey literature were searched. English language studies evaluating the impact of AMR (from any microbe) on patient, payer/provider and economic burden published between January 2013 and December 2015 were included. Independent screening of title/abstracts followed by full texts was performed using pre-specified criteria. A study quality score (from zero to one) was derived using Newcastle-Ottawa and Philips checklists. Extracted study data were used to compare study method and resulting burden estimate, according to perspective. Monetary costs were converted into 2013 USD. Out of 5187 unique retrievals, 214 studies were included. One hundred eighty-seven studies estimated patient health, 75 studies estimated payer/provider and 11 studies estimated economic burden. 64% of included studies were single centre. The majority of studies estimating patient or provider/payer burden used regression techniques. 48% of studies estimating mortality burden found a significant impact from resistance, excess healthcare system costs ranged from non-significance to $1 billion per year, whilst economic burden ranged from $21,832 per case to over $3 trillion in GDP loss. Median quality scores (interquartile range) for patient, payer/provider and economic burden studies were 0.67 (0.56-0.67), 0.56 (0.46-0.67) and 0.53 (0.44-0.60) respectively. This study highlights what methodological assumptions and biases can occur dependent on chosen outcome and perspective. Currently, there is considerable variability in burden estimates, which can lead in

Adaptive Role of Inversion Polymorphism of Drosophila subobscura in Lead Stressed Environment.

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Kenig, Bojan; Kurbalija Novičić, Zorana; Patenković, Aleksandra; Stamenković-Radak, Marina; Anđelković, Marko

2015-01-01

Local adaptation to environmental stress at different levels of genetic polymorphism in various plants and animals has been documented through evolution of heavy metal tolerance. We used samples of Drosophila subobscura populations from two differently polluted environments to analyze the change of chromosomal inversion polymorphism as genetic marker during laboratory exposure to lead. Exposure to environmental contamination can affect the genetic content within a particular inversion and produce targets for selection in populations from different environments. The aims were to discover whether the inversion polymorphism is shaped by the local natural environments, and if lead as a selection pressure would cause adaptive divergence of two populations during the multigenerational laboratory experiment. The results showed that populations retain signatures from past contamination events, and that heavy metal pollution can cause adaptive changes in population. Differences in inversion polymorphism between the two populations increased over generations under lead contamination in the laboratory. The inversion polymorphism of population originating from the more polluted natural environment was more stable during the experiment, both under conditions with and without lead. Therefore, results showed that inversion polymorphism as a genetic marker reflects a strong signature of adaptation to the local environment, and that historical demographic events and selection are important for both prediction of evolutionary potential and long-term viability of natural populations.

The global burden of conduct disorder and attention-deficit/hyperactivity disorder in 2010.

Science.gov (United States)

Erskine, Holly E; Ferrari, Alize J; Polanczyk, Guilherme V; Moffitt, Terrie E; Murray, Christopher J L; Vos, Theo; Whiteford, Harvey A; Scott, James G

2014-04-01

The Global Burden of Disease Study 2010 (GBD 2010) is the first to include conduct disorder (CD) and attention-deficit/hyperactivity disorder (ADHD) for burden quantification. A previous systematic review pooled the available epidemiological data for CD and ADHD, and predicted prevalence by country, region, age and sex for each disorder. Prevalence was then multiplied by a disability weight to calculate years lived with disability (YLDs). As no evidence of deaths resulting directly from either CD or ADHD was found, no years of life lost (YLLs) were calculated. Therefore, the number of disability-adjusted life years (DALYs) was equal to that of YLDs. Globally, CD was responsible for 5.75 million YLDs/DALYs with ADHD responsible for a further 491,500. Collectively, CD and ADHD accounted for 0.80% of total global YLDs and 0.25% of total global DALYs. In terms of global DALYs, CD was the 72nd leading contributor and among the 15 leading causes in children aged 5-19 years. Between 1990 and 2010, global DALYs attributable to CD and ADHD remained stable after accounting for population growth and ageing. The global burden of CD and ADHD is significant, particularly in male children. Appropriate allocation of resources to address the high morbidity associated with CD and ADHD is necessary to reduce global burden. However, burden estimation was limited by data lacking for all four epidemiological parameters and by methodological challenges in quantifying disability. Future studies need to address these limitations in order to increase the accuracy of burden quantification. © 2014 The Authors. Journal of Child Psychology and Psychiatry © 2014 Association for Child and Adolescent Mental Health.

Womenʼs Burden of Disease and Injuries in East Azerbaijan

Directory of Open Access Journals (Sweden)

Sevil Hakimi

2012-10-01

Full Text Available Background: The aim of this study is assessment of burden of disease in East Azerbaijan women. Materials and Methods: In this project we used of disability adjusted life years (DALY as an index of burden of disease. Results: Cardiovascular disease, cancers and unintended injuries 71.98% of DALY for premature death. The 3 leading causes of YLD in East Azerbaijan province were: psycineurotic disorders, musculoskeletal and urogenital diseases.Conclusion: This study shows that YLL is 3 fold of YLD and this indicated to lower quality of life of women.

Stress associated with caregiving: an examination of the stress process model among Kenyan Luo elders.

Science.gov (United States)

Ice, Gillian H; Sadruddin, Aalyia F A; Vagedes, Amy; Yogo, Jaja; Juma, Elizabeth

2012-06-01

Globally, a growing number of grandparents are caring for their grandchildren. The impact and burden associated with increases in custodial grandparenting, however, may differ by culture. In the United States, the caregiving role has been shown to be a significant source of stress for older adults. In cultures in which grandparents are more commonly involved in the care of young children, however, increasing caregiving roles may not be viewed as stressful. This study examines the impact of caregiving on perceived and physiological measures of stress among 640 Luo elders (60+) in western Kenya, where high HIV prevalence among younger-to-middle aged adults has led to a heavy burden of orphan care. Perceived stress levels were measured using the Luo Perceived Stress Scale (LPSS). Salivary cortisol and casual blood pressure were used as biomarkers of stress. Results were analyzed using random mixed effects models. Overall this study showed that caregivers have higher levels of perceived stress than non-caregivers. For women, household composition, including the number of orphans and adults in the homestead impacted perceived stress. Among men, those who perceived caregiving as burdensome had higher perceived stress. Despite the association between caregiving and perceived stress, there was a minimal relationship between caregiving and the two biomarkers of stress. This may be because caregiving is superimposed onto other stressors and therefore has a minimal physiological impact. These results highlight the importance of local context in determining the impact of the caregiving role on older adult well-being. Copyright © 2012 Elsevier Ltd. All rights reserved.

Moral Stress in Teaching Practice

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Colnerud, Gunnel

2015-01-01

The purpose of this article is to study whether moral stress is a phenomenon relevant to teaching practice and which may make a significant contribution to understanding why teachers repeatedly reported feeling burdened by work. Moral stress can be caused by acting in conflict with one's own conscience, e.g. when one knows the right thing to…

Health care of people at work. Workers exposed to lead. I. Inorganic lead

Energy Technology Data Exchange (ETDEWEB)

Waldron, H.A.

1978-01-01

The risks associated with exposure to inorganic lead and the means by which these risks can be minimized are outlined. Lead is used to make a variety of metal products, the grids and oxides in storage batteries, pigments, chemicals, and also for lead plating. In the United States about 70% of the total lead consumption is related to transportation. Uptake of inorganic lead is by ingestion and inhalation. About 90% of the total body burden of lead is contained within the skeletal tissues. Lead is excreted in the kidney, in sweat, and in milk. Toxic effects are directed against the blood, the nervous system, and the kidney. Symptoms of lead poisoning are abdominal pain, constipation, vomiting, asthenia, paresthesia, psychological symptoms, and diarrhea. Physical and biological monitoring can serve to protect workers. Diagnosis of lead poisoning is not easy. Treatment involves removal from exposure and/or treatment with a chelating agent.

Allostatic load but not medical burden predicts memory performance in late-life bipolar disorder.

Science.gov (United States)

Vaccarino, Sophie R; Rajji, Tarek K; Gildengers, Ariel G; Waters, Sarah E S; Butters, Meryl A; Menon, Mahesh; Blumberger, Daniel M; Voineskos, Aristotle N; Miranda, Dielle; Mulsant, Benoit H

2018-03-01

Older patients with bipolar disorder (BD) present with variable degrees of cognitive impairment. Over time, stress, mood episodes, and comorbidities increase the body's allostatic load. We assessed the extent to which allostatic load vs more traditional measures of medical burden account for the heterogeneity in cognition in this population. Thirty-five older euthymic patients with BD and 30 age-equated, gender-equated, and education-equated comparison participants were administered a comprehensive assessment including a neuropsychological battery, and 9 physiological measures to determine allostatic load. The relationship among allostatic load, medical burden, and cognition was assessed. Compared with the mentally healthy comparators, patients were impaired globally, and in 4 cognitive domains-information-processing speed / executive functioning, delayed memory, language, and visuomotor ability, and presented with greater medical burden but not a different allostatic load. Allostatic load, but not medical burden, was associated with delayed memory performance both in a correlational analysis and in a multivariate regression analysis. Euthymic older patients with BD are impaired on several cognitive domains and have high medical burden. Their memory performance is more strongly associated with allostatic load than with traditional measures of medical burden. These findings need to be replicated and extended longitudinally. Copyright © 2017 John Wiley & Sons, Ltd.

Burden control by artificial intelligence

Energy Technology Data Exchange (ETDEWEB)

Saxen, H.; Nikus, M. [Aabo Akademi, Turku (Finland). Heat Engineering Lab.

1998-07-01

The burden distribution plays an important role for the fuel economy of the blast furnace. By an appropriate burden distribution, the operation of the furnace is smooth and the gas is utilized well, the burden descends steadily and the wear of the lining is minimal. Since it is very difficult to obtain reliable information about the burden distribution in operating blast furnaces, this research project developed methods for interpretation of burden and gas distribution in the shaft mainly based on temperature measurements from above-burden probes.

Wafer scale lead zirconate titanate film preparation by sol-gel method using stress balance layer

International Nuclear Information System (INIS)

Lu Jian; Kobayashi, Takeshi; Yi Zhang; Maeda, Ryutaro; Mihara, Takashi

2006-01-01

In this paper, platinum/titanium (Pt/Ti) film was introduced as a residual stress balance layer into wafer scale thick lead zirconate titanate (PZT) film fabrication by sol-gel method. The stress developing in PZT film's bottom electrode as well as in PZT film itself during deposition were analyzed; the wafer curvatures, PZT crystallizations and PZT electric properties before and after using Pt/Ti stress balance layer were studied and compared. It was found that this layer is effective to balance the residual stress in PZT film's bottom electrode induced by thermal expansion coefficient mismatch and Ti diffusion, thus can notably reduce the curvature of 4-in. wafer from - 40.5 μm to - 12.9 μm after PZT film deposition. This stress balance layer was also found effective to avoid the PZT film cracking even when annealed by rapid thermal annealing with heating-rate up to 10.5 deg. C/s. According to X-ray diffraction analysis and electric properties characterization, crack-free uniform 1-μm-thick PZT film with preferred pervoskite (001) orientation, excellent dielectric constant, as high as 1310, and excellent remanent polarization, as high as 39.8 μC/cm 2 , can be obtained on 4-in. wafer

Psychological burden among women with polycystic ovarian syndrome in Oman: a case–control study

Directory of Open Access Journals (Sweden)

Sulaiman MA

2017-12-01

Full Text Available Maha AH Sulaiman,1 Yahya M Al-Farsi,1 Maha M Al-Khaduri,2 Mostafa I Waly,3 Jumana Saleh,4 Samir Al-Adawi5 1Department of Family Medicine and Public Health, 2Department of Obstetrics and Gynecology, College of Medicine and Health Sciences, 3Department of Nutrition and Food Sciences, College of Agricultural and Marine Sciences, 4Department of Biochemistry, 5Department of Behavioral Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Al-Khoudh, Muscat, Sultanate of Oman Purpose: Previous studies in Euro-American populations have shown that women with polycystic ovarian syndrome (PCOS have increased levels of “psychological burden”. While PCOS has been reported in Arab countries such as Oman, there is a dearth of studies of the occurrence of psychological burden among PCOS women in the Arab region. This study aimed to compare sociodemographic and clinical characteristics of PCOS women diagnosed with non-PCOS women and prevalence of severity of depression, anxiety and stress and to explore the association between PCOS and indices of psychological disturbances after adjusting for potential confounding factors.Patients and methods: This hospital-based case–control study was conducted among women aged 16–49 years. The study included 52 women diagnosed with PCOS (as per Rotterdam 2003 criteria and 60 control who were PCOS-free. The presence of psychological burden – depression, anxiety and stress – was quantified using Depression, Anxiety and Stress Scale-21 (DASS-21.Results: The crude odds ratios (ORs generated by logistic regression models indicated an increased risk of depression, anxiety and stress among women with PCOS compared to controls. The adjusted OR also indicated an increased risk of depression (OR =1.10; 95% confidence interval [CI] 0.50, 2.43, anxiety (OR =1.09; 95% CI 0.47, 2.52 and stress (OR =1.45; 95% CI 0.68, 3.12, However, no statistical differences were observed along the three psychological

N-Acetyl-L-Cysteine Affords Protection against Lead-Induced Cytotoxicity and Oxidative Stress in Human Liver Carcinoma (HepG2 Cells

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Paul B. Tchounwou

2007-06-01

Full Text Available Although lead exposure has declined in recent years as a result of change to lead-free gasoline, several epidemiological have pointed out that it represents a medical and public health emergency, especially in young children consuming high amounts of lead-contaminated flake paints. A previous study in our laboratory indicated that lead exposure induces cytotoxicity in human liver carcinoma cells. In the present study, we evaluated the role of oxidative stress in lead-induced toxicity, and the protective effect of the anti-oxidant n-acetyl-l-cysteine (NAC. We hypothesized that oxidative stress plays a role in lead-induced cytotoxicity, and that NAC affords protection against this adverse effect. To test this hypothesis, we performed the MTT [3-(4, 5-dimethylthiazol-2-yl-2, 5-diphenyltetrazolium bromide] assay and the trypan blue exclusion test for cell viability. We also performed the thiobarbituric acid test for lipid peroxidation. Data obtained from the MTT assay indicated that NAC significantly increased the viability of HepG2 cells in a dosedependent manner upon 48 hours of exposure. Similar trend was obtained with the trypan blue exclusion test. Data generated from the thiobarbituric acid test showed a significant (p ≤ 0.05 increase of MDA levels in lead nitrate-treated HepG2 cells compared to control cells. Interestingly, the addition of NAC to lead nitrate-treated HepG2 cells significantly decreased cellular content of reactive oxygen species (ROS, as evidenced by the decrease in lipid peroxidation byproducts. Overall, findings from this study suggest that NAC inhibits lead nitrate-induced cytotoxicity and oxidative stress in HepG2 cells. Hence, NAC may be used as a salvage therapy for lead-induced toxicity in exposed persons.

[Biopsychosocial approach to caregiving burden: Why should we care about caregivers' health?

Science.gov (United States)

Leurs, Antoine; Trojak, Benoit; Ponavoy, Eddy; Bonin, Bernard; Chauvet-Gelinier, Jean-Christophe

2018-06-11

There are 11 million family caregivers in France and some estimates indicate that there will be 17 million in 2020. Caregiving is a source of chronic stress that requires adaptation and coping strategies. Caregiving may benefit the health of a caregiver with a positive coping style and altruistic goals. However, the caregiver's burden is frequently associated with negative effects in terms of biopsychosocial imbalance and medical conditions, with frequent anxiety and depression. The management of the caregiving burden starts with the recognition of health professionals - caregivers may benefit from consultation-liaison psychiatry and multidisciplinary medico-social strategies, in addition to constant support from their GPs. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

The Burden of Dysphagia on Family Caregivers of the Elderly: A Systematic Review

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Ashwini M. Namasivayam-MacDonald

2018-06-01

Full Text Available With the rapid increase in the elderly population, there is a simultaneous increased need for care provided by family caregivers. Research in the field of head and neck cancer has indicated that caring for patients with dysphagia can impact a caregiver’s quality of life. Given that many older adults present with dysphagia, one can assume that their caregivers are equally, if not more greatly, affected. The purpose of this systematic review was to examine all relevant literature regarding the caregiver burden in caregivers of community-dwelling older adults with dysphagia. A review of relevant studies published through April 2018 was conducted using search terms related to dysphagia, caregiver burden, and older adults. The search yielded 2331 unique abstracts. Of the 176 abstracts that underwent full review, four were accepted. All reported an increase in caregiver burden due to presence of dysphagia in care recipients. Worsening feeding-related behaviors were associated with burden, and the use of feeding tubes was more frequently associated with “heavy burden”. The presence of dysphagia in community-dwelling older adults is a factor leading to an increased burden among caregivers. Although aspects of dysphagia play a role in the caregiver burden, the specific reasons for the increased burden are unknown. Clinicians should be aware of dysphagia as a source of the burden, and future studies should further define the relationship between dysphagia and the caregiver burden in order to develop comprehensive approaches to care.

Transcriptome Profiling of Louisiana iris Root and Identification of Genes Involved in Lead-Stress Response

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Songqing Tian

2015-11-01

Full Text Available Louisiana iris is tolerant to and accumulates the heavy metal lead (Pb. However, there is limited knowledge of the molecular mechanisms behind this feature. We describe the transcriptome of Louisiana iris using Illumina sequencing technology. The root transcriptome of Louisiana iris under control and Pb-stress conditions was sequenced. Overall, 525,498 transcripts representing 313,958 unigenes were assembled using the clean raw reads. Among them, 43,015 unigenes were annotated and their functions classified using the euKaryotic Orthologous Groups (KOG database. They were divided into 25 molecular families. In the Gene Ontology (GO database, 50,174 unigenes were categorized into three GO trees (molecular function, cellular component and biological process. After analysis of differentially expressed genes, some Pb-stress-related genes were selected, including biosynthesis genes of chelating compounds, metal transporters, transcription factors and antioxidant-related genes. This study not only lays a foundation for further studies on differential genes under Pb stress, but also facilitates the molecular breeding of Louisiana iris.

An Approach to Coordinate Efforts to Reduce the Public Health Burden of Stroke: The Delta States Stroke Consortium

OpenAIRE

Virginia J. Howard; Joe Acker; Camilo R. Gomez; Ada H. Griffies; Wanda Magers; Max Michael III; Sean R. Orr; Martha Phillips; James M. Raczynski; John E. Searcy; Richard M. Zweifler; George Howard

2004-01-01

Stroke is the third leading cause of death and a leading cause of disability in the United States, with a particularly high burden on the residents of the southeastern states, a region dubbed the Stroke Belt. These five states Alabama, Arkansas, Louisiana, Mississippi, and Tennessee have formed the Delta States Stroke Consortium to direct efforts to reduce this burden. The consortium is proposing an approach to identify domains where interventions may be instituted and an array of activitie...

Global Burden Of Disease Studies: Implications For Mental And Substance Use Disorders.

Science.gov (United States)

Whiteford, Harvey; Ferrari, Alize; Degenhardt, Louisa

2016-06-01

Global Burden of Disease studies have highlighted mental and substance use disorders as the leading cause of disability globally. Using the studies' findings for policy and planning requires an understanding of how estimates are generated, the required epidemiological data are gathered, disability and premature mortality are defined and counted, and comparative risk assessment for risk-factor analysis is undertaken. The high burden of mental and substance use disorders has increased their priority on the global health agenda, but not enough to prompt concerted action by governments and international agencies. Using Global Burden of Disease estimates in health policy and planning requires combining them with other information such as evidence on the cost-effectiveness of interventions designed to reduce the disorders' burden. Concerted action is required by mental health advocates and policy makers to assemble this evidence, taking into account the health, social, and economic challenges facing each country. Project HOPE—The People-to-People Health Foundation, Inc.

The economic burden of Clostridium difficile

Science.gov (United States)

McGlone, S. M.; Bailey, R. R.; Zimmer, S. M.; Popovich, M. J.; Tian, Y.; Ufberg, P.; Muder, R. R.; Lee, B. Y.

2013-01-01

Although Clostridium difficile (C. difficile) is the leading cause of infectious diarrhoea in hospitalized patients, the economic burden of this major nosocomial pathogen for hospitals, third-party payers and society remains unclear. We developed an economic computer simulation model to determine the costs attributable to healthcare-acquired C. difficile infection (CDI) from the hospital, third-party payer and societal perspectives. Sensitivity analyses explored the effects of varying the cost of hospitalization, C. difficile-attributable length of stay, and the probability of initial and secondary recurrences. The median cost of a case ranged from $9179 to $11 456 from the hospital perspective, $8932 to $11 679 from the third-party payor perspective, and $13 310 to $16 464 from the societal perspective. Most of the costs incurred were accrued during a patient’s primary CDI episode. Hospitals with an incidence of 4.1 CDI cases per 100 000 discharges would incur costs ≥$3.2 million (hospital perspective); an incidence of 10.5 would lead to costs ≥$30.6 million. Our model suggests that the annual US economic burden of CDI would be ≥$496 million (hospital perspective), ≥$547 million (third-party payer perspective) and ≥$796 million (societal perspective). Our results show that C. difficile infection is indeed costly, not only to third-party payers and the hospital, but to society as well. These results are consistent with current literature citing C. difficile as a costly disease. PMID:21668576

Exposing therapists to trauma-focused treatment in psychosis: effects on credibility, expected burden, and harm expectancies

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David P. G. van den Berg

2016-09-01

Full Text Available Background: Despite robust empirical support for the efficacy of trauma-focused treatments, the dissemination proves difficult, especially in relation to patients with comorbid psychosis. Many therapists endorse negative beliefs about the credibility, burden, and harm of such treatment. Objective: This feasibility study explores the impact of specialized training on therapists’ beliefs about trauma-focused treatment within a randomized controlled trial. Method: Therapist-rated (n=16 credibility, expected burden, and harm expectancies of trauma-focused treatment were assessed at baseline, post-theoretical training, post-technical training, post-supervised practical training, and at 2-year follow-up. Credibility and burden beliefs of therapists concerning the treatment of every specific patient in the trial were also assessed. Results: Over time, therapist-rated credibility of trauma-focused treatment showed a significant increase, whereas therapists’ expected burden and harm expectancies decreased significantly. In treating posttraumatic stress disorder (PTSD in patients with psychotic disorders (n=79, pre-treatment symptom severity was not associated with therapist-rated credibility or expected burden of that specific treatment. Treatment outcome had no influence on patient-specific credibility or burden expectancies of therapists. Conclusions: These findings support the notion that specialized training, including practical training with supervision, has long-term positive effects on therapists’ credibility, burden, and harm beliefs concerning trauma-focused treatment.

Pretreatment with low-dose gamma irradiation enhances tolerance to the stress of cadmium and lead in Arabidopsis thaliana seedlings.

Science.gov (United States)

Qi, Wencai; Zhang, Liang; Wang, Lin; Xu, Hangbo; Jin, Qingsheng; Jiao, Zhen

2015-05-01

Heavy metals are important environmental pollutants with negative impact on plant growth and development. To investigate the physiological and molecular mechanisms of heavy metal stress mitigated by low-dose gamma irradiation, the dry seeds of Arabidopsis thaliana were exposed to a Cobalt-60 gamma source at doses ranging from 25 to 150Gy before being subjected to 75µM CdCl2 or 500µM Pb(NO3)2. Then, the growth parameters, and physiological and molecular changes were determined in response to gamma irradiation. Our results showed that 50-Gy gamma irradiation gave maximal beneficial effects on the germination index and root length in response to cadmium/lead stress in Arabidopsis seedlings. The hydrogen peroxide and malondialdehyde contents in seedlings irradiated with 50-Gy gamma rays under stress were significantly lower than those of controls. The antioxidant enzyme activities and proline levels in the irradiated seedlings were significantly increased compared with the controls. Furthermore, a transcriptional expression analysis of selected genes revealed that some components of heavy metal detoxification were stimulated by low-dose gamma irradiation under cadmium/lead stress. Our results suggest that low-dose gamma irradiation alleviates heavy metal stress, probably by modulating the physiological responses and gene expression levels related to heavy metal resistance in Arabidopsis seedlings. Copyright © 2015 Elsevier Inc. All rights reserved.

Caregiver burden and coping strategies in caregivers of patients with Alzheimer’s disease

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Iavarone A

2014-07-01

Full Text Available Alessandro Iavarone,1,2 Antonio Rosario Ziello,3,4 Francesca Pastore,3 Angiola Maria Fasanaro,3 Carla Poderico5 1Neurological and Stroke Unit, CTO Hospital, 2Italian Association on Alzheimer's Disease (AIMA, 3Memory Clinic, Neurological Unit, AORN Cardarelli Hospital, Naples, Italy; 4Clinical Research, Telemedicine and Telepharmacy Centre, University of Camerino, Camerino, Italy; 5Department of Psychology, Second University of Naples, Caserta, Italy Background: Alzheimer’s disease (AD causes considerable distress in caregivers who are continuously required to deal with requests from patients. Coping strategies play a fundamental role in modulating the psychologic impact of the disease, although their role is still debated. The present study aims to evaluate the burden and anxiety experienced by caregivers, the effectiveness of adopted coping strategies, and their relationships with burden and anxiety. Methods: Eighty-six caregivers received the Caregiver Burden Inventory (CBI and the ­State-Trait Anxiety Inventory (STAI Y-1 and Y-2. The coping strategies were assessed by means of the Coping Inventory for Stressful Situations (CISS, according to the model proposed by Endler and Parker in 1990.Results: The CBI scores (overall and single sections were extremely high and correlated with dementia severity. Women, as well as older caregivers, showed higher scores. The trait anxiety (STAI-Y-2 correlated with the CBI overall score. The CISS showed that caregivers mainly adopted task-focused strategies. Women mainly adopted emotion-focused strategies and this style was related to a higher level of distress. Conclusion: AD is associated with high distress among caregivers. The burden strongly correlates with dementia severity and is higher in women and in elderly subjects. Chronic anxiety affects caregivers who mainly rely on emotion-oriented coping strategies. The findings suggest providing support to families of patients with AD through tailored

The Global Burden of Cancer 2013

Science.gov (United States)

2015-01-01

IMPORTANCE Cancer is among the leading causes of death worldwide. Current estimates of cancer burden in individual countries and regions are necessary to inform local cancer control strategies. OBJECTIVE To estimate mortality, incidence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) for 28 cancers in 188 countries by sex from 1990 to 2013. EVIDENCE REVIEW The general methodology of the Global Burden of Disease (GBD) 2013 study was used. Cancer registries were the source for cancer incidence data as well as mortality incidence (MI) ratios. Sources for cause of death data include vital registration system data, verbal autopsy studies, and other sources. The MI ratios were used to transform incidence data to mortality estimates and cause of death estimates to incidence estimates. Cancer prevalence was estimated using MI ratios as surrogates for survival data; YLDs were calculated by multiplying prevalence estimates with disability weights, which were derived from population-based surveys; YLLs were computed by multiplying the number of estimated cancer deaths at each age with a reference life expectancy; and DALYs were calculated as the sum of YLDs and YLLs. FINDINGS In 2013 there were 14.9 million incident cancer cases, 8.2 million deaths, and 196.3 million DALYs. Prostate cancer was the leading cause for cancer incidence (1.4 million) for men and breast cancer for women (1.8 million). Tracheal, bronchus, and lung (TBL) cancer was the leading cause for cancer death in men and women, with 1.6 million deaths. For men, TBL cancer was the leading cause of DALYs (24.9 million). For women, breast cancer was the leading cause of DALYs (13.1 million). Age-standardized incidence rates (ASIRs) per 100 000 and age-standardized death rates (ASDRs) per 100 000 for both sexes in 2013 were higher in developing vs developed countries for stomach cancer (ASIR, 17 vs 14; ASDR, 15 vs 11), liver cancer (ASIR, 15 vs 7; ASDR, 16

Curbing the burden of lung cancer.

Science.gov (United States)

Urman, Alexandra; Hosgood, H Dean

2016-06-01

Lung cancer contributes substantially to the global burden of disease and healthcare costs. New screening modalities using low-dose computerized tomography are promising tools for early detection leading to curative surgery. However, the screening and follow-up diagnostic procedures of these techniques may be costly. Focusing on prevention is an important factor to reduce the burden of screening, treatment, and lung cancer deaths. The International Agency for Research on Cancer has identified several lung carcinogens, which we believe can be considered actionable when developing prevention strategies. To curb the societal burden of lung cancer, healthcare resources need to be focused on early detection and screening and on mitigating exposure(s) of a person to known lung carcinogens, such as active tobacco smoking, household air pollution (HAP), and outdoor air pollution. Evidence has also suggested that these known lung carcinogens may be associated with genetic predispositions, supporting the hypothesis that lung cancers attributed to differing exposures may have developed from unique underlying genetic mechanisms attributed to the exposure of interest. For instance, smokingattributed lung cancer involves novel genetic markers of risk compared with HAP-attributed lung cancer. Therefore, genetic risk markers may be used in risk stratification to identify subpopulations that are at a higher risk for developing lung cancer attributed to a given exposure. Such targeted prevention strategies suggest that precision prevention strategies may be possible in the future; however, much work is needed to determine whether these strategies will be viable.

Global economic burden of schizophrenia: a systematic review

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Chong HY

2016-02-01

Full Text Available Huey Yi Chong,1 Siew Li Teoh,1 David Bin-Chia Wu,1 Surachai Kotirum,1 Chiun-Fang Chiou,2 Nathorn Chaiyakunapruk1,3–5 1School of Pharmacy, Monash University Malaysia, Selangor, Malaysia; 2Janssen Pharmaceutical Companies Asia Pacific, Singapore; 3Center of Pharmaceutical Outcomes Research (CPOR, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand; 4School of Pharmacy, University of Wisconsin, Madison, WI, USA; 5School of Population Health, University of Queensland, Brisbane, Australia Background: Schizophrenia is one of the top 25 leading causes of disability worldwide in 2013. Despite its low prevalence, its health, social, and economic burden has been tremendous, not only for patients but also for families, caregivers, and the wider society. The magnitude of disease burden investigated in an economic burden study is an important source to policymakers in decision making. This study aims to systematically identify studies focusing on the economic burden of schizophrenia, describe the methods and data sources used, and summarize the findings of economic burden of schizophrenia. Methods: A systematic review was performed for economic burden studies in schizophrenia using four electronic databases (Medline, EMBASE, PsycINFO, and EconLit from inception to August 31, 2014. Results: A total of 56 articles were included in this review. More than 80% of the studies were conducted in high-income countries. Most studies had undertaken a retrospective- and prevalence-based study design. The bottom-up approach was commonly employed to determine cost, while human capital method was used for indirect cost estimation. Database and literature were the most commonly used data sources in cost estimation in high-income countries, while chart review and interview were the main data sources in low and middle-income countries. Annual costs for the schizophrenia population in the country ranged from US$94

The effects of debt burden on the Nigerian economy | Ogege ...

African Journals Online (AJOL)

It employs the ordinary least squares (OLS) to test the relationship between debt burden and the growth in the Nigerian economy. The finding shows that there is a negative relationship between debt stock (internal and external debt) and gross domestic product, meaning that an increase in debt stock will lead to reduction ...

Oxidative Stress Induction by Lead in Leaves of Radish (Raphanus sativus Seedlings

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Nadjet BITEUR

2011-11-01

Full Text Available Oxidative stress was induced by lead acetate (Pb in Raphanus sativus seedlings grown in a hydroponic system using sand as substrate. Thirty day old acclimated seeds were treated for 7 days with five Pb levels (0 as control, 100, 200, 500 and 1000 mg l-1. Parameters such as growth, oxidative damage markers (lipid peroxidation, protein oxidation and hydrogen peroxide contents and enzymatic activities of catalase (CAT and peroxidase (POD were investigated. Lead concentration in plant tissues increased with increasing of Pb levels. Shoot fresh weight, chlorophyll and carotenoid concentration were significantly decreased at 100 mg l-1 Pb. Lipid peroxidation, protein oxidation and H2O2 levels were increased at 500 and 1000 mg l-1 Pb compared to control treatment, in shoots. Peroxidase activity showed a straight correlation with H2O2 concentration, whereas CAT activity decreased only in shoots. These changes in enzymatic and non-enzymatic antioxidants showed that the Pb exposition had a significant disturbance on Raphanus sativus plantlets and affect the biochemical and physiological processes.

Association of tibia lead and blood lead with end-stage renal disease: A pilot study of African-Americans

International Nuclear Information System (INIS)

Muntner, Paul; Menke, Andy; Batuman, Vecihi; Rabito, Felicia A.; He Jiang; Todd, Andrew C.

2007-01-01

The association between body lead burden and kidney disease remains controversial. Fifty-five African-American end-stage renal disease (ESRD) cases and 53 age- and sex-matched African-American controls without known renal disease were recruited from Tulane University-affiliated dialysis clinics and out-patient clinics, respectively. Blood lead was measured via atomic absorption spectrophotometry and tibia lead (a measure of body lead) was measured via 109 Cd-based K shell X-ray fluorescence. Median blood lead levels were significantly higher among ESRD cases (6 μg/dL) compared to their control counterparts (3 μg/dL; P<0.001). Although no participants had overt lead poisoning (blood lead ≥25 μg/dL), seven cases but no controls had blood lead levels above 10 μg/dL (P=0.006). The median tibia lead level was 17 micrograms of lead per gram of bone mineral (μg/g) and 13 μg/g among ESRD cases and their control counterparts, respectively (P=0.134). Four ESRD cases (7%), but no controls, had a tibia lead level above 40 μg/g (P=0.115) while a similar proportion of cases and controls had tibia lead between 20 and 39 μg/g (33% and 32%, respectively; P=0.726). After adjustment for potential confounders, the odds ratios of ESRD associated with a tibia lead ≥20 μg/g and each four-fold higher tibia lead (e.g., 5-20 μg/g) were 1.55 (95% CI: 0.55, 4.41) and 1.88 (95% CI: 0.53, 6.68), respectively. These findings support the need for prospective cohort studies of body lead burden and renal disease progression

Occupational health programme for lead workers in battery plants

Science.gov (United States)

Lee, Byung-Kook

The realization of problems resulting from the exposure to undue high lead levels of workers in lead-using industries, particularly in storage battery plants, has given rise to a new occupational health service, the so-called type specific (harmful agent specific) group occupational health. In 1988, the Korean Ministry of Labor designated the Institute of Industrial Medicine, Soonchunhyang University, as an authorized organization to take care of lead workers in lead industries. The following occupational health services are provided by the Institute: (i) physical health examination; (ii) biological monitoring with zinc protoporphyrin, urine δ-aminolevulinic acid and blood lead; (iii) respiratory protection with maintenance-free respirators; (iv) measurement of the environmental condition of workplaces; (v) health education. A three-year occupational health programme for lead workers has contributed to improvements in the working conditions of lead industries, particularly in large-scale battery plants, and has decreased the unnecessary high lead burden of workers through on-going medical surveillance with biological monitoring and health education schemes. The strong commitment of both employers and the government to improve the working conditions of lead industries, together with the full cooperation of lead workers, has served to reduce the high lead burdens of lead workers. This decreases the number of lead-poisoning cases and provides more comfortable workplaces, particularly in battery plants.

A study of the stressor, family environment and family burden in dissociative (conversion disorder patients

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Kamal K Verma

2017-01-01

Full Text Available Background: Dissociative disorder is a stress-related disorder usually present in adolescent and younger age group. It is also accompanied with significant impairment in activity of daily living and family relationship. Family environment plays important role in initiation and maintenance of symptoms and this put significant burden on family. Aim and Objective: To study presence of stressor, family environment, and assessment of family burden in dissociative disorder patients. Material and Method: This was a cross-sectional observational study in which 100 dissociatives disorder patients were included after fulfilling inclusion criteria from both inpatients and outpatient department of psychiatry. Results: In our study major part of the sample were women 60 (60%, among them most of were housewife and educated up to primary school. According to a stressor, 63 (63% patients had family stress/problem and out of them, 35 (58.4 were women. Seventy-four (74% patients had dissociative convulsion and out of them, 45 (75% were women. The dissociative disorder patients cause a considerable degree of burden over other family members in both men and women. There is a significant difference found in the family environment in term of personal growth dimension, relationship dimension in both men and women. Conclusion: Present study concludes that dissociative disorder patients cause a considerable degree of burden over other family members in term of leisure, physical, mental, financial, and routines family interrelationship domains. The family environment in term of personal growth dimension, relationship dimension has a casual effect on symptoms of dissociative disorder patients.

An increase in aerosol burden due to the land-sea warming contrast

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Hassan, T.; Allen, R.; Randles, C. A.

2017-12-01

Climate models simulate an increase in most aerosol species in response to warming, particularly over the tropics and Northern Hemisphere midlatitudes. This increase in aerosol burden is related to a decrease in wet removal, primarily due to reduced large-scale precipitation. Here, we show that the increase in aerosol burden, and the decrease in large-scale precipitation, is related to a robust climate change phenomenon—the land/sea warming contrast. Idealized simulations with two state of the art climate models, the National Center for Atmospheric Research Community Atmosphere Model version 5 (NCAR CAM5) and the Geophysical Fluid Dynamics Laboratory Atmospheric Model 3 (GFDL AM3), show that muting the land-sea warming contrast negates the increase in aerosol burden under warming. This is related to smaller decreases in near-surface relative humidity over land, and in turn, smaller decreases in large-scale precipitation over land—especially in the NH midlatitudes. Furthermore, additional idealized simulations with an enhanced land/sea warming contrast lead to the opposite result—larger decreases in relative humidity over land, larger decreases in large-scale precipitation, and larger increases in aerosol burden. Our results, which relate the increase in aerosol burden to the robust climate projection of enhanced land warming, adds confidence that a warmer world will be associated with a larger aerosol burden.

Danger ahead: the burden of diseases, injuries, and risk factors in the Eastern Mediterranean Region, 1990-2015.

Science.gov (United States)

2018-05-01

The Eastern Mediterranean Region faces several health challenges at a difficult time with wars, unrest, and economic change. We used the Global Burden of Disease 2015 study to present the burden of diseases, injuries, and risk factors in the Eastern Mediterranean Region from 1990 to 2015. Ischemic heart disease was the leading cause of death in the region in 2015, followed by cerebrovascular disease. Changes in total deaths ranged from a reduction of 25% for diarrheal diseases to an increase of about 42% for diabetes and tracheal, bronchus, and lung cancer. Collective violence and legal intervention increased by 850% during the time period. Diet was the leading risk factor for disability-adjusted life years (DALYs) for men compared to maternal malnutrition for females. Childhood undernutrition was the leading risk factor for DALYs in 1990 and 2005, but the second in 2015 after high blood pressure. Our study shows that the region is facing several health challenges and calls for global efforts to stabilise the region and to address the current and future burden of disease.

Role of Tyrosine Isomers in Acute and Chronic Diseases Leading to Oxidative Stress - A Review.

Science.gov (United States)

Molnár, Gergő A; Kun, Szilárd; Sélley, Eszter; Kertész, Melinda; Szélig, Lívia; Csontos, Csaba; Böddi, Katalin; Bogár, Lajos; Miseta, Attila; Wittmann, István

2016-01-01

Oxidative stress plays a major role in the pathogenesis of a variety of acute and chronic diseases. Measurement of the oxidative stress-related end products may be performed, e.g. that of structural isomers of the physiological para-tyrosine, namely meta- and ortho-tyrosine, that are oxidized derivatives of phenylalanine. Recent data suggest that in sepsis, serum level of meta-tyrosine increases, which peaks on the 2(nd) and 3(rd) days (ptyrosine excretion correlated with both need of daily insulin dose and the insulin-glucose product in non-diabetic septic cases (ptyrosine excretion, urinary meta-tyrosine/para-tyrosine, urinary ortho-tyrosine/para-tyrosine and urinary (meta- + orthotyrosine)/ para-tyrosine proved to be markers of carbohydrate homeostasis. In a chronic rodent model, we tried to compensate the abnormal tyrosine isomers using para-tyrosine, the physiological amino acid. Rats were fed a standard high cholesterol-diet, and were given para-tyrosine or vehicle orally. High-cholesterol feeding lead to a significant increase in aortic wall meta-tyrosine content and a decreased vasorelaxation of the aorta to insulin and the glucagon-like peptide-1 analogue, liraglutide, that both could be prevented by administration of para-tyrosine. Concluding, these data suggest that meta- and ortho-tyrosine are potential markers of oxidative stress in acute diseases related to oxidative stress, and may also interfere with insulin action in septic humans. Competition of meta- and ortho-tyrosine by supplementation of para-tyrosine may exert a protective role in oxidative stress-related diseases.

Thermal stress in the scanning tunneling microscopy of the metallic heterostructure lead on copper(111); Thermospannung bei der Rastertunnelmikroskopie der metallischen Heterostruktur Blei auf Kupfer(111)

Energy Technology Data Exchange (ETDEWEB)

Langenkamp, Winfried

2008-02-22

The thermal stress, which arises, when tip and sample of a scanning tunneling microscope have different temperatures, was studied in the system lead on copper(111). Thereby atomic resolution on the 4 x 4 superstructure of the lead atoms of the first layer was reached. The thermal stress of lead island was studied because the electronic density of states here is in the greatest part determined by quantum pot states. The density of states as function of the energy can by approached as step function und is by this available for a mathematical modelling. As sum of the influence of the substrates and the influence by the quantum pot states it bas possible to develop a model. in which the thermal stress for lead islands on copper(111) can be described also quantitatively.

404 water quality and syndicated lead burden of a community

African Journals Online (AJOL)

Osondu

1993-12-30

Dec 30, 1993 ... level water samples over the study period were, pH 6.7, TDS 66.0, TOC 2.3, NO3 ... High lead concentration as recorded in this study is a source of worry in view of the health .... analyses including pH, residual chlorine,.

Somatomedin activity before and after chelation therapy in lead-intoxicated children

International Nuclear Information System (INIS)

Rohn, R.D.; Hill, J.R.; Shelton, J.E.

1982-01-01

Somatomedin activity was measured in 21 lead-intoxicated children to determine whether plumbism interferes with the processes of statural (bone) growth. Somatomedin activity was measured both by the rabbit coastal cartilage bioassay and by radioimmunoassay of somatomedin-C. Compared to values in normal children, both the bioassay and radioimmunoassay somatomedin activity was increased. The degree of body lead burden was so extensive that the 21 study children required chelation therapy. Following EDTA or BAL + EDTA chelation therapy, the overall somatomedin activity of these children with plumbism further increased significantly. In contrast, measures of body lead burden--including blood lead levels--decreased after treatment in all lead-intoxicated youngsters. We conclude that plumbism is associated with increased somatomedin activity. Hence the increased somatomedin activity may explain why clinical experience fails to find any long-term deleterious effect of saturnism on statural (bone) growth. Possible mechanisms underlying the increased somatomedin activity in the lead-intoxicated children remain to be defined

Coping and subjective burden in caregivers of older relatives: a quantitative systematic review.

Science.gov (United States)

Del-Pino-Casado, Rafael; Frías-Osuna, Antonio; Palomino-Moral, Pedro A; Pancorbo-Hidalgo, Pedro L

2011-11-01

This article is a report on a review of the effect of coping strategies on subjective burden in informal caregivers of older adults. Informal care has negative effects on caregivers' health, and subjective burden is one of these. It has been linked with other effects (e.g. anxiety and depression). Thus, greater prevention of subjective burden will mean increased prevention of these effects. To achieve this, identification of factors related to subjective burden is essential. Electronic databases and manual searches of scientific journals. A quantitative systematic review was conducted including: (a) original studies (b) that related caregiver subjective burden to coping strategies compatible with the classifications of Lazarus & Folkman or Moos et al. (c) in informal caregivers of older relatives. The searches ranged from the first year included in each database until January 2010. After quality appraisal, ten studies were included; these, care-recipients living at home and having cognitive impairment. Four coping categories have been related to subjective burden: problem-focused, emotion-focused, approach and avoidance. Interesting results were only found for avoidance coping (positive association). In other categories, results were heterogeneous (problem-focused and approach) or we found few valid studies (emotion-focused). We found some evidence for a positive association between avoidance coping and subjective burden in home caregivers of older relatives with cognitive impairment. It is probable that avoidance coping either mediates or moderates the relationship between subjective burden and its outcomes, or that avoidance coping precedes subjective burden, which in turn leads to the coping outcomes. In both situations, avoidance coping is an ineffective coping. © 2011 Blackwell Publishing Ltd.

Stress leads to prosocial action in immediate need situations

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Tony W. Buchanan

2014-01-01

Full Text Available Stress clearly influences decision making, but the effects are complex. This review focuses on the potential for stress to promote prosocial decisions, serving others at a temporary cost to the self. Recent work has shown altruistic responses under stress, particularly when the target’s need is salient. We discuss potential mechanisms for these effects, including emotional contagion and offspring care mechanisms. These neurobiological mechanisms may promote prosocial—even heroic—action, particularly when an observer knows the appropriate response and can respond to a target in need. The effects of stress on behavior are not only negative, they can be adaptive and altruistic under conditions that promote survival and well-being at the individual and group level.

Factors associated with caregiver burden among pharmacotherapy-treated children/adolescents with ADHD in the Caregiver Perspective on Pediatric ADHD survey in Europe

Directory of Open Access Journals (Sweden)

Fridman M

2017-02-01

Full Text Available Moshe Fridman,1 Tobias Banaschewski,2 Vanja Sikirica,3 Javier Quintero,4 M Haim Erder,3 Kristina S Chen5 1AMF Consulting, Inc., Los Angeles, CA, USA; 2Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany; 3Global Health Economics Outcomes Research and Epidemiology, Shire, Wayne, PA, USA; 4Psychiatry Department, Hospital Universitario Infanta Leonor, Complutense University, Madrid, Spain; 5Global Health Economics Outcomes Research and Epidemiology, Shire, Lexington, MA, USA Background: Burden on caregivers of children/adolescents with attention-deficit/hyperactivity disorder (ADHD is multidimensional, but incompletely understood. Objective: To analyze caregiver burden across the concepts of work, social/family life, and parental worry/stress, in relation to selected contributing factors. Methods: The online Caregiver Perspective on Pediatric ADHD survey was fielded in ten European countries. Analysis included children/adolescents (6–17 years who were receiving/had received ADHD pharmacotherapy in the previous 6 months. Caregivers recorded their child’s/adolescent’s symptoms “on”/“off” medication (ie, when the caregiver reported that the child/adolescent forgot/chose not to take medication, before the onset of medication effect, or medication worn off. Effects of ADHD severity, comorbidities, and medication adherence on each burden outcome were assessed (multiple regression models. Results: In total, 2,326 caregivers were included (children/adolescents’ mean age: 11.5 years, 80% male. Caregivers reported missed/altered work, avoiding social activity, increased parental worry/stress, and strain on family life, despite using ADHD pharmacotherapy. Child/adolescent comorbidities and ADHD severity were significantly related to all burden concepts measured; the strongest comorbidity associations were with altered

Associations between advanced cancer patients' survival and family caregiver presence and burden.

Science.gov (United States)

Dionne-Odom, J Nicholas; Hull, Jay G; Martin, Michelle Y; Lyons, Kathleen Doyle; Prescott, Anna T; Tosteson, Tor; Li, Zhongze; Akyar, Imatullah; Raju, Dheeraj; Bakitas, Marie A

2016-05-01

We conducted a randomized controlled trial (RCT) of an early palliative care intervention (ENABLE: Educate, Nurture, Advise, Before Life Ends) for persons with advanced cancer and their family caregivers. Not all patient participants had a caregiver coparticipant; hence, we explored whether there were relationships between patient survival, having an enrolled caregiver, and caregiver outcomes prior to death. One hundred and twenty-three patient-caregiver dyads and 84 patients without a caregiver coparticipant participated in the ENABLE early versus delayed (12 weeks later) RCT. We collected caregiver quality-of-life (QOL), depression, and burden (objective, stress, and demand) measures every 6 weeks for 24 weeks and every 3 months thereafter until the patient's death or study completion. We conducted survival analyses using log-rank and Cox proportional hazards models. Patients with a caregiver coparticipant had significantly shorter survival (Wald = 4.31, HR = 1.52, CI: 1.02-2.25, P = 0.04). After including caregiver status, marital status (married/unmarried), their interaction, and relevant covariates, caregiver status (Wald = 6.25, HR = 2.62, CI: 1.23-5.59, P = 0.01), being married (Wald = 8.79, HR = 2.92, CI: 1.44-5.91, P = 0.003), and their interaction (Wald = 5.18, HR = 0.35, CI: 0.14-0.87, P = 0.02) were significant predictors of lower patient survival. Lower survival in patients with a caregiver was significantly related to higher caregiver demand burden (Wald = 4.87, CI: 1.01-1.20, P = 0.03) but not caregiver QOL, depression, and objective and stress burden. Advanced cancer patients with caregivers enrolled in a clinical trial had lower survival than patients without caregivers; however, this mortality risk was mostly attributable to higher survival by unmarried patients without caregivers. Higher caregiver demand burden was also associated with decreased patient survival. © 2016 The Authors. Cancer Medicine published by

The Role of Oxidative Stress in the Longevity and Insecticide Resistance Phenotype of the Major Malaria Vectors Anopheles arabiensis and Anopheles funestus.

Science.gov (United States)

Oliver, Shüné V; Brooke, Basil D

2016-01-01

Oxidative stress plays numerous biological roles, both functional and pathological. The role of oxidative stress in various epidemiologically relevant biological traits in Anopheles mosquitoes is not well established. In this study, the effects of oxidative stress on the longevity and insecticide resistance phenotype in the major malaria vector species An. arabiensis and An. funestus were examined. Responses to dietary copper sulphate and hydrogen peroxide were used as proxies for the oxidative stress phenotype by determining the effect of copper on longevity and hydrogen peroxide lethal dose. Glutathione peroxidase and catalase activities were determined colorimetrically. Oxidative burden was quantified as protein carbonyl content. Changes in insecticide resistance phenotype were monitored by WHO bioassay. Insecticide resistant individuals showed an increased capacity for coping with oxidative stress, mediated by increased glutathione peroxidase and catalase activity. This effect was observed in both species, as well as in laboratory strains and F1 individuals derived from wild-caught An. funestus mothers. Phenotypic capacity for coping with oxidative stress was greatest in strains with elevated Cytochrome P450 activity. Synergism of oxidative stress defence enzymes by dietary supplementation with haematin, 3-Amino-1, 2, 4-triazole and Sodium diethyldithiocarbamate significantly increased pyrethroid-induced mortality in An. arabiensis and An. funestus. It is therefore concluded that defence against oxidative stress underlies the augmentation of the insecticide resistance phenotype associated with multiple blood-feeding. This is because multiple blood-feeding ultimately leads to a reduction of oxidative stress in insecticide resistant females, and also reduces the oxidative burden induced by DDT and pyrethroids, by inducing increased glutathione peroxidase activity. This study highlights the importance of oxidative stress in the longevity and insecticide resistance

The global burden of dengue: an analysis from the Global Burden of Disease Study 2013

NARCIS (Netherlands)

J.D. Stanaway (Jeffrey D.); D.S. Shepard (Donald); E.A. Undurraga (Eduardo); Halasa, Y.A. (Yara A); L.E. Coffeng (Luc); Brady, O.J. (Oliver J); Hay, S.I. (Simon I); Bedi, N. (Neeraj); I.M. Bensenor (Isabela M.); C.A. Castañeda-Orjuela (Carlos A); T.-W. Chuang (Ting-Wu); K.B. Gibney (Katherine B); Z.A. Memish (Ziad); A. Rafay (Anwar); K.N. Ukwaja (Kingsley N); N. Yonemoto (Naohiro); C.J.L. Murray (Christopher)

2016-01-01

textabstractBackground Dengue is the most common arbovirus infection globally, but its burden is poorly quantified. We estimated dengue mortality, incidence, and burden for the Global Burden of Disease Study 2013. Methods We modelled mortality from vital registration, verbal autopsy, and

The burden of asthma in children: a Latin American perspective.

Science.gov (United States)

Fischer, Gilberto Bueno; Camargos, Paulo Augusto Moreira; Mocelin, Helena Teresinha

2005-03-01

Worldwide, studies on asthma prevalence have shown major rises over the last 30 years. The impact on the burden of asthma is being increasingly recognised. In some countries in Latin America, the prevalence of asthma is among the highest in the world. Asthma admissions are very common in children, leading to high costs for the health systems of those countries. Unfortunately, Latin America has limited resources to pay for appropriate treatment. The main goals of the international guidelines for asthma treatment are not being met. However, asthma programmes operating in some countries are showing promising results in reducing asthma admissions and consequently decreasing the burden of asthma. Local adaptation of international guidelines must be implemented in order to decrease costs and optimise outcomes.

Caregiving burden and psychological distress in Chinese spousal caregivers: gender difference in the moderating role of positive aspects of caregiving.

Science.gov (United States)

Wong, Daniel Fu Keung; Ng, Ting Kin; Zhuang, Xiao Yu

2018-05-21

This study endeavors to advance the current literature by examining the gender differences in the caregiving experiences and the stress-buffering role of positive aspects of caregiving (PAC) among Chinese spousal caregivers of frail elders in Hong Kong. Forty-nine husband caregivers and 121 wife caregivers of frail elders in Hong Kong (N = 170) responded to the Positive Aspects of Caregiving (PAC) scale, the Zarit Burden Interview (ZBI), the 21-item Depression, Anxiety, and Stress Scales (DASS-21), and demographic questions. These spousal caregivers were diverse in age, and their care receivers were diverse in terms of age and health condition. As predicted, there were significant gender differences in the moderating effects of PAC on the relationships of caregiving burden to depression, anxiety, and overall psychological distress. While PAC significantly buffered the effects of caregiving burden on depression, anxiety, and overall psychological distress for wife caregivers, the moderating effects of PAC were not significant for husband caregivers. Unexpectedly, wife caregivers reported lower PAC, higher caregiving burden, and higher psychological distress. As these findings suggest that PAC is lower but more beneficial for Chinese wife caregivers than Chinese husband caregivers, helping professionals are recommended to use strengths-based interventions that target PAC when working with Chinese wife caregivers.

Growth, photosynthesis and antioxidant responses of endophyte infected and non-infected rice under lead stress conditions.

Science.gov (United States)

Li, Xuemei; Bu, Ning; Li, Yueying; Ma, Lianju; Xin, Shigang; Zhang, Lihong

2012-04-30

An endophytic fungus was tested in rice (Oryza sativa L.) exposed to four levels of lead (Pb) stress (0, 50, 100 and 200 μM) to assess effects on plant growth, photosynthesis and antioxidant enzyme activity. Under Pb stress conditions, endophyte-infected seedlings had greater shoot length but lower root length compared to non-infected controls, and endophyte-infected seedlings had greater dry weight in the 50 and 100 μM Pb treatments. Under Pb stress conditions, chlorophyll and carotenoid levels were significantly higher in the endophyte-infected seedlings. Net photosynthetic rate, transpiration rate and water use efficiency were significantly higher in endophyte-infected seedlings in the 50 and 100 μM Pb treatments. In addition, chlorophyll fluorescence parameters Fv/Fm and Fv/Fo were higher in the infected seedlings compared to the non-infected seedlings under Pb stress. Malondialdehyde accumulation was induced by Pb stress, and it was present in higher concentration in non-infected seedlings under higher concentrations of Pb (100 and 200 μM). Antioxidant activity was either higher or unchanged in the infected seedlings due to responses to the different Pb concentrations. These results suggest that the endophytic fungus improved rice growth under moderate Pb levels by enhancing photosynthesis and antioxidant activity relative to non-infected rice. Copyright © 2012 Elsevier B.V. All rights reserved.

40 CFR 22.24 - Burden of presentation; burden of persuasion; preponderance of the evidence standard.

Science.gov (United States)

2010-07-01

... persuasion; preponderance of the evidence standard. 22.24 Section 22.24 Protection of Environment... Burden of presentation; burden of persuasion; preponderance of the evidence standard. (a) The complainant has the burdens of presentation and persuasion that the violation occurred as set forth in the...

Plasma Total Cysteine and Cardiovascular Risk Burden: Action and Interaction

Directory of Open Access Journals (Sweden)

Benedetta De Chiara

2012-01-01

Full Text Available We hypothesized that redox analysis could provide sensitive markers of the oxidative pathway associated to the presence of an increasing number of cardiovascular risk factors (RFs, independently of type. We classified 304 subjects without cardiovascular disease into 4 groups according to the total number of RFs (smoking, hypertension, hypercholesterolaemia, hyperhomocysteinaemia, diabetes, obesity, and their combination. Oxidative stress was evaluated by measuring plasma total and reduced homocysteine, cysteine (Cys, glutathione, cysteinylglycine, blood reduced glutathione, and malondialdehyde. Twenty-seven percent of subjects were in group 0 RF, 26% in 1 RF, 31% in 2 RF, and 16% in ≥3 RF. By multivariable ordinal regression analysis, plasma total Cys was associated to a higher number of RF (OR = 1.068; 95% CI = 1.027–1.110, =0.002. Total RF burden is associated with increased total Cys levels. These findings support a prooxidant effect of Cys in conjunction with RF burden, and shed light on the pathophysiologic role of redox state unbalance in preclinical atherosclerosis.

HOW TO MOTIVATE ENGLISH LEARNERS FACED WITH PSYCHOLOGICAL BURDEN

Directory of Open Access Journals (Sweden)

Himpun Panggabean

2007-01-01

Full Text Available The misleading assumptions of Indonesian-speaking learners of English on the nature of English results in psychological burden inhibiting the process of teaching and learning. The assumptions should be eliminated at the beginning of English class. Besides, the instructor should extensively motivate and encourage the learners to maximize their potentials in learning process. Such approach will gradually lead the learners to self-confidence and self-discovery.

Differential induction of heme oxygenase and other stress proteins in cultured hippocampal astrocytes and neurons by inorganic lead

International Nuclear Information System (INIS)

Cabell, Leigh; Ferguson, Charles; Luginbill, Deana; Kern, Marcey; Weingart, Adam; Audesirk, Gerald

2004-01-01

We examined the effects of exposure to inorganic lead (Pb 2+ ) on the induction of stress proteins in cultured hippocampal neurons and astrocytes, with particular emphasis on the induction of heme oxygenase-1 (HO-1). In radiolabeled neuronal cultures, Pb 2+ exposure had no significant effect on the synthesis of any protein at any concentration (up to 250 μM) or duration of exposure (up to 4 days). In radiolabeled astrocyte cultures, however, Pb 2+ exposure (100 nM to 100 μM; 1-4 days) increased synthesis of proteins with approximate molecular weights of 23, 32, 45, 57, 72, and 90 kDa. Immunoblot experiments showed that Pb 2+ exposure (100 nM to 10 μM, 1-14 days) induces HO-1 synthesis in astrocytes, but not in neurons; this is probably the 32-kDa protein. The other heme oxygenase isoform, HO-2, is present in both neurons and astrocytes, but is not inducible by Pb 2+ at concentrations up to 100 μM. HO-1 can be induced by a variety of stimuli. We found that HO-1 induction in astrocytes is increased by combined exposure to Pb 2+ and many other stresses, including heat, nitric oxide, H 2 O 2 , and superoxide. One of the stimuli that may induce HO-1 is oxidative stress. Lead exposure causes oxidative stress in many cell types, including astrocytes. Induction of HO-1 by Pb 2+ is reduced by the hydroxyl radical scavengers dimethylthiourea (DMTU) and mannitol, but not by inhibitors of calmodulin, calmodulin-dependent protein kinases, protein kinase C, or extracellular signal-regulated kinases (ERK). Therefore, we conclude that oxidative stress is an important mechanism by which Pb 2+ induces HO-1 synthesis in astrocytes

Measuring the global burden of disease and epidemiological transitions: 2002-2030.

Science.gov (United States)

Lopez, A D; Mathers, C D

2006-01-01

Any planning process for health development ought to be based on a thorough understanding of the health needs of the population. This should be sufficiently comprehensive to include the causes of premature death and of disability, as well as the major risk factors that underlie disease and injury. To be truly useful to inform health-policy debates, such an assessment is needed across a large number of diseases, injuries and risk factors, in order to guide prioritization. The results of the original Global Burden of Disease Study and, particularly, those of its 2000-2002 update provide a conceptual and methodological framework to quantify and compare the health of populations using a summary measure of both mortality and disability: the disability-adjusted life-year (DALY). Globally, it appears that about 56 million deaths occur each year, 10.5 million (almost all in poor countries) in children. Of the child deaths, about one-fifth result from perinatal causes such as birth asphyxia and birth trauma, and only slightly less from lower respiratory infections. Annually, diarrhoeal diseases kill over 1.5 million children, and malaria, measles and HIV/AIDS each claim between 500,000 and 800,000 children. HIV/AIDS is the fourth leading cause of death world-wide (2.9 million deaths) and the leading cause in Africa. The top three causes of death globally are ischaemic heart disease (7.2 million deaths), stroke (5.5 million) and lower respiratory diseases (3.9 million). Chronic obstructive lung diseases (COPD) cause almost as many deaths as HIV/AIDS (2.7 million). The leading causes of DALY, on the other hand, include causes that are common at young ages [perinatal conditions (7.1% of global DALY), lower respiratory infections (6.7%), and diarrhoeal diseases (4.7%)] as well as depression (4.1%). Ischaemic heart disease and stroke rank sixth and seventh, retrospectively, as causes of global disease burden, followed by road traffic accidents, malaria and tuberculosis

The Full Picture of Ulcerative Colitis: The Burden, the Patient, the Treatment

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Julián Panés

2015-12-01

Full Text Available Ulcerative colitis (UC carries a significant, progressive disease burden that is often underestimated or misinterpreted by healthcare providers. Adverse outcomes have a major impact on patient quality of life, with a significant burden of symptoms both during and between inflammation flares. Chronic, uncontrolled disease leads to epithelial fibrosis and ‘lead pipe’ colon, dysplasia, and potential colonic cancer. Healthcare providers and patients share similar treatment goals, even if these are not verbalised in the same way, and clinicians need to fully understand the issues most important to patients. Understanding and collaboration can improve identification of meaningful treatment goals and overall disease management. In real-world practice, patients should be categorised according to disease characteristics and prognosis, and managed with appropriate, optimised therapies. Early, top-down management should be implemented in high-risk patients and all patient-centric therapeutic decisions made within the context of a full benefit/risk assessment.

Adaptation to Chronic Nutritional Stress Leads to Reduced Dependence on Microbiota in Drosophila melanogaster.

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Erkosar, Berra; Kolly, Sylvain; van der Meer, Jan R; Kawecki, Tadeusz J

2017-10-24

Numerous studies have shown that animal nutrition is tightly linked to gut microbiota, especially under nutritional stress. In Drosophila melanogaster , microbiota are known to promote juvenile growth, development, and survival on poor diets, mainly through enhanced digestion leading to changes in hormonal signaling. Here, we show that this reliance on microbiota is greatly reduced in replicated Drosophila populations that became genetically adapted to a poor larval diet in the course of over 170 generations of experimental evolution. Protein and polysaccharide digestion in these poor-diet-adapted populations became much less dependent on colonization with microbiota. This was accompanied by changes in expression levels of dFOXO transcription factor, a key regulator of cell growth and survival, and many of its targets. These evolutionary changes in the expression of dFOXO targets to a large degree mimic the response of the same genes to microbiota, suggesting that the evolutionary adaptation to poor diet acted on mechanisms that normally mediate the response to microbiota. Our study suggests that some metazoans have retained the evolutionary potential to adapt their physiology such that association with microbiota may become optional rather than essential. IMPORTANCE Animals depend on gut microbiota for various metabolic tasks, particularly under conditions of nutritional stress, a relationship usually regarded as an inherent aspect of animal physiology. Here, we use experimental evolution in fly populations to show that the degree of host dependence on microbiota can substantially and rapidly change as the host population evolves in response to poor diet. Our results suggest that, although microbiota may initially greatly facilitate coping with suboptimal diets, chronic nutritional stress experienced over multiple generations leads to evolutionary adaptation in physiology and gut digestive properties that reduces dependence on the microbiota for growth and

Edaravone leads to proteome changes indicative of neuronal cell protection in response to oxidative stress.

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Jami, Mohammad-Saeid; Salehi-Najafabadi, Zahra; Ahmadinejad, Fereshteh; Hoedt, Esthelle; Chaleshtori, Morteza Hashemzadeh; Ghatrehsamani, Mahdi; Neubert, Thomas A; Larsen, Jan Petter; Møller, Simon Geir

2015-11-01

Neuronal cell death, in neurodegenerative disorders, is mediated through a spectrum of biological processes. Excessive amounts of free radicals, such as reactive oxygen species (ROS), has detrimental effects on neurons leading to cell damage via peroxidation of unsaturated fatty acids in the cell membrane. Edaravone (3-methyl-1-phenyl-2-pyrazolin-5-one) has been used for neurological recovery in several countries, including Japan and China, and it has been suggested that Edaravone may have cytoprotective effects in neurodegeneration. Edaravone protects nerve cells in the brain by reducing ROS and inhibiting apoptosis. To gain further insight into the cytoprotective effects of Edaravone against oxidative stress condition we have performed comparative two-dimensional gel electrophoresis (2DE)-based proteomic analyses on SH-SY5Y neuroblastoma cells exposed to oxidative stress and in combination with Edaravone. We showed that Edaravone can reverse the cytotoxic effects of H2O2 through its specific mechanism. We observed that oxidative stress changes metabolic pathways and cytoskeletal integrity. Edaravone seems to reverse the H2O2-mediated effects at both the cellular and protein level via induction of Peroxiredoxin-2. Copyright © 2015 Elsevier Ltd. All rights reserved.

Disease burden of COPD in China: a systematic review

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Zhu, Bifan; Wang, Yanfang; Ming, Jian; Chen, Wen; Zhang, Luying

2018-01-01

Chronic obstructive pulmonary disease (COPD) is one of the main contributors to the global burden of disease. The aim of this systematic review was to quantify the disease burden of COPD in China and to determine the risk factors of the disease. The number of studies included in the review was 47 with an average quality assessment score of 7.70 out of 10. Reported COPD prevalence varied between 1.20% and 8.87% in different provinces/cities across China. The prevalence rate of COPD was higher among men (7.76%) than women (4.07%). The disease was more prevalent in rural areas (7.62%) than in urban areas (6.09%). The diagnostic rate of COPD patients in China varied from 23.61% to 30.00%. The percentage of COPD patients receiving outpatient treatment was around 50%, while the admission rate ranged between 8.78% and 35.60%. Tobacco exposure and biomass fuel/solid fuel usage were documented as two important risk factors of COPD. COPD ranked among the top three leading causes of death in China. The direct medical cost of COPD ranged from 72 to 3,565 USD per capita per year, accounting for 33.33% to 118.09% of local average annual income. The most commonly used scales for the assessment of quality of life (QoL) included Saint George Respiratory Questionnaire, Airways Questionnaire 20, SF-36, and their revised versions. The status of QoL was worse among COPD patients than in non-COPD patients, and COPD patients were at higher risks of depression. The COPD burden in China was high in terms of economic burden and QoL. In view of the high smoking rate and considerable concerns related to air pollution and smog in China, countermeasures need to be taken to improve disease prevention and management to reduce disease burdens raised by COPD. PMID:29731623

Caregiver Burden in Alcohol Dependence Syndrome

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Ramanujam Vaishnavi

2017-01-01

Full Text Available Background. Alcoholism is a major threat to the individual as well as the society and the maximum burden of the illness is borne by the family. Aim. The study is aimed at assessing the pattern of burden on the caregivers of alcohol dependent patients and at assessing the relationship between the severity of dependence and the burden on caregivers. Settings and Design. Cross-sectional descriptive study conducted in the Department of Psychiatry, Sri Ramachandra Medical College and Research Institute. Materials and Methods. A cross-sectional assessment was done in 200 patients with alcohol dependence and their caregivers. The severity of dependence and the pattern of burden on caregivers were assessed. Statistical Analysis. The data thus collected was analyzed using SPSS version 20. Results. The study demonstrates that caregivers of alcohol dependent patients reported significant objective burden and subjective burden. Furthermore, the severity of alcohol dependence and the domains of burden such as financial burden, disruption of family interaction, and disruption of family routine activities were positively correlated with high level of significance. Conclusion. The current study has illustrated that all the caregivers experienced significant amount of burden which has to be addressed for better treatment outcome of the patients.

EAMJ Jan. Burden.indd

African Journals Online (AJOL)

2009-01-01

Jan 1, 2009 ... developed world where the burden of disease is accurately determined. ... Projections indicate an expected yearly incidence of 15 to 20 million new .... of global mortality and burden of diseases from 2002 to 2030. Plos. Med.

The relationship of metabolic burden to productivity levels in CHO cell lines.

Science.gov (United States)

Zou, Wu; Edros, Raihana; Al-Rubeai, Mohamed

2018-03-01

The growing demand for recombinant therapeutics has driven biotechnologists to develop new production strategies. One such strategy for increasing the expression of heterologous proteins has focused on enhancing cell-specific productivity through environmental perturbations. In this work, the effects of hypothermia, hyperosmolarity, high shear stress, and sodium butyrate treatment on growth and productivity were studied using three (low, medium, and high producing) CHO cell lines that differed in their specific productivities of monoclonal antibody. In all three cell lines, the inhibitory effect of these parameters on proliferation was demonstrated. Additionally, compared to the control, specific productivity was enhanced under all conditions and exhibited a consistent cell line specific pattern, with maximum increases (50-290%) in the low producer, and minimum increases (7-20%) in the high producer. Thus, the high-producing cell line was less responsive to environmental perturbations than the low-producing cell line. We hypothesize that this difference is most likely due to the bottleneck associated with a higher metabolic burden caused by higher antibody expression. Increased recombinant mRNA levels and pyruvate carboxylase activities due to low temperature and hyperosmotic stress were found to be positively associated with the metabolic burden. © 2017 International Union of Biochemistry and Molecular Biology, Inc.

The relationship between burden and well-being among caregivers of Italian people diagnosed with severe neuromotor and cognitive disorders.

Science.gov (United States)

Fianco, Andrea; Sartori, Raffaela D G; Negri, Luca; Lorini, Saverio; Valle, Giovanni; Delle Fave, Antonella

2015-04-01

In studies on caregiving, high levels of perceived burden are commonly considered as synonymous with poor well-being. This study aimed at better disentangling the relationship between burden and well-being dimensions through their joint investigation. To this purpose, perceived well-being and social resources were evaluated among caregivers reporting different levels of burden. Participants were 91 caregivers (mean age=50.4; SD=9.6), parents of people diagnosed with severe neuromotor and cognitive disorders. Participants completed a semi-structured interview and a set of scaled questionnaires: Caregiver Burden Inventory (CBI), Satisfaction with Life Scale, Positive and Negative Affect Schedule, Depression Anxiety Stress Scale, Eudaimonic and Hedonic Happiness Investigation, Resilience Scale for Adults, and Multidimensional Scale of Perceived Social Support. Participants were divided into two groups according to their perceived burden level, assessed through CBI. In both groups, the subjective components of burden accounted for the major fraction of the total burden level. Participants perceiving high burden reported higher levels of depression related emotions, lower life satisfaction and lower resilience than participants perceiving low burden. No group difference emerged in perceived meaningfulness and social support. A regression analysis showed that the best predictor of perceived burden was life satisfaction, followed to a lesser extent by resilience, while depression related emotions did not provide significant contribution. Findings suggest that the joint assessment of burden and well-being dimensions, that are co-existing in caregivers' experience, allow for the identification of personal and relational resources that can be usefully included in interventions addressed to caregivers. Copyright © 2015 Elsevier Ltd. All rights reserved.

The global burden of mental, neurological and substance use disorders: an analysis from the Global Burden of Disease Study 2010.

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Whiteford, Harvey A; Ferrari, Alize J; Degenhardt, Louisa; Feigin, Valery; Vos, Theo

2015-01-01

The Global Burden of Disease Study 2010 (GBD 2010), estimated that a substantial proportion of the world's disease burden came from mental, neurological and substance use disorders. In this paper, we used GBD 2010 data to investigate time, year, region and age specific trends in burden due to mental, neurological and substance use disorders. For each disorder, prevalence data were assembled from systematic literature reviews. DisMod-MR, a Bayesian meta-regression tool, was used to model prevalence by country, region, age, sex and year. Prevalence data were combined with disability weights derived from survey data to estimate years lived with disability (YLDs). Years lost to premature mortality (YLLs) were estimated by multiplying deaths occurring as a result of a given disorder by the reference standard life expectancy at the age death occurred. Disability-adjusted life years (DALYs) were computed as the sum of YLDs and YLLs. In 2010, mental, neurological and substance use disorders accounted for 10.4% of global DALYs, 2.3% of global YLLs and, 28.5% of global YLDs, making them the leading cause of YLDs. Mental disorders accounted for the largest proportion of DALYs (56.7%), followed by neurological disorders (28.6%) and substance use disorders (14.7%). DALYs peaked in early adulthood for mental and substance use disorders but were more consistent across age for neurological disorders. Females accounted for more DALYs in all mental and neurological disorders, except for mental disorders occurring in childhood, schizophrenia, substance use disorders, Parkinson's disease and epilepsy where males accounted for more DALYs. Overall DALYs were highest in Eastern Europe/Central Asia and lowest in East Asia/the Pacific. Mental, neurological and substance use disorders contribute to a significant proportion of disease burden. Health systems can respond by implementing established, cost effective interventions, or by supporting the research necessary to develop better

Lead-elevated activity of xanthine oxidase in lead-exposed workers

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Sławomir Kasperczyk

2013-04-01

Full Text Available Background: The aim of the present study was to explore the connection between lead toxicity and the activity of xanthine oxidase (XO. In addition, we indicated the uric acid (UA and creatinine levels and concentration of erythrocyte malondialdehyde (MDA to estimate oxidative stress intensity. Materials and Methods: The examined group consisted of 125 healthy male employees of zinc and lead works. The examined group was divided into tertiles according to blood lead levels. In the collected blood samples, concentrations of lead-exposure indices, UA, creatinine, and MDA as well as activity of XO were measured concomitantly. The control group consisted of 32 healthy male administrative workers who were exposed to lead only environmentally. Results: XO activity and MDA level were significantly elevated in all tertiles compared to the control group. Creatinine level was significantly elevated in the medium and high tertiles. However, the level of UA was significantly elevated in the high tertile, while in the low and medium tertile only a tendency toward higher values was observed. Conclusions: Occupational exposure to lead induces activity of XO. This induction may contribute to the observed simultaneously increased oxidative stress, measured as MDA level, and the increased level of UA. Med Pr 2013;64(2:175–180

Effects of leisure activities at home on perceived care burden and the endocrine system of caregivers of dementia patients: a randomized controlled study.

Science.gov (United States)

Hirano, Akemi; Umegaki, Hiroyuki; Suzuki, Yusuke; Hayashi, Toshio; Kuzuya, Masafumi

2016-02-01

Psychological stress associated with caregiving is thought to underlie the high incidence of hypertension, ischemic heart disease, and mortality, as well as reduced immune function, among caregivers of dementia patients. Here, we examined the effects of periodic leisure activities performed by caregivers of dementia patients with care recipients at home on perceived care burden and levels of stress hormones. Participants were 42 caregivers aged ≥ 65 years of patients diagnosed with Alzheimer's dementia. They were randomly assigned to intervention and non-intervention groups. The intervention group underwent a leisure activity program (30 min/3 times/week for 24 weeks) with the care recipient, and the control group underwent normal care activities. The Zarit Burden Interview (ZBI) score, a subjective indicator of care burden, significantly decreased after intervention in the intervention group (p leisure activity on the neuroendocrine system. Our findings suggest that periodic leisure activities can reduce perceived care burden among caregivers of dementia patients. However, in order to evaluate accurately the effects of leisure activities of the present study, long-term follow-up of both caregivers and care recipients is necessary. The Nagoya University Department of Medicine Ethics Committee Clinical Trials Registry Number is 1290.

The Global Cancer Burden

Centers for Disease Control (CDC) Podcasts

2012-02-02

This podcast describes the global burden of cancer and efforts by CDC and others to reduce that burden.  Created: 2/2/2012 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 2/2/2012.

Aging-associated oxidative stress leads to decrease in IAS tone via RhoA/ROCK downregulation.

Science.gov (United States)

Singh, Jagmohan; Kumar, Sumit; Krishna, Chadalavada Vijay; Rattan, Satish

2014-06-01

Internal anal sphincter (IAS) tone plays an important role in rectoanal incontinence (RI). IAS tone may be compromised during aging, leading to RI in certain patients. We examined the influence of oxidative stress in the aging-associated decrease in IAS tone (AADI). Using adult (4-6 mo old) and aging (24-30 mo old) rats, we determined the effect of oxidative stress on IAS tone and the regulatory RhoA/ROCK signal transduction cascade. We determined the effect of the oxidative stress inducer LY83583, which produces superoxide anions (O2 (·-)), on basal and stimulated IAS tone before and after treatment of intact smooth muscle strips and smooth muscle cells with the O2 (·-) scavenger SOD. Our data showed that AADI was associated with a decrease in RhoA/ROCK expression at the transcriptional and translational levels. Oxidative stress with a LY83583-mediated decrease in IAS tone and relaxation of IAS smooth muscle cells was associated with a decrease in RhoA/ROCK signal transduction, which was reversible by SOD. In addition, LY83583 caused a significant decrease in IAS contraction produced by the RhoA activator and a known RhoA/ROCK agonist, U46619, that was also reversible by SOD. The inhibitory effects of LY83583 and the ROCK inhibitor Y27632 on the U46619-induced increase in IAS tone were similar. We conclude that an increase in oxidative stress plays an important role in AADI in the elderly and may be one of the underlying mechanisms of RI in certain aging patients. Copyright © 2014 the American Physiological Society.

Resilience and burden in caregivers of older adults: moderating and mediating effects of perceived social support.

Science.gov (United States)

Ong, Hui Lin; Vaingankar, Janhavi Ajit; Abdin, Edimansyah; Sambasivam, Rajeswari; Fauziana, Restria; Tan, Min-En; Chong, Siow Ann; Goveas, Richard Roshan; Chiam, Peak Chiang; Subramaniam, Mythily

2018-01-31

The burden of caring for an older adult can be a form of stress and influence caregivers' daily lives and health. Previous studies have reported that resilience and social support play an important role in reducing physical and psychological burden in caregivers. Thus, the present study aimed to examine whether perceived social support served as a possible protective factor of burden among caregivers of older adults in Singapore using moderation and mediation effects' models. We conducted a cross-sectional study with 285 caregivers providing care to older adults aged 60 years and above who were diagnosed with physical and/or mental illness in Singapore. The Connor-Davidson Resilience Scale (CD-RISC) was used to measure resilience and burden was measured by the Zarit Burden Interview (ZBI). The Multidimensional Scale of Perceived Social Support (MSPSS) was used to measure perceived social support. Hayes' PROCESS macro was used to test moderation and mediation effects of perceived social support in the relationship between resilience and burden after controlling for sociodemographic variables. Indirect effects were tested using bootstrapped confidence intervals (CI). The mean scores observed were CD-RISC: 70.8/100 (SD = 15.1), MSPSS: 62.2/84 (SD = 12.2), and ZBI: 23.2/88 (SD = 16.0) respectively. While perceived social support served as a full mediator between resilience and caregiver burden (β = - 0.14, 95% CI -0.224 to - 0.072, p social support mediates the association between resilience and caregiver burden among caregivers of older adults in Singapore. It is crucial for healthcare professionals, particularly those who interact and deliver services to assist caregivers, to promote and identify supportive family and friends' network that may help to address caregiver burden.

Stress response of lead-exposed rainbow trout (Oncorhynchus mykiss) during swimming performance and hypoxia challenges

Energy Technology Data Exchange (ETDEWEB)

Phillips, K.A. [National Biological Service, La Crosse, WI (United States)]|[Univ. of Wisconsin, La Crosse, WI (United States); Caldwell, C.A. [National Biological Service, La Crosse, WI (United States); Sandheinrich, M.B. [Univ. of Wisconsin, La Crosse, WI (United States)

1995-12-31

Contaminants often invoke a stress response in aquatic organisms, and may compromise their capacity to respond to secondary stressors. This may reduce growth, reproduction and survival. The authors objectives were to assess the effects of lead and secondary stressors on hematology and blood chemistry of rainbow trout. After a 7 to 8-week aqueous exposure to Pb(100{micro}g/L), rainbow trout were challenged with forced swimming or hypoxia. Lead significantly reduced concentrations of 5-aminolevulinic acid dehydratase (ALAD), but not other constituents in the blood. Lead did not affect the swimming endurance of the fish. Hematocrit, mean cell hemoglobin content, and mean cell volume were significantly lower in Pb-exposed trout following the swimming challenge. Although hypoxia resulted in increased hematocrit and plasma glucose concentrations, there were no significant differences between the Pb and control groups. Hypoxia did not affect plasma chloride concentrations, although concentrations increased in Pb-exposed trout. There was no difference in lactic acid concentrations between Pb-exposed and control fish after forced swimming or hypoxia.

The protective role of exercise on stress system dysregulation and comorbidities.

Science.gov (United States)

Tsatsoulis, Agathocles; Fountoulakis, Stelios

2006-11-01

The human body, when under threat, elicits a set of neuroendocrine responses, including an increased secretion of glucocorticoids (GCs) and catecholamines from the adrenal gland and the activation of the sympathetic nervous system. These hormonal secretions allow a "fight or flight" response by mobilizing endogenous substrate and inducing a state of insulin resistance in the liver and skeletal muscles. Although the stress response was essential in ancient times to survive physical aggression, this threat has disappeared in our industrialized societies. However, in today's environment, the same stress responses can be elicited by emotional stimuli or professional and social stress. Such psychological stress may be protracted and unrelated to an increased metabolic demand. Thus, the energy mobilized is not used but is stored in visceral fat depots by the combined action of hypercortisolism and hyperinsulinemia. In addition, chronic activation of the stress system causes suppression of the gonadal, growth hormone (GH), and thyroid axes. These metabolic disturbances, in concert, lead to the clinical expression of a number of comorbidities including central obesity, hypertension, dyslipidemia, and endothelial dysfunction, all components of the metabolic syndrome and cardiometabolic risk factors. Moreover, chronic stress has deleterious effects on the brain and, in particular, affects hippocampal structure and function leading to cognitive and mood disturbances. Importantly, this stress-induced clinical phenotype is likely to be exaggerated in the presence of physical inactivity, resulting in a "stress-induced/exercise deficient" phenotype. Assuming that the stress response is a neuroendocrine mechanism that occurs in anticipation of physical action, then physical activity should be the natural means to prevent the consequences of stress. Indeed, accumulating evidence documents the beneficial effects of regular exercise in preventing or ameliorating the metabolic and

The Role of Oxidative Stress in the Longevity and Insecticide Resistance Phenotype of the Major Malaria Vectors Anopheles arabiensis and Anopheles funestus.

Directory of Open Access Journals (Sweden)

Shüné V Oliver

Full Text Available Oxidative stress plays numerous biological roles, both functional and pathological. The role of oxidative stress in various epidemiologically relevant biological traits in Anopheles mosquitoes is not well established. In this study, the effects of oxidative stress on the longevity and insecticide resistance phenotype in the major malaria vector species An. arabiensis and An. funestus were examined. Responses to dietary copper sulphate and hydrogen peroxide were used as proxies for the oxidative stress phenotype by determining the effect of copper on longevity and hydrogen peroxide lethal dose. Glutathione peroxidase and catalase activities were determined colorimetrically. Oxidative burden was quantified as protein carbonyl content. Changes in insecticide resistance phenotype were monitored by WHO bioassay. Insecticide resistant individuals showed an increased capacity for coping with oxidative stress, mediated by increased glutathione peroxidase and catalase activity. This effect was observed in both species, as well as in laboratory strains and F1 individuals derived from wild-caught An. funestus mothers. Phenotypic capacity for coping with oxidative stress was greatest in strains with elevated Cytochrome P450 activity. Synergism of oxidative stress defence enzymes by dietary supplementation with haematin, 3-Amino-1, 2, 4-triazole and Sodium diethyldithiocarbamate significantly increased pyrethroid-induced mortality in An. arabiensis and An. funestus. It is therefore concluded that defence against oxidative stress underlies the augmentation of the insecticide resistance phenotype associated with multiple blood-feeding. This is because multiple blood-feeding ultimately leads to a reduction of oxidative stress in insecticide resistant females, and also reduces the oxidative burden induced by DDT and pyrethroids, by inducing increased glutathione peroxidase activity. This study highlights the importance of oxidative stress in the longevity and

Patients' self-perceived burden, caregivers' burden and quality of life for amyotrophic lateral sclerosis patients: a cross-sectional study.

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Geng, Dan; Ou, RuWei; Miao, XiaoHui; Zhao, LiHong; Wei, QianQian; Chen, XuePing; Liang, Yan; Shang, HuiFang; Yang, Rong

2017-10-01

This study surveys the quality of life of amyotrophic lateral sclerosis patients and the factors associated with amyotrophic lateral sclerosis patients' self-perceived burden and their caregivers' burden. Burdens of patients with amyotrophic lateral sclerosis and their caregivers in Chinese population are largely unknown. A cross-sectional study was conducted among 81 pairs of amyotrophic lateral sclerosis patients and their caregivers. Amyotrophic lateral sclerosis patients' self-perceived burden and caregivers' burden were assessed by the Self-Perceived Burden Scale and Zarit-Burden Interview, respectively. Quality of life of amyotrophic lateral sclerosis patients was measured using the World Health Organization Quality of Life-Bref. The amyotrophic lateral sclerosis Functional Rating Scale-Revised questionnaire was used to estimate patients' physical function. Both patients and caregivers reported a mild to moderate burden. The World Health Organization quality of life-Bref scores were decreased in respondents with lower amyotrophic lateral sclerosis Functional Rating Scale-Revised, higher Self-Perceived Burden Scale and higher Zarit-Burden Interview scores. Self-Perceived Burden Scale scores were associated with patients' knowledge of amyotrophic lateral sclerosis, respiratory function and female sex. Zarit-Burden Interview scores were associated with caregivers' age, patients' motor function and out-of-pocket payment. With increase in amyotrophic lateral sclerosis patients' self-perceived burden and caregivers' burden, quality of life of amyotrophic lateral sclerosis patients decreased. Female patients, who had known more about the disease, and those with severe respiratory dysfunction were subject to higher self-perceived burden. Older caregivers and caregivers of patients with severe motor dysfunction and more out-of-pocket payment experienced more care burdens. Our study suggests that paying more attention to female amyotrophic lateral sclerosis patients

[Depression and burden on primary caregivers of elderly persons with physical dependence of the UMF 171].

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Navarro-Sandoval, Cristina; Uriostegui-Espíritu, Lizbeth Carlota; Delgado-Quiñones, Edna Gabriela; Sahagún-Cuevas, Minerva Natalia

2017-01-01

According to the National Health and Nutrition Survey of 2012, more than a quarter of older adults (26.9%) have some degree of disability, requiring a primary caregiver to perform basic activities of daily living. The aim is to determine the prevalence of depression and burden on primary caregivers of elderly persons with physical dependence. A descriptive cross-sectional study with non-probability sampling that included the primary caregivers of elderly patients with physical dependence. Barthel scale was applied as a tool to measure the level of physical dependence in elderly patients; while the primary caregivers were applied to the Beck Depression and Zarit scale for assessing the level of caregiver burden. A sample of 76 primary caregivers was calculated and descriptive statistical analysis was performed. Of the 76 primary caregivers, 55.3% were without depression, 32.9% had mild depression, and 11.8% with moderate depression. According to the Zarit scale, 40.8% had no burden, 44.7% had burden light, and 14.5% intense burden. The role of primary caregiver is a stressful task which can interfere with their family health; so our role is to provide care not only to the geriatric dependent patients, but also to their caregiver.

Living with someone with an eating disorder: factors affecting the caregivers' burden.

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Stefanini, Maria Cristina; Troiani, Maria Rita; Caselli, Michela; Dirindelli, Paolo; Lucarelli, Stefano; Caini, Saverio; Martinetti, Maria Grazia

2018-01-24

We focused on carers of subjects suffering from eating disorders (ED), and studied the characteristics that mostly expose them to high levels of stress, anxiety, depression and expressed emotion, favoring the accommodation of the family system to the cared person. We administered the accommodation and enabling scale for eating disorders (AESED) questionnaire, the family questionnaire (FQ) and the depression, anxiety and stress scale (DASS-21) questionnaire to 97 carers of 62 ED patients, and investigated the carer's characteristics associated with the scores in the three questionnaires. A personal history of ED, being the primary carer, and caring for a person with a diagnosis of anorexia nervosa are the characteristics that contribute most to aggravate the carers' burden in terms of stress, anxiety, depression, accommodation and enabling. Our findings may help doctors to provide effective support to caregivers and eventually improve the treatment of subjects with ED.

Evaluation of Oxidative Stress in Combination Therapy with D-penicillamine and N-Acetylcysteine (NAC in Lead Poisoning in Opium Addicts

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Saeedeh Shojaeepour

2017-12-01

Full Text Available Background: N-acetylcysteine (NAC is a putative antioxidant and has gained attention as a promising agent for chelating heavy metals including lead. Considering the animal studies results, we hypothesized that adding NAC to the treatment regimen may improve the success of treatment with lead chelators. Methods: A total of 46 patients who were lead-poisoned opioid addicts were divided into two groups randomly and treated with d-penicillamine (DP, 1g/day in four equal divided doses and NAC+DP (1 g/day + 150 mg/kg/day. The efficacy of treatment was evaluated by hospitalization period. Meanwhile, the oxidative stress parameters including lipid peroxidation, protein carbonyl, total antioxidant capacity (TAC, glutathione concentration and super oxide dismutase (SOD activity were determined on admission and discharge and compared with healthy normal controls. Results: Hospitalization period was not different between the two groups. Treatment with DP and DP+NAC significantly decreased oxidative stress in patients. On the discharge day, the SOD activity and TAC were significantly higher in DP+NAC group in comparison with the DP group. Conclusion: Although NAC recovers antioxidant capacity, the advantages of NAC in improvement of DP efficacy in lead poisoning is questionable. Further studies with larger sample size and combination with other chelators are recommended.

Household financial burden of phenylketonuria and its impact on treatment in China: a cross-sectional study.

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Wang, Lin; Zou, Hui; Ye, Fang; Wang, Kundi; Li, Xiaowen; Chen, Zhihua; Chen, Jie; Han, Bingjuan; Yu, Weimin; He, Chun; Shen, Ming

2017-05-01

Phenylketonuria (PKU) is a rare inborn disease, which, untreated, leading to severe neurobehavioral dysfunction. Considering its complexity, the management of PKU may bring a formidable economic burden to parents and caregivers. It is still unknown what the out-of-pocket expenses are for a patient with PKU in China. This paper explores the household financial burden of classical PKU and its impact on Chinese families in a quantitative manner for the first time. A non-interventional and observational study was conducted at the China-Japan Friendship Hospital, one of the national centers for inherited metabolic disorders in China. The medical and non-medical household financial burdens were consolidated into a questionnaire to evaluate the out-of-pocket costs (OOPCs) of PKU treatment and follow-up. The total OOPCs were USD$3766.1 (0y), USD$3795.2 (1-2 ys), USD$4657.7 (3-4 ys), USD$5979.9 (5-8 ys), and USD$5588.7 (9 ys and older) for PKU patients of different age groups. The median economic burden of classical PKU was 75.0 % of total annual family income (range 1.0-779.1 %), and 94.4 % of the families exceeding the threshold considered as catastrophic expenditure. There was a negative correlation between the financial burden and the proportion of time when Phe concentrations were in the desired target range (120-250 μmol/L) in 0-4-ys group (r = -0.474, p = 0.026). The management of PKU is associated with a severe financial burden on patients' families, which may lead to insufficient treatment or variation of blood Phe concentration. The current reimbursement policies are as yet inadequate. A national reimbursement system targeting treatment practices for PKU patients and other rare diseases across China is imperative.

DOBUTAMINE STRESS-ECHOCARDIOGRAPHY: POSSIBILITY OF CLINICAL USAGE IN CARDIOLOGY PRACTICE

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M. A. Saidova

2016-01-01

Full Text Available Currently stress-echocardiography or so-called burden echocardiography is essential method of patient examination to reveal latent ischemic heart disease (IHD. That is one of the mostly informative non-invasive methods of IHD diagnosis as well as efficacy evaluation of coronary angioplasty, surgical and pharmacological treatments of IHD. Dobutamine usage as a stress-agent at burden echocardiography allows evaluating not only ischemia but a myocardial vitality in post infarction area as well as clarify severity of valve stenosis, pulmonary hypertension and extent of latent obstruction of exhaust duct of the left ventricle. Method possibilities are presented as well as test protocol, main indications and contraindications.

Raman study of lead zirconate titanate under uniaxial stress

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Tallant, David R.; Simpson, Regina L.; Grazier, J. Mark; Zeuch, David H.; Olson, Walter R.; Tuttle, Bruce A.

2000-01-01

The authors used micro-Raman spectroscopy to monitor the ferroelectric (FE) to antiferroelectric (AFE) phase transition in PZT ceramic bars during the application of uniaxial stress. They designed and constructed a simple loading device, which can apply sufficient uniaxial force to transform reasonably large ceramic bars while being small enough to fit on the mechanical stage of the microscope used for Raman analysis. Raman spectra of individual grains in ceramic PZT bars were obtained as the stress on the bar was increased in increments. At the same time gauges attached to the PZT bar recorded axial and lateral strains induced by the applied stress. The Raman spectra were used to calculate an FE coordinate, which is related to the fraction of FE phase present. The authors present data showing changes in the FE coordinates of individual PZT grains and correlate these changes to stress-strain data, which plot the macroscopic evolution of the FE-to-AFE transformation. Their data indicates that the FE-to-AFE transformation does not occur simultaneously for all PZT grains but that grains react individually to local conditions

[Reducing the Care-Related Burdens of a Family Caregiver of a Person With Mild Cognitive Impairment: A Home-Based Case Management Program].

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Chen, Min-Chia; Chiu, Yi-Chen; Wei, Pi-Mei; Hsu, Wen-Chuin

2017-06-01

The long-term care of cognitively impaired patients with concomitant behavioral problems brings great stress and burdens to family caregivers. The present article describes a family caregiver with multiple chronic diseases who concurrently shouldered primary care responsibilities for her husband, a patient with mild cognitive impairment, problematic behaviors, and medication non-adherence issues. The period of care was between September 23rd and December 29th, 2015. Data on physiological, psychological, and social burdens were collected based on a stress process model for family caregiving. We then applied a home-based, individually tailored intervention, which included nursing education, skills training, listening/counseling, and resource connecting, that effectively helped the family caregiver reduce her burdens. Our assessment identified nursing-care-related problems as the primary source of caregiver burden in this case, with identified stressors including a lack of knowledge regarding patient care, medication management problems, sleep disorders, and inadequate social resources. Using continuous care interactions, we established a trust relationship with the family caregiver, prioritized her needs, and provided dementia care knowledge and skills, which gradually improved her caregiving competence. Our instruction included increasing caregiver understanding of the disease course of dementia, related problematic behaviors, and medication management. Our intervention enhanced the disease awareness of the caregiver and helped her become more positive about her caregiving tasks. Therefore, the negative impacts on her family were reduced. Social support and long-term care resources further reduced her burden and improved her quality of life.

Female caregivers and stroke severity determines caregiver stress in stroke patients

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Bindu Menon

2017-01-01

Full Text Available Background: Stroke is among the major causes of short- and long-term disability. This study aimed to understand the caregivers (CGs stress in stroke survivors. Materials and Methods: A 22-item questionnaire was administered to 201 CGs of stroke survivors. The variables tested were physical and mental health, social support, financial, and personal problems. CGs were divided into Group A (Barthel index [BI] 75 according to patient's BI, according to gender (male and female CG and relation; spouses (wife, husband, daughters, sons, daughter-in-law, grandchildren, and rest (father, mother, brother, sister, and in-laws. Data were analyzed using SPSS software version–21. Data were analyzed to determine which variables of the patient effects the CG stress. Results: Majority of the CGs (74.62% were females. 65% of CGs graded their burden as moderate to severe. 81% of CGs had left their work for caregiving. More than half of the CGs felt sleep disturbance and physical strain. Psychological instability and financial burdens were reported in 3/4th of CGs. Group A CGs faced more sleep, financial, health, and social life disturbance. Patient's bladder and bowel problems, shoulder pain, patients noncooperative attitude for medication administration, and physiotherapy were more upsetting for Group A CGs. Female CGs were subjected to more sleep disturbance, physical and psychological stress, faced more difficulty regarding the patient's bladder, bowel, personal hygiene needs, and physiotherapy. Female CGs felt less motivated in caregiving than male CGs. Wives and daughters-in-law experienced more burden. Time spent and burden perceived was more by female CGs (χ2 = 15.199, P = 0.002 than males (χ2 = 11.931, P = 0.018; wives and daughters than other relations (χ2 = 32.184, P = 0.000, (χ2 = 35.162, P = 0.019. Conclusion: Our study showed that caregiving burden was predominantly shouldered by females CGs. CGs faced physical, psychological, and socioeconomic

The Impact of Post-Traumatic Stress Disorder on the Burden of Migraine: Results From the National Comorbidity Survey-Replication.

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Rao, Aruna S; Scher, Ann I; Vieira, Rebeca V A; Merikangas, Kathleen R; Metti, Andrea L; Peterlin, B Lee

2015-01-01

Post-traumatic stress disorder (PTSD) has been linked with migraine in prior studies. To evaluate the individual and joint burdens of migraine and PTSD in a population-based cohort. The National Comorbidity Survey-Replication (NCS-R) is a general population study conducted in the United States from February 2001-April 2003. PTSD and migraine were assessed, and four groups defined based on their migraine and PTSD status. The four groups included those with no migraine and no PTSD (controls, n=4535), those with migraine and without PTSD (migraine alone, n=236), those with PTSD and without migraine (PTSD alone, n=244), and those with both migraine and PTSD (mig+PTSD, n=68). Logistic and Poisson regression models were used to assess the association between dichotomous/multilevel outcome variables indicating financial, health, and interpersonal burdens and each migraine/PTSD group. Compared to controls, those with Mig+PTSD were more likely to be in the low poverty index (48% vs 41%, AOR 2.16; CI: 1.10, 4.24) and were less likely to be working for pay or profit in the past week (50% vs 68%, AOR 0.42; CI: 0.24, 0.74) but not those with migraine or PTSD alone. Additionally, the number of days where work quality was cut due to physical or mental health or substance abuse in the past month was greater in all groups compared to controls: (1) migraine alone: mean 2.57 (SEM 0.32) vs mean 1.09 (SEM 0.08) days, ARR=2.39; CI: 2.19, 2.62; (2) PTSD alone: mean 2.43 (SEM 0.33) vs mean 1.09 (SEM 0.08) days, ARR=2.09; CI: 1.91, 2.29; (3) mig+PTSD: mean 8.2 (SEM 0.79) vs 1.09 (SEM 0.08) days, ARR 6.79; CI 6.16, 7.49; and was over 2.5-fold greater in those mig+PTSD than migraine alone (mean 8.0 [SEM 0.79] vs 2.6 days [SEM 0.72], ARR 2.77; CI: 2.45, 3.14). The likelihood of having difficulty getting along or maintaining a social life was also increased in all groups relative to controls: (1) migraine alone: 21% vs 5.4%, AOR 4.20; CI: 2.62, 6.74; (2) PTSD alone: 18% vs 5.4%, AOR 3.40; CI

Chronic social stress leads to altered sleep homeostasis in mice.

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Olini, Nadja; Rothfuchs, Iru; Azzinnari, Damiano; Pryce, Christopher R; Kurth, Salome; Huber, Reto

2017-06-01

Disturbed sleep and altered sleep homeostasis are core features of many psychiatric disorders such as depression. Chronic uncontrollable stress is considered an important factor in the development of depression, but little is known on how chronic stress affects sleep regulation and sleep homeostasis. We therefore examined the effects of chronic social stress (CSS) on sleep regulation in mice. Adult male C57BL/6 mice were implanted for electrocortical recordings (ECoG) and underwent either a 10-day CSS protocol or control handling (CON). Subsequently, ECoG was assessed across a 24-h post-stress baseline, followed by a 4-h sleep deprivation, and then a 20-h recovery period. After sleep deprivation, CSS mice showed a blunted increase in sleep pressure compared to CON mice, as measured using slow wave activity (SWA, electroencephalographic power between 1-4Hz) during non-rapid eye movement (NREM) sleep. Vigilance states did not differ between CSS and CON mice during post-stress baseline, sleep deprivation or recovery, with the exception of CSS mice exhibiting increased REM sleep during recovery sleep. Behavior during sleep deprivation was not affected by CSS. Our data provide evidence that CSS alters the homeostatic regulation of sleep SWA in mice. In contrast to acute social stress, which results in a faster SWA build-up, CSS decelerates the homeostatic build up. These findings are discussed in relation to the causal contribution of stress-induced sleep disturbance to depression. Copyright © 2017 Elsevier B.V. All rights reserved.

Medical and psychosocial predictors of caregiver distress and perceived burden following traumatic brain injury.

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Davis, Lynne C; Sander, Angelle M; Struchen, Margaret A; Sherer, Mark; Nakase-Richardson, Risa; Malec, James F

2009-01-01

To determine whether caregivers' medical and psychiatric histories, coping style, and social support predict global distress and perceived burden. Correlational, cohort study. A total of 114 caregivers of persons with moderate to severe traumatic brain injury, assessed 1 year postinjury. Ratings of caregivers' medical and psychiatric history; Disability Rating Scale; Ways of Coping Questionnaire; Multidimensional Scale of Perceived Social Support; Brief Symptom Inventory; and Modified Caregiver Appraisal Scale. Caregivers' medical and psychiatric histories predicted global distress, after accounting for education, sex, income, and relationship, as well as disability of the person with injury. Increased use of escape-avoidance as a coping strategy was related to increased distress. Perceived burden was predicted by disability in the person with injury, use of escape-avoidance, and perceived social support. Caregivers' preinjury functioning is more predictive of global distress, whereas the functioning of the person with injury is more predictive of injury-related burden. Caregivers' medical and psychiatric histories are important considerations when targeting interventions; global stress management strategies may be as important as assisting with injury-related issues.

Disease burden of COPD in China: a systematic review

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Zhu B

2018-04-01

Full Text Available Bifan Zhu,1 Yanfang Wang,2 Jian Ming,3 Wen Chen,4 Luying Zhang4 1Shanghai Health Development Research Center, Shanghai Medical Information Center, Shanghai, China; 2The First Affiliated Hospital of Wannan Medical College, Wuhu, China; 3IQVIA, Shanghai, China; 4School of Public Health, Fudan University, Shanghai, China Abstract: Chronic obstructive pulmonary disease (COPD is one of the main contributors to the global burden of disease. The aim of this systematic review was to quantify the disease burden of COPD in China and to determine the risk factors of the disease. The number of studies included in the review was 47 with an average quality assessment score of 7.70 out of 10. Reported COPD prevalence varied between 1.20% and 8.87% in different provinces/cities across China. The prevalence rate of COPD was higher among men (7.76% than women (4.07%. The disease was more prevalent in rural areas (7.62% than in urban areas (6.09%. The diagnostic rate of COPD patients in China varied from 23.61% to 30.00%. The percentage of COPD patients receiving outpatient treatment was around 50%, while the admission rate ranged between 8.78% and 35.60%. Tobacco exposure and biomass fuel/solid fuel usage were documented as two important risk factors of COPD. COPD ranked among the top three leading causes of death in China. The direct medical cost of COPD ranged from 72 to 3,565 USD per capita per year, accounting for 33.33% to 118.09% of local average annual income. The most commonly used scales for the assessment of quality of life (QoL included Saint George Respiratory Questionnaire, Airways Questionnaire 20, SF-36, and their revised versions. The status of QoL was worse among COPD patients than in non-COPD patients, and COPD patients were at higher risks of depression. The COPD burden in China was high in terms of economic burden and QoL. In view of the high smoking rate and considerable concerns related to air pollution and smog in China, countermeasures

The global burden of viral hepatitis from 1990 to 2013: findings from the Global Burden of Disease Study 2013

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Stanaway, Jeffrey D; Flaxman, Abraham D; Naghavi, Mohsen; Fitzmaurice, Christina; Vos, Theo; Abubakar, Ibrahim; Abu-Raddad, Laith J; Assadi, Reza; Bhala, Neeraj; Cowie, Benjamin; Forouzanfour, Mohammad H; Groeger, Justina; Hanafiah, Khayriyyah Mohd; Jacobsen, Kathryn H; James, Spencer L; MacLachlan, Jennifer; Malekzadeh, Reza; Martin, Natasha K; Mokdad, Ali A; Mokdad, Ali H; Murray, Christopher J L; Plass, Dietrich; Rana, Saleem; Rein, David B; Richardus, Jan Hendrik; Sanabria, Juan; Saylan, Mete; Shahraz, Saeid; So, Samuel; Vlassov, Vasiliy V; Weiderpass, Elisabete; Wiersma, Steven T; Younis, Mustafa; Yu, Chuanhua; Zaki, Maysaa El Sayed; Cooke, Graham S

2016-01-01

Summary Background With recent improvements in vaccines and treatments against viral hepatitis, an improved understanding of the burden of viral hepatitis is needed to inform global intervention strategies. We used data from the Global Burden of Disease (GBD) Study to estimate morbidity and mortality for acute viral hepatitis, and for cirrhosis and liver cancer caused by viral hepatitis, by age, sex, and country from 1990 to 2013. Methods We estimated mortality using natural history models for acute hepatitis infections and GBD’s cause-of-death ensemble model for cirrhosis and liver cancer. We used meta-regression to estimate total cirrhosis and total liver cancer prevalence, as well as the proportion of cirrhosis and liver cancer attributable to each cause. We then estimated cause-specific prevalence as the product of the total prevalence and the proportion attributable to a specific cause. Disability-adjusted life-years (DALYs) were calculated as the sum of years of life lost (YLLs) and years lived with disability (YLDs). Findings Between 1990 and 2013, global viral hepatitis deaths increased from 0·89 million (95% uncertainty interval [UI] 0·86–0·94) to 1·45 million (1·38–1·54); YLLs from 31·0 million (29·6–32·6) to 41·6 million (39·1–44·7); YLDs from 0·65 million (0·45–0·89) to 0·87 million (0·61–1·18); and DALYs from 31·7 million (30·2–33·3) to 42·5 million (39·9–45·6). In 2013, viral hepatitis was the seventh (95% UI seventh to eighth) leading cause of death worldwide, compared with tenth (tenth to 12th) in 1990. Interpretation Viral hepatitis is a leading cause of death and disability worldwide. Unlike most communicable diseases, the absolute burden and relative rank of viral hepatitis increased between 1990 and 2013. The enormous health loss attributable to viral hepatitis, and the availability of effective vaccines and treatments, suggests an important opportunity to improve public health. Funding Bill & Melinda

The Burden of Mental Disorders in the Eastern Mediterranean Region, 1990-2013

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Charara, Raghid; Forouzanfar, Mohammad; Naghavi, Mohsen; Moradi-Lakeh, Maziar; Afshin, Ashkan; Vos, Theo; Daoud, Farah; Wang, Haidong; El Bcheraoui, Charbel; Khalil, Ibrahim; Hamadeh, Randah R.; Khosravi, Ardeshir; Rahimi-Movaghar, Vafa; Khader, Yousef; Al-Hamad, Nawal; Makhlouf Obermeyer, Carla; Rafay, Anwar; Asghar, Rana; Rana, Saleem M.; Shaheen, Amira; Abu-Rmeileh, Niveen M. E.; Husseini, Abdullatif; Abu-Raddad, Laith J.; Khoja, Tawfik; Al Rayess, Zulfa A.; AlBuhairan, Fadia S.; Hsairi, Mohamed; Alomari, Mahmoud A.; Ali, Raghib; Roshandel, Gholamreza; Terkawi, Abdullah Sulieman; Hamidi, Samer; Refaat, Amany H.; Westerman, Ronny; Kiadaliri, Aliasghar Ahmad; Akanda, Ali S.; Ali, Syed Danish; Bacha, Umar; Badawi, Alaa; Bazargan-Hejazi, Shahrzad; Faghmous, Imad A. D.; Fereshtehnejad, Seyed-Mohammad; Fischer, Florian; Jonas, Jost B.; Kuate Defo, Barthelemy; Mehari, Alem; Omer, Saad B.; Pourmalek, Farshad; Uthman, Olalekan A.; Mokdad, Ali A.; Maalouf, Fadi T.; Abd-Allah, Foad; Akseer, Nadia; Arya, Dinesh; Borschmann, Rohan; Brazinova, Alexandra; Brugha, Traolach S.; Catalá-López, Ferrán; Degenhardt, Louisa; Ferrari, Alize; Haro, Josep Maria; Horino, Masako; Hornberger, John C.; Huang, Hsiang; Kieling, Christian; Kim, Daniel; Kim, Yunjin; Knudsen, Ann Kristin; Mitchell, Philip B.; Patton, George; Sagar, Rajesh; Satpathy, Maheswar; Savuon, Kim; Seedat, Soraya; Shiue, Ivy; Skogen, Jens Christoffer; Stein, Dan J.; Tabb, Karen M.; Whiteford, Harvey A.; Yip, Paul; Yonemoto, Naohiro; Murray, Christopher J. L.; Mokdad, Ali H.

2017-01-01

The Eastern Mediterranean Region (EMR) is witnessing an increase in chronic disorders, including mental illness. With ongoing unrest, this is expected to rise. This is the first study to quantify the burden of mental disorders in the EMR. We used data from the Global Burden of Disease study (GBD) 2013. DALYs (disability-adjusted life years) allow assessment of both premature mortality (years of life lost–YLLs) and nonfatal outcomes (years lived with disability–YLDs). DALYs are computed by adding YLLs and YLDs for each age-sex-country group. In 2013, mental disorders contributed to 5.6% of the total disease burden in the EMR (1894 DALYS/100,000 population): 2519 DALYS/100,000 (2590/100,000 males, 2426/100,000 females) in high-income countries, 1884 DALYS/100,000 (1618/100,000 males, 2157/100,000 females) in middle-income countries, 1607 DALYS/100,000 (1500/100,000 males, 1717/100,000 females) in low-income countries. Females had a greater proportion of burden due to mental disorders than did males of equivalent ages, except for those under 15 years of age. The highest proportion of DALYs occurred in the 25–49 age group, with a peak in the 35–39 years age group (5344 DALYs/100,000). The burden of mental disorders in EMR increased from 1726 DALYs/100,000 in 1990 to 1912 DALYs/100,000 in 2013 (10.8% increase). Within the mental disorders group in EMR, depressive disorders accounted for most DALYs, followed by anxiety disorders. Among EMR countries, Palestine had the largest burden of mental disorders. Nearly all EMR countries had a higher mental disorder burden compared to the global level. Our findings call for EMR ministries of health to increase provision of mental health services and to address the stigma of mental illness. Moreover, our results showing the accelerating burden of mental health are alarming as the region is seeing an increased level of instability. Indeed, mental health problems, if not properly addressed, will lead to an increased burden of

Non-fatal disease burden for subtypes of depressive disorder: population-based epidemiological study.

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Biesheuvel-Leliefeld, Karolien E M; Kok, Gemma D; Bockting, Claudi L H; de Graaf, Ron; Ten Have, Margreet; van der Horst, Henriette E; van Schaik, Anneke; van Marwijk, Harm W J; Smit, Filip

2016-05-12

Major depression is the leading cause of non-fatal disease burden. Because major depression is not a homogeneous condition, this study estimated the non-fatal disease burden for mild, moderate and severe depression in both single episode and recurrent depression. All estimates were assessed from an individual and a population perspective and presented as unadjusted, raw estimates and as estimates adjusted for comorbidity. We used data from the first wave of the second Netherlands-Mental-Health-Survey-and-Incidence-Study (NEMESIS-2, n = 6646; single episode Diagnostic and Statistical Manual (DSM)-IV depression, n = 115; recurrent depression, n = 246). Disease burden from an individual perspective was assessed as 'disability weight * time spent in depression' for each person in the dataset. From a population perspective it was assessed as 'disability weight * time spent in depression *number of people affected'. The presence of mental disorders was assessed with the Composite International Diagnostic Interview (CIDI) 3.0. Single depressive episodes emerged as a key driver of disease burden from an individual perspective. From a population perspective, recurrent depressions emerged as a key driver. These findings remained unaltered after adjusting for comorbidity. The burden of disease differs between the subtype of depression and depends much on the choice of perspective. The distinction between an individual and a population perspective may help to avoid misunderstandings between policy makers and clinicians.

The burden of parasitic zoonoses in Nepal: a systematic review.

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Brecht Devleesschauwer

Full Text Available Parasitic zoonoses (PZs pose a significant but often neglected threat to public health, especially in developing countries. In order to obtain a better understanding of their health impact, summary measures of population health may be calculated, such as the Disability-Adjusted Life Year (DALY. However, the data required to calculate such measures are often not readily available for these diseases, which may lead to a vicious circle of under-recognition and under-funding.We examined the burden of PZs in Nepal through a systematic review of online and offline data sources. PZs were classified qualitatively according to endemicity, and where possible a quantitative burden assessment was conducted in terms of the annual number of incident cases, deaths and DALYs.Between 2000 and 2012, the highest annual burden was imposed by neurocysticercosis and congenital toxoplasmosis (14,268 DALYs [95% Credibility Interval (CrI: 5450-27,694] and 9255 DALYs [95% CrI: 6135-13,292], respectively, followed by cystic echinococcosis (251 DALYs [95% CrI: 105-458]. Nepal is probably endemic for trichinellosis, toxocarosis, diphyllobothriosis, foodborne trematodosis, taeniosis, and zoonotic intestinal helminthic and protozoal infections, but insufficient data were available to quantify their health impact. Sporadic cases of alveolar echinococcosis, angiostrongylosis, capillariosis, dirofilariosis, gnathostomosis, sparganosis and cutaneous leishmaniosis may occur.In settings with limited surveillance capacity, it is possible to quantify the health impact of PZs and other neglected diseases, thereby interrupting the vicious circle of neglect. In Nepal, we found that several PZs are endemic and are imposing a significant burden to public health, higher than that of malaria, and comparable to that of HIV/AIDS. However, several critical data gaps remain. Enhanced surveillance for the endemic PZs identified in this study would enable additional burden estimates, and a more

Cardiac rehabilitation improves the ischemic burden in patients with ischemic heart disease who are not suitable for revascularization

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El Demerdash, Salah [Department of Cardiology, Ain Shams University Hospital, Cairo (Egypt); Khorshid, Hazem, E-mail: hazemkhorshid@yahoo.com [Department of Cardiology, Ain Shams University Hospital, Cairo (Egypt); Salah, Iman; Abdel-Rahman, Mohamed A. [Department of Cardiology, Ain Shams University Hospital, Cairo (Egypt); Salem, Alaa M. [Department of Internal Medicine, Medical Division, National Research Centre, Cairo (Egypt)

2015-07-15

Background: Ischemic heart diseases including stable angina & acute events, represent a huge burden on both the individual & the society and represent an important source of disability. Aim: We aimed to identify the effect of cardiac rehabilitation program (CRP) on the ischemic burden in patients with ischemic heart disease (IHD) unsuitable for coronary revascularization. Methods: The study included 40 patients with IHD who were not suitable for coronary revascularization either by PCI or CABG (due to unsuitable coronary anatomy, co morbidities, high surgical/procedural risk or patient preference). All patients were subjected to sophisticated CRP protocols, including patient education, nutritional, medical, psychological and sexual counseling and group smoking cessation. All patients participated in low intensity exercise program twice weekly. The patient’s symptoms, vitals and medications were evaluated at each visit and clinical and laboratory data, echocardiography and stress myocardial perfusion imaging (SPECT) were evaluated before and 3 months after the end of the study. Results: The mean age was 56.8 ± 3.1 years and only 2 patients (5%) were females. 22 (55%) patients were diabetic, 21 (53%) were hypertensive and 30 (75%) were smokers. It was found that 3 months after completion of CRP, there was a significant decrease in BMI (30.3 ± 2.9 vs. 31.2 ± 1.9, p < 0.001), and mean blood pressure (93.4 ± 11 vs. 105 ± 10.6 mmHg, p < 0.001). There was also a favorable effect on lipid profile and a significant improvement of the functional capacity in terms of NYHA functional class (2.1 ± 0.62 vs. 1.4 ± 0.6, p < 0.001). Despite that wall motion score index did not significantly change after CRP, there was a strong trend toward a better ejection fraction (53.7 ± 7.8 vs. 54.5 ± 6.3 %, p = 0.06) and significant improvement of Canadian cardiovascular class (1.42 ± 0.6 vs. 1.95 ± 0.5, p < 0.001) post CRP. Importantly, the difference between the SPECT

Cardiac rehabilitation improves the ischemic burden in patients with ischemic heart disease who are not suitable for revascularization

International Nuclear Information System (INIS)

El Demerdash, Salah; Khorshid, Hazem; Salah, Iman; Abdel-Rahman, Mohamed A.; Salem, Alaa M.

2015-01-01

Background: Ischemic heart diseases including stable angina & acute events, represent a huge burden on both the individual & the society and represent an important source of disability. Aim: We aimed to identify the effect of cardiac rehabilitation program (CRP) on the ischemic burden in patients with ischemic heart disease (IHD) unsuitable for coronary revascularization. Methods: The study included 40 patients with IHD who were not suitable for coronary revascularization either by PCI or CABG (due to unsuitable coronary anatomy, co morbidities, high surgical/procedural risk or patient preference). All patients were subjected to sophisticated CRP protocols, including patient education, nutritional, medical, psychological and sexual counseling and group smoking cessation. All patients participated in low intensity exercise program twice weekly. The patient’s symptoms, vitals and medications were evaluated at each visit and clinical and laboratory data, echocardiography and stress myocardial perfusion imaging (SPECT) were evaluated before and 3 months after the end of the study. Results: The mean age was 56.8 ± 3.1 years and only 2 patients (5%) were females. 22 (55%) patients were diabetic, 21 (53%) were hypertensive and 30 (75%) were smokers. It was found that 3 months after completion of CRP, there was a significant decrease in BMI (30.3 ± 2.9 vs. 31.2 ± 1.9, p < 0.001), and mean blood pressure (93.4 ± 11 vs. 105 ± 10.6 mmHg, p < 0.001). There was also a favorable effect on lipid profile and a significant improvement of the functional capacity in terms of NYHA functional class (2.1 ± 0.62 vs. 1.4 ± 0.6, p < 0.001). Despite that wall motion score index did not significantly change after CRP, there was a strong trend toward a better ejection fraction (53.7 ± 7.8 vs. 54.5 ± 6.3 %, p = 0.06) and significant improvement of Canadian cardiovascular class (1.42 ± 0.6 vs. 1.95 ± 0.5, p < 0.001) post CRP. Importantly, the difference between the SPECT

High burden and frailty: association with poor cognitive performance in older caregivers living in rural areas

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Allan Gustavo Brigola

2017-12-01

Full Text Available Abstract Introduction: Older caregivers living in rural areas may be exposed to three vulnerable conditions, i.e., those related to care, their own aging, and their residence context. Objective: To analyze the association of burden and frailty with cognition performance in older caregivers in rural communities. Method: In this cross-sectional survey, 85 older caregivers who cared for dependent elders were included in this study. Global cognition (Addenbrooke's Cognitive Examination – Revised; Mini Mental State Examination, burden (Zarit Burden Interview and frailty (Fried's frailty phenotype were assessed. All ethical principles were observed. Results: Older caregivers were mostly women (76.7%; mean age was 69 years. Cognitive impairment was present in 15.3%, severe burden in 8.2%, frailty in 9.4%, and pre-frailty in 52.9% of the older caregivers. More severely burdened or frail caregivers had worse cognitive performance than those who were not, respectively (ANOVA test. Caregivers presenting a high burden level and some frailty degree (pre-frail or frail simultaneously were more likely to have a reduced global cognition performance. Conclusion: A significant number of older caregivers had low cognitive performance. Actions and resources to decrease burden and physical frailty may provide better cognition and well-being, leading to an improved quality of life and quality of the care provided by the caregivers.

Childhood socioeconomic circumstances and depressive symptom burden across 15 years of follow-up during midlife: Study of Women's Health Across the Nation (SWAN).

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Bromberger, Joyce T; Schott, Laura L; Matthews, Karen A; Kravitz, Howard M; Harlow, Siobán D; Montez, Jennifer Karas

2017-08-01

Childhood socioeconomic disadvantage may contribute to adult depression. Understanding pathways by which early socioeconomic adversity may shape adult depression is important for identifying areas for intervention. Studies to date have focused on one potential pathway, adult socioeconomic status (SES), and assessed depression at only one or a few time points. Our aims were to examine (a) the association between childhood SES (low vs. high) and depressive symptom burden in midlife and (b) whether adult socioeconomic, psychosocial, and physical health characteristics are important pathways. Using annual data from a cohort of 1109 black and white US women recruited in 1996-1997, we evaluated the association between childhood SES and depressive symptom burden across 15 years in midlife and whether adult characteristics-financial difficulty, lower education, stressful events, low social support, low role functioning, medical conditions, and bodily pain-mediated the association. Depressive symptom burden was estimated by calculating area under the curve of annual scores across 15 years of the Center for Epidemiological Studies Depression (CES-D). In unadjusted models, low childhood SES was associated with greater depressive burden (P = 0.0002). Each hypothesized mediator, individually, did not reduce the association. However, when five of the hypothesized mediators were included together in the same analysis, they explained more than two thirds of the association between childhood SES and depressive symptom burden reducing the P value for childhood SES to non-significance (P = 0.20). These results suggest that childhood SES influences midlife depressive symptom burden through a cluster of economic stress, limited social resources, and physical symptoms in adulthood.

Protective effect of Allium sativum (garlic) aqueous extract against lead-induced oxidative stress in the rat brain, liver, and kidney.

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Manoj Kumar, V; Henley, A K; Nelson, C J; Indumati, O; Prabhakara Rao, Y; Rajanna, S; Rajanna, B

2017-01-01

The present investigation was undertaken to evaluate the ameliorative activity of Allium sativum against lead-induced oxidative stress in the brain, liver, and kidney of male rats. Four groups of male Wistar strain rats (100-120 g) were taken: group 1 received 1000 mg/L sodium acetate and group 2 was given 1000 mg/L lead acetate through drinking water for 2 weeks. Group 3 and 4 were treated with 250 mg/kg body weight/day of A. sativum and 500 mg/kg body weight/day of A. sativum, respectively, by oral intubation for a period of 2 weeks along with lead acetate. The rats were sacrificed after treatment and the brain, liver, and kidney were isolated on ice. In the brain, four important regions namely the hippocampus, cerebellum, cerebral cortex, and brain stem were separated and used for the present investigation. Blood was also drawn by cardiac puncture and preserved in heparinized vials at 4 °C for estimation of delta-aminolevulinic acid dehydratase (ALAD) activity. The results showed a significant (p sativum resulted in tissue-specific recovery of oxidative stress parameters namely ROS, LPP, and TPCC. A. sativum treatment also restored the blood delta-ALAD activity back to control. Overall, our results indicate that A. sativum administration could be an effective antioxidant treatment strategy for lead-induced oxidative insult.

Projections of global mortality and burden of disease from 2002 to 2030.

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Mathers, Colin D; Loncar, Dejan

2006-11-01

also assumes increased prevention activity, HIV/AIDS deaths are projected to drop to 3.7 million in 2030. Total tobacco-attributable deaths are projected to rise from 5.4 million in 2005 to 6.4 million in 2015 and 8.3 million in 2030 under our baseline scenario. Tobacco is projected to kill 50% more people in 2015 than HIV/AIDS, and to be responsible for 10% of all deaths globally. The three leading causes of burden of disease in 2030 are projected to include HIV/AIDS, unipolar depressive disorders, and ischaemic heart disease in the baseline and pessimistic scenarios. Road traffic accidents are the fourth leading cause in the baseline scenario, and the third leading cause ahead of ischaemic heart disease in the optimistic scenario. Under the baseline scenario, HIV/AIDS becomes the leading cause of burden of disease in middle- and low-income countries by 2015. These projections represent a set of three visions of the future for population health, based on certain explicit assumptions. Despite the wide uncertainty ranges around future projections, they enable us to appreciate better the implications for health and health policy of currently observed trends, and the likely impact of fairly certain future trends, such as the ageing of the population, the continued spread of HIV/AIDS in many regions, and the continuation of the epidemiological transition in developing countries. The results depend strongly on the assumption that future mortality trends in poor countries will have a relationship to economic and social development similar to those that have occurred in the higher-income countries.

Projections of global mortality and burden of disease from 2002 to 2030.

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Colin D Mathers

2006-11-01

reaches 80% by 2012. Under the optimistic scenario, which also assumes increased prevention activity, HIV/AIDS deaths are projected to drop to 3.7 million in 2030. Total tobacco-attributable deaths are projected to rise from 5.4 million in 2005 to 6.4 million in 2015 and 8.3 million in 2030 under our baseline scenario. Tobacco is projected to kill 50% more people in 2015 than HIV/AIDS, and to be responsible for 10% of all deaths globally. The three leading causes of burden of disease in 2030 are projected to include HIV/AIDS, unipolar depressive disorders, and ischaemic heart disease in the baseline and pessimistic scenarios. Road traffic accidents are the fourth leading cause in the baseline scenario, and the third leading cause ahead of ischaemic heart disease in the optimistic scenario. Under the baseline scenario, HIV/AIDS becomes the leading cause of burden of disease in middle- and low-income countries by 2015. CONCLUSIONS: These projections represent a set of three visions of the future for population health, based on certain explicit assumptions. Despite the wide uncertainty ranges around future projections, they enable us to appreciate better the implications for health and health policy of currently observed trends, and the likely impact of fairly certain future trends, such as the ageing of the population, the continued spread of HIV/AIDS in many regions, and the continuation of the epidemiological transition in developing countries. The results depend strongly on the assumption that future mortality trends in poor countries will have a relationship to economic and social development similar to those that have occurred in the higher-income countries.

Projections of Global Mortality and Burden of Disease from 2002 to 2030

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Mathers, Colin D; Loncar, Dejan

2006-01-01

. Under the optimistic scenario, which also assumes increased prevention activity, HIV/AIDS deaths are projected to drop to 3.7 million in 2030. Total tobacco-attributable deaths are projected to rise from 5.4 million in 2005 to 6.4 million in 2015 and 8.3 million in 2030 under our baseline scenario. Tobacco is projected to kill 50% more people in 2015 than HIV/AIDS, and to be responsible for 10% of all deaths globally. The three leading causes of burden of disease in 2030 are projected to include HIV/AIDS, unipolar depressive disorders, and ischaemic heart disease in the baseline and pessimistic scenarios. Road traffic accidents are the fourth leading cause in the baseline scenario, and the third leading cause ahead of ischaemic heart disease in the optimistic scenario. Under the baseline scenario, HIV/AIDS becomes the leading cause of burden of disease in middle- and low-income countries by 2015. Conclusions These projections represent a set of three visions of the future for population health, based on certain explicit assumptions. Despite the wide uncertainty ranges around future projections, they enable us to appreciate better the implications for health and health policy of currently observed trends, and the likely impact of fairly certain future trends, such as the ageing of the population, the continued spread of HIV/AIDS in many regions, and the continuation of the epidemiological transition in developing countries. The results depend strongly on the assumption that future mortality trends in poor countries will have a relationship to economic and social development similar to those that have occurred in the higher-income countries. PMID:17132052

The Burden of Schizophrenia on Caregivers

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Filiz Adana

2011-06-01

Full Text Available Caregivers’ burden in schizophrenia is a complex concept often with negative connotations. The concept refers to the impact of having a schizophrenia patient in the family including emotional, psychological, physical, economic distress and feelings of shame, embarrassment, guilt, and self-blame expe-rienced by the caregivers. There are objective and subjective aspects of care-givers’ burden. The objective burden refers to observed and verifiable impact of the diseased person in the family such as the patients disturbing behaviors, economic difficulties, and loss of income, restricted social activities, distressed household atmosphere, and undesirable influences on physical and mental health of the family members. The subjective burden refers to the extent of emotional distress caused by the objective burden. The data in the pertinent literature suggest an association between caregivers’ burden and sex, ethnicity, culture, caregivers’ health and quality of life, social support, and the symptomatology as presented by the patient. In order to promote mental health of schizophrenia patients along with their caregivers, the mental health workers should strive to find the means of supporting, informing, and cooperating with the family members. Psychosocial interventions designed for families and psychosocial rehabilitations programs designed for schizophrenia patients are effective means of easing caregivers’ burden.

Family burden, child disability, and the adjustment of mothers caring for children with epilepsy: Role of social support and coping.

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Carlson, Jeffrey M; Miller, Paul A

2017-03-01

This study was designed to contribute to the existing research on the coping behaviors, social support, and mental health outcomes in parents of children with epilepsy in the United States. Participants included 152, predominantly Caucasian (89.5%), married (78.9%) women (95.4%). Via a web-based interface, mothers completed questionnaires assessing the impact of their child's disability on their family (i.e., severity of their child's disability, family burden, and personal stress), social resources (i.e., perceived social support), coping (i.e., emotion-focused and social support seeking), and adjustment (i.e., depression and anxiety). After controlling for demographic variables, mediational analysis revealed that mothers' perceptions of the severity of their child's disability were associated with decreased perceived social support, which was then related to higher reported levels of depression and anxiety. Similarly, low levels of perceived social support partially mediated the relation between family burden and depression, anxiety, and stress. Finally, mothers' perceptions of the severity of their children's disability and family burden were unrelated to their reports of emotion-focused or social support seeking coping. However, their use of emotion-focused and social support seeking behaviors was related to lower levels of depression. Low levels of perceived social support may help to explain the mechanisms underlying the relation between mothers' perceptions of the severity of their child's disability and family burden on their mental health adjustment, such as depression and anxiety. Copyright © 2017 Elsevier Inc. All rights reserved.

The identification of lead ammunition as a source of lead exposure in First Nations: The use of lead isotope ratios

International Nuclear Information System (INIS)

Tsuji, Leonard J.S.; Wainman, Bruce C.; Martin, Ian D.; Sutherland, Celine; Weber, Jean-Philippe; Dumas, Pierre; Nieboer, Evert

2008-01-01

The use of lead shotshell to hunt water birds has been associated with lead-contamination in game meat. However, evidence illustrating that lead shotshell is a source of lead exposure in subsistence hunting groups cannot be deemed definitive. This study seeks to determine whether lead shotshell constitutes a source of lead exposure using lead isotope ratios. We examined stable lead isotope ratios for lichens, lead shotshell and bullets, and blood from residents of Fort Albany and Kashechewan First Nations, and the City of Hamilton, Ontario, Canada. Data were analyzed using ANOVA and regression analyses. ANOVA of isotope ratios for blood revealed significant differences with respect to location, but not sex. Hamilton differed from both Kashechewan and Fort Albany; however, the First Nations did not differ from each other. ANOVA of the isotope ratios for lead ammunition and lichens revealed no significant differences between lichen groups (north and south) and for the lead ammunition sources (pellets and bullets). A plot of 206 Pb/ 204 Pb and 206 Pb/ 207 Pb values illustrated that lichens and lead ammunition were distinct groupings and only the 95% confidence ellipse of the First Nations group overlapped that of lead ammunition. In addition, partial correlations between blood-lead levels (adjusted for age) and isotope ratios revealed significant (p 206 Pb/ 204 Pb and 206 Pb/ 207 Pb, and a significant negative correlation for 208 Pb/ 206 Pb, as predicted if leaded ammunition were the source of lead exposure. In conclusion, lead ammunition was identified as a source of lead exposure for First Nations people; however, the isotope ratios for lead shotshell pellets and bullets were indistinguishable. Thus, lead-contaminated meat from game harvested with lead bullets may also be contributing to the lead body burden

Oxidative Stress Control by Apicomplexan Parasites

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Soraya S. Bosch

2015-01-01

Full Text Available Apicomplexan parasites cause infectious diseases that are either a severe public health problem or an economic burden. In this paper we will shed light on how oxidative stress can influence the host-pathogen relationship by focusing on three major diseases: babesiosis, coccidiosis, and toxoplasmosis.

Impact physiologique et pathologique du stress oxydant chez le cheval

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De Moffarts, Brieuc; Kirschvink, Nathalie; Pincemail, Joël; Lekeux, Pierre

2005-01-01

Oxidative stress has become of increasing interest in research and in equine and human medicine. If the pro-oxidant burden overwhelms the endogenous antioxidant defence of the organism, the arising imbalance between pro- and antioxidants is defined as oxidative stress. Different pathways might increase the generation of reactive oxygen species ( ROS) and results in oxidative stress. In physiological conditions, like during moderated exercise, the balance between ROS production and antioxidant...

Psychological stress in rheumatoid arthritis patients: a comparative Polish-German study: summary of the current conceptualization of the role of stress in rheumatoid arthritis.

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Bugajska, J; Brzosko, M; Jedryka-Góral, A; Głuszko, P; Zołnierczyk-Zreda, D; Sagan, A; Konarska, M; Rell-Bakalarska, M; Pazdur, J; Zeidler, H; Rihl, M

2010-02-01

Cultural differences in experiencing individual stress in rheumatoid arthritis (RA) patients might be observed. The aim of the study was to assess quality of life and psychological stress (distress) in RA patients, and to evaluate socio-demographic and disease specific variables predicting stress of patients. The study covered 300 Polish and 137 German RA patients. SF-36v2 scale was used to evaluate the patients' health. Psychological stress was defined as the feeling of "social isolation" and "being a burden" as demanding help in everyday activities. In both countries, the mental and physical health of patients deteriorated and about 50% of patients required support in everyday activities. 95% of Polish and 62% of German patients felt rejected from social activities. For the psychological stress perceived, functional capacity class 3 and male gender were shown to be predictive in Polish patients and living in a small town - in German patients. In the Polish group, the tertiary/bachelor level of education was linked with lower distress level. RA has a serious impact on the mental health owing to a great disease burden. Awareness of impact of the disease on quality of life and psychological stress of patients should be considered in routine clinical practice. Copyright 2009 Elsevier B.V. All rights reserved.

To Treat or to Prevent?: Reducing the Population Burden of Violence-related Post-traumatic Stress Disorder.

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Cerdá, Magdalena; Tracy, Melissa; Keyes, Katherine M; Galea, Sandro

2015-09-01

Violence-related post-traumatic stress disorder (PTSD) remains a prevalent and disabling psychiatric disorder in urban areas. However, the most effective allocation of resources into prevention and treatment to reduce this problem is unknown. We contrasted the impact of two interventions on violence-related PTSD: (1) a population-level intervention intended to prevent violence (i.e., hot-spot policing), and (2) an individual-level intervention intended to shorten PTSD duration (i.e., cognitive-behavioral therapy-CBT). We used agent-based modeling to simulate violence and PTSD in New York City under four scenarios: (1) no intervention, (2) targeted policing to hot spots of violence, (3) increased access to CBT for people who suffered from violence-related PTSD, and (4) a combination of the two interventions. Combined prevention and treatment produced the largest decrease in violence-related PTSD prevalence: hot-spot policing plus a 50% increase in CBT for 5 years reduced the annual prevalence of violence-related PTSD from 3.6% (95% confidence interval = 3.5%, 3.6%) to 3.4% (3.3%, 3.5%). It would have been necessary to implement hot-spot policing or to increase CBT by 200% for 10 years for either intervention to achieve the same reduction in isolation. This study provides an empirically informed demonstration that investment in combined strategies that target social determinants of mental illness and provide evidence-based treatment to those affected by psychiatric disorders can produce larger reductions in the population burden from violence-related PTSD than either preventive or treatment interventions alone. However, neither hot-spot policing nor CBT, alone or combined, will produce large shifts in the population prevalence of violence-related PTSD.

Caregiver Burden, Care Recipient Depressive Symptomology, and Social Exchange: Does Race Matter?

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Ejem, Deborah; Bauldry, Shawn; Bakitas, Marie; Drentea, Patricia

2018-04-01

Informal caregivers play a vital role in supporting seriously ill patients. However, informal caregiving is burdensome and can lead to negative health outcomes for the caregiver and the care recipient. The study's aim was to evaluate relationships among caregiver burden, care recipient depressive symptomology, and race. Guided by the social exchange perspective, we examined cross-sectional dyadic data from the National Long-Term Care Survey (N = 1279). Using ordinal logistic regression, we found that higher caregiver-reported objective burden was associated with higher care recipient depressive symptoms ( P exchange of the social good "helpful company" with a caregiver. These findings illustrate the importance of supporting reciprocal exchange as a promising component of maintaining balanced caregiver-care recipient relationships among black older adults and their informal caregivers.

Relationships between temperaments, occupational stress, and insomnia among Japanese workers.

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Deguchi, Yasuhiko; Iwasaki, Shinichi; Ishimoto, Hideyuki; Ogawa, Koichiro; Fukuda, Yuichi; Nitta, Tomoko; Mitake, Tomoe; Nogi, Yukako; Inoue, Koki

2017-01-01

Insomnia among workers reduces the quality of life, contributes toward the economic burden of healthcare costs and losses in work performance. The relationship between occupational stress and insomnia has been reported in previous studies, but there has been little attention to temperament in occupational safety and health research. The aim of this study was to clarify the relationships between temperament, occupational stress, and insomnia. The subjects were 133 Japanese daytime local government employees. Temperament was assessed using the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Auto questionnaire (TEMPS-A). Occupational stress was assessed using the Generic Job Stress Questionnaire (GJSQ). Insomnia was assessed using the Athens Insomnia Scale (AIS). Stepwise multiple logistic regression analyses were conducted. In a stepwise multivariate logistic regression analysis, it was found that the higher subdivided stress group by "role conflict" (OR = 5.29, 95% CI, 1.61-17.32) and anxious temperament score (OR = 1.33; 95% CI, 1.19-1.49) was associated with the presence of insomnia using an adjusted model, whereas other factors were excluded from the model. The study limitations were the sample size and the fact that only Japanese local government employees were surveyed. This study demonstrated the relationships between workers' anxious temperament, role conflict, and insomnia. Recognizing one's own anxious temperament would lead to self-insight, and the recognition of anxious temperament and reduction of role conflict by their supervisors or coworkers would reduce the prevalence of insomnia among workers in the workplace.

The Global Burden of Mental, Neurological and Substance Use Disorders: An Analysis from the Global Burden of Disease Study 2010

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Whiteford, Harvey A.; Ferrari, Alize J.; Degenhardt, Louisa; Feigin, Valery; Vos, Theo

2015-01-01

Background The Global Burden of Disease Study 2010 (GBD 2010), estimated that a substantial proportion of the world’s disease burden came from mental, neurological and substance use disorders. In this paper, we used GBD 2010 data to investigate time, year, region and age specific trends in burden due to mental, neurological and substance use disorders. Method For each disorder, prevalence data were assembled from systematic literature reviews. DisMod-MR, a Bayesian meta-regression tool, was used to model prevalence by country, region, age, sex and year. Prevalence data were combined with disability weights derived from survey data to estimate years lived with disability (YLDs). Years lost to premature mortality (YLLs) were estimated by multiplying deaths occurring as a result of a given disorder by the reference standard life expectancy at the age death occurred. Disability-adjusted life years (DALYs) were computed as the sum of YLDs and YLLs. Results In 2010, mental, neurological and substance use disorders accounted for 10.4% of global DALYs, 2.3% of global YLLs and, 28.5% of global YLDs, making them the leading cause of YLDs. Mental disorders accounted for the largest proportion of DALYs (56.7%), followed by neurological disorders (28.6%) and substance use disorders (14.7%). DALYs peaked in early adulthood for mental and substance use disorders but were more consistent across age for neurological disorders. Females accounted for more DALYs in all mental and neurological disorders, except for mental disorders occurring in childhood, schizophrenia, substance use disorders, Parkinson’s disease and epilepsy where males accounted for more DALYs. Overall DALYs were highest in Eastern Europe/Central Asia and lowest in East Asia/the Pacific. Conclusion Mental, neurological and substance use disorders contribute to a significant proportion of disease burden. Health systems can respond by implementing established, cost effective interventions, or by supporting the

Economic development by reducing the burden of cardiovascular disease in South Asia

International Nuclear Information System (INIS)

Iqbal, M.P.

2012-01-01

The countries of South Asia afflicted with poverty and are under tremendous economic strain. The high prevalence of cardiovascular disease (CVD) due to urbanization and adoption of unhealthy life style is putting further stress on the economy of these countries. The projected cost of CVD in terms of lost GDP by 2015 could be 31 billion US dollars in Pakistan and 237 billion dollars in India if appropriate measures are not adopted to decrease the burden tobacco use, alcohol use, hypertension, obesity, high cholesterol, high glucose, low intake of fruits and vegetables and physical inactivity. By adopting policies for control of tobacco use, alcohol use, easy availability of health-promoting foods, provision of opportunities for engaging in physical activity, control of pollution, dissemination of health promotion messages through media and school curricula and introduction of cost-effective screening programs the burden of CVD could be reduced in this region, thereby having a positive impact on the economy of South Asian countries. (author)

Patient Reported Burden of Asthma on Resource Use and Productivity Across 11 Countries in Europe

NARCIS (Netherlands)

Fletcher, Monica; Jha, Ashok; Dunlop, William; Heron, Louise; Wolfram, Verena; Van der Molen, Thys; Price, David

Asthma affects 30 million people in Western Europe, leading to substantial burden on healthcare systems and economies. REcognise Asthma and LInk to Symptoms and Experience (REALISE (TM)) was a large European survey across 11 countries assessing patient attitudes and behaviors towards their asthma.

The endocannabinoid gene faah2a modulates stress-associated behavior in zebrafish.

Directory of Open Access Journals (Sweden)

Randall G Krug

Full Text Available The ability to orchestrate appropriate physiological and behavioral responses to stress is important for survival, and is often dysfunctional in neuropsychiatric disorders that account for leading causes of global disability burden. Numerous studies have shown that the endocannabinoid neurotransmitter system is able to regulate stress responses and could serve as a therapeutic target for the management of these disorders. We used quantitative reverse transcriptase-polymerase chain reactions to show that genes encoding enzymes that synthesize (abhd4, gde1, napepld, enzymes that degrade (faah, faah2a, faah2b, and receptors that bind (cnr1, cnr2, gpr55-like endocannabinoids are expressed in zebrafish (Danio rerio. These genes are conserved in many other vertebrates, including humans, but fatty acid amide hydrolase 2 has been lost in mice and rats. We engineered transcription activator-like effector nucleases to create zebrafish with mutations in cnr1 and faah2a to test the role of these genes in modulating stress-associated behavior. We showed that disruption of cnr1 potentiated locomotor responses to hyperosmotic stress. The increased response to stress was consistent with rodent literature and served to validate the use of zebrafish in this field. Moreover, we showed for the first time that disruption of faah2a attenuated the locomotor responses to hyperosmotic stress. This later finding suggests that FAAH2 may be an important mediator of stress responses in non-rodent vertebrates. Accordingly, FAAH and FAAH2 modulators could provide distinct therapeutic options for stress-aggravated disorders.

Family demands, social support and caregiver burden in Taiwanese family caregivers living with mental illness: the role of family caregiver gender.

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Hsiao, Chiu-Yueh

2010-12-01

The purpose of this study was to assess gender effects on family demands, social support and caregiver burden as well as to examine contributing factors of caregiver burden in caring for family members with mental illness. Providing continued care and support for people with mental illness is demanding and challenging. Findings of earlier caregiving studies on the role of caregiver gender in response to caregiver burden and caregiving-related factors have been inconsistent. Little research has been undertaken to examine gender effect on family demands, social support and caregiver burden in Taiwanese family caregivers of individuals with mental illness. Cross-sectional, descriptive correlation design. Data from 43 families, including at least one male and female family caregiver in each family, were analysed using descriptive statistics, principal component analysis and mixed linear modelling. Demographic data, Perceived Stress Scale, Perceived Social Support and Caregiver Burden Scale-Brief were used to collect data. Female family caregivers perceived less social support and experienced higher degrees of caregiver burden compared with male family caregivers. In contrast, no significant gender effect was associated with family demands. Family caregivers with greater family demands and less social support experienced higher degrees of caregiver burden. The results reinforced those of previously published studies that caregiver burden is highly prevalent among female family caregivers. Caregiver gender appears to be highly valuable for explaining family demands, social support and caregiver burden. Health care professionals should continue to collaborate with family caregivers to assess potential gender effects on available support and design gender-specific interventions to alleviate caregiver burden. © 2010 Blackwell Publishing Ltd.

Structural and functional changes in the gastric intramural nervous plexus in emotionally stressed rats exposed to low doses of prolonged ionizing radiation and lead

International Nuclear Information System (INIS)

Lapsha, V.I.; Bocharova, V.N.; Utkina, L.N.; Rolevich, I.V.

1999-01-01

Changes in the catecholamine content in adrenergic fibres, acethylcholinesterase activity, and in the energy metabolism enzymes lactate dehydrogenase and succinate dehydrogenase in neurons of the gastric intramural plexus during emotional stress in rats a day after combined exposure to prolonged (30 days) ionizing radiation at a total dose 1.0 Gy and 0.6 mg/kg lead were studied. A decrease in catecholamines in adrenergic fibres and acethylcholinesterase and lactate dehydrogenase activity in neurons was observed. An enhanced sensitivity of the gastric intramural plexus after the prolonged exposure to small doses of ionizing radiation and lead in conditions of emotional stress was suggested [ru

Caregiver burden of Mexican dementia patients: the role of dysexecutive syndrome, sleep disorders, schooling and caregiver depression.

Science.gov (United States)

Rosas-Carrasco, Óscar; Guerra-Silla, María de Guadalupe; Torres-Arreola, Laura Del Pilar; García-Peña, Carmen; Escamilla-Jiménez, Cristopher Isaac; González-González, César

2014-01-01

As a result of the accelerated growth of the elderly population, reconfiguration of families and member roles, and the increase of mental disorders, it is necessary to investigate the effects of this set of factors on the caregivers of patients with dementia in Mexico. Mental disorders of individuals have a negative impact on their physical and emotional quality of life, leading to greater dependence and making the caring experience a heavy burden. Several studies (none in Mexico) have used either the characteristics of the patient or caregiver to determine the burden, but few studies have included both profiles within a single study. The objective of the present study was to analyze the characteristics of the patients and caregivers associated with caregiver burden. A multicenter study was carried out in six health institutions located in Mexico City, including 175 patients (and their caregivers) diagnosed with different types of dementia. We used the Spanish Caregiver Burden Screen. Descriptive analysis and logistic regressions were used to estimate the effect of the covariates on the caregiver burden. The results showed that patient variables have a greater impact on caregiver burden than caregiver-associated variables. Dysexecutive syndrome, sleep disorders, schooling and caregiver depression are associated with a higher level of caregiver burden. Caregiver burden is a complex phenomenon. The results of the present study showed the need to implement multifactorial interventions targeting the caregiver to reduce the burden, strengthen the skills for patient management to avoid depression, improve patient health, and diminish functional dependence and future hospitalization. © 2013 Japan Geriatrics Society.

The factors affecting the burden of care of informal caregivers of the elderly in Tehran

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Hosein Rohani

2015-03-01

Full Text Available Background: Rapid growth of the elderly population followed by an increase in long term care will lead to a rise in the health costs of the elderly and the healthcare burden of their caregivers. This study was carried out to examine the factors affecting the burden of care for informal caregivers in order to design better interventional programs and to reduce this burden and unwanted consequences. Methods: This cross-sectional study was conducted in retirement associations of Tehran in 2012. The study population included 200 elderly and 200 caregivers. The instruments for data collection included two questionnaires about the elderly and their caregivers that were completed in a face-to-face interview. The data were analyzed by SPSS-16 software using multiple linear regression. Results: About 60% of the elderly and 34% of caregivers were female. Burden of care was low in 70%, moderate in 11.5%, and high in 18.5% of caregivers. Female caregivers were suffering 1.42 unit more burden of care than male caregivers (P= 0.027. Also, there was a significant association between the burden of care of untrained caregivers and instrumental activities of the daily living of the elderly (P< 0.001, daily activity of the elderly (P<0.001 and adequacy of wage (= 0.001. Conclusion: According to the results, being a female caregiver, daily physical activity of the elderly, instrumental activities of the daily living of the elderly, and adequacy of the wage were the most important factors in increasing the burden of care for caregivers of the elderly.

Repeated short-term stress synergizes the ROS signalling through up regulation of NFkB and iNOS expression induced due to combined exposure of trichloroethylene and UVB rays.

Science.gov (United States)

Ali, Farrah; Sultana, Sarwat

2012-01-01

Restraint stress is known to catalyse the pathogenesis of the variety of chronic inflammatory disorders. The present study was designed to evaluate the effect of repeated short-term stress (RRS) on cellular transduction apart from oxidative burden and early tumour promotional biomarkers induced due to combined exposure of trichloroethylene (TCE) and Ultra-violet radiation (UVB). RRS leads to the increase in the expression of the stress responsive cellular transduction elements NFkB-p65 and activity of iNOS in the epidermal tissues of mice after toxicant exposure. RRS augments the steep depletion of the cellular antioxidant machinery which was evidenced by the marked depletion in GSH (Glutathione and GSH dependant enzymes), superoxide dismutase and catalase activity that were observed at significance level of P stressed animals and down regulation of DT-diaphorase activity (P short-term stress in the toxic response of TCE and UVB radiation.

Vitamin B12 deficiency results in severe oxidative stress, leading to memory retention impairment in Caenorhabditis elegans.

Science.gov (United States)

Bito, Tomohiro; Misaki, Taihei; Yabuta, Yukinori; Ishikawa, Takahiro; Kawano, Tsuyoshi; Watanabe, Fumio

2017-04-01

Oxidative stress is implicated in various human diseases and conditions, such as a neurodegeneration, which is the major symptom of vitamin B 12 deficiency, although the underlying disease mechanisms associated with vitamin B 12 deficiency are poorly understood. Vitamin B 12 deficiency was found to significantly increase cellular H 2 O 2 and NO content in Caenorhabditis elegans and significantly decrease low molecular antioxidant [reduced glutathione (GSH) and L-ascorbic acid] levels and antioxidant enzyme (superoxide dismutase and catalase) activities, indicating that vitamin B 12 deficiency induces severe oxidative stress leading to oxidative damage of various cellular components in worms. An NaCl chemotaxis associative learning assay indicated that vitamin B 12 deficiency did not affect learning ability but impaired memory retention ability, which decreased to approximately 58% of the control value. When worms were treated with 1mmol/L GSH, L-ascorbic acid, or vitamin E for three generations during vitamin B 12 deficiency, cellular malondialdehyde content as an index of oxidative stress decreased to the control level, but the impairment of memory retention ability was not completely reversed (up to approximately 50%). These results suggest that memory retention impairment formed during vitamin B 12 deficiency is partially attributable to oxidative stress. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Comparative Effect of Silymarin and D-Penicillamine on Lead Induced Hemotoxicity and Oxidative Stress in Rat

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Seyedeh Missagh Jalali*

2017-03-01

Full Text Available Background: This study was performed to investigate the adverse effects of acute lead intoxication on hemogram, erythrocyte osmotic fragility and oxidant/antioxidant status and the probable ameliorating effect of silymarin in comparison to d-penicillamine. Methods: Forty-eight albino rats were divided in 8 groups and received the following treatments in a 10 day experiment in Shahid Chamran University of Ahvaz, southwest Iran in 2015. Group 1: Normal saline as control; Group 2: 25 mg/kg lead acetate, intraperitoneally (IP for the last 5 days; Group 3: 100 mg/kg D-penicillamine, IP for the last 5 days; Group 4: 200 mg/kg silymarin, orally for 10 days; Group 5, 6, 7 and 8: In addition to lead, they received D-penicillamine, for the last 5 days, silymarin for 10 days, a combination of silymarin for 10 days and D-penicillamine for the last 5 days, and silymarin for the last 5 days, respectively. Results: Lead exposure induced a significant microcytic anemia accompanied by a significant elevation in total leukocyte, lymphocyte and neutrophil counts. Erythrocyte superoxide dismutase (SOD and glutathion peroxidase (Gpx activities were significantly increased along with a significant elevation of malondialdehyde (MDA concentration in lead treated rats. Activities of SOD and Gpx were significantly alleviated by silymarin administration for 10 days while both D-penicillamine and silymarin could significantly reduce MDA concentration. Conclusion: Acute lead exposure induced significant leukocytosis and anemia that was associated with increased activity of erythrocyte antioxidant enzymes and lipid peroxidation. Silymarin in contrast to D-penicillamine treatment was more effective in preventing lead-induced oxidative stress in erythrocytes.

Optimising molecular diagnostic capacity for effective control of tuberculosis in high-burden settings.

Science.gov (United States)

Sabiiti, W; Mtafya, B; Kuchaka, D; Azam, K; Viegas, S; Mdolo, A; Farmer, E C W; Khonga, M; Evangelopoulos, D; Honeyborne, I; Rachow, A; Heinrich, N; Ntinginya, N E; Bhatt, N; Davies, G R; Jani, I V; McHugh, T D; Kibiki, G; Hoelscher, M; Gillespie, S H

2016-08-01

The World Health Organization's 2035 vision is to reduce tuberculosis (TB) associated mortality by 95%. While low-burden, well-equipped industrialised economies can expect to see this goal achieved, it is challenging in the low- and middle-income countries that bear the highest burden of TB. Inadequate diagnosis leads to inappropriate treatment and poor clinical outcomes. The roll-out of the Xpert(®) MTB/RIF assay has demonstrated that molecular diagnostics can produce rapid diagnosis and treatment initiation. Strong molecular services are still limited to regional or national centres. The delay in implementation is due partly to resources, and partly to the suggestion that such techniques are too challenging for widespread implementation. We have successfully implemented a molecular tool for rapid monitoring of patient treatment response to anti-tuberculosis treatment in three high TB burden countries in Africa. We discuss here the challenges facing TB diagnosis and treatment monitoring, and draw from our experience in establishing molecular treatment monitoring platforms to provide practical insights into successful optimisation of molecular diagnostic capacity in resource-constrained, high TB burden settings. We recommend a holistic health system-wide approach for molecular diagnostic capacity development, addressing human resource training, institutional capacity development, streamlined procurement systems, and engagement with the public, policy makers and implementers of TB control programmes.

Stress and hormones

Directory of Open Access Journals (Sweden)

Salam Ranabir

2011-01-01

Full Text Available In the modern environment one is exposed to various stressful conditions. Stress can lead to changes in the serum level of many hormones including glucocorticoids, catecholamines, growth hormone and prolactin. Some of these changes are necessary for the fight or flight response to protect oneself. Some of these stressful responses can lead to endocrine disorders like Graves′ disease, gonadal dysfunction, psychosexual dwarfism and obesity. Stress can also alter the clinical status of many preexisting endocrine disorders such as precipitation of adrenal crisis and thyroid storm.

Family caregiving for older adults : gendered roles and caregiver burden in emigrant households of Kerala, India

NARCIS (Netherlands)

Ugargol, Allen Prabhaker; Bailey, Ajay

2018-01-01

The Indian state of Kerala leads the demographic transition and characteristically showcases emigration of predominantly male adult children, leaving behind parents, spouses and children. When men emigrate, gendered contexts burden women, especially spouses and daughters-in-law, with caregiving

Embryonic exposure to lead: comparison of immune and cellular responses in unchallenged and virally stressed chickens

Energy Technology Data Exchange (ETDEWEB)

Lee, Ji-Eun; Kao, Elizabeth; Dietert, Rodney R. [Institute for Comparative and Environmental Toxicology, College of Veterinary Medicine, Cornell University, Ithaca, NY (United States); Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University, Ithaca, NY (United States); Naqi, Syed A. [Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University, Ithaca, NY (United States)

2002-01-01

-exposed chickens. These results suggest that low-level exposure to lead has a direct effect on the developing chicken immune system, which is evident even during a postnatal infection. Furthermore, some of the changes were observed only when chicks were stressed by the viral infection. It appears that lead exposure during different stages of embryonic development is likely to result in different immunotoxic outcomes in juveniles. (orig.)

Work Stress, Caregiving, and Allostatic Load

DEFF Research Database (Denmark)

Dich, Nadya; Lange, Theis; Head, Jenny

2015-01-01

OBJECTIVES: Studies investigating health effects of work and family stress usually consider these factors in isolation. The present study investigated prospective interactive effects of job strain and informal caregiving on allostatic load (AL), a multisystem indicator of physiological......). Regardless of job strain, participants with low caregiving burden (below sample median) had lower subsequent AL levels than did non-caregivers (b = -0.22, 95% confidence interval = -0.06--0.37). CONCLUSIONS: The study provides some evidence for adverse effects of stress at work combined with family demands...

Stress leads to contrasting effects on the levels of brain derived neurotrophic factor in the hippocampus and amygdala.

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Harini Lakshminarasimhan

Full Text Available Recent findings on stress induced structural plasticity in rodents have identified important differences between the hippocampus and amygdala. The same chronic immobilization stress (CIS, 2 h/day causes growth of dendrites and spines in the basolateral amygdala (BLA, but dendritic atrophy in hippocampal area CA3. CIS induced morphological changes also differ in their temporal longevity--BLA hypertrophy, unlike CA3 atrophy, persists even after 21 days of stress-free recovery. Furthermore, a single session of acute immobilization stress (AIS, 2 h leads to a significant increase in spine density 10 days, but not 1 day, later in the BLA. However, little is known about the molecular correlates of the differential effects of chronic and acute stress. Because BDNF is known to be a key regulator of dendritic architecture and spines, we investigated if the levels of BDNF expression reflect the divergent effects of stress on the hippocampus and amygdala. CIS reduces BDNF in area CA3, while it increases it in the BLA of male Wistar rats. CIS-induced increase in BDNF expression lasts for at least 21 days after the end of CIS in the BLA. But CIS-induced decrease in area CA3 BDNF levels, reverses to normal levels within the same period. Finally, BDNF is up regulated in the BLA 1 day after AIS and this increase persists even 10 days later. In contrast, AIS fails to elicit any significant change in area CA3 at either time points. Together, these findings demonstrate that both acute and chronic stress trigger opposite effects on BDNF levels in the BLA versus area CA3, and these divergent changes also follow distinct temporal profiles. These results point to a role for BDNF in stress-induced structural plasticity across both hippocampus and amygdala, two brain areas that have also been implicated in the cognitive and affective symptoms of stress-related psychiatric disorders.

A tailored relocation stress intervention programme for family caregivers of patients transferred from a surgical intensive care unit to a general ward.

Science.gov (United States)

Lee, Seul; Oh, HyunSoo; Suh, YeonOk; Seo, WhaSook

2017-03-01

To develop and examine a relocation stress intervention programme tailored for the family caregivers of patients scheduled for transfer from a surgical intensive care unit to a general ward. Family relocation stress syndrome has been reported to be similar to that exhibited by patients, and investigators have emphasised that nurses should make special efforts to relieve family relocation stress to maximise positive contributions to the well-being of patients by family caregivers. A nonequivalent control group, nonsynchronised pretest-post-test design was adopted. The study subjects were 60 family caregivers of patients with neurosurgical or general surgical conditions in the surgical intensive care unit of a university hospital located in Incheon, South Korea. Relocation stress and family burden were evaluated at three times, that is before intervention, immediately after transfer and four to five days after transfer. This relocation stress intervention programme was developed for the family caregivers based on disease characteristics and relocation-related needs. In the experimental group, relocation stress levels significantly and continuously decreased after intervention, whereas in the control group, a slight nonsignificant trend was observed. Family burden levels in the control group increased significantly after transfer, whereas burden levels in the experimental group increased only marginally and nonsignificantly. No significant between-group differences in relocation stress or family burden levels were observed after intervention. Relocation stress levels of family caregivers were significantly decreased after intervention in the experimental group, which indicates that the devised family relocation stress intervention programme effectively alleviated family relocation stress. The devised intervention programme, which was tailored to disease characteristics and relocation-related needs, may enhance the practicality and efficacy of relocation stress

Protective effects of Spirulina maxima on hyperlipidemia and oxidative-stress induced by lead acetate in the liver and kidney.

Science.gov (United States)

Ponce-Canchihuamán, Johny C; Pérez-Méndez, Oscar; Hernández-Muñoz, Rolando; Torres-Durán, Patricia V; Juárez-Oropeza, Marco A

2010-03-31

Oxidative damage has been proposed as a possible mechanism involved in lead toxicity, specially affecting the liver and kidney. Previous studies have shown the antioxidant effect of Spirulina maxima in several experimental models of oxidative stress. The current study was carried out to evaluate the antioxidant activity of Spirulina maxima against lead acetate-induced hyperlipidemia and oxidative damage in the liver and kidney of male rats. Control animals were fed on a standard diet and did not receive lead acetate (Control group). Experimental animals were fed on a standard laboratory diet with or without Spirulina maxima 5% in the standard laboratory diet and treated with three doses of lead acetate (25 mg each/weekly, intraperitoneal injection) (lead acetate with Spirulina, and lead acetate without Spirulina groups). The results showed that Spirulina maxima prevented the lead acetate-induced significant changes on plasma and liver lipid levels and on the antioxidant status of the liver and kidney. On the other hand, Spirulina maxima succeeded to improve the biochemical parameters of the liver and kidney towards the normal values of the Control group. It was concluded that Spirulina maxima has protective effects on lead acetate-induced damage, and that the effects are associated with the antioxidant effect of Spirulina.

Vaccine-associated paralytic poliomyelitis: a review of the epidemiology and estimation of the global burden.

Science.gov (United States)

Platt, Lauren R; Estívariz, Concepción F; Sutter, Roland W

2014-11-01

Vaccine-associated paralytic poliomyelitis (VAPP) is a rare adverse event associated with oral poliovirus vaccine (OPV). This review summarizes the epidemiology and provides a global burden estimate. A literature review was conducted to abstract the epidemiology and calculate the risk of VAPP. A bootstrap method was applied to calculate global VAPP burden estimates. Trends in VAPP epidemiology varied by country income level. In the low-income country, the majority of cases occurred in individuals who had received >3 doses of OPV (63%), whereas in middle and high-income countries, most cases occurred in recipients after their first OPV dose or unvaccinated contacts (81%). Using all risk estimates, VAPP risk was 4.7 cases per million births (range, 2.4-9.7), leading to a global annual burden estimate of 498 cases (range, 255-1018). If the analysis is limited to estimates from countries that currently use OPV, the VAPP risk is 3.8 cases per million births (range, 2.9-4.7) and a burden of 399 cases (range, 306-490). Because many high-income countries have replaced OPV with inactivated poliovirus vaccine, the VAPP burden is concentrated in lower-income countries. The planned universal introduction of inactivated poliovirus vaccine is likely to substantially decrease the global VAPP burden by 80%-90%. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Persistent ER stress induces the spliced leader RNA silencing pathway (SLS, leading to programmed cell death in Trypanosoma brucei.

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Hanoch Goldshmidt

2010-01-01

Full Text Available Trypanosomes are parasites that cycle between the insect host (procyclic form and mammalian host (bloodstream form. These parasites lack conventional transcription regulation, including factors that induce the unfolded protein response (UPR. However, they possess a stress response mechanism, the spliced leader RNA silencing (SLS pathway. SLS elicits shut-off of spliced leader RNA (SL RNA transcription by perturbing the binding of the transcription factor tSNAP42 to its cognate promoter, thus eliminating trans-splicing of all mRNAs. Induction of endoplasmic reticulum (ER stress in procyclic trypanosomes elicits changes in the transcriptome similar to those induced by conventional UPR found in other eukaryotes. The mechanism of up-regulation under ER stress is dependent on differential stabilization of mRNAs. The transcriptome changes are accompanied by ER dilation and elevation in the ER chaperone, BiP. Prolonged ER stress induces SLS pathway. RNAi silencing of SEC63, a factor that participates in protein translocation across the ER membrane, or SEC61, the translocation channel, also induces SLS. Silencing of these genes or prolonged ER stress led to programmed cell death (PCD, evident by exposure of phosphatidyl serine, DNA laddering, increase in reactive oxygen species (ROS production, increase in cytoplasmic Ca(2+, and decrease in mitochondrial membrane potential, as well as typical morphological changes observed by transmission electron microscopy (TEM. ER stress response is also induced in the bloodstream form and if the stress persists it leads to SLS. We propose that prolonged ER stress induces SLS, which serves as a unique death pathway, replacing the conventional caspase-mediated PCD observed in higher eukaryotes.

Organizational stress management interventions: Is it the singer not the song? [Editorial

NARCIS (Netherlands)

Kompier, M.A.J.; Aust, B.

2016-01-01

Good reasons exist for combating stress at work. It is a burden for individual employees and their families and costly to companies and society. Moreover preventing stress at work is a sign of good corporate citizenship as it respects modern legislation that stimulates the provision of a good

Burden of disease from toxic waste sites in India, Indonesia, and the Philippines in 2010.

Science.gov (United States)

Chatham-Stephens, Kevin; Caravanos, Jack; Ericson, Bret; Sunga-Amparo, Jennifer; Susilorini, Budi; Sharma, Promila; Landrigan, Philip J; Fuller, Richard

2013-07-01

Prior calculations of the burden of disease from toxic exposures have not included estimates of the burden from toxic waste sites due to the absence of exposure data. We developed a disability-adjusted life year (DALY)-based estimate of the disease burden attributable to toxic waste sites. We focused on three low- and middle-income countries (LMICs): India, Indonesia, and the Philippines. Sites were identified through the Blacksmith Institute's Toxic Sites Identification Program, a global effort to identify waste sites in LMICs. At least one of eight toxic chemicals was sampled in environmental media at each site, and the population at risk estimated. By combining estimates of disease incidence from these exposures with population data, we calculated the DALYs attributable to exposures at each site. We estimated that in 2010, 8,629,750 persons were at risk of exposure to industrial pollutants at 373 toxic waste sites in the three countries, and that these exposures resulted in 828,722 DALYs, with a range of 814,934-1,557,121 DALYs, depending on the weighting factor used. This disease burden is comparable to estimated burdens for outdoor air pollution (1,448,612 DALYs) and malaria (725,000 DALYs) in these countries. Lead and hexavalent chromium collectively accounted for 99.2% of the total DALYs for the chemicals evaluated. Toxic waste sites are responsible for a significant burden of disease in LMICs. Although some factors, such as unidentified and unscreened sites, may cause our estimate to be an underestimate of the actual burden of disease, other factors, such as extrapolation of environmental sampling to the entire exposed population, may result in an overestimate of the burden of disease attributable to these sites. Toxic waste sites are a major, and heretofore underrecognized, global health problem.

Tolerance and stress response of sclerotiogenic Aspergillus oryzae G15 to copper and lead.

Science.gov (United States)

Long, Dan-Dan; Fu, Rong-Rong; Han, Jian-Rong

2017-07-01

Aspergillus oryzae G15 was cultured on Czapek yeast extract agar medium containing different concentrations of copper and lead to investigate the mechanisms sustaining metal tolerance. The effects of heavy metals on biomass, metal accumulation, metallothionein (MT), malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), and peroxidase (POD) were evaluated. Cu and Pb treatment remarkably delayed sclerotial maturation and inhibited mycelial growth, indicating the toxic effects of the metals. Cu decreased sclerotial biomass, whereas Pb led to an increase in sclerotial biomass. G15 bioadsorbed most Cu and Pb ions on the cell surface, revealing the involvement of the extracellular mechanism. Cu treatment significantly elevated MT level in mycelia, and Pb treatment at concentrations of 50-100 mg/L also caused an increase in MT content in mycelia. Both metals significantly increased MDA level in sclerotia. The variations in MT and MDA levels revealed the appearance of heavy metal-induced oxidative stress. The activities of SOD, CAT, and POD varied with heavy metal concentrations, which demonstrated that tolerance of G15 to Cu and Pb was associated with an efficient antioxidant defense system. In sum, the santioxidative detoxification system allowed the strain to survive in high concentrations of Cu and Pb. G15 depended mostly on sclerotial differentiation to defend against Pb stress.

Effects of Nonhydrostatic Stress on Structural and Optoelectronic Properties of Methylammonium Lead Bromide Perovskite

Energy Technology Data Exchange (ETDEWEB)

Zhang, Rong; Cai, Weizhao; Bi, Tiange; Zarifi, Niloofar; Terpstra, Tyson; Zhang, Chuang; Verdent, Z. Valy; Zurek, Eva; Deemyad, Shanti (Buffalo); (Utah)

2017-07-13

We report synchrotron X-ray diffraction, photoconductivity, and photoluminescence investigations of methylammonium-lead-bromide (MAPbBr3) under various stress conditions, supported by density-functional-theory (DFT) calculations. The properties of MAPbBr3 show substantial dependence on the hydrostatic conditions. While nonhydrostatic compression of MAPbBr3 leads to amorphization above 2.4 GPa, under quasi-hydrostatic (Ar) and hydrostatic (He) pressure, the sample remains in crystalline phases. A sequence of phase transitions between two cubic phases and orthorhombic Pnma phase is observed when using Ar, or no pressure-transmitting-medium (PTM). In helium-PTM only transitions between the two cubic structures and a new isostructural phase transition with a large volume collapse to a third cubic-phase at 2.7 GPa was observed. The photoluminescence measurements indicate a pressure-induced band gap-narrowing in the cubic phase I, and a blue-shift in the orthorhombic structure. DFT calculations illustrate that the dynamics of the organic molecules and the inorganic lattice, coupled via the N–H···Br hydrogen-bonding interactions, affect the Pb–Br distance and the bandgap evolution under pressure.

The Burden of Schizophrenia on Caregivers

OpenAIRE

Filiz Adana; Hulya Arslantas

2011-01-01

Caregivers’ burden in schizophrenia is a complex concept often with negative connotations. The concept refers to the impact of having a schizophrenia patient in the family including emotional, psychological, physical, economic distress and feelings of shame, embarrassment, guilt, and self-blame expe-rienced by the caregivers. There are objective and subjective aspects of care-givers’ burden. The objective burden refers to observed and verifiable impact of the diseased person in the family suc...

Stress modulation of drug self-administration: implications for addiction comorbidity with post-traumatic stress disorder

Science.gov (United States)

Logrip, Marian L.; Zorrilla, Eric P.; Koob, George F.

2011-01-01

Drug abuse and dependence present significant health burdens for our society, affecting roughly 10% of the population. Stress likely contributes to the development and persistence of drug use; for example, rates of substance dependence are elevated among individuals diagnosed with post-traumatic stress disorder (PTSD). Thus, understanding the interaction between stress and drug use, and associated neuroadaptations, is key for developing therapies to combat substance use disorders. For this purpose, many rodent models of the effects of stress exposure on substance use have been developed; the models can be classified according to three categories of stress exposure: developmental, adult nonsocial, and adult social. The present review addresses preclinical findings on the effect of each type of trauma on responses to and self-administration of drugs of abuse by focusing on a key exemplar for each category. In addition, the potential efficacy of targeting neuropeptide systems that have been implicated in stress responses and stress system neuroadaptation in order to treat comorbid PTSD and substance abuse will be discussed. PMID:21782834

Contaminated lead environments of man: reviewing the lead isotopic evidence in sediments, peat, and soils for the temporal and spatial patterns of atmospheric lead pollution in Sweden.

Science.gov (United States)

Bindler, Richard

2011-08-01

Clair Patterson and colleagues demonstrated already four decades ago that the lead cycle was greatly altered on a global scale by humans. Moreover, this change occurred long before the implementation of monitoring programs designed to study lead and other trace metals. Patterson and colleagues also developed stable lead isotope analyses as a tool to differentiate between natural and pollution-derived lead. Since then, stable isotope analyses of sediment, peat, herbaria collections, soils, and forest plants have given us new insights into lead biogeochemical cycling in space and time. Three important conclusions from our studies of lead in the Swedish environment conducted over the past 15 years, which are well supported by extensive results from elsewhere in Europe and in North America, are: (1) lead deposition rates at sites removed from major point sources during the twentieth century were about 1,000 times higher than natural background deposition rates a few thousand years ago (~10 mg Pb m(-2) year(-1) vs. 0.01 mg Pb m(-2) year(-1)), and even today (~1 mg Pb m(-2) year(-1)) are still almost 100 times greater than natural rates. This increase from natural background to maximum fluxes is similar to estimated changes in body burdens of lead from ancient times to the twentieth century. (2) Stable lead isotopes ((206)Pb/(207)Pb ratios shown in this paper) are an effective tool to distinguish anthropogenic lead from the natural lead present in sediments, peat, and soils for both the majority of sites receiving diffuse inputs from long range and regional sources and for sites in close proximity to point sources. In sediments >3,500 years and in the parent soil material of the C-horizon, (206)Pb/(207)Pb ratios are higher, 1.3 to >2.0, whereas pollution sources and surface soils and peat have lower ratios that have been in the range 1.14-1.18. (3) Using stable lead isotopes, we have estimated that in southern Sweden the cumulative anthropogenic burden of

Modeling The Economic Burden Of Adult Vaccine-Preventable Diseases In The United States.

Science.gov (United States)

Ozawa, Sachiko; Portnoy, Allison; Getaneh, Hiwote; Clark, Samantha; Knoll, Maria; Bishai, David; Yang, H Keri; Patwardhan, Pallavi D

2016-11-01

Vaccines save thousands of lives in the United States every year, but many adults remain unvaccinated. Low rates of vaccine uptake lead to costs to individuals and society in terms of deaths and disabilities, which are avoidable, and they create economic losses from doctor visits, hospitalizations, and lost income. To identify the magnitude of this problem, we calculated the current economic burden that is attributable to vaccine-preventable diseases among US adults. We estimated the total remaining economic burden at approximately $9 billion (plausibility range: $4.7-$15.2 billion) in a single year, 2015, from vaccine-preventable diseases related to ten vaccines recommended for adults ages nineteen and older. Unvaccinated individuals are responsible for almost 80 percent, or $7.1 billion, of the financial burden. These results not only indicate the potential economic benefit of increasing adult immunization uptake but also highlight the value of vaccines. Policies should focus on minimizing the negative externalities or spillover effects from the choice not to be vaccinated, while preserving patient autonomy. Project HOPE—The People-to-People Health Foundation, Inc.

Assessing the burden of medical impoverishment by cause: a systematic breakdown by disease in Ethiopia.

Science.gov (United States)

Verguet, Stéphane; Memirie, Solomon Tessema; Norheim, Ole Frithjof

2016-10-21

Out-of-pocket (OOP) medical expenses often lead to catastrophic expenditure and impoverishment in low- and middle-income countries. Yet, there has been no systematic examination of which specific diseases and conditions (e.g., tuberculosis, cardiovascular disease) drive medical impoverishment, defined as OOP direct medical costs pushing households into poverty. We used a cost and epidemiological model to propose an assessment of the burden of medical impoverishment in Ethiopia, i.e., the number of households crossing a poverty line due to excessive OOP direct medical expenses. We utilized disease-specific mortality estimates from the Global Burden of Disease study, epidemiological and cost inputs from surveys, and secondary data from the literature to produce a count of poverty cases due to OOP direct medical costs per specific condition. In Ethiopia, in 2013, and among 20 leading causes of mortality, we estimated the burden of impoverishment due to OOP direct medical costs to be of about 350,000 poverty cases. The top three causes of medical impoverishment were diarrhea, lower respiratory infections, and road injury, accounting for 75 % of all poverty cases. We present a preliminary attempt for the estimation of the burden of medical impoverishment by cause for high mortality conditions. In Ethiopia, medical impoverishment was notably associated with illness occurrence and health services utilization. Although currently used estimates are sensitive to health services utilization, a systematic breakdown of impoverishment due to OOP direct medical costs by cause can provide important information for the promotion of financial risk protection and equity, and subsequent design of health policies toward universal health coverage, reduction of direct OOP payments, and poverty alleviation.

The Economic Burden Attributable to a Child's Inpatient Admission for Diarrheal Disease in Rwanda.

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Ngabo, Fidele; Mvundura, Mercy; Gazley, Lauren; Gatera, Maurice; Rugambwa, Celse; Kayonga, Eugene; Tuyishime, Yvette; Niyibaho, Jeanne; Mwenda, Jason M; Donnen, Philippe; Lepage, Philippe; Binagwaho, Agnes; Atherly, Deborah

2016-01-01

Diarrhea is one of the leading causes of childhood morbidity and mortality. Hospitalization for diarrhea can pose a significant burden to health systems and households. The objective of this study was to estimate the economic burden attributable to hospitalization for diarrhea among children less than five years old in Rwanda. These data can be used by decision-makers to assess the impact of interventions that reduce diarrhea morbidity, including rotavirus vaccine introduction. This was a prospective costing study where medical records and hospital bills for children admitted with diarrhea at three hospitals were collected to estimate resource use and costs. Hospital length of stay was calculated from medical records. Costs incurred during the hospitalization were abstracted from the hospital bills. Interviews with the child's caregivers provided data to estimate household costs which included transport costs and lost income. The portion of medical costs borne by insurance and household were reported separately. Annual economic burden before and after rotavirus vaccine introduction was estimated by multiplying the reported number of diarrhea hospitalizations in public health centers and district hospitals by the estimated economic burden per hospitalization. All costs are presented in 2014 US$. Costs for 203 children were analyzed. Approximately 93% of the children had health insurance coverage. Average hospital length of stay was 5.3 ± 3.9 days. Average medical costs for each child for the illness resulting in a hospitalization were $44.22 ± $23.74 and the total economic burden was $101, of which 65% was borne by the household. For households in the lowest income quintile, the household costs were 110% of their monthly income. The annual economic burden to Rwanda attributable to diarrhea hospitalizations ranged from $1.3 million to $1.7 million before rotavirus vaccine introduction. Households often bear the largest share of the economic burden attributable to

The Economic Burden Attributable to a Child's Inpatient Admission for Diarrheal Disease in Rwanda.

Directory of Open Access Journals (Sweden)

Fidele Ngabo

Full Text Available Diarrhea is one of the leading causes of childhood morbidity and mortality. Hospitalization for diarrhea can pose a significant burden to health systems and households. The objective of this study was to estimate the economic burden attributable to hospitalization for diarrhea among children less than five years old in Rwanda. These data can be used by decision-makers to assess the impact of interventions that reduce diarrhea morbidity, including rotavirus vaccine introduction.This was a prospective costing study where medical records and hospital bills for children admitted with diarrhea at three hospitals were collected to estimate resource use and costs. Hospital length of stay was calculated from medical records. Costs incurred during the hospitalization were abstracted from the hospital bills. Interviews with the child's caregivers provided data to estimate household costs which included transport costs and lost income. The portion of medical costs borne by insurance and household were reported separately. Annual economic burden before and after rotavirus vaccine introduction was estimated by multiplying the reported number of diarrhea hospitalizations in public health centers and district hospitals by the estimated economic burden per hospitalization. All costs are presented in 2014 US$.Costs for 203 children were analyzed. Approximately 93% of the children had health insurance coverage. Average hospital length of stay was 5.3 ± 3.9 days. Average medical costs for each child for the illness resulting in a hospitalization were $44.22 ± $23.74 and the total economic burden was $101, of which 65% was borne by the household. For households in the lowest income quintile, the household costs were 110% of their monthly income. The annual economic burden to Rwanda attributable to diarrhea hospitalizations ranged from $1.3 million to $1.7 million before rotavirus vaccine introduction.Households often bear the largest share of the economic burden

CHESS improves cancer caregivers' burden and mood: results of an eHealth RCT.

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DuBenske, Lori L; Gustafson, David H; Namkoong, Kang; Hawkins, Robert P; Atwood, Amy K; Brown, Roger L; Chih, Ming-Yuan; McTavish, Fiona; Carmack, Cindy L; Buss, Mary K; Govindan, Ramaswamy; Cleary, James F

2014-10-01

Informal caregivers (family and friends) of people with cancer are often unprepared for their caregiving role, leading to increased burden or distress. Comprehensive Health Enhancement Support System (CHESS) is a Web-based lung cancer information, communication, and coaching system for caregivers. This randomized trial reports the impact on caregiver burden, disruptiveness, and mood of providing caregivers access to CHESS versus the Internet with a list of recommended lung cancer websites. A total of 285 informal caregivers of patients with advanced nonsmall cell lung cancer were randomly assigned to a comparison group that received Internet or a treatment group that received Internet and CHESS. Caregivers were provided a computer and Internet service if needed. Written surveys were completed at pretest and during the intervention period bimonthly for up to 24 months. Analyses of covariance (ANCOVAs) compared the intervention's effect on caregivers' disruptiveness and burden (CQOLI-C), and negative mood (combined Anxiety, Depression, and Anger scales of the POMS) at 6 months, controlling for blocking variables (site, caregiver's race, and relationship to patient) and the given outcome at pretest. Caregivers randomized to CHESS reported lower burden, t(84) = 2.36, p = .021, d = .39, and negative mood, t(86) = 2.82, p = .006, d = .44, than those in the Internet group. The effect on disruptiveness was not significant. Although caring for someone with a terminal illness will always exact a toll on caregivers, eHealth interventions like CHESS may improve caregivers' understanding and coping skills and, as a result, ease their burden and mood.

CHESS Improves Cancer Caregivers’ Burden and Mood: Results of an eHealth RCT

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DuBenske, Lori L.; Gustafson, David H.; Namkoong, Kang; Hawkins, Robert P.; Atwood, Amy K.; Brown, Roger L.; Chih, Ming-Yuan; McTavish, Fiona; Carmack, Cindy L.; Buss, Mary K.; Govindan, Ramaswamy; Cleary, James F.

2014-01-01

Objective Informal caregivers (family and friends) of people with cancer are often unprepared for their caregiving role, leading to increased burden or distress. CHESS (Comprehensive Health Enhancement Support System) is a web-based lung cancer information, communication and coaching system for caregivers. This randomized trial reports the impact on caregiver burden, disruptiveness and mood of providing caregivers access to CHESS versus the Internet with a list of recommended lung cancer websites. Methods 285 informal caregivers of patients with advanced non-small cell lung cancer were randomly assigned to a comparison group that received Internet or a treatment group that received Internet and CHESS. Caregivers were provided a computer and Internet service if needed. Written surveys were completed at pretest and during the intervention period bimonthly for up to 24 months. ANCOVA analyses compared the intervention’s effect on caregivers’ disruptiveness and burden (CQOLI-C), and negative mood (combined Anxiety, Depression, and Anger scales of the POMS) at six months, controlling for blocking variables (site, caregiver’s race, and relationship to patient) and the given outcome at pretest. Results Caregivers randomized to CHESS reported lower burden [t (84) = 2.36, p = .021, d= .39] and negative mood [t (86) = 2.82, p = .006, d= .44] than those in the Internet group. The effect on disruptiveness was not significant. Conclusions Although caring for someone with a terminal illness will always exact a toll on caregivers, eHealth interventions like CHESS may improve caregivers’ understanding and coping skills and, as a result, ease their burden and mood. PMID:24245838

Consumer credit as a novel marker for economic burden and health after cancer in a diverse population of breast cancer survivors in the USA.

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Dean, Lorraine T; Schmitz, Kathryn H; Frick, Kevin D; Nicholas, Lauren H; Zhang, Yuehan; Subramanian, S V; Visvanathan, Kala

2018-06-01

Consumer credit may reflect financial hardship that patients face due to cancer treatment, which in turn may impact ability to manage health after cancer; however, credit's relationship to economic burden and health after cancer has not been evaluated. From May to September 2015, 123 women with a history of breast cancer residing in Pennsylvania or New Jersey completed a cross-sectional survey of demographics, socioeconomic position, comorbidities, SF-12 self-rated health, economic burden since cancer diagnosis, psychosocial stress, and self-reported (poor to excellent) credit quality. Ordinal logistic regression evaluated credit's contribution to economic burden and self-rated health. Mean respondent age was 64 years. Mean year from diagnosis was 11.5. Forty percent of respondents were Black or Other and 60% were White. Twenty-four percent self-reported poor credit, and 76% reported good to excellent credit quality. In adjusted models, changing income, using savings, borrowing money, and being unable to purchase a health need since cancer were associated with poorer credit. Better credit was associated with 7.72 ([1.22, 14.20], p = 0.02) higher physical health t-score, and a - 2.00 ([- 3.92, - 0.09], p = 0.04) point change in psychosocial stress. This exploratory analysis establishes the premise for consumer credit as a marker of economic burden and health for breast cancer survivors. Future work should validate these findings in larger samples and for other health conditions. Stabilizing and monitoring consumer credit may be a potential intervention point for mitigating economic burden after breast cancer.

Normalized wall index specific and MRI-based stress analysis of atherosclerotic carotid plaques. A study comparing acutely symptomatic and asymptomatic patients

International Nuclear Information System (INIS)

Zhu, C.; Teng, Z.; Sadat, U.; Young, V.E.; Graves, M.J.; Gillard, J.H.; Li Zhiyong

2010-01-01

Biomechanical stresses play an important role in determining plaque stability. Quantification of these simulated stresses can be potentially used to assess plaque vulnerability and differentiate different patient groups. 54 asymptomatic and 45 acutely symptomatic patients underwent in vivo multicontrast magnetic resonance imaging (MRI) of the carotid arteries. Plaque geometry used for finite element analysis was derived from in vivo MRI at the sites of maximum and minimum plaque burden. In total, 198 slices were used for the computational simulations. A pre-shrink technique was used to refine the simulation. Maximum principle stress at the vulnerable plaque sites (id est (ie), critical stress) was extracted for the selected slices and a comparison was performed between the 2 groups. Critical stress in the slice with maximum plaque burden is significantly higher in acutely symptomatic patients as compared to asymptomatic patients (median, inter quartile range: 198.0 kPa (119.8-359.0 kPa) vs 138.4 kPa (83.8-242.6 kPa), P=0.04). No significant difference was found in the slice with minimum plaque burden between the 2 groups (196.7 kPa (133.3-282.7 kPa) vs 182.4 kPa (117.2-310.6 kPa), P=0.82). Acutely symptomatic carotid plaques have significantly high biomechanical stresses than asymptomatic plaques. This might be potentially useful for establishing a biomechanical risk stratification criteria based on plaque burden in future studies. (author)

Diagnostic value of ST-segment deviations during cardiac exercise stress testing: Systematic comparison of different ECG leads and time-points.

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Puelacher, Christian; Wagener, Max; Abächerli, Roger; Honegger, Ursina; Lhasam, Nundsin; Schaerli, Nicolas; Prêtre, Gil; Strebel, Ivo; Twerenbold, Raphael; Boeddinghaus, Jasper; Nestelberger, Thomas; Rubini Giménez, Maria; Hillinger, Petra; Wildi, Karin; Sabti, Zaid; Badertscher, Patrick; Cupa, Janosch; Kozhuharov, Nikola; du Fay de Lavallaz, Jeanne; Freese, Michael; Roux, Isabelle; Lohrmann, Jens; Leber, Remo; Osswald, Stefan; Wild, Damian; Zellweger, Michael J; Mueller, Christian; Reichlin, Tobias

2017-07-01

Exercise ECG stress testing is the most widely available method for evaluation of patients with suspected myocardial ischemia. Its major limitation is the relatively poor accuracy of ST-segment changes regarding ischemia detection. Little is known about the optimal method to assess ST-deviations. A total of 1558 consecutive patients undergoing bicycle exercise stress myocardial perfusion imaging (MPI) were enrolled. Presence of inducible myocardial ischemia was adjudicated using MPI results. The diagnostic value of ST-deviations for detection of exercise-induced myocardial ischemia was systematically analyzed 1) for each individual lead, 2) at three different intervals after the J-point (J+40ms, J+60ms, J+80ms), and 3) at different time points during the test (baseline, maximal workload, 2min into recovery). Exercise-induced ischemia was detected in 481 (31%) patients. The diagnostic accuracy of ST-deviations was highest at +80ms after the J-point, and at 2min into recovery. At this point, ST-amplitude showed an AUC of 0.63 (95% CI 0.59-0.66) for the best-performing lead I. The combination of ST-amplitude and ST-slope in lead I did not increase the AUC. Lead I reached a sensitivity of 37% and a specificity of 83%, with similar sensitivity to manual ECG analysis (34%, p=0.31) but lower specificity (90%, pST-deviations is highest when evaluated at +80ms after the J-point, and at 2min into recovery. Copyright © 2017 Elsevier B.V. All rights reserved.

Analysis of lead/acid battery life cycle factors: their impact on society and the lead industry

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Robertson, J. G. S.; Wood, J. R.; Ralph, B.; Fenn, R.

The underlying theme of this paper is that society, globally, is undergoing a fundamental conceptual shift in the way it views the environment and the role of industry within it. There are views in certain quarters that this could result in the virtual elimination of the lead industry's entire product range. Despite these threats, it is argued that the prospects for the lead industry appear to be relatively favourable in a number of respects. The industry's future depends to a significant degree, however, upon its ability to argue its case in a number of key areas. It is contended, therefore, that if appropriate strategies and means are promulgated, the prospects of the industry would appear to be relatively healthy. But, for this to happen with optimal effectiveness, a conceptual change will be necessary within the industry. New strategies and tools will have to be developed. These will require a significantly more integrated, holistically based and 'reflexive' approach than previously. The main elements of such an approach are outlined. With reference to the authors' ongoing research into automotive lead/acid starting lighting ignition (SLI) batteries, the paper shows how the technique of in-depth life cycle assessment (LCA), appropriately adapted to the needs of the industry, will provide a crucial role in this new approach. It also shows how it may be used as an internal design and assessment tool to identify those stages in the battery life cycle that give rise to the greatest environmental burdens, and to assess the effects of changes in the cycle to those burdens. It is argued that the development of this approach requires the serious and urgent attention of the whole of the lead industry. Also to make the LCA tool fully effective, it must be based on a 'live' database that is produced, maintained and continually updated by the industry.

How Do Stress Exposure and Stress Regulation Relate to Borderline Personality Disorder?

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Nadège Bourvis

2017-11-01

Full Text Available Borderline personality disorder (BPD is a severe and frequent disorder characterized by a pervasive pattern of instability affecting impulse control, emotional regulation, cognitive processing, self-image and interpersonal relationships. Patients’ personal histories are often marked by stressful or traumatic experiences, either unique or repeated. Moreover, while clinical signs of the disorder include both chronic and acute features, acute features are mostly triggered by acute stressful situations. Such features include transient cognitive distortion, intense anger, uncontrollable impulsivity, and self-harm behavior – including suicide – and contribute to the burden of the disease. In this paper, we review the various aspects (epidemiological, clinical, and physiological contributing to the relationship between BDP and stress. In particular, we explore the statistical association between stress exposure and the emergence of BPD while taking into account other psychopathologies, such as post-traumatic stress disorder. Then, the different aspects of stress responses (namely, the phenomenological, behavioral, hormonal, neuro-vegetative and neural responses are reviewed in BPD patients. Pathophysiological hypotheses are formulated to explain the differences in responses between BPD patients and healthy subjects and their relation to BPD symptoms. Although the pathogenesis remains uncertain, our conclusions seem to reflect a specific biological and neural pattern of altered stress perception and regulation in BPD.

How Do Stress Exposure and Stress Regulation Relate to Borderline Personality Disorder?

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Bourvis, Nadège; Aouidad, Aveline; Cabelguen, Clémence; Cohen, David; Xavier, Jean

2017-01-01

Borderline personality disorder (BPD) is a severe and frequent disorder characterized by a pervasive pattern of instability affecting impulse control, emotional regulation, cognitive processing, self-image and interpersonal relationships. Patients' personal histories are often marked by stressful or traumatic experiences, either unique or repeated. Moreover, while clinical signs of the disorder include both chronic and acute features, acute features are mostly triggered by acute stressful situations. Such features include transient cognitive distortion, intense anger, uncontrollable impulsivity, and self-harm behavior - including suicide - and contribute to the burden of the disease. In this paper, we review the various aspects (epidemiological, clinical, and physiological) contributing to the relationship between BDP and stress. In particular, we explore the statistical association between stress exposure and the emergence of BPD while taking into account other psychopathologies, such as post-traumatic stress disorder. Then, the different aspects of stress responses (namely, the phenomenological, behavioral, hormonal, neuro-vegetative and neural responses) are reviewed in BPD patients. Pathophysiological hypotheses are formulated to explain the differences in responses between BPD patients and healthy subjects and their relation to BPD symptoms. Although the pathogenesis remains uncertain, our conclusions seem to reflect a specific biological and neural pattern of altered stress perception and regulation in BPD.

How Do Stress Exposure and Stress Regulation Relate to Borderline Personality Disorder?

Science.gov (United States)

Bourvis, Nadège; Aouidad, Aveline; Cabelguen, Clémence; Cohen, David; Xavier, Jean

2017-01-01

Borderline personality disorder (BPD) is a severe and frequent disorder characterized by a pervasive pattern of instability affecting impulse control, emotional regulation, cognitive processing, self-image and interpersonal relationships. Patients’ personal histories are often marked by stressful or traumatic experiences, either unique or repeated. Moreover, while clinical signs of the disorder include both chronic and acute features, acute features are mostly triggered by acute stressful situations. Such features include transient cognitive distortion, intense anger, uncontrollable impulsivity, and self-harm behavior – including suicide – and contribute to the burden of the disease. In this paper, we review the various aspects (epidemiological, clinical, and physiological) contributing to the relationship between BDP and stress. In particular, we explore the statistical association between stress exposure and the emergence of BPD while taking into account other psychopathologies, such as post-traumatic stress disorder. Then, the different aspects of stress responses (namely, the phenomenological, behavioral, hormonal, neuro-vegetative and neural responses) are reviewed in BPD patients. Pathophysiological hypotheses are formulated to explain the differences in responses between BPD patients and healthy subjects and their relation to BPD symptoms. Although the pathogenesis remains uncertain, our conclusions seem to reflect a specific biological and neural pattern of altered stress perception and regulation in BPD. PMID:29250007

Inhibition of stress corrosion cracking of alloy 600 in 10% NaOH solutions with and with lead oxide at 315 C

International Nuclear Information System (INIS)

Hur, D.H.; Kim, J.S.; Baek, J.S.; Kim, J.G.

2002-01-01

Alloy 600 steam generator tube materials have experienced various degradations by corrosion such as stress corrosion cracking (SCC) on the inner and outer diameter surface of tube, intergranular attack and pitting, and by mechanical damage such as fretting-wear and fatigue. These tube degradations not only increase the costs for tube inspection, maintenance and repair but also reduce the operation safety and the efficiency of plants. Therefore, the methodologies have been extensively developed to mitigate them. The addition of inhibitors to the coolant is a feasible method to mitigate tube degradations in operating plants. In this paper, a new inhibitor is proposed to mitigate the secondary side stress corrosion cracking of alloy 600 tubes. The effect of inhibitors on the electrochemical behavior and the stress corrosion cracking resistance of alloy 600 was evaluated in 10% sodium hydroxide solution with and without lead oxide at 315 C. The specimens of a C-ring type for stress corrosion cracking test were polarized at 150 mV above the corrosion potential for 120 hours without and with inhibitors such as titanium oxide, titanium boride, cerium boride. The chemical compositions of the films formed on the crack tip in the C-ring specimens were analyzed using a scanning Auger electron spectroscopy. The cerium boride, the most effective inhibitors, was observed to decrease the crack propagation rate more than a factor of three compared with that obtained in pure 10% NaOH solution. Furthermore, no SCC was observed in lead contaminated 10% NaOH solution by the addition of the cerium boride. (authors)

Relationships between temperaments, occupational stress, and insomnia among Japanese workers.

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Yasuhiko Deguchi

Full Text Available Insomnia among workers reduces the quality of life, contributes toward the economic burden of healthcare costs and losses in work performance. The relationship between occupational stress and insomnia has been reported in previous studies, but there has been little attention to temperament in occupational safety and health research. The aim of this study was to clarify the relationships between temperament, occupational stress, and insomnia. The subjects were 133 Japanese daytime local government employees. Temperament was assessed using the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Auto questionnaire (TEMPS-A. Occupational stress was assessed using the Generic Job Stress Questionnaire (GJSQ. Insomnia was assessed using the Athens Insomnia Scale (AIS. Stepwise multiple logistic regression analyses were conducted. In a stepwise multivariate logistic regression analysis, it was found that the higher subdivided stress group by "role conflict" (OR = 5.29, 95% CI, 1.61-17.32 and anxious temperament score (OR = 1.33; 95% CI, 1.19-1.49 was associated with the presence of insomnia using an adjusted model, whereas other factors were excluded from the model. The study limitations were the sample size and the fact that only Japanese local government employees were surveyed. This study demonstrated the relationships between workers' anxious temperament, role conflict, and insomnia. Recognizing one's own anxious temperament would lead to self-insight, and the recognition of anxious temperament and reduction of role conflict by their supervisors or coworkers would reduce the prevalence of insomnia among workers in the workplace.

Stress Management: Spirituality

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Healthy Lifestyle Stress management Taking the path less traveled by exploring your spirituality can lead to a clearer life purpose, better personal relationships and enhanced stress management skills. By Mayo Clinic Staff Some stress relief ...

Early Reading Proficiency. Leading Indicator Spotlight

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Musen, Lindsey

2010-01-01

In "Beyond Test Scores: Leading Indicators for Education," Foley and colleagues (2008) define leading indicators as those that "provide early signals of progress toward academic achievement" (p. 1) and stress that educators "need leading indicators to help them see the direction their efforts are going in and to take…

[What worries Hungarian men? Characteristics of masculine gender role stress].

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Susánszky, Anna; Susánszky, Eva; Kopp, Mária

2009-07-01

The aim of this study was to establish the characteristics of stress associated with male gender role and its relationship to health and to risk behaviours among Hungarian men. The present analysis is based on data of the Hungarostudy 2006 survey. Forty-one percent of the participants were men. Eighty nine percent of the male respondents completed the Eisler-Skidmore Masculine Gender Role Stress Scale; data of 1764 persons were analyzed. Anxiety about sexual performance, breadwinner role, and appearance (i.e. tradition factor) causes a much greater burden of stress than anxiety about changing gender relationships (i.e. modernization factor). With the increase of age, stress caused by traditional role expectations significantly decreases; tensions caused by women's dominance and by situations which demand emotional response and empathy are the highest among middle aged men. Traditional gender role stress is more prevalent among pensioners than among economically active men; stress caused by the modernization of masculine gender role particularly afflicts unemployed men. Married men are to the least extent troubled by female dominance and difficulties in expressing emotions. Of the two dimensions analyzed here (tradition and modernization) only the values on the tradition factor were related to health status, psychological wellbeing, and frequency of smoking. Modernization of gender roles represents only a small--if any--stressor in the life of Hungarian men; on the other hand, unsuccessful adaptation to traditional role expectations highly increases the burden of stress and is closely related to smoking.

Care burden and its predictive factors in parents of newly diagnosed children with acute lymphoblastic leukemia in academic hospitals in China.

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Wang, Jingting; Shen, Nanping; Zhang, Xiaoyan; Shen, Min; Xie, Anwei; Howell, Doris; Yuan, Changrong

2017-12-01

Caring for children with acute lymphoblastic leukemia (ALL) is a distressing experience for parents without medical training. The experience can lead to parents' care burden. This study explored care burden among parents of children with ALL and its related factors. A total of 130 parents were surveyed with the Zarit Burden Inventory (ZBI), Perceived Social Support Scale (PSSS), Zung's Self-rating Anxiety Scale (SAS), Zung's Self-rating Depression Scale (SDS), Medical Outcome Study Short Form 36 (SF-36), and a study specific demographic information questionnaire. Independent-samples T test, one-way ANOVA, Pearson correlation analysis and multivariate linear regression analysis (stepwise method), and binomial logistic regression were used in data analysis. The mean score of parents' care burden overall was 37.74 ± 16.57, 17 (13.08%) had little or no burden, 57 (43.85%) had mild-to-moderate burden, 44 (33.84%) had moderate-to-severe burden, and 12 (9.23%) had severe burden. Regression analyses indicated daily care time, anxiety, general health, average monthly family income, social support, and number of co-caregivers were factors associated with care burden. These variables accounted for 51% of the variance in care burden. Other demographic information of parents and children, depression, and other dimensions of SF-36 were not related to care burden. The severe burden level was associated the increase risk of emotional distress compared with little or no burden group (OR = 37.500, 95% CI = 4.515-311.348, P = 0.001). The results indicated that care burden in parents of children newly diagnosed with ALL is high. Parents with lower levels of care burden tend to have less daily care time, more co-caregivers, higher income, less anxiety, better general health, and social support. Strategies are needed to help reduce parents' care burden.

12 CFR 508.10 - Burden of persuasion.

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2010-01-01

... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Burden of persuasion. 508.10 Section 508.10 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY REMOVALS, SUSPENSIONS, AND PROHIBITIONS WHERE A CRIME IS CHARGED OR PROVEN § 508.10 Burden of persuasion. The petitioner has the burden of...

Burden of rheumatoid arthritis in the Nordic region, 1990-2015: a comparative analysis using the Global Burden of Disease Study 2015.

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Kiadaliri, A A; Kristensen, L-E; Englund, M

2018-03-01

To report mortality and disability due to rheumatoid arthritis (RA) in the Nordic region (Denmark, Finland, Greenland, Iceland, Norway, and Sweden) using data from the Global Burden of Disease Study (GBD) 2015. Using the results of GBD 2015, we present rates and trends in prevalence, mortality, years of life lost, years lived with disability (YLD), and disability-adjusted life-years (DALYs) of RA in the Nordic region during 1990-2015. In 2015, the age-standardized prevalence of RA was higher in the Nordic region than the global level (0.44%, 95% uncertainty interval 0.40-0.48%, vs 0.35%, 0.32-0.38%). For women (men), DALYs increased by 2.4% (12.9%), from 29 263 (10 909) in 1990 to 29 966 (12 311) in 2015. The burden of RA as a proportion of total DALYs in women (men) increased from 0.90% (0.29%) in 1990 to 0.94% (0.36%) in 2015. Age-standardized DALY rates declined in all countries except Denmark and Greenland between 1990 and 2015. Of 315 conditions studied, RA was ranked as the 16th (37th) leading cause of YLD in women (men) in the region. Of 195 countries studied, Greenland, Finland, Denmark, Norway, Sweden, and Iceland had the 7th, 11th, 28th, 38th, 48th, and 78th highest age-standardized YLD rates for RA, respectively. The prevalence of RA in the Nordic region is higher than the global average. Current trends in population growth and ageing suggest a potential increase in RA burden in the coming decades in the region that should be considered in healthcare resources allocation.

The Burden of Power: Construing Power as Responsibility (Rather Than as Opportunity) Alters Threat-Challenge Responses.

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Scholl, Annika; de Wit, Frank; Ellemers, Naomi; Fetterman, Adam K; Sassenberg, Kai; Scheepers, Daan

2018-07-01

Power usually lowers stress responses. In stressful situations, having high (vs. low) power heightens challenge and lowers threat. Yet, even power-holders may experience threat when becoming aware of the responsibility that accompanies their power. Power-holders can construe (i.e., understand) a high-power position primarily as opportunity to "make things happen" or as responsibility to "take care of things." Power-holders construing power as responsibility (rather than opportunity) may be more likely to experience demands-such as taking care of important decisions under their control-as outweighing their resources, resulting in less challenge and more threat. Four experiments with subjective and cardiovascular threat-challenge indicators support this. Going beyond prior work on structural aspects (e.g., power instability) that induce stress, we show that merely the way how power-holders construe their power can evoke stress. Specifically, we find that power construed as responsibility (vs. opportunity) is more likely to imply a "burden" for the power-holder.

Pressurizer /Auxiliary Spray Piping Stress Analysis For Determination Of Lead Shielding Maximum Allow Able Load

International Nuclear Information System (INIS)

Setjo, Renaningsih

2000-01-01

Piping stress analysis for PZR/Auxiliary Spray Lines Nuclear Power Plant AV Unit I(PWR Type) has been carried out. The purpose of this analysis is to establish a maximum allowable load that is permitted at the time of need by placing lead shielding on the piping system on class 1 pipe, Pressurizer/Auxiliary Spray Lines (PZR/Aux.) Reactor Coolant Loop 1 and 4 for NPP AV Unit one in the mode 5 and 6 during outage. This analysis is intended to reduce the maximum amount of radiation dose for the operator during ISI ( In service Inspection) period.The result shown that the maximum allowable loads for 4 inches lines for PZR/Auxiliary Spray Lines is 123 lbs/feet

The relationship between the spiritual attitude of the family caregivers of older patients with stroke and their burden

Directory of Open Access Journals (Sweden)

Torabi Chafjiri R

2017-03-01

Full Text Available Razieh Torabi Chafjiri,1 Nasrin Navabi,2 Abbas Shamsalinia,2 Fatemeh Ghaffari2 1Gilan University of Medical Sciences, Rudsar Shahid Ansari Hospital, Rudsar, Gilan, Iran; 2Ramsar Nursing Care Research Center, School of Nursing and Midwifery, Babol University of Medical Sciences, Babol, Mazandaran, Iran Introduction: Stroke is a chronic condition that necessitates multidimensional and overwhelming care. The caregivers of stroke patients are faced with various stressors that can threaten different aspects of their health, especially their mental health. Spiritual attitude and being spiritually oriented contribute significantly to mental health and can be used as a strategy for adapting to the stressful events that are part of the role of caregiving. This study was therefore conducted to investigate the relationship between the spiritual attitude of the family caregivers of older patients with stroke and their burden.Methods: This descriptive cross-sectional study was conducted in 2016. The study population consisted of all the family caregivers of older patients with stroke presenting to health care centers and nursing service companies of Gilan Province in Iran. The participants were selected through convenience sampling and consisted of 407 participants. Data were collected using the Spiritual Attitude Scale and the Caregiver Burden Inventory and were then analyzed in SPSS-18 using Pearson’s correlation coefficient at a significance level of 0.05.Results: The results showed that 88.9% of the caregivers were females. The mean age of the participants was 38.3±8.8 years. The duration of caregiving was <5 years in 84.4% of the participants, while its mean was 4.2±2.5 years. The mean score of spiritual attitude was 108.77±6.20. The majority of the participants (49.3% had moderate and relatively favorable spiritual attitude (a score of 72–120, 27.8% had high or favorable spiritual attitude; 8.7% had mild burden, 54.4% had moderate burden

Gastroesophageal reflux disease burden in Iran.

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Delavari, Alireza; Moradi, Ghobad; Elahi, Elham; Moradi-Lakeh, Maziar

2015-02-01

Gastroesophageal reflux disease is one of the most common disorders of the gastrointestinal tract. The prevalence of this disease ranges from 5% to 20% in Asia, Europe, and North America. The aim of this study was to estimate the burden of gastroesophageal reflux disease in Iran. Burden of gastroesophageal reflux disease in Iran was estimated for one year from 21 March 2006 to 20 March 2007. The definition was adjusted with ICD-code of K21. Incident-based disability-adjusted life year (DALY) was used as the unit of analysis to quantify disease burden. A simplified disease model and DisMod II software were used for modeling. The annual incidence for total population of males and females in Iran was estimated 17.72 and 28.06 per 1000, respectively. The average duration of gastroesophageal reflux disease as a chronic condition was estimated around 10 years in both sexes. Total DALYs for an average of 59 symptomatic days per year was estimated 153,554.3 (60,330.8 for males and 93,223.5 for females).   The results of this study showed that reflux imposes high burden and high financial costs on the Iranian population. The burden of this disease in Iran is more similar to that of European countries rather than Asian countries. It is recommended to consider the disease as a public health problem and make decisions and public health plans to reduce the burden and financial costs of the disease in Iran.

Factors affecting caregiver burden of terminally ill adults in the home setting - A systematic review.

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He Leow, Mabel Qi; Wai Chi Chan, Sally

Background: Terminally ill people have complex physical and psychological needs. As a result, their caregivers may experience high levels of burden, and some caregivers are unable to cope with the burden. Thus, it is important to determine the various factors that may influence caregiver burden, so that healthcare professionals may implement strategies to reduce caregiver burden. In this review, "caregiver burden" was expanded to include "caregiver stress" and "caregiver strain", as the two terms were related to caregiver burden. The objective of this systematic review was to identify the factors that may influence caregiver burden of a terminally ill adult in the home setting. Types of participants: This review considered adult participants (above age 18) who were the main caregivers of a terminally ill adult in the home setting, and providing care for the terminally ill person at the point of participation in the study.Types of intervention: There was no specific intervention of interest for the study.Types of outcomes: The focus of study was the factors that affected caregiver burden of the terminally ill person.Types of studies: Quantitative studies such as randomised controlled trials (RCTs), controlled clinical trials (CCTs), interrupted time series (ITSs), controlled before after designs (CBAs), observational design (cohort, case-control), and descriptive surveys were included in the study. This review was limited to papers in English and Mandarin. A literature search from the inception of the database to October 2010 was conducted using major electronic databases. The databases used were CINAHL, MEDLINE, PsycINFO (Ovid), Scopus, SpringerLink, ScienceDirect, Web of Science, Mosby's Nursing Consult, Mednar: Deep web medical search, Proquest Dissertations and Theses and China Journal Net.Methodological quality: The quality of the potential studies was assessed by two independent reviewers using the critical appraisal checklists for descriptive/case studies

Equity implications of two burden-sharing rules for stabilizing greenhouse-gas concentrations

International Nuclear Information System (INIS)

Miketa, Asami; Schrattenholzer, Leo

2006-01-01

This paper focuses on the equity aspects of international burden sharing for global CO 2 emission stabilization. It first summarizes and classifies equity principles proposed in the published literature of the field. Of these, the authors selected three major equity principles, i.e., egalitarian equity, horizontal equity, and proportional equality (often referred to also as sovereign equity) to carry out a detailed examination of two sets of quantitative emission entitlements, which are based on two burden-sharing rules, i.e., the equal emissions per capita approach and the carbon intensity approach. The two burden-sharing rules were chosen as not only particularly popular, but also because their application results in distinctly different burden sharing among countries. To make the two rules comparable, we used a global carbon-emission path until the year 2050 that leads to an atmospheric CO 2 concentration of 550 ppm. We then used the two rules for allocating the global emissions described by that path to allocate carbon emission entitlements to 67 countries and 9 world regions. In general, developing countries receive relatively higher entitlements under the equal emissions per capita approach whereas industrialized countries are relatively better off under the carbon intensity approach. In some countries and regions, emission entitlements as calculated by any of the two burden-sharing rules are so low that it would be unrealistic to assume that actual emissions can be limited to the emission entitlements assigned to them without using flexibility mechanisms such as those defined in the Kyoto Protocol. In this sense, the calculated entitlements can be also interpreted as the initial allocation of tradable emission allowances of countries or regions. Nonetheless, we considered any numerical determination of resulting carbon trade flows to be outside the scope of our paper

Effects of rehabilitation services on anxiety, depression, care-giving burden and perceived social support of stroke caregivers.

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Karahan, Ali Yavuz; Kucuksen, Sami; Yilmaz, Halim; Salli, Ali; Gungor, Tayfun; Sahin, Muhammed

2014-01-01

Few data are available on the specific care giving-related problems of stroke patient's caregivers and factors that influence the burden of these caregivers. To study the influences of the active rehabilitation process on anxiety, depression, care burden and perceived social support level of stroke patients caregivers. A prospective clinical trial. Patients and caregivers entering a rehabilitation program at a university hospital in Turkey. Ninety patients with a first episode of stroke and 90 caregivers responsible for their care were recruited for our study. Patients and caregivers were assessed before and after the active rehabilitation process. The functional disability level of the patients was assessed by Functional Independence Measure (FIM). The Beck Anxiety Scale (BAS) and the Beck Depression Scale (BDS) were used for anxiety and depression assessment, the Zarit Care Burden Scale (ZCBS) for care burden assessment and the Multi-Dimensional Scale of Perceived Social Support (MDSPSS) for perceived social support assessment. A statistically significant rise is observed in the special person sub-assessment of MDSPSS in both female and male caregivers. Also, a significant decrease in care burden, anxiety and depression levels of caregivers was noted after the rehabilitation program (p social support in addition to the support provided by family and friends. Also, our positive results were associated with an improvement in the patients' functional level and an increase in the acquisition of knowledge and skill required of caregivers in order to provide care during rehabilitation. The rehabilitation team should be aware of the fact that the perceived care burden may be greater due to the lack of knowledge concerning available resources and due to the inability to cope with stress effectively.

Occupations, perceived stress, and stress-related disorders among women and men in the public sector in Sweden.

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Håkansson, Carita; Ahlborg, Gunnar

2017-01-01

Stress-related disorders are a public health problem and represent a significant burden to individuals and society. It is, therefore, of importance to regard stress in a wider context and identify risk factors not only at work but in all occupations in everyday life, to prevent ill health. The aim of this study was to examine potential associations between everyday occupations, perceived stress, and stress-related disorders as well as potential gender differences. A survey was mailed to a random selection of 3481 employees in the public sector in Western Sweden. Cox regressions with constant time at risk were used, in order to calculate prevalence ratios (PR) and their 95% confidence intervals (CI). The results showed a clear association between reporting imbalance between different everyday occupations and both perceived stress and stress-related disorders among men and women. Imbalance between different everyday occupations seems to be an important risk factor for perceived stress and stress-related disorder among both women and men. To enable people to achieve balance between different everyday occupations may be a useful way to prevent stress, stress-related disorders, and sick leave, and to promote better health and well-being.

[Disease burden of liver cancer in the Chinese population, in 1990 and 2013].

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Wang, L J; Yin, P; Liu, Y N; Liu, J M; Qi, J L; Zhou, M G

2016-06-01

To analyze the disease burden of liver cancer in the Chinese population in 1990 and 2013. Data from Global Burden of Diseases 2013 (GBD2013) was used to analyze the disease burden of liver cancer in China. The main outcome measurements would include mortality and disability-adjusted life years (DALY). Again, GBD global standard population in 2013 was used as the reference population to calculate the age-standardized rate. Related changes on percentage from 1990 to 2013 were calculated to analyze the changing patterns of disease burden for liver cancer in China. In 2013, a total of 358 100 people died of liver cancer, with the crude death rate as 25.85/100 000, in China. Number of deaths due to liver cancer secondary to hepatitis B was 163 600 (accounting for 45.69%). Number of deaths due to liver cancer secondary to hepatitis C was 134 200 (accounting for 37.48%) with DALY due to liver cancer appeared as 40.80 million person years. In 2013, the leading causes of DALY related to liver cancer was liver cancer secondary to hepatitis B, followed by liver cancer secondary to hepatitis C, liver cancer secondary to alcohol use, other liver cancers, with related DALYs as 4 652.0, 3 394.3, 964.3 and 592.1 thousands person years, respectively. The disease burdens of liver cancer secondary to various kinds of liver cancer were significantly higher in males than in females. Compared with 1990, the standardized mortality of liver cancer reduced by 25.00%, the DALY attributable to liver cancer increased by 16.95% and the standardized DALY rate attributable to liver cancer reduced by 33.47%. The burden of liver cancer secondary to hepatitis C became more serious and the standardized death rate increased by 106.18%, together with the standardized DALY rate increased by 91.68% in the past 23 years. Disease burden of liver cancer among young adults and the elderly were most serious. When comparing with the data in 1990, the standardized DALY rate showed declining trend in all the

Relationship Between Job Stress Among Nurses with Their General Health Status in Kamali Hospital in 1392

Directory of Open Access Journals (Sweden)

B. Mashak

2015-11-01

Full Text Available Background: In jobs where human contact is like nursing, more tension there. This destructive and multidimensional phenomenon can be increased absenteeism, reduced work efficiency and create energy and physical and mental illnesses lead to a decline in the quality of patient care. The purpose of this study was to investigate the relationship between stress and general health and help reduce the stress they are. Methods: This cross-sectional study on 78 public health nurses and Grft.prsshOsipow questionnaire included demographic information, job stress indicators (6 Stress workload involved, incompetence of duality role, scope, roles, responsibilities and physical environment and public health have been classified. Results: The findings show different aspects of occupational stress on 2/49% of the variation in the role and functions of stress, mild confusion, the burden of duties (45%, responsibility and physical environment (62%, stress higher. The aspects of public health, 48% of nurses in the physical symptoms (moderate and (63% of anxiety in the top 40 percent in the social dysfunction in Hdpayyn and 40% of the depression at the bottom were evaluated. Conclusion: The results of this study were determined and compared with previous studies in the same field  Create occupational stress can adversely affect the performance of nurses and public health they have.Implementing ways to reduce stress and burnout can promote mental health nurses to help improve the quality of nursing care.The results will help health systems to create a quiet working conditions largely reduce occupational stress.

Review: a conceptual model of perceived burden of informal caregivers for older persons with a severe functional psychiatric syndrome and concomitant problematic behaviour.

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Zegwaard, Marian I; Aartsen, Marja J; Cuijpers, Pim; Grypdonck, Mieke Hf

2011-08-01

This literature review aims to delineate the determinants of perceived burden by informal caregivers and provide insight into the interrelatedness between these determinants. Despite the attention given to the various determinants of perceived burden, their interrelatedness has not been unravelled. Insight into this interrelatedness is mandatory for the development of successful, complex, multivariate interventions to reduce perceived burden of informal caregivers. DESIGN; Systematic review. Four electronic databases, CINAHL, Embase psychiatry, Medline, Psychinfo and reference lists of selected articles, were searched. Publications between January 1985-2008 were included if they concerned mental illness, burden and care giving. Articles were selected according to predefined inclusion and exclusion criteria. The results of mostly descriptive, cross-sectional and univariate research and the more process-oriented results coming from qualitative burden research are organised in a process orientated conceptual scheme or model adapted from the stress-theoretical framework by Lazarus and Folkman. The model indicates that perceived burden must be understood through the individual appraisal of stressors and the availability and use of internal and external resources. Perceived burden is the outcome of multiple, clinically overlapping psychiatric problems, problematic behaviour and functional disabilities. So far, intervention programs to reduce perceived burden of informal caregivers have not devoted much attention to the interrelatedness of the origins of burden. The conceptual model provides an overview of the various determinants of perceived burden and a clear picture of the possible interrelatedness appears. This overview of the most important sources of burden helps to develop a complex, multivariate intervention that is comprehensive, long-term, individually tailored and has the flexibility to meet the dynamics of burden over time. Use of the conceptual model is

When does stress help or harm? The effects of stress controllability and subjective stress response on Stroop performance.

Directory of Open Access Journals (Sweden)

Roselinde Kaiser Henderson

2012-06-01

Full Text Available The ability to engage in goal-directed behavior despite exposure to stress is critical to resilience. Questions of how stress can impair or improve behavioral functioning are important in diverse settings, from athletic competitions to academic testing to clinical therapy. Previous research suggests that controllability is a key factor in the impact of stress on behavior: learning how to control stressors buffers people from the negative effects of stress on subsequent cognitively demanding tasks. In addition, research suggests that the impact of stress on cognitive functioning depends on an individual’s response to stressors: moderate responses to stress can lead to improved performance while extreme (high or low responses can lead to impaired performance. The present studies tested the hypothesis that 1 learning to behaviorally control stressors leads to improved performance on a test of general executive functioning, the color-word Stroop, and that 2 this improvement emerges specifically for people who report moderate (subjective responses to stress. Experiment 1: Stroop performance, measured before and after a stress manipulation, was compared across groups of undergraduate participants (n=109. People who learned to control a noise stressor and received accurate performance feedback demonstrated reduced Stroop interference compared with people exposed to uncontrollable noise stress and feedback indicating an exaggerated rate of failure. In the group who learned behavioral control, those who reported moderate levels of stress showed the greatest reduction in Stroop interference. In contrast, in the group exposed to uncontrollable events, self-reported stress failed to predict performance. Experiment 2: In a second sample (n=90, we specifically investigated the role of controllability by keeping the rate of failure feedback constant across groups. In the group who learned behavioral control, those who reported moderate levels of stress

Relationships among Communication Self-Efficacy, Communication Burden, and the Mental Health of the Families of Persons with Aphasia.

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Tatsumi, Hiroshi; Nakaaki, Shutaro; Satoh, Masayuki; Yamamoto, Masahiko; Chino, Naohito; Hadano, Kazuo

2016-01-01

The purpose of this study was to elucidate the relationships among communication self-efficacy (SE), communication burden, and the mental health of the families of persons with aphasia using structural equation modeling (SEM). This study examined 110 pairs of persons with aphasia receiving home care and 1 family caregiver per person with aphasia. The survey items for this study consisted of the Communication Self-efficacy Scale, the Communication Burden Scale, the Geriatric Depression Scale-Short Form-Japanese, and the Health-Related Quality of Life: SF-8 Health Survey. The relationships between the constructive concept of "communication self-efficacy" and "communication burden," and "mental-health status" were analyzed using SEM. The results of the SEM analysis revealed that a high communication SE of the families was associated with low burden of communication and good mental-health status. Psychoeducational programs that address the communication SE of family caregivers may have the potential to reduce the burden of communication and to improve the mental health of caregivers. These programs could lead to an enhanced quality of life for both persons with aphasia and their families. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Effect of Educational Program on the Burden of Family Caregivers of Hemodialysis Patients

Directory of Open Access Journals (Sweden)

Mansoureh Ashghali Farahani

2016-04-01

Full Text Available Background: Studies suggest that family caregivers of hemodialysis patients experience a high level of burden, which could lead to numerous physical and psychological problems. Despite the need for adequate training and support, these caregivers are mostly neglected, and few studies have been performed in this regard. Aim: to evaluate the effect of educational programs on the home care of hemodialysis patients and burden of their family caregivers. Method: This randomized controlled clinical trial was conducted on 76 caregivers of hemodialysis patients referred to Shahid Hasheminejad Hemodialysis Center of Tehran, Iran in 2015.­ Subjects were divided into two groups of intervention and control (n=38. The intervention group received four training sessions on the home care of hemodialysis patients for two weeks, and the control group received routine care. Data were collected using the Caregiver Burden Inventory (CBI at the beginning and six weeks after the intervention­. Data analysis was performed in SPSS V.21 using Chi-square, Fisher’s exact test, independent and paired T-test, and Mann-Whitney U test. Results: In this study, no significant difference was observed between the two groups in terms of demographic characteristics. At the baseline, mean score of caregiver burden in the intervention and control groups was 88.5±11.7 and 84.9±15.1, respectively, and no significant difference was observed between the groups in this regard (P=0.30. Six weeks after the intervention, the results of independent T-test revealed a significant difference between the mean scores of caregiver burden in the intervention (58.7±6.6 and control groups (87.8±11.7 ­(P

The Economic Burden Attributable to a Child’s Inpatient Admission for Diarrheal Disease in Rwanda

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Ngabo, Fidele; Mvundura, Mercy; Gazley, Lauren; Gatera, Maurice; Rugambwa, Celse; Kayonga, Eugene; Tuyishime, Yvette; Niyibaho, Jeanne; Mwenda, Jason M.; Donnen, Philippe; Lepage, Philippe; Binagwaho, Agnes; Atherly, Deborah

2016-01-01

Background Diarrhea is one of the leading causes of childhood morbidity and mortality. Hospitalization for diarrhea can pose a significant burden to health systems and households. The objective of this study was to estimate the economic burden attributable to hospitalization for diarrhea among children less than five years old in Rwanda. These data can be used by decision-makers to assess the impact of interventions that reduce diarrhea morbidity, including rotavirus vaccine introduction. Methods This was a prospective costing study where medical records and hospital bills for children admitted with diarrhea at three hospitals were collected to estimate resource use and costs. Hospital length of stay was calculated from medical records. Costs incurred during the hospitalization were abstracted from the hospital bills. Interviews with the child’s caregivers provided data to estimate household costs which included transport costs and lost income. The portion of medical costs borne by insurance and household were reported separately. Annual economic burden before and after rotavirus vaccine introduction was estimated by multiplying the reported number of diarrhea hospitalizations in public health centers and district hospitals by the estimated economic burden per hospitalization. All costs are presented in 2014 US$. Results Costs for 203 children were analyzed. Approximately 93% of the children had health insurance coverage. Average hospital length of stay was 5.3 ± 3.9 days. Average medical costs for each child for the illness resulting in a hospitalization were $44.22 ± $23.74 and the total economic burden was $101, of which 65% was borne by the household. For households in the lowest income quintile, the household costs were 110% of their monthly income. The annual economic burden to Rwanda attributable to diarrhea hospitalizations ranged from $1.3 million to $1.7 million before rotavirus vaccine introduction. Conclusion Households often bear the largest share

The cost of environmental lead (Pb) poisoning in Nigeria ...

African Journals Online (AJOL)

To estimate the costs of Pb poisoning attributable to petrochemicals in Nigeria, we conducted a meta-analysis of measured blood lead levels (BLL) and we used published Relative Risk values for disease categories to estimate the proportion of overall disease burden attributable to Pb. We modeled the health costs of Pb ...

Chronic disease burden predicts food insecurity among older adults.

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Jih, Jane; Stijacic-Cenzer, Irena; Seligman, Hilary K; Boscardin, W John; Nguyen, Tung T; Ritchie, Christine S

2018-06-01

Increased out-of-pocket health-care expenditures may exert budget pressure on low-income households that leads to food insecurity. The objective of the present study was to examine whether older adults with higher chronic disease burden are at increased risk of food insecurity. Secondary analysis of the 2013 Health and Retirement Study (HRS) Health Care and Nutrition Study (HCNS) linked to the 2012 nationally representative HRS. USA. Respondents of the 2013 HRS HCNS with household incomes insecurity was 27·8 %. Compared with those having 0-1 conditions, respondents with MCC were significantly more likely to report food insecurity, with the adjusted odds ratio for those with 2-4 conditions being 2·12 (95 % CI 1·45, 3·09) and for those with ≥5 conditions being 3·64 (95 % CI 2·47, 5·37). A heavy chronic disease burden likely exerts substantial pressure on the household budgets of older adults, creating an increased risk for food insecurity. Given the high prevalence of food insecurity among older adults, screening those with MCC for food insecurity in the clinical setting may be warranted in order to refer to community food resources.

Metal accumulation in marine bivalves under various tributyltin burdens.

Science.gov (United States)

Tang, Chuan-Ho; Lin, Chan-Shing; Wang, Wei-Hsien

2009-11-01

In the present study, a field survey was conducted to measure the accumulation of butyltin, Cu, Zn, and Cd in green mussels (Perna viridis) and Pacific oysters (Crassostrea gigas) at the regions along a tributyltin pollution gradient. A negative correlation was found between the tributyltin/total butyltin ratio (0.87-0.31) and tributyltin content (114-5,817 ng/g as tin dry wt) in oysters, while the Cu content (44.2-381 mg/kg dry wt) was positively correlated with the logarithm of tributyltin content during the summer and winter. This suggests that as the tributyltin burden increases, the rates of tributyltin metabolism may be elevated, leading to enhanced Cu accumulation. A similar accumulation pattern for Zn was also found in oysters. In mussels, however, the tributyltin/total butyltin ratio and the Cu and Zn contents remained relatively constant (~ 0.7, 12, and 100 mg/kg dry wt, respectively) regardless of the tributyltin burden. Clearly, the butyltin and Cu/Zn accumulation processes in oysters differ from those in mussels under tributyltin pollution. These observations provide valuable information for those who evaluate or compare tributyltin and/or Cu/Zn pollution using oysters and mussels as bioindicators.

Lead poisoning in dogs

Energy Technology Data Exchange (ETDEWEB)

Wilson, M R; Lewis, G

1963-08-03

Within a short period, 14 cases of lead poisoning in the dogs have been encountered. A detailed record appears justified as no published reference can be found to this condition occurring in Britain and because reports from other countries stress the similarity of the clinical manifestations of lead poisoning to those of the common infections of the dog. Five of the 14 clinical cases of lead poisoning are described. The available literature is reviewed and the diagnosis and significance of the condition discussed. 19 references, 2 tables.

[Disease burden on drowning in the Chinese population, in 1990 and 2013].

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Deng, X; Jin, Y; Ye, P P; Wang, L H; Duan, L L

2017-10-10

Objective: To comprehensively analyze the disease burden of drowning in the Chinese population both at the national and provincial levels in 1990 and 2013, to provide reference for the development of strategies regarding drowning prevention. Methods: Both methods related to unified measurement framework and standardized estimation on Global Burden of Disease in 2013, were used. Data on deaths caused by injuries were from the following sources which include: Disease Surveillance Points, the National Maternal and Child Health Surveillance Network, the Death Registration Reporting System of Chinese Center for Disease Control and Prevention, Death Registration System and death information from Macau and Hong Kong areas of China. Injury-related incidence data was from the National Injury Surveillance System and literature review. Parameters as death/death rate, years of life lost due to premature mortality (YLL)/standardized YLL rate, years living with disability (YLD)/standardized YLD rate and disability-adjusted of life years (DALY)/standardized DALY were used to analyze the disease burden and changing trend on drowning at both the national and all the provincial levels. Results: In 2013, the number of deaths due to drowning was63 619 in China, with the standardized mortality rate as 5.29 per 100 000, accounting for 8.0 % of the total injury deaths. Drowning was the fourth leading cause of injury death in the whole population and the first leading cause of injury death among children aged standardized mortality, standardized YLL, standardized YLD and standardized DALY of drowning all declined in 2013. The five provinces/districts/cities with the highest rates of drowning were Xinjiang (10.08 per 100 000), Jiangxi (8.44 per 100 000), Anhui (7.92 per 100 000), Guizhou (7.77 per 100 000) and Sichuan (7.68 per 100 000). Standardized mortality of drowning reduced in all provinces in 2013. Conclusions: Disease burden of drowning in the Chinese population, especially in

Induction of stress responses by polluting agents which dis-regulate cellular homeostasis

International Nuclear Information System (INIS)

Mothersill, Carmel

2001-01-01

There is growing concern both in the scientific community and among the general public about the effects of exposure to low levels of radiation and environmental chemicals. The increased incidence of cancer, reproduction disorders and allergies have been associated with ambient environmental exposure to these pollutants. The pollution burden is generally made up of a mixture of agents, occurring at concentrations of the individual compounds which are not considered harmful and which are below the action level. Individual pollutants can act through a variety of primary toxicity mechanisms. However the resulting secondary and tertiary toxicity mechanisms which affect cellular homeostasis might be more common. These resulting stress responses, including oxidative stress, have been associated with effects that include increased level of death during cell division, increased levels of mutation and increased tolerance of mutations in cell populations, increased levels of cytogenetic abnormalities and many other symptoms. These effects are linked to a persistent increase in (oxidative) stress and are particularly evident in the haematopoietic system (possibly due to the high rate self of renewal in that system). Therefore prolonged exposure to mixtures of chemicals and radiation might result in additive and synergistic stress responses which can induce long-term delayed effects, often in progeny or in cells not directly exposed to the agent/s. The existence of a common (oxidative) stress mechanism means that the effects of individual pollutants may not be considered in isolation. Rather the total pollution burden may need to be measured using a response rather than a dose based scoring or ranking system. Improved understanding of toxicity mechanisms and effects underpins improved risk assessment and identification of biomarkers. The immune system plays a pivotal role in maintaining health status, and disruption of immune functions can lead to increased susceptibility to

Burden of Proof in Bioethics.

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Koplin, Julian J; Selgelid, Michael J

2015-11-01

A common strategy in bioethics is to posit a prima facie case in favour of one policy, and to then claim that the burden of proof (that this policy should be rejected) falls on those with opposing views. If the burden of proof is not met, it is claimed, then the policy in question should be accepted. This article illustrates, and critically evaluates, examples of this strategy in debates about the sale of organs by living donors, human enhancement, and the precautionary principle. We highlight general problems with this style of argument, and particular problems with its use in specific cases. We conclude that the burden ultimately falls on decision-makers (i.e. policy-makers) to choose the policy supported by the best reasons. © 2015 John Wiley & Sons Ltd.

Identification of the sources of metal (lead) contamination in drinking waters in north-eastern Tasmania using lead isotopic compositions.

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Harvey, P J; Handley, H K; Taylor, M P

2015-08-01

This study utilises a range of scientific approaches, including lead isotopic compositions, to differentiate unknown sources of ongoing lead contamination of a drinking water supply in north-eastern Tasmania, Australia. Drinking water lead concentrations are elevated above the Australian Drinking Water Guideline (10 μg/L), reaching 540 μg/L in the supply network. Water lead isotopic compositions from the town of Pioneer ((208)Pb/(207)Pb 2.406, (206)Pb/(207)Pb 1.144 to (208)Pb/(207)Pb 2.360, (206)Pb/(207)Pb 1.094) and Ringarooma ((208)Pb/(207)Pb 2.398, (206)Pb/(207)Pb 1.117) are markedly different from the local bedrock ((208)Pb/(207)Pb 2.496, (206)Pb/(207)Pb 1.237). The data show that the lead in the local waters is sourced from a combination of dilapidated drinking water infrastructure, including lead jointed pipelines, end-of-life polyvinyl chloride pipes and household plumbing. Drinking water is being inadvertently contaminated by aging infrastructure, and it is an issue that warrants investigation to limit the burden of disease from lead exposure.

Digital poly-victimization: The increasing importance of online crime and harassment to the burden of victimization.

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Hamby, Sherry; Blount, Zach; Smith, Alli; Jones, Lisa; Mitchell, Kimberly; Taylor, Elizabeth

2018-01-01

Many forms of victimization, including bullying and property crime, are increasingly moving online, but most studies of poly-victimization still primarily focus on in-person crime and violence. Few studies have examined the importance of incorporating technology-based victimizations for assessing the true burden of violence. The purpose of this study is to explore whether digital poly-victimization contributes to post-traumatic stress and anxiety/dysphoria symptoms after controlling for in-person poly-victimization. Given that technology use and technology-based victimization are changing rapidly, a mixed methods approach was adopted. In the first two phases, focus groups and cognitive interviews (89 total participants) were used to identify the range of digital victimization and develop the Digital Poly-Victimization Scale. In the third phase, the new measure was included in a community survey (n = 478, 57.5% female; 62.6% earning under $50,000 per year) in a rural Southern region, along with measures of in-person poly-victimization, posttraumatic stress and anxiety/dysphoria symptoms, and other outcomes and personal characteristics. A comprehensive measure of digital poly-victimization indicated that almost 3 in 4 participants (72.3%) had experienced at least one form of digital victimization. The results indicated that digital poly-victimization contributed unique variance to post-traumatic stress and anxiety/dysphoria symptoms (p Digital victimization often presents fewer risks to perpetrators and can be expected to represent an increasing share of the societal burden of violence. Future research on poly-victimization should pay more attention to the role of digital victimization.

[Osteoporosis and stress].

Science.gov (United States)

Kumano, Hiroaki

2005-09-01

There may be three ways of relationship between stress and osteoporosis. The first is that stress induces some physiological changes leading to osteoporosis. The second is that stress induces behavioral distortion of eating, drinking, exercise, and sleep habits, which leads to osteoporosis. The third is that osteoporosis, on the other hand, brings about anxiety, depression, loss of social roles, and social isolation, which leads to stress. The susceptible sex and age groups are postmenopausal women and young women. The abrupt decrease of estrogen in postmenopausal women promotes reabsorption of bone, and it was also reported that the increase of interleukin-6 (IL-6) that is downstream of estrogen was related to the production of osteoclast and to the development of disability of the aged. Regarding the association with stress, while it was reported that depression or depressive states directly increased inflammation-induced cytokines including IL-6, it was also pointed out that stress-induced easy infectious may produce chronic infection, which indirectly increases inflammation-induced cytokines. Anorexia Nervosa that is assumed to be associated with adolescent developmental stress is noteworthy in young women. Amenorrhea is always present in this disease, and in addition to bone reabsorption associated with estrogen deficiency, the decrease of bone formation associated with malnutrition may be related to the development of osteoporosis.

Nations within a nation: variations in epidemiological transition across the states of India, 1990-2016 in the Global Burden of Disease Study.

Science.gov (United States)

2017-12-02

18% of the world's population lives in India, and many states of India have populations similar to those of large countries. Action to effectively improve population health in India requires availability of reliable and comprehensive state-level estimates of disease burden and risk factors over time. Such comprehensive estimates have not been available so far for all major diseases and risk factors. Thus, we aimed to estimate the disease burden and risk factors in every state of India as part of the Global Burden of Disease (GBD) Study 2016. Using all available data sources, the India State-Level Disease Burden Initiative estimated burden (metrics were deaths, disability-adjusted life-years [DALYs], prevalence, incidence, and life expectancy) from 333 disease conditions and injuries and 84 risk factors for each state of India from 1990 to 2016 as part of GBD 2016. We divided the states of India into four epidemiological transition level (ETL) groups on the basis of the ratio of DALYs from communicable, maternal, neonatal, and nutritional diseases (CMNNDs) to those from non-communicable diseases (NCDs) and injuries combined in 2016. We assessed variations in the burden of diseases and risk factors between ETL state groups and between states to inform a more specific health-system response in the states and for India as a whole. DALYs due to NCDs and injuries exceeded those due to CMNNDs in 2003 for India, but this transition had a range of 24 years for the four ETL state groups. The age-standardised DALY rate dropped by 36·2% in India from 1990 to 2016. The numbers of DALYs and DALY rates dropped substantially for most CMNNDs between 1990 and 2016 across all ETL groups, but rates of reduction for CMNNDs were slowest in the low ETL state group. By contrast, numbers of DALYs increased substantially for NCDs in all ETL state groups, and increased significantly for injuries in all ETL state groups except the highest. The all-age prevalence of most leading NCDs

Mental Health Nurse's Exposure to Workplace Violence Leads to Job Stress, Which Leads to Reduced Professional Quality of Life.

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Itzhaki, Michal; Bluvstein, Irit; Peles Bortz, Anat; Kostistky, Hava; Bar Noy, Dor; Filshtinsky, Vivian; Theilla, Miriam

2018-01-01

Professional quality of life (ProQOL) reflects how individuals feel about their work as helpers. Psychiatric ward nurses cope with significant psychological and physical challenges, including exposure to verbal and physical violence. This study was based on two aspects of ProQOL, the positive compassion satisfaction, and the negative compassion fatigue, with the aim of investigating the relation of ProQOL to job stress and violence exposure at a large mental health center. Data were collected from 114 mental health nurses (49/63 M/F) who completed a self-administered questionnaire examining violence exposure, ProQOL, and job stress. The results showed that during the last year, almost all nurses (88.6%) experienced verbal violence, and more than half (56.1%) experienced physical violence. Only 2.6% experienced no violence. ProQOL was not associated with violence exposure but was reduced by work stress and by previous exposure to violence; nurses who perceived their work as more stressful had lower satisfaction from their work. In conclusion, although most mental health nurses are exposed to physical and verbal violence, their ProQOL is more related to job stress than to workplace violence (WPV). Hospital managements should conduct work stress reduction intervention programs and promote strategizes to reduce WPV. Further exploration of (a) factors affecting ProQOL and (b) the effect of violence coping workshops on ProQOL is warranted.

Diet, Lifestyle and Chronic disease burden

NARCIS (Netherlands)

Struijk, E.A.

2014-01-01

Background Diet, Body Mass Index (BMI), physical activity and smoking are among the most important lifestyle factors that influence global disease burden. In this thesis we investigate the relations of these factors with total disease burden in a large Dutch population, the EPIC-NL cohort. In this

Effects of yoga on cancer-related fatigue and global side-effect burden in older cancer survivors.

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Sprod, Lisa K; Fernandez, Isabel D; Janelsins, Michelle C; Peppone, Luke J; Atkins, James N; Giguere, Jeffrey; Block, Robert; Mustian, Karen M

2015-01-01

Sixty percent of cancer survivors are 65years of age or older. Cancer and its treatments lead to cancer-related fatigue and many other side effects, in turn, creating substantial global side-effect burden (total burden from all side effects) which, ultimately, compromises functional independence and quality of life. Various modes of exercise, such as yoga, reduce cancer-related fatigue and global side-effect burden in younger cancer survivors, but no studies have specifically examined the effects of yoga on older cancer survivors. The purpose of this study was to assess the effects of a 4-week yoga intervention (Yoga for Cancer Survivors: YOCAS©®) on overall cancer-related fatigue, and due to its multidimensional nature, the subdomains of cancer-related fatigue (general, physical, emotional, and mental) and global side-effect burden in older cancer survivors. We conducted a secondary analysis on data from a multicenter phase III randomized controlled clinical trial with 2 arms (standard care and standard care plus a 4-week YOCAS©® intervention). The sample for this secondary analysis was 97 older cancer survivors (≥60years of age), between 2months and 2years post-treatment, who participated in the original trial. Participants in the YOCAS©® intervention arm reported significantly lower cancer-related fatigue, physical fatigue, mental fatigue, and global side-effect burden than participants in the standard care arm following the 4-week intervention period (peffective standardized yoga intervention for reducing cancer-related fatigue, physical fatigue, mental fatigue, and global side-effect burden among older cancer survivors. Copyright © 2014 Elsevier Inc. All rights reserved.

CAREGIVER BURDEN AMONG PEOPLE CARING FOR PATIENTS WITH SCHIZOPHRENIA

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Shivani Bansal

2017-04-01

Full Text Available BACKGROUND Caregivers of patients suffering from mental illness report burden in different areas including effects on family functioning, psychological problems, financial problems and health. The aim of the study is to determine the sociodemographic profile and caregiver burden among caregivers of persons with schizophrenia and to study the effect of patients’ psychopathology on caregiver burden scale. MATERIALS AND METHODS The present study was conducted in the Psychiatry Department, Government Medical College, Amritsar. A sample size of 34 was taken who were primary caregivers (preferably parents or spouse of schizophrenia patients diagnosed using ICD10. Measures included caregiver’s demographic variables and caregiver’s burden using the Zarit burden interview and PANSS scale in patients. Statistical Analysis- Data was analysed using SPSS software version 21. RESULTS The mean age of the caregiver was 42 SD (12.16 years. The majority of the caregivers were parents, married and employed. The mean average score of the responses to Zarit burden interview was (SD=59.52 ± 20.92. Majority of the caregivers experienced severe burden (52.9%, 9 (26.4% caregivers had reported moderate burden and 6 (17.6% had reported mild burden. The mean duration of illness was 6.89 (SD=5.03 years. The level of burden experienced was significantly associated with total PANSS score, negative symptoms, positive symptoms, general psychopathology score and duration of schizophrenia illness (p=0.00. CONCLUSION There is need for psychological assistance and social support for the vulnerable caregivers to help them reduce the burden levels and employ positive coping strategies.

Economic burden of disease-associated malnutrition in China.

Science.gov (United States)

Linthicum, Mark T; Thornton Snider, Julia; Vaithianathan, Rhema; Wu, Yanyu; LaVallee, Chris; Lakdawalla, Darius N; Benner, Jennifer E; Philipson, Tomas J

2015-05-01

Disease-associated malnutrition (DAM) is a well-recognized problem in many countries, but the extent of its burden on the Chinese population is unclear. This article reports the results of a burden-of-illness study on DAM in 15 diseases in China. Using data from the World Health Organization (WHO), the China Health and Nutrition Survey, and the published literature, mortality and disability-adjusted life years (DALYs) lost because of DAM were calculated; a financial value of this burden was calculated following WHO guidelines. DALYs lost annually to DAM in China varied across diseases, from a low of 2248 in malaria to a high of 1 315 276 in chronic obstructive pulmonary disease. The total burden was 6.1 million DALYs, for an economic burden of US$66 billion (Chinese ¥ 447 billion) annually. This burden is sufficiently large to warrant immediate attention from public health officials and medical providers, especially given that low-cost and effective interventions are available. © 2014 APJPH.

Association of impairments of older persons with caregiver burden among family caregivers: Findings from rural South India.

Science.gov (United States)

Ajay, Shweta; Kasthuri, Arvind; Kiran, Pretesh; Malhotra, Rahul

In India, owing to cultural norms and a lack of formal long-term care facilities, responsibility for care of the older person falls primarily on the family. Based on the stress process model, we assessed the association of type and number of impairments of older persons (∼primary stressors) with caregiver burden among their family caregivers in rural South India. All impaired older persons (aged ≥60, with impairment in activities of daily living (ADL) or cognition or vision or hearing) residing in 8 villages in Bangalore district, Karnataka, India, and their primary informal caregivers were interviewed. Caregiver burden was measured using the Zarit Burden Interview (ZBI; higher score indicating greater perceived burden). Linear regression models, adjusting for background characteristics of older persons and caregivers, assessed the association of type of impairment (physical [Yes/No], cognitive [Yes/No], vision [Yes/No] and hearing [Yes/No]) and number (1 or 2 or 3 or 4) of older person impairments with caregiver burden. A total of 140 caregivers, caring for 149 older persons, were interviewed. The mean (standard deviation) ZBI score was 21.2 (12.9). Of the various older person impairments, ZBI score was associated only with physical impairment (β=6.6; 95% CI: 2.1-11.1). Relative to caregivers of older person with one impairment, those caring for an older person with all 4 impairments had significantly higher ZBI score (β=13.9; CI: 2.5-25.4). Caregivers of older persons with multiple impairments, especially physical impairment, are vulnerable. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

When does stress help or harm? The effects of stress controllability and subjective stress response on stroop performance.

Science.gov (United States)

Henderson, Roselinde K; Snyder, Hannah R; Gupta, Tina; Banich, Marie T

2012-01-01

The ability to engage in goal-directed behavior despite exposure to stress is critical to resilience. Questions of how stress can impair or improve behavioral functioning are important in diverse settings, from athletic competitions to academic testing. Previous research suggests that controllability is a key factor in the impact of stress on behavior: learning how to control stressors buffers people from the negative effects of stress on subsequent cognitively demanding tasks. In addition, research suggests that the impact of stress on cognitive functioning depends on an individual's response to stressors: moderate responses to stress can lead to improved performance while extreme (high or low) responses can lead to impaired performance. The present studies tested the hypothesis that (1) learning to behaviorally control stressors leads to improved performance on a test of general executive functioning, the color-word Stroop, and that (2) this improvement emerges specifically for people who report moderate (subjective) responses to stress. Experiment 1: Stroop performance, measured before and after a stress manipulation, was compared across groups of undergraduate participants (n = 109). People who learned to control a noise stressor and received accurate performance feedback demonstrated reduced Stroop interference compared with people exposed to uncontrollable noise stress and feedback indicating an exaggerated rate of failure. In the group who learned behavioral control, those who reported moderate levels of stress showed the greatest reduction in Stroop interference. In contrast, in the group exposed to uncontrollable events, self-reported stress failed to predict performance. Experiment 2: In a second sample (n = 90), we specifically investigated the role of controllability by keeping the rate of failure feedback constant across groups. In the group who learned behavioral control, those who reported moderate levels of stress showed the greatest Stroop

Burden of Rabies

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... this? Submit Button Past Emails The Burden of Rabies Recommend on Facebook Tweet Share Compartir Learn how ... bitten by an animal that has the disease. Rabies in the U.S. Rabies continues to be a ...

Financial Burden Borne by Laparoscopic Living Kidney Donors.

Science.gov (United States)

Wiseman, Jennifer F; Jacobs, Cheryl L; Larson, Dawn B; Berglund, Danielle M; Garvey, Catherine A; Ibrahim, Hassan N; Matas, Arthur J

2017-09-01

Living kidney donors have donation-related out-of-pocket costs (direct costs) and/or ongoing daily expenses while losing income (indirect costs). Yet there is little information about how much of a subjective burden these constitute for the donors. From December 2003 through December 2014, we surveyed donors 6 months postdonation to determine their financial burden related to donation (on a scale of 1 to 10) and what resources were used to cover expenses. Of 1136 surveyed, 796 (70%) responded. Among respondents, mean age at donation was 43.6 ± 10.6 years, 64% were women, 96% were white, and 53% were related by blood to their recipient. Overall, 26% scored their financial burden as 5 or higher; 8% scored it as 8 or higher. Increased expenses were associated with a higher reported burden; however, significant burden was reported by some with no out-of-pocket expenses (presumably due to lost wages and continuing expenses). The burden was scored as 5 or higher by 27% of those employed outside the home (n = 660), 15% homemakers, 13% retirees, 40% students; 28% unemployed; and 26% whose occupation was unknown. Over half (51%) of those receiving a local or (means-tested) national grant still reported moderate to severe burden. Besides grants, donors used a variety of sources to help offset expenses: dipped into savings, borrowed from friends or family, took out a loan, and/or had a fundraiser. Those with the highest burden reported using the most additional sources. Donors should not have to incur costs or a financial burden to donate; the transplant community should strive to make donation financially neutral.

EFFECTS OF REHABILITATION SERVICES ON ANXIETY, DEPRESSION, CARE-GIVING BURDEN AND PERCEIVED SOCIAL SUPPORT OF STROKE CAREGIVERS

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Ali Yavuz Karahan

2014-01-01

Full Text Available Background: Few data are available on the specific care giving-related problems of stroke patient’s caregivers and factors that influence the burden of these caregivers. Aim: To study the influences of the active rehabilitation process on anxiety, depression, care burden and perceived social support level of stroke patients caregivers. Design: A prospective clinical trial. Setting: Patients and caregivers entering a rehabilitation program at a university hospital in Turkey. Populations: Ninety patients with a first episode of stroke and 90 caregivers responsible for their care were recruited for our study. Methods: Patients and caregivers were assessed before and after the active rehabilitation process. The functional disability level of the patients was assessed by Functional Independence Measure (FIM. The Beck Anxiety Scale (BAS and the Beck Depression Scale (BDS were used for anxiety and depression assessment, the Zarit Care Burden Scale (ZCBS for care burden assessment and the Multi-Dimensional Scale of Perceived Social Support (MDSPSS for perceived social support assessment. Results: A statistically significant rise is observed in the special person sub-assessment of MDSPSS in both female and male caregivers. Also, a significant decrease in care burden, anxiety and depression levels of caregivers was noted after the rehabilitation program (p < 0.05. Conclusion: Caregivers accept the rehabilitation period as important social support in addition to the support provided by family and friends. Also, our positive results were associated with an improvement in the patients’ functional level and an increase in the acquisition of knowledge and skill required of caregivers in order to provide care during rehabilitation. Clinical Rehabilitation Impact: The rehabilitation team should be aware of the fact that the perceived care burden may be greater due to the lack of knowledge concerning available resources and due to the inability to cope with

Insight into the oxidative stress induced by lead and/or cadmium in blood, liver and kidneys.

Science.gov (United States)

Matović, Vesna; Buha, Aleksandra; Ðukić-Ćosić, Danijela; Bulat, Zorica

2015-04-01

Besides being important occupational hazards, lead and cadmium are nowadays metals of great environmental concern. Both metals, without any physiological functions, can induce serious adverse health effects in various organs and tissues. Although Pb and Cd are non-redox metals, one of the important mechanisms underlying their toxicity is oxidative stress induction as a result of the generation of reactive species and/or depletion of the antioxidant defense system. Considering that the co-exposure to both metals is a much more realistic scenario, the effects of these metals on oxidative status when simultaneously present in the organism have become one of the contemporary issues in toxicology. This paper reviews short and long term studies conducted on Pb or Cd-induced oxidative stress in blood, liver and kidneys as the most prominent target organs of the toxicity of these metals and proposes the possible molecular mechanisms of the observed effects. The review is also focused on the results obtained for the effects of the combined treatment with Pb and Cd on oxidative status in target organs and on the mechanisms of their possible interactions. Copyright © 2015 Elsevier Ltd. All rights reserved.

Psychosocial burden differences between women of reproductive age and menopausal age due to abnormal Pap smear: A pilot study of the East Coast of Malaysia

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Shabbir Ahmad Sheikh

2016-01-01

Conclusion: Psychosocial burden due to abnormal Pap smear results in terms of mental stress, overwhelming beliefs, and feelings of guilt and worry of HPV infection and possibility of cervical cancer were noted more in reproductive age groups as compared to the menopausal age group. Health-care providers should be aware of these psychosocial effects whereby they can refer such patients to a gynecologic oncologist for proper counseling at the proper time so that the negative impact due to this psychosocial burden can be prevented.

The global burden of paediatric heart disease

DEFF Research Database (Denmark)

Musa, Ndidiamaka L; Hjortdal, Vibeke; Zheleva, Bistra

2017-01-01

An estimated 15 million children die or are crippled annually by treatable or preventable heart disease in low- and middle-income countries. Global efforts to reduce under-5 mortality have focused on reducing death from communicable diseases in low- and middle-income countries with little...... to no attention focusing on paediatric CHD and acquired heart disease. Lack of awareness of CHD and acquired heart disease, access to care, poor healthcare infrastructure, competing health priorities, and a critical shortage of specialists are important reasons why paediatric heart disease has not been addressed...... in low resourced settings. Non-governmental organisations have taken the lead to address these challenges. This review describes the global burden of paediatric heart disease and strategies to improve the quality of care for paediatric heart disease. These strategies would improve outcomes for children...

Medication burden in CKD-5D: impact of dialysis modality and setting

OpenAIRE

Parker, Kathrine; Nikam, Milind; Jayanti, Anuradha; Mitra, Sandip

2014-01-01

Background Medication adherence is thought to be around 50% in the general and dialysis population. Reducing the pill burden (PB) reduces regime complexity and can improve adherence. Increased adherence should lead to improvement in treatment outcomes and patient quality of life. There is currently little published data on PB in CKD-5D across dialysis modalities. Methods This is a retrospective, single renal network study. All in-centre HD (MHD), peritoneal dialysis (PD) and home HD (HHD) pat...

Beyond Attributable Burden: Estimating the Avoidable Burden of Disease Associated with Household Air Pollution.

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Randall Kuhn

Full Text Available The Global Burden of Disease (GBD studies have transformed global understanding of health risks by producing comprehensive estimates of attributable disease burden, or the current disease that would be eliminated if a risk factor did not exist. Yet many have noted the greater policy significance of avoidable burden, or the future disease that could actually be eliminated if a risk factor were eliminated today. Avoidable risk may be considerably lower than attributable risk if baseline levels of exposure or disease are declining, or if a risk factor carries lagged effects on disease. As global efforts to deliver clean cookstoves accelerate, a temporal estimation of avoidable risk due to household air pollution (HAP becomes increasingly important, particularly in light of the rapid uptake of modern stoves and ongoing epidemiologic transitions in regions like South and Southeast Asia.We estimate the avoidable burden associated with HAP using International Futures (IFs, an integrated forecasting system that has been used to model future global disease burdens and risk factors. Building on GBD and other estimates, we integrated a detailed HAP exposure estimation and exposure-response model into IFs. We then conducted a counterfactual experiment in which HAP exposure is reduced to theoretical minimum levels in 2015. We evaluated avoidable mortality and DALY reductions for the years 2015 to 2024 relative to a Base Case scenario in which only endogenous changes occurred. We present results by cause and region, looking at impacts on acute lower respiratory infection (ALRI and four noncommunicable diseases (NCDs. We found that just 2.6% of global DALYs would be averted between 2015 and 2024, compared to 4.5% of global DALYs attributed to HAP in the 2010 GBD study, due in large part to the endogenous tendency towards declining traditional stove usage in the IFs base case forecast. The extent of diminished impact was comparable for ALRI and affected NCDs

Behavior of active deposit of lead (Teisinger) in the Japanese free from occupational exposure to lead

Energy Technology Data Exchange (ETDEWEB)

Araki, S

1973-12-01

Intravenous infusion of calcium disodium ethylenediamine tetraacetate (CaEDTA) was given to 45 Japanese adults without occupational exposure to lead for 1 hr at a dosage of 20 mg/kg body weight in 250 ml of 5 percent glucose solution. The urinary excretion of lead was estimated for 24 hr before, and for 2 hr and 24 hr after the administration. The least variation of the lead content was recognized in the 24-hour urinary excretion after the injection of CaEDTA. No sexual difference was noted in the creatinine-corrected lead concentration. By multiple linear regression and correlation analyses, age was found to be significant in determining positively the lead level mobilized in 24-hour urine samples. Height was significant in determining positively the spontaneous 24-hour urinary lead excretion. Certain significant correlations existed among lead in blood, delta-aminolevulinic acid dehydratase in erythrocytes, delta-aminolevulinic acid in urine, coproporphyrin in urine, lead in urine, and lead mobilized by CaEDTA. The existence of active body burden of lead was suggested in human subjects under usual urban conditions where the total ambient lead concentration averaged 1.7 micrograms/cm m of air. Based on a few assumptions, it was calculated that about 3 micrograms of lead was retained on the average per day by a Japanese adult. Daily retention of lead by Japanese adults was formularized as lead in micrograms equals a constant (K) times daily creatinine excretion in grams, where K is 1.77 in men and 2.73 in women. (Air Pollut. Abstr.)

Stress following extinction learning leads to a context-dependent return of fear.

Science.gov (United States)

Hamacher-Dang, Tanja C; Merz, Christian J; Wolf, Oliver T

2015-04-01

It has been suggested that extinction-based therapy benefits from administration of the stress hormone cortisol. However, it is unclear whether similar effects can be obtained by inducing stress instead of administering cortisol, and whether the effects also persist if memory is tested in a different context (renewal test) or after exposure to an aversive stimulus (reinstatement). The present study therefore applied a fear conditioning (context A, day 1) and extinction (context B, day 2) paradigm in healthy men. After fear extinction, participants were exposed to a stress or control procedure (n = 20 each). Fear retrieval was tested in contexts A and B on day 3. Postextinction stress increased skin conductance responses to the extinguished stimulus in the retrieval and reinstatement test especially in the acquisition context. The context-dependent return of fear may reflect enhancing effects of stress on the consolidation of contextual cues. Copyright © 2014 Society for Psychophysiological Research.

Global and National Burden of Diseases and Injuries Among Children and Adolescents Between 1990 and 2013: Findings From the Global Burden of Disease 2013 Study.

Science.gov (United States)

Kyu, Hmwe H; Pinho, Christine; Wagner, Joseph A; Brown, Jonathan C; Bertozzi-Villa, Amelia; Charlson, Fiona J; Coffeng, Luc Edgar; Dandona, Lalit; Erskine, Holly E; Ferrari, Alize J; Fitzmaurice, Christina; Fleming, Thomas D; Forouzanfar, Mohammad H; Graetz, Nicholas; Guinovart, Caterina; Haagsma, Juanita; Higashi, Hideki; Kassebaum, Nicholas J; Larson, Heidi J; Lim, Stephen S; Mokdad, Ali H; Moradi-Lakeh, Maziar; Odell, Shaun V; Roth, Gregory A; Serina, Peter T; Stanaway, Jeffrey D; Misganaw, Awoke; Whiteford, Harvey A; Wolock, Timothy M; Wulf Hanson, Sarah; Abd-Allah, Foad; Abera, Semaw Ferede; Abu-Raddad, Laith J; AlBuhairan, Fadia S; Amare, Azmeraw T; Antonio, Carl Abelardo T; Artaman, Al; Barker-Collo, Suzanne L; Barrero, Lope H; Benjet, Corina; Bensenor, Isabela M; Bhutta, Zulfiqar A; Bikbov, Boris; Brazinova, Alexandra; Campos-Nonato, Ismael; Castañeda-Orjuela, Carlos A; Catalá-López, Ferrán; Chowdhury, Rajiv; Cooper, Cyrus; Crump, John A; Dandona, Rakhi; Degenhardt, Louisa; Dellavalle, Robert P; Dharmaratne, Samath D; Faraon, Emerito Jose A; Feigin, Valery L; Fürst, Thomas; Geleijnse, Johanna M; Gessner, Bradford D; Gibney, Katherine B; Goto, Atsushi; Gunnell, David; Hankey, Graeme J; Hay, Roderick J; Hornberger, John C; Hosgood, H Dean; Hu, Guoqing; Jacobsen, Kathryn H; Jayaraman, Sudha P; Jeemon, Panniyammakal; Jonas, Jost B; Karch, André; Kim, Daniel; Kim, Sungroul; Kokubo, Yoshihiro; Kuate Defo, Barthelemy; Kucuk Bicer, Burcu; Kumar, G Anil; Larsson, Anders; Leasher, Janet L; Leung, Ricky; Li, Yongmei; Lipshultz, Steven E; Lopez, Alan D; Lotufo, Paulo A; Lunevicius, Raimundas; Lyons, Ronan A; Majdan, Marek; Malekzadeh, Reza; Mashal, Taufiq; Mason-Jones, Amanda J; Melaku, Yohannes Adama; Memish, Ziad A; Mendoza, Walter; Miller, Ted R; Mock, Charles N; Murray, Joseph; Nolte, Sandra; Oh, In-Hwan; Olusanya, Bolajoko Olubukunola; Ortblad, Katrina F; Park, Eun-Kee; Paternina Caicedo, Angel J; Patten, Scott B; Patton, George C; Pereira, David M; Perico, Norberto; Piel, Frédéric B; Polinder, Suzanne; Popova, Svetlana; Pourmalek, Farshad; Quistberg, D Alex; Remuzzi, Giuseppe; Rodriguez, Alina; Rojas-Rueda, David; Rothenbacher, Dietrich; Rothstein, David H; Sanabria, Juan; Santos, Itamar S; Schwebel, David C; Sepanlou, Sadaf G; Shaheen, Amira; Shiri, Rahman; Shiue, Ivy; Skirbekk, Vegard; Sliwa, Karen; Sreeramareddy, Chandrashekhar T; Stein, Dan J; Steiner, Timothy J; Stovner, Lars Jacob; Sykes, Bryan L; Tabb, Karen M; Terkawi, Abdullah Sulieman; Thomson, Alan J; Thorne-Lyman, Andrew L; Towbin, Jeffrey Allen; Ukwaja, Kingsley Nnanna; Vasankari, Tommi; Venketasubramanian, Narayanaswamy; Vlassov, Vasiliy Victorovich; Vollset, Stein Emil; Weiderpass, Elisabete; Weintraub, Robert G; Werdecker, Andrea; Wilkinson, James D; Woldeyohannes, Solomon Meseret; Wolfe, Charles D A; Yano, Yuichiro; Yip, Paul; Yonemoto, Naohiro; Yoon, Seok-Jun; Younis, Mustafa Z; Yu, Chuanhua; El Sayed Zaki, Maysaa; Naghavi, Mohsen; Murray, Christopher J L; Vos, Theo

2016-03-01

The literature focuses on mortality among children younger than 5 years. Comparable information on nonfatal health outcomes among these children and the fatal and nonfatal burden of diseases and injuries among older children and adolescents is scarce. To determine levels and trends in the fatal and nonfatal burden of diseases and injuries among younger children (aged infection/AIDS, measles, hepatitis B) where the disease process is complex or the cause of death data were insufficient or unavailable, we used natural history models. For most nonfatal health outcomes, DisMod-MR 2.0, a Bayesian metaregression tool, was used to meta-analyze the epidemiological data to generate prevalence estimates. Of the 7.7 (95% uncertainty interval [UI], 7.4-8.1) million deaths among children and adolescents globally in 2013, 6.28 million occurred among younger children, 0.48 million among older children, and 0.97 million among adolescents. In 2013, the leading causes of death were lower respiratory tract infections among younger children (905.059 deaths; 95% UI, 810,304-998,125), diarrheal diseases among older children (38,325 deaths; 95% UI, 30,365-47,678), and road injuries among adolescents (115,186 deaths; 95% UI, 105,185-124,870). Iron deficiency anemia was the leading cause of years lived with disability among children and adolescents, affecting 619 (95% UI, 618-621) million in 2013. Large between-country variations exist in mortality from leading causes among children and adolescents. Countries with rapid declines in all-cause mortality between 1990 and 2013 also experienced large declines in most leading causes of death, whereas countries with the slowest declines had stagnant or increasing trends in the leading causes of death. In 2013, Nigeria had a 12% global share of deaths from lower respiratory tract infections and a 38% global share of deaths from malaria. India had 33% of the world's deaths from neonatal encephalopathy. Half of the world's diarrheal deaths among

ANALYSIS OF TAX BURDEN PARAMETERS OF UKRAINE'S ECONOMY

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I. Moyseyenko

2017-11-01

Full Text Available The need to solve the problems of macro-economic stabilization of the country's economy on the basis of determining the tax system efficiency led to the actuality and importance of developing methodological issues of macro-economic tax regulation. In terms of macro-financial stability for the purpose of strategic analysis, the macroeconomic category of tax burden and its fiscal efficiency in terms of direct and indirect taxation is considered. Tax burden indicators at a macro-level quantitatively measure the total level of tax payment and pumping up the budget. Based on the analysis of tax burden it is found that in Ukraine the major fiscal function is performed by consumption taxes (indirect taxes. The methodological principles of the diagnostics of tax burden influence on macro-indices of economic stabilization are as follows: selecting parameters of monitoring tax burden state and fiscal burden efficiency; the assessment of an impact on fiscal efficiency on macro-indices. To prognosticate the efficiency of fiscal burden performance in terms of indirect taxes linear and exponential trend equations are calculated. In terms of the analysis of macro-financial stability the usage of tax rates of indirect taxes as indicators of fiscal efficiency provides sufficient reasons for the conclusions regarding long-term trends of pumping the budget.

Subjective burden on spouses of schizophrenia patients

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Surekha Kumari

2009-01-01

Full Text Available Background : There is limited information from India on subjective burden on spouses of schizophrenia patients. The aim of the present study was to assess and compare patterns of subjective burden on spouses of schizophrenia patients. Materials and Methods: The present study was conducted at the OPD level, and follow-up was done at the Ranchi Institute of Neuropsychiatry and Sciences (RINPAS during the period May 2008 to November 2008. Tools utilized were sociodemographic data sheet, Family Burden Interview Schedule developed by Pai and R. L. Kapur (1981. The sample comprised of 50 samples of spouses (25 male and 25 female spouses of schizophrenia patients. Results: The findings suggest that both the groups, viz., male and female spouses of schizophrenia patients, showed moderate level of subjective burden, i.e., 13 (52% and 15 (60% male and female spouses, respectively, which was statistically found to be insignificant. Conclusion : No significant difference was found between male and female spouses of schizophrenia patients with regard to the level of subjective burden.

Double burden of malnutrition: A silent driver of double burden of disease in low– and middle–income countries

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Ivana Kolcˇic´

2012-09-01

Full Text Available Double burden of malnutrition, characterised by undernutrition among poor children and obesity among deprived adults, is a serious global problem and an important promoter of ‘double burden of disease’ which is currently affecting low– and middle–income countries. Possible ways to reduce this burden is through education on the importance of equilibrium between energy intake and expenditure; ensuring conditions for optimal fetal and early child development; and reducing poverty as one of the main drivers of both undernutrition and obesity, through empowering local communities.

Stress corrosion cracking of steam generator tubing materials in lead containing solution

International Nuclear Information System (INIS)

Kim, H.P.; Hwang, S.S.; Kim, J.S.; Hong, J.H.

2007-01-01

Stress corrosion cracking (SCC) in lead (Pb) containing environments has been one of key issues in the nuclear power industry since Pb had been identified as a cause of the SCC of steam generator (SG) tubing materials in some power plants. To mitigate or prevent degradation of SG tubing materials, a mechanistic understanding of SCC in Pb containing environment is needed, along with an understanding of the source and transport behaviors of Pb species in the secondary circuit. In this work, SCC behaviors of Alloy 600 in Pb containing environments were studied. Influences of microstructures of Alloy 600 and the inhibitive additives were investigated using the C-ring and the slow strain rate tests in caustic solution and demineralized water at 315 o C. Microstructures of Alloy 600 were varied by heat treatment at different temperatures. The additives examined were nickel boride (NiB) and cerium boride (CeB 6 ). The surface films were analyzed using Auger Electron Spectroscopy (AES) and Energy Dispersive X-ray Spectroscopy (EDS). The SCC mode varied with microstructure. Effectiveness of the additives in Pb containing environments is discussed. (author)

The impending financial healthcare burden and ethical dilemma of systemic therapy in metastatic cancer.

Science.gov (United States)

Riaz, Muhammad Kashif; Bal, Susan; Wise-Draper, Trisha

2016-09-01

Metastatic cancer remains a devastating disease that threatens to disrupt entire family structures creating economic and psychosocial stress. Fortunately, great strides have resulted in improved therapies over the years but at a huge social-economic cost. The economic burden has risen greatly and carries with it new ethical concerns when deciding treatment. Here, we discuss the financial and ethical challenges that oncologists and their patients face in the era of novel treatment strategies. J. Surg. Oncol. 2016;114:323-328. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Impacts of aerosol lead to natural ecosystems

International Nuclear Information System (INIS)

Murozumi, Masayo; Nakamura, Seiji; Yoshida, Katsumi

1982-01-01

Impacts of aerosol lead have changed the concentration and isotopic ratios of the element circulating in remote ecosystems in the Hidaka and Tarumae mountains. Concentrations of lead in successive each 10 years ring veneer of Cercidiphyllum Japonica show that amount of the element residing on the bark and supwood layers has increased by a factor of 2 or more in comparison with that of the core part. The isotopic ratios of lead in the basement rocks and soils under the ecosystems converge to a certain narrow spot along the isochron Iine of the element, and distinguish their geochronogical characteristics from other leads of different sources. In these ecosystems, however, the lead isotopic ratios of materials exposed to the atmosphere are similar to those of foreign and anthropogenic aerosol lead but are evidently dissimilar to those of the rocks and soils. Furthermore, the lead isotopic ratios in yearly ring veneers of Ceridiphyllum Japonica and Ostrya Japonica show a certain differentiation towards the bark from the core, i.e., an approach to those of anthropogenic aerosol lead from those of the basement rocks and soils, as listed in Table 7. The lead burden per hectare in these remote ecosystems has increased to 4 g by the impact of 2 g of aerosol lead. (author)

Validating a Cantonese short version of the Zarit Burden Interview (CZBI-Short) for dementia caregivers.

Science.gov (United States)

Tang, Jennifer Yee-Man; Ho, Andy Hau-Yan; Luo, Hao; Wong, Gloria Hoi-Yan; Lau, Bobo Hi-Po; Lum, Terry Yat-Sang; Cheung, Karen Siu-Lan

2016-09-01

The present study aimed to develop and validate a Cantonese short version of the Zarit Burden Interview (CZBI-Short) for Hong Kong Chinese dementia caregivers. The 12-item Zarit Burden Interview (ZBI) was translated into spoken Cantonese and back-translated by two bilingual research assistants and face validated by a panel of experts. Five hundred Chinese dementia caregivers showing signs of stress reported their burden using the translated ZBI and rated their depressive symptoms, overall health, and care recipients' physical functioning and behavioral problems. The factor structure of the translated scale was identified using principal component analysis and confirmatory factor analysis; internal consistency and item-total correlations were assessed; and concurrent validity was tested by correlating the ZBI with depressive symptoms, self-rated health, and care recipients' physical functioning and behavioral problems. The principal component analysis resulted in 11 items loading on a three-factor model comprised role strain, self-criticism, and negative emotion, which accounted for 59% of the variance. The confirmatory factor analysis supported the three-factor model (CZBI-Short) that explained 61% of the total variance. Cronbach's alpha (0.84) and item-total correlations (rho = 0.39-0.71) indicated CZBI-Short had good reliability. CZBI-Short showed correlations with depressive symptoms (r = 0.50), self-rated health (r = -0.26) and care recipients' physical functioning (r = 0.18-0.26) and disruptive behaviors (r = 0.36). The 12-item CZBI-Short is a concise, reliable, and valid instrument to assess burden in Chinese dementia caregivers in clinical and social care settings.

Socioeconomic burden of hereditary angioedema

DEFF Research Database (Denmark)

Aygören-Pürsün, Emel; Bygum, Anette; Beusterien, Kathleen

2014-01-01

who were working or in school (n = 120), 72 provided work/school absenteeism data, resulting in an estimated 20 days missing from work/school on average per year; 51% (n = 84) indicated that HAE has hindered their career/educational advancement. CONCLUSION: HAE poses a considerable burden on patients...... and their families in terms of direct medical costs and indirect costs related to lost productivity. This burden is substantial at the time of attacks and in between attacks....

The burden of leishmaniasis in Iran, acquired from the global burden of disease during 1990–2010

Directory of Open Access Journals (Sweden)

Alireza Badirzadeh

2017-09-01

Full Text Available Objective: To report and measure the burden of leishmaniasis in Iran using the global burden of disease (GBD results, conducted by the Institute for Health Metrics and Evaluation for the years 1990 to 2010, and provide some recommendations for reaching better conclusions about the burden of disease. Methods: GBD burden and fatality rates of leishmaniasis were compared with the findings registered by the Ministry of Health and Medical Education (MOHME. Data obtained from the GBD for the years 1990 to 2010 were used to estimate the disability-adjusted life-years and fatality rates of leishmaniasis in Iran. Results: The GBD estimated 229 714 disability-adjusted life-years due to leishmaniasis in Iranian people of all ages and both sexes. The number of deaths caused by visceral leishmaniasis (VL had decreased significantly in recent years. MOHME registered data on fewer than 30 deaths in Iran from 1990 to 2010. Conclusions: The underreporting of VL deaths is always more pronounced. Findings indicate that the GBD estimation of mortality rates was surprisingly higher than MOHME’s data. The burden of leishmaniasis decreased significantly between the years 1990 and 2010 in both data sources. The possible explanation for this decrease has been discovered through the establishment of a VL surveillance system in various parts of Iran, particularly in endemic areas.

The relationship between the spiritual attitude of the family caregivers of older patients with stroke and their burden.

Science.gov (United States)

Torabi Chafjiri, Razieh; Navabi, Nasrin; Shamsalinia, Abbas; Ghaffari, Fatemeh

2017-01-01

Stroke is a chronic condition that necessitates multidimensional and overwhelming care. The caregivers of stroke patients are faced with various stressors that can threaten different aspects of their health, especially their mental health. Spiritual attitude and being spiritually oriented contribute significantly to mental health and can be used as a strategy for adapting to the stressful events that are part of the role of caregiving. This study was therefore conducted to investigate the relationship between the spiritual attitude of the family caregivers of older patients with stroke and their burden. This descriptive cross-sectional study was conducted in 2016. The study population consisted of all the family caregivers of older patients with stroke presenting to health care centers and nursing service companies of Gilan Province in Iran. The participants were selected through convenience sampling and consisted of 407 participants. Data were collected using the Spiritual Attitude Scale and the Caregiver Burden Inventory and were then analyzed in SPSS-18 using Pearson's correlation coefficient at a significance level of 0.05. The results showed that 88.9% of the caregivers were females. The mean age of the participants was 38.3±8.8 years. The duration of caregiving was relationship was observed in this study between the mean score of spiritual attitude and the total score of burden in all its dimensions, namely, time dependence, as well as the developmental, physical, social and emotional dimensions. Providing strategies for improving spirituality, such as teaching spiritual self-care, can improve their burden. Given that such strategies are psychologically approved and pose no side effects, they can be used as an effective, low-cost and risk-free approach for all caregivers, so that they can acquire the necessary spiritual support for overcoming the stress caused by caring for family members through the reinforcement of their spiritual beliefs in the ultimate

Management of Occupational Stress

Directory of Open Access Journals (Sweden)

Trandafir Lenuţa

2015-06-01

Full Text Available Stress is an important problem in the majority of countries. Apart from the fact that it is responsible for numerous diseases, it also causes much suffering. Stress appears as an adaptation reaction of our body to those external factors that we perceive as being agressive and which frequently lead us to an alarm state, felt both psychically (tension, fear, anxiety, and physically (increase of the adrenaline secretion, intensity of heartbeats, sweating. It isn’t actually a disease, but it can lead to sickness in time. This is why it is good to know what stresses us and how we can escape stress.

Anatomy of lead poisoning

African Journals Online (AJOL)

ABEOLUGBENGAS

Results: The primary form of lead toxicity is by oxidative stress mechanisms, apoptosis and necrosis involving ... néfastes sur la reproduction à l'avenir. Résultats:La forme ... prostate cancers, abnormal sexual ..... ensure this work is a success.

Integrated physiological mechanisms of exercise performance, adaptation, and maladaptation to heat stress.

Science.gov (United States)

Sawka, Michael N; Leon, Lisa R; Montain, Scott J; Sonna, Larry A

2011-10-01

This article emphasizes significant recent advances regarding heat stress and its impact on exercise performance, adaptations, fluid electrolyte imbalances, and pathophysiology. During exercise-heat stress, the physiological burden of supporting high skin blood flow and high sweating rates can impose considerable cardiovascular strain and initiate a cascade of pathophysiological events leading to heat stroke. We examine the association between heat stress, particularly high skin temperature, on diminishing cardiovascular/aerobic reserves as well as increasing relative intensity and perceptual cues that degrade aerobic exercise performance. We discuss novel systemic (heat acclimation) and cellular (acquired thermal tolerance) adaptations that improve performance in hot and temperate environments and protect organs from heat stroke as well as other dissimilar stresses. We delineate how heat stroke evolves from gut underperfusion/ischemia causing endotoxin release or the release of mitochondrial DNA fragments in response to cell necrosis, to mediate a systemic inflammatory syndrome inducing coagulopathies, immune dysfunction, cytokine modulation, and multiorgan damage and failure. We discuss how an inflammatory response that induces simultaneous fever and/or prior exposure to a pathogen (e.g., viral infection) that deactivates molecular protective mechanisms interacts synergistically with the hyperthermia of exercise to perhaps explain heat stroke cases reported in low-risk populations performing routine activities. Importantly, we question the "traditional" notion that high core temperature is the critical mediator of exercise performance degradation and heat stroke. Published 2011. This article is a U.S. Government work and is in the public domain in the USA.

Investing in improved performance of national tuberculosis programs reduces the tuberculosis burden: analysis of 22 high-burden countries, 2002-2009.

Science.gov (United States)

Akachi, Yoko; Zumla, Alimuddin; Atun, Rifat

2012-05-15

To assess the impact of investment in national tuberculosis programs (NTPs) on NTP performance and tuberculosis burden in 22 high-burden countries, as determined by the World Health Organization (WHO). Estimates of annual tuberculosis burden and NTP performance indicators and control variables during 2002-2009 were obtained from the Organization for Economic Cooperation and Development, the WHO, the World Bank, and the Penn World Table for the 22 high-burden countries. Panel data analysis was performed using the outcome variables tuberculosis incidence, prevalence, and mortality and the key explanatory variables Partnership case detection rate and treatment success rate, controlling for gross domestic product per capita, population structure, and human immunodeficiency virus (HIV) prevalence. A $1 per capita (general population) higher NTP budget (including domestic and external sources) was associated with a 1.9% (95% confidence interval, .12%-3.6%) higher estimated case detection rate the following year for the 22 high-burden countries between 2002 and 2009. In the final models, which corrected for autocorrelation and heteroskedasticity, achieving the STOP TB Partnership case detection rate target of >70% was associated with significantly (P < .01) lower tuberculosis incidence, prevalence, and mortality the following year, even when controlling for general economic development and HIV prevalence as potential confounding variables. Increased investment in NTPs was significantly associated with improved performance and with a downward trend in the tuberculosis burden in the 22 high-burden countries during 2002-2009.

Alcohol consumption and burden of disease in the Americas in 2012: implications for alcohol policy.

Science.gov (United States)

Shield, Kevin D; Monteiro, Maristela; Roerecke, Michael; Smith, Blake; Rehm, Jürgen

2015-12-01

To describe the volume and patterns of alcohol consumption up to and including 2012, and to estimate the burden of disease attributable to alcohol consumption as measured in deaths and disability-adjusted life years (DALYs) lost in the Americas in 2012. Measures of alcohol consumption were obtained from the World Health Organization (WHO) Global Information System on Alcohol and Health (GISAH). The burden of alcohol consumption was estimated in both deaths and DALYs lost based on mortality data obtained from WHO, using alcohol-attributable fractions. Regional groupings for the Americas were based on the WHO classifications for 2004 (according to child and adult mortality). Regional variations were observed in the overall volume of alcohol consumed, the proportion of the alcohol market attributable to unrecorded alcohol consumption, drinking patterns, prevalence of drinking, and prevalence of heavy episodic drinking, with inhabitants of the Americas consuming more alcohol (8.4 L of pure alcohol per adult in 2012) compared to the world average. The Americas also experienced a high burden of disease attributable to alcohol consumption (4.7% of all deaths and 6.7% of all DALYs lost), especially in terms of injuries attributable to alcohol consumption. Alcohol is consumed in a harmful manner in the Americas, leading to a high burden of disease, especially in terms of injuries. New cost-effective alcohol policies, such as increasing alcohol taxation, increasing the minimum legal age to purchase alcohol, and decreasing the maximum legal blood alcohol content while driving, should be implemented to decrease the harmful consumption of alcohol and the resulting burden of disease.

THE COMBINED EFFECTS OF STRESS CONCENTRATION AND TENSILE STRESSES FROM AUTOFRETTAGE ON THE LIFE OF PRESSURE VESSELS

Science.gov (United States)

2017-02-22

information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing ... hydraulically or mechanically overstrained in order to impart favorable near bore residual compressive hoop stresses in an attempt to enhance fatigue life. As a...detrimental. In the early stages of development of each system, multiple full size vessels are hydraulically fatigue tested and a safe life is

Economic burden of malignant blood disorders across Europe: a population-based cost analysis.

Science.gov (United States)

Burns, Richeal; Leal, Jose; Sullivan, Richard; Luengo-Fernandez, Ramon

2016-08-01

Malignant blood disorders are a leading contributor to cancer incidence and mortality across Europe. Despite their burden, no study has assessed the economic effect of blood cancers in Europe. We aimed to assess the economic burden of malignant blood disorders across the 28 countries in the European Union (EU), Iceland, Norway, and Switzerland. Malignant blood disorder-related costs were estimated for 28 EU countries, Iceland, Norway, and Switzerland for 2012. Country-specific costs were estimated with aggregate data on morbidity, mortality, and health-care resource use obtained from international and national sources. Health-care costs were estimated from expenditure on primary, outpatient, emergency, inpatient care, and drugs. Costs of informal care and productivity losses due to morbidity and early death were also included. For countries in the EU, malignant blood disorders were compared with the economic burden of overall cancer. Malignant blood disorders cost the 31 European countries €12 billion in 2012. Health-care cost €7·3 billion (62% of total costs), productivity losses cost €3·6 billion (30%), and informal care cost €1 billion (8%). For the EU countries, malignant blood disorders cost €6·8 billion (12%) of the total health-care expenditure on cancer (€57 billion), with this proportion being second only to breast cancer. In terms of total cancer costs in the EU (€143 billion), malignant blood disorders cost €12 billion (8%). Malignant blood disorders represent a leading cause of death, health-care service use, and costs, not only to European health-care systems, but to society overall. Our results add to essential public health knowledge needed for effective national cancer-control planning and priorities for public research funding. European Hematology Association. Copyright © 2016 Elsevier Ltd. All rights reserved.

Reducing the silent burden of impaired mental health.

Science.gov (United States)

Jané-Llopis, Eva; Anderson, Peter; Stewart-Brown, Sarah; Weare, Katherine; Wahlbeck, Kristian; McDaid, David; Cooper, Cary; Litchfield, Paul

2011-08-01

Mental and behavioral disorders account for about one third of the world's disability caused by all ill health among adults, with unipolar depressive disorders set to be the world's number one cause of illhealth and premature death in 2030, affecting high- and low-income countries. There is a range of evidence-based cost-effective interventions that can be implemented in parenting, at schools, at the workplace, and in older age that can promote health and well-being, reduce mental disorders, lead to improved productivity, and increase resilience to cope with many of the stressors in the world. These facts need to be better communicated to policymakers to ensure that the silent burden of impaired mental health is adequately heard and reduced.

Economic Burden of Pediatric Asthma: Annual Cost of Disease in Iran.

Science.gov (United States)

Sharifi, Laleh; Dashti, Raheleh; Pourpak, Zahra; Fazlollahi, Mohammad Reza; Movahedi, Masoud; Chavoshzadeh, Zahra; Soheili, Habib; Bokaie, Saied; Kazemnejad, Anoushiravan; Moin, Mostafa

2018-02-01

Asthma is the first cause of children hospitalization and need for emergency and impose high economic burden on the families and governments. We aimed to investigate the economic burden of pediatric asthma and its contribution to family health budget in Iran. Overall, 283 pediatric asthmatic patients, who referred to two tertiary pediatric referral centers in Tehran capital of Iran, included from 2010-2012. Direct and indirect asthma-related costs were recorded during one-year period. Data were statistically analyzed for finding association between the costs and factors that affect this cost (demographic variables, tobacco smoke exposure, control status of asthma and asthma concomitant diseases). Ninety-two (32.5%) females and 191(67.5%) males with the age range of 1-16 yr old were included. We found the annual total pediatrics asthma related costs were 367.97±23.06 USD. The highest cost belonged to the medications (69%) and the lowest one to the emergency (2%). We noticed a significant increasing in boys' total costs ( P =0.011), and 7-11 yr old age group ( P =0.018). In addition, we found significant association between total asthma costs and asthma control status ( P =0.011). The presence of an asthmatic child can consume nearly half of the health budget of a family. Our results emphasis on improving asthma management programs, which leads to successful control status of the disease and reduction in economic burden of pediatric asthma.

The economic burden of schizophrenia in Malaysia.

Science.gov (United States)

Teoh, Siew Li; Chong, Huey Yi; Abdul Aziz, Salina; Chemi, Norliza; Othman, Abdul Razak; Md Zaki, Nurzuriana; Vanichkulpitak, Possatorn; Chaiyakunapruk, Nathorn

2017-01-01

Schizophrenia (SCZ) is a highly debilitating disease despite its low prevalence. The economic burden associated with SCZ is substantial and mainly attributed to productivity loss. To improve the understanding of economic burden of SCZ in the low- and middle-income country regions, we aimed to determine the economic burden of SCZ in Malaysia. A retrospective study was conducted using a prevalence-based approach from a societal perspective in Malaysia with a 1 year period from 2013. We used micro-costing technique with bottom-up method and included direct medical cost, direct non-medical cost, and indirect cost. The main data source was medical chart review which was conducted in Hospital Kuala Lumpur (HKL). The medical charts were identified electronically by matching the unique patient's identification number registered under the National Mental Health Schizophrenia Registry and the list of patients in HKL in 2013. Other data sources were government documents, literatures, and local websites. To ensure robustness of result, probabilistic sensitivity analysis was conducted. The total estimated number of treated SCZ cases in Malaysia in 2015 was 15,104 with the total economic burden of USD 100 million (M) which was equivalent to 0.04% of the national gross domestic product. On average, the mean cost per patient was USD 6,594. Of the total economic burden of SCZ, 72% was attributed to indirect cost, costing at USD 72M, followed by direct medical cost (26%), costing at USD 26M, and direct non-medical cost (2%), costing at USD 1.7M. This study highlights the magnitude of economic burden of SCZ and informs the policy-makers that there is an inadequate support for SCZ patients. More resources should be allocated to improve the condition of SCZ patients and to reduce the economic burden.

Uncertainties in Organ Burdens Estimated from PAS

International Nuclear Information System (INIS)

La Bone, T.R.

2004-01-01

To calculate committed effective dose equivalent, one needs to know the quantity of the radionuclide in all significantly irradiated organs (the organ burden) as a function of time following the intake. There are two major sources of uncertainty in an organ burden estimated from personal air sampling (PAS) data: (1) The uncertainty in going from the exposure measured with the PAS to the quantity of aerosol inhaled by the individual, and (2) The uncertainty in going from the intake to the organ burdens at any given time, taking into consideration the biological variability of the biokinetic models from person to person (interperson variability) and in one person over time (intra-person variability). We have been using biokinetic modeling methods developed by researchers at the University of Florida to explore the impact of inter-person variability on the uncertainty of organ burdens estimated from PAS data. These initial studies suggest that the uncertainties are so large that PAS might be considered to be a qualitative (rather than quantitative) technique. These results indicate that more studies should be performed to properly classify the reliability and usefulness of using PAS monitoring data to estimate organ burdens, organ dose, and ultimately CEDE

Bruxism affects stress responses in stressed rats.

Science.gov (United States)

Sato, Chikatoshi; Sato, Sadao; Takashina, Hirofumi; Ishii, Hidenori; Onozuka, Minoru; Sasaguri, Kenichi

2010-04-01

It has been proposed that suppression of stress-related emotional responses leads to the simultaneous activation of both sympathetic and parasympathetic divisions of the autonomic nervous system (ANS) and that the expression of these emotional states has a protective effect against ulcerogenesis. In the present study, we investigated whether stress-induced bruxism activity (SBA) has a physiological effect of on the stress-induced changes of the stomach, thymus, and spleen as well as blood leukocytes, cortisol, and adrenaline. This study demonstrated that SBA attenuated the stress-induced ulcer genesis as well as degenerative changes of thymus and spleen. SBA also attenuated increases of adrenaline, cortisol, and neutrophils in the blood. In conclusion, expression of aggression through SBA during stress exposure attenuates both stress-induced ANS response, including gastric ulcer formation.

High glucose-induced oxidative stress represses sirtuin deacetylase expression and increases histone acetylation leading to neural tube defects.

Science.gov (United States)

Yu, Jingwen; Wu, Yanqing; Yang, Peixin

2016-05-01

Aberrant epigenetic modifications are implicated in maternal diabetes-induced neural tube defects (NTDs). Because cellular stress plays a causal role in diabetic embryopathy, we investigated the possible role of the stress-resistant sirtuin (SIRT) family histone deacetylases. Among the seven sirtuins (SIRT1-7), pre-gestational maternal diabetes in vivo or high glucose in vitro significantly reduced the expression of SIRT 2 and SIRT6 in the embryo or neural stem cells, respectively. The down-regulation of SIRT2 and SIRT6 was reversed by superoxide dismutase 1 (SOD1) over-expression in the in vivo mouse model of diabetic embryopathy and the SOD mimetic, tempol and cell permeable SOD, PEGSOD in neural stem cell cultures. 2,3-dimethoxy-1,4-naphthoquinone (DMNQ), a superoxide generating agent, mimicked high glucose-suppressed SIRT2 and SIRT6 expression. The acetylation of histone 3 at lysine residues 56 (H3K56), H3K14, H3K9, and H3K27, putative substrates of SIRT2 and SIRT6, was increased by maternal diabetes in vivo or high glucose in vitro, and these increases were blocked by SOD1 over-expression or tempol treatment. SIRT2 or SIRT6 over-expression abrogated high glucose-suppressed SIRT2 or SIRT6 expression, and prevented the increase in acetylation of their histone substrates. The potent sirtuin activator (SRT1720) blocked high glucose-increased histone acetylation and NTD formation, whereas the combination of a pharmacological SIRT2 inhibitor and a pan SIRT inhibitor mimicked the effect of high glucose on increased histone acetylation and NTD induction. Thus, diabetes in vivo or high glucose in vitro suppresses SIRT2 and SIRT6 expression through oxidative stress, and sirtuin down-regulation-induced histone acetylation may be involved in diabetes-induced NTDs. The mechanism underlying pre-gestational diabetes-induced neural tube defects (NTDs) is still elusive. Our study unravels a new epigenetic mechanism in which maternal diabetes-induced oxidative stress represses

Towards an artificial therapy assistant: Measuring excessive stress from speech

NARCIS (Netherlands)

van der Sluis, Frans; van den Broek, Egon; Dijkstra, Ton; Traver, V.; Fred, A.; Filipe, J.; Gamboa, H.

2011-01-01

The measurement of (excessive) stress is still a challenging endeavor. Most tools rely on either introspection or expert opinion and are, therefore, often less reliable or a burden on the patient. An objective method could relieve these problems and, consequently, assist diagnostics. Speech was

Mental Health Nurse’s Exposure to Workplace Violence Leads to Job Stress, Which Leads to Reduced Professional Quality of Life

Directory of Open Access Journals (Sweden)

Michal Itzhaki

2018-02-01

Full Text Available Professional quality of life (ProQOL reflects how individuals feel about their work as helpers. Psychiatric ward nurses cope with significant psychological and physical challenges, including exposure to verbal and physical violence. This study was based on two aspects of ProQOL, the positive compassion satisfaction, and the negative compassion fatigue, with the aim of investigating the relation of ProQOL to job stress and violence exposure at a large mental health center. Data were collected from 114 mental health nurses (49/63 M/F who completed a self-administered questionnaire examining violence exposure, ProQOL, and job stress. The results showed that during the last year, almost all nurses (88.6% experienced verbal violence, and more than half (56.1% experienced physical violence. Only 2.6% experienced no violence. ProQOL was not associated with violence exposure but was reduced by work stress and by previous exposure to violence; nurses who perceived their work as more stressful had lower satisfaction from their work. In conclusion, although most mental health nurses are exposed to physical and verbal violence, their ProQOL is more related to job stress than to workplace violence (WPV. Hospital managements should conduct work stress reduction intervention programs and promote strategizes to reduce WPV. Further exploration of (a factors affecting ProQOL and (b the effect of violence coping workshops on ProQOL is warranted.

[Burden, empathy, and resilience in dependent people caregivers].

Science.gov (United States)

Navarro-Abal, Yolanda; López-López, María José; Climent-Rodríguez, José Antonio; Gómez-Salgado, Juan

2018-02-10

To analyse the differences in perceived burden between family caregivers who are users of patient associations and those who are not; to assess the relationship between burden, resilience, and empathy levels. Retrospective ex post facto study of two groups, one of them quasi control. The sample was composed of 155 informal caregivers (28 men and 155 women); 109 of them were users of patient relatives' associations and 46 were not. Both descriptive and bivariate comparative analyses were carried out. Caregivers who were members of patient associations showed lower burden and empathy levels than those who were not. This highlighted that the higher their level of perceived burden, the lower their level of resilience. Belonging to carers' associations results in a lower level of perceived burden and a lower risk of developing compassion fatigue syndrome. Copyright © 2018 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

The epidemiology of cardiovascular diseases in sub-Saharan Africa: the Global Burden of Diseases, Injuries and Risk Factors 2010 Study.

Science.gov (United States)

Moran, Andrew; Forouzanfar, Mohammad; Sampson, Uchechukwu; Chugh, Sumeet; Feigin, Valery; Mensah, George

2013-01-01

The epidemiology of cardiovascular diseases in sub-Saharan Africa is unique among world regions, with about half of cardiovascular diseases (CVDs) due to causes other than atherosclerosis. CVD epidemiology data are sparse and of uneven quality in sub-Saharan Africa. Using the available data, the Global Burden of Diseases, Risk Factors, and Injuries (GBD) 2010 Study estimated CVD mortality and burden of disease in sub-Saharan Africa in 1990 and 2010. The leading CVD cause of death and disability in 2010 in sub-Saharan Africa was stroke; the largest relative increases in CVD burden between 1990 and 2010 were in atrial fibrillation and peripheral arterial disease. CVD deaths constituted only 8.8% of all deaths and 3.5% of all disability-adjusted life years (DALYs) in sub-Sahara Africa, less than a quarter of the proportion of deaths and burden attributed to CVD in high income regions. However, CVD deaths in sub-Saharan Africa occur at younger ages on average than in the rest of the world. It remains uncertain if increased urbanization and life expectancy in some parts of sub-Saharan African nations will transition the region to higher CVD burden in future years. © 2013.

The Epidemiology of Cardiovascular Diseases in Sub-Saharan Africa: The Global Burden of Diseases, Injuries and Risk Factors 2010 Study

Science.gov (United States)

Moran, Andrew; Forouzanfar, Mohammad; Sampson, Uchechukwu; Chugh, Sumeet; Feigin, Valery; Mensah, George

2014-01-01

The epidemiology of cardiovascular diseases in sub-Saharan Africa is unique among world regions, with about half of cardiovascular diseases (CVDs) due to causes other than atherosclerosis. CVD epidemiology data are sparse and of uneven quality in sub-Saharan Africa. Using the available data, the Global Burden of Diseases, Risk Factors, and Injuries (GBD) 2010 Study estimated CVD mortality and burden of disease in sub-Saharan Africa in 1990 and 2010. The leading CVD cause of death and disability in 2010 in sub-Saharan Africa was stroke; the largest relative increases in CVD burden between 1990 and 2010 were in atrial fibrillation and peripheral arterial disease. CVD deaths constituted only 8.8% of all deaths and 3.5% of all disability-adjusted life years (DALYs) in sub-Sahara Africa, less than a quarter of the proportion of deaths and burden attributed to CVD in high income regions. However, CVD deaths in sub-Saharan Africa occur at younger ages on average than in the rest of the world. It remains uncertain if increased urbanization and life expectancy in some parts of sub-Saharan African nations will transition the region to higher CVD burden in future years. PMID:24267430

Stress on the Job: How Family Literacy Program Directors Perceive Occupational Stress

Science.gov (United States)

Sandlin, Jennifer A.; Chen, Chia-Yin

2007-01-01

Little research has examined stress among family literacy administrators, although studies in other contexts reveal occupational stress can lead to illness, distress, and organizational problems. This article presents findings from a recent study of stress among family literacy program directors in Texas. Findings reveal family literacy program…

A novel approach for measuring the burden of uncomplicated Plasmodium falciparum malaria: application to data from Zambia.

Directory of Open Access Journals (Sweden)

Valerie Crowell

Full Text Available Measurement of malaria burden is fraught with complexity, due to the natural history of the disease, delays in seeking treatment or failure of case management. Attempts to establish an appropriate case definition for a malaria episode has often resulted in ambiguities and challenges because of poor information about treatment seeking, patterns of infection, recurrence of fever and asymptomatic infection. While the primary reason for treating malaria is to reduce disease burden, the effects of treatment are generally ignored in estimates of the burden of malaria morbidity, which are usually presented in terms of numbers of clinical cases or episodes, with the main data sources being reports from health facilities and parasite prevalence surveys. The use of burden estimates that do not consider effects of treatment, leads to under-estimation of the impact of improvements in case management. Official estimates of burden very likely massively underestimate the impact of the roll-out of ACT as first-line therapy across Africa. This paper proposes a novel approach for estimating burden of disease based on the point prevalence of malaria attributable disease, or equivalently, the days with malaria fever in unit time. The technique makes use of data available from standard community surveys, analyses of fever patterns in malaria therapy patients, and data on recall bias. Application of this approach to data from Zambia for 2009-2010 gave an estimate of 2.6 (95% credible interval: 1.5-3.7 malaria attributable fever days per child-year. The estimates of recall bias, and of the numbers of days with illness contributing to single illness recalls, could be applied more generally. To obtain valid estimates of the overall malaria burden using these methods, there remains a need for surveys to include the whole range of ages of hosts in the population and for data on seasonality patterns in confirmed case series.

Stress inducible overexpression of AtHDG11 leads to improved drought and salt stress tolerance in peanut (Arachis hypogaea L.)

Science.gov (United States)

Banavath, Jayanna N.; Chakradhar, Thammineni; Pandit, Varakumar; Konduru, Sravani; Guduru, Krishna K.; Akila, Chandra S.; Podha, Sudhakar; Puli, Chandra O. R.

2018-03-01

Peanut is an important oilseed and food legume cultivated as a rain-fed crop in semi-arid tropics. Drought and high salinity are the major abiotic stresses limiting the peanut productivity in this region. Development of drought and salt tolerant peanut varieties with improved yield potential using biotechnological approach is highly desirable to improve the peanut productivity in marginal geographies. As abiotic stress tolerance and yield represent complex traits, engineering of regulatory genes to produce abiotic stress-resilient transgenic crops appears to be a viable approach. In the present study, we developed transgenic peanut plants expressing an Arabidopsis homeodomain-leucine zipper transcription factor (AtHDG11) under stress inducible rd29Apromoter. A stress-inducible expression of AtHDG11 in three independent homozygous transgenic peanut lines resulted in improved drought and salt tolerance through up-regulation of known stress responsive genes(LEA, HSP70, Cu/Zn SOD, APX, P5CS, NCED1, RRS5, ERF1, NAC4, MIPS, Aquaporin, TIP, ELIP ) in the stress gene network , antioxidative enzymes, free proline along with improved water use efficiency traits such as longer root system, reduced stomatal density, higher chlorophyll content, increased specific leaf area, improved photosynthetic rates and increased intrinsic instantaneous WUE. Transgenic peanut plants displayed high yield compared to non-transgenic plants under both drought and salt stress conditions. Holistically, our study demonstrates the potentiality of stress-induced expression of AtHDG11 to improve the drought, salt tolerance in peanut.

A new paradigm of quantifying ecosystem stress through chemical signatures

Energy Technology Data Exchange (ETDEWEB)

Kravitz, Ben [Atmospheric Sciences and Global Change Division, Pacific Northwest National Laboratory, P.O. Box 999, MSIN K9-30 Richland Washington 99352 USA; Guenther, Alex B. [Department of Earth System Science, University of California Irvine, 3200 Croul Hall Street Irvine California 92697 USA; Gu, Lianhong [Environmental Sciences Division, Oak Ridge National Laboratory, Oak Ridge Tennessee 37831 USA; Karl, Thomas [Institute of Atmospheric and Crysopheric Sciences, University of Innsbruck, Innrain 52f A-6020 Innsbruck Austria; Kaser, Lisa [National Center for Atmospheric Research, P.O. Box 3000 Boulder Colorado 80307 USA; Pallardy, Stephen G. [Department of Forestry, University of Missouri, 203 Anheuser-Busch Natural Resources Building Columbia Missouri 65211 USA; Peñuelas, Josep [CREAF, Cerdanyola del Vallès 08193 Catalonia Spain; Global Ecology Unit CREAF-CSIC-UAB, CSIC, Cerdanyola del Vallès 08193 Catalonia Spain; Potosnak, Mark J. [Department of Environmental Science and Studies, DePaul University, McGowan South, Suite 203 Chicago Illinois 60604 USA; Seco, Roger [Department of Earth System Science, University of California Irvine, 3200 Croul Hall Street Irvine California 92697 USA

2016-11-01

Stress-induced emissions of biogenic volatile organic compounds (VOCs) from terrestrial ecosystems may be one of the dominant sources of VOC emissions world-wide. Understanding the ecosystem stress response could reveal how ecosystems will respond and adapt to climate change and, in turn, quantify changes in the atmospheric burden of VOC oxidants and secondary organic aerosols. Here we argue, based on preliminary evidence from several opportunistic measurement sources, that chemical signatures of stress can be identified and quantified at the ecosystem scale. We also outline future endeavors that we see as next steps toward uncovering quantitative signatures of stress, including new advances in both VOC data collection and analysis of "big data."

Measuring the burden of neglected tropical diseases: the global burden of disease framework.

Directory of Open Access Journals (Sweden)

Colin D Mathers

2007-11-01

Full Text Available Reliable, comparable information about the main causes of disease and injury in populations, and how these are changing, is a critical input for debates about priorities in the health sector. Traditional sources of information about the descriptive epidemiology of diseases, injuries, and risk factors are generally incomplete, fragmented, and of uncertain reliability and comparability. The Global Burden of Disease (GBD study has provided a conceptual and methodological framework to quantify and compare the health of populations using a summary measure of both mortality and disability, the disability-adjusted life year (DALY.This paper describes key features of the Global Burden of Disease analytic approach, which provides a standardized measurement framework to permit comparisons across diseases and injuries, as well as risk factors, and a systematic approach to the evaluation of data. The paper describes the evolution of the GBD, starting from the first study for the year 1990, summarizes the methodological improvements incorporated into GBD revisions for the years 2000-2004 carried out by the World Health Organization, and examines priorities and issues for the next major GBD study, funded by the Bill & Melinda Gates Foundation, and commencing in 2007.The paper presents an overview of summary results from the Global Burden of Disease study 2002, with a particular focus on the neglected tropical diseases, and also an overview of the comparative risk assessment for 26 global risk factors. Taken together, trypanosomiasis, Chagas disease, schistosomiasis, leishmaniasis, lymphatic filariasis, onchocerciasis, intestinal nematode infections, Japanese encephalitis, dengue, and leprosy accounted for an estimated 177,000 deaths worldwide in 2002, mostly in sub-Saharan Africa, and about 20 million DALYs, or 1.3% of the global burden of disease and injuries. Further research is currently underway to revise and update these estimates.

Some remarks on the natural radiation burden of population

International Nuclear Information System (INIS)

Feher, I.; Gemesi, J.; Toth, A.

1975-04-01

A large scale of the population's radiation burden is due to the natural radioactivity of building materials. An appropriate model has been developed for the calculation of the burden of population from the concentration of radioisotopes in building materials. The external and internal radiation burden of Hungary's population were determined (weighted means were 33 mrem/year and the bronhial dose 730 mrad/year, respectively) and the effect of new building technologies and materials on the radiation burden was studied. In dwellings built of precast concrete slabs containing low-activity ballast available in Hungary the radiation burden was found to be significantly lower than the present average. The increase in the contamination hazard expected from the peaceful uses of atomic energy could be compensated by reducing the average external radiation burden together with the average bronchial dose. This reduction can be 1.6 mrem/year and 58 mrad/year, respectively (according to our estimations based on simple assumptions), requiring acceptable excess cost. (K.A.)

A safe strategy to decrease fetal lead exposure in a woman with chronic intoxication.

Science.gov (United States)

Leiba, Adi; Hu, Howard; Zheng, Amin; Kales, Stefanos N

2010-08-01

During pregnancy skeletal lead is mobilized by maternal bone turnover and can threaten fetal development. The exact strategy suggested to women of childbearing age, who were chronically exposed to lead, and, thus, have high bone lead burden, is not well established. We describe 4 years of follow-up of a 29-year-old woman with chronic lead intoxication. We (a) advised her to delay conception until 'toxicological clearance', (b) treated her with multiple courses of lead chelator, DMSA, and (c) prescribed oral calcium. Patient had low blood lead and protoporphyrin level during pregnancy until delivery. Delaying conception, lead chelation, and calcium supplementation can decrease fetal exposure.

The effect of oral administration of Allium sativum extracts on lead nitrate induced toxicity in male mice.

Science.gov (United States)

Sharma, Veena; Sharma, Arti; Kansal, Leena

2010-03-01

Lead is a common environmental occupational toxic metal, known to have indirect oxidative effects. Considering the antioxidant properties of garlic, this study was undertaken to evaluate the therapeutic efficacy of garlic extracts in terms of normalization of altered hematological, biochemical and immunological parameters, and depletion of inorganic lead burden in blood, kidney and brain tissues. Chronic lead nitrate ingestion showed a significant decline in total erythrocyte count, total leukocyte count, hemoglobin concentration, lymphocyte and monocyte content, while neutrophil content increased in lead nitrate treated group. Pb(NO(3))(2) exposure elicited a significant escalation in thiobarbituric acid reactive substances level and depletion in reduced glutathione content and antioxidant enzymes namely, superoxide dismutase and catalase in kidney and brain. Activities of aspartate transaminase, alanine transaminase, acid phosphatase and alkaline phosphatase augmented significantly in kidney and brain of lead exposed mice. Lead nitrate treatment decreased protein content while cholesterol and lead burden increased significantly. A decrease in viability of macrophage, phagocytic index, immunoglobulin level and plaque count were the salient features observed in lead exposed animals. However, oral administration of garlic extracts to Pb(NO(3))(2) treated groups attenuated the deranged parameters to some extent. This indicates that garlic can be a protective regimen for lead toxicity. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

Estimating the true global burden of mental illness.

Science.gov (United States)

Vigo, Daniel; Thornicroft, Graham; Atun, Rifat

2016-02-01

We argue that the global burden of mental illness is underestimated and examine the reasons for under-estimation to identify five main causes: overlap between psychiatric and neurological disorders; the grouping of suicide and self-harm as a separate category; conflation of all chronic pain syndromes with musculoskeletal disorders; exclusion of personality disorders from disease burden calculations; and inadequate consideration of the contribution of severe mental illness to mortality from associated causes. Using published data, we estimate the disease burden for mental illness to show that the global burden of mental illness accounts for 32·4% of years lived with disability (YLDs) and 13·0% of disability-adjusted life-years (DALYs), instead of the earlier estimates suggesting 21·2% of YLDs and 7·1% of DALYs. Currently used approaches underestimate the burden of mental illness by more than a third. Our estimates place mental illness a distant first in global burden of disease in terms of YLDs, and level with cardiovascular and circulatory diseases in terms of DALYs. The unacceptable apathy of governments and funders of global health must be overcome to mitigate the human, social, and economic costs of mental illness. Copyright © 2016 Elsevier Ltd. All rights reserved.

The burden experienced by family caregivers of patients with ...

African Journals Online (AJOL)

BACKGROUND: Caring for patients with chronic medical and psychiatric disorders is associated with significant burden. However little is known about the burden experience by caregivers of patients with epilepsy in Nigeria. The objective of this study, therefore, was to assess the level and correlates of burden among ...

Alcohol consumption and burden of disease in the Americas in 2012: implications for alcohol policy

Directory of Open Access Journals (Sweden)

Kevin D. Shield

Full Text Available OBJECTIVE:To describe the volume and patterns of alcohol consumption up to and including 2012, and to estimate the burden of disease attributable to alcohol consumption as measured in deaths and disability-adjusted life years (DALYs lost in the Americas in 2012. METHODS: Measures of alcohol consumption were obtained from the World Health Organization (WHO Global Information System on Alcohol and Health (GISAH. The burden of alcohol consumption was estimated in both deaths and DALYs lost based on mortality data obtained from WHO, using alcohol-attributable fractions. Regional groupings for the Americas were based on the WHO classifications for 2004 (according to child and adult mortality. RESULTS: Regional variations were observed in the overall volume of alcohol consumed, the proportion of the alcohol market attributable to unrecorded alcohol consumption, drinking patterns, prevalence of drinking, and prevalence of heavy episodic drinking, with inhabitants of the Americas consuming more alcohol (8.4 L of pure alcohol per adult in 2012 compared to the world average. The Americas also experienced a high burden of disease attributable to alcohol consumption (4.7% of all deaths and 6.7% of all DALYs lost, especially in terms of injuries attributable to alcohol consumption. CONCLUSIONS: Alcohol is consumed in a harmful manner in the Americas, leading to a high burden of disease, especially in terms of injuries. New cost-effective alcohol policies, such as increasing alcohol taxation, increasing the minimum legal age to purchase alcohol, and decreasing the maximum legal blood alcohol content while driving, should be implemented to decrease the harmful consumption of alcohol and the resulting burden of disease.

Environmental exposure to lead induces oxidative stress and modulates the function of the antioxidant defense system and the immune system in the semen of males with normal semen profile

Energy Technology Data Exchange (ETDEWEB)

Kasperczyk, Aleksandra; Dobrakowski, Michał [Dept. of Biochemistry, School of Medicine with the Division of Dentistry, Medical University of Silesia, Katowice, Jordana 19, 41-808 Zabrze (Poland); Czuba, Zenon P. [Dept. of Microbiology and Immunology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Katowice, Jordana 19, 41-808 Zabrze (Poland); Horak, Stanisław [I-st Chair and Clin. Dept. of Gynecology, Obstetrics and Gynecological Oncology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Katowice, Batorego 15, 41-902 Bytom (Poland); Kasperczyk, Sławomir, E-mail: kaslav@mp.pl [Dept. of Biochemistry, School of Medicine with the Division of Dentistry, Medical University of Silesia, Katowice, Jordana 19, 41-808 Zabrze (Poland)

2015-05-01

We investigated the associations between environmental exposure to lead and a repertoire of cytokines in seminal plasma of males with normal semen profile according to the WHO criteria. Based on the median lead concentration in seminal plasma, 65 samples were divided into two groups: low (LE) and high exposure to lead (HE). Differences in semen volume and the pH, count, motility and morphology of sperm cells were not observed between the examined groups. The total oxidant status value and the level of protein sulfhydryl groups as well as the activities of manganese superoxide dismutase and catalase were significantly higher in the HE group, whereas the total antioxidant capacity value and the activities of glutathione reductase and glutathione-S-transferase were depressed. IL-7, IL-10, IL-12, and TNF-α levels were significantly higher in the HE group compared with the LE group. Environmental exposure to lead is sufficient to induce oxidative stress in seminal plasma and to modulate antioxidant defense system. - Highlights: • Lead induces oxidative stress in seminal plasma in human. • Lead modulates antioxidant defense system in seminal plasma in human. • Lead does not change a Th1/Th2 imbalance in seminal plasma in human.

Mild heat stress at a young age in Drosophila melanogaster leads to ...

Indian Academy of Sciences (India)

Unknown

effect on stress resistance later in life, and on longevity. ... bouts of mild heat stress (3 h at 34°C) at a young age (days 2, 4 and 6 post-eclosion) or held under .... The mortality during the investigated lifespan .... at least during early senescence.

Caregiving burden and its determinants in Polish caregivers of stroke survivors.

Science.gov (United States)

Jaracz, Krystyna; Grabowska-Fudala, Barbara; Górna, Krystyna; Kozubski, Wojciech

2014-10-27

Despite the growing body of literature on the consequences of providing non-professional care to stroke survivors, the determinants of caregiving burden are still not fully recognized. Identification of significant determinants can facilitate caregiver intervention programs. The aim of this study was to evaluate the level of burden borne by caregivers of stroke patients and to identify the most important determinants of burden at 6 months after hospitalization. Data were collected from 150 pairs of stroke patients/caregivers. Caregiver burden was assessed on the Caregiver Burden scale (CB). Several characteristics were measured as potential predictors of the burden. Special attention was paid to the caregiver's sense of coherence (SOC) and anxiety. Regression analysis was employed to test the hypothesized relationships between these variables and the burden. Forty-seven percentage of the caregivers reported a substantial burden (severe or moderate). Caregiver SOC (p emotional state and the level of patients' dependency, as these are the vital and modifiable factors affecting caregiver burden following stroke.

The connection between animal stress and meat production: Uncoupling of the growth hormone/insulin-like growth factor 1 axis

Science.gov (United States)

For decades, researchers have demonstrated that "stress" can have detrimental effects on the immune system. However, what had not been distinguished until recently are the divergent effects of "acute" stress associated with subclinical immunological burdens on the animal versus long-term or "chronic...

The void nucleation mechanism within lead phase during spallation of leaded brass

Science.gov (United States)

Yang, Yang; Wang, Can; Chen, Xingzhi; Chen, Kaiguo; Hu, Haibo; Fu, Yanan

2018-07-01

The incipient spall behaviours of Cu-34%Zn-3%Pb leaded brass samples with annealed and cryogenic-treated conditions were loaded using one-stage light gas gun experiments. The effect of Pb-phase on dynamic damage nucleation in leaded brass specimens was investigated by means of optical microscopy, scanning electron microscopy and x-ray computer tomography. It was found that the voids of incipient spall were mainly nucleated in the interior of the lead (no tensile stress would be produced within lead according to the impact theory) instead of nucleated at the phase interface as expected by quasi-static damage fracture theory. A nucleation model is proposed in the present work that is the asymmetry high compression zones in the centre of the lead-phase were formed by the rarefaction wave convergence effects of matrix/quasi-spherical lead interface, which caused adiabatic temperature rise that exceeded melting point of lead due to severe plastic deformation, finally led to local melting and void nucleation. In addition, the spall strength and damage rate increased with the increase in the Pb-phase number.

Global burden of stroke and risk factors in 188 countries, during 1990-2013

DEFF Research Database (Denmark)

Feigin, Valery L; Roth, Gregory A; Naghavi, Mohsen

2016-01-01

the population-attributable fraction (PAF) of stroke-related disability-adjusted life-years (DALYs) associated with potentially modifiable environmental, occupational, behavioural, physiological, and metabolic risk factors in different age and sex groups worldwide and in high-income countries and low......·2-73·5) and environmental factors (air pollution and lead exposure; 33·4%, 95% UI 32·4-34·3) were the second and third largest contributors to DALYs. Globally, 29·2% (95% UI 28·2-29·6) of the burden of stroke was attributed to air pollution. Although globally there were no significant differences between sexes......-income and middle-income countries, from 1990 to 2013. METHODS: We used data on stroke-related DALYs, risk factors, and PAF from the GBD 2013 Study to estimate the burden of stroke by age and sex (with corresponding 95% uncertainty intervals [UI]) in 188 countries, as measured with stroke-related DALYs in 1990...

Loss of NHE1 activity leads to reduced oxidative stress in heart and mitigates high-fat diet-induced myocardial stress.

Science.gov (United States)

Prasad, Vikram; Lorenz, John N; Miller, Marian L; Vairamani, Kanimozhi; Nieman, Michelle L; Wang, Yigang; Shull, Gary E

2013-12-01

Acute inhibition of the NHE1 Na(+)/H(+) exchanger protects against ischemia-reperfusion injury and chronic inhibition attenuates development of cardiac hypertrophy and failure. To determine the cardiac effects of chronic inhibition of NHE1 under non-pathological conditions we used NHE1-null mice as a model of long-term NHE1 inhibition. Cardiovascular performance was relatively normal in Nhe1(-/-) mice although cardiac contractility and relaxation were slightly improved in mutant mice of the FVB/N background. GSH levels and GSH:GSSG ratios were elevated in Nhe1(-/-) hearts indicating an enhanced redox potential. Consistent with a reduced need for antioxidant protection, expression of heat shock proteins Hsp60 and Hsp25 was lower in Nhe1(-/-) hearts. Similarly, expression of mitochondrial superoxide dismutase 2 was reduced, with no increase in expression of other ROS scavenging enzymes. GLUT1 levels were increased in Nhe1(-/-) hearts, the number of lipid droplets in myocytes was reduced, and PDK4 expression was refractory to high-fat diet-induced upregulation observed in wild-type hearts. High-fat diet-induced stress was attenuated in Nhe1(-/-) hearts, as indicated by smaller increases in phosphorylation of Hsp25 and α-B crystallin, and there was better preservation of insulin sensitivity, as evidenced by PKB/Akt phosphorylation. Plasma glucose and insulin levels were lower and high-fat diet-induced hepatic lipid accumulation was reduced in Nhe1(-/-) mice, demonstrating extracardiac effects of NHE1 ablation. These data indicate that long-term ablation of NHE1 activity increases the redox potential, mitigates high-fat diet-induced myocardial stress and fatty liver disease, leads to better preservation of insulin sensitivity, and may alter both cardiac and systemic metabolic substrate handling in mice. © 2013 Elsevier Ltd. All rights reserved.

Possible role of Arthrospira platensis in reversing oxidative stress-mediated liver damage in rats exposed to lead.

Science.gov (United States)

Khalil, Samah R; Elhady, Walaa M; Elewa, Yaser H A; Abd El-Hameed, Noura E; Ali, Sozan A

2018-01-01

Environmental pollutants, particularly metallic elements, mobilized and released into the environment, eventually accumulate in the food chain and thus pose a serious threat to human and animal health. In the present study, the role of Arthrospira (Spirulina platensis; SP) as a protector against oxidative stress-mediated liver damage induced by an exposure to lead acetate (LA; as a metallic pollutant) was assessed. To achieve this aim, rats were orally administered with 300 mg/kg bw SP for 15 days, before and concurrently with an intraperitoneal injection of 50 mg/kg bw LA (6 injections throughout 15 days). As a result, co-administration of SP with LA reduced the amount of lead that accumulated in both blood and liver tissue of the exposed rats and minimized the increased levels of lipid peroxidation, protein oxidation, DNA oxidative damage, and liver enzyme endpoints. In addition, because of SP administration, the levels of depleted biomarkers of antioxidant status and total antioxidant capacity in LA-exposed rats improved. Moreover, SP protected the liver tissue against the changes caused by LA exposure and also decreased the reactivity of HSP70 in the cytoplasm of hepatocytes. Collectively, our data suggest that SP has a potential use as a food supplement in the regions highly polluted with heavy metals such as lead. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

6 CFR 27.325 - Burden of proof.

Science.gov (United States)

2010-01-01

... 6 Domestic Security 1 2010-01-01 2010-01-01 false Burden of proof. 27.325 Section 27.325 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY CHEMICAL FACILITY ANTI-TERRORISM... burden of proving the facts necessary to support the challenged administrative action at every proceeding...

Formalising arguments about the burden of persuasion.

NARCIS (Netherlands)

Prakken, H.; Sartor, G.

2007-01-01

This paper presents an argument-based logic for reasoning about allocations of the burden of persuasion. The logic extends the system of Prakken (2001), which in turn modified the system of Prakken & Sartor (1996) with the possibility to distribute the burden of proof over both sides in an argument

Vision problems are a leading source of modifiable health expenditures.

Science.gov (United States)

Rein, David B

2013-12-13

According to recent studies, visual problems represent one of the top contributors to economic health burden in the United States. This burden is divided nearly equally between direct expenditures for the care and treatment of visual problems, and the indirect costs of outcomes caused by low vision, including productivity losses, the cost of care, and incremental nursing home placements. A large amount of academic research is devoted to visual science, the biology of the visual system, and the medical treatment of visual disorders. Compared to the burden, a disproportionate share of this research is devoted to the study of retinal disorders and glaucoma. This is understandable, as research into the retina and optic nerve has the potential to unlock fundamental insights into the nature of sight and visual cognition. However, population visual health and the functionality that depends upon it also may benefit greatly from additional research into areas of prevention, rehabilitation, and adaptation. In addition, comparative research into the benefits of resource allocation across prevention, treatment, and rehabilitative resources could lead to improvements in population health.

IGF-1, oxidative stress, and atheroprotection

Science.gov (United States)

Higashi, Yusuke; Sukhanov, Sergiy; Anwar, Asif; Shai, Shaw-Yung; Delafontaine, Patrice

2009-01-01

Atherosclerosis is a chronic inflammatory disease in which early endothelial dysfunction and subintimal modified lipoprotein deposition progress to complex, advanced lesions that are predisposed to erosion, rupture and thrombosis. Oxidative stress plays a critical role not only in initial lesion formation but also in lesion progression and destabilization. While growth factors are thought to promote vascular smooth muscle cell proliferation and migration, thereby increasing neointima, recent animal studies indicate that IGF-1 exerts pleiotropic anti-oxidant effects along with anti-inflammatory effects that together reduce atherosclerotic burden. This review discusses the effects of IGF-1 in vascular injury and atherosclerosis models, emphasizing the relationship between oxidative stress and potential atheroprotective actions of IGF-1. PMID:20071192

Burden Sharing with Climate Change Impacts

Science.gov (United States)

Tavoni, M.; van Vuuren, D.; De Cian, E.; Marangoni, G.; Hof, A.

2014-12-01

Efficiency and equity have been at the center of the climate change policy making since the very first international environmental agreements on climate change, though over time how to implement these principles has taken different forms. Studies based on Integrated Assessment Models have also shown that the economic effort of achieving a 2 degree target in a cost-effective way would differ widely across regions (Tavoni et al. 2013) because of diverse economic and energy structure, baseline emissions, energy and carbon intensity. Policy instruments, such as a fully-fledged, global emission trading schemes can be used to pursuing efficiency and equity at the same time but the literature has analyzed the compensations required to redistribute only mitigation costs. However, most of these studies have neglected the potential impacts of climate change. In this paper we use two integrated assessment models -FAIR and WITCH- to explore the 2°C policy space when accounting for climate change impacts. Impacts are represented via two different reduced forms equations, which despite their simplicity allows us exploring the key sensitivities- Our results show that in a 2 degree stabilization scenarios residual damages remain significant (see Figure 1) and that if you would like to compensate those as part of an equal effort scheme - this would lead to a different allocation than focusing on a mitigation based perspective only. The residual damages and adaptation costs are not equally distributed - and while we do not cover the full uncertainty space - with 2 different models and 2 sets of damage curves we are still able to show quite similar results in terms of vulnerable regions and the relative position of the different scenarios. Therefore, accounting for the residual damages and the associated adaptation costs on top of the mitigation burden increases and redistributes the full burden of total climate change.

Double burden of disease in the slums of Kenya

NARCIS (Netherlands)

Oti, S.O.

2015-01-01

The goal of this thesis was to provide evidence of a double burden of disease in the slums of Nairobi and to make a case for an integrated health systems approach to tackling this situation. A double burden of disease refers to the coexistence of a high burden of communicable and non-communicable

Burden attributable to child maltreatment in Australia.

Science.gov (United States)

Moore, Sophie E; Scott, James G; Ferrari, Alize J; Mills, Ryan; Dunne, Michael P; Erskine, Holly E; Devries, Karen M; Degenhardt, Louisa; Vos, Theo; Whiteford, Harvey A; McCarthy, Molly; Norman, Rosana E

2015-10-01

Child maltreatment is a complex phenomenon, with four main types (childhood sexual abuse, physical abuse, emotional abuse, and neglect) highly interrelated. All types of maltreatment have been linked to adverse health consequences and exposure to multiple forms of maltreatment increases risk. In Australia to date, only burden attributable to childhood sexual abuse has been estimated. This study synthesized the national evidence and quantified the burden attributable to the four main types of child maltreatment. Meta-analyses, based on quality-effects models, generated pooled prevalence estimates for each maltreatment type. Exposure to child maltreatment was examined as a risk factor for depressive disorders, anxiety disorders and intentional self-harm using counterfactual estimation and comparative risk assessment methods. Adjustments were made for co-occurrence of multiple forms of child maltreatment. Overall, an estimated 23.5% of self-harm, 20.9% of anxiety disorders and 15.7% of depressive disorders burden in males; and 33.0% of self-harm, 30.6% of anxiety disorders and 22.8% of depressive disorders burden in females was attributable to child maltreatment. Child maltreatment was estimated to cause 1.4% (95% uncertainty interval 0.4-2.3%) of all disability-adjusted life years (DALYs) in males, and 2.4% (0.7-4.1%) of all DALYs in females in Australia in 2010. Child maltreatment contributes to a substantial proportion of burden from depressive and anxiety disorders and intentional self-harm in Australia. This study demonstrates the importance of including all forms of child maltreatment as risk factors in future burden of disease studies. Copyright © 2015 Elsevier Ltd. All rights reserved.

Maternal Stress Combined with Terbutaline Leads to Comorbid Autistic-Like Behavior and Epilepsy in a Rat Model.

Science.gov (United States)

Bercum, Florencia M; Rodgers, Krista M; Benison, Alex M; Smith, Zachariah Z; Taylor, Jeremy; Kornreich, Elise; Grabenstatter, Heidi L; Dudek, F Edward; Barth, Daniel S

2015-12-02

Human autism is comorbid with epilepsy, yet, little is known about the causes or risk factors leading to this combined neurological syndrome. Although genetic predisposition can play a substantial role, our objective was to investigate whether maternal environmental factors alone could be sufficient. We examined the independent and combined effects of maternal stress and terbutaline (used to arrest preterm labor), autism risk factors in humans, on measures of both autistic-like behavior and epilepsy in Sprague-Dawley rats. Pregnant dams were exposed to mild stress (foot shocks at 1 week intervals) throughout pregnancy. Pups were injected with terbutaline on postnatal days 2-5. Either maternal stress or terbutaline resulted in autistic-like behaviors in offspring (stereotyped/repetitive behaviors and deficits in social interaction or communication), but neither resulted in epilepsy. However, their combination resulted in severe behavioral symptoms, as well as spontaneous recurrent convulsive seizures in 45% and epileptiform spikes in 100%, of the rats. Hippocampal gliosis (GFAP reactivity) was correlated with both abnormal behavior and spontaneous seizures. We conclude that prenatal insults alone can cause comorbid autism and epilepsy but it requires a combination of teratogens to achieve this; testing single teratogens independently and not examining combinatorial effects may fail to reveal key risk factors in humans. Moreover, astrogliosis may be common to both teratogens. This new animal model of combined autism and epilepsy permits the experimental investigation of both the cellular mechanisms and potential intervention strategies for this debilitating comorbid syndrome. Copyright © 2015 the authors 0270-6474/15/3515894-09$15.00/0.

The effect of group psycho-education program on the burden of family caregivers with multiple sclerosis patients in Isfahan in 2013-2014.

Science.gov (United States)

Pahlavanzadeh, Saeid; Dalvi-Isfahani, Fariba; Alimohammadi, Nasrollah; Chitsaz, Ahmad

2015-01-01

Lack of adequate training and support of primary caregivers of multiple sclerosis (MS) patients is the major factor in causing stress, anxiety, and increase of burden. Therefore, the treatment team members such as psychiatric nurses can help these vulnerable people overcome psychiatric pressures effectively not only through their care and referral role but also through their supportive characteristic, which helps the patients improve their clinical status, together with their social, familial, and work adaptation. Therefore, the researcher tried to identify the effect of a group psycho-education program on the burden family caregivers with MS patients. This is a two-group three-stage clinical trial. The researcher referred to the heads of neurology clinics to present the purpose of the study and to start the sampling. The neurology clinics of AL Zahra University Hospital, and also a Private Neurology Clinic were selected to collect the data of the study. The subjects were randomly selected, and then, assigned to two groups of study and control. Independent t-test showed a significant reduction in family caregivers' burden immediately after and 1-month after intervention in the study group, compared to control. Repeated measure ANOVA showed a significant reduction in caregivers' burden mean score in the study group (P family caregivers' burden, it is recommended to develop and design other programs for the family caregivers of the patients with MS.

Private prayer among Alzheimer's caregivers: mediating burden and resiliency.

Science.gov (United States)

Wilks, Scott E; Vonk, M Elizabeth

2008-01-01

This study examined whether the coping method of private prayer served as a protective factor of resiliency among a sample (N = 304) of Alzheimer's caregivers. Participants in caregiver support groups completed questionnaires that assessed a number of constructs, including caregiving burden; prayer frequency; use of private prayer as a means of coping; and perceived resiliency. The sample averaged a moderate level of burden and a great extent of prayer usage. Caregiving burden had positively affected the extent of prayer usage and negatively influenced perceived resiliency. Findings from hierarchical regression analysis showed that caregiving burden and private prayer significantly influenced variation in perceived resiliency scores. Results from a regression equation series and path analysis provided support for prayer as a mediator between burden and perceived resiliency. Implications for social work practice and education are discussed.

Stress in childhood

Science.gov (United States)

... body changes, in both boys and girls Seeing parents go through a divorce or separation Money problems in the family Living in an unsafe home or neighborhood SIGNS OF UNRESOLVED STRESS IN ... lead parents to suspect an increased stress level is present. ...

Gills are an initial target of zinc oxide nanoparticles in oysters Crassostrea gigas, leading to mitochondrial disruption and oxidative stress

International Nuclear Information System (INIS)

Trevisan, Rafael; Delapedra, Gabriel; Mello, Danielle F.; Arl, Miriam; Schmidt, Éder C.; Meder, Fabian; Monopoli, Marco; Cargnin-Ferreira, Eduardo; Bouzon, Zenilda L.; Fisher, Andrew S.; Sheehan, David; Dafre, Alcir L.

2014-01-01

Graphical abstract: - Highlights: • ZnONP exposure causes an initial accumulation of zinc in gills and later in digestive gland. • Zinc burden occurs by ZnONP endocytosis or uptake of ionic zinc after dissociation. • ZnONP exposure disrupts mitochondrial ultrastructure in both tissues. • Mitochondrial damage and oxidative stress are major features of ZnONP acute toxicity. - Abstract: The increasing industrial use of nanomaterials during the last decades poses a potential threat to the environment and in particular to organisms living in the aquatic environment. In the present study, the toxicity of zinc oxide nanoparticles (ZnONP) was investigated in Pacific oysters Crassostrea gigas. The nanoscale of ZnONP, in vehicle or ultrapure water, was confirmed, presenting an average size ranging from 28 to 88 nm. In seawater, aggregation was detected by TEM and DLS analysis, with an increased average size ranging from 1 to 2 μm. Soluble or nanoparticulated zinc presented similar toxicity, displaying a LC 50 (96 h) around 30 mg/L. High zinc dissociation from ZnONP, releasing ionic zinc in seawater, is a potential route for zinc assimilation and ZnONP toxicity. To investigate mechanisms of toxicity, oysters were treated with 4 mg/L ZnONP for 6, 24 or 48 h. ZnONP accumulated in gills (24 and 48 h) and digestive glands (48 h). Ultrastructural analysis of gills revealed electron-dense vesicles near the cell membrane and loss of mitochondrial cristae (6 h). Swollen mitochondria and a more conspicuous loss of mitochondrial cristae were observed after 24 h. Mitochondria with disrupted membranes and an increased number of cytosolic vesicles displaying electron-dense material were observed 48 h post exposure. Digestive gland showed similar changes, but these were delayed relative to gills. ZnONP exposure did not greatly affect thiol homeostasis (reduced and oxidized glutathione) or immunological parameters (phagocytosis, hemocyte viability and activation and total hemocyte

Gills are an initial target of zinc oxide nanoparticles in oysters Crassostrea gigas, leading to mitochondrial disruption and oxidative stress

Energy Technology Data Exchange (ETDEWEB)

Trevisan, Rafael; Delapedra, Gabriel; Mello, Danielle F.; Arl, Miriam [Department of Biochemistry, Federal University of Santa Catarina, 88040-900 Florianópolis, SC (Brazil); Schmidt, Éder C. [Department of Cell Biology, Embryology and Genetic, Federal University of Santa Catarina, 88049-900 Florianópolis, SC (Brazil); Meder, Fabian; Monopoli, Marco [Centre for Bionano Interactions, University College Dublin, Dublin (Ireland); Cargnin-Ferreira, Eduardo [Federal Institute of Santa Catarina, Campus Garopaba, Laboratory of Histological Markers, 88495-000 Garopaba, SC (Brazil); Bouzon, Zenilda L. [Department of Cell Biology, Embryology and Genetic, Federal University of Santa Catarina, 88049-900 Florianópolis, SC (Brazil); Fisher, Andrew S. [School of Geography, Earth and Environmental Sciences, University of Plymouth, PL4 8AA Plymouth (United Kingdom); Sheehan, David [Department of Biochemistry, University College Cork, Cork (Ireland); Dafre, Alcir L., E-mail: alcir.dafre@ufsc.br [Department of Biochemistry, Federal University of Santa Catarina, 88040-900 Florianópolis, SC (Brazil)

2014-08-15

Graphical abstract: - Highlights: • ZnONP exposure causes an initial accumulation of zinc in gills and later in digestive gland. • Zinc burden occurs by ZnONP endocytosis or uptake of ionic zinc after dissociation. • ZnONP exposure disrupts mitochondrial ultrastructure in both tissues. • Mitochondrial damage and oxidative stress are major features of ZnONP acute toxicity. - Abstract: The increasing industrial use of nanomaterials during the last decades poses a potential threat to the environment and in particular to organisms living in the aquatic environment. In the present study, the toxicity of zinc oxide nanoparticles (ZnONP) was investigated in Pacific oysters Crassostrea gigas. The nanoscale of ZnONP, in vehicle or ultrapure water, was confirmed, presenting an average size ranging from 28 to 88 nm. In seawater, aggregation was detected by TEM and DLS analysis, with an increased average size ranging from 1 to 2 μm. Soluble or nanoparticulated zinc presented similar toxicity, displaying a LC{sub 50} (96 h) around 30 mg/L. High zinc dissociation from ZnONP, releasing ionic zinc in seawater, is a potential route for zinc assimilation and ZnONP toxicity. To investigate mechanisms of toxicity, oysters were treated with 4 mg/L ZnONP for 6, 24 or 48 h. ZnONP accumulated in gills (24 and 48 h) and digestive glands (48 h). Ultrastructural analysis of gills revealed electron-dense vesicles near the cell membrane and loss of mitochondrial cristae (6 h). Swollen mitochondria and a more conspicuous loss of mitochondrial cristae were observed after 24 h. Mitochondria with disrupted membranes and an increased number of cytosolic vesicles displaying electron-dense material were observed 48 h post exposure. Digestive gland showed similar changes, but these were delayed relative to gills. ZnONP exposure did not greatly affect thiol homeostasis (reduced and oxidized glutathione) or immunological parameters (phagocytosis, hemocyte viability and activation and total

Stress on stress response of wild mussels, Mytilus edulis and Mytilus trossulus, as an indicator of ecosystem health

International Nuclear Information System (INIS)

Hellou, J.; Law, R.J.

2003-01-01

Mussels' health as indicated by the survival time of 50% of sampled animals (LT 50 ) when maintained in air at 15 deg. C was examined at three sites in Halifax Harbour with expected differing levels of contamination. Condition and gonad indices, lipid content and the body burden of polycyclic aromatic compounds (PACs) were compared with this stress response in 60 groups of mussels covering two species. At each sampling time, the bioaccumulation of PACs, lipid content and condition indices were higher whithin Mytilus edulis and Mytilus trossulus displaying shorter survival than at the other sites. M. edulis was generally more tolerant than M. trossulus (for n=11, LT 50 of 9.3 and 7.9 days), with indications of shorter and later gonad development in M. trossulus. Minimum and maximum tolerance was apparent in June and October (LT 50 spanning 3-14 days), respectively. Our results indicate that the stress on stress response provides a simple and sensitive indicator of environmental health, which could be integrated with mussel watch studies. - Stress on stress response is a simple and sensitive indicator of environmental condition

20 CFR 498.215 - The hearing and burden of proof.

Science.gov (United States)

2010-04-01

... burden of going forward and the burden of persuasion with respect to affirmative defenses and any... persuasion with respect to all other issues. (c) The burden of persuasion will be judged by a preponderance...

Burden of disease, injuries, risk factors and challenges for the health system in Mexico

Directory of Open Access Journals (Sweden)

Rafael Lozano

2013-09-01

Full Text Available Objective. To present the results of the burden of disease, injuries and risk factors in Mexico from 1990 to 2010 for the principal illnesses, injuries and risk factors by sex. Materials and methods. A secondary analysis of the study results published by the Global Burden of Disease 2010 for Mexico performed by IHME. Results. In 2010, Mexico lost 26.2 million of Disability adjusted live years (DALYs, 56 % were in male and 44 % in women. The main causes of DALYs in men are violence, ischemic heart disease and road traffic injuries. In the case of women the leading causes are diabetes, chronic kidney disease and ischemic heart diseases. The mental disorders and musculoskeletal conditions concentrate 18% of health lost. The risk factors that most affect men in Mexico are: alcohol consumption, overweight/obesity, high blood glucose levels and blood pressure and tobacco consumption (35.6 % of DALYs lost. In women, overweight and obesity, high blood sugar and blood pressure, lack of physical activity and consumption of alcohol are responsible for 40 % of DALYs lost. In both sexes the problems with diet contribute 12% of the burden. Conclusions. The epidemiological situation in Mexico, demands an urgent adaptation and modernization of the health system

Coping With Stress as an LGBTQ+ Health Care Professional.

Science.gov (United States)

Eliason, Michele J; Streed, Carl; Henne, Michael

2018-01-01

Lesbian, gay, bisexual, transgender, queer, and other sexual/gender minority (LGBTQ+) health care providers face both general work-related stresses and working in heteronormative settings with ill-informed or hostile coworkers and patients, yet there has been little study of whether the coping strategies are specific to LGBTQ+ stress. We analyzed qualitative data from 277 health care professionals. Sources of stress included religiously and politically conservative coworkers, coworker/patient lack of knowledge, stresses of being closeted, and concerns about being out to patients. Consequences of being out as LGBTQ+ included lack of promotions, gossip, refusals of tenure, and anti-LGBTQ+ comments and behaviors in the workplace. Respondents showed mostly positive coping strategies to deal with stress, including becoming educators/advocates and self-care activities. Self-care options were common in rural areas with few LGBTQ+ social resources. Negative coping strategies were reported by 18% of respondents. The study highlights the extra burden of stress on LGBTQ+ health care providers.

Economic and disease burden of dengue in Mexico.

Directory of Open Access Journals (Sweden)

Eduardo A Undurraga

2015-03-01

Full Text Available Dengue imposes a substantial economic and disease burden in most tropical and subtropical countries. Dengue incidence and severity have dramatically increased in Mexico during the past decades. Having objective and comparable estimates of the economic burden of dengue is essential to inform health policy, increase disease awareness, and assess the impact of dengue prevention and control technologies.We estimated the annual economic and disease burden of dengue in Mexico for the years 2010-2011. We merged multiple data sources, including a prospective cohort study; patient interviews and macro-costing from major hospitals; surveillance, budget, and health data from the Ministry of Health; WHO cost estimates; and available literature. We conducted a probabilistic sensitivity analysis using Monte Carlo simulations to derive 95% certainty levels (CL for our estimates. Results suggest that Mexico had about 139,000 (95%CL: 128,000-253,000 symptomatic and 119 (95%CL: 75-171 fatal dengue episodes annually on average (2010-2011, compared to an average of 30,941 symptomatic and 59 fatal dengue episodes reported. The annual cost, including surveillance and vector control, was US$170 (95%CL: 151-292 million, or $1.56 (95%CL: 1.38-2.68 per capita, comparable to other countries in the region. Of this, $87 (95%CL: 87-209 million or $0.80 per capita (95%CL: 0.62-1.12 corresponds to illness. Annual disease burden averaged 65 (95%CL: 36-99 disability-adjusted life years (DALYs per million population. Inclusion of long-term sequelae, co-morbidities, impact on tourism, and health system disruption during outbreaks would further increase estimated economic and disease burden.With this study, Mexico joins Panama, Puerto Rico, Nicaragua, and Thailand as the only countries or areas worldwide with comprehensive (illness and preventive empirical estimates of dengue burden. Burden varies annually; during an outbreak, dengue burden may be significantly higher than that of

Economic and disease burden of dengue in Mexico.

Science.gov (United States)

Undurraga, Eduardo A; Betancourt-Cravioto, Miguel; Ramos-Castañeda, José; Martínez-Vega, Ruth; Méndez-Galván, Jorge; Gubler, Duane J; Guzmán, María G; Halstead, Scott B; Harris, Eva; Kuri-Morales, Pablo; Tapia-Conyer, Roberto; Shepard, Donald S

2015-03-01

Dengue imposes a substantial economic and disease burden in most tropical and subtropical countries. Dengue incidence and severity have dramatically increased in Mexico during the past decades. Having objective and comparable estimates of the economic burden of dengue is essential to inform health policy, increase disease awareness, and assess the impact of dengue prevention and control technologies. We estimated the annual economic and disease burden of dengue in Mexico for the years 2010-2011. We merged multiple data sources, including a prospective cohort study; patient interviews and macro-costing from major hospitals; surveillance, budget, and health data from the Ministry of Health; WHO cost estimates; and available literature. We conducted a probabilistic sensitivity analysis using Monte Carlo simulations to derive 95% certainty levels (CL) for our estimates. Results suggest that Mexico had about 139,000 (95%CL: 128,000-253,000) symptomatic and 119 (95%CL: 75-171) fatal dengue episodes annually on average (2010-2011), compared to an average of 30,941 symptomatic and 59 fatal dengue episodes reported. The annual cost, including surveillance and vector control, was US$170 (95%CL: 151-292) million, or $1.56 (95%CL: 1.38-2.68) per capita, comparable to other countries in the region. Of this, $87 (95%CL: 87-209) million or $0.80 per capita (95%CL: 0.62-1.12) corresponds to illness. Annual disease burden averaged 65 (95%CL: 36-99) disability-adjusted life years (DALYs) per million population. Inclusion of long-term sequelae, co-morbidities, impact on tourism, and health system disruption during outbreaks would further increase estimated economic and disease burden. With this study, Mexico joins Panama, Puerto Rico, Nicaragua, and Thailand as the only countries or areas worldwide with comprehensive (illness and preventive) empirical estimates of dengue burden. Burden varies annually; during an outbreak, dengue burden may be significantly higher than that of the pre

Prevalence and burden of Sickle Cell Disease among ...

African Journals Online (AJOL)

femi oloka

the variables pain severity, monthly income, the psychological and ... 44% had significant psychological burden while 37.3% have socio-cultural burden. The ..... 6. Otis-Green S. Psychosocial Pain. Assessment Form. In Dow (Ed.), Nursing.

Exploring the associations between spiritual well-being, burden, and quality of life in family caregivers of cancer patients.

Science.gov (United States)

Spatuzzi, Roberta; Giulietti, Maria Velia; Ricciuti, Marcello; Merico, Fabiana; Fabbietti, Paolo; Raucci, Letizia; Bilancia, Domenico; Cormio, Claudia; Vespa, Anna

2018-05-11

The spiritual dimension is important in the process of coping with stress and may be of special relevance for those caring for cancer patients in the various phases of caregivership, although current attention is most prevalent at the end of life. This study explores the associations among spiritual well-being (SWB), caregiver burden, and quality of life (QoL) in family caregivers of patients with cancer during the course of the disease. This is a cross-sectional study. All participants (n = 199) underwent the following self-report questionnaires: the SWB-Index, the Medical Outcomes Study Short Form, and the Caregiver Burden Inventory (CBI). SWB scores were dichotomized at a cutoff corresponding to the 75th percentile. Statistical analyses were made using the Student t or by chi-square test to compare high and low SWB groups.ResultThe high SWB group reported significantly better Medical Outcomes Study Short Form scores in bodily pain (p = 0.035), vitality (p scale. The high SWB group also had better CBI scores in the physical (p = 0.049) and developmental burden (p = 0.053) subscales. There were no significant differences in the other CBI scores (overall and sections).Significance of resultsThis study points out that high SWB caregivers have a more positive QoL and burden. Knowledge of these associations calls for more attention on the part of healthcare professionals toward spiritual resources among family cancer caregivers from the moment of diagnosis and across the entire cancer trajectory.

Burden of mortality in Greenland--today and tomorrow

DEFF Research Database (Denmark)

Nielsen, Lasse Christian; Hansen, Kristian Schultz; Nielsen, Ulla Ringgren

2004-01-01

: Concerted multi-sectoral approaches and broad holistic health strategies related to health promotion and prevention today will strategically improve the capability of the Greenlandic society to manage the future disease burden from ageing via its health care sector and the institutional sector for care......OBJECTIVES: Investigation of the relative impact of three factors expected to influence the future mortality burden in Greenland: demographic change, epidemiological transition and behavioural patterns. STUDY DESIGN: To identify general trends in public health status, evaluating the effect...... of public health campaigns and providing the basis for making predictions of future trends in the mortality burden data from the Greenlandic Death Causes Register to estimate Years of Life Lost (YLL) in the period 1976-1998 has been used. METHODS: YLL were estimated according to the Burden of Disease Method...

The impact of dietary risk factors on the burden of non-communicable diseases in Ethiopia : findings from the Global Burden of Disease study 2013

NARCIS (Netherlands)

Melaku, Yohannes Adama; Temesgen, Awoke Misganaw; Deribew, Amare; Tessema, Gizachew Assefa; Deribe, Kebede; Sahle, Berhe W.; Abera, Semaw Ferede; Bekele, Tolesa; Lemma, Ferew; Amare, Azmeraw T.; Seid, Oumer; Endris, Kedir; Hiruye, Abiy; Worku, Amare; Adams, Robert; Taylor, Anne W.; Gill, Tiffany K.; Shi, Zumin; Afshin, Ashkan; Forouzanfar, Mohammad H.

2016-01-01

Background: The burden of non-communicable diseases (NCDs) has increased in sub-Saharan countries, including Ethiopia. The contribution of dietary behaviours to the NCD burden in Ethiopia has not been evaluated. This study, therefore, aimed to assess diet-related burden of disease in Ethiopia

The management of trauma and posttraumatic stress disorder in HIV ...

African Journals Online (AJOL)

Women are disproportionately affected by the HIV epidemic and also carry a higher burden of early childhood trauma, other life traumas (e.g. rape and partner violence) and post-traumatic stress disorder (PTSD).1,2 Yet PTSD and other common psychiatric disorders (e.g. depression, alcohol abuse) are commonly ...

Participation in a US community-based cardiovascular health study: investigating nonrandom selection effects related to employment, perceived stress, work-related stress, and family caregiving.

Science.gov (United States)

MacDonald, Leslie A; Fujishiro, Kaori; Howard, Virginia J; Landsbergis, Paul; Hein, Misty J

2017-09-01

Participation in health studies may be inversely associated with employment and stress. We investigated whether employment, perceived stress, work-related stress, and family caregiving were related to participation in a longitudinal US community-based health study of black and white men and women aged ≥45 years. Prevalence ratios and confidence intervals were estimated for completion of the second stage (S2) of a two-stage enrollment process by employment (status, type), and stress (perceived stress, work-related stress, caregiving), adjusting for age, sex, race, region, income, and education. Eligibility and consent for a follow-up occupational survey were similarly evaluated. Wage- but not self-employed participants were less likely than the unemployed to complete S2. Among the employed, S2 completion did not vary by stress; however, family caregivers with a short time burden of care (stress levels. Limited evidence of selection bias was seen by employment and stress within a large US community-based cohort, but findings suggest the need for enrollment procedures to consider possible barriers to participation among wage-employed individuals. Published by Elsevier Inc.

Pathogenesis of Chronic Hyperglycemia: From Reductive Stress to Oxidative Stress

Directory of Open Access Journals (Sweden)

Liang-Jun Yan

2014-01-01

Full Text Available Chronic overnutrition creates chronic hyperglycemia that can gradually induce insulin resistance and insulin secretion impairment. These disorders, if not intervened, will eventually be followed by appearance of frank diabetes. The mechanisms of this chronic pathogenic process are complex but have been suggested to involve production of reactive oxygen species (ROS and oxidative stress. In this review, I highlight evidence that reductive stress imposed by overflux of NADH through the mitochondrial electron transport chain is the source of oxidative stress, which is based on establishments that more NADH recycling by mitochondrial complex I leads to more electron leakage and thus more ROS production. The elevated levels of both NADH and ROS can inhibit and inactivate glyceraldehyde 3-phosphate dehydrogenase (GAPDH, respectively, resulting in blockage of the glycolytic pathway and accumulation of glycerol 3-phospate and its prior metabolites along the pathway. This accumulation then initiates all those alternative glucose metabolic pathways such as the polyol pathway and the advanced glycation pathways that otherwise are minor and insignificant under euglycemic conditions. Importantly, all these alternative pathways lead to ROS production, thus aggravating cellular oxidative stress. Therefore, reductive stress followed by oxidative stress comprises a major mechanism of hyperglycemia-induced metabolic syndrome.

[Burden of proof in medical cases--presumption of fact and prima facie evidence. 1. Burden of proof].

Science.gov (United States)

Sliwka, Marcin

2004-01-01

The aim of this paper was to present the main rules concerning the burden of proof in polish civil trials, including medical cases. This paper also describes the subject of evidence were presented and explained. The court influence on evidence procedure was also analysed. The effect of the institution of informed consent on burden of proof in polish civil law is also described. This paper includes numerous High Court sentences on evidential and medical issues.

Stirring the Pot: Can Dietary Modification Alleviate the Burden of CKD?

Directory of Open Access Journals (Sweden)

Matthew Snelson

2017-03-01

Full Text Available Diet is one of the largest modifiable risk factors for chronic kidney disease (CKD-related death and disability. CKD is largely a progressive disease; however, it is increasingly appreciated that hallmarks of chronic kidney disease such as albuminuria can regress over time. The factors driving albuminuria resolution remain elusive. Since albuminuria is a strong risk factor for GFR loss, modifiable lifestyle factors that lead to an improvement in albuminuria would likely reduce the burden of CKD in high-risk individuals, such as patients with diabetes. Dietary therapy such as protein and sodium restriction has historically been used in the management of CKD. Evidence is emerging to indicate that other nutrients may influence kidney health, either through metabolic or haemodynamic pathways or via the modification of gut homeostasis. This review focuses on the role of diet in the pathogenesis and progression of CKD and discusses the latest findings related to the mechanisms of diet-induced kidney disease. It is possible that optimizing diet quality or restricting dietary intake could be harnessed as an adjunct therapy for CKD prevention or progression in susceptible individuals, thereby reducing the burden of CKD.

Or mutation leads to photo-oxidative stress responses in cauliflower (Brassica oleracea) seedlings during de-etiolation.

Science.gov (United States)

Men, Xiao; Dong, Kang

2013-11-01

The Orange (Or) gene is a gene mutation that can increase carotenoid content in plant tissues normally devoid of pigments. It affects plastid division and is involved in the differentiation of proplastids or non-colored plastids into chromoplasts. In this study, the de-etiolation process of the wild type (WT) cauliflower (Brassica oleracea L. var. botrytis) and Or mutant seedlings was investigated. We analyzed pigment content, plastid development, transcript abundance and protein levels of genes involved in the de-etiolation process. The results showed that Or can increase the carotenoid content in green tissues, although not as effectively as in non-green tissues, and this effect might be caused by the changes in biosynthetic pathway genes at both transcriptional and post-transcriptional levels. There was no significant difference in the plastid development process between the two lines. However, the increased content of antheraxanthin and anthocyanin, and higher expression levels of violaxanthin de-epoxidase gene (VDE) suggested a stress situation leading to photoinhibition and enhanced photoprotection in the Or mutant. The up-regulated expression levels of the reactive oxygen species (ROS)-induced genes, ZAT10 for salt tolerance zinc finger protein and ASCORBATE PEROXIDASE2 (APX2), suggested the existence of photo-oxidative stress in the Or mutant. In summary, abovementioned findings provide additional insight into the functions of the Or gene in different tissues and at different developmental stages.

The Global Burden of Occupational Disease.

Science.gov (United States)

Rushton, Lesley

2017-09-01

Burden of occupational disease estimation contributes to understanding of both magnitude and relative importance of different occupational hazards and provides essential information for targeting risk reduction. This review summarises recent key findings and discusses their impact on occupational regulation and practice. New methods have been developed to estimate burden of occupational disease that take account of the latency of many chronic diseases and allow for exposure trends and workforce turnover. Results from these studies have shown in several countries and globally that, in spite of improvements in workplace technology, practices and exposures over the last decades, occupational hazards remain an important cause of ill health and mortality worldwide. Major data gaps have been identified particularly regarding exposure information. Reliable data on employment and disease are also lacking especially in developing countries. Burden of occupational disease estimates form an important part of decision-making processes.

Stress in the caregivers of Alzheimer's patients: an experimental investigation in Italy.

Science.gov (United States)

Aguglia, E; Onor, M L; Trevisiol, M; Negro, C; Saina, M; Maso, E

2004-01-01

In Italy, the family constitutes the major caregiving response to the needs of the elderly who are no longer self-sufficient. These caregivers are often wives or daughters who have chosen to keep the patient at home with them. On average, three-quarters of the caregiver's day is devoted to the patient, a proportion that tends to increase linearly as the disease progresses. The primary aim of our study was to describe a group of Italian caregivers of patients with a diagnosis of dementia to assess their levels of stress. We then correlated these caregivers with a number of sociodemographic variables and the patients' degree of cognitive impairment and independence in daily life activities. The study was conducted on a sample group of 236 caregivers of patients with a diagnosis of Alzheimer's disease (AD) according to the DSM-IV criteria. Each caregiver took part in a sociodemographic interview and filled in two questionnaires: the Caregiver Burden Inventory (CBI), to quantify the caregiving workload and the Brief Symptom Inventory (BSI), to assess the level of anxiety and depression. Patients were administered the Mini-Mental State Examination (MMSE) to evaluate their level of cognitive impairment and the Instrumental Activities of Daily Living (IADL) and Activities of Daily Living (ADL) tests to quantify their level of independence. The analysis of the results shows that the average Italian caregiver of an AD patient is a woman, approximately 60 years old. The majority of caregivers are spouses, followed by children. In general, these caregivers work at home, are housewives or retired, and are personally involved in caring for the patients. The greater the level of a patient's cognitive impairment and the less independent they are, the greater amount of care and supervision they require, leaving less free time for the caregiver; this leads to higher levels of anxiety related to caregiving. Toward the final stages of the disease, patient care tasks take up nearly

Adaptive and Pathogenic Responses to Stress by Stem Cells during Development

OpenAIRE

Mansouri, Ladan; Xie, Yufen; Rappolee, Daniel A

2012-01-01

Cellular stress is the basis of a dose-dependent continuum of responses leading to adaptive health or pathogenesis. For all cells, stress leads to reduction in macromolecular synthesis by shared pathways and tissue and stress-specific homeostatic mechanisms. For stem cells during embryonic, fetal, and placental development, higher exposures of stress lead to decreased anabolism, macromolecular synthesis and cell proliferation. Coupled with diminished stem cell proliferation is a stress-induce...

Burdens of Proof, Presumptions and Standards of Proof in Criminal ...

African Journals Online (AJOL)

Worku_Y

evidential and persuasive burdens of proof as between the state and the ..... scholars have observed that the evidential burden is a function of the burden of ..... required to convince judges by creating such an intensity of belief in their minds.

Using the stress and adversity inventory as a teaching tool leads to significant learning gains in two courses on stress and health.

Science.gov (United States)

Slavich, George M; Toussaint, Loren

2014-10-01

The ability to measure cumulative stress exposure is important for research and teaching in stress and health, but until recently, no structured system has existed for assessing exposure to stress over the lifespan. Here, we report the results of two experimental studies that examined the pedagogical efficacy of using an automated system for assessing life stress, called the Stress and Adversity Inventory (STRAIN), for teaching courses on stress and health. In Study 1, a randomized, wait-list controlled experiment was conducted with 20 college students to test whether the STRAIN, coupled with a related lecture and discussion, promoted learning about stress and health. Results showed that this experiential lesson led to significant learning gains. To disentangle the effects of completing the STRAIN from participating in the lecture and discussion, we subsequently conducted Study 2 on 144 students using a 2 (STRAIN versus control activity) by 2 (STRAIN-specific lecture versus general stress lecture) repeated-measures design. Although the STRAIN-specific lecture was sufficient for promoting learning, completing the STRAIN also generated significant learning gains when paired with only the general stress lecture. Together, these studies suggest that the STRAIN is an effective tool for promoting experiential learning and teaching students about stress and health. Copyright © 2013 John Wiley & Sons, Ltd.

34 CFR 34.14 - Burden of proof.

Science.gov (United States)

2010-07-01

... 34 Education 1 2010-07-01 2010-07-01 false Burden of proof. 34.14 Section 34.14 Education Office of the Secretary, Department of Education ADMINISTRATIVE WAGE GARNISHMENT § 34.14 Burden of proof. (a... those in § 34.24. (d)(1) If you object on the ground that applicable law bars us from collecting the...

Burden of diabetes mellitus attributable to demographic levels in Qatar: an emerging public health problem.

Science.gov (United States)

Bener, Abdulbari; Kim, Eun-Jung; Mutlu, Fatih; Eliyan, Afnan; Delghan, Hamsa; Nofal, Enas; Shalabi, Luma; Wadi, Nada

2014-01-01

Diabetes is one of the main contributors to ill health and premature mortality worldwide and its prevalence has been rising during the last decades. The aim of the present study was to quantify the burden of disease in terms of deaths and loss of healthy life years (DALYs) attributed to diabetes by its demographic levels in the State of Qatar. The methods were largely based on the established Global Burden of Disease methodology and use the burden of disease in terms of disability adjusted life years (DALYs) and the years lost due to disability (YLD) as the outcome measure. We calculated years lost due to disability (YLD) and years life lost (YLL) attributable to diabetes. The study was conducted during the period from June 2013 to January 2014. The study findings revealed that disability adjusted life years (DALYs) has been increasing across the years and reached to 4.35 in 2011 from 2.58 in 2007. DALYs for men was remarkably higher than women during the period (2007-2011). Diabetes mellitus was the 6th leading cause of disease burden in Qatar (3.8%). The YLD showed a sharp increase in men (2.52 in 2011 from 1.34 in 2007) and women (1.05 in 2011 from 0.33 in 2007) during the year 2011. YLL portion of women enlarged considerably in 2011 (0.10) compared to 2010 (0.04). YLL for men and women was fluctuating across the years with a decrease in 2011 (18%) from 2007 (35%). Men and women in the age group 30-44 years had the highest peak across the years. The study findings revealed that diabetes disease burden was considerably high in Qatar, particularly in the working age group. DALYs has been increasing across the years. Copyright © 2014 Diabetes India. Published by Elsevier Ltd. All rights reserved.

Soil Lead Testing at a High Spatial Resolution in an Urban Community Garden: A Case Study in Relic Lead in Terre Haute, Indiana.

Science.gov (United States)

Latimer, Jennifer C; Van Halen, David; Speer, James; Krull, Stephanie; Weaver, Patricia; Pettit, Joseph; Foxx, Heather

2016-10-01

Industrial emissions, deteriorating or improperly removed lead paint, and the use of lead additives in fuel have left a substantial burden of heavy metals, such as lead, in urban soils. Much of this lead remains near the surface where it has the potential to impact human health. Exposure to lead, especially in children, can have lasting impacts on neurological development and academic achievement. Urban gardening, in particular, is an activity that could result in increased exposure to soil lead for many unsuspecting gardeners. During the summer of 2012, more than 1,061 surface soil samples were collected from an approximately 1.25 acre urban community garden in Terre Haute, Indiana. Samples were collected to evaluate the spatial distribution of lead across the community garden on the plot level. The results highlight the variability that can be seen within small areas of a former residential property, for example lead concentrations that are low (garden plot as concentrations that are considered high (>600 ppm). Based on the results of this work, several areas of concern were identified and the community garden was reconfigured to reduce potential lead exposure to gardeners and the local community.

Acute Stress Decreases but Chronic Stress Increases Myocardial Sensitivity to Ischemic Injury in Rodents

OpenAIRE

Eisenmann, Eric D.; Rorabaugh, Boyd R.; Zoladz, Phillip R.

2016-01-01

Cardiovascular disease is the largest cause of mortality worldwide, and stress is a significant contributor to the development of cardiovascular disease. The relationship between acute and chronic stress and cardiovascular disease is well-evidenced. Acute stress can lead to arrhythmias and ischemic injury. However, recent evidence in rodent models suggests that acute stress can decrease sensitivity to myocardial ischemia-reperfusion injury. Conversely, chronic stress is arrythmogenic and incr...

Estimating the Global Burden of Endemic Canine Rabies

Science.gov (United States)

Hampson, Katie; Coudeville, Laurent; Lembo, Tiziana; Sambo, Maganga; Kieffer, Alexia; Attlan, Michaël; Barrat, Jacques; Blanton, Jesse D.; Briggs, Deborah J.; Cleaveland, Sarah; Costa, Peter; Freuling, Conrad M.; Hiby, Elly; Knopf, Lea; Leanes, Fernando; Meslin, François-Xavier; Metlin, Artem; Miranda, Mary Elizabeth; Müller, Thomas; Nel, Louis H.; Recuenco, Sergio; Rupprecht, Charles E.; Schumacher, Carolin; Taylor, Louise; Vigilato, Marco Antonio Natal; Zinsstag, Jakob; Dushoff, Jonathan

2015-01-01

Background Rabies is a notoriously underreported and neglected disease of low-income countries. This study aims to estimate the public health and economic burden of rabies circulating in domestic dog populations, globally and on a country-by-country basis, allowing an objective assessment of how much this preventable disease costs endemic countries. Methodology/Principal Findings We established relationships between rabies mortality and rabies prevention and control measures, which we incorporated into a model framework. We used data derived from extensive literature searches and questionnaires on disease incidence, control interventions and preventative measures within this framework to estimate the disease burden. The burden of rabies impacts on public health sector budgets, local communities and livestock economies, with the highest risk of rabies in the poorest regions of the world. This study estimates that globally canine rabies causes approximately 59,000 (95% Confidence Intervals: 25-159,000) human deaths, over 3.7 million (95% CIs: 1.6-10.4 million) disability-adjusted life years (DALYs) and 8.6 billion USD (95% CIs: 2.9-21.5 billion) economic losses annually. The largest component of the economic burden is due to premature death (55%), followed by direct costs of post-exposure prophylaxis (PEP, 20%) and lost income whilst seeking PEP (15.5%), with only limited costs to the veterinary sector due to dog vaccination (1.5%), and additional costs to communities from livestock losses (6%). Conclusions/Significance This study demonstrates that investment in dog vaccination, the single most effective way of reducing the disease burden, has been inadequate and that the availability and affordability of PEP needs improving. Collaborative investments by medical and veterinary sectors could dramatically reduce the current large, and unnecessary, burden of rabies on affected communities. Improved surveillance is needed to reduce uncertainty in burden estimates and to