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Sample records for treat related illnesses

  1. Heat-Related Illnesses

    Medline Plus

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

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

    Directory of Open Access Journals (Sweden)

    Peng Xiaomei

    2008-08-01

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

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

    Science.gov (United States)

    Jimerson, Shane R.; Miller, David N.

    2008-01-01

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

  4. Heat-Related Illnesses

    Science.gov (United States)

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

  5. Heat-Related Illnesses

    Medline Plus

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

  6. Heat-Related Illnesses

    Medline Plus

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

  7. Heat-Related Illnesses

    Medline Plus

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

  8. Disaster-related injuries and illnesses treated by American Red Cross disaster health services during Hurricanes Gustav and Ike.

    Science.gov (United States)

    Noe, Rebecca S; Schnall, Amy H; Wolkin, Amy F; Podgornik, Michelle N; Wood, April D; Spears, Jeanne; Stanley, Sharon A R

    2013-01-01

    To describe the injuries and illnesses treated by the American Red Cross (Red Cross) during Hurricanes Gustav and Ike disaster relief operations reported on a new Aggregate Morbidity Report Form. From August 28 to October 18, 2008, 119 Red Cross field service locations in Louisiana, Mississippi, Tennessee, and Texas addressed the healthcare needs of people affected by the hurricanes. From these locations, individual client visit data were retrospectively collated per site onto new 24-hour Aggregate Morbidity Report Forms. A total of 3863 clients were treated. Of the clients, 48% were girls and women and 44% were boys and men; 61% were 19 to 64 years old. Ninety-eight percent of the visits occurred in shelters. The reasons for half of the visits were acute illness and symptoms (eg, pain) and 16% were for routine follow-up care. The majority (65%) of the 2516 visits required treatment at a field location, although 34%, or 1296 visits, required a referral, including 543 healthcare facility transfers. During the hurricanes, a substantial number of displaced evacuees sought care for acute and routine healthcare needs. The capacity of the Red Cross to address the immediate and ongoing health needs of sheltered clients for an extended period of time is a critical resource for local public health agencies, which are often overwhelmed during a disaster. This article highlights the important role that this humanitarian organization fills, to decrease surge to local healthcare systems and to monitor health effects following a disaster. The Aggregate Morbidity Report Form has the potential to assist greatly in this role, and thus its utility for real-time reporting should be evaluated further.

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

    DEFF Research Database (Denmark)

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

    2017-01-01

    OBJECTIVE: To determine if the use of fresh frozen plasma/frozen plasma 24 hours compared to solvent detergent plasma is associated with international normalized ratio reduction or ICU mortality in critically ill children. DESIGN: This is an a priori secondary analysis of a prospective, observati......OBJECTIVE: To determine if the use of fresh frozen plasma/frozen plasma 24 hours compared to solvent detergent plasma is associated with international normalized ratio reduction or ICU mortality in critically ill children. DESIGN: This is an a priori secondary analysis of a prospective....... SETTING: One hundred one PICUs in 21 countries. PATIENTS: All critically ill children admitted to a participating unit were included if they received at least one plasma unit during six predefined 1-week (Monday to Friday) periods. All children were exclusively transfused with either fresh frozen plasma...... was independently associated with reduced ICU mortality (odds ratio, 0.40; 95% CI, 0.16-0.99; p = 0.05). CONCLUSIONS: Solvent detergent plasma use in critically ill children may be associated with improved survival. This hypothesis-generating data support a randomized controlled trial comparing solvent detergent...

  10. Disaster related heat illness

    International Nuclear Information System (INIS)

    Miyake, Yasufumi

    2012-01-01

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

  11. Heat-Related Illnesses

    Medline Plus

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

  12. Heat Related Illnesses

    National Research Council Canada - National Science Library

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

    2006-01-01

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

  13. Heat-Related Illnesses

    Medline Plus

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

  14. Treated Mental Illness and the Risk of Child Abuse Perpetration.

    Science.gov (United States)

    Friedman, Susan Hatters; McEwan, Miranda V

    2018-02-01

    Despite a limited empirical literature, parental mental illness is often cited as a major risk factor for violence against children. However, mental illness that is adequately treated would not be expected to lead to increased violence risk. This study compared incidents of violence toward children perpetrated by parents who were newly discharged from inpatient psychiatric treatment with violence perpetrated by other parents in the same communities to determine whether parents with treated mental illness had an elevated risk of child abuse perpetration. A secondary analysis of data from the MacArthur Violence Risk Assessment Study was conducted. Violence toward children reported by parents and by collateral informants at the initial ten-week follow-up interview was analyzed for two groups: study participants discharged from inpatient psychiatric facilities and parents in the community matched by neighborhood. Of the 416 parents in the participant group, 20 (5%) committed violence toward a child in the ten weeks after discharge, compared with 41 (14%) of the 299 parents in the comparison group. In the participant group, diagnostic categories of parents who committed violence toward a child were as follows: serious mental illness only (8% of whom were violent), substance use disorder only (3%), both serious mental illness and substance use disorder (4%), and another issue (7%). This study found that parents with treated serious mental illness were not at higher risk than other parents in their community of perpetrating violence toward children. Parents who were admitted to an acute psychiatric facility and treated appeared to be at lower risk of being violent toward children than other parents in their community.

  15. Heat-related illness in the African wilderness

    African Journals Online (AJOL)

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

  16. Oral health impacts of medications used to treat mental illness.

    Science.gov (United States)

    Cockburn, N; Pradhan, A; Taing, M W; Kisely, S; Ford, P J

    2017-12-01

    Many psychotropic medications affect oral health. This review identified oral side effects for antidepressant, antipsychotic, anticonvulsant, antianxiety and sedative drugs that are recommended in Australia for the management of common mental illnesses and provides recommendations to manage these side-effects. The Australian Therapeutic Guidelines and the Australian Medicines Handbook were searched for medications used to treat common mental health conditions. For each medication, the generic name, class, and drug company reported side-effects were extracted from the online Monthly Index of Medical Specialties (eMIMs) and UpToDate databases. Meyler's Side Effect of Drugs Encyclopaedia was used to identify additional oral adverse reactions to these medications. Fifty-seven drugs were identified: 23 antidepressants, 22 antipsychotics or mood stabilisers, and 12 anxiolytic or sedative medications. Xerostomia (91%) the most commonly reported side effect among all classes of medications of the 28 identified symptoms. Other commonly reported adverse effects included dysguesia (65%) for antidepressants, and tardive dyskinesia (94%) or increased salivation (78%) for antipsychotic medications. While xerostomia has often been reported as a common adverse effect of psychotropic drugs, this review has identified additional side effects including dysguesia from antidepressants and tardive dyskinesia and increased salivation from antipsychotics. Clinicians should consider oral consequences of psychotropic medication in addition to other side-effects when prescribing. For antidepressants, this would mean choosing duloxetine, agomelatine and any of the serotonin re-uptake inhibitors except sertraline. In the case of antipsychotics and mood stabilisers, atypical agents have less oral side effects than older alternatives. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Treating Gulf War Illness with Novel Anti-Inflammatories: A Screening of Botantical Microglia Modulators

    Science.gov (United States)

    2016-10-01

    AWARD NUMBER: W81XWH-14-1-0623 TITLE: Treating Gulf War Illness with Novel Anti-Inflammatories: A Screening of Botantical Microglia Modulators...Report 3. DATES COVERED 30 Sep 2015 - 29 Sep 2016 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Treating Gulf War Illness with Novel Anti...SUBJECT TERMS Gulf War Illness, botanical, anti-inflammatory, biomarker, microglia, improvement, treatment 16. SECURITY CLASSIFICATION OF: 17

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

    Science.gov (United States)

    Muschalla, Beate; Glatz, Johannes; Linden, Michael

    2014-01-01

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

  19. Treating Mental Illness among Diabetic Black Male Adolescents: A Review

    Science.gov (United States)

    Banks, Andrae; Fields, Lashawnda; O'Dwyer, Curtis; Scott, Marquisha Lawrence; Joe, Sean

    2018-01-01

    Objective: To examine randomized controlled trials (RCTs) for treatment evidence for Black male adolescents suffering from comorbid mental illness and diabetes mellitus. Method: A review of the studies published in English-language journals was conducted. Results: We found no RCT focused on Black males with diabetes mellitus Type 2 (DMT2).…

  20. Heat-Related Illness among Oregon Farmworkers

    Directory of Open Access Journals (Sweden)

    Jeffrey W. Bethel

    2014-09-01

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

  1. Decompression illness treated in Denmark 1999-2013

    DEFF Research Database (Denmark)

    Juhl, Christian Svendsen; Hedetoft, Morten; Bidstrup, Daniel

    2016-01-01

    of previous dives, type of diving, initial type of hyperbaric treatment and DCI symptoms. Trend in annual case numbers was evaluated using run chart analysis and Spearman's correlation. Age, height, weight, and BMI were evaluated using linear regression. The presence of long-term residual symptoms......INTRODUCTION: The incidence, diver characteristics and symptomatology of decompression illness (DCI) in Denmark has not been assessed since 1982, and the presence of long-term residual symptoms among divers receiving hyperbaric oxygen therapy in Denmark has never been estimated to our knowledge...

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

    Science.gov (United States)

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

  3. Relatives perception of writing diaries for critically ill

    DEFF Research Database (Denmark)

    Nielsen, Anne Højager; Angel, Sanne

    2015-01-01

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

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

    OpenAIRE

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

    2016-01-01

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

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

    Data.gov (United States)

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

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

    Science.gov (United States)

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

    2017-06-01

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

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

    DEFF Research Database (Denmark)

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

    2018-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Hong-Tao Zhou

    2014-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Janusz Kocjan

    2015-06-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

    Manning, Louise

    2017-06-13

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

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

    DEFF Research Database (Denmark)

    Laursen, Jannie; Andresen, Kristoffer; Rosenberg, Jacob

    2016-01-01

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

  13. How diaries written for critically ill influence the relatives

    DEFF Research Database (Denmark)

    Nielsen, Anne Højager; Angel, Sanne

    2016-01-01

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

  14. Individual Differences on Job Stress and Related Ill Health

    Directory of Open Access Journals (Sweden)

    Miodraga Stefanovska Petkovska

    2014-03-01

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

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

    African Journals Online (AJOL)

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

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

    African Journals Online (AJOL)

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

  17. Temperature-Related Death and Illness. Chapter 2

    Science.gov (United States)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Kathryn Lane

    2018-03-01

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

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

    Science.gov (United States)

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

    2015-12-01

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

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

    NARCIS (Netherlands)

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

    2015-01-01

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

  1. Self-reported comfort treating severe mental illnesses among pre-doctoral graduate students in clinical psychology.

    Science.gov (United States)

    Buck, Benjamin; Romeo, Katy Harper; Olbert, Charles M; Penn, David L

    2014-12-01

    One possible explanation for the dearth of psychologists working in severe mental illness (SMI) areas is a lack of training opportunities. Recent studies have shown that while training opportunities have increased, there remain fewer resources available for SMI training compared to other disorders. Examines whether students express discomfort working with this population and whether they are satisfied with their level of training in SMI. One-hundred sixty-nine students currently enrolled in doctoral programs in clinical psychology in the United States and Canada were surveyed for their comfort treating and satisfaction with training related to a number of disorders. RESULTS indicate that students are significantly less comfortable treating and finding a referral for a patient with schizophrenia as well as dissatisfied with their current training in SMI and desirous of more training. Regression analyses showed that dissatisfaction with training predicted a desire for more training; however, discomfort in treating people with SMI did not predict a desire for more training in this sample. This pattern generally held across disorders. Our results suggest general discomfort among students surveyed in treating SMI compared to other disorders.

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

    African Journals Online (AJOL)

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

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

    Directory of Open Access Journals (Sweden)

    Roy Liff

    2017-06-01

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

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

    Science.gov (United States)

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

    2017-12-01

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

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

    NARCIS (Netherlands)

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

    2005-01-01

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

  6. PRIMARY PALLIATIVE CARE? - Treating terminally ill cancer patients in the primary care sector

    DEFF Research Database (Denmark)

    Neergaard, Mette Asbjørn; Jensen, Anders Bonde; Olesen, Frede

    BACKGROUND. Palliative care for cancer patients is an important part of a GP's work. Although every GP is frequently involved in care for terminally ill cancer patients, only little is known about how these palliative efforts are perceived by the patients and their families, a knowledge...... that is vital to further improve palliative care in the primary sector.AIM. The aim of the study was to analyse the quality of palliative home care with focus on the GP's role based on evaluations by relatives of recently deceased cancer patients and professionals from both the primary and secondary health care...... approach.RESULTS. The analyses revealed several key areas, e.g.: 1) How to take, give and maintain professional responsibility for palliative home care. 2) A need for transparent communication both among primary care professionals and among professionals across the primary/secondary interface. 3...

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

    Science.gov (United States)

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

    2011-12-01

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

  8. A Therapeutic Approach for Treating Chronic Illness and Disability among College Students

    Science.gov (United States)

    Haemmelmann, Katie L.; McClain, Mary-Catherine

    2013-01-01

    Research in chronic illness and disability (CID) in college students has demonstrated that students with disabilities encounter more difficulties psychosocially than their nondisabled counterparts. Subsequently, these difficulties impact the ability of these students to successfully adapt. Using the illness intrusiveness model in combination with…

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

    Science.gov (United States)

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

    2014-12-01

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

  10. Late effects of cranial irradiation on visual attention in children treated for hematologic illnesses

    International Nuclear Information System (INIS)

    Hill, D.L.

    1992-01-01

    A cross-sectional design was employed to assess the effects of CNS therapy including cranial irradiation (CRT) on visual attention. Forty one children between the ages of 8 and 16 years, 24 with a history of CRT, were tested. The attentional measure was a set of 14 timed, age-normed visual cancellation tasks that permitted an assessment of task-relevant motor response speed in the measurement of attentional efficiency. CRT doses ranged from 1000 to 4800 rads, administered to whole brain between 1 and 12 years prior to testing. It was found that increasing doses of CRT were associated with slower motor responding. Motor speed accounted for a significant proportion of variance in attentional task performance: slowed motor responding must be controlled by covariation in the measurement of attentional abilities in CRT-treated children. No child receiving CRT before age 4 and more than 5 years prior to testing performed above the mean overall on the attentional task, compared to several children demonstrating above-average performance who received CRT less than 5 years prior to testing. Scores for the CRT group were highly correlated with IQ and achievement results. CRT variables (dose, age at earliest CRT, time since CRT) explained half the variance in attentional task performance. Children who received CRT performed significantly below the mean on subtests with the most complex, symbolic or sequential target stimuli, a pattern that has predicted poor academic achievement in non-medically ill children. It was concluded that children receiving CRT should continue to be evaluated more than five years after treatment to monitor potential late effects of neurotoxic treatment. Longitudinal, prospective, well-controlled dose-effect research using a developmentally sensitive, theoretically grounded battery of attentional measures is needed to best compare neurotoxicity of different treatment regima in children

  11. Melatonin and melatonin agonists to prevent and treat delirium in critical illness: a systematic review protocol

    Directory of Open Access Journals (Sweden)

    Jennifer Foster

    2016-11-01

    Full Text Available Abstract Background Delirium is a syndrome characterized by acute fluctuations and alterations in attention and arousal. Critically ill patients are at particularly high risk, and those that develop delirium are more likely to experience poor clinical outcomes such as prolonged duration of ICU and hospital length of stay, and increased mortality. Melatonin and melatonin agonists (MMA have the potential to decrease the incidence and severity of delirium through their hypnotic and sedative-sparing effects, thus improving health-related outcomes. The objective of this review is to synthesize the available evidence pertaining to the efficacy and safety of MMA for the prevention and treatment of ICU delirium. Methods We will search Ovid MEDLINE, Web of Science, EMBASE, PsycINFO, the Cochrane Central Register of Controlled Trials (CENTRAL, and CINAHL to identify studies evaluating MMA in critically ill populations. We will also search http://apps.who.int/trialsearch for ongoing and unpublished studies and PROSPERO for registered reviews. We will not impose restrictions on language, date, or journal of publication. Authors will independently screen for eligible studies using pre-defined criteria; data extraction from eligible studies will be performed in duplicate. The Cochrane Risk of Bias Scale and the Newcastle-Ottawa Scale will be used to assess the risk of bias and quality of randomized and non-randomized studies, respectively. Our primary outcome of interest is delirium incidence, and secondary outcomes include duration of delirium, number of delirium- and coma-free days, use of physical and chemical (e.g., antipsychotics or benzodiazepines restraints, duration of mechanical ventilation, ICU and hospital length of stay, mortality, long-term neurocognitive outcomes, hospital discharge disposition, and adverse events. We will use Review Manager (RevMan to pool effect estimates from included studies. We will present results as relative risks with

  12. A Multimodal Evaluation of the Comparative Efficacy of Yoga versus a Patient Centered Support Group for Treating Chronic Pain in Gulf War Illness

    Science.gov (United States)

    2016-10-01

    Treating Chronic Pain in Gulf War Illness PRINCIPAL INVESTIGATOR: Peter Bayley, PhD RECIPIENT: Palo Alto Veterens Institute for Research Palo Alto, CA...Centered Support Group for Treating Chronic Pain in Gulf War Illness 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S...with Gulf War Illness (GWI). A secondary objective is to provide veterans with skills in yoga breathing, postures, and meditation that can be used to

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

    Science.gov (United States)

    Christensen, Alan J.; And Others

    1996-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Michael T Schmeltz

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

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

    Science.gov (United States)

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

    2017-01-01

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

  16. Ketoconazole hepatotoxicity in a patient treated for environmental illness and systemic candidiasis

    Energy Technology Data Exchange (ETDEWEB)

    Brusko, C.S.; Marten, J.T. (Purdue University School of Pharmacy and Pharmacal Sciences, Lafayette, IN (United States))

    1991-12-01

    Environmental illness, a hypothesized disease caused by exposure to substances such as combustion products, pesticides, food additives, and Candida albicans, is discussed. The case of a patient with environmental illness and systemic candidiasis for six weeks with ketoconazole, liver enzyme concentrations increased. One month after discontinuation of ketoconazole, the liver enzyme concentrations decreased; however, over the next five months, liver enzymes and bilirubin increased. The patient developed encephalopathy and eventually was transferred to a medical center for possible liver transplant. A review of the literature pertaining to ketoconazole hepatotoxicity is also presented.16 references.

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

    Science.gov (United States)

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

    2016-01-01

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

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

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

    CERN Multimedia

    HR department

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Ajak Manguak Agau

    2017-08-01

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

  2. Relating illness complexity to reimbursement in CKD patients.

    Science.gov (United States)

    Bessette, Russell W; Carter, Randy L

    2011-01-01

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

  3. Biomedicine or Holistic Medicine for Treating Mentally Ill Patients? A Philosophical and Economical Analysis

    Directory of Open Access Journals (Sweden)

    Søren Ventegodt

    2007-01-01

    Full Text Available Today we have two scientific medical traditions, two schools or treatment systems: holistic medicine and biomedicine. The two traditions are based on two very different philosophical positions: subjectivistic and objectivistic. The philosopher Buber taught us that you can say I-Thou or I-It, holding the other person as a subject or an object. These two fundamentally different attitudes seem to characterize the difference in world view and patient approach in the two schools, one coming from psychoanalysis and the old, holistic tradition of Hippocratic medicine. Holistic medicine during the last decade has developed its philosophical positions and is today an independent, medical system seemingly capable of curing mentally ill patients at the cost of a few thousand Euros with no side effects and with lasting value for the patient. The problem is that very few studies have tested the effect of holistic medicine on mentally ill patients. Another problem is that the effect of holistic medicine must be documented in a way that respects this school's philosophical integrity, allowing for subjective assessment of patient benefit and using the patient as his/her own control, as placebo control cannot be used in placebo-only treatment. As the existing data are strongly in favor of using holistic medicine, which seems to be safer, more efficient, and cheaper, it is recommended that clinical holistic medicine also be used as treatment for mental illness. More research and funding is needed to develop scientific holistic medicine.

  4. Biomedicine or holistic medicine for treating mentally ill patients? A philosophical and economical analysis.

    Science.gov (United States)

    Ventegodt, Søren; Kandel, Isack; Merrick, Joav

    2007-12-18

    Today we have two scientific medical traditions, two schools or treatment systems: holistic medicine and biomedicine. The two traditions are based on two very different philosophical positions: subjectivistic and objectivistic. The philosopher Buber taught us that you can say I-Thou or I-It, holding the other person as a subject or an object. These two fundamentally different attitudes seem to characterize the difference in world view and patient approach in the two schools, one coming from psychoanalysis and the old, holistic tradition of Hippocratic medicine. Holistic medicine during the last decade has developed its philosophical positions and is today an independent, medical system seemingly capable of curing mentally ill patients at the cost of a few thousand Euros with no side effects and with lasting value for the patient. The problem is that very few studies have tested the effect of holistic medicine on mentally ill patients. Another problem is that the effect of holistic medicine must be documented in a way that respects this school's philosophical integrity, allowing for subjective assessment of patient benefit and using the patient as his/her own control, as placebo control cannot be used in placebo-only treatment. As the existing data are strongly in favor of using holistic medicine, which seems to be safer, more efficient, and cheaper, it is recommended that clinical holistic medicine also be used as treatment for mental illness. More research and funding is needed to develop scientific holistic medicine.

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

    Science.gov (United States)

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

    2017-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Elena Losina

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

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

    Science.gov (United States)

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

    2017-01-01

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

  8. Relating illness complexity to reimbursement in CKD patients

    Directory of Open Access Journals (Sweden)

    Bessette RW

    2011-09-01

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

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

    Science.gov (United States)

    Paul, Fiona; Rattray, Janice

    2008-05-01

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

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

    Science.gov (United States)

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

    2017-08-01

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

  11. Non-Thyroidal Illness Syndrome in Patients Exposed to Indoor Air Dampness Microbiota Treated Successfully with Triiodothyronine

    Directory of Open Access Journals (Sweden)

    Taija Liisa Somppi

    2017-08-01

    Full Text Available Long-term exposure to dampness microbiota induces multi-organ morbidity. One of the symptoms related to this disorder is non-thyroidal illness syndrome (NTIS. A retrospective study was carried out in nine patients with a history of mold exposure, experiencing chronic fatigue, cognitive disorder, and different kinds of hypothyroid symptoms despite provision of levothyroxine (3,5,3′,5′-tetraiodothyronine, LT4 monotherapy. Exposure to volatile organic compounds present in water-damaged buildings including metabolic products of toxigenic fungi and mold-derived inflammatory agents can lead to a deficiency or imbalance of many hormones, such as active T3 hormone. Since the 1970s, the synthetic prohormone, levothyroxine (LT4, has been the most commonly prescribed thyroid hormone in replacement monotherapy. It has been presumed that the peripheral conversion of T4 (3,5,3′,5′-tetraiodothyronine into T3 (3,5,3′-triiodothyronine is sufficient to satisfy the overall tissue requirements. However, evidence is presented that this not the case for all patients, especially those exposed to indoor air molds. This retrospective study describes the successful treatment of nine patients in whom NTIS was treated with T3-based thyroid hormone. The treatment was based on careful interview, clinical monitoring, and laboratory analysis of serum free T3 (FT3, reverse T3 (rT3 and thyroid-stimulating hormone, free T4, cortisol, and dehydroepiandrosterone (DHEA values. The ratio of FT3/rT3 was calculated. In addition, some patients received adrenal support with hydrocortisone and DHEA. All patients received nutritional supplementation and dietary instructions. During the therapy, all nine patients reported improvements in all of the symptom groups. Those who had residual symptoms during T3-based therapy remained exposed to indoor air molds in their work places. Four patients were unable to work and had been on disability leave for a long time during LT4 monotherapy

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

    Science.gov (United States)

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

    2018-01-01

    Previous school-based hand hygiene interventions have reported to successfully reduce infectious illness among schoolchildren. But few studies have tested the effect in large populations with adequate statistical power and analyses. The aim of this study was to evaluate whether a school-based multicomponent intervention to improve handwashing among schoolchildren, the Hi Five study, succeeded in reducing infectious illness and illness-related absenteeism in schools. The Hi Five study was a three-armed cluster-randomized controlled trial involving 43 randomly selected Danish schools; two intervention arms involving 14 schools each, and 15 control schools. Infectious illness days, infectious illness episodes and illness-related absenteeism were estimated in multilevel regressions, based on available cases of text messages answered by parents and based on questionnaire data reported by schoolchildren, respectively. At follow-up, children in the intervention schools did not differ from the control schools in number of illness days [odds ratio (OR)I-arm I: 0.91 (0.77-1.07) and ORI-arm II: 0.94 (0.79-1.12)] and illness episodes [ORI-arm I: 0.95 (0.81-1.11) and ORI-arm II: 0.98 (0.84-1.16)] or in reporting illness-related absenteeism [ORI-arm I: 1.09 (0.83-1.43) & ORI-arm II: 1.06 (0.81-1.40)]. The multicomponent Hi Five intervention achieved no difference in the number of illness days, illness episodes or illness-related absenteeism among children in intervention schools compared with control schools. It is noteworthy that one of the main components in the intervention, a mandatory daily handwashing before lunch, was only implemented by 1 of 3 of teachers in intervention schools.

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

    Directory of Open Access Journals (Sweden)

    Tanja Pate

    2016-09-01

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

  14. Decompression illness in divers treated in Auckland, New Zealand, 1996-2012.

    Science.gov (United States)

    Haas, Rachel M; Hannam, Jacqueline A; Sames, Christopher; Schmidt, Robert; Tyson, Andrew; Francombe, Marion; Richardson, Drew; Mitchell, Simon J

    2014-03-01

    The treatment of divers for decompression illness (DCI) in Auckland, New Zealand, has not been described since 1996, and subsequent trends in patient numbers and demographics are unmeasured. This was a retrospective audit of DCI cases requiring recompression in Auckland between 01 January 1996 and 31 December 2012. Data describing patient demographics, dive characteristics, presentation of DCI and outcomes were extracted from case notes and facility databases. Trends in annual case numbers were evaluated using Spearman's correlation coefficients (ρ) and compared with trends in entry-level diver certifications. Trends in patient demographics and delay between diving and recompression were evaluated using regression analyses. There were 520 DCI cases. Annual caseload decreased over the study period (ρ = 0.813, P Auckland have declined significantly over the last 17 years. The most plausible explanation is declining diving activity but improvements in diving safety cannot be excluded. The delay between diving and recompression has reduced.

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Rupert Conrad

    2014-01-01

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

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

    Science.gov (United States)

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

    2018-05-01

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

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

    Science.gov (United States)

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

    2009-12-01

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

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

    African Journals Online (AJOL)

    2017-08-03

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

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

    Science.gov (United States)

    Yang, Lawrence H; Wonpat-Borja, Ahtoy J

    2012-08-01

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

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

    Science.gov (United States)

    Angelo, Kristina M; Kozarsky, Phyllis E; Ryan, Edward T; Chen, Lin H; Sotir, Mark J

    2017-09-01

    As international travel increases, travellers may be at increased risk of acquiring infectious diseases not endemic in their home countries. Many journal articles and reference books related to travel medicine cite that between 22-64% of international travellers become ill during or after travel; however, this information is minimal, outdated and limited by poor generalizability. We aim to provide a current and more accurate estimate of the proportion of international travellers who acquire a travel-related illness. We identified studies via PubMed or travel medicine experts, published between January 1, 1976-December 31, 2016 that included the number of international travellers acquiring a travel-related illness. We excluded studies that focused on a single disease or did not determine a rate based on the total number of travellers. We abstracted information on traveller demographics, trip specifics, study enrollment and follow-up and number of ill travellers and their illnesses. Of 743 studies, nine met the inclusion criteria. The data sources were from North America (four studies) and Europe (five studies). Most travellers were tourists, the most frequent destination regions were Asia and Africa, and the median trip duration ranged from 8-21 days. Six studies enrolled participants at the travellers' pre-travel consultation. All studies collected data through either extraction from the medical record, weekly diaries, or pre- and post-travel questionnaires. Data collection timeframes varied by study. Between 6-87% of travellers became ill across all studies. Four studies provided the best estimate: between 43-79% of travellers who frequently visited developing nations (e.g. India, Tanzania, and Kenya) became ill; travellers most frequently reported diarrhoea. This is the most comprehensive assessment available on the proportion of international travellers that develop a travel-related illness. Additional cohort studies would provide needed data to more precisely

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

    Science.gov (United States)

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

    2017-01-01

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

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

    NARCIS (Netherlands)

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

    2015-01-01

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

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

    NARCIS (Netherlands)

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

    2013-01-01

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

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

    NARCIS (Netherlands)

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

    2013-01-01

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

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

    Science.gov (United States)

    Linville, P W

    1987-04-01

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

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

    NARCIS (Netherlands)

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

    2017-01-01

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

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

    Science.gov (United States)

    2012-01-01

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

  9. Effectiveness of laparoscopic surgeries in treating infertility related to endometriosis

    Directory of Open Access Journals (Sweden)

    Aneta Słabuszewska-Jóźwiak

    2015-05-01

    Laparoscopy is a vital therapeutic method. Operative laparoscopy is an efficient method for treating infertility related to endometriosis, and the procedure seems to be the most effective particularly at stage III rAFS. The period for expectant management after a surgical procedure should last 6 months.

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

    Science.gov (United States)

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

    2017-08-22

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

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

    Science.gov (United States)

    Stewart, S H; Watt, M C

    2000-01-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Science.gov (United States)

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

    2017-09-01

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

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

    NARCIS (Netherlands)

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

    2011-01-01

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

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

    NARCIS (Netherlands)

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

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Leese Morven

    2011-07-01

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

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

    NARCIS (Netherlands)

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

    2014-01-01

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

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

    Science.gov (United States)

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

    2002-01-15

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

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

    Directory of Open Access Journals (Sweden)

    Jungwoo Sohn

    2014-11-01

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

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

    OpenAIRE

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

    2013-01-01

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

  2. Injection related anxiety in insulin-treated diabetes.

    Science.gov (United States)

    Zambanini, A; Newson, R B; Maisey, M; Feher, M D

    1999-12-01

    The presence of injection related anxiety and phobia may influence compliance, glycaemic control and quality of life in patients with insulin-treated diabetes. Unselected consecutive, insulin-treated patients attending a diabetes clinic for follow-up, completed a standardised questionnaire providing an injection anxiety score (IAS) and general anxiety score (GAS). A total of 115 insulin-treated (80 Type 1 and 35 Type 2) diabetic patients completed the questionnaire. Injections had been avoided secondary to anxiety in 14% of cases and 42% expressed concern at having to inject more frequently. An IAS > or = 3 was seen in 28% of patients and of these, 66% injected insulin one to two times/day, 45% had avoided injections, and 70% would be bothered by more frequent injections. A significant correlation between IAS and GAS was seen (Kendall's tau-a 0.30, 95% CI 0.19-0.41, P < 0.001). GAS was significantly associated with both previous injection avoidance and expressed concern at increased injection frequency. No significant correlation was seen with HbA1c and injection or general anxiety scores. Symptoms relating to insulin injection anxiety and phobia have a high prevalence in an unselected group of diabetic patients requiring insulin injections and are associated with higher levels of general anxiety.

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

    Directory of Open Access Journals (Sweden)

    Lau Claudia H

    2012-05-01

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

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

    Science.gov (United States)

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

    2012-06-01

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

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

    Science.gov (United States)

    Fagan, Kathleen M; Hodgson, Michael J

    2017-02-01

    A 2009 Government Accounting Office (GAO) report, along with numerous published studies, documented that many workplace injuries are not recorded on employers' recordkeeping logs required by the Occupational Safety and Health Administration (OSHA) and consequently are under-reported to the Bureau of Labor Statistics (BLS), resulting in a substantial undercount of occupational injuries in the United States. OSHA conducted a Recordkeeping National Emphasis Program (NEP) from 2009 to 2012 to identify the extent and causes of unrecorded and incorrectly recorded occupational injuries and illnesses. OSHA found recordkeeping violations in close to half of all facilities inspected. Employee interviews identified workers' fear of reprisal and employer disciplinary programs as the most important causes of under-reporting. Subsequent inspections in the poultry industry identified employer medical management policies that fostered both under-reporting and under-recording of workplace injuries and illnesses. OSHA corroborated previous research findings and identified onsite medical units as a potential new cause of both under-reporting and under-recording. Research is needed to better characterize and eliminate obstacles to the compilation of accurate occupational injury and illness data. Occupational health professionals who work with high hazard industries where low injury rates are being recorded may wish to scrutinize recordkeeping practices carefully. This work suggests that, although many high-risk establishments manage recordkeeping with integrity, the lower the reported injury rate, the greater the likelihood of under-recording and under-reporting of work-related injuries and illnesses. Published by Elsevier Ltd.

  6. Golf-related injuries treated in United States emergency departments.

    Science.gov (United States)

    Walsh, Brittany A; Chounthirath, Thiphalak; Friedenberg, Laura; Smith, Gary A

    2017-11-01

    This study investigates unintentional non-fatal golf-related injuries in the US using a nationally representative database. This study analyzed golf-related injuries treated in US hospital emergency departments from 1990 through 2011 using the National Electronic Injury Surveillance System database. Injury rates were calculated using golf participation data. During 1990 through 2011, an estimated 663,471 (95% CI: 496,370-830,573) individuals ≥7years old were treated in US emergency departments for golf-related injuries, averaging 30,158 annually or 12.3 individuals per 10,000 golf participants. Patients 18-54years old accounted for 42.2% of injuries, but injury rates per 10,000 golf participants were highest among individuals 7-17years old (22.1) and ≥55years old (21.8) compared with 18-54years old (7.6). Patients ≥55years old had a hospital admission rate that was 5.01 (95% CI: 4.12-6.09) times higher than that of younger patients. Injured by a golf club (23.4%) or struck by a golf ball (16.0%) were the most common specified mechanisms of injury. The head/neck was the most frequently injured body region (36.2%), and sprain/strain (30.6%) was the most common type of injury. Most patients were treated and released (93.7%) and 5.9% required hospitalization. Although golf is a source of injury among all age groups, the frequency and rate of injury were higher at the two ends of the age spectrum. Given the higher injury and hospital admission rates of patients ≥55years, this age group merits the special attention of additional research and injury prevention efforts. Copyright © 2017 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2018-01-26

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

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

    Science.gov (United States)

    Eriksson, Therese; Westerberg, Yvonne; Jonsson, Hans

    2011-12-01

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

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

    OpenAIRE

    Eriksson, Therese

    2012-01-01

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

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

    OpenAIRE

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

    2013-01-01

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

  11. The disease related deaths due to differentiated thyroid carcinomas treated multidisciplinary, including radioiodine

    International Nuclear Information System (INIS)

    Stefanovic, Lj.; Kermeci, K.; Malesevic, M.; Mihailovic, J.; Srbovan, D.; Popadic, S.

    2002-01-01

    Aim: To analyse the disease related deaths of differentiated thyroid carcinoma (DTC) patients treated multidisciplinary, including radioiodine. Patients and Methods: 364 DTC patients were treated from 1977 to the end of 2000. All patients were operated, treated by radioiodine and by hormonal therapy, external radiotherapy was applied in 22 and chemotherapy in 6 of them. 54 treated patients were lost from the follow-up. The course of disease and outcomes are known in 310 patients, among them 53 patients died. The disease related deaths occurred in 33 (10.6%) patients. Results: Between 33 patients whose deaths were in relation with DTC the disease progression was the cause of deaths in 30 (9.7% of treated) patients (the locoregional disease in 10, distant metastases /M1/ in 17, locoregional disease + M1 in 3 patients). From the late complications of treatment died 3 (1%) patients (all of them were in complete remission to the deaths). The mean survival of these 33 patients from the diagnosis to the end of the life was 6.9 years, median 5.1 years, range 2 months to 23.9 years. The five years survived 54.6% of them, 10 years 21.2% and more than 20 years 3%. M1 had 72.7% of patients (lung and/or bone M1 were present in 91.7% of them), N1 had 69.7% and in 30.3% local tumor was T4. In relation to all treated patients died 14.6% men compared to 9% women (p<0.05), 15.7% of patients 45 years old or older compared to 4.4% of younger then 45 years (p<0.001) and 21.3% of patients with follicular type of DTC compared to 7.3% with papillary type (p<0.001). From all patients without radioiodine accumulation in tumor tissue died 60%. Conclusion: The DTC related deaths were the consequence of M1 and less frequently the result of locoregional disease (T4 and/or N1) in about 1/10 of all treated patients. The deaths as result of the late complications of treatment were exceptional. The deaths were significantly more frequent between males, patients 45 years old or older and patients

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

    Directory of Open Access Journals (Sweden)

    Noriko Takahashi

    2015-03-01

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

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

    Science.gov (United States)

    Finch, Caroline F; Boufous, Soufiane

    2008-01-01

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

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

    Science.gov (United States)

    Karnon, Jonathan; Tsuchiya, Aki; Dolan, Paul

    2005-11-01

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

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

    Science.gov (United States)

    Scott, Russ

    2015-08-01

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

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

    DEFF Research Database (Denmark)

    Hansen, C. D.; Andersen, JH

    2008-01-01

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

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

    Science.gov (United States)

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

    2017-11-01

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

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

    Science.gov (United States)

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

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

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

    NARCIS (Netherlands)

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

    2017-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Lucia D'Ambruoso

    2012-08-01

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

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

    Science.gov (United States)

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

    2016-07-01

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

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

    Science.gov (United States)

    Mannarini, Stefania; Boffo, Marilisa

    2014-01-01

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

  3. Treating asthma with a self-management model of illness behaviour in an Australian community pharmacy setting.

    Science.gov (United States)

    Smith, Lorraine; Bosnic-Anticevich, Sinthia Z; Mitchell, Bernadette; Saini, Bandana; Krass, Ines; Armour, Carol

    2007-04-01

    Asthma affects a considerable proportion of the population worldwide and presents a significant health problem in Australia. Given its chronic nature, effective asthma self-management approaches are important. However, despite research and interventions targeting its treatment, the management of asthma remains problematic. This study aimed to develop, from a theoretical basis, an asthma self-management model and implement it in an Australian community pharmacy setting in metropolitan Sydney, using a controlled, parallel-groups repeated-measures design. Trained pharmacists delivered a structured, step-wise, patient-focused asthma self-management program to adult participants over a 9-month period focusing on identification of asthma problems, goal setting and strategy development. Data on process- clinical- and psychosocial-outcome measures were gathered. Results showed that participants set an average of four new goals and six repeated goals over the course of the intervention. Most common goal-related themes included asthma triggers, asthma control and medications. An average of nine strategies per participant was developed to achieve the set goals. Common strategies involved visiting a medical practitioner for review of medications, improving adherence to medications and using medications before exercise. Clinical and psychosocial outcomes indicated significant improvements over time in asthma symptom control, asthma-related self-efficacy and quality of life, and negative affect. These results suggest that an asthma self-management model of illness behaviour has the potential to provide patients with a range of process skills for self-management, and deliver improvements in clinical and psychosocial indicators of asthma control. The results also indicate the capacity for the effective delivery of such an intervention by pharmacists in Australian community pharmacy settings.

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

    International Nuclear Information System (INIS)

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

    2014-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-10-15

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2017-01-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    N. V. Fomina

    2016-01-01

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

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

    Science.gov (United States)

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

    2011-08-30

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

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

    Directory of Open Access Journals (Sweden)

    Mann Vera

    2009-07-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Science.gov (United States)

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

    2018-06-10

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

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

    Science.gov (United States)

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

    2018-03-07

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

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

    Science.gov (United States)

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

    2017-12-01

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

  16. Treatment Related Cardiac Toxicity in Patients Treated for Breast Cancer

    National Research Council Canada - National Science Library

    Marks, Lawrence B

    2006-01-01

    Purpose: To determine the incidence dose/time-dependence and functional significance of regional cardiac perfusion abnormalities in patients with left-sided breast cancer treated with radiation therapy (RT...

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

    Science.gov (United States)

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

    2018-05-30

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

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

    International Nuclear Information System (INIS)

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

    1997-01-01

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

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

    Science.gov (United States)

    Generous, Mark Alan; Keeley, Maureen P

    2014-01-01

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

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

    Science.gov (United States)

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

    2012-01-01

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

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

    DEFF Research Database (Denmark)

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

    2001-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1982-02-15

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

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

    Science.gov (United States)

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

    2010-10-01

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

  4. Cirrhosis related chylous ascites successfully treated with TIPS.

    Science.gov (United States)

    de Vries, G J; Ryan, B M; de Bièvre, M; Driessen, A; Stockbrugger, R W; Koek, G H

    2005-04-01

    We describe a patient with chylous ascites, who was extensively investigated for the cause. No malignant or lymphatic disease could be found, but a liver biopsy revealed liver cirrhosis. The chylous ascites was unsuccessfully treated with a sodium restriction diet, diuretics and a medium chain triglyceride diet. After the placement of a transjugular intrahepatic portosystemic shunt the ascites disappeared.

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

    Science.gov (United States)

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

    2012-06-13

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2017-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Maria W. Mauritz

    2013-04-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Science.gov (United States)

    Martin, Shadi Sahami

    2009-01-01

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

  11. Incidence of Decompression Illness and Other Diving Related Medical Problems Amongst Royal Navy Divers 1995-1999

    Science.gov (United States)

    1999-01-01

    conditions hypobares ou hyperbares ] To order the complete compilation report, use: ADA395680 The component part is provided here to allow users access to...following report: TITLE: Operational Medical Issues in Hypo-and Hyperbaric Conditions [les Questions medicales a caractere oprationel liees aux...Navy diving accidents, and with the assistance of the British Hyperbaric Association (BHA) all civilian cases of decompression illness treated by member

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

    Science.gov (United States)

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

    2012-12-05

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

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

    Directory of Open Access Journals (Sweden)

    Patten Scott B

    2012-12-01

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

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

    Science.gov (United States)

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

    2014-08-01

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

  15. Can the Cancer-related Fatigue Case-definition Criteria Be Applied to Chronic Medical Illness? A Comparison between Breast Cancer and Systemic Sclerosis.

    Science.gov (United States)

    Kwakkenbos, Linda; Minton, Ollie; Stone, Patrick C; Alexander, Susanna; Baron, Murray; Hudson, Marie; Thombs, Brett D

    2015-07-01

    Fatigue is a crucial determinant of quality of life across rheumatic diseases, but the lack of agreed-upon standards for identifying clinically significant fatigue hinders research and clinical management. Case definition criteria for cancer-related fatigue were proposed for inclusion in the International Classification of Diseases. The objective was to evaluate whether the cancer-related fatigue case definition performed equivalently in women with breast cancer and systemic sclerosis (SSc) and could be used to identify patients with chronic illness-related fatigue. The cancer-related fatigue interview (case definition criteria met if ≥ 5 of 9 fatigue-related symptoms present with functional impairment) was completed by 291 women with SSc and 278 women successfully treated for breast cancer. Differential item functioning was assessed with the multiple indicator multiple cause model. Items 3 (concentration) and 10 (short-term memory) were endorsed significantly less often by women with SSc compared with cancer, controlling for responses on other items. Omitting these 2 items from the case definition and requiring 4 out of the 7 remaining symptoms resulted in a similar overall prevalence of cancer-related fatigue in the cancer sample compared with the original criteria (37.4% vs 37.8%, respectively), with 97.5% of patients diagnosed identically with both definitions. Prevalence of chronic illness-related fatigue was 36.1% in SSc using 4 of 7 symptoms. The cancer-related fatigue criteria can be used equivalently to identify patients with chronic illness-related fatigue when 2 cognitive fatigue symptoms are omitted. Harmonized definitions and measurement of clinically significant fatigue will advance research and clinical management of fatigue in rheumatic diseases and other conditions.

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

    NARCIS (Netherlands)

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

    1999-01-01

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

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

    Science.gov (United States)

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

    2015-05-01

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

  18. Treating symptoms or assisting human development: Can different environmental conditions affect personal development for patients with severe mental illness? A qualitative study.

    Science.gov (United States)

    Lauveng, Arnhild; Tveiten, Sidsel; Ekeland, Tor-Johan; Torleif, Ruud

    2016-01-01

    Recent research suggests that a basic anomaly in self-experience may be a core factor in patients with severe mental illnesses. Given the importance of sense of self, the traditional treatment of symptoms might not be the most effective for these groups of patients. This qualitative study examines how differences in social environmental conditions, organized as education or treatment, might affect personal development in patients with severe mental illness. A qualitative hermeneutical design was used. Data were collected through qualitative interviews. Informants included 14 patients in psychiatric treatment and 15 students at schools for adults with mental illness. Most informants were interviewed on two occasions, 6-8 months apart, totaling 47 interviews. All participants had been diagnosed with severe mental illness with pronounced impact on daily functioning (most often psychoses or personality disorders) for a minimum of 2 years. Findings and interpretations showed that the students experienced a supportive environment focused mostly on education. They described personal and enduring development in areas such as capacity for relationships, regulation of symptoms, subjective well-being, and integration in society. The patients experienced an environment focused more on treatment of their illness and less on personal development and interests. They described little development, much loneliness, a poor quality of life, an objectifying attitude of themselves and others, and hopelessness. Even if more research is needed, findings indicate that for this group of patients, problems may be closely related to identity development. Therefore, instead of solemnly focusing on specific symptoms, it might be more effective to support patients' personal and social development by offering intensive and lasting social environmental conditions. This includes stable and mutual relationships, intrinsically motivated activities, and an environment that supports personal choices

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

    Science.gov (United States)

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

    2012-01-01

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

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

    Science.gov (United States)

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

    2013-05-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  2. BASTILLE - Better Analysis Software to Treat ILL Experiments - a unified, unifying approach to data reduction and analysis

    International Nuclear Information System (INIS)

    Johnson, M.

    2011-01-01

    Data reduction and analysis is a key component in the production of scientific results. If this component, like any other in the chain, is weak, the final output is compromised. The current situation for data reduction and analysis may be regarded as adequate, but it is variable, depending on the instrument, and should be improved. In particular the delivery of new and upgraded instruments in Millennium Phase I and those proposed for Phase II will bring new demands and challenges for software development. Failure to meet these challenges will hamper the exploitation of higher data rates and the delivery of new science. The proposed project is to provide a single, underpinning software infrastructure for data analysis, which would ensure: 1) a clear vision of software provision at ILL; 2) a clear role for the 'Computing for Science' Group (CS) in maintaining and developing the infrastructure and the codes; 3) a well-defined framework for recruiting and training CS staff; 4) ease and efficiency of development within a common, well-defined software environment; 5) safeguarding of key, existing software; and 6) ease of communication with other software like instrument control software to allow real-time data analysis and experiment control, or software from other institutes or sources

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

    NARCIS (Netherlands)

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

    2011-01-01

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

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

    NARCIS (Netherlands)

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

    2012-01-01

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

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

    NARCIS (Netherlands)

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

    2012-01-01

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

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

    NARCIS (Netherlands)

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

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Tayseer Zaytoun

    2017-04-01

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

  8. Radiation dose to relations of patients treated with 131I

    International Nuclear Information System (INIS)

    Pant, G.S.; Sharma, S.K.; Bal, C.S.; Rakesh Kumar; Rath, G.K.

    2003-01-01

    Due to its efficacy and simplicity, radioiodine treatment of thyrotoxicosis and differentiated thyroid cancer (DTC) has become extremely popular. A large number of such patients are getting benefit with this treatment modality. Though the radiation dose to the relations of these patients, who may be in close proximity for some time after treatment have been mentioned as within safe limits but we do have sufficient data of our own in India. The life style and social conditions in India are very different than in the developed world. We have been measuring external dose in relations/attendants of these patients who have enough chance to come in close contacts with patients during and after their radioiodine treatment. The TL discs of CaSO 4 (Renentech Laboratories) were exposed to graded doses of gamma photons from 131 I for establishing a dose response relationship. The annealed discs from a given lot were measured for background counts and issued to the relations of patients who have maximum chance of being in proximity with the patient for 2 weeks. The TLDs were collected after a use of 2 weeks for dose estimation. We have so far studied 60 families with a total of 71 attendants. The external doses in all the persons attending the patients at home are well within safe prescribed limits. However, due to varied social and practical circumstances 5 persons exceeded 1 mSv dose. This is possibly due to travelling long distance by train immediately after discharge from the hospital when the accompanying person remains in close proximity throughout the journey. There are situations for non-ambulatory patients, when the attendants have to attend them for relatively longer period. (author)

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

    Science.gov (United States)

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

    2016-03-25

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

  10. Research status of conbercept treating age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    Hai-Yan He

    2015-08-01

    Full Text Available Age-related macular degeneration(AMDis one of the major reasons of blindness among the elderly in the developed countries. As AMD patients are increasing year by year, AMD has become one of the important topics of ophthalmic research to prevent blindness. Its pathogenesis is not fully understood, but many studies have shown that vascular endothelial growth factor(VEGFplays an important role in the pathogenesis. With the development and application of anti-VEGF drugs, there are a variety of drugs applied to the disease. This article introduces conbercept for the treatment of AMD.

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

    NARCIS (Netherlands)

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

    2008-01-01

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

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

    Science.gov (United States)

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

    2018-06-19

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

  13. mPneumonia: Development of an Innovative mHealth Application for Diagnosing and Treating Childhood Pneumonia and Other Childhood Illnesses in Low-Resource Settings.

    Directory of Open Access Journals (Sweden)

    Amy Sarah Ginsburg

    Full Text Available Pneumonia is the leading infectious cause of death in children worldwide. Each year, pneumonia kills an estimated 935,000 children under five years of age, with most of these deaths occurring in developing countries. The current approach for pneumonia diagnosis in low-resource settings--using the World Health Organization Integrated Management of Childhood Illness (IMCI paper-based protocols and relying on a health care provider's ability to manually count respiratory rate--has proven inadequate. Furthermore, hypoxemia--a diagnostic indicator of the presence and severity of pneumonia often associated with an increased risk of death--is not assessed because pulse oximetry is frequently not available in low-resource settings. In an effort to address childhood pneumonia mortality and improve frontline health care providers' ability to diagnose, classify, and manage pneumonia and other childhood illnesses, PATH collaborated with the University of Washington to develop "mPneumonia," an innovative mobile health application using an Android tablet. mPneumonia integrates a digital version of the IMCI algorithm with a software-based breath counter and a pediatric pulse oximeter. We conducted a design-stage usability field test of mPneumonia in Ghana, with the goal of creating a user-friendly diagnostic and management tool for childhood pneumonia and other childhood illnesses that would improve diagnostic accuracy and facilitate adherence by health care providers to established guidelines in low-resource settings. The results of the field test provided valuable information for understanding the usability and acceptability of mPneumonia among health care providers, and identifying approaches to iterate and improve. This critical feedback helped ascertain the common failure modes related to the user interface design, navigation, and accessibility of mPneumonia and the modifications required to improve user experience and create a tool aimed at decreasing

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

    Science.gov (United States)

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

    2016-06-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  17. Robotic Radiosurgery. Treating prostata cancer and related genitourinary applications

    International Nuclear Information System (INIS)

    Ponsky, Lee E.

    2012-01-01

    Prostate cancer is the most common cancer among North American and European men, but its treatment continues to be problematic owing to serious side-effects, including erectile dysfunction, urinary incontinence, and potential lower GI complications. Robotic radiosurgery offers a novel, rapid, non-invasive outpatient treatment option for prostate cancer that combines robotics, advanced image-guided motion detection, and automated real-time corrective spatial positioning with submillimeter precision. This book examines all aspects of the treatment of prostate cancer with robotic radiosurgery. After introductory sections on radiosurgery as a multidisciplinary practice and specific issues relating to prostate cancer, the important challenge posed by prostate motion when administering radiation therapy is examined in depth, with detailed discussion as to how image-guided robotic radiosurgery overcomes this problem by continously identifying the precise location of the prostate throughout the course of treatment. A further major section is devoted to a discussion of techniques and potential radiobiological and clinical advantages of hypofractionated radiation delivery by means of robotic radiosurgery systems. The book closes by discussing other emerging genitourinary applications of robotic radiosurgery. All of the authors are experts in their field who present a persuasive case for this fascinating technique. (orig.)

  18. Robotic Radiosurgery. Treating prostata cancer and related genitourinary applications

    Energy Technology Data Exchange (ETDEWEB)

    Ponsky, Lee E. (ed.) [Case Western Reserve University School of Medicine, Cleveland, OH (United States). University Hospitals Case Medical Center

    2012-07-01

    Prostate cancer is the most common cancer among North American and European men, but its treatment continues to be problematic owing to serious side-effects, including erectile dysfunction, urinary incontinence, and potential lower GI complications. Robotic radiosurgery offers a novel, rapid, non-invasive outpatient treatment option for prostate cancer that combines robotics, advanced image-guided motion detection, and automated real-time corrective spatial positioning with submillimeter precision. This book examines all aspects of the treatment of prostate cancer with robotic radiosurgery. After introductory sections on radiosurgery as a multidisciplinary practice and specific issues relating to prostate cancer, the important challenge posed by prostate motion when administering radiation therapy is examined in depth, with detailed discussion as to how image-guided robotic radiosurgery overcomes this problem by continously identifying the precise location of the prostate throughout the course of treatment. A further major section is devoted to a discussion of techniques and potential radiobiological and clinical advantages of hypofractionated radiation delivery by means of robotic radiosurgery systems. The book closes by discussing other emerging genitourinary applications of robotic radiosurgery. All of the authors are experts in their field who present a persuasive case for this fascinating technique. (orig.)

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

    Directory of Open Access Journals (Sweden)

    Walvoort SJW

    2016-07-01

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

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

    Science.gov (United States)

    Eklund, Mona; Ostman, Margareta

    2010-07-01

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

  1. Floating arterial thrombus related stroke treated by intravenous thrombolysis.

    Science.gov (United States)

    Vanacker, P; Cordier, M; Janbieh, J; Federau, C; Michel, P

    2014-01-01

    The effects of intravenous thrombolysis on floating thrombi in cervical and intracranial arteries of acute ischemic stroke patients are unknown. Similarly, the best prevention methods of early recurrences remain controversial. This study aimed to describe the clinical and radiological outcome of thrombolyzed strokes with floating thrombi. We retrospectively analyzed all thrombolyzed stroke patients in our institution between 2003 and 2010 with floating thrombi on acute CT-angiography before the intravenous thrombolysis. The floating thrombus was diagnosed if an elongated thrombus of at least 5 mm length, completely surrounded by contrast on supra-aortic neck or intracerebral arteries, was present on CT-angiography. Demographics, vascular risk factors, and comorbidities were recorded and stroke etiology was determined after a standardized workup. Repeat arterial imaging was performed by CTA at 24 h or before if clinical worsening was noted and then by Doppler and MRA during the first week and at four months. Of 409 thrombolyzed stroke patients undergoing acute CT Angiography, seven (1.7%) had a floating thrombus; of these seven, six had it in the anterior circulation. Demographics, risk factors and stroke severity of these patients were comparable to the other thrombolyzed patients. After intravenous thrombolysis, the floating thrombi resolved completely at 24 h in four of the patients, whereas one had an early recurrent stroke and one developed progressive worsening. One patient developed early occlusion of the carotid artery with floating thrombus and subsequently a TIA. The two patients with a stable floating thrombus had no clinical recurrences. In the literature, only one of four reported cases were found to have a thrombolysis-related early recurrence. Long-term outcome seemed similar in thrombolyzed patients with floating thrombus, despite a possible increase of very early recurrence. It remains to be established whether acute mechanical thrombectomy could be

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

    Science.gov (United States)

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

    2009-01-01

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

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

    DEFF Research Database (Denmark)

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

    2018-01-01

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

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

    Science.gov (United States)

    Kobau, Rosemarie; Zack, Matthew M

    2013-11-01

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

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

    NARCIS (Netherlands)

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

    2010-01-01

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

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

    Science.gov (United States)

    McClellan, Jon; And Others

    1995-01-01

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

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

    NARCIS (Netherlands)

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

    2010-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Fischer Julia

    2009-01-01

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

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

    Science.gov (United States)

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

    2013-06-01

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

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

    Science.gov (United States)

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

    2017-11-09

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

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

    Science.gov (United States)

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

    2012-01-01

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

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

    Science.gov (United States)

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

    2011-09-01

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

  13. Two-step versus one-step FT4 assays in heparin treated patients and non-thyroidal illness

    International Nuclear Information System (INIS)

    Reiners, C.; Bieler, G.; Ertl, G.; Gloss, H.; Boerner, W.

    1985-01-01

    The primary intention of this study is to inform the clinician about the direction and the order of magnitude of possible disturbances of different FT 4 parameters under the condition mentioned last, which is not uncommon in daily routine. No single FT 4 -RIA proved be valid in severe NTI. There is the risk to misinterprete hyperthyroidism as euthyroidism with 1step assays and the possibility to classify euthyroid patients falsely as hyperthyroid with 2step assays. In relation to this problem, the sometimes lowered FT 4 values by 1step methods are clinically not so important. It has to be established, wether TSH assays of high sensitivity are able to overcome some of the difficulties with determinations of peripheral thyroid hormones in NTI. (orig./MG)

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

    Directory of Open Access Journals (Sweden)

    Stacey Chamberlain

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

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

    Science.gov (United States)

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

    2013-06-01

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

  16. Gaining perspective on own illness - the lived experiences of a patient education programme for women with treated coeliac disease.

    Science.gov (United States)

    Ring Jacobsson, Lisa; Milberg, Anna; Hjelm, Katarina; Friedrichsen, Maria

    2016-05-01

    To explore the lived experiences of women with coeliac disease after attending a patient education programme, to gain a broader perspective of its influence. Adults, particularly women, with coeliac disease report suffering from poor well-being and reduced quality of life in terms of health. Patient education programmes might support and encourage them in the search for possible improvements in lifestyle and in their approach to the disease. A qualitative phenomenological study. Personal narrative interviews with 14 women suffering from coeliac disease who had participated in an educational programme. Data analysis in accordance with Giorgi was performed. The essential structure of women's lived experiences following their participation in the patient education programme was found to be an interaction with others with the same disease, which left the women feeling individually strengthened. The interaction enabled the participants to acquire a broader view of their life with coeliac disease. As a result, this realigned their sense of self in relation to their own disease. In coping with coeliac disease, it seems that women need interaction with others with the disease to experience togetherness within a group, get the opportunity to compare themselves with others and to exchange knowledge. The interaction appears to result in that women acquire an overview of life with the disease, develop a greater confidence and dare to try new things in life. When designing a patient education programme it seems important to consider the needs of persons to meet others with the same disease, and to ask them about their need for knowledge, rather than simply assuming that health care professionals know what they need. © 2016 John Wiley & Sons Ltd.

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Science.gov (United States)

    Olasoji, M; Maude, P; McCauley, K

    2017-08-01

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

  19. Treating the untreated: applying a community-based, culturally sensitive psychiatric intervention to confined and physically restrained mentally ill individuals in Bali, Indonesia.

    Science.gov (United States)

    Suryani, Luh Ketut; Lesmana, Cokorda Bagus Jaya; Tiliopoulos, Niko

    2011-11-01

    This study identified, mapped and treated the clinical features of mentally ill people, who had been isolated and restrained by family and community members as a result of a functional failure of the traditional medical, hospital-based mental health model currently practiced in Indonesia. A 10-month epidemiological population survey was carried out in Karangasem regency of Bali, Indonesia. A total of 404,591 individuals were clinically interviewed, of which 895 individuals with mental health problems were identified, with 23 satisfying criteria of physical restraint and confinement. Of the latter, twenty were males; age range was 19-69 years, all diagnosed by the researchers with schizophrenia-spectrum disorder (ICD-10 diagnostic criteria). Duration of restraint ranged from 3 months to 30 years (mean = 8.1 years, SD = 8.3 years). Through the application of a holistic intervention model, all patients exhibited a remarkable recovery within 19 months of treatment. We conclude that the development of a community-based, culturally sensitive and respectful mental health model can serve as an optimum promoter of positive mental health outcomes.

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

    Science.gov (United States)

    Åsbring, Pia

    2012-11-01

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

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

    Science.gov (United States)

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

    2016-07-01

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

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

    Science.gov (United States)

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

    2016-10-01

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

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

    Science.gov (United States)

    Baker, Amy Elizabeth Zanker; Procter, Nicholas Gerard

    2014-07-01

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

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

    Science.gov (United States)

    Su, Szu-Huei; Wu, Li-Min

    2018-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Karl Gauffin

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

  6. EUROPAEM EMF Guideline 2016 for the prevention, diagnosis and treatment of EMF-related health problems and illnesses.

    Science.gov (United States)

    Belyaev, Igor; Dean, Amy; Eger, Horst; Hubmann, Gerhard; Jandrisovits, Reinhold; Kern, Markus; Kundi, Michael; Moshammer, Hanns; Lercher, Piero; Müller, Kurt; Oberfeld, Gerd; Ohnsorge, Peter; Pelzmann, Peter; Scheingraber, Claus; Thill, Roby

    2016-09-01

    , the emerging electromagnetic hypersensitivity (EHS) is more and more recognized by health authorities, disability administrators and case workers, politicians, as well as courts of law. We recommend treating EHS clinically as part of the group of chronic multisystem illnesses (CMI), but still recognizing that the underlying cause remains the environment. In the beginning, EHS symptoms occur only occasionally, but over time they may increase in frequency and severity. Common EHS symptoms include headaches, concentration difficulties, sleep problems, depression, a lack of energy, fatigue, and flu-like symptoms. A comprehensive medical history, which should include all symptoms and their occurrences in spatial and temporal terms and in the context of EMF exposures, is the key to making the diagnosis. The EMF exposure is usually assessed by EMF measurements at home and at work. Certain types of EMF exposure can be assessed by asking about common EMF sources. It is very important to take the individual susceptibility into account. The primary method of treatment should mainly focus on the prevention or reduction of EMF exposure, that is, reducing or eliminating all sources of high EMF exposure at home and at the workplace. The reduction of EMF exposure should also be extended to public spaces such as schools, hospitals, public transport, and libraries to enable persons with EHS an unhindered use (accessibility measure). If a detrimental EMF exposure is reduced sufficiently, the body has a chance to recover and EHS symptoms will be reduced or even disappear. Many examples have shown that such measures can prove effective. To increase the effectiveness of the treatment, the broad range of other environmental factors that contribute to the total body burden should also be addressed. Anything that supports homeostasis will increase a person's resilience against disease and thus against the adverse effects of EMF exposure. There is increasing evidence that EMF exposure has a

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

    Science.gov (United States)

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

    2017-08-17

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

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

    Science.gov (United States)

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

    2017-06-01

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

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

    Science.gov (United States)

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

    2014-12-01

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

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

    Science.gov (United States)

    Landzelius, Kyra Marie

    2003-03-01

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

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

    International Nuclear Information System (INIS)

    Roberts, P.B.

    1976-09-01

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

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

    Directory of Open Access Journals (Sweden)

    Westendorp Rudi GJ

    2003-12-01

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

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

    Science.gov (United States)

    Marquez, Jorge A; Ramírez García, Jorge I

    2013-06-01

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

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

    Science.gov (United States)

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

    2016-06-01

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

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

    Science.gov (United States)

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

    2017-07-01

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

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

    Science.gov (United States)

    Wilski, Maciej; Tasiemski, Tomasz

    2016-07-01

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

  17. Reducing the Incidence of Cast-related Skin Complications in Children Treated With Cast Immobilization.

    Science.gov (United States)

    Difazio, Rachel L; Harris, Marie; Feldman, Lanna; Mahan, Susan T

    2017-12-01

    Cast immobilization remains the mainstay of pediatric orthopaedic care, yet little is known about the incidence of cast-related skin complications in children treated with cast immobilization. The purposes of this quality improvement project were to: (1) establish a baseline rate of cast-related skin complications in children treated with cast immobilization, (2) identify trends in children who experienced cast-related skin complications, (3) design an intervention aimed at decreasing the rate of cast-related skin complications, and (4) determine the effectiveness of the intervention. A prospective interrupted time-series design was used to determine the incidence of cast-related skin complications overtime and compare the rates of skin complications before and after an intervention designed to decrease the incidence of cast-related heel complications. All consecutive patients who were treated with cast immobilization from September 2012 to September 2014 were included. A cast-related skin complications data collection tool was used to capture all cast-related skin complications. A high rate of heel events was noted in our preliminary analysis and an intervention was designed to decrease the rate of cast-related skin complications, including the addition of padding during casting and respective provider education. The estimated cast-related skin events rate for all patients was 8.9 per 1000 casts applied. The rate for the total preintervention sample was 13.6 per 1000 casts which decreased to 6.6 in the postintervention sample. When examining the heel-only group, the rate was 17.1 per 1000 lower extremity casts applied in the preintervention group and 6.8 in the postintervention group. Incorporating padding to the heel of lower extremity cast was an effective intervention in decreasing the incidence of cast-related skin complications in patients treated with cast immobilization. Level II.

  18. Water tubing-related injuries treated in US emergency departments, 1991-2009.

    Science.gov (United States)

    Heinsimer, Kevin R; Nelson, Nicolas G; Roberts, Kristin J; McKenzie, Lara B

    2013-02-01

    The objective was to describe the patterns and mechanisms of water tubing-related injuries treated in U.S. emergency departments. The National Electronic Injury Surveillance System was used to examine cases of water tubing-related injuries. Sample weights were used to calculate national estimates of water tubing-related injuries. Analyses were conducted in 2010. From 1991-2009 an estimated 69,471 injuries were treated in US emergency departments for water tubing-related injuries. The annual number of cases increased 250% over the 19-year study period (P tubing-related injuries differ for children and adults. Research is needed to determine how best to reduce these injuries.

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

    Science.gov (United States)

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

    2013-10-24

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

  20. EUROPAEM EMF Guideline 2015 for the prevention, diagnosis and treatment of EMF-related health problems and illnesses.

    Science.gov (United States)

    Belyaev, Igor; Dean, Amy; Eger, Horst; Hubmann, Gerhard; Jandrisovits, Reinhold; Johansson, Olle; Kern, Markus; Kundi, Michael; Lercher, Piero; Mosgöller, Wilhelm; Moshammer, Hanns; Müller, Kurt; Oberfeld, Gerd; Ohnsorge, Peter; Pelzmann, Peter; Scheingraber, Claus; Thill, Roby

    2015-01-01

    Chronic diseases and illnesses associated with unspecific symptoms are on the rise. In addition to chronic stress in social and work environments, physical and chemical exposures at home, at work, and during leisure activities are causal or contributing environmental stressors that deserve attention by the general practitioner as well as by all other members of the health care community. It seems certainly necessary now to take "new exposures" like electromagnetic field (EMF) into account. Physicians are increasingly confronted with health problems from unidentified causes. Studies, empirical observations, and patient reports clearly indicate interactions between EMF exposure and health problems. Individual susceptibility and environmental factors are frequently neglected. New wireless technologies and applications have been introduced without any certainty about their health effects, raising new challenges for medicine and society. For instance, the issue of so-called non-thermal effects and potential long-term effects of low-dose exposure were scarcely investigated prior to the introduction of these technologies. Common EMF sources include Wi-Fi access points, routers and clients, cordless and mobile phones including their base stations, Bluetooth devices, ELF magnetic fields from net currents, ELF electric fields from electric lamps and wiring close to the bed and office desk. On the one hand, there is strong evidence that long-term-exposure to certain EMF exposures is a risk factor for diseases such as certain cancers, Alzheimer's disease and male infertility. On the other hand, the emerging electromagnetic hypersensitivity (EHS) is more and more recognized by health authorities, disability administrators and case workers, politicians, as well as courts of law. We recommend treating EHS clinically as part of the group of chronic multisystem illnesses (CMI) leading to a functional impairment (EHS), but still recognizing that the underlying cause remains the

  1. Psychodynamics in medically ill patients.

    Science.gov (United States)

    Nash, Sara Siris; Kent, Laura K; Muskin, Philip R

    2009-01-01

    This article explores the role of psychodynamics as it applies to the understanding and treatment of medically ill patients in the consultation-liaison psychiatry setting. It provides historical background that spans the eras from Antiquity (Hippocrates and Galen) to nineteenth-century studies of hysteria (Charcot, Janet, and Freud) and into the twentieth century (Flanders Dunbar, Alexander, Engle, and the DSM). The article then discusses the effects of personality on medical illness, treatment, and patients' ability to cope by reviewing the works of Bibring, Kahana, and others. The important contribution of attachment theory is reviewed as it pertains the patient-physician relationship and the health behavior of physically ill patients. A discussion of conversion disorder is offered as an example of psychodynamics in action. This article highlights the important impact of countertransference, especially in terms of how it relates to patients who are extremely difficult and "hateful," and explores the dynamics surrounding the topic of physician-assisted suicide, as it pertains to the understanding of a patient's request to die. Some attention is also given to the challenges surrounding the unique experience of residents learning how to treat medically ill patients on the consultation-liaison service. Ultimately, this article concludes that the use and understanding of psychodynamics and psychodynamic theory allows consultation-liaison psychiatrists the opportunity to interpret the life narratives of medically ill patients in a meaningful way that contributes importantly to treatment.

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

    Science.gov (United States)

    Di Filippo, A; De Gaudio, A R

    2003-12-01

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

  3. Burnout in Social Workers Treating Children as Related to Demographic Characteristics, Work Environment, and Social Support

    Science.gov (United States)

    Hamama, Liat

    2012-01-01

    This study examined sense of burnout among 126 social workers who directly treat children and adolescents within the human service professions. Burnout was investigated in relation to social workers' demographic characteristics (age, family status, education, and seniority at work), extrinsic and intrinsic work conditions, and social support by…

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

    Science.gov (United States)

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

    2018-02-23

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

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

    Science.gov (United States)

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

    2004-06-01

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

  6. Trends in fall-related injuries among older adults treated in emergency departments in the USA.

    Science.gov (United States)

    Orces, Carlos H; Alamgir, Hasanat

    2014-12-01

    To examine national trends in fall-related injuries among older adults treated in emergency departments (ED) and project these injuries until the year 2030. The Web-based Injury Statistics Query and Reporting System was used to generate data on fall-related injuries treated in ED. Joinpoint regression analysis was used to examine the average annual change in injury rates over time. Fall-related injury and hospitalisation rates increased on average by 2% (95% CI 1.5% to 2.7%) and by 4% (95% CI 2.9% to 5.0%) per year, respectively. Assuming the increase in fall-related injury rates remains unchanged, the number of fall-related injuries may increase to 5.7 million by the year 2030. Fall-related injuries among older adults treated in ED increased in the USA during the study period. Moreover, a marked increase in the number of these injuries may occur over the next decades. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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

    Science.gov (United States)

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

    2016-12-01

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

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

    Science.gov (United States)

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

    2011-01-01

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

  9. Mortality and health-related quality of life in patients surgically treated for spondylodiscitis

    DEFF Research Database (Denmark)

    Dragsted, Casper; Aagaard, Theis; Ohrt-Nissen, Søren

    2017-01-01

    center. Indications for surgery, pre- and postoperative neurological impairment, comorbidities, and mortality were recorded. A survey was conducted on all eligible patients with the EuroQol 5-dimension (EQ-5D) questionnaire and Oswestry Disability Index (ODI). RESULTS: Sixty-five patients were diagnosed...... neurological impairment. CONCLUSIONS: Several years after surgery, patients surgically treated for spondylodiscitis have significantly lower HRQL and more disability than the background population. Neurological impairment prior to index surgery predicts adverse outcome in terms of disability and lower HRQL.......PURPOSE: To assess mortality, disability, and health-related quality of life (HRQL) in patients surgically treated for spondylodiscitis. METHODS: A retrospective longitudinal study was conducted on all patients surgically treated for spondylodiscitis over a 6-year period at a single tertiary spine...

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

    Science.gov (United States)

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

    2000-05-01

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

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

    Science.gov (United States)

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

    2002-01-01

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

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

    Science.gov (United States)

    Clauw, Daniel J; Williams, David A

    2002-05-01

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

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

    NARCIS (Netherlands)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

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

    OpenAIRE

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

    2011-01-01

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

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

    OpenAIRE

    Hadano,Yoshiro; Shirano,Michinori; Goto,Tetsushi

    2016-01-01

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

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

    Science.gov (United States)

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

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

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

    Science.gov (United States)

    Navon, Shaul

    2014-07-01

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

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

    Science.gov (United States)

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

    2016-04-01

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

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

    Science.gov (United States)

    Tunalı, Varol; Turgay, Nevin

    2017-06-01

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

  1. Snow shovel-related injuries and medical emergencies treated in US EDs, 1990 to 2006.

    Science.gov (United States)

    Watson, Daniel S; Shields, Brenda J; Smith, Gary A

    2011-01-01

    Injuries and medical emergencies associated with snow shovel use are common in the United States. This is a retrospective analysis of data from the National Electronic Injury Surveillance System. This study analyzes the epidemiologic features of snow shovel-related injuries and medical emergencies treated in US emergency departments (EDs) from 1990 to 2006. An estimated 195 100 individuals (95% confidence interval, 140 400-249 800) were treated in US EDs for snow shovel-related incidents during the 17-year study period, averaging 11 500 individuals annually (SD, 5300). The average annual rate of snow shovel-related injuries and medical emergencies was 4.15 per 100 000 population. Approximately two thirds (67.5%) of these incidents occurred among males. Children younger than 18 years comprised 15.3% of the cases, whereas older adults (55 years and older) accounted for 21.8%. The most common diagnosis was soft tissue injury (54.7%). Injuries to the lower back accounted for 34.3% of the cases. The most common mechanism of injury/nature of medical emergency was acute musculoskeletal exertion (53.9%) followed by slips and falls (20.0%) and being struck by a snow shovel (15.0%). Cardiac-related ED visits accounted for 6.7% of the cases, including all of the 1647 deaths in the study. Patients required hospitalization in 5.8% of the cases. Most snow shovel-related incidents (95.6%) occurred in and around the home. This is the first study to comprehensively examine snow shovel-related injuries and medical emergencies in the United States using a nationally representative sample. There are an estimated 11 500 snow shovel-related injuries and medical emergencies treated annually in US EDs. Copyright © 2011 Elsevier Inc. All rights reserved.

  2. Evaluation of Related Factors in the Failure of Endodontically Treated Teeth: A Cross-sectional Study.

    Science.gov (United States)

    Olcay, Keziban; Ataoglu, Hanife; Belli, Sema

    2018-01-01

    The aim of this study was to review the factors related to the failure and extraction of unsuccessful endodontically treated teeth. A total of 1000 teeth treated with nonsurgical root canal therapy were analyzed, and the following information was recorded for each patient: reasons for failure and extraction, type of tooth, presence and type of coronal restoration, smoking status, age, gender, and level of education. One main reason was recorded for each failed tooth. The associations between reasons for failure, patient, and tooth were tested by using χ 2 analysis. Of the 1000 endodontically failed teeth analyzed in this study, 28.1% (n = 281) were extracted, 66% (n = 660) were re-treated, and 5.9% (n = 59) were treated with apical surgery. Among the reasons for failure, restorative and endodontic reasons were seen most frequently (43.9%, n = 439), whereas orthodontic reasons were seldom seen (0.1%, n = 1). The most common reason for extraction was for prosthetic reasons (40.8%), and perforation/stripping was the least common (2.9%). The mandibular first molars were the most frequently extracted teeth (27.4%, n = 77). The most common reason for the extraction of endodontically treated teeth was for prosthetic reasons. Among the reasons for failure, restorative and endodontic reasons were the most frequently seen, and orthodontic reasons were the most seldom. The teeth that failed most frequently were mandibular first molars, and the teeth that failed least frequently were maxillary third molars. The most common reason for the extraction of failed endodontically treated teeth was for prosthetic reasons. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    Karademas, Evangelos C; Petrakis, Charoula

    2009-08-01

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

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

    Science.gov (United States)

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

    2000-11-01

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

  5. Interventions for treating patients with chikungunya virus infection-related rheumatic and musculoskeletal disorders: A systematic review.

    Directory of Open Access Journals (Sweden)

    Arturo Martí-Carvajal

    Full Text Available Chikungunya virus infection (CHIKV is caused by a mosquito-borne alphavirus. CHIKV causes high fever and painful rheumatic disorders that may persist for years. Because little is known about interventions for treating CHIKV-related illness, we conducted a systematic review.We used Cochrane methods. We searched PubMed, EMBASE, Cochrane Library, LILACS and other sources from the earliest records to March 2016. We had no language restrictions. We included randomized controlled trials assessing any intervention for treating acute or chronic CHIKV-related illness. Our primary outcomes were pain relief, global health status (GHS or health related quality of life (HRQL, and serious adverse events (SAEs. We assessed bias risk with the Cochrane tool and used GRADE to assess evidence quality.We screened 2,229 records and found five small trials with a total of 402 participants. Patients receiving chloroquine (CHQ had better chronic pain relief than those receiving placebo (relative risk [RR] 2.67, 95% confidence interval [CI] 1.23 to 5.77, N = 54, but acute pain relief was marginally not different between groups (mean difference [MD] 1.46, 95% CI 0.00 to 2.92, N = 54. SAEs were similar (RR = 15.00, 95% CI 0.90 to 250.24, N = 54. Comparing CHQ with paracetamol (PCM, CHQ patients had better pain relief (RR = 1.52, 95% CI 1.20 to 1.93, N = 86. Compared with hydroxychloroquine (HCHQ, disease-modifying anti-rheumatic drugs (DMARDs reduced pain (MD = -14.80, 95% CI -19.12 to -10.48, N = 72. DMARDs patients had less disability (MD = -0.74, 95% CI -0.92 to -0.56, N = 72 and less disease activity (MD = -1.35; 95% CI -1.70 to -1.00; N = 72. SAEs were similar between DMARDs and HCHQ groups (RR = 2.84, 95% CI 0.12 to 67.53, N = 72. Comparing meloxicam (MXM with CHQ, there was no difference in pain relief (MD = 0.24, 95% CI = -0.81 to 1.29; p = 0.65, N = 70, GHS or HRQL (MD = -0.31, 95% CI -2.06 to 1.44, N = 70 or SAEs (RR = 0.85, 95% CI 0.30 to 2.42, N = 70. Finally

  6. Mental Illness

    Science.gov (United States)

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

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

    NARCIS (Netherlands)

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

    2010-01-01

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

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

    NARCIS (Netherlands)

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

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

  9. Sex-related differences in patients treated surgically for aneurysmal subarachnoid hemorrhage

    International Nuclear Information System (INIS)

    Horiuchi, Tetsuyoshi; Tanaka, Yuichiro; Hongo, Kazuhiro

    2006-01-01

    Sex-related differences were examined in the clinical course of patients treated surgically for aneurysmal subarachnoid hemorrhage. Retrospective analyses were carried out to evaluate sex-related differences in aneurysm location, aneurysm size, preoperative neurological condition, preoperative computed tomography findings, and outcome among 2577 patients who underwent surgical repair of ruptured aneurysms. The internal carotid artery was most frequently affected in women and the anterior cerebral artery in men. Intracerebral or intraventricular hematoma was more common in men than in women. Some differences may be related to the location of the aneurysm. Sex-related differences were prominent in the 5th decade of life. These findings might be related to the menopause. Sex hormones may be involved in aneurysm formation. (author)

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

    Science.gov (United States)

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

    2017-03-01

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

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

    Science.gov (United States)

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

    2000-01-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

  13. Chronic illness in the workplace: stigma, identity threat and strain.

    Science.gov (United States)

    McGonagle, Alyssa K; Barnes-Farrell, Janet L

    2014-10-01

    Chronic illness affects a large and growing number of workers in the United States and globally. Stigmatization (devaluation) at work based on chronic illness may be stressful for individuals and therefore may lead to negative psychological consequences (i.e. strains). In order to better understand stressful experiences of stigma for workers with chronic illnesses, a model of stigma-related identity threat (perceptions that one is at risk of being treated negatively at work because of chronic illness) was tested on a sample of 203 working adults with chronic illnesses. The following variables related to workers' perceptions of chronic illness-related identity threat: workers' boundary flexibility (flexibility in managing their work and life), their meta-perceptions of devaluation (perceptions of others' devaluation of them based on illness) and their job self-efficacy (feelings of confidence related to performing their job). In turn, perceptions of identity threat related to both feelings of psychological strain and (lower levels of) perceived work ability. Surprisingly, neither stigma centrality (how fundamental illness is to one's identity) nor supervisor support related to workers' identity threat perceptions. Copyright © 2013 John Wiley & Sons, Ltd.

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

    Science.gov (United States)

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

    2016-03-01

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

  15. Pediatric volleyball-related injuries treated in US emergency departments, 1990-2009.

    Science.gov (United States)

    Pollard, Katherine A; Shields, Brenda J; Smith, Gary A

    2011-09-01

    This study describes the epidemiology of pediatric volleyball-related injuries treated in US hospital emergency departments. Data for children younger than 18 years obtained from the National Electronic Injury Surveillance System of the US Consumer Product Safety Commission from 1990 through 2009 were analyzed. An estimated 692 024 volleyball-related injuries to children younger than 18 years occurred during the study period. The annual number of injuries declined significantly by 23% during the study period; however, the annual injury rate remained unchanged, and the number of volleyball-related concussions/closed head injuries increased significantly. Upper (48%) and lower (39%) extremity injuries occurred most frequently, as did strains/sprains (54%). Contact with the net/pole was associated with concussions/closed head injury our findings indicate opportunities for making volleyball an even safer sport for children. Protective padding, complying with US volleyball standards, should cover all volleyball poles and protruding hardware to prevent impact-related injuries.

  16. Mountain biking-related injuries treated in emergency departments in the United States, 1994-2007.

    Science.gov (United States)

    Nelson, Nicolas G; McKenzie, Lara B

    2011-02-01

    Injury research on mountain biking has been mostly limited to examining professional riders and off-road biking. Mountain bikes represent the largest segment of bike sales in the United States. Recreational mountain bike use is popular and understudied. To describe the scope, distribution, and trends of mountain bike-related injuries treated in US emergency departments. Descriptive epidemiologic study. A retrospective analysis was conducted with data from the National Electronic Injury Surveillance System of the US Consumer Product Safety Commission for patients aged ≥ 8 years from 1994 through 2007. Sample weights provided by the system were used to calculate national estimates of mountain bike-related injuries based on 4624 cases. Bivariate comparisons between categorical variables were assessed with injury proportion ratios and 95% confidence intervals. Nationwide, an estimated 217 433 patients were treated for mountain bike-related injuries in US emergency departments from 1994 to 2007, an average of 15 531 injuries per year. The annual number of injuries decreased 56%, from a high of 23 177 in 1995 to 10 267 in 2007 (P bike-related injuries decreased from 1994 to 2007. Upper extremity fractures were the most common injury. Girls and women may be more likely than boys and men to sustain more severe injuries requiring hospitalization. Despite the decline over the past decade, more can be done to improve safety and reduce injuries in this popular recreational activity.

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

    Science.gov (United States)

    Svensson, Bengt; Hansson, Lars

    2016-01-01

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

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

    Science.gov (United States)

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

    2013-06-01

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

  19. Heat-Related Illnesses

    Medline Plus

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

  20. Heat-Related Illnesses

    Science.gov (United States)

    1988-04-01

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

  1. Heat-Related Illnesses

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

  2. Heat-Related Illnesses

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

  3. Heat-Related Illnesses

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

  4. Heat-Related Illnesses

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

  5. Heat-Related Illnesses

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

  6. Heat-Related Illnesses

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

  7. Heat-Related Illnesses

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

  8. Heat-Related Illnesses

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

  9. Heat-Related Illnesses

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

  10. Heat-Related Illnesses

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

  11. Heat-Related Illnesses

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

  12. Heat-Related Illnesses

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

  13. Heat-Related Illnesses

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

  14. Heat-Related Illnesses

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

  15. Selective decontamination of the digestive tract in critically ill patients treated in intensive care units: a mixed-methods feasibility study (the SuDDICU study).

    Science.gov (United States)

    Francis, Jill J; Duncan, Eilidh M; Prior, Maria E; Maclennan, Graeme S; Dombrowski, Stephan; Bellingan, Geoff U; Campbell, Marion K; Eccles, Martin P; Rose, Louise; Rowan, Kathryn M; Shulman, Rob; Peter R Wilson, A; Cuthbertson, Brian H

    2014-04-01

    Hospital-acquired infections (HAIs) are a major cause of morbidity and mortality. Critically ill patients in intensive care units (ICUs) are particularly susceptible to these infections. One intervention that has gained much attention in reducing HAIs is selective decontamination of the digestive tract (SDD). SDD involves the application of topical non-absorbable antibiotics to the oropharynx and stomach and a short course of intravenous (i.v.) antibiotics. SDD may reduce infections and improve mortality, but has not been widely adopted in the UK or internationally. Hence, there is a need to identify the reasons for low uptake and whether or not further clinical research is needed before wider implementation would be considered appropriate. The project objectives were to (1) identify and describe the SDD intervention, (2) identify views about the evidence base, (3) identify acceptability of further research and (4) identify feasibility of further randomised controlled trials (RCTs). A four-stage approach involving (1) case studies of two ICUs in which SDD is delivered including observations, interviews and documentary analysis, (2) a three-round Delphi study for in-depth investigation of clinicians' views, including semi-structured interviews and two iterations of questionnaires with structured feedback, (3) a nationwide online survey of consultants in intensive care medicine and clinical microbiology and (4) semistructured interviews with international clinical triallists to identify the feasibility of further research. Case studies were set in two UK ICUs. Other stages of this research were conducted by telephone and online with NHS staff working in ICUs. (1) Staff involved in SDD adoption or delivery in two UK ICUs, (2) ICU experts (intensive care consultants, clinical microbiologists, hospital pharmacists and ICU clinical leads), (3) all intensive care consultants and clinical microbiologists in the UK with responsibility for patients in ICUs were invited and

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

    DEFF Research Database (Denmark)

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

    2001-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Yamilé Benítez Lambert

    2011-10-01

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

  18. Measurement of radiation exposure in relatives of thyroid cancer patients treated with (131)I.

    Science.gov (United States)

    Ramírez-Garzón, Y T; Ávila, O; Medina, L A; Gamboa-deBuen, I; Rodríguez-Laguna, A; Buenfil, A E; Ruíz-Trejo, C; Estrada, E; Brandan, M E

    2014-11-01

    This work evaluates the radiological risk that patients treated with I for differentiated thyroid cancer could present to relatives and occupationally exposed workers. Recently, the International Atomic Energy Agency issued document K9010241, which recommends that patient discharge from the hospital must be based on the particular status of each patient. This work measures effective dose received by caregivers of patients treated with I at the Instituto Nacional de Cancerología, Mexico City. Thermoluminescent dosimeters were carried during a 15-d period by 40 family caregivers after patient release from hospital. Relatives were classified into two groups, ambulatory and hospitalized, according to the release mode of the patient, and three categories according to the individual patient home and transport facilities. Categories A, B, and C were defined going from most to least adequate concerning public exposure risk. Measurements were performed for 20 family caregivers in each group. The effective dose received by all caregivers participating in this study was found to be less than 5 mSv, the recommended limit per event for caregivers suggested by ICRP 103. In addition, 70 and 90% of ambulatory and hospitalized groups, respectively, received doses lower than 1 mSv. Caregivers belonging to category C, with home situations that are not appropriate for immediate release, received the highest average doses; i.e., 2.2 ± 1.3 and 3.1 ± 1.0 mSv for hospitalized and ambulatory patients, respectively. Results of this work have shown that the proper implementation of radiation protection instructions for relatives and patients can reduce significantly the risk that differentiated thyroid cancer patients treated with I can represent for surrounding individuals. The results also stress the relevance of the patient's particular lifestyle and transport conditions as the prevailing factors related to the dose received by the caregiver. Therefore, the patient's status should be

  19. The study is believed to be used to treat illnesses Yau ceremony of Phutai. Natal village , Tambon Tao Ngoi, Tao Ngoi District, Sakon Nakhon Province

    Directory of Open Access Journals (Sweden)

    Boonchom Srisa-ard

    2016-12-01

    Full Text Available This research aimed to 1 study the beliefs and the cause of the ailments of the ceremony to Yau. Which is from Thailand, Village Natal district, Tao Ngoi District, Sakon Nakhon 2 to study the composition of the ceremony Yao and 3 to study the Yau ceremony. The method resources from data collection divided into two parts, there were 1 documentation research articles, theses, books, textbooks and information from the Internet, and 2 the interview with the people who knew the four ceremonies of You. The study found the phenomenon as follows: 1 Belief in the Yau ceremony, that Yau is believed to cure illness, disease caused by an act of the devil. The treatment with modern medicine can not be cured. Parents or family elders had prior therapy with Yau. The disease which is believed to occur in this manner must be gone because of Yao. Some of which can actually be cured, mean while some extended for several more years. The treatment facilities for patients is that Yao can be come home. And pitched immediate treatment faster than the health center or hospital where the procedure was hospitalized several timeconsuming steps. 2 The components of Yau ceremony, are Yau illnesses, Yau is patient, the Yao spit, and music instruments. 3 The ceremony of Yau has five phases: preparation before starting the ceremony. Next, the invitation to the major deities or spirits. then Yao toss the cause of the illness. the reassure patients to leave the various deities and spirits. leave the body return to and live in their residence.

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

    NARCIS (Netherlands)

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

    2009-01-01

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

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

    Science.gov (United States)

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

    2014-09-01

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

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

    Science.gov (United States)

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

    2017-10-01

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

  3. Postoperative ileus-related morbidity profile in patients treated with alvimopan after bowel resection.

    Science.gov (United States)

    Wolff, Bruce G; Weese, James L; Ludwig, Kirk A; Delaney, Conor P; Stamos, Michael J; Michelassi, Fabrizio; Du, Wei; Techner, Lee

    2007-04-01

    Postoperative ileus (POI), an interruption of coordinated bowel motility after operation, is exacerbated by opioids used to manage pain. Alvimopan, a peripherally acting mu-opioid receptor antagonist, accelerated gastrointestinal (GI) recovery after bowel resection in randomized, double-blind, placebo-controlled, multicenter phase III POI trials. The effect of alvimopan on POI-related morbidity for patients who underwent bowel resection was evaluated in a post-hoc analysis. Incidence of POI-related postoperative morbidity (postoperative nasogastric tube insertion or POI-related prolonged hospital stay or readmission) was analyzed in four North American trials for placebo or alvimopan 12 mg administered 30 minutes or more preoperatively and twice daily postoperatively until hospital discharge (7 or fewer postoperative days). GI-related adverse events and opioid consumption were summarized for each treatment. Estimations of odds ratios of alvimopan to placebo and number needed to treat (NNT) to prevent one patient from experiencing an event of POI-related morbidity were derived from the analysis. Patients receiving alvimopan 12 mg were less likely to experience POI-related morbidity than patients receiving placebo (odds ratio = 0.44, p POI-related morbidity. There was a lower incidence of postoperative nasogastric tube insertion, and other GI-related adverse events on postoperative days 3 to 6 in the alvimopan group than the placebo group. Opioid consumption was comparable between groups. Alvimopan 12 mg was associated with reduced POI-related morbidity compared with placebo, without compromising opioid-based analgesia in patients undergoing bowel resection. Relatively low NNTs are clinically meaningful and reinforce the potential benefits of alvimopan for the patient and health care system.

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

    Directory of Open Access Journals (Sweden)

    Alexander Domnich

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

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

    Science.gov (United States)

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

    2014-09-01

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

  6. Recent advances in understanding and treating COPD related to α1-antitrypsin deficiency.

    Science.gov (United States)

    Henao, Maria Paula; Craig, Timothy J

    2016-12-01

    Alpha-1-antitrypsin deficiency (AATD) is an orphan disease that predisposes individuals to COPD and liver disease. The following is a comprehensive review of AATD from epidemiology to treatment for physicians who treat COPD or asthma. Areas covered: In this comprehensive review of alpha-1-antitrypsin deficiency, we describe the historical perspective, genetics, epidemiology, clinical presentation and symptoms, screening and diagnosis, and treatments of the condition. Expert commentary: The two most important directions for advancing the understanding of AATD involve improving detection of the condition, especially in asymptomatic patients, and advancing knowledge of treatments directed specifically at AATD-related conditions. With regard to treatment for AATD-related conditions, research must continue to explore the implications and importance of augmentation therapy as well as consider new implementations that may prove more successful taking into consideration not only factors of pulmonary function and liver health, but also product availability and financial viability.

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

    Science.gov (United States)

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

    2017-01-01

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

  8. A simple technique for treating age-related macular degeneration with external beam radiotherapy

    International Nuclear Information System (INIS)

    Roos, Daniel E.; Francis, J. Winston; Newnham, W. John

    1999-01-01

    Purpose: To develop a simple external beam photon radiotherapy technique to treat age-related macular degeneration without the need for simulation, planning computed tomography (CT) or computer dosimetry. Methods and Materials: The goal was to enable the treatment to be set up reliably on the treatment machine on Day 1 with the patient supine in a head cast without any prior planning. Using measurements of ocular globe topography from Karlsson et al. (Int J Radiat Oncol Biol Phys 1996; 33: 705-712), we chose a point 1.5 cm behind the anterior surface of the upper eyelid (ASUE) as the isocentre of a half-beam, blocked, 5.0 x 3.0-cm, angled lateral field to treat the involved eye. This would position the isocentre about 0.5 cm behind the posterior surface of the lens, and a little over 1 cm in front of the macula, according to Karlsson et al. The setup requires initial adjustment of the gantry from horizontal (to account for any asymmetry of position of the eyes), then angling 15 deg. posteriorly to avoid the contralateral eye. Finally, the couch is raised to position the isocentre 1.5 cm behind the ASUE. Results: To verify the applicability of the technique, we performed CT and computer dosimetry on the first 11 eyes so treated. Our CT measurements were in good agreement with Karlsson et al. The lens dose was < 5% and the macula was within the 95% isodose curve in each case (6-MV linac). Treatment setup time is approximately 10 min each day. The 11 patients were treated with 5 x 2.00 Gy (2 patients) or 5 x 3.00 Gy (9 patients), and subjective response on follow-up over 1 to 12 months (median 4 months) was comparable to previously reported results, with no significant acute side effects. Conclusion: Our technique is easy to set up and reliably treats the macula, with sparing of the lens and contralateral eye. It enables treatment to commence rapidly and cost-effectively without the need for simulation or CT computer planning

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

    Science.gov (United States)

    Pachoud, B; Corbière, M

    2014-06-01

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

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

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    Celenkosini T. Nxumalo

    2017-10-01

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

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

    Science.gov (United States)

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

    2012-09-18

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

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

    Directory of Open Access Journals (Sweden)

    de Graaff Fuusje M

    2012-09-01

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

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

    Science.gov (United States)

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

    2017-09-01

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

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

    NARCIS (Netherlands)

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

    2006-01-01

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

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

    Science.gov (United States)

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

    2015-11-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  17. Outcomes of surgically treated human papillomavirus-related oropharyngeal squamous cell carcinoma with N3 disease.

    Science.gov (United States)

    Zenga, Joseph; Haughey, Bruce H; Jackson, Ryan S; Adkins, Douglas R; Aranake-Chrisinger, John; Bhatt, Neel; Gay, Hiram A; Kallogjeri, Dorina; Martin, Eliot J; Moore, Eric J; Paniello, Randal C; Rich, Jason T; Thorstad, Wade L; Nussenbaum, Brian

    2017-09-01

    To evaluate outcomes for patients with pathological N3 (pN3) neck disease from human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) and determine variables predictive of survival. Retrospective case series with chart review. This study was conducted between 1998 and 2013 and included patients with HPV-related OPSCC treated with surgery with or without adjuvant therapy and who had pN3 nodal disease. The primary outcome was disease-specific survival (DSS). Secondary outcomes included overall survival (OS), disease-free survival (DFS), adverse events, and gastrostomy tube rates. Thirty-nine patients were included, of whom 36 (90%) underwent adjuvant therapy. Median follow-up was 39 months (range, 2-147 months). Mean age was 56 years, and 87% were male. Seventeen patients (44%) underwent selective neck dissection, whereas six (15%) underwent radical (n = 2) or extended radical (n = 4) neck dissection. Ninety-two percent had extracapsular extension. Five-year Kaplan-Meier estimated DSS, OS, and DFS were 89% (95% confidence interval [CI]: 79%-99%), 87% (95% CI: 75%-99%), and 84% (95% CI: 72%-96%), respectively. The disease recurrence rate was 10% (5% regional, 5% distant metastasis). Patients with less than 5 pathologically positive lymph nodes (P = .041) had improved DFS. Patients with HPV-related OPSCC and pN3 nodal disease treated with surgery and adjuvant therapy have very favorable long-term survival and regional control. Patients with five or more pathologically positive lymph nodes may be at higher risk for recurrence. 4. Laryngoscope, 127:2033-2037, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  18. Estimation of radiation burden to relatives of patients treated with radioiodine for cancer therapy

    International Nuclear Information System (INIS)

    Tandon, Pankaj; Rohatgi, Rupali; Gaur, P.K.; Rao, B.S.; Gill, B.S.; Hari Babu, T.; Venkatesh, Meera

    2005-01-01

    Patients treated with radioiodine present a radiation hazard and precautions are necessary to limit the radiation dose to family members, nursing staff and members of the public. The precautions advised are usually based on the instantaneous dose rates or iodine retention and do not take into account the time spent in close proximity with a patient. The purpose of this study was to draw guidelines based on the actual measurements and confirm if the present guidelines for discharge of the 131 I-treated thyroid cancer patients are adequate or not. External exposure rates were measured on 37 patients using a calibrated ionization survey meter. The patients' exposure rates were measured at the time of the discharge from the hospital. The patient and their relatives were given lockets embedded with CaSO 4 :Dy dosimeters at the time of discharge from the hospital. These lockets were given with a chain to be worn in the neck for 15 days. These lockets were collected after a fortnight and read out in a conventional TLD reader. These dose estimates can be used to calculate the limits for the patient movements so as to limit doses received to less than 1 mSv for the family members. This study dealt only with the external exposure; the problem of internal contamination was not considered. In our study the doses to the patient have also been measured in order to estimate the percentage of dose received by their relatives. In our study, most of the cases the dose received by the relatives of the patients are more than 1 mSv, which is more than the limit prescribed by the International Commission of Radiological Protection (ICRP) for the general public. (author)

  19. Length of Recovery From Sports-Related Concussions in Pediatric Patients Treated at Concussion Clinics.

    Science.gov (United States)

    Thomas, Donald J; Coxe, Kathryn; Li, Hongmei; Pommering, Thomas L; Young, Julie A; Smith, Gary A; Yang, Jingzhen

    2018-01-01

    We quantified the length of recovery time by week in a cohort of pediatric sports-related concussion patients treated at concussion clinics, and examined patient and injury characteristics associated with prolonged recovery. A retrospective, cohort design. Seven concussion clinics at a Midwest children's hospital. Patients aged 10 to 17 years with a diagnosed sports-related concussion presenting to the clinic within 30 days of injury. Length of recovery by week. Unadjusted and adjusted multinomial logistic regression analyses were used to model the effect of patient and injury characteristics on length of recovery by week. Median length of recovery was 17 days. Only 16.3% (299/1840) of patients recovered within one week, whereas 26.4% took longer than four weeks to recover. By 2 months postinjury, 6.7% of patients were still experiencing symptoms. Higher symptom scores at injury and initial visit were significantly associated with prolonged symptoms by week. Patients who presented to the clinic more than 2 weeks postinjury or who had 2 or more previous concussions showed increased risk for prolonged recovery. Females were at greater risk for prolonged recovery than males (odds ratio = 2.08, 95% confidence interval = 1.49-2.89). Age was not significantly associated with recovery length. High symptom scores at injury and initial visit, time to initial clinical presentation, presence of 2 or more previous concussions, and female sex are associated with prolonged concussion recovery. Further research should aim to establish objective measures of recovery, accounting for treatment received during the recovery. The median length of recovery is 17 days among pediatric sports-related concussion patients treated at concussion clinics. Only 16.3% of patients recovered within one week, whereas 26.4% took longer than 4 weeks to recover.

  20. Relating calls to US poison centers for potential exposures to medications to Centers for Disease Control and Prevention reporting of influenza-like illness.

    Science.gov (United States)

    Beauchamp, Gillian A; McKeown, Nathanael J; Rodriguez, Sergio; Spyker, Daniel A

    2016-03-01

    The Centers for Disease Control (CDC) monitors influenza like illness (ILI) and the National Poison Data System (NPDS) warehouses call data uploaded by US poison centers regarding reported exposures to medication. We examined the relationship between calls to poison centers regarding reported exposures to medications commonly used to treat ILI and weekly reports of ILI. The CDC reports ILI, by age group, for each of 10 Health and Human Services (HHS) regions. We examined NPDS summary data from calls reported to poison centers regarding reported exposures to acetaminophen, cough/cold medications, and promethazine, for the same weeks, age groups, and HHS regions for influenza seasons 2000-2013. ILI and NPDS exposures were examined using graphical plots, descriptive statistics, stepwise regression analysis, and Geographic Information Systems (GIS). About 5,101,841 influenza-like illness cases were reported to the CDC, and 2,122,940 calls regarding reported exposures to medications commonly used to treat ILI, were reported by poison centers to the NPDS over the 13 flu seasons. Analysis of stepwise models of the linear untransformed data involving 24 NPDS data groups and for 60 ILI measures, over the 13 influenza seasons, demonstrated that reported exposures to medications used to treat ILI correlated with reported cases of ILI with a median R(2 )=( )0.489 (min R(2 )=( )0.248, max R(2 )=( )0.717), with mean ± SD of R(2 )=( )0.494 ± 0.121. Median number of parameters used (degrees of freedom - 1) was 7. NPDS data regarding poison center calls for selected ILI medication exposures were highly correlated with CDC ILI data. Since NPDS data are available in real time, it provides complimentary ILI monitoring. This approach may provide public health value in predicting other illnesses which are not currently as thoroughly monitored.

  1. MVP expression is related to IGF1-R in cervical carcinoma patients treated by radiochemotherapy.

    Science.gov (United States)

    Lloret, Marta; Lara, Pedro Carlos; Bordón, Elisa; Rey, Agustin; Falcón, Orlando; Apolinario, Rosa Maria; Clavo, Bernardino; Ruiz, Ana

    2008-09-01

    To assess the expression of MVP in cervix carcinoma patients treated by radiochemotherapy, its relation to clinical and pathologic prognostic factors and its role in predicting clinical outcome. In addition the relation to IGF-1R expression in this cohort of patients will be explored. Sixty consecutive patients suffering from localized cervix carcinoma were prospectively included in this study from July 1999 to December 2003. Follow-up was closed in November 2007. Patients were staged following the TNM classification. All patients received pelvic radiation (45-64.80 Gy in 1.8-2 Gy fractions) followed brachytherapy and concomitant cisplatin at 40 mg/m(2)/week doses. MVP expression was studied by immunohistochemistry in paraffin-embedded tumour tissue. MVP was expressed in 58 patients (96.7%) and no relation was found with clinicopathological variables. High MVP expression was related to high IGF1-R expression (p=0.023). Complete response after treatment was observed in 50 patients (83.3%). Clinical stage of the disease and clinical response to radiochemotherapy were the most important prognostic factors related to survival. High MVP and IGF-1R tumour expression was strongly related to poor local and regional disease-free survival (p=0.006), distant disease-free survival (p=0.050), disease-free survival (p=0.006), and cause-specific survival (p=0.007) in patients achieving a complete response. MVP and IGF-1R expression were related in clinical cervical tumours and confer reduced long-term local control in patients who achieved clinical complete response to radiochemotherapy.

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

    Science.gov (United States)

    Wuellner, Sara; Phipps, Polly

    2018-05-01

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

  3. Children treated for lawn mower-related injuries in US emergency departments, 1990-2014.

    Science.gov (United States)

    Ren, Karen S; Chounthirath, Thiphalak; Yang, Jingzhen; Friedenberg, Laura; Smith, Gary A

    2017-06-01

    Investigate the epidemiology of lawn mower-related injuries to children in the US. A retrospective analysis was conducted of children younger than 18years of age treated in US emergency departments for a lawn mower-related injury from 1990 through 2014 using data from the National Electronic Injury Surveillance System. An estimated 212,258 children lawn mower-related injuries from 1990 through 2014, equaling an average annual rate of 11.9 injuries per 100,000 US children. The annual injury rate decreased by 59.9% during the 25-year study period. The leading diagnosis was a laceration (38.5%) and the most common body region injured was the hand/finger (30.7%). Struck by (21.2%), cut by (19.9%), and contact with a hot surface (14.1%) were the leading mechanisms of injury. Patients Lawn mower-related injuries continue to be a cause of serious morbidity among children. Although the annual injury rate decreased significantly over the study period, the number of injuries is still substantial, indicating the need for additional prevention efforts. In addition to educational approaches, opportunities exist for improvements in mower design and lawn mower safety standards. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Immunoglobulin G4-Related Retroperitoneal Fibrosis Treated with Hochuekkito, a Kampo Medicine, following Steroid Treatment

    Directory of Open Access Journals (Sweden)

    Minoru Fukuchi

    2014-05-01

    Full Text Available We report a case of immunoglobulin G4 (IgG4-related retroperitoneal fibrosis (RF with complete remission and no relapses after therapy with steroids and Hochuekkito, a Kampo (i.e. traditional Japanese herbal medicine. A 62-year-old Japanese man was admitted to our hospital for treatment of a retroperitoneal mass detected by computed tomography. The mass had a maximum diameter of 11.0 cm; it involved the left ureter and was associated with left hydronephrosis. After inserting a ureteral stent, we performed a biopsy by laparotomy. Histopathology revealed IgG4-related RF. The lesion disappeared after 7 months of steroid therapy. We subsequently used Hochuekkito as an alternative maintenance treatment because of steroid-related complications. The patient has not relapsed in the 3 years since starting the medication. To the best of our knowledge, this is the first case of IgG4-related RF treated with Hochuekkito as a maintenance treatment.

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

    Science.gov (United States)

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

    2014-01-01

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

  6. Soccer-Related Injuries Treated in Emergency Departments: 1990-2014.

    Science.gov (United States)

    Smith, Nicholas A; Chounthirath, Thiphalak; Xiang, Huiyun

    2016-10-01

    To investigate the epidemiology of youth soccer-related injuries treated in emergency departments in the United States. A retrospective analysis was conducted of soccer-related injuries among children 7 through 17 years of age from 1990 through 2014 with data from the National Electronic Injury Surveillance System. Injury rates were calculated from soccer participation data. An estimated 2 995 765 (95% confidence interval [CI], 2 309 112-3 682 418) children 7 through 17 years old were treated in US emergency departments for soccer-related injuries during the 25-year study period, averaging 119 831 (95% CI, 92 364-147 297) annually. The annual injury rate per 10 000 soccer participants increased significantly, by 111.4%, from 1990 to 2014. Patients 12 to 17 years old accounted for 72.7% of injuries, 55.5% of patients were male, and most injuries occurred in a place of sport or recreation (68.5%) or school (25.7%). Struck by (38.5%) and fell (28.7%) were the leading mechanisms of injury. Injuries most commonly were diagnosed as sprain or strain (34.6%), fracture (23.2%), and soft tissue injury (21.9%), and occurred to the upper extremity (20.7%), ankle (17.8%), and head or neck (17.7%). Concussions or other closed head injuries accounted for 7.3% of the injuries, but the annual rate of concussions/closed head injuries per 10 000 participants increased significantly, by 1595.6%, from 1990 to 2014. This study is the first to comprehensively investigate soccer-related injuries and calculate injury rates based on soccer participation data among children at the national level. The increasing number and rate of pediatric soccer-related injuries, especially soccer-related concussions/closed head injuries, underscore the need for increased efforts to prevent these injuries. Copyright © 2016 by the American Academy of Pediatrics.

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

    Science.gov (United States)

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

    2018-04-01

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

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

    Science.gov (United States)

    Yunus, Muhammad B

    2008-06-01

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

  9. Variability of disease activity in patients treated with ranibizumab for neovascular age-related macular degeneration.

    Science.gov (United States)

    Enders, P; Scholz, P; Muether, P S; Fauser, S

    2016-08-01

    PurposeTo analyze choroidal neovasularization (CNV) activity and recurrence patterns in patients with neovascular age-related macular degeneration (nAMD) treated with ranibizumab, and the correlation with individual intraocular vascular endothelial growth factor (VEGF) suppression time (VST).MethodsPost-hoc analysis of data from a prospective, non-randomized clinical study. Patients with nAMD treated with ranibizumab on a pro re nata regimen. Disease activity was analyzed monthly by spectral-domain optical coherence tomography and correlated with VSTs.ResultsOverall, 73 eyes of 73 patients were included in the study with a mean follow-up of 717 days (range: 412-1239 days). Overall, the mean CNV-activity-free interval was 76.5 days (range: 0-829 days). The individual range of the length of dry intervals was high. A total of 42% of patients had a range of more than 90 days. Overall, 16% of patients showed persistent activity. And 12% stayed dry after the initial ranibizumab treatment. No significant correlation was found between the CNV-recurrence pattern and VST (P=0.12).ConclusionsCNV activity in nAMD is irregular, which is reflected in the range of the duration of dry intervals and late recurrences. The biomarker VST solely seems not to be sufficient to explain recurrence pattern of CNV in all AMD patients.

  10. Dendrobium: Sources of Active Ingredients to Treat Age-Related Pathologies

    Science.gov (United States)

    Cakova, Veronika; Bonte, Frederic; Lobstein, Annelise

    2017-01-01

    Dendrobium represents one of the most important orchid genera, ornamentally and medicinally. Dendrobiums are sympodial epiphytic plants, which is a name they are worthy of, the name coming from Greek origin: "dendros", tree, and "bios", life. Dendrobium species have been used for a thousand years as first-rate herbs in traditional Chinese medicine (TCM). They are source of tonic, astringent, analgesic, antipyretic, and anti-inflammatory substances, and have been traditionally used as medicinal herbs in the treatment of a variety of disorders, such as, nourishing the stomach, enhancing production of body fluids or nourishing Yin. The Chinese consider Dendrobium as one of the fifty fundamental herbs used to treat all kinds of ailments and use Dendrobium tonic for longevity. This review is focused on main research conducted during the last decade (2006-2016) on Dendrobium plants and their constituents, which have been subjected to investigations of their pharmacological effects involving anticancer, anti-diabetic, neuroprotective and immunomodulating activities, to report their undeniable potential for treating age-related pathologies. PMID:29344419

  11. Prospectively surveying health-related quality of life and symptom relief in a lot-based sample of medical cannabis-using patients in urban Washington State reveals managed chronic illness and debility.

    Science.gov (United States)

    Aggarwal, S K; Carter, G T; Sullivan, M D; Zumbrunnen, C; Morrill, R; Mayer, J D

    2013-09-01

    To characterize health-related quality of life (HRQoL) in medical cannabis patients. Short Form 36 (SF-36) Physical Health Component Score and Mental Health Component Score (MCS) surveys as well has CDC (Centers for Disease Control) HRQoL-14 surveys were completed by 37 qualified patients. Mean SF-36 PCS and MCS, normalized at 50, were 37.4 and 44.2, respectively. Eighty percent of participants reported activity/functional limitations secondary to impairments or health problems. Patients reported using medical cannabis to treat a wide array of symptoms across multiple body systems with relief ratings consistently in the 7-10/10 range. The HRQoL results in this sample of medical cannabis-using patients are comparable with published norms in other chronically ill populations. Data presented provide insight into medical cannabis-using patients' self-rated health, HRQoL, disease incidences, and cannabis-related symptom relief.

  12. Radiation Exposure to Relatives of Patients Treated with Iodine-131 for Thyroid Cancer at Siriraj Hospital

    International Nuclear Information System (INIS)

    Tonnonchiang, S.; Sritongkul, N.; Chaudakshetrin, P.; Tuntawiroon, M.

    2012-01-01

    Thyroid carcinoma patients treated with I-131 are potential source of high radiation exposure to relatives who are knowingly and willingly exposed to ionizing radiation as a result of providing support and comfort to patients undergoing radionuclide therapy. The purpose of this study is to present the results of measurements of radiation doses to relatives who designated to care fornon self-supporting patients treated with radioiodine at Radionuclide Therapy Ward, Siriraj Hospital. Twenty caregivers of 20 patients underwent radioiodine therapy for thyroid cancers with a standard protocol were given specific instructions with regard to radiation safety and provided with electronic digital dosimeter (PDM 112) to continuously measure radiation dose received on the daily basis, during three days in the hospital. On the day of patients' release, in vivo bioassays were performed on caregivers to determine the thyroid uptake estimates. The 3-day accumulative doses to caregivers to patients receiving 5.55 GBq (n=11) and 7.4 GBq (n=9) of I-131 ranged from 37 to 333 μSv and 176 to 1920 μSv respectively depending on the extent and level of supports required. The thyroid uptake estimates in all caregivers were undetectable. Electronic dosimeters indicated a maximum whole-body effective dose of 1920 μSv was more than the public dose limit of 1 mSv but within the general dose constraint of 5 mSv. Radiation dose to caregivers of a non self-supporting hospitalized patient undergoing radioiodine therapy were well below the limits recommended by the ICRP and the IAEA. The patients can be comforted with confidence that dose to caregivers will be below the 5- mSv limit. This study provides guidance for medical practitioners to obtain practical radiation safety concerns associated with hospitalized patients receiving I-131 therapy especially when patients are comforted in the hospital ward by caregivers. (author)

  13. Nursery Product-Related Injuries Treated in United States Emergency Departments.

    Science.gov (United States)

    Gaw, Christopher E; Chounthirath, Thiphalak; Smith, Gary A

    2017-04-01

    The goal of this study was to determine the epidemiology of injuries associated with nursery products among young children treated in US emergency departments. Data from the National Electronic Injury Surveillance System were retrospectively analyzed for patients aged nursery product from 1991 through 2011. An estimated 1 391 844 (95% confidence interval, 1 169 489-1 614 199) nursery product-related injuries among children aged Nursery product-related injuries were most commonly associated with baby carriers (19.5%), cribs/mattresses (18.6%), strollers/carriages (16.5%), or baby walkers/jumpers/exercisers (16.2%). The most common mechanism of injury was a self-precipitated fall (80.0%), and the most frequently injured body region was the head or neck (47.1%). Although successful injury prevention efforts with baby walkers led to a decline in nursery product-related injuries from 1991 to 2003, the number and rate of these injuries have been increasing since 2003. Greater efforts are warranted to prevent injuries associated with other nursery products, especially baby carriers, cribs, and strollers. Prevention of falls and concussions/closed head injuries associated with nursery products also deserves special attention. Copyright © 2017 by the American Academy of Pediatrics.

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

    Science.gov (United States)

    Cardi, Valentina; Tchanturia, Kate; Treasure, Janet

    2018-01-17

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

  15. Reported incidence and precipitating factors of work-related stress and mental ill-health in the United Kingdom (1996-2001).

    Science.gov (United States)

    Cherry, Nicola M; Chen, Yiqun; McDonald, J Corbett

    2006-09-01

    Work-related mental ill-health appears to be increasing. Population-based data on incidence are scarce but in the United Kingdom occupational physicians and psychiatrists report these conditions to voluntary surveillance schemes. To estimate the incidence of work-related stress and mental illness reported 1996-2001 by occupational physicians and 1999-2001 by psychiatrists. Estimated annual average incidence rates were calculated by sex, occupation and industry against appropriate populations at risk. An in-house coding scheme was used to classify and analyse data on precipitating events. An estimated annual average of 3,624 new cases were reported by psychiatrists, and 2,718 by occupational physicians; the rates were higher for men in reports based on the former and for women on the latter. Most diagnoses were of anxiety/depression or work-related stress, with post-traumatic stress accounting for approximately 10% of cases reported by psychiatrists. High rates of ill-health were seen among professional and associated workers and in those in personal and protective services. Factors (such as work overload) intrinsic to the job and issues with interpersonal relations were the most common causes overall. The steep increase in new cases of work-related mental ill-health reported by occupational physicians since 1996 may reflect a greater willingness by workers to seek help but may also signify an increasing dissonance between workers' expectations and the work environment. Greater expertise is needed to improve the workplace by adjustment of job demands, improvement of working relations, increasing workers' capacities and management of organizational change.

  16. Improvement in health-related quality of life in osteoporosis patients treated with teriparatide

    Directory of Open Access Journals (Sweden)

    Papaioannou Alexandra

    2008-11-01

    Full Text Available Abstract Background Individuals with osteoporosis and recent vertebral fractures suffer from pain and impaired health-related quality of life (HRQL. To determine whether patients with osteoporosis treated with teriparatide experienced improvement in HRQL and pain symptoms after several months of therapy. Methods We retrospectively studied a sample of osteoporosis patients treated with teriparatide in a Canadian rheumatology practice. We included patients that received teriparatide therapy with baseline and follow-up Mini-Osteoporosis Quality of Life Questionnaire (OQLQ data. Follow-up data was measured at three or six months. We used a paired Student's t-test to compare baseline and follow-up measurements for each of the questionnaire's ten questions (five domains. Statistical analysis was also repeated to only include patients who suffered a prior vertebral fracture. Results 57 patients were included in the study, including 47 women. The mean age was 63.8 years (standard deviation 12.1 years. About sixty five percent (37/57 had previously sustained one or more osteoporotic fractures and about 38.6% (22/57 had suffered a prior vertebral fracture. About 44% (25/57 of individuals were taking one or more types of pain medications regularly prior to starting therapy. At follow-up, significant improvements were observed in the OQLQ domains of pain symptoms. This was seen when all patients on teriparatide were included, and also when only patients with prior vertebral fractures were included. There was also an improvement in emotional functioning, relating to fear of falling at 3 months follow-up (p = 0.019. Respondents also reported improvement in the domain of activities of daily living, relating to vacuuming at 6 months follow-up (p = 0.036, and an improvement in the leisure domain, relating to ease of traveling in the prior vertebral fracture population at 3 months follow-up (p = 0.012. However, there was no significant improvement observed in the

  17. Follow-up study of patients treated by x-ray epilation for Tinea capitis. Resurvey of post-treatment illness and mortality experience

    International Nuclear Information System (INIS)

    Shore, R.E.; Albert, R.E.; Pasternack, B.S.

    1976-01-01

    This is the second follow-up study of 2,215 persons who during childhood between 1940 and 1959 had been given x-ray therapy for tinea capitis and of 1,395 persons well matched for age, sex, and race who were treated for the same disease during the same period without the use of x-ray therapy. The major finding of the study was an excess incidence in the irradiated cases of tumors of the head and neck including the skin, brain, thyroid, and parotid. However, between the groups there was no difference in death due to malignant neoplasms or any other cause. Among white patients, a 40 percent excess of treated psychiatric disorders was observed in the irradiated group, but there was no difference among blacks

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

    Science.gov (United States)

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

    2009-07-28

    Parents of chronically ill children are at risk for a lower Health Related Quality of Life (HRQoL). Insight in the dynamics of factors influencing parental HRQoL is necessary for development of interventions. Aim of the present study was to explore the influence of demographic and disease related factors on parental HRQoL, mediated by employment, income, leisure time, holiday and emotional support in a comprehensive model. In a cross-sectional design, 543 parents of chronically ill children completed questionnaires. A conceptual model of parental HRQoL was developed. Structural equation modeling was performed to explore the relations in the conceptual model, and to test if the model fitted the data. The model fitted the data closely (CHISQ(14) = 11.37, p = 0.66; RMSEA = 0.0, 90%CI [0.00;0.034]. The effect of socio-demographic and medical data on HRQoL was mediated by days on holiday (MCS: beta = .21) and emotional support (PCS: beta = .14; MCS: beta = .28). Also, female gender (beta = -.10), age (beta = .10), being chronically ill as a parent (beta = -.34), and care dependency of the child (beta = -.14; beta = -.15) were directly related to parental HRQoL. The final model was slightly different from the conceptual model. Main factors explaining parental HRQoL seemed to be emotional support, care dependency, days on holiday and being chronically ill as a parent. Holiday and emotional support mediated the effect of demographic and disease-related factors on HRQoL. Hours of employment, leisure time and household income did not mediate between background characteristics and HRQoL, contrasting the hypotheses.

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

    Directory of Open Access Journals (Sweden)

    Heymans Hugo SA

    2009-07-01

    Full Text Available Abstract Background Parents of chronically ill children are at risk for a lower Health Related Quality of Life (HRQoL. Insight in the dynamics of factors influencing parental HRQoL is necessary for development of interventions. Aim of the present study was to explore the influence of demographic and disease related factors on parental HRQoL, mediated by employment, income, leisure time, holiday and emotional support in a comprehensive model. Methods In a cross-sectional design, 543 parents of chronically ill children completed questionnaires. A conceptual model of parental HRQoL was developed. Structural equation modeling was performed to explore the relations in the conceptual model, and to test if the model fitted the data. Results The model fitted the data closely (CHISQ(14 = 11.37, p = 0.66; RMSEA = 0.0, 90%CI [0.00;0.034]. The effect of socio-demographic and medical data on HRQoL was mediated by days on holiday (MCS: β = .21 and emotional support (PCS: β = .14; MCS: β = .28. Also, female gender (β = -.10, age (β = .10, being chronically ill as a parent (β = -.34, and care dependency of the child (β = -.14; β = -.15 were directly related to parental HRQoL. Conclusion The final model was slightly different from the conceptual model. Main factors explaining parental HRQoL seemed to be emotional support, care dependency, days on holiday and being chronically ill as a parent. Holiday and emotional support mediated the effect of demographic and disease-related factors on HRQoL. Hours of employment, leisure time and household income did not mediate between background characteristics and HRQoL, contrasting the hypotheses.

  20. Cannabidiol regulation of learned fear: implications for treating anxiety-related disorders

    Directory of Open Access Journals (Sweden)

    Regimantas Jurkus

    2016-11-01

    Full Text Available Anxiety and trauma-related disorders are psychiatric diseases with a lifetime prevalence of up to 25%. Phobias and post-traumatic stress disorder (PTSD are characterized by abnormal and persistent memories of fear-related contexts and cues. The effects of psychological treatments such as exposure therapy are often only temporary and medications can be ineffective and have adverse side effects. Growing evidence from human and animal studies indicates that cannabidiol, the main non-psychotomimetic phytocannabinoid present in Cannabis sativa, alleviates anxiety in paradigms assessing innate fear. More recently, the effects of cannabidiol on learned fear have been investigated in preclinical studies with translational relevance for phobias and PTSD. Here we review the findings from these studies, with an emphasis on cannabidiol regulation of contextual fear. The evidence indicates that cannabidiol reduces learned fear in different ways: (1 cannabidiol decreases fear expression acutely, (2 cannabidiol disrupts memory reconsolidation, leading to sustained fear attenuation upon memory retrieval, and (3 cannabidiol enhances extinction, the psychological process by which exposure therapy inhibits learned fear. We also present novel data on cannabidiol regulation of learned fear related to explicit cues, which indicates that auditory fear expression is also reduced acutely by cannabidiol. We conclude by outlining future directions for research to elucidate the neural circuit, psychological, cellular, and molecular mechanisms underlying the regulation of fear memory processing by cannabidiol. This line of investigation may lead to the development of cannabidiol as a novel therapeutic approach for treating anxiety and trauma-related disorders such as phobias and PTSD in the future.

  1. Fatigue and fatigue-related symptoms in patients treated for different causes of hypothyroidism.

    Science.gov (United States)

    Louwerens, Marloes; Appelhof, Bente C; Verloop, Herman; Medici, Marco; Peeters, Robin P; Visser, Theo J; Boelen, Anita; Fliers, Eric; Smit, Johannes W A; Dekkers, Olaf M

    2012-12-01

    Research on determinants of well-being in patients on thyroid hormone replacement therapy is warranted, as persistent fatigue-related complaints are common in this population. In this study, we evaluated the impact of different states of hypothyroidism on fatigue and fatigue-related symptoms. Furthermore, the relationship between fatigue and the TSH receptor (TSHR)-Asp727Glu polymorphism, a common genetic variant of the TSHR, was analyzed. A cross-sectional study was performed in 278 patients (140 patients treated for differentiated thyroid carcinoma (DTC) and 138 with autoimmune hypothyroidism (AIH)) genotyped for the TSHR-Asp727Glu polymorphism. The multidimensional fatigue inventory (MFI-20) was used to assess fatigue, with higher MFI-20 scores indicating more fatigue-related complaints. MFI-20 scores were related to disease status and Asp727Glu polymorphism status. AIH patients scored significantly higher than DTC patients on all five MFI-20 subscales (P<0.001), independent of clinical and thyroid hormone parameters. The frequency of the TSHR-Glu727 allele was 7.2%. Heterozygous DTC patients had more favorable MFI-20 scores than wild-type DTC patients on four of five subscales. The modest effect of the TSHR-Asp727Glu polymorphism on fatigue was found in DTC patients only. AIH patients had significantly higher levels of fatigue compared with DTC patients, which could not be attributed to clinical or thyroid hormone parameters. The modest effect of the TSHR-Asp727Glu polymorphism on fatigue in DTC patients should be confirmed in other cohorts.

  2. Mediation analysis of critical time intervention for persons living with serious mental illnesses: assessing the role of family relations in reducing psychiatric rehospitalization.

    Science.gov (United States)

    Tomita, Andrew; Lukens, Ellen P; Herman, Daniel B

    2014-03-01

    Critical Time Intervention (CTI) is a time-limited care coordination intervention designed to reduce homelessness and other adverse outcomes for persons living with serious mental illness during the transition period between institutions and community living. This study assesses whether CTI improves the quality of family relationships between family members and individuals living with serious mental illness, and examines whether changes in quality of family relationship mediated the association between the intervention and psychiatric rehospitalization outcomes. This study utilizes data from a randomized controlled trial that assessed the effect of CTI in preventing homelessness. Following discharge from inpatient psychiatric treatment in New York City, 150 previously homeless persons living with serious mental illness were randomly assigned to receive usual services only or 9 months of CTI in addition to usual services. Findings from mixed-effects regression models indicated that those assigned to the CTI group reported greater frequency of family contact and greater improvement in satisfaction with family relations than the comparison group during the 18-month follow-up period. Mediation analysis revealed that greater improvement in satisfaction with family relations mediated the effect of CTI on psychiatric rehospitalization outcome, but only at a modest level. These findings suggest that a relatively brief but targeted intervention delivered at the point of hospital discharge may contribute to strengthening family relations and that improvement in perceived family relationship quality can contribute to a reduction in psychiatric rehospitalization.

  3. “Helping my neighbour is like giving a loan…” –the role of social relations in chronic illness in rural Uganda

    Directory of Open Access Journals (Sweden)

    Jovita Amurwon

    2017-11-01

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

  4. Longitudinal study of respiratory function and symptoms in a non-smoking group of long-term officially-acknowledged victims of pollution-related illness.

    Science.gov (United States)

    Tanaka, Takako; Asai, Masaharu; Yanagita, Yorihide; Nishinakagawa, Tsuyoshi; Miyamoto, Naomi; Kotaki, Kenji; Yano, Yudai; Kozu, Ryo; Honda, Sumihisa; Senjyu, Hideaki

    2013-08-17

    Air pollution is known to be a leading cause of respiratory symptoms. Many cross-sectional studies reported that air pollution caused respiratory disease in Japanese individuals in the 1960s. Japan has laws regulating air pollution levels and providing compensation for victims of pollution-related respiratory disease. However, long-term changes in respiratory function and symptoms in individuals who were exposed to air pollution in the 1960s have not been well studied. This study aimed to investigate longitudinal respiratory function and symptoms in older, non-smoking, long-term officially-acknowledged victims of pollution-related illness. The study included 563 officially-acknowledged victims of pollution-related illness living in Kurashiki, Okayama who were aged ≥ 65 years in 2009. Data were retrospectively collected from yearly respiratory symptom questionnaires and spirometry examinations conducted from 2000 to 2009. Respiratory function declined significantly from 2000 to 2009 (p pollutants around 1970 resulted in a decrease in respiratory function and an increase in respiratory symptoms in the study population. From 2000 to 2009, the mean annual changes in respiratory function were within the normal range, even though the severity of dyspnea worsened. The changes in respiratory function and symptoms over the study period were probably due to aging. The laws governing air pollution levels and providing compensation for officially-acknowledged victims of pollution-related illness in Japan may be effective for respiratory disease cause by pollution.

  5. Use of aromatase inhibitors to treat endometriosis-related pain symptoms: a systematic review

    Directory of Open Access Journals (Sweden)

    Venturini Pier L

    2011-06-01

    Full Text Available Abstract This systematic review aims to assess the efficacy of aromatase inhibitors (AIs in treating pain symptoms caused by endometriosis. A comprehensive literature search was conducted to identify all the published studies evaluating the efficacy of type II nonsteroidal aromatase inhibitors (anastrozole and letrozole in treating endometriosis-related pain symptoms. The MEDLINE, EMBASE, PubMed, and SCOPUS databases and the Cochrane System Reviews were searched up to October 2010. This review comprises of the results of 10 publications fitting the inclusion criteria; these studies included a total of 251 women. Five studies were prospective non-comparative, four were randomized controlled trials (RCTs and one was a prospective patient preference trial. Seven studies examined the efficacy of AIs in improving endometriosis-related pain symptoms, whilst three RCTs investigated the use of AIs as post-operative therapy in preventing the recurrence of pain symptoms after surgery for endometriosis. All the observational studies demonstrated that AIs combined with either progestogens or oral contraceptive pill reduce the severity of pain symptoms and improve quality of life. One patient preference study demonstrated that letrozole combined with norethisterone acetate is more effective in reducing pain and deep dyspareunia than norethisterone acetate alone. However, letrozole causes a higher incidence of adverse effects and does not improve patients' satisfaction or influence recurrence of symptoms after discontinuation of treatment. A RCT showed that combining letrozole with norethisterone acetate causes a lower incidence of adverse effects and lower discontinuation rate than combining letrozole with triptorelin. Two RCTs demonstrated that, after surgical treatment of endometriosis, the administration of AIs combined with gonadotropin releasing hormone analogue for 6 months reduces the risk of endometriosis recurrence when compared with gonadotropin

  6. Work-related thumb disorders in South African physiotherapists treating musculoskeletal conditions using manual therapy techniques

    Directory of Open Access Journals (Sweden)

    Heather Jenkins

    2015-05-01

    Full Text Available Research question: What is the prevalence of and factors associated with work-related thumb problems (WRTP in South African physiotherapists treating musculoskeletal conditions using manual therapy techniques? Design: A cross-sectional, descriptive study design was used and data were collected using two Internet-based questionnaires. Participants: The sample size calculated for the study was 284 using 95% confidence levels and a 5% margin of error. There were 395 participants that were included in the study. Outcome measures: The variables measured included demographic, employment, educational and occupational factors. Results: The lifetime prevalence of WRTP in the physiotherapists was 65.3%. The manual techniques that were significantly associated with WRTP in the respondents who reported thumb problems were all grades of transverse glides applied to the spine as well as grade II–IV unilateral and central posterior-anterior pressures to the spine. The factors that remained significantly associated with WRTP in all 395 respondents after regression analysis were the cervical treatment of up to six patients a day and hyperextension > 30° of the non-dominant interphalangeal (IP joint of the thumb. Conclusion: This study confirms that a high percentage of physiotherapists using manual therapy techniques to treat musculoskeletal conditions are experiencing WRTP. Recommendations: The development of a valid and reliable WRTP screening tool is needed to aid in the identification of physiotherapists at risk and thus in the primary prevention of WRTP. A longitudinal study which follows newly qualified physiotherapists is recommended to investigate a possible cause-effect relationship and preventative strategies for WRTP in physiotherapists.

  7. The hospital costs of treating work-related sawmill injuries in British Columbia.

    Science.gov (United States)

    Alamgir, Hasanat; Tompa, Emile; Koehoorn, Mieke; Ostry, Aleck; Demers, Paul A

    2007-05-01

    This study estimates the hospital costs of treating work-related injury among a cohort of sawmill workers in British Columbia. Hospital discharge records were extracted from 1989 to 1998 for a cohort of 5,876 actively employed sawmill workers. Injury cases were identified as work-related from these records using ICD-9 external cause of injury codes that indicate place of occurrence and the responsibility of payment schedule that identifies workers' compensation as being responsible for payment. The hospitals in British Columbia have a standard ward rate chart prepared annually by the provincial Ministry of Health to bill and collect payment from agency like workers' compensation agency. Costs were calculated from the hospital perspective using this billing chart. All costs were expressed in 1995 Canadian dollars. The workers' compensation claim records for this study population were extracted and matched with the hospitalised work-related injury records. Costs were also calculated for work-related hospitalisations that the hospital did not appear to be reimbursed for by the workers' compensation system. There were 173 injuries requiring hospitalisation during the 10-year followup period. The median stay in hospitals was 3 days and the median hospital costs were $847. The most costly cause of injury categories were fire, flame, natural and environmental and struck against with median costs of $10,575 and $1,206, respectively, while the least costly category was cutting and piercing with median costs of $296. The most costly nature of injury categories were burns and fracture of lower limb with median costs of $10,575 and $1,800, respectively, while the least costly category was dislocation, sprains and strains with median costs of $437. The total hospital costs for all the work-related injuries were $434,990. Out of a total hospital cost of $434,990 for the 173 work-related injuries, the provincial compensation agency apparently did not compensate $50,663 (12

  8. A meta-analysis of trials using the intention to treat principle for glutamine supplementation in critically ill patients with burn.

    Science.gov (United States)

    Lin, Jiun-Jie; Chung, Xiu-Juan; Yang, Chung-Yih; Lau, Hui-Ling

    2013-06-01

    During critical illness, the demand for glutamine may exceed that which can be mobilized from muscle stores. Infections increase mortality, morbidity, length-of-stay, antibiotic usage and the cost of care. This is a major health care issue. RCTs were identified from the electronic databases: the Cochrane Library, MEDLINE, PubMed web of knowledge and hand searching journals. The trials compared the supplementation with glutamine and non-supplementation in burn. Statistical analysis was performed using RevMan5.1 software, from Cochrane Collaboration. 216 papers showed a match, in the keyword search. Upon screening the title, reading the abstract and the entire article, only four RCTs, involving 155 patients, were included. For both the glutamine group and control group, total burn surface area (TBSA) (MD=2.02, 95% CI -2.17, 6.21, p=0.34) was similar. Glutamine supplementation was associated with a statistically significant decrease in the number of patients with gram-negative bacteremia (OR 0.27, 95% CI 0.08-0.92, p=0.04) and hospital mortality (OR=0.13, 95% CI 0.03, 0.51, p=0.004), however, no statistical difference was noted between groups, for the other results. Glutamine supplemented nutrition can be associated with a reduction in mortality in hospital, complications due to gram-negative bacteremia in burn patients. Further larger and better quality trials are required, in order to determine whether any differences are statistically and clinically important. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

  9. A 4-Year Longitudinal Study of 555 Patients Treated with Ranibizumab for Neovascular Age-related Macular Degeneration

    DEFF Research Database (Denmark)

    Rasmussen, Annette; Bloch, Sara B; Fuchs, Josefine

    2013-01-01

    To investigate the visual outcome, pattern of discontinuation, ocular complications, and mortality of patients treated with a variable ranibizumab dosing regimen for neovascular age-related macular degeneration (AMD) for 4 years.......To investigate the visual outcome, pattern of discontinuation, ocular complications, and mortality of patients treated with a variable ranibizumab dosing regimen for neovascular age-related macular degeneration (AMD) for 4 years....

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

    Directory of Open Access Journals (Sweden)

    Bonsaksen T

    2013-12-01

    Full Text Available Tore Bonsaksen,1 Stacey Haukeland-Parker,2 Anners Lerdal,3,4 May Solveig Fagermoen4,5 1Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway; 2Department of Physiotherapy, Østfold Hospital Trust, Fredrikstad, Norway; 3Research Department, Lovisenberg Diakonale Hospital, Oslo, Norway; 4Department of Nursing Science, Institute of Health and Society, University of Oslo, Oslo, Norway; 5Department of Gastroenterology, Division of Medicine, Oslo University Hospital, Oslo, Norway Abstract: Chronic obstructive pulmonary disease (COPD is a progressive respiratory disease with an increasing prevalence worldwide. Its potential consequences, including reduced function and reduced social participation, are likely to be associated with decreased health-related quality of life (HRQoL. However, illness perceptions and self-efficacy beliefs may also play a part in determining HRQoL in persons with COPD. The aim of this study was to explore the relationships between illness perceptions, self-efficacy, and HRQoL in a sample of persons with COPD in a longitudinal perspective. The context of the study was a patient education course from which the participants were recruited. Data concerning sociodemographic variables, social support, physical activity, illness perceptions, general self-efficacy, and HRQoL were collected before the course started and 1 year after completion. Linear regression was used in the analyses. The results showed that less consequences and less symptoms (identity were associated with higher physical HRQoL (PCS at baseline and at 1-year follow-up. Less emotional response was similarly associated with higher mental HRQoL (MCS at both time points. Lower self-efficacy showed a borderline significant association with higher PCS at baseline, but was unrelated to MCS at both time points. Self-efficacy showed no influence on the associations

  11. Searching for God: Illness-Related Mortality Threats and Religious Search Volume in Google in 16 Nations.

    Science.gov (United States)

    Pelham, Brett W; Shimizu, Mitsuru; Arndt, Jamie; Carvallo, Mauricio; Solomon, Sheldon; Greenberg, Jeff

    2018-03-01

    We tested predictions about religiosity and terror management processes in 16 nations. Specifically, we examined weekly variation in Google search volume in each nation for 12 years (all weeks for which data were available). In all 16 nations, higher than usual weekly Google search volume for life-threatening illnesses (cancer, diabetes, and hypertension) predicted increases in search volume for religious content (e.g., God, Jesus, prayer) in the following week. This effect held up after controlling for (a) recent past and annual variation in religious search volume, (b) increases in search volume associated with religious holidays, and (c) variation in searches for a non-life-threatening illness ("sore throat"). Terror management threat reduction processes appear to occur across the globe. Furthermore, they may occur over much longer periods than those studied in the laboratory. Managing fears of death via religious belief regulation appears to be culturally pervasive.

  12. Health-related behavior, profile of health locus of control and acceptance of illness in patients suffering from chronic somatic diseases.

    Directory of Open Access Journals (Sweden)

    Konrad Janowski

    Full Text Available PURPOSE: The purpose of the study was to determine health-related behaviors, profile of health locus of control (HLC, and to assess the relationships between these constructs among patients suffering from chronic somatic diseases. MATERIAL AND METHODS: Three-hundred adult patients suffering from various chronic diseases participated in the study. The patients' mean age was 54.6 years (SD = 17.57. RESULTS: No statistically significant differences were found between the different clinical groups in health-related behavior, acceptance of illness, internal HLC or chance HLC. Patients with neurologic conditions showed slightly lower powerful others HLC than did some other clinical groups. Health-related behavior was significantly positively related to all three categories of HLC, with most prominent associations observed with powerful others HLC. Only one type of health-related behavior--preventive behavior--correlated significantly and negatively with acceptance of illness. Differences in the frequency of health-related behavior were also found due to gender (women showing more healthy nutritional habits than men, age (older subjects showing more frequent health-promoting behavior, education (higher education was associated with less frequent health-promoting behavior and marital status (widowed subjects reporting more frequent health-promoting behavior. CONCLUSIONS: Health-related behavior in patients with chronic diseases seems to be unrelated to a specific diagnosis; however it shows associations with both internal and external HLC. Sociodemographic factors are also crucial factors determining frequency of health-related behavior in such patients.

  13. B-vitamin status in relation to bone mineral density in treated celiac disease patients.

    Science.gov (United States)

    Clarke, Michelle; Ward, Mary; Dickey, William; Hoey, Leane; Molloy, Anne M; Waldron, Lisa; Varghese, Abraham; McCann, Adrian; Blayney, Jaine K; McNulty, Helene

    2015-08-01

    Patients with celiac disease (CD) are at increased risk of osteoporosis and compromised B-vitamin status. Emerging evidence supports a beneficial role of folate and the metabolically related B-vitamins in bone health in generally healthy adults, but no previous study has investigated this in CD patients. The aim of the current study was to examine the relationship of folate, vitamins B12, B6 and B2 (riboflavin), and the related metabolite homocysteine, with bone mineral density (BMD) in CD patients. Of the 400 treated adult CD patients invited to participate, 110 responded and met the eligibility criteria for study participation. BMD was measured using dual energy X-ray absorptiometry scanning at the lumbar spine (L1-L4), femoral neck, and total hip sites. Biomarker status of the relevant B-vitamins and homocysteine, and dietary B-vitamin intakes, were measured. The significant predictors of low BMD were increasing age (B = 0.080, p B = 0.072, p = 0.004), whereas no significant relationship with serum 25-hydroxyvitamin D (B = 0.093, p = 0.928) was observed. Following adjustment for these predictors, serum vitamin B12 (but no other B-vitamin biomarker) was found to be a significant determinant of BMD at the femoral neck (β = 0.416, p = 0.011) and total hip (β = 0.327, p = 0.049) in men only. No significant relationships were found between any of the B-vitamin biomarkers investigated and BMD (at any measured site) in women. These findings add to current evidence suggesting a potential role of vitamin B12 in BMD, particularly in men, and show such a relationship for the first time in CD patients.

  14. Radiation exposure of relatives of patients treated with Ra-223 dichloride

    International Nuclear Information System (INIS)

    Wanke, C.; Szermerski, B.; Solle, A.; Geworski, L.; Kranert, W.T.; Andreeff, M.; TU Dresden

    2015-01-01

    Since November 2013, a radiopharmaceutical containing Ra-223 dichloride as active substance is approved in the European Union for patients with castration resistant prostate cancer with symptomatic bone metastases and no known visceral metastases. Ra-223 (T 1/2 = 11.43 d) decays via a chain of 4 alpha and 2 beta decays. This therapy is presently the only application of an alpha emitter in clinical routine therapy. To show that the exposure of relatives and caregivers of patients treated with Ra-223 dichloride in an outpatient setting does not exceed a value of 1 mSv, the multicenter study ''RAPSODY'' was conducted. As Ra-223 and most of its progeny emit alpha particles, the internal exposure had to be evaluated in particular. Within this study, measurements of the radiation emitted from the patient were performed using standard dose-rate meters. Wipe-tests were taken in the patients' homes to identify significant contaminations and evaluated by liquid scintillation counting. Samples of saliva and sweat were taken and measured using gamma spectrometry. Ra-223 disintegrates to the noble gas Rn-219 and was measured in the exhaled breath from the patients using conventional Radon Monitors. Furthermore, a computational fluid dynamics simulation (CFD) was performed to assess the radioactivity in the air, which could be inhaled by persons close to the patient. Conclusions: The potential exposure of relatives and caregivers by external irradiation and incorporation of radioactivity exhaled or excreted by the patient with saliva or sweat is well below 1 mSv. No objections are seen regarding outpatient treatment. This paper summarizes contents of a poster presented at the Annual Meeting of the Society of Nuclear Medicine and Molecular Imaging.

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

    Directory of Open Access Journals (Sweden)

    Müller L

    2017-05-01

    Full Text Available Lisa Müller,1 Carolin Hildebrandt,1,2 Erich Müller,3 Renate Oberhoffer,2 Christian Raschner1 1Department of Sport Science, University of Innsbruck, Innsbruck, Austria; 2Department of Sport and Health Science, Preventative Pediatrics, Technical University of Munich, Munich, Germany; 3Department of Sport Science and Kinesiology, University of Salzburg, Salzburg, Austria Background: Studies on injuries and illnesses involving youth ski racers younger than 15 years are lacking in the literature. The aim of this study was prospectively to assess the incidence, prevalence, and severity of traumatic and overuse injuries, as well as illnesses of elite youth ski racers with regard to sex, biological maturity status, and relative age.Subjects and methods: A prospective, longitudinal cohort design was used to monitor the anthropometrics, training characteristics, traumatic and overuse injuries, and illnesses of 82 elite youth ski racers (51 males, 31 females, age 9–14 years over 2 consecutive years. The exact training exposure (skiing and athletic was recorded. Relative age and estimated biological maturity status were assessed.Results: Relatively low injury incidence or prevalence (traumatic, 0.86/1,000 hours of training; overuse, 0.28/1,000 hours and comparably high illness prevalence (2.4/athlete were reported. The knee was the most commonly affected body part (traumatic injuries 36.5%, overuse injuries 82%. A high number of bone fractures were revealed (46%, while no stress fractures occurred; 66% of the illnesses were respiratory tract infections. No differences were found between males and females, the differing maturity groups, or relative age quartiles. Early-maturing athletes had comparably low traumatic and overuse-injury rates. Relatively younger athletes had low traumatic injury rates.Conclusion: The injury-prevention measures implemented in the training process of youth ski racers seem to contribute to a low incidence of injury. Biological

  16. Evolution of Geographic Atrophy in Participants Treated with Ranibizumab for Neovascular Age-related Macular Degeneration.

    Science.gov (United States)

    Thavikulwat, Alisa T; Jacobs-El, Naima; Kim, Jane S; Agrón, Elvira; Hasan, Jesia; Meyerle, Catherine B; Valent, David; Cukras, Catherine A; Wiley, Henry E; Wong, Wai T; Chew, Emily Y

    2017-01-01

    To evaluate the risk factors, incidence, and rate of progression of geographic atrophy (GA) in eyes with neovascular age-related macular degeneration (nAMD) treated with ranibizumab. Post-hoc analysis of a prospective clinical study. 69 participants with nAMD in at least one eye. Participants were prospectively treated in the study eye with 0.5 mg intravitreal ranibizumab. Study eyes received 4 monthly injections followed by pro re nata injections until a fluid-free macula was achieved on optical coherence tomography. Risk factors assessed included baseline demographics, treatment, and ocular characteristics on imaging. Eyes were evaluated on fundus autofluorescence (FAF) for GA. The rate of GA area growth in study and fellow eyes was analyzed by linear regression of square-root transformed areas. Development of new-onset GA and rate of GA area growth measured on ocular imaging, including FAF images of the study eyes. Sixty-nine participants (mean age 78.8±7.8 years) with an average of 40.0±13.6 months of follow-up were analyzed. Twenty-two of 69 study eyes (32%) were treatment naïve. During their first year of the study, participants received an average of 9.2±3.3 injections in the study eye. Of 63 study eyes with quality baseline images, 22 (35%) had pre-existing GA. Of the remaining 41 eyes, 7 (17%) developed new-onset GA during study follow-up. Those who developed new GA were older (all ≥79 years old) and had received fewer study injections on average (6.9 vs. 10.4 injections at 1 year) compared to those who did not develop new GA. Of the 12 treatment naïve study eyes without GA at baseline, 1 (8.3%) developed new GA during the study. In 21 study eyes with quantifiable GA area, eyes with GA present at baseline (16/21) enlarged by 0.34±0.26 mm/year, compared to 0.19±0.12 mm/year in eyes developing new-onset GA (5/21). While 17% of study eyes without GA present at baseline receiving ranibizumab developed new GA, the role of ranibizumab in the development

  17. [How is burnout treated? Treatment approaches between wellness, job-related prevention of stress, psychotherapy, and social criticism].

    Science.gov (United States)

    Hillert, A

    2012-02-01

    The subjective illness burnout is often described as the combination of workload-related suffering and job dissatisfaction, thus, leading to depressive symptoms. Burnout is a serious model of personal illness perception, but not useful as a diagnosis term because of its lack of specification and reliability. In this respect, burnout therapy cannot be regarded as a specific form of psychotherapy or any other form of therapy, but rather a pragmatic procedure focusing on the burnout clients' needs. When applying scientific standards, the evidence of a more or less specific anti-burnout effect of such procedures involving relaxation, wellness, alternative medical approaches, and psychotherapy are between weak and non-existent. From a conceptual point of view, strategies focusing on relaxation and symptom-reduction can be distinguished from prospective, job-related stress management efforts. In clinical psychotherapeutic settings, aspects of both are usually combined in programs claimed to be integrative or holistic. However, whether these programs really enhance the individual therapeutic outcome has yet to be proved in controlled clinical trials. The efficacy of preventive anti-stress programs and of job-related therapeutic groups, offered complementary to common therapeutic programs in psychosomatic hospitals, have been demonstrated in several studies. Therapeutic information focusing on side effects of social and work-related changes on an individual's psychosomatic wellbeing are needed. The prominent term burnout may be helpful in the public discussion but is not useful in the conceptual framework of a rational, scientific-based procedure in this field.

  18. [Psychiatric patients and relatives instruct German police officers - an anti-stigma project of "BASTA - the alliance for mentally ill people"].

    Science.gov (United States)

    Wundsam, Kerstin; Pitschel-Walz, Gabi; Leucht, Stefan; Kissling, Werner

    2007-05-01

    Contact with police officers due to schizophrenia and resort to violence in such interactions is a common occurrence and represents a source for stigmatisation of mentally ill people. Aim of this project was to establish a program for police officers to reduce that stigma. The seminar was developed by a German anti-stigma organisation in cooperation with sociology teachers of the Bavarian police academy. Evaluations focussed on the police officers "social distance" and "negative stereotypes" towards mentally ill people. The personal contact between officers and the referees (patients, relatives, professionals) was the core of the seminar. Results of a debriefing after the pilot-project was overall positive. Evaluations in the renewal years showed significant improvement within the scale "social distance" (p stigma interventions.

  19. Home treatment for acute psychiatric illness.

    Science.gov (United States)

    Dean, C; Gadd, E M

    1990-11-03

    To determine the factors influencing the successful outcome of community treatment for severe acute psychiatric illnesses that are traditionally treated in hospital. All patients from a single electoral ward who were either admitted to hospital or treated at home over a two year period (1 October 1987 to 30 September 1989) were included in the study and their case notes audited. The second year of the study is reported. Electoral ward of Sparkbrook, Birmingham. 99 Patients aged 16-65 with severe acute psychiatric illness. 65 Patients were managed by home treatment alone; 34 required admission to hospital. The location of treatment was significantly (all p less than 0.05) influenced by social characteristics of the patients (marital state, age (in men), ethnicity, and living alone) and by characteristics of the referral (occurring out of hours; assessment taking place at hospital or police station). DSM-III-R diagnosis was more weakly associated with outcome. Violence during the episode was significantly related to admission, although deliberate self harm was not. Home treatment is feasible for most patients with acute psychiatric illness. A 24 hour on call assessment service increases the likelihood of success because admission is determined more strongly by social characteristics of the patient and the referral than by illness factors. Admission will still be required for some patients. A locally based mental health resource centre, a 24 hour on call service, an open referral system, and an active follow up policy increase the effectiveness of a home treatment service.

  20. Steam-treated wood pellets: Environmental and financial implications relative to fossil fuels and conventional pellets for electricity generation

    International Nuclear Information System (INIS)

    McKechnie, Jon; Saville, Brad; MacLean, Heather L.

    2016-01-01

    Highlights: • Steam-treated pellets can greatly reduce greenhouse gas emissions relative to coal. • Cost advantage is seen relative to conventional pellets. • Higher pellet cost is more than balanced by reduced retrofit capital requirements. • Low capacity factors further favour steam-treated pellets over conventional pellets. - Abstract: Steam-treated pellets can help to address technical barriers that limit the uptake of pellets as a fuel for electricity generation, but there is limited understanding of the cost and environmental impacts of their production and use. This study investigates life cycle environmental (greenhouse gas (GHG) and air pollutant emissions) and financial implications of electricity generation from steam-treated pellets, including fuel cycle activities (biomass supply, pellet production, and combustion) and retrofit infrastructure to enable 100% pellet firing at a generating station that previously used coal. Models are informed by operating experience of pellet manufacturers and generating stations utilising coal, steam-treated and conventional pellets. Results are compared with conventional pellets and fossil fuels in a case study of electricity generation in northwestern Ontario, Canada. Steam-treated pellet production has similar GHG impacts to conventional pellets as their higher biomass feedstock requirement is balanced by reduced process electricity consumption. GHG reductions of more than 90% relative to coal and ∼85% relative to natural gas (excluding retrofit infrastructure) could be obtained with both pellet options. Pellets can also reduce fuel cycle air pollutant emissions relative to coal by 30% (NOx), 97% (SOx), and 75% (PM 10 ). Lesser retrofit requirements for steam-treated pellets more than compensate for marginally higher pellet production costs, resulting in lower electricity production cost compared to conventional pellets ($0.14/kW h vs. $0.16/kW h). Impacts of retrofit infrastructure become increasingly

  1. Disentangling depression and anxiety in relation to neuroticism, extraversion, suicide, and self-harm among adult psychiatric inpatients with serious mental illness.

    Science.gov (United States)

    Subica, Andrew M; Allen, Jon G; Frueh, B Christopher; Elhai, Jon D; Fowler, J Christopher

    2016-11-01

    Little is known about depression-anxiety comorbidity and its association with personality traits and suicide/self-harm in adult psychiatric inpatients with serious mental illness (SMI), impacting clinical assessment and treatment. This study sought to determine the symptom structure of depression-anxiety comorbidity and its relation to neuroticism, extraversion, and suicide/self-harm behaviour in this high-risk population. Nine hundred and sixty-two adults receiving inpatient care at a private psychiatric hospital completed questionnaires at admission. Confirmatory factor analyses compared a bifactor solution specifying a general distress factor and two specific depression and anxiety factors against unidimensional and correlated factors solutions. The bifactor solutions' factors were subsequently correlated with neuroticism and extraversion subscales and pre-hospitalization suicide/self-harm behaviours. The bifactor model rendered superior fit to sample data and a robust general factor - accounting for 77.61% of common item variance - providing the first evidence for a tripartite structure of depression and anxiety among adult inpatients. The bifactor solution-outputted independent general distress, depression, and anxiety factors positively correlated with neuroticism, the personality dimension corresponding to trait negative affectivity. The general distress and depression factors associated with recent self-harm, but factors showed no associations with prior suicidal behaviour. In adult psychiatric inpatients, general distress substantially underlies comorbid depression and anxiety symptom variation and may contribute to recent incidence of self-harm. Transdiagnostic assessments and interventions targeting general distress may temper depression, anxiety, and self-harm in adult inpatients. Clinical implications Depression-anxiety comorbidity symptomology in adult psychiatric inpatients is primarily composed of general distress. General distress and specific

  2. Outcomes of HPV-related oropharyngeal cancer patients treated by radiotherapy alone using altered fractionation

    International Nuclear Information System (INIS)

    O’Sullivan, Brian; Huang Shaohui; Perez-Ordonez, Bayardo; Massey, Christine; Siu, Lillian L.; Weinreb, Ilan; Hope, Andrew; Kim, John; Bayley, Andrew J.; Cummings, Bernard; Ringash, Jolie; Dawson, Laura A.; Cho, B.C. John; Chen, Eric; Irish, Jonathan; Gilbert, Ralph W.; Hui, Angela; Liu Feifei; Zhao, Helen; Waldron, John N.

    2012-01-01

    Purpose: To report outcome of HPV-related [HPV(+)] oropharyngeal cancer (OPC) managed predominantly by altered-fractionation radiotherapy-alone (RT-alone). Methods: OPCs treated with RT-alone (n = 207) or chemoradiotherapy (CRT) (n = 151) from 2001 to 2008 were included. Overall survival (OS), local (LC), regional (RC) and distant (DC) control were compared for HPV(+) vs. HPV-unrelated [HPV(−)], by RT-alone vs. CRT, and by smoking pack-years (⩽10 vs. >10). Multivariate analysis identified predictors. Results: HPV(+) (n = 277) had better OS (81% vs. 44%), LC (93% vs. 76%), RC (94% vs. 79%) (all p < 0.01) but similar DC (89% vs. 86%, p = 0.87) vs. HPV(−) (n = 81). HPV(+) stage IV CRT (n = 125) had better OS (89% vs. 70%, p < 0.01), but similar LC (93% vs. 90%, p = 0.41), RC (94% vs. 90%, p = 0.31) and DC (90% vs. 83%, p = 0.22) vs. RT-alone (n = 96). Both HPV(+) RT-alone (n = 37) and CRT (n = 67) stage IV minimal smokers had favorable OS (86% vs. 88%, p = 0.45), LC (95% vs. 92%, p = 0.52), RC (97% vs. 93%, p = 0.22), and DC (92% vs. 86%, p = 0.37). RT-alone and heavy-smoking were independent predictors for lower OS but not CSS in multivariate analysis. Conclusions: Overall, HPV(+) RT-alone stage IV demonstrated lower survival but comparable disease control vs. CRT, but no difference was apparent among minimal smokers.

  3. Efficacy of esomeprazole in treating acid-related diseases in Japanese populations

    Directory of Open Access Journals (Sweden)

    Furuta T

    2012-05-01

    Full Text Available Mitsushige Sugimoto1, Takahisa Furuta21First Department of Medicine, 2Center for Clinical Research, Hamamatsu University School of Medicine, Shizuoka, JapanAbstract: Esomeprazole (Nexium®; AstraZeneca, the S-isomer of omeprazole, is the first proton pump inhibitor (PPI to be developed as an optical isomer. Compared with omeprazole, esomeprazole has an improved pharmacokinetic profile with regards to CYP2C19 (S-mephenytoin 4'-hydroxylase genotype, showing increased systemic exposure and less interindividual variability. Further, esomeprazole is a more potent acid inhibitor than other currently available PPIs and is therefore used as a first-line drug for acid-related diseases. While esomeprazole has been available in a number of countries worldwide, the compound only received authorized permission to be marketed in Japan in September 2011. The standard esomeprazole dose in Japan for the treatment of peptic ulcers and gastroesophageal reflux disease (GERD is 20 mg. Other advised dosages are 10 mg for nonerosive reflux disease and 20 mg twice-daily dosing for eradication of Helicobacter pylori. In Japanese, the effective rate of esomeprazole 20 mg during 24 weeks for GERD patients is 92.0% (88.0%–96.0%, while the prevention of peptic ulcer development using 20 mg for 24 weeks in patients treated with nonsteroidal anti-inflammatory drugs is 96.0% (92.8%–99.1%. Although clinical data are limited, the usefulness of esomeprazole is expected in Japanese subjects given the reduced prevalence of CYP2C19 rapid metabolizers in Japan compared with Western countries.Keywords: esomeprazole, PPI, CYP2C19, peptic ulcer, GERD, H. pylori

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

    Science.gov (United States)

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

    2016-11-01

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

  5. To assess the relations between breast feeding and illness in children under two years of age with particular reference to respiratory tract infections

    International Nuclear Information System (INIS)

    Javed, N.; Zaidi, N.; Khan, M.A.

    2008-01-01

    The study was carried out to examine the relation between the breast feeding and morbidity as a result of respiratory illness and infection in the children less than two years of age. This is a prospective analysis of 131 children attending the outdoor paediatric department of Federal Government Services Hospital, Islamabad during the month of February 2006. A close ended pretested questionnaire was filled after taking informed consent from patient's parents. Out of total 131 enrolled cases (76 male and 55 female) 62 (47%) were breast fed; 56 (43%) bottle fed; while 13 (10%) had mix feeding. Among 38 children, having past history of respiratory tract infections episodes in last one month, only 04 (10%) were breast fed and remaining 34 (90%) were either bottle fed or had partial breast feeding. Out of 62 breast fed children, only 04 (6%) had recurrent episodes of respiratory tract infections, on the other hand out of 56 bottle fed 32 (57%) had previous history of respiratory illness. In our study there is a significant correlation between breast feeding and reduction in number of Respiratory tact infections episodes. Predominant breast feeding for at leas six months and partial breast feeding for up to one year may reduce the prevalence and subsequent morbidity of respiratory illness and infection in infancy. (author)

  6. Diarrheal Illness

    Centers for Disease Control (CDC) Podcasts

    2011-08-30

    Dr. Steve Monroe, director of CDC’s Division of High-Consequence Pathogens and Pathology, discusses diarrheal illness, its causes, and prevention.  Created: 8/30/2011 by National Center for Emerging Zoonotic and Infectious Diseases (NCEZID).   Date Released: 8/31/2011.

  7. Isolation and Suffering Related to Serious and Terminal Illness: Metaphors and Lessons From Albert Camus' Novel, The Plague.

    Science.gov (United States)

    Tuffuor, Akosua N; Payne, Richard

    2017-09-01

    Health care providers have much to learn from Albert Camus' great novel, The Plague. The Plague tells the story of a bubonic plague epidemic through the lens of doctor-narrator Rieux. In addition to Rieux, this essay also focuses on the perspective of Father Paneloux, a Jesuit priest, who provides important religious commentary on the epidemic, before falling victim to it and dying. Camus' masterful engagement of the metaphor of isolation and its profound impact on suffering emphasizes the important role of community and spiritual perspectives of patients and providers in coping with serious illness, death, and dying. The Plague is relevant today, particularly given the challenges of distancing, alienation, and isolation imposed by not only disease but also by technology and clinical and administrative practices that have unintended consequences of incentivizing separation between patient and healer, thus engendering greater stress and suffering in both. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  8. Relative risk of diabetes, dyslipidaemia, hypertension and the metabolic syndrome in people with severe mental illnesses: Systematic review and metaanalysis

    Directory of Open Access Journals (Sweden)

    King Michael B

    2008-09-01

    Full Text Available Abstract Background Severe mental illnesses (SMI may be independently associated with cardiovascular risk factors and the metabolic syndrome. We aimed to systematically assess studies that compared diabetes, dyslipidaemia, hypertension and metabolic syndrome in people with and without SMI. Methods We systematically searched MEDLINE, EMBASE, CINAHL & PsycINFO. We hand searched reference lists of key articles. We employed three search main themes: SMI, cardiovascular disease, and each cardiovascular risk factor. We selected cross-sectional, case control, cohort or intervention studies comparing one or more risk factor in both SMI and a reference group. We excluded studies without any reference group. We extracted data on: study design, cardiovascular risk factor(s and their measurement, diagnosis of SMI, study setting, sampling method, nature of comparison group and data on key risk factors. Results Of 14592 citations, 134 papers met criteria and 36 were finally included. 26 reported on diabetes, 12 hypertension, 11 dyslipidaemia, and 4 metabolic syndrome. Most studies were cross sectional, small and several lacked comparison data suitable for extraction. Meta-analysis was possible for diabetes, cholesterol and hypertension; revealing a pooled risk ratio of 1.70 (1.21 to 2.37 for diabetes and 1.11 (0.91 to 1.35 of hypertension. Restricting SMI to schizophreniform illnesses yielded a pooled risk ratio for diabetes of 1.87 (1.68 to 2.09. Total cholesterol was not higher in people with SMI (Standardized Mean Difference -0.10 (-0.55 to 0.36 and there were inconsistent data on HDL, LDL and triglycerides with some, but not all, reporting lower levels of HDL cholesterol and raised triglyceride levels. Metabolic syndrome appeared more common in SMI. Conclusion Diabetes (but not hypertension is more common in SMI. Data on other risk factors were limited by poor quality or inconsistent research findings, but a small number of studies show greater prevalence

  9. Prisoners signify: a political discourse analysis of mental illness in a prison control unit.

    Science.gov (United States)

    Cloyes, Kristin Gates

    2007-09-01

    Increasingly, US prisoners diagnosed with mental illness are housed in control units, the most restrictive form of confinement in the US prison system. This situation has led to intense debate over the legal, ethical and clinical status of mental illness. This is a semiotic struggle with profound effects, yet most related work treats mental illness as a neutral, individual variable. Few analyses locate mental illness within a larger sociopolitical context. Fewer still focus on discursive practice. None critically analyze the accounts of control unit prisoners, who talk about extreme marginality and risk for victimization. This paper has two aims: (i) to develop a systematic method of analysis that accounts for signification as discourse-in-action; and (ii) to show how prisoners' signification of mental illness articulates agency through and against marginalizing discourse. Political discourse analysis demonstrates how control unit prisoners with psychiatric diagnoses signify mental illness, and articulate safer identifications in the process.

  10. Development of Age-Related Macular Degeneration (AMD) in the Fellow Eye of Patients with AMD Treated by Treat-and-Extend Intravitreal Therapy with Aflibercept.

    Science.gov (United States)

    Mimura, Kensuke; Matsumoto, Hidetaka; Morimoto, Masahiro; Akiyama, Hideo

    2018-01-01

    To evaluate the development of neovascular age-related macular degeneration (nAMD) in the fellow eye in patients with unilateral nAMD treated by a treat-and-extend (TAE) regimen with intravitreal aflibercept injections. We retrospectively studied 104 patients with treatment-naïve unilateral nAMD. We assessed best-corrected visual acuity (BCVA) and exudative changes in the treated eyes and development of nAMD in the fellow eye for 2 years. The subjects included 46 patients with typical AMD (tAMD), 44 with polypoidal choroidal vasculopathy (PCV), and 14 with retinal angiomatous proliferation (RAP). BCVA was significantly improved after the loading phase in all subtypes. Forty-six patients (44.2%) had no recurrence within 2 years after the loading phase, including 12 (26.1%) with tAMD, 23 (52.2%) with PCV, and 11 (78.6%) with RAP (p < 0.01). Eleven patients (10.6%) developed nAMD in the fellow eye within 2 years, including 4 (8.7%) with tAMD, 0 (0%) with PCV, and 7 (50.0%) with RAP (p < 0.001). Patients with RAP had significantly more frequent development of nAMD in the fellow eye compared to other subtypes, while they showed significantly less recurrence during the TAE regimen with intravitreal aflibercept injections. Development of nAMD in the fellow eye should be monitored in RAP when the injection interval is extended. © 2017 S. Karger AG, Basel.

  11. Corrosion rates of fasteners in treated wood exposed to 100% relative humidity

    Science.gov (United States)

    Samuel L. Zelinka; Douglas R. Rammer

    2009-01-01

    In the past, gravimetric corrosion data for fasteners exposed to treated wood has been reported as a percent weight loss. Although percent weight loss is a valid measure of corrosion for comparing identical fasteners, it can distort the corrosion performance of fasteners with different geometries and densities. This report reevaluates a key report on the corrosiveness...

  12. Sports injuries and illnesses during the Winter Olympic Games 2010.

    Science.gov (United States)

    Engebretsen, Lars; Steffen, Kathrin; Alonso, Juan Manuel; Aubry, Mark; Dvorak, Jiri; Junge, Astrid; Meeuwisse, Willem; Mountjoy, Margo; Renström, Per; Wilkinson, Mike

    2010-09-01

    Identification of high-risk sports, including their most common and severe injuries and illnesses, will facilitate the identification of sports and athletes at risk at an early stage. To analyse the frequencies and characteristics of injuries and illnesses during the XXI Winter Olympic Games in Vancouver 2010. All National Olympic Committees' (NOC) head physicians were asked to report daily the occurrence (or non-occurrence) of newly sustained injuries and illnesses on a standardised reporting form. In addition, the medical centres at the Vancouver and Whistler Olympic clinics reported daily on all athletes treated for injuries and illnesses. Physicians covering 2567 athletes (1045 females, 1522 males) from 82 NOCs participated in the study. The reported 287 injuries and 185 illnesses resulted in an incidence of 111.8 injuries and 72.1 illnesses per 1000 registered athletes. In relation to the number of registered athletes, the risk of sustaining an injury was highest for bobsleigh, ice hockey, short track, alpine freestyle and snowboard cross (15-35% of registered athletes were affected in each sport). The injury risk was lowest for the Nordic skiing events (biathlon, cross country skiing, ski jumping, Nordic combined), luge, curling, speed skating and freestyle moguls (less than 5% of registered athletes). Head/cervical spine and knee were the most common injury locations. Injuries were evenly distributed between training (54.0%) and competition (46.0%; p=0.18), and 22.6% of the injuries resulted in an absence from training or competition. In skeleton, figure and speed skating, curling, snowboard cross and biathlon, every 10th athlete suffered from at least one illness. In 113 illnesses (62.8%), the respiratory system was affected. At least 11% of the athletes incurred an injury during the games, and 7% of the athletes an illness. The incidence of injuries and illnesses varied substantially between sports. Analyses of injury mechanisms in high-risk Olympic winter

  13. Foodborne Illness

    OpenAIRE

    He, Zhan; Liu, Xuan; Li, Renjie

    2008-01-01

    Foodborne illnesses are a significant public health challenge in the world. Preventing foodborne disease in meat processing is an essential point to insure food safety and quality. HACCP systems currently are used for food processor to identify food safety hazards and prevent food is contaminated. By the introducing HACCP system into China in 1990s, Chinese government and enterprises have took more attention to control and monitoring the flow of food to insure food quality in processors. Meat...

  14. Foodborne Illness

    Science.gov (United States)

    1983-02-01

    contaminate different dietary constituents. These toxins may be of biologic origin (microbial. plant, or animal toxins) or they may be inorganic or...food mine if similar illness has occurred concomitantly poisoning for planning specific therapy, for esti- in companions or family members. Seek to...gin 4 to 8 hours after ingestion of the toxin and speciated botulinum immunoglobulin of equine include severe retching, vomiting, diarrhea, and

  15. An eHealth Application of Self-Reported Sports-Related Injuries and Illnesses in Paralympic Sport: Pilot Feasibility and Usability Study.

    Science.gov (United States)

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

    2017-11-29

    Sport participation is associated with a risk of sports-related injuries and illnesses, and Paralympic athletes' additional medical issues can be a challenge to health care providers and medical staff. However, few prospective studies have assessed sports-related injuries and illnesses in Paralympic sport (SRIIPS) over time. Advances in mobile phone technology and networking systems offer novel opportunities to develop innovative eHealth applications for collection of athletes' self-reports. Using eHealth applications for collection of self-reported SRIIPS is an unexplored area, and before initiation of full-scale research of SRIIPS, the feasibility and usability of such an approach needs to be ascertained. The aim of this study was to perform a 4-week pilot study and (1) evaluate the monitoring feasibility and system usability of a novel eHealth application for self-reported SRIIPS and (2) report preliminary data on SRIIPS. An eHealth application for routine collection of data from athletes was developed and adapted to Paralympic athletes. A 4-week pilot study was performed where Paralympic athletes (n=28) were asked to weekly self-report sport exposure, training load, general well-being, pain, sleep, anxiety, and possible SRIIPS. The data collection was followed by a poststudy use assessment survey. Quantitative data related to the system use (eg, completed self-reports, missing responses, and errors) were analyzed using descriptive statistics. The qualitative feasibility and usability data provided by the athletes were condensed and categorized using thematic analysis methods. The weekly response rate was 95%. The athletes were of the opinion that the eHealth application was usable and feasible but stated that it was not fully adapted to Paralympic athletes and their impairments. For example, it was difficult to understand how a new injury or illness should be identified when the impairment was involved. More survey items related to the impairments were

  16. An eHealth Application of Self-Reported Sports-Related Injuries and Illnesses in Paralympic Sport: Pilot Feasibility and Usability Study

    Science.gov (United States)

    2017-01-01

    Background Sport participation is associated with a risk of sports-related injuries and illnesses, and Paralympic athletes’ additional medical issues can be a challenge to health care providers and medical staff. However, few prospective studies have assessed sports-related injuries and illnesses in Paralympic sport (SRIIPS) over time. Advances in mobile phone technology and networking systems offer novel opportunities to develop innovative eHealth applications for collection of athletes’ self-reports. Using eHealth applications for collection of self-reported SRIIPS is an unexplored area, and before initiation of full-scale research of SRIIPS, the feasibility and usability of such an approach needs to be ascertained. Objective The aim of this study was to perform a 4-week pilot study and (1) evaluate the monitoring feasibility and system usability of a novel eHealth application for self-reported SRIIPS and (2) report preliminary data on SRIIPS. Methods An eHealth application for routine collection of data from athletes was developed and adapted to Paralympic athletes. A 4-week pilot study was performed where Paralympic athletes (n=28) were asked to weekly self-report sport exposure, training load, general well-being, pain, sleep, anxiety, and possible SRIIPS. The data collection was followed by a poststudy use assessment survey. Quantitative data related to the system use (eg, completed self-reports, missing responses, and errors) were analyzed using descriptive statistics. The qualitative feasibility and usability data provided by the athletes were condensed and categorized using thematic analysis methods. Results The weekly response rate was 95%. The athletes were of the opinion that the eHealth application was usable and feasible but stated that it was not fully adapted to Paralympic athletes and their impairments. For example, it was difficult to understand how a new injury or illness should be identified when the impairment was involved. More survey items

  17. Parasitic Diseases and Psychiatric Illness

    OpenAIRE

    Weiss, Mitchell Gralnick

    1994-01-01

    Distinguishing parasitic diseases from other infections and tropical medical disorders based on microbiological classification is a matter of convenience. Organic brain syndromes are associated with both protozoan and helminthic infections; side-effects of drugs commonly used to treat parasitoses may impair mood and cause anxiety, agitation or psychosis. Emotional states may in turn affect the experience of medical illness. Psychiatrically significant features of medical illness are determine...

  18. The role of secure attachment, empathic self-efficacy, and stress perception in causal beliefs related to mental illness – a cross-cultural study: Italy versus Israel

    Directory of Open Access Journals (Sweden)

    Mannarini S

    2017-10-01

    Full Text Available Stefania Mannarini,1 Alisa Reikher,1 Sharon Shani,1 Inbal Shani-Zinovich2 1Department of Philosophy, Sociology, Education and Applied Psychology, Interdepartmental Center for Family Research, University of Padova, Padova, Italy; 2Department of Counseling and Human Development, Faculty of Education, University of Haifa, Mount Carmel, Haifa, Israel Background: Research suggests that “mental illness etiological beliefs” and attitudes toward mentally ill people are significantly related; it has also been demonstrated that adult attachment style and empathic self-efficacy affect such attitudes. Moreover, community or regional culture has a significant impact on etiology beliefs and attitudes toward the mentally sick. Materials and methods: We carried out this study in Italy and Israel among psychology students to compare two cultures in regards to causal beliefs of mental disorders and the roles that specific variables, such as secure attachment, empathic self-efficacy, and stress, play in etiological beliefs. The participants (N=305 were students who belonged to two universities: Padua (N=183 and Haifa (N=122. The Many Facet Rasch Model (MFRM was applied in a cross-cultural perspective to analyze the differential functioning of specific etiological beliefs in relation to the above mentioned variables; the effect of gender and religious beliefs was also entered in the MFRM. Results: The two cultures reacted differently to the biogenetic and psychosocial causal explanations of mental disorders: Israeli students endorsed the biogenetic causal beliefs model more frequently than the Italians. Among other findings, concerning the biogenetic model, the Italian students were predominantly males, who declared to be religious and reported lower levels of secure attachment than Israelis. On the other hand, the Israeli students who manifested a preference toward the biogenetic explanation were mostly females, who declared not to be religious and who

  19. Retrospective analysis of 27 cases of bisphosphonate-related osteonecrosis of the jaw treated surgically or nonsurgically

    Directory of Open Access Journals (Sweden)

    Shin-Yu Lu

    2014-06-01

    Conclusion: Our study demonstrates a high success rate of conservative and surgical treatment of BRONJ. This is the first reported use of GBR to successfully treat oral BPh-related osteonecrosis of the jaw. Irrigation with antimicrobial rinses may result in pain reduction, and regression or even resolution of BRONJ.

  20. Distribution of nontuberculous mycobacteria in treated patients with pulmonary disease in Greece - relation to microbiological data.

    Science.gov (United States)

    Manika, Katerina; Tsikrika, Stamatoula; Tsaroucha, Emilia; Karabela, Simona; Karachaliou, Iris; Bosmi, Ioulia; Kioumis, Ioannis; Papavasileiou, Apostolos

    2015-01-01

    The aim was to assess the distribution of nontuberculous mycobacteria (NTM) in treated patients with pulmonary disease (PD) in Greece. Patients treated for NTM PD at the two largest chest diseases hospitals in Greece, in the period 1990-2013 were investigated. For the years 2005-2013 data on NTM isolation frequency were recorded. M. avium complex (MAC) was the predominant cause of NTM PD disease followed by M. kansasii and rapid growing mycobacteria (RGM). The pathogenicity of RGM was significantly lower than this of MAC and M. kansasii. An increase was observed in the percentage of isolated NTM species that were considered clinically significant over the study period. The increasing number of NTM PD in Greece is a consequence of their isolation being more frequently considered as clinically relevant.

  1. Improvements in or relating to a fluidizing process and apparatus for treating comminuted solid materials

    Energy Technology Data Exchange (ETDEWEB)

    1949-02-15

    A fluidizing process of treating comminuted solid materials cyclically with different gaseous materials in different treatment zones, which comprises fluidizing comminuted solid material in contiguous treatment zones with different gaseous materials, and establishing unequal fluid-static heads in said zones to effect cyclic flow of said solid material through said zones which are in communication adjacent their respective top and bottom portions and permit the overflow of said solid material from one of said zones to another.

  2. Subfoveal fibrosis in eyes with neovascular age-related macular degeneration treated with intravitreal ranibizumab

    DEFF Research Database (Denmark)

    Bloch, Sara Brandi; Lund-Andersen, Henrik; Sander, Birgit

    2013-01-01

    To assess baseline and follow-up characteristics of choroidal neovascularization (CNV) lesions in age-related macular degeneration in relation to the development of subfoveal subretinal fibrosis.......To assess baseline and follow-up characteristics of choroidal neovascularization (CNV) lesions in age-related macular degeneration in relation to the development of subfoveal subretinal fibrosis....

  3. Prevention of influenza-related illness in young infants by maternal vaccination during pregnancy [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Marta C Nunes

    2018-01-01

    Full Text Available The influenza virus circulates yearly and causes global epidemics. Influenza infection affects all age groups and causes mild to severe illness, and young infants are at particular risk for serious disease. The most effective measure to prevent influenza disease is vaccination; however, no vaccine is licensed for use in infants younger than 6 months old. Thus, there is a crucial need for other preventive strategies in this high-risk age group. Influenza vaccination during pregnancy protects both the mothers and the young infants against influenza infection. Vaccination during pregnancy boosts the maternal antibodies and increases the transfer of immunoglobulin G from the mother to the fetus through the placenta, which confers protection against infection in infants too young to be vaccinated. Data from clinical trials and observational studies did not demonstrate adverse effects to the mother, the fetus, or the infant after maternal influenza vaccination. We present the current data on the effectiveness and safety of influenza vaccination during pregnancy in preventing disease in the young infant.

  4. Illness Identity in Adults with a Chronic Illness.

    Science.gov (United States)

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

    2018-02-21

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

  5. "Why throw away something useful?": Attitudes and opinions of people treated for bipolar disorder and their relatives on organ and tissue donation.

    Science.gov (United States)

    Padoan, Carolina S; Garcia, Lucas F; Rodrigues, Aline A; Patusco, Lucas M; Atz, Mariana V; Kapczinski, Flavio; Goldim, José R; Magalhães, Pedro V S

    2017-03-01

    In regard to mental illness, brain donation is essential for the biological investigation of central pathology. Nevertheless, little is known about the thoughts of people with mental disorders on tissue donation for research. Here, our objective was to understand the attitudes and opinions of people treated for bipolar disorder and their relatives regarding donation in general, and particularly donation for research. This is a qualitative study that used in-depth interviews to determine the thoughts of participants regarding tissue donation for research. Theoretical sampling was used as a recruitment method. Grounded theory was used as a framework for content analyses of the interviews. A semi-structured interview guide was applied with the topics: donation in general; donation for research; mental health and body organs; opinion regarding donation; feelings aroused by the topic. Although all participants were aware of organ donation for transplant, they were surprised that tissue could be donated for research. Nevertheless, once they understood the concept they were usually in favor of the idea. Although participants demonstrated a general lack of knowledge on donation for research, they were willing to learn more and viewed it as a good thing, with altruistic reasons often cited as a motive for donation. We speculate that bridging this knowledge gap may be a fundamental step towards a more ethical postmortem tissue donation process.

  6. Prospective evaluation of angiogenic, hypoxic and EGFR-related biomarkers in recurrent glioblastoma multiforme treated with cetuximab, bevacizumab and irinotecan

    DEFF Research Database (Denmark)

    Hasselbalch, Benedikte; Eriksen, Jesper Grau; Broholm, Helle

    2010-01-01

    , hypoxia and mediators of the epidermal growth factor receptor (EGFR) pathway were investigated. Tumor tissue was obtained from a previous phase II study, treating recurrent primary glioblastoma multiforme (GBM) patients with the EGFR inhibitor cetuximab in combination with bevacizumab and irinotecan....... Of the 37 patients with available tumor tissue, 29 were evaluable for response. We concurrently performed immunohistochemical stainings on tumor tissue from 21 GBM patients treated with bevacizumab and irinotecan. We found a tendency of correlation between the hypoxia-related markers, indicating...

  7. Chronic Illness & Mental Health

    Science.gov (United States)

    ... increased risk of cardiovascular disease, diabetes, stroke, and Alzheimer’s disease, for example. Research also suggests that people with depression are at higher risk for osteoporosis relative to others. The reasons are not yet clear. One factor with some of these illnesses is that many ...

  8. Foodborne Illness Retrospective

    Centers for Disease Control (CDC) Podcasts

    2015-05-07

    Dr. Paul Mead and Dr. Peter Drotman discuss the historic October 1999 article, Food-related Illness and Death in the United States.  Created: 5/7/2015 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 5/7/2015.

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

    Science.gov (United States)

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

    2017-07-01

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

  10. Health-related quality of life of young people with long-term illnesses before and after transfer from child to adult healthcare.

    Science.gov (United States)

    While, A E; Heery, E; Sheehan, A M; Coyne, I

    2017-01-01

    The numbers of children with long-term illnesses surviving into adulthood and transferring from child to adult services has increased dramatically in the last 30 years. This study aimed to examine health-related quality of life pre- and post-transfer from child to adult healthcare for young people with three long-term illnesses. A total of 217 young people with cystic fibrosis, congenital heart defects or diabetes attending child and adult hospital services in Dublin, Ireland completed a questionnaire survey. Multiple linear regression was used to identify predictors of five dimensions of health-related quality of life pre- and post-transfer. Post-transfer young people with congenital heart disease and diabetes reported significantly lower physical well-being than their pre-transfer counterparts. Pre-transfer young people with cystic fibrosis reported significantly lower physical well-being than those with diabetes, but there was no significant difference post-transfer. Pre-transfer females reported lower scores than males on the Psychological Well-being and Autonomy and Parent Relation dimensions; however, these differences disappeared post-transfer. Higher maternal overprotection scores were associated with significantly lower scores on the Psychological Well-being, Autonomy and Parent Relation, and Social Support and Peers dimensions, regardless of transfer status. Disease group, gender and maternal overprotection were predictors of health-related quality of life pre- and post-transfer from child to adult healthcare. Transition programmes should promote self-management and discourage parental overprotection. © 2016 John Wiley & Sons Ltd.

  11. Severe vitamin D deficiency upon admission in critically ill patients is related to acute kidney injury and a poor prognosis.

    Science.gov (United States)

    Zapatero, A; Dot, I; Diaz, Y; Gracia, M P; Pérez-Terán, P; Climent, C; Masclans, J R; Nolla, J

    2018-05-01

    To evaluate the prevalence of vitamin D deficiency in critically ill patients upon admission to an Intensive Care Unit (ICU) and its prognostic implications. A single-center, prospective observational study was carried out from January to November 2015. Patients were followed-up on until death or hospital discharge. The department of Critical Care Medicine of a university hospital. All adults admitted to the ICU during the study period, without known factors capable of altering serum 25(OH)D concentration. Determination of serum 25(OH)D levels within the first 24h following admission to the ICU. Prevalence and mortality at 28 days. The study included 135 patients, of which 74% presented deficient serum 25(OH)D levels upon admission to the ICU. Non-survivors showed significantly lower levels than survivors (8.14ng/ml [6.17-11.53] vs. 12ng/ml [7.1-20.30]; P=.04], and the serum 25(OH)D levels were independently associated to mortality (OR 2.86; 95% CI 1.05-7.86; P=.04]. The area under the ROC curve was 0.61 (95% CI 0.51-0.75), and the best cut-off point for predicting mortality was 10.9ng/ml. Patients with serum 25(OH)D<10.9ng/ml also showed higher acute kidney injury rates (13 vs. 29%; P=.02). Vitamin D deficiency is highly prevalent upon admission to the ICU. Severe Vitamin D deficiency (25[OH]D<10.9ng/ml) upon admission to the ICU is associated to acute kidney injury and mortality. Copyright © 2017 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  12. High altitude illness

    Science.gov (United States)

    Hartman-Ksycińska, Anna; Kluz-Zawadzka, Jolanta; Lewandowski, Bogumił

    High-altitude illness is a result of prolonged high-altitude exposure of unacclimatized individuals. The illness is seen in the form of acute mountain sickness (AMS) which if not treated leads to potentially life-threatening high altitude pulmonary oedema and high-altitude cerebral oedema. Medical problems are caused by hypobaric hypoxia stimulating hypoxia-inducible factor (HIF) release. As a result, the central nervous system, circulation and respiratory system function impairment occurs. The most important factor in AMS treatment is acclimatization, withdrawing further ascent and rest or beginning to descent; oxygen supplementation, and pharmacological intervention, and, if available, a portable hyperbaric chamber. Because of the popularity of high-mountain sports and tourism better education of the population at risk is essential.

  13. A population-based study of sport and recreation-related head injuries treated in a Canadian health region.

    Science.gov (United States)

    Harris, Andrew W; Jones, C Allyson; Rowe, Brian H; Voaklander, Donald C

    2012-07-01

    To report the rates of SR-related HIs presenting to EDs in a Canadian population-based sample. Descriptive epidemiology study. Using administrative data, sport and recreation-related emergency department presentations for persons 0-35 years of age, from April 1997 through March 2008, were obtained from the Edmonton Zone (formerly the Capital Health Region), Alberta Health Services through the Ambulatory Care Classification System. Of the 3,230,890 visits to the emergency departments of the five hospitals in Edmonton, 63,219 sport and recreation-related injury records and 4935 sport and recreation-head injury records were identified. Head injuries were most frequently treated for the activities of hockey (20.7%), cycling (12.0%), and skiing/snowboarding/sledding. Males accounted for 71.9% (n=3546) and patients less than 18 years of age sustained 3446 (69.8%) sport and recreation-head injuries. Sport and recreation-related head injuries most frequently treated in emergency departments involve common activities such as hockey, cycling, skiing/snowboarding/sledding, and soccer. Males and those less than 18 years of age sustain the majority of sport and recreation-related head injuries treated in emergency departments. These findings underscore the importance of sport-specific policies and safety promotion for the prevention of head injuries, in sports and recreational activities. Copyright © 2011 Sports Medicine Australia. All rights reserved.

  14. Nutrition-related risk indexes and long-term mortality in noncritically ill inpatients who receive total parenteral nutrition (prospective multicenter study).

    Science.gov (United States)

    Tapia, María José; Ocón, Julia; Cabrejas-Gómez, Carmen; Ballesteros-Pomar, María D; Vidal-Casariego, Alfonso; Arraiza-Irigoyen, Carmen; Olivares, Josefina; Conde-García, Ma Carmen; García-Manzanares, Álvaro; Botella-Romero, Francisco; Quílez-Toboso, Rosa P; Cabrerizo, Lucio; Rubio, Miguel A; Chicharro, Luisa; Burgos, Rosa; Pujante, Pedro; Ferrer, Mercedes; Zugasti, Ana; Petrina, Estrella; Manjón, Laura; Diéguez, Marta; Carrera, Ma José; Vila-Bundo, Anna; Urgelés, Juan Ramón; Aragón-Valera, Carmen; Sánchez-Vilar, Olga; Bretón, Irene; García-Peris, Pilar; Muñoz-Garach, Araceli; Márquez, Efren; del Olmo, Dolores; Pereira, José Luis; Tous, María C; Olveira, Gabriel

    2015-10-01

    Malnutrition in hospitalized patients is associated with an increased risk of death, in both the short and the long term. The purpose of this study was to determine which nutrition-related risk index predicts long-term mortality better (three years) in patients who receive total parenteral nutrition (TPN). This prospective, multicenter study involved noncritically ill patients who were prescribed TPN during hospitalization. Data were collected on Subjective Global Assessment (SGA), Nutritional Risk Index (NRI), Geriatric Nutritional Risk Index (GNRI), body mass index, albumin and prealbumin, as well as long-term mortality. Over the 1- and 3-year follow-up periods, 174 and 244 study subjects (28.8% and 40.3%) respectively, died. Based on the Cox proportional hazards survival model, the nutrition-related risk indexes most strongly associated with mortality were SGA and albumin (Nutrition and Metabolism. All rights reserved.

  15. Surgical nurses' work-related stress when caring for severely ill and dying patients in cancer after participating in an educational intervention on existential issues.

    Science.gov (United States)

    Udo, Camilla; Danielson, Ella; Henoch, Ingela; Melin-Johansson, Christina

    2013-10-01

    The aim of this study was to describe surgical nurses' perceived work-related stress in the care of severely ill and dying patients with cancer after participating in an educational intervention on existential issues. This article reports a mixed methods pilot study of an education programme consisting of lectures and supervised discussions conducted in 2009-2010 in three surgical wards in a county hospital in Sweden. The concurrent data collections consisted of repeated interviews with eleven nurses in an educational group, and questionnaires were distributed to 42 nurses on four occasions. Directly after the educational intervention, the nurses described working under high time pressure. They also described being hindered in caring because of discrepancies between their caring intentions and what was possible in the surgical care context. Six months later, the nurses described a change in decision making, and a shift in the caring to make it more in line with their own intentions and patients' needs rather than the organizational structure. They also reported decreased feelings of work-related stress, decreased stress associated with work-load and feeling less disappointed at work. Results indicate that it may be possible to influence nurses' work-related stress through an educational intervention. According to nurses' descriptions, reflecting on their ways of caring for severely ill and dying patients, many of whom had cancer, from an existential perspective, had contributed to enhanced independent decision making in caring. This in turn appears to have decreased their feelings of work-related stress and disappointment at work. Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. Diabetic status and the relation of the three domains of glycemic control to mortality in critically ill patients: an international multicenter cohort study.

    Science.gov (United States)

    Krinsley, James S; Egi, Moritoki; Kiss, Alex; Devendra, Amin N; Schuetz, Philipp; Maurer, Paula M; Schultz, Marcus J; van Hooijdonk, Roosmarijn T M; Kiyoshi, Morita; Mackenzie, Iain M J; Annane, Djillali; Stow, Peter; Nasraway, Stanley A; Holewinski, Sharon; Holzinger, Ulrike; Preiser, Jean-Charles; Vincent, Jean-Louis; Bellomo, Rinaldo

    2013-03-01

    Hyperglycemia, hypoglycemia, and increased glycemic variability have each been independently associated with increased risk of mortality in critically ill patients. The role of diabetic status on modulating the relation of these three domains of glycemic control with mortality remains uncertain. The purpose of this investigation was to determine how diabetic status affects the relation of hyperglycemia, hypoglycemia, and increased glycemic variability with the risk of mortality in critically ill patients. This is a retrospective analysis of prospectively collected data involving 44,964 patients admitted to 23 intensive care units (ICUs) from nine countries, between February 2001 and May 2012. We analyzed mean blood glucose concentration (BG), coefficient of variation (CV), and minimal BG and created multivariable models to analyze their independent association with mortality. Patients were stratified according to the diagnosis of diabetes. Among patients without diabetes, mean BG bands between 80 and 140 mg/dl were independently associated with decreased risk of mortality, and mean BG bands>or=140 mg/dl, with increased risk of mortality. Among patients with diabetes, mean BG from 80 to 110 mg/dl was associated with increased risk of mortality and mean BG from 110 to 180 mg/dl with decreased risk of mortality. An effect of center was noted on the relation between mean BG and mortality. Hypoglycemia, defined as minimum BGor=20%, was independently associated with increased risk of mortality only among patients without diabetes. Derangements of more than one domain of glycemic control had a cumulative association with mortality, especially for patients without diabetes. Although hyperglycemia, hypoglycemia, and increased glycemic variability is each independently associated with mortality in critically ill patients, diabetic status modulates these relations in clinically important ways. Our findings suggest that patients with diabetes may benefit from higher glucose

  17. Improvement of health-related quality of life and work productivity in chronic hepatitis C patients with early and advanced fibrosis treated with ledipasvir and sofosbuvir.

    Science.gov (United States)

    Younossi, Zobair M; Stepanova, Maria; Afdhal, Nezam; Kowdley, Kris V; Zeuzem, Stefan; Henry, Linda; Hunt, Sharon L; Marcellin, Patrick

    2015-08-01

    New interferon-free anti-HCV regimens are highly efficacious with a favorable safety profile. We assessed health-related quality of life (HRQL) and work productivity in patients with different stages of hepatic fibrosis treated with sofosbuvir+ledipasvir. Four questionnaires [Chronic Liver Disease Questionnaire-HCV (CLDQ-HCV), Short Form-36 (SF-36), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), Work Productivity and Activity Index:Specific Health Problem (WPAI:SHP)] were administered at baseline, during, and after treatment with sofosbuvir+ledipasvir+ribavirin or sofosbuvir+ledipasvir (ION-1,2,3 clinical trials). Metavir fibrosis stage was determined from pre-treatment liver biopsies. There were 1005 patients included (stage F0: n=94; F1: n=311; F2: n=301; F3: n=197; F4: n=102). At baseline, patients with more advanced fibrosis had more HRQL impairments, predominantly related to physical functioning (stage 0 vs. stage 4 by up to 0.126 on a normalized 0-1 scale p0.05 across fibrosis stages). In multivariate analysis, advanced fibrosis was independently associated with impairment of HRQL and work productivity (beta up to -0.056 in comparison with none-to-mild fibrosis, pwork productivity after viral clearance was not related to the stage of fibrosis (all p>0.05). Although advanced hepatic fibrosis is associated with HRQL and work productivity impairment, viral eradication with sofosbuvir+ledipasvir leads to HRQL improvement regardless of fibrosis stage. HCV patients with early fibrosis experience similar improvement of patient reported outcomes as those with advanced fibrosis. Copyright © 2015 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

  18. Health-related quality of life for pediatric emergency department febrile illnesses: an Evaluation of the Pediatric Quality of Life Inventory™ 4.0 generic core scales

    Directory of Open Access Journals (Sweden)

    Stevens Molly W

    2009-01-01

    Full Text Available Abstract Objective We sought to assess the validity and short-term responsiveness of the Pediatric Quality of Life Inventory™ 4.0 Generic Core Scales (PedsQL™ for febrile illnesses evaluated in the pediatric emergency department (ED. Design Prospective cohort study of children 2–18 years discharged after ED evaluation for fever (≥ 38°C. Self-administered, parent-report of health-related quality of life (HRQOL was assessed using the PedsQL™ Acute Version, a validated HRQOL instrument. HRQOL was measured on ED presentation and at 7–10 day follow-up. At follow-up, duration of fever, child functional impairment, missed daycare/school, and disrupted family unit functioning, were assessed. Results Of 160 subjects enrolled, 97 (61% completed the study; mean follow-up was 8.7 days. Mean total HRQOL score on ED presentation was 76.4; mean follow-up score was 86.3. Compared to subjects that returned to baseline, statistically significant differences in HRQOL were noted for those with prolonged fever, child functional impairment, and relapse. Significant correlation was observed between HRQOL at follow-up and days of daycare/school missed (r = -0.35, p = .003 and days of family disruption (r = -0.43, p Conclusion The PedsQL™ appears to be a valid and responsive indicator of HRQOL for short-term febrile illnesses evaluated in the ED.

  19. Correlates of Illness Severity in Infectious Mononucleosis

    Directory of Open Access Journals (Sweden)

    John Odame

    2014-01-01

    Full Text Available INTRODUCTION: Understanding the spectrum and frequencies of Epstein-Barr virus (EBV complications and markers of illness severity in immunocompetent patients with primary EBV infection will inform management of patients with EBV-related illnesses.

  20. Fatigue and fatigue-related symptoms in patients treated for different causes of hypothyroidism

    NARCIS (Netherlands)

    Louwerens, M.; Appelhof, B.C.; Verloop, H.; Medici, M.; Peeters, R.P.; Visser, T.J.; Boelen, A.; Fliers, E.; Smit, J.W.A.; Dekkers, O.M.

    2012-01-01

    OBJECTIVE: Research on determinants of well-being in patients on thyroid hormone replacement therapy is warranted, as persistent fatigue-related complaints are common in this population. In this study, we evaluated the impact of different states of hypothyroidism on fatigue and fatigue-related

  1. Fatigue and fatigue-related symptoms in patients treated for different causes of hypothyroidism

    NARCIS (Netherlands)

    Louwerens, Marloes; Appelhof, Bente C.; Verloop, Herman; Medici, Marco; Peeters, Robin P.; Visser, Theo J.; Boelen, Anita; Fliers, Eric; Smit, Johannes W. A.; Dekkers, Olaf M.

    2012-01-01

    Objective: Research on determinants of well-being in patients on thyroid hormone replacement therapy is warranted, as persistent fatigue-related complaints are common in this population. In this study, we evaluated the impact of different states of hypothyroidism on fatigue and fatigue-related

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

    Science.gov (United States)

    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.

  3. Embarrassment When Illness Strikes A Close Relative: A World Mental Health Survey Consortium Multi-Site Study

    Science.gov (United States)

    Ahmedani, Brian K.; Kubiak, Sheryl Pimlott; Kessler, Ronald C.; de Graaf, Ron; Alonso, Jordi; Bruffaerts, Ronny; Zarkov, Zahari; Viana, Maria Carmen; Huang, Y.Q.; Hu, Chiyi; Posada-Villa, Jose A.; Lepine, Jean-Pierre; Angermeyer, Matthias C.; de Girolamo, Giovanni; Karam, Aimee N.; Medina-Mora, Maria Elena; Gureje, Oye; Ferry, Finola; Sagar, Rajesh; Anthony, James C.

    2014-01-01

    Background This global study seeks to estimate the degree to which a family member might feel embarrassed when a close relative is suffering from an alcohol, drug, or mental health condition (ADMC) versus a general medical condition (GMC). To date, most studies have considered embarrassment and stigma in society and internalized by the afflicted individual, but have not assessed family embarrassment in a large scale study. Method In 16 sites of the World Mental Health Surveys (WMHS), standardized assessments were completed including items on family embarrassment. Site matching was used to constrain local socially shared determinants of stigma-related feelings, enabling a conditional logistic regression model that estimates the embarrassment close relatives may hold in relation to family members affected by an ADMC, GMC, or both conditions. Results There was a statistically robust association such that subgroups with an ADMC-affected relative were more likely to feel embarrassed as compared to subgroups with a relative affected by a GMC (p<0.001), even with covariate adjustments for age and sex. Conclusions The pattern of evidence from this research is consistent with conceptual models for interventions that target individual- and family-level stigma-related feelings of embarrassment as might be part of the obstacles to effective early intervention and treatment for ADMC conditions. Macro-level interventions are underway, but micro-level interventions also may be required among family members, along with care for each person with an ADMC. PMID:23298443

  4. Boxing, Wrestling, and Martial Arts Related Injuries Treated in Emergency Departments in the United States, 2002-2005

    OpenAIRE

    Pappas, Evangelos

    2007-01-01

    The incidence of injury in combat sports has not been adequately reported although it is important to identify the nature and frequency of injuries prior to the implementation of prevention programs. This study compared injury rates treated in Hospital Emergency Departments between different combat sports of boxing, wrestling, and martial arts. A secondary objective described anatomic region and diagnosis of these injuries. Data were obtained on all boxing, wrestling, and martial arts-related...

  5. Can diabetes be treated as an indirectly work-related disease?

    Directory of Open Access Journals (Sweden)

    Andrzej Marcinkiewicz

    2017-10-01

    Full Text Available In this article the authors attempted to analyze the arguments for considering diabetes as a work-related disease. An overview of literature has been done out of articles published in the years 1980–2016, with the use of combination of key words referring to employment, workplace, and diabetes. The PubMed database was the source of data. The authors indicate that the following arguments are in favor of diabetes being recognized as a work-related disease: diabetes is not an occupational disease, it is not directly related to the work environment or the way the work is performed, but there are observed adverse effects of occupational work-related nuisances, such as night shift work, long work hours, job strain or workplace standing time, which influence its development and course. The number of publications on diabetes, including the problem of occupational work is comparable to the number of analogous publications concerning work-related diseases such as hypertension or ischemic heart disease. Moreover, some aspects of professional activity and diabetes were also included in clinical recommendations for the workplace, which is uncommon in the case of other diseases, even those generally recognized as work-related. Data from medical references, indicating the effectiveness of workplace interventions aimed at preventing diabetes development and/or worsening of its course should be considered as an argument for the inclusion of diabetes into the group of work-related diseases. This should also support the need for further research and practical actions aimed at preventing diabetes at the workplace. Med Pr 2017;68(5:667–675

  6. Factors related to psychotherapists' self-assessment when treating anxiety and other disorders.

    Science.gov (United States)

    Parker, Zachary J; Waller, Glenn

    2015-03-01

    The aim of the study was to replicate and extend recent findings regarding therapists' self-assessment biases. This study examined clinicians' estimates of their abilities when working with general clinical groups and with anxious patients, and of the recovery/improvement rates of their clients. It also considered what clinician personality traits and clinical practice elements were associated with such estimates. A total of 195 out 801 clinicians completed a survey regarding self-ratings, team ratings, therapy outcomes for their clients, and their own personality traits. The great majority of clinicians rated themselves and their teams as being better clinicians than their peers, though not to as extreme a level as in the previous study. They also reported exceptionally positive therapy outcomes. Due to the large proportion of non-responders, it is possible that these findings do not reflect actual self-assessment bias, but a greater willingness to participate among clinicians who are more skilled and with particular personality styles. However, the data suggest that perceptions of skill and therapy outcome might be associated with clinician personality characteristics, though not with other clinical practice variables. These interpretations should be treated with caution due to the limited response rate. Different possible explanations for these patterns of self-assessment are outlined, including conscious and unconscious processes. Methods for enhancing accurate skill perception are discussed, including self-monitoring and supervision. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Do single and partnered women with gynecologic cancer differ in types and intensities of illness- and treatment-related psychosocial concerns? A pilot study.

    Science.gov (United States)

    de Groot, Janet M; Mah, Kenneth; Fyles, Anthony; Winton, Susan; Greenwood, Sarah; DePetrillo, Denny; Devins, Gerald M

    2007-09-01

    We compared the psychosocial and psychosexual concerns of single and partnered women with gynecologic cancer, since relationship status and psychosocial context are known to affect sexuality, a life domain commonly affected by this cancer. A cross-sectional convenience sample of 49 women (68% response), with ovarian (n=31), endometrial (n=12), and cervical (n=6) cancer, responded to a 72-item self-report Cancer Concerns Questionnaire and additional psychosocial questionnaires. Single (n=13) and partnered women (n=36) similarly reported prognosis as their highest concern, but single women (26% of the sample) reported that communication with the treatment team, treatment side effects, and prognosis were of greater salience to them than did partnered women. The latter group had greater sexuality and partner relationship concerns. These preliminary findings suggest that relationship status, whether partnered or single, influences current psychosocial concerns among women with gynecologic cancer, despite similar levels of illness- and treatment-related intrusions on important life domains.

  8. How medical technologies shape the experience of illness.

    Science.gov (United States)

    Hofmann, Bjørn; Svenaeus, Fredrik

    2018-02-03

    In this article we explore how diagnostic and therapeutic technologies shape the lived experiences of illness for patients. By analysing a wide range of examples, we identify six ways that technology can (trans)form the experience of illness (and health). First, technology may create awareness of disease by revealing asymptomatic signs or markers (imaging techniques, blood tests). Second, the technology can reveal risk factors for developing diseases (e.g., high blood pressure or genetic tests that reveal risks of falling ill in the future). Third, the technology can affect and change an already present illness experience (e.g., the way blood sugar measurement affects the perceived symptoms of diabetes). Fourth, therapeutic technologies may redefine our experiences of a certain condition as diseased rather than unfortunate (e.g. assisted reproductive technologies or symptom based diagnoses in psychiatry). Fifth, technology influences illness experiences through altering social-cultural norms and values regarding various diagnoses. Sixth, technology influences and changes our experiences of being healthy in contrast and relation to being diseased and ill. This typology of how technology forms illness and related conditions calls for reflection regarding the phenomenology of technology and health. How are medical technologies and their outcomes perceived and understood by patients? The phenomenological way of approaching illness as a lived, bodily being-in-the-world is an important approach for better understanding and evaluating the effects that medical technologies may have on our health, not only in defining, diagnosing, or treating diseases, but also in making us feel more vulnerable and less healthy in different regards.

  9. Outcomes of critically ill intensive care unit patients treated with fosfomycin for infections due to pandrug-resistant and extensively drug-resistant carbapenemase-producing Gram-negative bacteria.

    Science.gov (United States)

    Pontikis, Konstantinos; Karaiskos, Ilias; Bastani, Styliani; Dimopoulos, George; Kalogirou, Michalis; Katsiari, Maria; Oikonomou, Angelos; Poulakou, Garyphallia; Roilides, Emmanuel; Giamarellou, Helen

    2014-01-01

    Fosfomycin is active in vitro against extensively drug-resistant (XDR) and pandrug-resistant (PDR) Pseudomonas aeruginosa and Klebsiella pneumoniae carbapenemase-producing strains; however, the in vivo effectiveness against such pathogens is almost unknown. A multicentre, observational, prospective case-series study was performed in 11 ICUs. All consecutive fosfomycin-treated patients suffering from XDR or PDR fosfomycin-susceptible, microbiologically documented infections were recorded. Clinical and microbiological outcomes were assessed. A safety analysis was performed. In total, 68 patients received fosfomycin during the study period, 48 of whom were considered suitable for effectiveness analysis based on predefined criteria. Bacteraemia and ventilator-associated pneumonia were the main infections. Carbapenemase-producing K. pneumoniae and P. aeruginosa were isolated in 41 and 17 cases, respectively. All isolates exhibited an XDR or PDR profile, being fosfomycin-susceptible by definition. Fosfomycin was administered intravenously at a median dose of 24g/day for a median of 14 days, mainly in combination with colistin or tigecycline. Clinical outcome at Day 14 was successful in 54.2% of patients, whilst failure, indeterminate outcome and superinfection were documented in 33.3%, 6.3% and 6.3%, respectively. All-cause mortality at Day 28 was 37.5%. Bacterial eradication was observed in 56.3% of cases. Fosfomycin resistance developed in three cases. The main adverse event was reversible hypokalaemia. In conclusion, fosfomycin could have a place in the armamentarium against XDR and PDR Gram-negative infections in the critically ill. Resistance development during therapy, which has been a matter of concern in previous studies, did not occur frequently. The necessity of combination with other antibiotics requires further investigation. Copyright © 2013 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

  10. Taking cognizance of mental illness in schizophrenics and its association with crime and substance-related diagnoses.

    Science.gov (United States)

    Munkner, R; Haastrup, S; Jørgensen, T; Andreasen, A H; Kramp, P

    2003-02-01

    To analyse how committed crimes and substance-related diagnoses are associated with the age on the first contact with the psychiatric hospital system and the age at diagnosing of schizophrenia among schizophrenics. In a register-based study including all Danes diagnosed with schizophrenia born after November 1, 1963, data on criminality, substance-related diagnoses and contacts with the psychiatric hospital system were analysed. Compared with the non-convicted schizophrenics the convicted were older on first contact with the psychiatric hospital system and older when the diagnosis of schizophrenia was first given. In contrast, having a substance-related diagnosis was associated with a younger age on first contact but did not influence the age at which the diagnosis of schizophrenia was given. It is important that both psychiatrists and the judicial system are aware of possible psychotic symptoms in criminal and abusing individuals to enable earlier detection and treatment.

  11. Illness perceptions among cancer survivors.

    Science.gov (United States)

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

    2016-03-01

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

  12. Common pitfalls in statistical analysis: Absolute risk reduction, relative risk reduction, and number needed to treat

    Science.gov (United States)

    Ranganathan, Priya; Pramesh, C. S.; Aggarwal, Rakesh

    2016-01-01

    In the previous article in this series on common pitfalls in statistical analysis, we looked at the difference between risk and odds. Risk, which refers to the probability of occurrence of an event or outcome, can be defined in absolute or relative terms. Understanding what these measures represent is essential for the accurate interpretation of study results. PMID:26952180

  13. Coronary artery bypass grafting-related bleeding complications in patients treated with dual antiplatelet treatment

    NARCIS (Netherlands)

    Tomšič, Anton; Schotborgh, Mark A.; Manshanden, Johan S. J.; Li, Wilson W. L.; de Mol, Bas A. J. M.

    2016-01-01

    To evaluate the relationship between the timing of either ticagrelor or clopidogrel discontinuation and bleeding-related complications in patients undergoing isolated on-pump coronary artery bypass grafting (CABG). Between January 2012 and December 2014, 705 consecutive patients underwent isolated

  14. Coronary artery bypass grafting-related bleeding complications in patients treated with dual antiplatelet treatment.

    NARCIS (Netherlands)

    Tomsic, A.; Schotborgh, M.A.; Manshanden, J.S.; Li, W.W.L.; Mol, B.A. de

    2016-01-01

    OBJECTIVES: To evaluate the relationship between the timing of either ticagrelor or clopidogrel discontinuation and bleeding-related complications in patients undergoing isolated on-pump coronary artery bypass grafting (CABG). METHODS: Between January 2012 and December 2014, 705 consecutive patients

  15. Fatigue and fatigue-related symptoms in patients treated for different causes of hypothyroidism

    NARCIS (Netherlands)

    J.W.K. Louwerens; B.C. Appelhof (Bente); H. Verloop (Herman); M. Medici (Marco); R.P. Peeters (Robin); T.J. Visser (Theo); A. Boelen (Anita); E. Fliers (Eric); J.W.A. Smit (Jan); O.M. Dekkers (Olaf)

    2012-01-01

    textabstractObjective: Research on determinants of well-being in patients on thyroid hormone replacement therapy is warranted, as persistent fatigue-related complaints are common in this population. In this study, we evaluated the impact of different states of hypothyroidism on fatigue and

  16. Taking cognizance of mental illness in schizophrenics and its association with crime and substance-related diagnoses

    DEFF Research Database (Denmark)

    Munkner, R; Haastrup, S; Jørgensen, T

    2003-01-01

    with schizophrenia born after November 1, 1963, data on criminality, substance-related diagnoses and contacts with the psychiatric hospital system were analysed. RESULTS: Compared with the non-convicted schizophrenics the convicted were older on first contact with the psychiatric hospital system and older when...... are aware of possible psychotic symptoms in criminal and abusing individuals to enable earlier detection and treatment....

  17. Taking cognizance of mental illness in schizophrenics and its association with crime and substance-related diagnoses

    DEFF Research Database (Denmark)

    Munkner, R; Haastrup, S; Jørgensen, T

    2003-01-01

    OBJECTIVE: To analyse how committed crimes and substance-related diagnoses are associated with the age on the first contact with the psychiatric hospital system and the age at diagnosing of schizophrenia among schizophrenics. METHOD: In a register-based study including all Danes diagnosed with sc...

  18. Taking cognizance of mental illness in schizophrenics and its association with crime and substance-related diagnoses

    DEFF Research Database (Denmark)

    Munkner, R; Haastrup, S; Jørgensen, T

    2003-01-01

    the diagnosis of schizophrenia was first given. In contrast, having a substance-related diagnosis was associated with a younger age on first contact but did not influence the age at which the diagnosis of schizophrenia was given. CONCLUSION: It is important that both psychiatrists and the judicial system...

  19. Lung Microbiota Is Related to Smoking Status and to Development of Acute Respiratory Distress Syndrome in Critically Ill Trauma Patients.

    Science.gov (United States)

    Panzer, Ariane R; Lynch, Susan V; Langelier, Chaz; Christie, Jason D; McCauley, Kathryn; Nelson, Mary; Cheung, Christopher K; Benowitz, Neal L; Cohen, Mitchell J; Calfee, Carolyn S

    2018-03-01

    Cigarette smoking is associated with increased risk of acute respiratory distress syndrome (ARDS) in patients after severe trauma; however, the mechanisms underlying this association are unknown. To determine whether cigarette smoking contributes to ARDS development after trauma by altering community composition of the lung microbiota. We studied the lung microbiota of mechanically ventilated patients admitted to the ICU after severe blunt trauma. To do so, we used 16S ribosomal RNA gene amplicon sequencing of endotracheal aspirate samples obtained on ICU admission (n = 74) and at 48 hours after admission (n = 30). Cigarette smoke exposure (quantified using plasma cotinine), ARDS development, and other clinical parameters were correlated with lung microbiota composition. Smoking status was significantly associated with lung bacterial community composition at ICU admission (P = 0.007 by permutational multivariate ANOVA [PERMANOVA]) and at 48 hours (P = 0.03 by PERMANOVA), as well as with significant enrichment of potential pathogens, including Streptococcus, Fusobacterium, Prevotella, Haemophilus, and Treponema. ARDS development was associated with lung community composition at 48 hours (P = 0.04 by PERMANOVA) and was characterized by relative enrichment of Enterobacteriaceae and of specific taxa enriched at baseline in smokers, including Prevotella and Fusobacterium. After severe blunt trauma, a history of smoking is related to lung microbiota composition, both at the time of ICU admission and at 48 hours. ARDS development is also correlated with respiratory microbial community structure at 48 hours and with taxa that are relatively enriched in smokers at ICU admission. The data derived from this pilot study suggest that smoking-related changes in the lung microbiota could be related to ARDS development after severe trauma.

  20. Paraprotein–Related Kidney Disease: Diagnosing and Treating Monoclonal Gammopathy of Renal Significance

    Science.gov (United States)

    Rosner, Mitchell H.; Edeani, Amaka; Yanagita, Motoko; Glezerman, Ilya G.

    2016-01-01

    Paraprotein–related kidney disease represents a complex group of diseases caused by an abnormal paraprotein secreted by a clone of B cells. The disease manifestations range from tubulopathies, such as the Fanconi syndrome, to a spectrum of glomerular diseases that can present with varying degrees of proteinuria and renal dysfunction. Diagnosis of these diseases can be challenging because of the wide range of manifestations as well as the relatively common finding of a serum paraprotein, especially in elderly patients. Thus, renal biopsy along with detailed hematologic workup is essential to link the presence of the paraprotein to the associated renal disease. Recent advances in treatment with more effective and targeted chemotherapies, as well as stem cell transplantation, have improved the renal and overall prognosis for many of these disorders. PMID:27526705

  1. Stress, glucocorticoids and memory: implications for treating fear-related disorders.

    Science.gov (United States)

    de Quervain, Dominique; Schwabe, Lars; Roozendaal, Benno

    2017-01-01

    Glucocorticoid stress hormones are crucially involved in modulating mnemonic processing of emotionally arousing experiences. They enhance the consolidation of new memories, including those that extinguish older memories, but impair the retrieval of information stored in long-term memory. As strong aversive memories lie at the core of several fear-related disorders, including post-traumatic stress disorder and phobias, the memory-modulating properties of glucocorticoids have recently become of considerable translational interest. Clinical trials have provided the first evidence that glucocorticoid-based pharmacotherapies aimed at attenuating aversive memories might be helpful in the treatment of fear-related disorders. Here, we review important advances in the understanding of how glucocorticoids mediate stress effects on memory processes, and discuss the translational potential of these new conceptual insights.

  2. Hypomagnesemia and mild rhabdomyolysis in living related donor renal transplant recipient treated with cyclosporine A.

    Science.gov (United States)

    Cavdar, C; Sifil, A; Sanli, E; Gülay, H; Camsari, T

    1998-12-01

    Since cyclosporine A (CsA) had been used in renal transplant recipients, important improvements in short-term and long-term graft survivals have been detected. In spite of these improvements CsA seems to have several adverse effects. First, CsA leads to nephrotoxicity. Moreover, CsA affects the other organs and systems (skin, liver, nervous system, etc.) and causes, increased risks of infections and malignancies. Hypomagnesemia is one of the side effects of CsA therapy, but it is a rare condition in living related donor renal transplant recipients. It may also cause multi-system dysfunction, especially hypocalcemia and hypokalemia, which cannot be corrected without magnesium therapy. In addition, rhabdomyolysis was detected in animals, but it has not been reported in living related donor renal transplant recipients. In this case report, a living related donor renal transplant recipient who suffered from hypomagnesemia and mild rhabdomyolysis due to CsA therapy will be described and discussed.

  3. Football-related injuries among 6- to 17-year-olds treated in US emergency departments, 1990-2007.

    Science.gov (United States)

    Nation, Adam D; Nelson, Nicolas G; Yard, Ellen E; Comstock, R Dawn; McKenzie, Lara B

    2011-03-01

    Football is one of the most popular youth sports in the United States despite the high rate of injuries. Previously published studies have investigated football-related injuries that occurred in organized play but have excluded those that occurred during unorganized play. Through use of the National Electronic Injury Surveillance System database, cases of football-related injuries were identified for analysis. Sample weights were used to calculate national estimates. An estimated 5 252 721 children and adolescents 6 to 17 years old were treated in US emergency departments for football-related injuries. The annual number of cases increased by 26.5% over the 18-year study period. The 12- to 17-year-old age group accounted for 77.8% of all injuries and had nearly twice the odds of sustaining a concussion. The findings suggest the need for increased prevention efforts to lower the risk of football-related injury in children and adolescents.

  4. Alterations in brain structures related to taste reward circuitry in ill and recovered anorexia nervosa and in bulimia nervosa.

    Science.gov (United States)

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

    2013-10-01

    The pathophysiology of anorexia nervosa remains obscure, but structural brain alterations could be functionally important biomarkers. The authors assessed taste pleasantness and reward sensitivity in relation to brain structure, which may be related to food avoidance commonly seen in eating disorders. The authors used structural MR imaging to study gray and white matter volumes in women with current restricting-type anorexia nervosa (N=19), women recovered from restricting-type anorexia nervosa (N=24), women with bulimia nervosa (N=19), and healthy comparison women (N=24). All eating disorder groups exhibited increased gray matter volume of the medial orbitofrontal cortex (gyrus rectus). Manual tracing confirmed larger gyrus rectus volume, and volume predicted taste pleasantness ratings across all groups. Analyses also indicated other morphological differences between diagnostic categories. Antero-ventral insula gray matter volumes were increased on the right side in the anorexia nervosa and recovered anorexia nervosa groups and on the left side in the bulimia nervosa group relative to the healthy comparison group. Dorsal striatum volumes were reduced in the recovered anorexia nervosa and bulimia nervosa groups and predicted sensitivity to reward in all three eating disorder groups. The eating disorder groups also showed reduced white matter in right temporal and parietal areas relative to the healthy comparison group. The results held when a range of covariates, such as age, depression, anxiety, and medications, were controlled for. Brain structure in the medial orbitofrontal cortex, insula, and striatum is altered in eating disorders and suggests altered brain circuitry that has been associated with taste pleasantness and reward value.

  5. The Burden of Illness Related to Chronic Obstructive Pulmonary Disease Exacerbations in Québec, Canada

    Directory of Open Access Journals (Sweden)

    Tam Dang-Tan

    2017-01-01

    Full Text Available Background. Chronic obstructive pulmonary disease (COPD prevalence in Canada has risen over time. COPD-related exacerbations contribute to the increased health care utilization (HCU in this population. This study investigated the impact of exacerbations on COPD-related HCU. Methods. This retrospective observational cohort study used patient data from the Québec provincial health insurance databases. Eligible patients with a new HCU claim with a diagnostic billing for COPD during 2001–2010 were followed until March 31, 2011. Exacerbation rates and time to first exacerbation were assessed. Unadjusted analyses and multivariable models compared the rate of HCU by exacerbation classification (any [moderate/severe], moderate, or severe. Results. The exacerbation event rate in patients with an exacerbation was 34.3 events/100 patient-years (22.7 for moderate exacerbations and 11.6 for severe exacerbations. Median time to first exacerbation of any classification was 37 months. In unadjusted analyses, COPD-related HCU significantly increased with exacerbation severity. In the multivariable, HCU rates were significantly higher after exacerbation versus before exacerbation (p<0.01 for patients with an exacerbation or moderate exacerbations. For severe exacerbations, general practitioner, respiratory specialist, emergency room, and hospital visits were significantly higher after exacerbation versus before exacerbation (p<0.001. Conclusions. Exacerbations were associated with increased HCU, which was more pronounced for patients with severe exacerbations. Interventions to reduce the risk of exacerbations in patients with COPD may reduce disease burden.

  6. Risk factors influencing dentists' hepatitis B-related knowledge and attitudes and their willingness to treat hepatitis B positive patients.

    Science.gov (United States)

    Khosravanifard, B; Rakhshan, V; Sherafat, S; Najafi-Salehi, L

    2015-02-25

    This study assessed factors that could predict dentists' knowledge, attitudes and behaviour towards hepatitis B virus (HBV). A total of 300 dentists in Tehran, Islamic Republic of Iran were surveyed and their demographic, educational and office characteristics were analysed in relation to their scores on knowledge about HBV, self-reported attitudes towards treating people infected with HBV and actual behaviour towards treating simulated HBV-positive patients. Having a Master's degree, faculty membership, taking ≥ 3 continuing education courses, wearing eye-shields, spending more time on preparing dental units and higher self-confidence about knowledge predicted better knowledge. A positive attitude was associated with having attended more courses and working in group practice. The number of courses and a shorter dental unit preparation time positively affected dentists' behaviour.

  7. Serum BDNF levels in relation to illness severity, suicide attempts, and central serotonin activity in patients with major depressive disorder: a pilot study.

    Science.gov (United States)

    Park, Young-Min; Lee, Bun-Hee; Um, Tae Hyun; Kim, Sollip

    2014-01-01

    The aim of this study was to test the hypothesis that serum levels of brain-derived neurotrophic factor (BDNF) are correlated with the loudness dependence of auditory evoked potentials (LDAEP). The question of whether there is a difference in BDNF levels between depressive patients according to their illness severity, history of suicide attempts, and central serotonin activity was also addressed. A sample of 51 patients who met the criteria for major depressive disorder following diagnosis using axis I of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders - text revision comprised the study subjects. The patients were stratified into two subgroups based on their illness severity, history of suicide attempts, and their LDAEP values. The LDAEP was evaluated by measuring the auditory event-related potentials, and serum BDNF was measured using blood sampling before beginning medication with serotonergic agents. There was no difference in serum BDNF levels between the two patient subgroups. The subgroup with moderate-to-severe depression (n = 16) was reanalyzed after stratifying it into two subgroups according to LDAEP and BDNF values (dichotomized at the medians into low and high). The high-LDAEP subgroup had higher serum BDNF levels and total Barratt Impulsiveness Scale score than the low-LDAEP subgroup (p = 0.03 and 0.036, respectively). Serum BDNF levels were positively correlated with LDAEP and total Beck Hopelessness Scale (BHS) score (r = 0.56, p = 0.025, and r = 0.59, p = 0.016, respectively). The high-BDNF subgroup had a higher LDAEP and total BHS score than the low-BDNF subgroup (p = 0.046 and p = 0.011, respectively). This is the first study to demonstrate a relationship between the BDNF level and LDAEP in Asian depressive patients. Intriguingly, the high-BDNF subgroup (divided according to illness severity) exhibited a more severe psychopathology on some psychometric rating scales, a finding that

  8. Promising technological innovations in cognitive training to treat eating-related behavior.

    Science.gov (United States)

    Forman, Evan M; Goldstein, Stephanie P; Flack, Daniel; Evans, Brittney C; Manasse, Stephanie M; Dochat, Cara

    2018-05-01

    One potential reason for the suboptimal outcomes of treatments targeting appetitive behavior, such as eating and alcohol consumption, is that they do not target the implicit cognitive processes that may be driving these behaviors. Two groups of related neurocognitive processes that are robustly associated with dysregulated eating and drinking are attention bias (AB; selective attention to specific stimuli) and executive function (EF; a set of cognitive control processes such as inhibitory control, working memory, set shifting, that govern goal-directed behaviors). An increasing body of work suggests that EF and AB training programs improve regulation of appetitive behaviors, especially if trainings are frequent and sustained. However, several key challenges, such as adherence to the trainings in the long term, and overall potency of the training, remain. The current manuscript describes five technological innovations that have the potential to address difficulties related to the effectiveness and feasibility of EF and AB trainings: (1) deployment of training in the home, (2) training via smartphone, (3) gamification, (4) virtual reality, and (5) personalization. The drawbacks of these innovations, as well as areas for future research, are also discussed. The above-mentioned innovations are likely to be instrumental in the future empirical work to develop and evaluate effective EF and AB trainings for appetitive behaviors. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. MACULAR ATROPHY FINDINGS BY OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY COMPARED WITH FUNDUS AUTOFLUORESCENCE IN TREATED EXUDATIVE AGE-RELATED MACULAR DEGENERATION.

    Science.gov (United States)

    Takasago, Yukari; Shiragami, Chieko; Kobayashi, Mamoru; Osaka, Rie; Ono, Aoi; Yamashita, Ayana; Tsujikawa, Akitaka; Hirooka, Kazuyuki

    2017-11-28

    To compare the areas of choriocapillaris (CC) nonperfusion and macular atrophy (MA) in treated exudative age-related macular degeneration. This was a prospective, observational, cross-sectional study. Forty-four eyes exhibiting MA (42 patients with age-related macular degeneration), with a dry macula, underwent fundus autofluorescence and optical coherence tomography angiography. The area of MA detected by fundus autofluorescence and CC nonperfusion detected by optical coherence tomography angiography was measured using image analysis software. The rates of concordance between the MA and CC nonperfusion areas were calculated. We qualitatively and quantitatively compared the areas of MA and CC nonperfusion in age-related macular degeneration eyes. The mean areas of MA and CC nonperfusion were 5.95 ± 4.50 mm and 10.66 ± 7.05 mm, respectively (paired t-test, P autofluorescence matching optical coherence tomography angiography showed that the CC nonperfusion area was almost included in the MA area. The mean concordance rate for the MA area inside the CC nonperfusion area was 87.7 ± 13.9%. The MA and CC nonperfusion areas markedly overlapped. The area of CC nonperfusion correlated with the MA area. Choroidal ischemia might be involved in the pathogenesis of MA in treated age-related macular degeneration.This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  10. Benefits of Medical Home Care Reaching Beyond Chronically Ill Teens: Exploring Parent Health-Related Quality of Life.

    Science.gov (United States)

    Chavez, Laura J; Grannis, Connor; Dolce, Millie; Chisolm, Deena J

    2018-03-15

    Caring for teens with special health care needs places physical and mental health burdens on parents, which can be exacerbated by the stresses of transitions to independence. Medical homes can improve teen transitions to greater self-management and reduce health care-related time and financial burdens for families. We examined the association between parent-reported teen medical home status and caregiver health-related quality of life (HRQOL). The study sample included parents or caregivers of teens with special health care needs aged 15 to 18 recruited from a pediatric Medicaid accountable care organization who participated in a survey (response rate, 40.5%). The primary outcome was parent HRQOL scores (0-100 points) measured using the Pediatric Quality of Life Inventory Family Impact Module. Medical home status was based on parent report of teen's health care meeting medical home criteria. Linear regression models were used to estimate HRQOL scores, adjusted for demographic characteristics, health literacy, and teen functional limitation. Among 488 parents, 27% reported their teen received care consistent with a medical home. Adjusted parent HRQOL scores were significantly higher among those whose teens had a medical home (74.40; 95% confidence interval, 71.31-77.48), relative to those whose teens did not (65.78; 95% confidence interval, 63.92-67.65). Medical home subscale analyses showed HRQOL scores had significant positive associations with family-centered care and coordinated care, but not other subscales. Teen medical home status was positively associated with caregiver HRQOL, suggesting that the medical home may benefit overall caregiver well-being. In particular, receiving care that was family centered and coordinated appeared to be the most beneficial. Copyright © 2018 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  11. Are carer attitudes toward medications related to self-reported medication adherence amongst people with mental illness?

    Science.gov (United States)

    Deane, Frank P; McAlpine, Elizabeth; Byrne, Mitchell K; Davis, Esther L; Mortimer, Christine

    2017-11-22

    Medication nonadherence among consumers with psychiatric disorders can significantly affect the health and wellbeing of the consumer and their family. Previous research has suggested that carers have an impact on consumer attitudes toward medication and adherence. Yet, how carer attitudes toward medication may be related to consumer attitudes and adherence has received little investigation. This exploratory study aimed to investigate the relationships between carer and consumer attitudes toward medication and consumer adherence behaviour. A cross-sectional survey assessing consumer and carer attitudes toward medication and consumer adherence was conducted amongst 42 consumer-carer dyads. Correlation analyses showed a positive association between consumer and carer attitudes toward medication and between consumer and carer attitudes with adherence. There was a general indication that the greater the difference between consumer and carer attitudes, the lower the level of adherence. Regression analyses revealed that while neither consumer nor carer attitudes were significant predictors of adherence, carer attitudes appeared to have a stronger role in adherence than consumer attitudes. These preliminary results highlight the importance of carer attitudes in relation to patient perceptions and behaviours toward medication, and thus the potential benefits of addressing both consumer and carer attitudes in any intervention for improving adherence. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Understanding and remediating social-cognitive dysfunctions in patients with serious mental illness using relational frame theory

    Directory of Open Access Journals (Sweden)

    Annemieke eHendriks

    2016-02-01

    Full Text Available Impairments in social cognition and perspective-taking play an important role in the psychopathology and social functioning of individuals with social anxiety, autism or schizophrenia-spectrum disorders, among other clinical presentations. Perspective-taking has mostly been studied using the concept of Theory of Mind (ToM, which describes the sequential development of these skills in young children, as well as clinical populations experiencing perspective-taking difficulties. Several studies mention positive results of Theory of Mind based training programs, however, the precise processes involved in the achievement of these improvements are difficult to determine. Relational Frame Theory (RFT is a modern behavioural account of complex cognitive functions, and is argued to provide a more precise approach to the assessment and training of perspective-taking, among other relational skills. Results of RFT-based studies of perspective-taking in developmental and clinical settings are discussed. The development of training methods targeting perspective-taking deficits from an RFT point of view appears to provide promising applications for the enhancement of current treatments of people with social-cognitive dysfunctions.

  13. Understanding and Remediating Social-Cognitive Dysfunctions in Patients with Serious Mental Illness Using Relational Frame Theory.

    Science.gov (United States)

    Hendriks, Annemieke L; Barnes-Holmes, Yvonne; McEnteggart, Ciara; De Mey, Hubert R A; Janssen, Gwenny T L; Egger, Jos I M

    2016-01-01

    Impairments in social cognition and perspective-taking play an important role in the psychopathology and social functioning of individuals with social anxiety, autism, or schizophrenia-spectrum disorders, among other clinical presentations. Perspective-taking has mostly been studied using the concept of Theory of Mind (ToM), which describes the sequential development of these skills in young children, as well as clinical populations experiencing perspective-taking difficulties. Several studies mention positive results of ToM based training programs; however, the precise processes involved in the achievement of these improvements are difficult to determine. Relational Frame Theory (RFT) is a modern behavioral account of complex cognitive functions, and is argued to provide a more precise approach to the assessment and training of perspective-taking, among other relational skills. Results of RFT-based studies of perspective-taking in developmental and clinical settings are discussed. The development of training methods targeting perspective-taking deficits from an RFT point of view appears to provide promising applications for the enhancement of current treatments of people with social-cognitive dysfunctions.

  14. Mechanisms of hyponatremia in patients with decompensated liver cirrhosis treated with terlipressin and related treatment principles

    Directory of Open Access Journals (Sweden)

    YOU Jia

    2016-11-01

    Full Text Available Esophagogastric variceal bleeding and hepatorenal syndrome are common complications in patients with decompensated liver cirrhosis and portal hypertension. Terlipressin can lead to the constriction of visceral vessels, reduce portal venous pressure, and increase renal perfusion and is the first-line drug. In recent years, it has been reported that some patients experienced hyponatremia during the treatment with terlipressin. Since patients with liver cirrhosis tend to develop hyponatremia, the application of terlipressin may have an adverse effect on the management of serum sodium level in such patients. This article summarizes the incidence rate of hyponatremia during terlipressin treatment and related risk factors and introduces the pathogenesis of hyponatremia during terlipressin treatment in patients with decompensated liver cirrhosis and the treatment principles for hyponatremia. If the occurrence of hyponatremia can be controlled, terlipressin may be an effective drug for the treatment of portal hypertension.

  15. Relation between simple cytological test and persistence of disease in radiation-treated uterine cervix carcinomas

    Energy Technology Data Exchange (ETDEWEB)

    Schreiner, P

    1985-07-01

    A cytological study was conducted covering 174 epidermoid uterine cervix carcinoma patients who had been given combined radiation therapy. The changes were assessed in the karyopyknotic index (KPI) as related to radiation therapy and the incidence of local relapses. At the limit KPI value of 10, the average reliability of the method for diagnosing persistence in the group under study was 83.0%. Patients showing KPI of more than 10 at six weeks following the termination of radical radiation therapy represent a poor prognosis group whereas those showing KPI values lower than 10 have good prognosis. The results show that no strict hormonal dependence of the KPI value exists in uterine cervix carcinoma patients; only a different situation exists which is probably due to the tumor-organism interaction or to the metabolism of the tumor itself.

  16. Nocardia asteroides peritoneal dialysis-related peritonitis: First case in pediatrics, treated with protracted linezolid.

    Science.gov (United States)

    El-Naggari, Mohamed; El Nour, Ibtisam; Al-Nabhani, Dana; Al Muharrmi, Zakaria; Gaafar, Heba; Abdelmogheth, Anas A W

    2016-01-01

    Nocardia asteroides is a rare pathogen in peritoneal dialysis-related peritonitis. We report on a 13-year-old female with Nocardia asteroides peritonitis complicated by an intra-abdominal abscess. Linezolid was administered intravenously for 3 months and followed by oral therapy for an additional 5 months with close monitoring for adverse effects. The patient was discharged after 3 months of hospitalization on hemodialysis. The diagnosis and management of such cases can be problematic due to the slow growth and difficulty of identifying Nocardia species. The optimal duration of treatment for Nocardia peritonitis is not known. Linezolid can be used for prolonged periods in cases of trimethoprim/sulfamethoxazole-resistant cases with close monitoring for adverse effects. Copyright © 2015 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  17. Relation between simple cytological test and persistence of disease in radiation-treated uterine cervix carcinomas

    International Nuclear Information System (INIS)

    Schreiner, P.

    1985-01-01

    A cytological study was conducted covering 174 epidermoid uterine cervix carcinoma patients who had been given combined radiation therapy. The changes were assessed in the karyopyknotic index (KPI) as related to radiation therapy and the incidence of local relapses. At the limit KPI value of 10, the average reliability of the method for diagnosing persistence in the group under study was 83.0%. Patients showing KPI of more than 10 at six weeks following the termination of radical radiation therapy represent a poor prognosis group whereas those showing KPI values lower than 10 have good prognosis. The results show that no strict hormonal dependence of the KPI value exists in uterine ceervix carcinoma patients; only a different situation exists which is probably due to the tumor-organism interaction or to the metabolism of the tumor itself. (author)

  18. Report of 3 Patients With Urea Cycle Defects Treated With Related Living-Donor Liver Transplant.

    Science.gov (United States)

    Özçay, Figen; Barış, Zeren; Moray, Gökhan; Haberal, Nihan; Torgay, Adnan; Haberal, Mehmet

    2015-11-01

    Urea cycle defects are a group of metabolic disorders caused by enzymatic disruption of the urea cycle pathway, transforming nitrogen to urea for excretion from the body. Severe cases present in early infancy with life-threatening metabolic decompensation, and these episodes of hyperammonemia can be fatal or result in permanent neurologic damage. Despite the progress in pharmacologic treatment, long-term survival is poor especially for severe cases. Liver transplant is an alternative treatment option, providing sufficient enzymatic activity and decreasing the risk of metabolic decompensation. Three patients with urea cycle defects received related living-donor liver transplants at our hospital. Patients presented with late-onset ornithine transcarbamylase deficiency, argininosuccinate lyase deficiency, and citrullinemia. Maximum pretransplant ammonia levels were between 232 and 400 μmol/L (normal range is 18-72 μmol/L), and maximum posttransplant values were 52 to 94 μmol/L. All patients stopped medical treatment and dietary protein restriction for urea cycle defects after transplant. The patient with late-onset ornithine transcarbamylase deficiency already had motor deficits related to recurrent hyperammonemia attacks pretransplant. A major improvement could not be achieved, and he is wheelchair dependent at the age of 6 years. The other 2 patients had normal motor and mental skills before transplant, which have continued 12 and 14 months after transplant. Hepatic artery thrombosis in the patient with the ornithine transcarbamylase deficiency, intraabdominal infection in the patient with argininosuccinate lyase deficiency, and posterior reversible encephalopathy syndrome in the patient with citrullinemia were early postoperative complications. Histopathologic changes in livers explanted from patients with ornithine transcarbamylase deficiency and citrullinemia were nonspecific. The argininosuccinate lyase-deficient patient had portoportal fibrosis and cirrhotic

  19. Changes in health-related quality of life and quality of care among terminally ill cancer patients and survival prediction: Multicenter prospective cohort study.

    Science.gov (United States)

    Lee, Myung Kyung; Lee, Woo Jin; Do, Young Rok; Lee, Keun Seok; Jung, Kyung Hae; Heo, Dae Seog; Kim, Sam Yong; Park, Sang Yoon; Jeong, Hyun Sik; Kang, Jung Hun; Kim, Si-Young; Park, Sook Ryun; Yun, Young Ho

    2015-08-01

    This study examined changes in health-related quality of life (HRQoL) and quality of care (QoC) as perceived by terminally ill cancer patients and a stratified set of HRQoL or QoC factors that are most likely to influence survival at the end of life (EoL). We administered questionnaires to 619 consecutive patients immediately after they were diagnosed with terminal cancer by physicians at 11 university hospitals and at the National Cancer Center in Korea. Subjects were followed up over 161.2 person-years until their deaths. We measured HRQoL using the core 30-item European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, and QoC using the Quality Care Questionnaire-End of Life (QCQ-EoL). We evaluated changes in HRQoL and QoC issues during the first three months after enrollment, performing sensitivity analysis by using data generated via four methods (complete case analysis, available case analysis, the last observation carried forward, and multiple imputation). Emotional and cognitive functioning decreased significantly over time, while dyspnea, constipation, and pain increased significantly. Dignity-conserving care, care by healthcare professionals, family relationships, and QCQ-EoL total score decreased significantly. Global QoL, appetite loss, and Eastern Cooperative Oncology Group Performance Status (ECOG-PS) scores were significantly associated with survival. Future standardization of palliative care should be focused on assessment of these deteriorated types of quality. Accurate estimates of the length of life remaining for terminally ill cancer patients by such EoL-enhancing factors as global QoL, appetite loss, and ECOG-PS are needed to help patients experience a dignified and comfortable death.

  20. Illness and determinants of health-related quality of life in a cross-sectional sample of schoolchildren in different weight categories

    Directory of Open Access Journals (Sweden)

    Kesztyüs, Dorothea

    2014-01-01

    Full Text Available [english] Aim: To study associations between health-related quality of life (HRQoL, frequency of illness, and weight in primary school children in southern Germany. Methods: Data from baseline measurements of the outcome evaluation of a teacher based health promotion programme (“Join the Healthy Boat” were analysed. Parents provided information about their children’s HRQoL (KINDL, EQ5D-Y Visual Analogue Scale. The number of visits to a physician, children’s days of absence because of sickness, and parental days of absence from work due to their children’s illness during the last year of school/kindergarten were queried. Children’s weight status was determined by body mass index (BMI, central obesity by waist to height ratio (WHtR ≥0.5. Results: From 1,888 children (7.1±0.6 years, 7.8% were underweight, 82% had normal weight, 5.7% were overweight and 4.4% obese. 8.4% of all children were centrally obese. Bivariate analysis showed no significant differences for parental absence and visits to a physician in weight groups classified by BMI, but obese children had more sick days than non-obese. Centrally obese children differed significantly from the rest in the number of sick days and visits to a physician, but not in the frequency of parental absence. In regression analyses, central obesity correlated significantly with EQ5D-Y VAS, KINDL total score and the subscales of “psyche”, “family” and “friends”. BMI weight groups showed no significant associations. Conclusions: Central obesity but not BMI derived overweight and obesity is associated with HRQoL and visits to a physician in primary school children. Future studies should include WHtR. Preventive measures for children should focus on a reduction of or slowed increase in waist circumference.

  1. Recurring alcohol-related care between 1998 and 2007 among people treated for an alcohol-related disorder in 1997: A register study in Stockholm County

    Directory of Open Access Journals (Sweden)

    Kåreholt Ingemar

    2011-07-01

    Full Text Available Abstract Background Inpatient care for alcohol intoxication is increasing in Sweden, especially among young women. Since it is well known that alcohol disorder is a chronic relapsing illness, this study examines the extent to which people return for more care. Method All inpatients with alcohol-related diagnoses in Stockholm County during 1997 were followed prospectively to 2007 through registers. The proportion reappearing for the same diagnosis, other alcohol-related inpatient, or outpatient care each year after baseline, as well as the number of years the inpatients reappeared were calculated (n = 2735. Three diagnoses were examined separately; alcohol dependence, harmful use of alcohol, and alcohol intoxication. Results Three out of five inpatients with an alcohol diagnoses reappeared for more alcohol-related inpatient care during the following decade. The proportion returning was largest the year after baseline and then decreased curvilinearly over time. The inclusion of outpatient care increased proportions, but did not change patterns. Of those with an alcohol dependence diagnosis at baseline 42 percent returned for more alcohol-related inpatient care the first, 28 percent the fifth, and 25 percent the tenth year. Corresponding proportions for harmful use and intoxication were smaller. One in five among those with an alcohol dependence returned for more than five of the ten years. Ordered logistic regressions confirmed that besides diagnosis, age and gender were independently related to the number of years returning to care. Conclusions While middle-aged males with alcohol dependence were in a revolving door, young female inpatients with intoxication diagnosis returned to a comparably lower degree.

  2. Anxiety in Medically Ill Children/Adolescents

    OpenAIRE

    Pao, Maryland; Bosk, Abigail

    2010-01-01

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

  3. Longitudinal spirometry among patients in a treatment program for community members with World Trade Center (WTC)-related illness

    Science.gov (United States)

    Liu, Mengling; Qian, Meng; Cheng, Qinyi; Berger, Kenneth I.; Shao, Yongzhao; Turetz, Meredith; Kazeros, Angeliki; Parsia, Sam; Goldring, Roberta M.; Fernandez-Beros, Maria Elena; Marmor, Michael; Reibman, Joan

    2013-01-01

    Objective The course of lung function in community members exposed to World Trade Center (WTC) dust and fumes remains undefined. We studied longitudinal spirometry among patients in the WTC Environmental Health Center (WTCEHC) treatment program. Methods Observational study of 946 WTCEHC patients with repeated spirometry measures analyzed on the population as a whole and stratified by smoking status, initial spirometry pattern and WTC-related exposure category. Results Improvement in forced expiratory volume (FVC; 54.4 ml/year; 95% CI: 45.0-63.8) and forced expiratory volume in one second (FEV1; 36.8 ml/year; 95% CI: 29.3-44.3) was noted for the population as a whole. Heavy smokers did not improve. Spirometry changes differed depending on initial spirometry pattern and exposure category. Conclusions These data demonstrate spirometry improvement in select populations suggesting reversibility in airway injury and reinforcing the importance of continued treatment. PMID:22995806

  4. Campylobacter contamination and the relative risk of illness from organic broiler meat in comparison with conventional broiler meat

    DEFF Research Database (Denmark)

    Rosenquist, Hanne; Boysen, Louise; Krogh, Anne Louise

    2013-01-01

    Danish organic broiler meat, represented by carcasses sampled at the end of processing after chilling, was more frequently contaminated with thermotolerant Campylobacter spp. than conventional broiler carcasses; the yearly mean prevalence being 54.2% (CI: 40.9-67.5) for organic and 19.7% (CI: 14.......8-24.7) for conventional carcasses. Campylobacter jejuni was the most frequently isolated species. The difference in prevalence was obvious in all quarters of the year. Contamination of organic and conventional broiler carcasses was more likely to occur in the warmer summer months, in this case in the third quarter......, as also documented for conventional broiler flocks. When contaminated, the mean concentration of Campylobacter on neck skin samples of organic and conventional carcasses was not significantly different (P=0.428); 2.0±0.65log10cfu/g and 2.1±0.93log10cfu/g, respectively. Assessing the relative risk...

  5. Ill Health-Related Job Loss: A One-Year Follow-Up of 54,026 Employees.

    Science.gov (United States)

    Dutheil, Frédéric; Naughton, Geraldine; Sindyga, Patricia; Lesage, François-Xavier

    2016-09-01

    The diagnoses of workers being unfit to work may be a relevant health indicator. Therefore, the aim of this study was to analyze the one-year incidence of an unfit to work diagnosis. This one-year prospective study included all workers undergoing annual work medical examination from occupational health services in Troyes, France. Twenty-one occupational physicians followed 54,026 employees. The all-cause incidence of being unfit to return to work was 0.772%. The two main causes of being unfit to work were musculoskeletal disorders (61%) and psychopathologies (24%). The relative risk (RR) of being unfit to work, independent of the cause, was higher when employees were aged over 50 years (RR = 2.51), and female (RR = 1.51). Prospective results from occupational physicians' medical records may provide significant and cost-effective directions to prioritize actions and target health promotion in the workplace.

  6. Treating thalassemia major-related iron overload: the role of deferiprone

    Directory of Open Access Journals (Sweden)

    Berdoukas V

    2012-10-01

    Full Text Available Vasilios Berdoukas,1 Kallistheni Farmaki,2 Susan Carson,1 John Wood,3 Thomas Coates11Division of Hematology/Oncology, Children's Hospital Los Angeles, Los Angeles, CA, USA; 2Thalassemia Unit, General Hospital of Corinth, Corinth, Greece; 3Division of Cardiology, Children's Hospital Los Angeles, Los Angeles, CA, USAAbstract: Over the last 20 years, management for thalassemia major has improved to the point where we predict that patients' life expectancy will approach that of the normal population. These outcomes result from safer blood transfusions, the availability of three iron chelators, new imaging techniques that allow specific organ assessment of the degree of iron overload, and improvement in the treatment of hepatitis. In October 2011, the Food and Drug Administration licensed deferiprone, further increasing the available choices for iron chelation in the US. The ability to prescribe any of the three chelators as well as their combinations has led to more effective reduction of total body iron. The ability to determine the amount of iron in the liver and heart by magnetic resonance imaging allows the prescription of the most appropriate chelation regime for patients and to reconsider what our aims with respect to total body iron should be. Recent evidence from Europe has shown that by normalizing iron stores not only are new morbidities prevented but also reversal of many complications such as cardiac failure, hypothyroidism, hypogonadism, impaired glucose tolerance, and type 2 diabetes can occur, improving survival and patients' quality of life. The most effective way to achieve normal iron stores seems to be with the combination of deferoxamine and deferiprone. Furthermore, outcomes should continue to improve in the future. Starting relative intensive chelation in younger children may prevent short stature and abnormal pubertal maturation as well as other iron-related morbidities. Also, further information should become available on the

  7. Medical care costs incurred by patients with smoking-related non-small cell lung cancer treated at the National Cancer Institute of Mexico.

    Science.gov (United States)

    Arrieta, Oscar; Quintana-Carrillo, Roger Humberto; Ahumada-Curiel, Gabriel; Corona-Cruz, Jose Francisco; Correa-Acevedo, Elma; Zinser-Sierra, Juan; de la Mata-Moya, Dolores; Mohar-Betancourt, Alejandro; Morales-Oyarvide, Vicente; Reynales-Shigematsu, Luz Myriam

    2014-01-01

    Smoking is a public health problem in Mexico and worldwide; its economic impact on developing countries has not been well documented. The aim of this study was to assess the direct medical costs attributable to smoking incurred by lung cancer patients treated at the National Cancer Institute of Mexico (INCan). The study was conducted at INCan in 2009. We carried out a cost of illness (COI) methodology, using data derived from an expert panel consensus and from medical chart review. A panel of experts developed a diagnostic-therapeutic guide that combined the hospital patient pathways and the infrastructure, human resources, technology, and services provided by the medical units at INCan. Cost estimates in Mexican pesos were adjusted by inflation and converted into US Dollars using the 2013 FIX exchange rate for foreign transactions (1 USD = 13.06 Mexican pesos). A 297 incident cases diagnosed with any type of lung cancer were analyzed. According to clinical stage, the costs per patient were 13,456; 35,648; 106,186; and 144,555 USD, for lung cancer stages I, II, III, and IV respectively. The weighted average annual cost/patient was and 139,801 USD and the average annual cost/patient that was attributable to smoking was 92,269 USD. This cost was independent of the clinical stage, with stage IV representing 96% of the annual cost. The total annual cost of smoking-related lung cancer at INCan was 19,969,781 USD. The medical care costs of lung cancer attributable to smoking represent a high cost both for INCan and the Mexican health sector. These costs could be reduced if all provisions established in the Framework Convention of Tobacco Control of the World Health Organization were implemented in Mexico.

  8. Unusual case of stroke related to Kocuria Kristinae endocarditis treated with surgical procedure.

    Science.gov (United States)

    Aleksic, D; Miletic-Drakulic, S; Boskovic-Matic, T; Simovic, S; Toncev, G

    2016-01-01

    We report the case of a 35-year-old man with stroke related to infective endocarditis (IE) caused by Kocuria kristinae . The patient with chronic hepatitis C virus infection and a former intravenous drug user developed a stroke suddenly, after three months duration of fever and malaise. Duplex ultrasonography of the carotid arteries (zero level diastolic flow, diastolic reversed flow) focused attention to cardiac valve pathology and endocarditis (definite confirmation was made by transesophageal echocardiography). Kocuria kristinae was grown from the blood culture and antibiotic therapy administered, according to the antibiogram, did not cure the infection and the patient underwent an aortic valve replacement with a mechanical prosthesis and debridement of the mitral valve. One year after the surgery, the patient had no subjective problems and neurological findings were normal.  Conclusion: To our knowledge, this is the first case of IE caused by Kocuria kristinae , which was diagnosed after the development of stroke, where IE was suspected based on Duplex ultrasonography of the carotid arteries.  This is the second case of infection by this bacterium which could not be cured by antibiotics only and had to be submitted to surgical intervention. Hippokratia 2016, 20(3): 231-234.

  9. Intravenous glucose intake independently related to intensive care unit and hospital mortality : an argument for glucose toxicity in critically ill patients

    NARCIS (Netherlands)

    van der Voort, PHJ; Feenstra, RA; Bakker, AJ; de Heide, L; Boerma, EC; van der Horst, ICC

    Objective It is assumed that the toxic effects of glucose play a role in the outcome of critically ill patients. We studied the impact of the amount of infused glucose as a determinant of mortality. Design A retrospective cohort study design was used as blood glucose levels in critically ill

  10. Cytosolic calcium rises and related events in ergosterol-treated Nicotiana cells.

    Science.gov (United States)

    Vatsa, Parul; Chiltz, Annick; Luini, Estelle; Vandelle, Elodie; Pugin, Alain; Roblin, Gabriel

    2011-07-01

    The typical fungal membrane component ergosterol was previously shown to trigger defence responses and protect plants against pathogens. Most of the elicitors mobilize the second messenger calcium, to trigger plant defences. We checked the involvement of calcium in response to ergosterol using Nicotiana plumbaginifolia and Nicotiana tabacum cv Xanthi cells expressing apoaequorin in the cytosol. First, it was verified if ergosterol was efficient in these cells inducing modifications of proton fluxes and increased expression of defence-related genes. Then, it was shown that ergosterol induced a rapid and transient biphasic increase of free [Ca²⁺](cyt) which intensity depends on ergosterol concentration in the range 0.002-10 μM. Among sterols, this calcium mobilization was specific for ergosterol and, ergosterol-induced pH and [Ca²⁺](cyt) changes were specifically desensitized after two subsequent applications of ergosterol. Specific modulators allowed elucidating some events in the signalling pathway triggered by ergosterol. The action of BAPTA, LaCl₃, nifedipine, verapamil, neomycin, U73122 and ruthenium red suggested that the first phase was linked to calcium influx from external medium which subsequently triggered the second phase linked to calcium release from internal stores. The calcium influx and the [Ca²⁺](cyt) increase depended on upstream protein phosphorylation. The extracellular alkalinization and ROS production depended on calcium influx but, the ergosterol-induced MAPK activation was calcium-independent. ROS were not involved in cytosolic calcium rise as described in other models, indicating that ROS do not systematically participate in the amplification of calcium signalling. Interestingly, ergosterol-induced ROS production is not linked to cell death and ergosterol does not induce any calcium elevation in the nucleus. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  11. Emerging vascular endothelial growth factor antagonists to treat neovascular age-related macular degeneration.

    Science.gov (United States)

    Hussain, Rehan M; Ciulla, Thomas A

    2017-09-01

    Evolving anti-vascular endothelial growth factor (VEGF) treatments for neovascular age-related macular degeneration (nAMD) include long acting agents, combination strategies involving new pathways, topical agents, sustained-release, and genetic therapy strategies. Areas covered: Brolucizumab and abicipar pegol have smaller molecular size, facilitating higher concentrations and potentially longer duration than current anti-VEGF agents. Agents being combined with anti-VEGFs include OPT-302 (to inhibit VEGF-C and VEGF-D); pegpleranib and rinucumab (to inhibit platelet derived growth factor, PDGF - but both failed to show consistently improved visual outcomes compared to anti-VEGF monotherapy); and RG7716, ARP-1536 and nesvacumab (to activate the Tie-2 tyrosine kinase receptor, which reduces permeability). X-82 is an oral anti-VEGF and anti-PDGF being tested in phase 2 studies. Topical anti-VEGF ± anti-PDGF drugs under study include pazopanib, PAN-90806, squalamine lactate, regorafinib, and LHA510. Sustained-release anti-VEGF delivery treatments, such as the ranibizumab Port Delivery System, GB-102, NT-503, hydrogel depot, Durasert, and ENV1305 aim to reduce the burden of frequent injections. Gene therapies with new viral vectors hold the potential to induce sustained expression of anti-angiogenic proteins via the retina's cellular apparatus, and include AVA-101/201, ADVM-202/302, AAV2-sFLT01, RGX314, and Retinostat. Expert opinion: There are many emerging anti-VEGF treatments that aim to improve visual outcomes and reduce the treatment burden of nAMD.

  12. The analysis of Drug - Related Problems in patients with gastroesophageal reflux disease treated with proton-pump inhibitors

    Directory of Open Access Journals (Sweden)

    Milutinović Jelena D.

    2015-01-01

    Full Text Available Introduction: Drug-related problems are frequent in almost all therapeutic areas. Aims: The aim of this paper was to detect drug - related problems in patients with gastroesophageal reflux and to analyze their possible association with the patient characteristics. Material and methods: The study was designed as descriptive, retrospective, crosssectional study aiming to determine the most common drug - related problems in patients with gastro-esophageal reflux disease treated with proton-pump inhibitors. The survey was conducted at the Department of Gastroenterology, Clinical Centre in Kragujevac. The study enrolled all patients treated from gastroesophageal reflux disease with proton pump inhibitors during the time period from 1.1.2014 until 1.1.2015. The study used descriptive statistics (percentage distribution, mean and standard deviation. The correlation between the number of adverse events and patient characteristics was also calculated. Results: The average age of the patients was 55.97±15.811 years, and 43 of the patients (60.6 % were male. The average hospitalization duration was 12.30±8.89 days. Based on the Pharmaceutical Care Network Europe classification, there were 182 Drug-Related Problems which was, on average, 2.56 problems per patient. Only 5 patients (7% did not report any problem while 11 patients (15.49% had over 10 possible drug-drug interactions. The most common problems which occurred were erroneous drug choice, inappropriate administration and possible interactions between medications. Conclusions: Based on the results of this study, one must pay attention to possible drug interactions and other problems which may occur with proton-pump inhibitors. Recognition of different sub-types of drug-related problems and of factors associated with drug related problems may reduce risk from adverse outcomes of gastro-esophageal reflux disease treatment with proton pump inhibitors.

  13. Using nature-based rehabilitation to restart a stalled process of rehabilitation in individuals with stress-related mental illness.

    Science.gov (United States)

    Sahlin, Eva; Ahlborg, Gunnar; Tenenbaum, Artur; Grahn, Patrik

    2015-02-09

    After a period of decrease, sick leave in Sweden due to psychiatric diagnoses is on the increase. The lack of established rehabilitation programmes for patients with stress-related mental disorders (SRMD) has opened up for the use of garden/nature in a multimodal rehabilitation context (Nature-Based Rehabilitation, NBR). Region Västra Götaland (VGR) started an NBR to offer additional rehabilitation for its employees on long-term sick leave due to SRMD, where initial care had not been sufficient. The aim was to explore whether the mental health and well-being of NBR participants had improved at the end of the NBR and at three follow-ups, and to explore the development of sick leave and health care utilization according to the NBR model (n = 57) and an occupational health service (OHS) model (n = 45). Self-assessment instruments for measuring burnout, depression, anxiety and wellbeing, and data from regional and national registers were used. Results showed decreased scores on burnout, depression and anxiety, and increased well-being scores and significantly reduced health care utilization in the NBR group. A large movement from ordinary sickness benefit to rehabilitation benefit was observed, which was not observed in the OHS group. The two groups were in different rehabilitation phases, which limited comparisons. The results point to beneficial effects of using NBR for this patient group and for enhancing a stalled rehabilitation process.

  14. Assessment of potential zoonotic disease exposure and illness related to an annual bat festival--Idanre, Nigeria.

    Science.gov (United States)

    Vora, Neil M; Osinubi, Modupe; Wallace, Ryan M; Aman-Oloniyo, Abimbola; Gbadegesin, Yemi H; Sebastian, Yennan Kerecvel; Saliman, Olugbon Abdullateef; Niezgoda, Mike; Davis, Lora; Recuenco, Sergio

    2014-04-18

    Bats provide vital ecologic services that humans benefit from, such as seed dispersal and pest control, and are a food source for some human populations. However, bats also are reservoirs for a number of high-consequence zoonoses, including paramyxoviruses, filoviruses, and lyssaviruses. The variety of viruses that bats harbor might be related to their evolutionary diversity, ability to fly large distances, long lifespans, and gregarious roosting behaviors. Every year a festival takes place in Idanre, Nigeria, in which males of all ages enter designated caves to capture bats; persons are forbidden from entering the caves outside of these festivities. Festival participants use a variety of techniques to capture bats, but protective equipment rarely is used, placing hunters at risk for bat scratches and bites. Many captured bats are prepared as food, but some are transported to markets in other parts of the country for sale as bushmeat. Bats also are presented to dignitaries in elaborate rituals. The health consequences of contact with these bats are unknown, but a number of viruses have been previously identified among Nigerian bats, including lyssaviruses, pegiviruses, and coronaviruses. Furthermore, the caves are home to Rousettus aegyptiacus bats, which are reservoirs for Marburg virus in other parts of Africa.

  15. Using Nature-Based Rehabilitation to Restart a Stalled Process of Rehabilitation in Individuals with Stress-Related Mental Illness

    Directory of Open Access Journals (Sweden)

    Eva Sahlin

    2015-02-01

    Full Text Available After a period of decrease, sick leave in Sweden due to psychiatric diagnoses is on the increase. The lack of established rehabilitation programmes for patients with stress-related mental disorders (SRMD has opened up for the use of garden/nature in a multimodal rehabilitation context (Nature-Based Rehabilitation, NBR. Region Västra Götaland (VGR started an NBR to offer additional rehabilitation for its employees on long-term sick leave due to SRMD, where initial care had not been sufficient. The aim was to explore whether the mental health and well-being of NBR participants had improved at the end of the NBR and at three follow-ups, and to explore the development of sick leave and health care utilization according to the NBR model (n = 57 and an occupational health service (OHS model (n = 45. Self-assessment instruments for measuring burnout, depression, anxiety and wellbeing, and data from regional and national registers were used. Results showed decreased scores on burnout, depression and anxiety, and increased well-being scores and significantly reduced health care utilization in the NBR group. A large movement from ordinary sickness benefit to rehabilitation benefit was observed, which was not observed in the OHS group. The two groups were in different rehabilitation phases, which limited comparisons. The results point to beneficial effects of using NBR for this patient group and for enhancing a stalled rehabilitation process.

  16. A comparison of survival of patients treated for AIDS-related central nervous system lymphoma with and without tissue diagnosis

    International Nuclear Information System (INIS)

    Kaufmann, Thomas; Nisce, Lourdes Z.; Coleman, Morton

    1996-01-01

    Purpose: This is a retrospective review of the treatment outcome of radiation therapy (RT) in acquired immunedeficiency syndrome (AIDS) patients with presumed primary central nervous system (CNS) non-Hodgkin's lymphoma (NHL), with and without tissue verification. Methods and Materials: Twenty-seven patients with AIDS-related CNS NHL were treated between 1986 and 1992. They were divided into two groups. Group 1 consisted of nine patients with a positive histology for NHL. They were treated with dexamethasone (DXM) and whole brain RT. Group 2 consisted of 18 patients who, because of unique circumstances, were treated without histologic confirmation of NHL. Rapid clinical and/or radiologic response to DXM and whole-brain RT was interpreted as NHL. Results: For group 1, the response rate was 87.5%, mean survival 6.1 months, and median survival 4.5 months. For group 2, the response rate was 72.2%, mean survival 5.2 months, and median survival 4.5 months. The overall response rate was 76.9%, mean survival 5.8 months, and median survival 4.5 months. Conclusions: In instances where a tissue diagnosis cannot be established, a positive response to an empiric trial of DXM and RT to 20 Gy may constitute presumptive evidence of NHL

  17. Mental Illness Statistics

    Science.gov (United States)

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

  18. Health promotion behaviors and related factors in end stage renal disease patients treated with continuous ambulatory peritoneal dialysis.

    Science.gov (United States)

    Wechpradit, Apinya; Thaiyuenwong, Jutiporn; Kanjanabuch, Talerngsak

    2011-09-01

    To present study health promotion behaviors and related factors in end stage renal disease (ESRD) patients treated with continuous ambulatory peritoneal dialysis (CAPD). Questionnaires of Pender to evaluate health promotion behaviors which measure 5 aspects of health-affected behaviors were examined in 90 CAPD patients at dialysis unit of Udornthani Hospital. Results were categorized into 3 groups according to Bloom's scale as follows: high, moderate, and low levels. The data were displayed as ranges or means +/- standard deviation, according to the characteristics of each variable, with a 5% (p cherish health behaviors of the patients.

  19. Impact of malaria related messages on insecticide-treated net (ITN) use for malaria prevention in Ghana

    OpenAIRE

    Owusu Adjah, Ebenezer S; Panayiotou, Andrie G

    2014-01-01

    Background: Media messages have been used in Ghana to promote insecticide-treated net (ITN)/bed net usage in an effort to impact on malaria prevention. The aim of this study was to assess the effect of such malaria-related messages delivered through electronic/print media and by volunteers/health workers on the use of ITNs by children living in a household. Methods: Data was collected from September to November of 2008 using a structured, interviewer-administered questionnaire by the Ghana St...

  20. Dance-related injuries in children and adolescents treated in US emergency departments in 1991-2007.

    Science.gov (United States)

    Roberts, Kristin J; Nelson, Nicolas G; McKenzie, Lara

    2013-02-01

    Dancing is one of the most physically strenuous activities on the musculoskeletal system. As other literature has previously described, the types, sites, and rates of dance-related injuries are similar to those suffered by athletes in traditional sports. A retrospective analysis was conducted with data from the National Electronic Injury Surveillance System from 1991-2007. Sample weights were used to calculate national estimates of dance-related injuries. Trend significance of the numbers and age-adjusted rates of dance-related injuries over time was analyzed using linear regression. An estimated 113,084 children and adolescents 3-19 years of age were treated in US emergency departments for dance-related injuries. Classical dance (ballet, jazz, tap, modern) accounted for 55.0% of dance-related injuries. Adolescents 15-19 years of age constituted 40.4% of the dance-related injury cases. The majority of injuries (58.1%) occurred to the lower extremities. Sprains or strains were the most common injury (52.4%) and falls were the most common mechanism of injury (44.8%). Dance-related injuries have distinct injury patterns and mechanisms of injury. Injury patterns differ by types of dance and by age. Further research is needed to identify injury prevention strategies specific to these age groups.

  1. Narrative skills of children treated for brain tumours: The impact of tumour and treatment related variables on microstructure and macrostructure.

    Science.gov (United States)

    Docking, Kimberley; Munro, Natalie; Marshall, Tara; Togher, Leanne

    2016-01-01

    The narrative skills of children with brain tumours were examined. Influence of tumour location, radiotherapy, time post-treatment and presence of hydrocephalus was also investigated, as well as associations between narrative and language abilities. Seventeen children (aged 5;6-14;11) treated for brain tumour and their matched controls completed a narrative assessment and comprehensive language testing. Audio recorded narratives were analysed for microstructure and macrostructure elements. Between-group comparisons were conducted. Narrative elements were explored in association with tumour and treatment-related variables. Correlation analysis examined relationships between narrative scores and language test performance. While significant differences were not found between two groups of children across narrative elements, sub-group comparisons revealed marginal differences in macrostructure related to tumour location and hydrocephalus. Children treated with methods other than radiotherapy showed a significant increase in number of mazes in their narratives compared to children who received radiotherapy. Strong positive correlations also existed between narrative elements and language performance. Preliminary findings highlight the importance of investigating narrative abilities as part of a comprehensive language assessment. Macrostructure should be routinely examined where children are diagnosed with either posterior fossa tumour or hydrocephalus or have undergone surgery and/or chemotherapy for brain tumour.

  2. Gastrointestinal toxicity and its relation to dose distributions in the anorectal region of prostate cancer patients treated with radiotherapy

    International Nuclear Information System (INIS)

    Heemsbergen, Wilma D.; Hoogeman, Mischa S.; Hart, Guus A.M.; Lebesque, Joos V.; Koper, Peter C.M.

    2005-01-01

    Purpose: To study the correlations between the dose distributions in the anorectal region and late GI symptoms in patients treated for localized prostate carcinoma. Methods and materials: Data from a randomized study were analyzed. In this trial, patients were treated with either rectangular or conformal fields with a dose of 66 Gy. Data concerning GI symptoms were collected from questionnaires of 197 patients. The distributions of the anorectal region were projected on maps, and the dose parameters were calculated. The incidences of complaints were studied as a function of the dose-area parameters and clinical parameters, using a proportional hazard regression model. Finally, we tested a series of dose parameters originating from different parts of the anorectal region. Results: Analyzing the total region, only a statistically significant dose-area effect relation for bleeding was found (p < 0.01). Defining subareas, we found effect relations for bleeding, soiling, fecal incontinence, and mucus loss. For bleeding and mucus loss, the strongest correlation was found for the dose received by the upper 70-80% of the anorectal region (p < 0.01). For soiling and fecal incontinence, we found the strongest association with the dose to the lower 40-50% (p < 0.05). Conclusion: We found evidence that complaints originate from specific regions of the irradiated lower GI tract. Bleeding and mucus loss are probably related to irradiation of the upper part of the rectum. Soiling and fecal incontinence are more likely related to the dose to the anal canal and the lower part of the rectum

  3. Running-related injuries in school-age children and adolescents treated in emergency departments from 1994 through 2007.

    Science.gov (United States)

    Mehl, Ann J; Nelson, Nicolas G; McKenzie, Lara B

    2011-02-01

    Running for exercise is a popular way to motivate children to be physically active. Running-related injuries are well studied in adults but little information exists for children and adolescents. Through use of the National Electronic Injury Surveillance System database, cases of running-related injuries were selected by using activity codes for exercise (which included running and jogging). Sample weights were used to calculate national estimates. An estimated 225 344 children and adolescents 6 to 18 years old were treated in US emergency departments for running-related injuries. The annual number of cases increased by 34.0% over the study period. One third of the injuries involved a running-related fall and more than one half of the injuries occurred at school. The majority of injuries occurred to the lower extremities and resulted in a sprain or strain. These findings emphasize the need for scientific evidence-based guidelines for pediatric running. The high proportion of running-related falls warrants further research.

  4. Pikuni-Blackfeet traditional medicine: Neuroprotective activities of medicinal plants used to treat Parkinson's disease-related symptoms.

    Science.gov (United States)

    de Rus Jacquet, Aurélie; Tambe, Mitali Arun; Ma, Sin Ying; McCabe, George P; Vest, Jay Hansford C; Rochet, Jean-Christophe

    2017-07-12

    Parkinson's disease (PD) is a multifactorial neurodegenerative disorder affecting 5% of the population over the age of 85 years. Current treatments primarily involve dopamine replacement therapy, which leads to temporary relief of motor symptoms but fails to slow the underlying neurodegeneration. Thus, there is a need for safe PD therapies with neuroprotective activity. In this study, we analyzed contemporary herbal medicinal practices used by members of the Pikuni-Blackfeet tribe from Western Montana to treat PD-related symptoms, in an effort to identify medicinal plants that are affordable to traditional communities and accessible to larger populations. The aims of this study were to (i) identify medicinal plants used by the Pikuni-Blackfeet tribe to treat individuals with symptoms related to PD or other CNS disorders, and (ii) characterize a subset of the identified plants in terms of antioxidant and neuroprotective activities in cellular models of PD. Interviews of healers and local people were carried out on the Blackfeet Indian reservation. Plant samples were collected, and water extracts were produced for subsequent analysis. A subset of botanical extracts was tested for the ability to induce activation of the Nrf2-mediated transcriptional response and to protect against neurotoxicity elicited by the PD-related toxins rotenone and paraquat. The ethnopharmacological interviews resulted in the documentation of 26 medicinal plants used to treat various ailments and diseases, including symptoms related to PD. Seven botanical extracts (out of a total of 10 extracts tested) showed activation of Nrf2-mediated transcriptional activity in primary cortical astrocytes. Extracts prepared from Allium sativum cloves, Trifolium pratense flowers, and Amelanchier arborea berries exhibited neuroprotective activity against toxicity elicited by rotenone, whereas only the extracts prepared from Allium sativum and Amelanchier arborea alleviated PQ-induced dopaminergic cell death

  5. Is appreciation of written education about pain neurophysiology related to changes in illness perceptions and health status in patients with fibromyalgia?

    NARCIS (Netherlands)

    van Ittersum, M. W.; van Wilgen, C. P.; Groothoff, J. W.; van der Schans, C. P.

    2011-01-01

    Objective: To investigate the appreciation of written education about pain neurophysiology in patients with fibromyalgia (FM) and its effects on illness perceptions and perceived health status. Methods: A booklet explaining pain neurophysiology was sent to participants with FM. Appreciation was

  6. Is appreciation of written education about pain neurophysiology related to changes in illness perceptions and health status in patients with fibromyalgia?

    NARCIS (Netherlands)

    van Ittersum, Miriam; van Wilgen, C P; Groothoff, J W; van der Schans, C.P.

    2011-01-01

    OBJECTIVE: To investigate the appreciation of written education about pain neurophysiology in patients with fibromyalgia (FM) and its effects on illness perceptions and perceived health status. METHODS: A booklet explaining pain neurophysiology was sent to participants with FM. Appreciation was

  7. Cyanobacteria and Algae Blooms: Review of Health and Environmental Data from the Harmful Algal Bloom-Related Illness Surveillance System (HABISS) 2007–2011

    Science.gov (United States)

    Backer, Lorraine C.; Manassaram-Baptiste, Deana; LePrell, Rebecca; Bolton, Birgit

    2015-01-01

    Algae and cyanobacteria are present in all aquatic environments. We do not have a good sense of the extent of human and animal exposures to cyanobacteria or their toxins, nor do we understand the public health impacts from acute exposures associated with recreational activities or chronic exposures associated with drinking water. We describe the Harmful Algal Bloom-related Illness Surveillance System (HABISS) and summarize the collected reports describing bloom events and associated adverse human and animal health events. For the period of 2007–2011, Departments of Health and/or Environment from 11 states funded by the National Center for Environmental Health (NCEH), Centers for Disease Control and Prevention contributed reports for 4534 events. For 2007, states contributed 173 reports from historical data. The states participating in the HABISS program built response capacity through targeted public outreach and prevention activities, including supporting routine cyanobacteria monitoring for public recreation waters. During 2007–2010, states used monitoring data to support196 public health advisories or beach closures. The information recorded in HABISS and the application of these data to develop a wide range of public health prevention and response activities indicate that cyanobacteria and algae blooms are an environmental public health issue that needs continuing attention. PMID:25826054

  8. The NDE1 genomic locus can affect treatment of psychiatric illness through gene expression changes related to microRNA-484.

    Science.gov (United States)

    Bradshaw, Nicholas J; Ukkola-Vuoti, Liisa; Pankakoski, Maiju; Zheutlin, Amanda B; Ortega-Alonso, Alfredo; Torniainen-Holm, Minna; Sinha, Vishal; Therman, Sebastian; Paunio, Tiina; Suvisaari, Jaana; Lönnqvist, Jouko; Cannon, Tyrone D; Haukka, Jari; Hennah, William

    2017-11-01

    Genetic studies of familial schizophrenia in Finland have observed significant associations with a group of biologically related genes, DISC1 , NDE1 , NDEL1 , PDE4B and PDE4D , the 'DISC1 network'. Here, we use gene expression and psychoactive medication use data to study their biological consequences and potential treatment implications. Gene expression levels were determined in 64 individuals from 18 families, while prescription medication information has been collected over a 10-year period for 931 affected individuals. We demonstrate that the NDE1 SNP rs2242549 associates with significant changes in gene expression for 2908 probes (2542 genes), of which 794 probes (719 genes) were replicable. A significant number of the genes altered were predicted targets of microRNA-484 ( p = 3.0 × 10 -8 ), located on a non-coding exon of NDE1 Variants within the NDE1 locus also displayed significant genotype by gender interaction to early cessation of psychoactive medications metabolized by CYP2C19. Furthermore, we demonstrate that miR-484 can affect the expression of CYP2C19 in a cell culture system. Thus, variation at the NDE1 locus may alter risk of mental illness, in part through modification of miR-484, and such modification alters treatment response to specific psychoactive medications, leading to the potential for use of this locus in targeting treatment. © 2017 The Authors.

  9. Is appreciation of written education about pain neurophysiology related to changes in illness perceptions and health status in patients with fibromyalgia?

    Science.gov (United States)

    van Ittersum, M W; van Wilgen, C P; Groothoff, J W; van der Schans, C P

    2011-11-01

    To investigate the appreciation of written education about pain neurophysiology in patients with fibromyalgia (FM) and its effects on illness perceptions and perceived health status. A booklet explaining pain neurophysiology was sent to participants with FM. Appreciation was assessed with 10 questions addressing relevance (0-30) and reassurance (0-30). Illness perceptions, catastrophizing and health status were measured with the Revised Illness Perception Questionnaire (IPQ-R), the Pain Catastrophizing Scale (PCS) and the Fibromyalgia Impact Questionnaire (FIQ) at baseline (T0), after a 2-week control period (T1) and 6 weeks after the intervention (T2). Forty-one patients participated. Mean (SD) scores for relevance and reassurance were 21.6 (5.6) and 18.7 (5.7), respectively. Only illness coherence, emotional representations, pain and fatigue changed significantly between T0 and T2. Correlations between appreciation and changes in outcomes ranged between r=0.00 and r=0.34. Although a majority of subjects appreciated the written information, it did not have clinically relevant effects on illness perceptions, catastrophizing or impact of FM on daily life. Written education about pain neurophysiology is inadequate toward changing illness perceptions, catastrophizing or perceived health status of participants with FM; education should be incorporated into a broader multidisciplinary self-management program. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  10. Use of Curcumin, a Natural Polyphenol for Targeting Molecular Pathways in Treating Age-Related Neurodegenerative Diseases

    Directory of Open Access Journals (Sweden)

    Panchanan Maiti

    2018-05-01

    Full Text Available Progressive accumulation of misfolded amyloid proteins in intracellular and extracellular spaces is one of the principal reasons for synaptic damage and impairment of neuronal communication in several neurodegenerative diseases. Effective treatments for these diseases are still lacking but remain the focus of much active investigation. Despite testing several synthesized compounds, small molecules, and drugs over the past few decades, very few of them can inhibit aggregation of amyloid proteins and lessen their neurotoxic effects. Recently, the natural polyphenol curcumin (Cur has been shown to be a promising anti-amyloid, anti-inflammatory and neuroprotective agent for several neurodegenerative diseases. Because of its pleotropic actions on the central nervous system, including preferential binding to amyloid proteins, Cur is being touted as a promising treatment for age-related brain diseases. Here, we focus on molecular targeting of Cur to reduce amyloid burden, rescue neuronal damage, and restore normal cognitive and sensory motor functions in different animal models of neurodegenerative diseases. We specifically highlight Cur as a potential treatment for Alzheimer’s, Parkinson’s, Huntington’s, and prion diseases. In addition, we discuss the major issues and limitations of using Cur for treating these diseases, along with ways of circumventing those shortcomings. Finally, we provide specific recommendations for optimal dosing with Cur for treating neurological diseases.

  11. Exercise Prevents Mental Illness

    Science.gov (United States)

    Purnomo, K. I.; Doewes, M.; Giri, M. K. W.; Setiawan, K. H.; Wibowo, I. P. A.

    2017-03-01

    Multiple current studies show that neuroinflammation may contribute to mental illness such as depression, anxiety, and mood disorder. Chronic inflammation in peripheral tissues is indicated by the increase of inflammatory marker like cytokine IL-6, TNF-α, and IL-1β. Pro-inflammatory cytokine in peripheral tissues can reach brain tissues and activate microglia and it causes neuroinflammation. Psychological stress may led peripheral and central inflammation. Activated microglia will produce pro-inflammatory cytokine, ROS, RNS, and tryptophan catabolizes. This neuroinflammation can promote metabolism changes of any neurotransmitter, such as serotonin, dopamine, and glutamate that will influence neurocircuit in the brain including basal ganglia and anterior cingulated cortex. It leads to mental illness. Exercise give contribution to reduce tissue inflammation. When muscle is contracting in an exercise, muscle will produce the secretion of cytokine like IL-6, IL-1ra, and IL-10. It will react as anti-inflammation and influence macrophage, T cell, monosit, protein Toll-Like Receptor (TLR), and then reduce neuroinflammation, characterised by the decrease of pro-inflammatory cytokine and prevent the activation of microglia in the brain. The objective of the present study is to review scientific articles in the literature related to the contribution of exercise to prevent and ease mental illness.

  12. Spiritual Well-Being as a Component of Health-Related Quality of Life: The Functional Assessment of Chronic Illness Therapy—Spiritual Well-Being Scale (FACIT-Sp

    Directory of Open Access Journals (Sweden)

    Jason M. Bredle

    2011-03-01

    Full Text Available The Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp-12 is a 12-item questionnaire that measures spiritual well-being in people with cancer and other chronic illnesses. Cancer patients, psychotherapists, and religious/spiritual experts provided input on the development of the items. It was validated with a large, ethnically diverse sample. It has been successfully used to assess spiritual well-being across a wide range of religious traditions, including those who identify themselves as “spiritual yet not religious.” Part of the larger FACIT measurement system that assesses multidimensional health related quality of life (HRQOL, the FACIT-Sp-12 has been translated and linguistically validated in 15 languages and has been used in dozens of studies examining the relationships among spiritual well-being, health, and adjustment to illness.

  13. Validation of the All Patient Refined Diagnosis Related Group (APR-DRG) Risk of Mortality and Severity of Illness Modifiers as a Measure of Perioperative Risk.

    Science.gov (United States)

    McCormick, Patrick J; Lin, Hung-Mo; Deiner, Stacie G; Levin, Matthew A

    2018-03-22

    The All Patient Refined Diagnosis Related Group (APR-DRG) is an inpatient visit classification system that assigns a diagnostic related group, a Risk of Mortality (ROM) subclass and a Severity of Illness (SOI) subclass. While extensively used for cost adjustment, no study has compared the APR-DRG subclass modifiers to the popular Charlson Comorbidity Index as a measure of comorbidity severity in models for perioperative in-hospital mortality. In this study we attempt to validate the use of these subclasses to predict mortality in a cohort of surgical patients. We analyzed all adult (age over 18 years) inpatient non-cardiac surgery at our institution between December 2005 and July 2013. After exclusions, we split the cohort into training and validation sets. We created prediction models of inpatient mortality using the Charlson Comorbidity Index, ROM only, SOI only, and ROM with SOI. Models were compared by receiver-operator characteristic (ROC) curve, area under the ROC curve (AUC), and Brier score. After exclusions, we analyzed 63,681 patient-visits. Overall in-hospital mortality was 1.3%. The median number of ICD-9-CM diagnosis codes was 6 (Q1-Q3 4-10). The median Charlson Comorbidity Index was 0 (Q1-Q3 0-2). When the model was applied to the validation set, the c-statistic for Charlson was 0.865, c-statistic for ROM was 0.975, and for ROM and SOI combined the c-statistic was 0.977. The scaled Brier score for Charlson was 0.044, Brier for ROM only was 0.230, and Brier for ROM and SOI was 0.257. The APR-DRG ROM or SOI subclasses are better predictors than the Charlson Comorbidity Index of in-hospital mortality among surgical patients.

  14. Validation of an uncertainty of illness scale adapted to use with Spanish emergency department patients and their accompanying relatives or friends.

    Science.gov (United States)

    Ruymán Brito-Brito, Pedro; García-Tesouro, Esther; Fernández-Gutiérrez, Domingo Ángel; García-Hernández, Alfonso Miguel; Fernández-Gutiérrez, Raquel; Burillo-Putze, Guillermo

    2018-01-01

    To validate a Spanish adaptation of the Mishel Uncertainty of Illness Scale for use with emergency-department (ED) patients and their accompanying relatives or friends (the UIS-ED). We first developed a version of the questionnaire for Spanish ED situations. Next we assessed the content validity index for each of its items, revised it, and reassessed its face validity to produce a second version, which we then piloted in 20 hospital ED patients. A third revised version was then validated in a population of 320 adults (160 patients and 160 accompanying persons) who attended the ED between November 2015 and September 2016. The 12-item UIS-ED (60 points) was administered by 2 nurses while the patients and accompanying persons were in the ED. We gathered sociodemographic and clinical data as well as the subjects' perception about the information they were given. The mean (SD) uncertainty score among patients was 29 (11) points. Accompanying persons had a mean score of 36 (13) points. Factorial analysis confirmed the instrument's construct validity, finding that both dimensions of the original Mishel scale (complexity and ambiguity) were present in 6 items each. Factorial analysis explained 60% of the total variance in the patient version and 67% of the variance in the version for accompanying persons. Reliability statistics were good, with Cronbach's α values ranging from 0.912 to 0.938. Split-half reliability statistics ranged from 0.901 to 0.933. Correlations were significant in the analysis of convergent validity. The UIS-ED questionnaire may prove to be a simple, valid, and reliable way for assessing uncertainty in patients and their accompanying friends or relatives attending Spanish EDs.

  15. Cultural Variation in Implicit Mental Illness Stigma.

    Science.gov (United States)

    Cheon, Bobby K; Chiao, Joan Y

    2012-10-01

    Culture shapes how individuals perceive and respond to others with mental illness. Prior studies have suggested that Asians and Asian Americans typically endorse greater stigma of mental illness compared to Westerners (White Europeans and Americans). However, whether these differences in stigma arise from cultural variations in automatic affective reactions or deliberative concerns of the appropriateness of one's reactions to mental illness remains unknown. Here we compared implicit and explicit attitudes toward mental illness among Asian and Caucasian Americans. Asian Americans showed stronger negative implicit attitudes toward mental illness relative to Caucasian Americans, suggesting that cultural variation in stigma of mental illness can be observed even when concerns regarding the validity and appropriateness of one's attitudes toward mental illness are minimized. Asian Americans also explicitly endorsed greater desire for social distance from mental illness relative to Caucasian Americans. These findings suggest that cultural variations in mental illness stigma may arise from cultural differences in automatic reactions to mental illness, though cultural variations in deliberative processing may further shape differences in these immediate reactions to mental illness.

  16. Illness perceptions and psychological distress associated with physical health-related quality of life in primary Sjögren's syndrome compared to systemic lupus erythematosus and rheumatoid arthritis.

    Science.gov (United States)

    Kotsis, Konstantinos; Voulgari, Paraskevi V; Tsifetaki, Niki; Drosos, Alexandros A; Carvalho, André F; Hyphantis, Thomas

    2014-12-01

    Notwithstanding that psychological distress and illness perceptions are important in determining outcomes in rheumatic diseases, few studies investigated these variables in primary Sjögren's syndrome (pSS). We aimed to compare illness perceptions and psychological distress in patients with pSS, systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) and to test whether their associations with health-related quality of life (HRQoL) are similar in these groups of patients. In 57 patients with pSS, 75 with SLE and 199 with RA, we administered the Patient Health Questionnaire (PHQ-9), the Symptom Check-List and the Brief-Illness Perception Questionnaire to assess psychological variables and the World Health Organization Quality of Life Instrument, Short-Form to assess HRQoL. Hierarchical regression models determined the associations of psychological variables with HRQoL after adjusting for demographic variables and clinical parameters. The prevalence of clinically significant depressive symptoms (PHQ-9 ≥ 10) was 24.6 % in pSS, 29.3 % in SLE and 25.1 % in RA. Patients with pSS showed little understanding of their disease (comprehensibility) and attributed more symptoms to their illness (identity) compared with the other groups of patients. Illness perceptions and depressive symptoms were independently associated with physical HRQoL in a similar pattern in all three groups. In pSS, however, the patients' worries about the consequences of their illness was a stronger correlate of physical HRQoL than pain. These findings indicate that psychological factors are important correlates of HRQoL in these disease groups and encourage the design of psycho-educational therapies targeting disease-related cognitions in pSS in an attempt to improve patient's physical HRQoL.

  17. Effect of community integrated management of childhood illness on ...

    African Journals Online (AJOL)

    treated at home, severe illness should be treated by a health professional. Most child .... 3 Intensive Care Unit, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Osun State, Nigeria ..... delay could be to try home care including.

  18. Savings in acute care costs if all older adults treated for fall-related injuries completed matter of balance.

    Science.gov (United States)

    Howland, Jonathan; Shankar, Kalpana Narayan; Peterson, Elizabeth W; Taylor, Alyssa A

    Falls among older adults are a common and serious public health problem. Evidence-based fall prevention programs delivered in community settings and targeting older adults living independently are increasingly deployed throughout the nation. These programs tend to be offered by public and private organizations that serve older adults, and recruitment usually occurs through direct marketing to the target population, rather than through referrals from healthcare providers. Matter of Balance , a program developed to reduce fear of falling and associated activity restriction in community-dwelling older adults, is currently being delivered in 38 of the 50 United States. In this study, we estimate the one-year medical care cost savings if older adults treated at Massachusetts hospitals for fall-related injuries were referred by healthcare providers to participate in Matter of Balance . Data from several sources were used for this study. We estimated annual cost savings in older adult falls recidivism for a hypothetical 100 patients presenting at an emergency department for a fall-related injury, assuming that all were referred to, and 50 % completed, Matter of Balance . This cost-saving estimate was subsequently expanded based on the actual number (43,931) of older adult patients presenting at, and discharged from Massachusetts emergency departments for all fall-related injuries in 2012. Cost savings were calculated for two additional participation rates: 25 % and 75 %. The return on investment (ROI), was calculated based on the percentage of return per each dollar invested. The calculated ROI for Matter of Balance was 144 %. Statewide savings ranged from $2.79 million assuming a 25 % participation rate to $8.37 million, assuming a 75 % participation rate. Referral to evidence-based falls prevention programs of older adult patients presenting at EDs with a fall-related injury could reduce subsequent falls and associated treatment costs.

  19. Meta-Analysis of Suicide-Related Behavior or Ideation in Child, Adolescent, and Adult Patients Treated with Atomoxetine

    Science.gov (United States)

    Wietecha, Linda A.; Wang, Shufang; Buchanan, Andrew S.; Kelsey, Douglas K.

    2014-01-01

    Abstract Objective: This meta-analysis examined suicide-related events in the acute phases of double-blind, placebo-controlled atomoxetine trials in pediatric and adult patients with attention-deficit/hyperactivity disorder (ADHD). Methods: A total of 3883 pediatric and 3365 adult patients were included. Potential events were identified from the adverse events database using a text-string search. Mantel–Haenszel risk ratios (MHRR) were calculated for potential suicide-related events categorized according to United States Food and Drug Administration defined codes. Results: In this data set, no completed suicides were reported in the pediatric or adult populations. One pediatric (attempted suicide) (and no adult patient events) was categorized as suicidal behavior in the atomoxetine group. The frequency of combined suicidal behavior or ideation with atomoxetine treatment was 0.37% in pediatric patients (vs. 0.07% with placebo) and 0.11% in adults (vs. 0.12% with placebo) and the risk compared with placebo was not statistically significant (MHRR=1.57; p=0.42 and MHRR=0.96; p=0.96, respectively). In pediatric patients, suicidal ideation only was reported more frequently compared with placebo (MHRR=1.63; p=0.41). Conclusions: Overall in this data set, no completed suicides and 1 pediatric patient suicidal behavior event were reported in atomoxetine-treated pediatric and adult patients. Suicidal ideation was uncommon among atomoxetine-treated pediatric and adult patients, although it was reported more frequently in atomoxetine-treated pediatric patients compared with placebo; the reporting rate difference was not statistically significant. The MHRR of suicidal ideation was consistent with a previous meta-analysis of similar design. There was no evidence of increased risk for suicidal behavior in atomoxetine-treated pediatric or adult patients. Clinical trial registration information: http://www.clinicaltrials.gov. The data reported are from an analysis of 23 pediatric

  20. Health-Related Quality of Life of Young Adults Treated with Recombinant Human Growth Hormone during Childhood.

    Directory of Open Access Journals (Sweden)

    Grit Sommer

    Full Text Available Since recombinant human growth hormone (rhGH became available in 1985, the spectrum of indications has broadened and the number of treated patients increased. However, long-term health-related quality of life (HRQoL after childhood rhGH treatment has rarely been documented. We assessed HRQoL and its determinants in young adults treated with rhGH during childhood.For this study, we retrospectively identified former rhGH patients in 11 centers of paediatric endocrinology, including university hospitals and private practices. We sent a questionnaire to all patients treated with rhGH for any diagnosis, who were older than 18 years, and who resided in Switzerland at time of the survey. Three hundred participants (58% of 514 eligible returned the questionnaire. Mean age was 23 years; 56% were women; 43% had isolated growth hormone deficiency, or idiopathic short stature; 43% had associated diseases or syndromes, and 14% had growth hormone deficiency after childhood cancer. Swiss siblings of childhood cancer survivors and the German norm population served as comparison groups. HRQoL was assessed using the Short Form-36. We found that the Physical Component Summary of healthy patients with isolated growth hormone deficiency or idiopathic short stature resembled that of the control group (53.8 vs. 54.9. Patients with associated diseases or syndromes scored slightly lower (52.5, and former cancer patients scored lowest (42.6. The Mental Component Summary was similar for all groups. Lower Physical Component Summary was associated with lower educational level (coeff. -1.9. Final height was not associated with HRQoL.In conclusion, HRQoL after treatment with rhGH in childhood depended mainly on the underlying indication for rhGH treatment. Patients with isolated growth hormone deficiency/idiopathic short stature or patients with associated diseases or syndromes had HRQoL comparable to peers. Patients with growth hormone deficiency after childhood cancer were

  1. Glutamyl aminopeptidase in microvesicular and exosomal fractions of urine is related with renal dysfunction in cisplatin-treated rats.

    Directory of Open Access Journals (Sweden)

    Andrés Quesada

    Full Text Available The aim of this work was to investigate if the content of glutamyl aminopeptidase (GluAp in microvesicular and exosomal fractions of urine is related with renal dysfunction in cisplatin-treated rats.Urine samples were collected 24 hours after injection of cisplatin (7 mg/kg, n = 10 or saline serum (n = 10, and they were subjected to differential centrifugation at 1.000, 17.000 and 200.000 g to obtain microvesicular and exosomal fractions. GluAp was measured with a commercial ELISA kit in both fractions. Serum creatinine (SCr and body weight were measured 15 days after treatment. We analyzed if early excretion of GluAp in microsomal and exosomal fractions was correlated with final SCr and body weight increase. In a second experiment, enzymatic activities of GluAp and alanyl aminopeptidase (AlaAp in urine, microvesicular and exosomal fractions were measured three days after injection. We analyzed the correlation of both markers with SCr determined at this point. Finally, we studied the expression of GluAp and extracellular vesicles markers Alix and tumor susceptibility gene (TSG101 in both fractions by immunoblotting.GluAp excretion was increased in all fractions of urine after cisplatin treatment, even if data were normalized per mg of creatinine, per body weight or per total protein content of each fraction. We found significant predictive correlations with SCr concentration, and inverse correlations with body weight increase determined 15 days later. Three days after injection, aminopeptidasic activities were markedly increased in all fractions of urine in cisplatin-treated rats. The highest correlation coefficient with SCr was found for GluAp in microvesicular fraction. Increase of GluAp in microvesicular and exosomal fractions from cisplatin-treated rats was confirmed by immunoblotting. Alix and TSG101 showed different patterns of expression in each fraction.Determination of GluAp content or its enzymatic activity in microvesicular and

  2. To treat or not to treat with testosterone replacement therapy: a contemporary review of management of late-onset hypogonadism and critical issues related to prostate cancer.

    Science.gov (United States)

    Kava, Bruce R

    2014-07-01

    Over the last 10 years there has been a dramatic increase in the number of patients identified and treated with testosterone replacement therapy (TRT) for late-onset hypogonadism (LOH). By virtue of age, race, and family history, many of these patients are concurrently at risk for harboring indolent prostate cancer. Other men are at increased risk for prostate cancer as a result of an elevated serum PSA level or having had a prior prostate biopsy showing prostatic intraepithelial neoplasia (PIN) or atypical small acinar proliferation (ASAP). The clinician is often challenged with the decision whether to initiate TRT in these patients. This review presents a contemporary overview of the rationale for TRT, as well as the relationship between testosterone (endogenous and exogenous) and premalignant and malignant lesions of the prostate. We will discuss preliminary data from several recent series demonstrating that TRT may be safely administered in select patients with certain premalignant and bona fide malignant tumors of the prostate. In the absence of a large randomized clinical trial with long-term outcome data evaluating TRT, we hope that this overview will provide clinicians with an evidence-based approach to managing these anxiety-provoking - and often frustrating - clinical scenarios.

  3. Angiogenesis-related protein expression in bevacizumab-treated metastatic colorectal cancer: NOTCH1 detrimental to overall survival

    International Nuclear Information System (INIS)

    Paiva, Tadeu Ferreira Jr.; Jesus, Victor Hugo Fonseca de; Marques, Raul Amorim; Costa, Alexandre André Balieiro Anastácio da; Macedo, Mariana Petaccia de; Peresi, Patricia Maria; Damascena, Aline; Rossi, Benedito Mauro; Begnami, Maria Dirlei; Lima, Vladmir Cláudio Cordeiro de

    2015-01-01

    The development of targeted therapies has undoubtedly broadened therapeutic options for patients with colorectal cancer (CRC). The use of bevacizumab to reduce angiogenesis has been associated with improved clinical outcomes. However, an urgent need for prognostic/predictive biomarkers for anti-angiogenic therapies still exists. Clinical data of 105 CRC patients treated with bevacizumab in conjunction with chemotherapy were analyzed. The expression of vascular endothelial growth factor (VEGF) receptors, NOTCH1 receptor and its ligand DLL4 were determined by immunohistochemistry. Tumor samples were arranged on a tissue microarray. The association between protein expression and clinicopathological characteristics and outcomes was determined. Bevacizumab was administered as a first-line of treatment in 70.5 % of our cases. The median progression-free survival (PFS) was 10.2 months. The median overall survival (OS) of the total cohort was 24.4 months. Bevacizumab, as the first-line of treatment, and the presence of liver metastasis were independently associated with objective response rate. Membrane VEGFR1 and VEGFR3 expressions were associated with the presence of lung metastasis; interestingly, VEGFR3 was associated with less liver metastasis. NOTCH1 expression was associated with lymph node metastasis. There was a trend toward association between improved PFS and lower NOTCH1 expression (p = 0.06). Improved OS was significantly associated with lower NOTCH1 expression (p = 0.01). In a multivariate analysis, ECOG (Eastern Cooperative Oncology Group) performance status, liver metastasis, histological grade, and NOTCH1 expression were independently associated with OS. Our findings illustrated the expression profile of angiogenesis-related proteins and their association with clinicopathological characteristics and outcomes. NOTCH1 expression is a detrimental prognostic factor in metastatic CRC patients treated with chemotherapy plus bevacizumab. The online version of

  4. Factors related to quality of life and satisfaction with nasal appearance in patients treated for unilateral cleft lip and palate.

    Science.gov (United States)

    Mani, Maria; Reiser, Erika; Andlin-Sobocki, Anna; Skoog, Valdemer; Holmström, Mats

    2013-07-01

    Objective : To identify factors related to quality of life (QoL) and satisfaction with nasal appearance among patients treated for unilateral cleft lip and palate (UCLP). Design : Cross-sectional population study with long-term follow-up. Patients/Settings : All patients with UCLP born between 1960 and 1987, treated at Uppsala University Hospital, were invited (n  =  109); 86 (79%) participated. Mean follow-up time was 35 years. Main Outcome Measures : Quality of life was measured with Short Form-36 (SF-36) and analyzed using mental and physical cluster scores (MCS and PCS). Nasal appearance was self-assessed with the "Satisfaction With Appearance" questionnaire and by panel judgment. Multivariate regression analyses explored endogenous factors (age, gender, infancy cleft width, nasal function, nasolabial appearance) and exogenous factors (marital status, number of children, education level, operation method, number of rhinoplasties performed). Results : A larger cleft width in infancy was associated with less satisfaction with nasal appearance as adults. A lower mental health QoL was associated with less satisfaction with nasal appearance. Despite female gender being linked to less satisfaction with nasal appearance, it was associated with higher mental health QoL. Higher resistance during nasal breathing was associated with lower physical health QoL. Conclusions : Gender and infant cleft width may affect QoL and satisfaction with nasal appearance among adults. They are potential predictive factors for satisfaction with nasal appearance and QoL during adulthood. The correlation of nasal function impairment and decreased physical health QoL underlines the importance of treatment of nasal symptoms in these patients.

  5. Atypical Clinical Behavior of p16-Confirmed HPV-Related Oropharyngeal Squamous Cell Carcinoma Treated With Radical Radiotherapy

    International Nuclear Information System (INIS)

    Huang Shaohui; Perez-Ordonez, Bayardo; Liu Feifei; Waldron, John; Ringash, Jolie; Irish, Jonathan; Cummings, Bernard; Siu, Lillian L.; Kim, John; Weinreb, Ilan; Hope, Andrew; Gullane, Patrick; Brown, Dale; Shi, Willa; O’Sullivan, Brian

    2012-01-01

    Purpose: To report atypical clinical behavior observed in human papillomavirus (HPV)–related oropharyngeal carcinoma (OPC) treated with radiotherapy. Methods and Materials: A retrospective cohort study was conducted for all newly diagnosed OPC cases treated with radiotherapy on July 1, 2003 to April 30, 2009. HPV positivity was determined by p16 immunostaining in tumors. The incidence of additional malignancies and the pattern of distant metastases (DMs) were compared between the HPV-positive (HPV+) and HPV-negative (HPV–) cohorts. Results: HPV status was evaluated in 318 of 613 consecutive OPC cases (52%), showing 236 HPV+ and 82 HPV– patients. Compared with HPV–, HPV+ cases were less likely to have additional malignancies (prior: 11% vs. 20%, p = 0.038; synchronous: 1% vs. 9%, p = 0.001; metachronous: 6% vs. 16%, p = 0.003). Whereas the majority (10 of 12) of HPV– additional head-and-neck (HN) mucosal malignancies were in the oral cavity, there was none (0 of 7) in the HPV+ cohort (p < 0.001). HPV+ synchronous HN second primaries (SPs) were in the supraglottis, post-cricoid, and nasopharynx; metachronous HN SPs were in the glottis, supraglottis, and ethmoid plus glottis/post-cricoid region. All SPs that could be tested were HPV+. There was no difference in DM rate (10% vs. 15%, p = 0.272), but HPV+ DMs were more likely to involve multiple organs (46% vs. 0%, p = 0.005) and unusual sites. Conclusions: This study reports atypical clinical behavior seen in HPV+ OPC, including multicentric lesions in HN mucosa and DM to multiple organs and unusual sites. The frequency of these events is low, but they may have clinical implications. The routine assessment of HPV status for all OPC is warranted.

  6. Atypical Clinical Behavior of p16-Confirmed HPV-Related Oropharyngeal Squamous Cell Carcinoma Treated With Radical Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Huang Shaohui [Department of Radiation Oncology, Princess Margaret Hospital/University of Toronto, Toronto, Ontario (Canada); Perez-Ordonez, Bayardo [Department of Pathology, University Health Network, Toronto, Ontario (Canada); Liu Feifei [Department of Radiation Oncology, Princess Margaret Hospital/University of Toronto, Toronto, Ontario (Canada); Division of Applied Molecular Oncology, Ontario Cancer Institute, University Health Network, Toronto, Ontario (Canada); Waldron, John; Ringash, Jolie [Department of Radiation Oncology, Princess Margaret Hospital/University of Toronto, Toronto, Ontario (Canada); Irish, Jonathan [Department of Surgical Oncology, Princess Margaret Hospital/University of Toronto, Toronto, Ontario (Canada); Cummings, Bernard [Department of Radiation Oncology, Princess Margaret Hospital/University of Toronto, Toronto, Ontario (Canada); Siu, Lillian L. [Division of Medical Oncology, Princess Margaret Hospital/University of Toronto, Toronto, Ontario (Canada); Kim, John [Department of Radiation Oncology, Princess Margaret Hospital/University of Toronto, Toronto, Ontario (Canada); Weinreb, Ilan [Department of Pathology, University Health Network, Toronto, Ontario (Canada); Hope, Andrew [Department of Radiation Oncology, Princess Margaret Hospital/University of Toronto, Toronto, Ontario (Canada); Gullane, Patrick; Brown, Dale [Department of Surgical Oncology, Princess Margaret Hospital/University of Toronto, Toronto, Ontario (Canada); Shi, Willa [Division of Applied Molecular Oncology, Ontario Cancer Institute, University Health Network, Toronto, Ontario (Canada); O' Sullivan, Brian, E-mail: Brian.OSullivan@rmp.uhn.on.ca [Department of Radiation Oncology, Princess Margaret Hospital/University of Toronto, Toronto, Ontario (Canada)

    2012-01-01

    Purpose: To report atypical clinical behavior observed in human papillomavirus (HPV)-related oropharyngeal carcinoma (OPC) treated with radiotherapy. Methods and Materials: A retrospective cohort study was conducted for all newly diagnosed OPC cases treated with radiotherapy on July 1, 2003 to April 30, 2009. HPV positivity was determined by p16 immunostaining in tumors. The incidence of additional malignancies and the pattern of distant metastases (DMs) were compared between the HPV-positive (HPV+) and HPV-negative (HPV-) cohorts. Results: HPV status was evaluated in 318 of 613 consecutive OPC cases (52%), showing 236 HPV+ and 82 HPV- patients. Compared with HPV-, HPV+ cases were less likely to have additional malignancies (prior: 11% vs. 20%, p = 0.038; synchronous: 1% vs. 9%, p = 0.001; metachronous: 6% vs. 16%, p = 0.003). Whereas the majority (10 of 12) of HPV- additional head-and-neck (HN) mucosal malignancies were in the oral cavity, there was none (0 of 7) in the HPV+ cohort (p < 0.001). HPV+ synchronous HN second primaries (SPs) were in the supraglottis, post-cricoid, and nasopharynx; metachronous HN SPs were in the glottis, supraglottis, and ethmoid plus glottis/post-cricoid region. All SPs that could be tested were HPV+. There was no difference in DM rate (10% vs. 15%, p = 0.272), but HPV+ DMs were more likely to involve multiple organs (46% vs. 0%, p = 0.005) and unusual sites. Conclusions: This study reports atypical clinical behavior seen in HPV+ OPC, including multicentric lesions in HN mucosa and DM to multiple organs and unusual sites. The frequency of these events is low, but they may have clinical implications. The routine assessment of HPV status for all OPC is warranted.

  7. DAF-fluorescence without NO: elicitor treated tobacco cells produce fluorescing DAF-derivatives not related to DAF-2 triazol.

    Science.gov (United States)

    Rümer, Stefan; Krischke, Markus; Fekete, Agnes; Mueller, Martin J; Kaiser, Werner M

    2012-08-15

    Diaminofluorescein-dyes (DAFs) are widely used for visualizing NO· production in biological systems. Here it was examined whether DAF-fluorescence could be evoked by other means than nitrosation. Tobacco (Nicotiana tabacum) suspension cells treated with the fungal elicitor cryptogein released compound(s) which gave a fluorescence increase in the cell-free filtrate after addition of DAF-2 or DAF-FM or DAR-4M. DAF-reactive compounds were relatively stable and identified as reaction products of H(2)O(2) plus apoplastic peroxidase (PO). CPTIO prevented formation of these products. Horseradish-peroxidase (HR-PO) plus H(2)O(2) also generated DAF-fluorescence in vitro. Using RP-HPLC with fluorescence detection, DAF derivatives were further analyzed. In filtrates from cryptogein-treated cells, fluorescence originated from two novel DAF-derivatives also obtained in vitro with DAF-2+HR-PO+H(2)O(2). DAF-2T was only detected when an NO donor (DEA-NO) was present. Using high resolution mass spectrometry, the two above-described novel DAF-reaction products were tentatively identified as dimers. In cells preloaded with DAF-2 DA and incubated with or without cryptogein, DAF-fluorescence originated from a complex pattern of multiple products different from those obtained in vitro. One specific peak was responsive to exogenous H(2)O(2), and another, minor peak eluted at or close to DAF-2T. Thus, in contrast to the prevailing opinion, DAF-2 can be enzymatically converted into a variety of highly fluorescing derivatives, both inside and outside cells, of which none (outside) or only a minor part (inside) appeared NO· dependent. Accordingly, DAF-fluorescence and its prevention by cPTIO do not necessarily indicate NO· production. Copyright © 2012 Elsevier Inc. All rights reserved.

  8. Predictive models of long-term anatomic outcome in age-related macular degeneration treated with as-needed Ranibizumab.

    Science.gov (United States)

    Gonzalez-Buendia, Lucia; Delgado-Tirado, Santiago; Sanabria, M Rosa; Fernandez, Itziar; Coco, Rosa M

    2017-08-18

    To analyze predictors and develop predictive models of anatomic outcome in neovascular age-related macular degeneration (AMD) treated with as-needed ranibizumab after 4 years of follow-up. A multicenter consecutive case series non-interventional study was performed. Clinical, funduscopic and OCT characteristics of 194 treatment-naïve patients with AMD treated with as-needed ranibizumab for at least 2 years and up to 4 years were analyzed at baseline, 3 months and each year until the end of the follow-up. Baseline demographic and angiographic characteristics were also evaluated. R Statistical Software was used for statistical analysis. Main outcome measure was final anatomic status. Factors associated with less probability of preserved macula were diagnosis in 2009, older age, worse vision, presence of atrophy/fibrosis, pigment epithelium detachment, and geographic atrophy/fibrotic scar/neovascular AMD in the fellow eye. Factors associated with higher probability of GA were presence of atrophy and greater number of injections, whereas male sex, worse vision, lesser change in central macular thickness and presence of fibrosis were associated with less probability of GA as final macular status. Predictive model of preserved macula vs. GA/fibrotic scar showed sensibility of 77.78% and specificity of 69.09%. Predictive model of GA vs. fibrotic scar showed sensibility of 68.89% and specificity of 72.22%. We identified predictors of final macular status, and developed two predictive models. Predictive models that we propose are based on easily harvested variables, and, if validated, could be a useful tool for individual patient management and clinical research studies.

  9. Incidence and relative risk of peripheral neuropathy in cancer patients treated with eribulin: a meta-analysis.

    Science.gov (United States)

    Peng, Ling; Hong, Yun; Ye, Xianghua; Shi, Peng; Zhang, Junyan; Wang, Yina; Zhao, Qiong

    2017-12-19

    Eribulin is a microtubule inhibitor, which is approved for the treatment of breast cancer. Peripheral neuropathy has been reported in the studies of eribulin, but the incidence and relative risk (RR) of eribulin-associated peripheral neuropathy varied greatly in cancer patients. The purpose of this meta-analysis was to determine the overall incidence and RR of eribulin-associated peripheral neuropathy in cancer patients. Pubmed database and Embase and abstracts presented at the American Society of Clinical Oncology (ASCO) meetings were systematically reviewed for primary studies. Eligible studies included prospective clinical trials and expanded access programs of cancer patients treated with eribulin. Statistical analyses were performed to calculate the incidences, RRs, and 95% confidence intervals (CIs). Altogether, 4,849 patients from 19 clinical trials were selected for this meta-analysis. The incidences of all-grade and high-grade peripheral neuropathy were 27.5% (95% CI: 23.3-32.4%) and 4.7% (95% CI: 3.6-6.2%), respectively. The relative risks of peripheral neuropathy of eribulin compared to control were increased for all-grade (RR = 1.89, 95% CI: 1.10-3.25) but not statistically significant for high-grade (RR = 2.98, 95% CI: 0.71-12.42). The use of eribulin is associated with an increased incidence of peripheral neuropathy. The RR is increased for all-grade peripheral neuropathy.

  10. Proteomic Analysis Reveals the Deregulation of Inflammation-Related Proteins in Acupuncture-Treated Rats with Asthma Onset

    Directory of Open Access Journals (Sweden)

    Yu-Dong Xu

    2012-01-01

    Full Text Available Although the beneficial effects of acupuncture in asthma treatment have been well documented, little is known regarding the biological basis of this treatment. Changes in the lung proteome of acupuncture-treated rats with asthma onset were comparatively analyzed using a two-dimensional gel electrophoresis (2DE and mass-spectrometry- (MS- based proteomic approach. Acupuncture on specific acupuncture points appeared to improve respiratory function and reduce the total number of leukocytes and eosinophils in bronchoalveolar lavage fluid in OVA-induced asthma onset. Image analysis of 2DE gels revealed 32 differentially expressed acupuncture-specific protein spots in asthma onset; 30 of which were successfully identified as 28 unique proteins using LC-MS/MS. Bioinformatic analyses indicated that these altered proteins are most likely involved in inflammation-related biological functions, and the functional associations of these proteins result in an inflammation signaling pathway. Acupuncture regulates the pathway at different levels by regulating several key nodal proteins, including downregulating of proinflammatory proteins (e.g., S100A8, RAGE, and S100A11 and upregulating of anti-inflammatory proteins (e.g., CC10, ANXA5, and sRAGE. These deregulated inflammation-related proteins may mediate, at least in part, the antiasthmatic effect of acupuncture. Further functional investigation of these acupuncture-specific effector proteins could identify new drug candidates for the prophylaxis and treatment of asthma.

  11. Patient-Generated Subjective Global Assessment in relation to site, stage of the illness, reason for hospital admission, and mortality in patients with gynecological tumors.

    Science.gov (United States)

    Rodrigues, Camila Santos; Chaves, Gabriela Villaça

    2015-03-01

    This study aimed to identify factors related to the illness and to oncological treatment as determinants of the nutritional status of patients with gynecological tumors. This is a retrospective study; the group was composed of 146 women histopathologically shown to have gynecological tumors, at different stages of treatment, and hospitalized at the foremost centers for the prevention and treatment of cancer in Rio de Janeiro. To obtain a nutritional diagnosis, we used the Patient-Generated Subjective Global Assessment (PG-SGA). We did multiple comparisons of the numeric variables between the three PG-SGA nutritional status-classification groups by performing Kruskal-Wallis analysis of variance. We used the Mann-Whitney test to compare numerical variables between two groups. We analyzed the associations between categorical variables by using either the chi-squared (χ (2)) test or Fisher's exact test. Of the women, 62.4 % were found to be at nutritional risk or to have some level of malnourishment, being more associated with the reason for hospital admission and stage disease that properly to the tumor site. The median PG-SGA score was points, with 62.3 % of the group returning 9 or more points. Women diagnosed with endometrial cancer were found to be predominantly well nourished, and those with tumors in the ovary were more frequently diagnosed as being severely malnourished. Our findings support early nutritional intervention in the population identified as being at greater nutritional risk, aiming to minimize the loss of muscle mass and body weight, as well as to improve symptoms management, thus helping to achieve better clinical results.

  12. Pharmacokinetics of trimethoprim-sulfamethoxazole in critically ill and non-critically ill AIDS patients.

    OpenAIRE

    Chin, T W; Vandenbroucke, A; Fong, I W

    1995-01-01

    Current dosage regimens of trimethoprim-sulfamethoxazole used to treat Pneumocystis carinii pneumonia in AIDS patients have been based on data from healthy subjects or patients without AIDS. The clearance and absorption characteristics of the drugs may potentially be different between patients with and without AIDS. This study was conducted to assess the pharmacokinetics of trimethoprim-sulfamethoxazole in critically ill and non-critically ill AIDS patients treated for P. carinii pneumonia. P...

  13. Healthcare disparities in critical illness.

    Science.gov (United States)

    Soto, Graciela J; Martin, Greg S; Gong, Michelle Ng

    2013-12-01

    To summarize the current literature on racial and gender disparities in critical care and the mechanisms underlying these disparities in the course of acute critical illness. MEDLINE search on the published literature addressing racial, ethnic, or gender disparities in acute critical illness, such as sepsis, acute lung injury, pneumonia, venous thromboembolism, and cardiac arrest. Clinical studies that evaluated general critically ill patient populations in the United States as well as specific critical care conditions were reviewed with a focus on studies evaluating factors and contributors to health disparities. Study findings are presented according to their association with the prevalence, clinical presentation, management, and outcomes in acute critical illness. This review presents potential contributors for racial and gender disparities related to genetic susceptibility, comorbidities, preventive health services, socioeconomic factors, cultural differences, and access to care. The data are organized along the course of acute critical illness. The literature to date shows that disparities in critical care are most likely multifactorial involving individual, community, and hospital-level factors at several points in the continuum of acute critical illness. The data presented identify potential targets as interventions to reduce disparities in critical care and future avenues for research.

  14. Trauma related to falls from trees treated in a specialized trauma centre in Burkina-Faso-one hundred and six cases treated in one year.

    Science.gov (United States)

    Dakouré, Patrick W H; Diallo, Malick; Traoré, André-Charles V; Gandéma, Salifou; Barro, Sie Drissa; Traoré, Ibrahim Alain; Zaré, Cyprien

    2015-12-01

    Falls from trees related traumas are rarely reported in literature. They are public health problems in developing countries where their frequency is still important. The aim of the study is to describe falls from trees related trauma patterns and to present preventative measures. An annual ongoing prospective study was held in our trauma emergency department (ED) about all the patients who sustained an injury after a recent fall from tree. A questionnaire related to the patient and to the trauma was established. The data were encoded and analysed by a statistical software. One hundred six patients who sustained a fall from tree trauma, out of a total of 139, were studied. Most patients were under 15 years old (76.4 %); they were injured in fruits season (33 %) after a fall from a fruit tree (mango trees, Shea trees, Néré, etc.) and were received late (86 %). Injuries were polymorphic from traumatic brain injuries (51.8 %) and spine injuries (13.2 %) to thoraco-abdominal (21.6 %) and limbs injuries (46.2 %). Three housewives were pregnant at the time of the trauma with secondary abortions. Patients were managed medically (33.9 %), surgically (19.8 %) or by casting (34.9 %) with good outcome in 59 cases. Twelve patients refused medical care and two died. Education programs must focus on picking fruits and leaves in order to make them safe and prevent injuries related to these traditional or professional activities.

  15. Product related adult genitourinary injuries treated at emergency departments in the United States from 2002 to 2010.

    Science.gov (United States)

    Bagga, Herman S; Tasian, Gregory E; Fisher, Patrick B; McCulloch, Charles E; McAninch, Jack W; Breyer, Benjamin N

    2013-04-01

    We describe the epidemiological features of adult genitourinary injuries related to consumer products and determined the patient cohorts, products and situations associated with increased genitourinary injury risk. The National Electronic Injury Surveillance System, a data set validated to provide a probability sample of injury related emergency department presentations in the United States, was analyzed to characterize genitourinary injuries from 2002 to 2010. We analyzed 3,545 observations to derive national estimates. An estimated 142,144 adults (95% CI 115,324-168,964) presented to American emergency departments with genitourinary injuries from 2002 to 2010. Of the injuries 69% occurred in men. A large majority of injuries involved the external genitalia. The most common categories of products involved were sporting items in 30.2% of cases, clothing articles in 9.4% and furniture in 9.2%. The highest prevalence of injury was at ages 18 to 28 years (37.5%), which was most often related to sports equipment, such as bicycles. Older cohorts (age greater than 65 years) more commonly sustained injuries during falls and often in the bathroom during use of a shower or tub. Of all patients 88% were evaluated and treated in the emergency department without inpatient admission, although the admission rate increased with increasing patient age. Acute genitourinary injury is often associated with common consumer items and with identifiable high risk cohorts, products and situations. Consumers, practitioners and safety champions can use our epidemiological data to prioritize and develop strategies aimed at the prevention, limitation and informed treatment of such injuries. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  16. Stigma associated with mental illness: perspectives of university students in Qatar.

    Science.gov (United States)

    Zolezzi, Monica; Bensmail, Nawal; Zahrah, Farah; Khaled, Salma Mawfek; El-Gaili, Tayseer

    2017-01-01

    Stigma in relation to mental illness is one of the main factors inhibiting people from seeking help. Studies have been undertaken looking into the knowledge, attitudes, and beliefs (KAB) about mental illness among residents in Qatar; however, none have looked specifically at students in higher education. The aim of this study was to understand the KAB toward mental illness among students at a Qatari university and determine if there are any differences based on gender, nationality, and college type. A convenience sample of students from all genders, colleges, and nationalities was approached to participate in a survey that consisted of four sections: demographic, beliefs, attitudes, and help-seeking and treatment preferences associated with mental illness. Chi-square testing was performed to test for differences in the distribution of proportions of our primary outcomes (students' beliefs, attitudes, and help-seeking and treatment preferences). A total of 282 students completed the survey. The majority of the participating students were females (59.3%), non-Qataris (64.3%), and enrolled in science-based colleges (62.7%). Beliefs reflecting poor mental health literacy, such as "medications to treat mental illness can cause addiction", "mental illness is not like any other illness", or that "mental illness is a punishment from God", were reported by a majority of students (84.4%, 56.7%, and 50.2%, respectively). Stigmatizing attitudes that were endorsed by a majority of students included believing that people with mental illness cannot have regular jobs (60.2%), that people with mental illness are dangerous (65.7%), and that they would not marry someone with a mental illness (88.9%). Additionally, 33.6% of students indicated they would be ashamed to mention if someone in their family or they themself, had a mental illness. A vast majority of students (86.3%) indicated to prefer family and friend's support as treatment options. Significant differences in KAB about

  17. Is appreciation of written education about pain neurophysiology related to changes in illness perceptions and health status in patients with fibromyalgia?

    NARCIS (Netherlands)

    van Ittersum, M. W.; van Wilgen, C