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PubMed1992

Drug exposed infants and their mothers: facts, myths, and needs.

There is much interest in the use and abuse of chemicals by pregnant women. Although maternal chemical use is believed to be harmful to the fetus and has become the basis for criminal prosecution of mothers, obtaining accurate information about the incidence and consequences of prenatal exposure is difficult. This article critically examines the research on incidence and consequences of chemical use and offers suggestions for providing services to this vulnerable population for health care social workers in policy and practice positions.

Combined Modality Therapy↗

PubMed2000

Exploring psychological benefits associated with moderate alcohol use: a necessary corrective to assessments of drinking outcomes?

The aim of this paper is to identify positive psychological concomitants of moderate alcohol consumption. Current research and public-health perspectives on alcohol emphasize harms disproportionately relative to benefits. The major exception is research establishing beneficial effects of moderate drinking on cardiovascular health and overall mortality. In addition, much observational and experiential data suggest the widespread prevalence of positive drinking experiences. This paper is one of the first attempts since 1985 to codify such benefits in epidemiological terms. Methodological difficulties in accomplishing this include defining moderate drinking, controlling for confounding variables, and establishing causality. Nonetheless, evidence of psychological benefits has been found in experimental, observational, interview, self-report, correlational, and some prospective research. These positive findings are in the areas of subjective health, mood enhancement, stress reduction, sociability, social integration, mental health, long-term cognitive functioning, and work income/disability. Problem drinkers and alcoholics also seek mood and other benefits from alcohol, but are more likely to drink to counteract negative feelings and to support their egos than are social drinkers. It is as yet impossible to determine to what extent moderate alcohol consumption causes positive psychological outcomes and to what extent it is part of a complex pattern of mutually reinforcing variables.

Adolescent↗

PubMed1982

Chest physiotherapy: a review.

Postural drainage enhances mucociliary clearance and produces larger sputum volumes than an equivalent control period in disease characterised by excessive tracheobronchial secretions. Postural drainage, percussion and vibration will improve pulmonary function only in patients with large sputum volumes. There is no evidence that sputum yield is increased by the addition of percussion and vibration. From radioaerosol studies effective cough is limited to central airways. Breathing exercises may be of some immediate value in asthma but are without long term advantages and probably do not alter the ventilation of the underlying lung. IPPB probably does not improve delivery of bronchodilators and is of no benefit (and possible harmful) in the long term treatment of chronic bronchitis. Infective exacerbations of chronic bronchitis not characterised by copious volumes of sputum, uncomplicated pneumonia and routine post-operative states are not indications for chest physiotherapy. The value of regular physiotherapy on ventilation, gas exchange, work of breathing and incidence of infective exacerbations is uncertain but exercise training and rehabilitation of chronic obstructive airways disease improves exercise tolerance and mobility.

Breathing Exercises↗

PubMed2001

Active recovery and post-exercise white blood cell count, free fatty acids, and hormones in endurance athletes.

Strenuous endurance exercise in fasted subjects is accompanied by increased plasma levels of catecholamines, leucocytosis, low insulin, and elevated plasma free fatty acids (FFA). Immediately after such exercise, plasma FFA may rise to high and potentially harmful levels, whereas the white blood cell count (WBCC) rapidly decreases towards or below baseline values. The present work investigated how active recovery (AR) for 15 min at 50% of maximal oxygen consumption (VO2max), after 60 min of uphill running at 83% of VO2max, influenced plasma FFA, lymphocyte, neutrophil, granulocyte, and monocyte count, as well as adrenaline, noradrenaline, insulin and cortisol concentrations until 120 min post-exercise. Thirteen endurance athletes participated in the study [24.2 (3.7) years, 1.82 (0.06) m, 76.7 (7.9) kg and VO2max 69.2 (6.8) ml min-1 kg-1]. In a randomized order, the subjects completed two sets of strenuous workouts, followed by either AR or complete rest in the supine position (RR). Compared with RR, AR strongly counteracted the rapid increase in plasma FFA 5 min post-exercise. The decreases in neutrophil and monocyte counts post-exercise were nullified by AR, and the cell count stayed above resting values throughout the observation period. AR also counteracted the rapid return of hormone concentration towards baseline levels. It would appear that active recovery at low intensity after strenuous exercise can maintain sufficient adrenergic activation to counteract the post-exercise drop in WBCC. However, in spite of keeping the catecholamine concentration high and insulin levels low, AR can also maintain a low plasma FFA concentration, probably because of the continued use of FFA in muscle. It remains to be elucidated whether the observed high FFA and low WBCC values after RR have a negative effect on health. If so, AR could be a preventive measure.

Adult↗

PubMedDate not supplied

The breast cancer prevention diet by Dr. Bob Arnot: unscientific and deceptive--a disservice to American women.

The following report is a critical review of the recently published book by NBC's chief medical correspondent, Dr. Bob Arnot, entitled, The Breast Cancer Prevention Diet: The Powerful Foods, Supplements, and Drugs That Can Save Your Life. The review represents the official opinion of the American Council on Science and Health (ACSH), a nonprofit public health education and advocacy group supported by a board of over 250 scientific and policy advisors. The scientists at the ACSH express their profound concern about the misleading, unscientific, and speculative advice that Dr. Arnot offers to women who wish to reduce their risk of breast cancer, i.e., to all women. The ACSH believes, first, that in the absence of sound, peer-reviewed evidence supporting such advice, there is harm in recommending lifestyle modifications for the purpose of preventing breast cancer. The ACSH also believes that a physician (and particularly one in a position of public trust, such as a professional media health expert) should refrain from selling advice based on the twin philosophies that "you can't afford to wait" for the evidence, and that "you can only improve your health" with this diet. Indeed, unproven interventions such as those put forth in this book can have negative effects on both physical and psychological health. The ACSH contacted many of the scientists quoted or cited in Dr. Arnot's book. Some expressed concerns regarding the book's message or the misrepresentation of their work or both. Those physicians affiliated with the Memorial-Sloan Kettering Cancer Center (MSKCC) in New York, while expressing their concerns about the claims made in the book, informed the ACSH that they had been "advised" not to comment on The Breast Cancer Prevention Diet. The MSKCC public relations office acknowledged that the center had serious concerns about the Arnot book and that these concerns had been conveyed to the publisher, Little, Brown and Co., and to Dr. Arnot. The MSKCC representative noted that Dr. Arnot had "graciously" agreed to delete all references to MSKCC from future editions.

Breast Neoplasms↗

PubMed1994

Is knowing your cholesterol number harmful?

To examine the potential adverse psychological effects of screening for hypercholesterolemia, 287 men working at a motor-car assembly or steel-making plant who were ultimately diagnosed as having hypercholesterolemia and 236 randomly selected normal cholesterol controls from the same plants completed psychological questionnaires at the initial screen and 1-year later. At baseline and before diagnosis, hypercholesterolemic men scored higher on mental health and lower on negative affect than controls (p values < 0.05). One year later no adverse changes on the psychological measures were found irrespective of the type of follow-up care that they were randomly assigned to receive. Surprisingly only about half of the hypercholesterolemic men believed they had hypercholesterolemia at follow-up despite being told otherwise. Baseline scores of those who did not accept the label (n = 122) [classified as deniers] were higher on measures of positive affect and lower on measures of negative effect than those of hypercholesterolemic men who accepted the disease label (n = 73) (p values < 0.05). Moreover they held more negative attitudes towards dietary change at baseline (p < 0.03), made fewer dietary changes (p values < 0.05), and had a lesser change in total cholesterol. We conclude that a hypercholesterolemia detection and treatment program conducted in a working adult population had no adverse psychological consequences. It did, however, reveal a large subset of hypercholesterolemic men who did not accept the label despite being told they had this problem. Denial was a significant barrier to health behaviour change and may represent a maladaptive coping style for men at risk of cardiovascular disease. High cholesterol appears to be associated with better mental health and those who deny having hypercholesterolemia have the best mental health. The multifarious relationship between cholesterol, mental health, and denial deserves further study.

Adult↗

PubMed2004

Amphetamines for schizophrenia.

BACKGROUND: It is estimated that between 10% and 65% of people with schizophrenia use illicit drugs such as amphetamines. This group have an increased rate of hospitalisation, homelessness, unemployment and suicide compared with those with schizophrenia who do not abuse drugs. OBJECTIVES: To evaluate the effects of amphetamines for people with schizophrenia in terms of clinically meaningful outcomes, cognitive functioning and physiological tests. SEARCH STRATEGY: We searched the Cochrane Schizophrenia Group's Register (February 2002). SELECTION CRITERIA: We included all randomised controlled trials investigating the effects of amphetamines on people with schizophrenia, compared with a placebo intervention. DATA COLLECTION AND ANALYSIS: Working independently, we selected and critically appraised studies, extracted data and analysed on an intention-to-treat basis. Where possible and appropriate we calculated risk ratios (RR) and their 95% confidence intervals (CI), with the number needed to treat (NNT). For continuous data we calculated Weighted Mean Differences (WMD). MAIN RESULTS: We included four short studies with a total of 83 participants. Data were few and poorly reported. The results indicated a reduction of negative symptoms for people allocated to amphetamines (n = 16, 1 RCT, WMD -3 CI -5.02 to -0.98). No such effect was found for positive symptom change (n = 16, 1 RCT, WMD 0 CI -4.46 to 4.46). Compared with placebo, amphetamines significantly increased metabolism in the left and right cerebellum (n = 23, 1 RCT, WMD 0.12 CI 0.06 to 0.18; n = 23 1 RCT, WMD 0.12 CI 0.06 to 0.18) and left striatum (n = 23, 1 RCT, WMD 0.14 CI 0.00 to 0.28) and also significantly decreased metabolism in the left dorsolateral prefrontal cortex (n = 23, 1 RCT, WMD -0.09 CI -0.17 to -0.01). REVIEWERS' CONCLUSIONS: Understandably amphetamines are rarely formally evaluated in randomised studies and therefore unpublished work in this area is likely to exist. Addition of more studies may clarify reasons why people with schizophrenia persist in taking these harmful stimulants.

Amphetamine-Related Disorders↗

PubMed2006

A survey of pediatricians' attitudes and experiences with court in cases of child maltreatment.

OBJECTIVES: To explore pediatricians' attitudes and experiences with the court system in child maltreatment cases. DESIGN: An anonymous, cross-sectional survey of a random sample of pediatricians registered with the North Carolina Medical Board. RESULTS: The response rate of the study was 60% (N=270). Few pediatricians (10%) reported that they had "ever" suspected maltreatment but decided not to report it. Pediatricians were equally likely to recall positive and negative experiences in court for child abuse cases. Pediatricians with negative court experiences were more likely to view reporting as time-consuming and were more than twice as likely not to report suspected cases of maltreatment (OR 2.4, 95% CI 1.04, 6.0). Seventy-five percent of pediatricians felt that court is harmful or distressing for children. CONCLUSIONS: The majority of pediatricians report suspected cases of child maltreatment. Pediatrician's court experiences play a role in the response to child maltreatment cases, influencing attitudes towards the legal system and the process of caring for maltreated children. Future research efforts should address physicians' concerns about the impact of court on children, ways to improve the working relationship between the legal system and physicians, and the training needs of physicians in child maltreatment, including testifying and understanding the court process.

Adult↗

PubMed2005

Automated system for fast and accurate analysis of SF6 injected in the surface ocean.

This paper describes an automated sampling and analysis system for the shipboard measurement of dissolved sulfur hexafluoride (SF6) in surface marine environments into which SF6 has been deliberately released. This underway system includes a gas chromatograph associated with an electron capture detector, a fast and highly efficient SF6-extraction device, a global positioning system, and a data acquisition system based on Visual Basic 6.0/C 6.0. This work is distinct from previous studies in that it quantifies the efficiency of the SF6-extraction device and its carryover effect and examines the effect of surfactant on the SF6-extraction efficiency. Measurements can be continuously performed on seawater samples taken from a seawater line installed onboard a research vessel. The system runs on an hourly cycle during which one set of four SF6 standards is measured and SF6 derived from the seawater stream is subsequently analyzed for the rest of each 1 h period. This state-of-art system was successfully used to trace a water mass carrying Cochlodinium polykrikoides, which causes harmful algal blooms (HAB) in the coastal waters of southern Korea. The successful application of this analysis system in tracing the HAB-infected water mass suggests that the SF6 detection method described in this paper will improve the quality of the future study of biogeochemical processes in the marine environment.

Automation↗

PubMedDate not supplied

Protective and pathogenic roles of CD8+ T cells during malaria infection.

CD8+ T cells play a key role in protection against pre-erythrocytic stages of malaria infection. Many vaccine strategies are based on the idea of inducing a strong infection-blocking CD8+ T cell response. Here, we summarize what is known about the development, specificity and protective effect of malaria-specific CD8+ T cells and report on recent developments in the field. Although work in mouse models continues to make progress in our understanding of the basic biology of these cells, many questions remain to be answered - particularly on the roles of these cells in human infections. Increasing evidence is also emerging of a harmful role for CD8+ T cells in the pathology of cerebral malaria in rodent systems. Once again, the relevance of these results to human disease is one of the primary questions facing workers in this field.

Animals↗

PubMed2006

Breastfeeding beliefs and practices among migrant mothers in slums of Diyarbakir, Turkey, 2001.

BACKGROUND: A qualitative investigation and a population survey were conducted to explore the breastfeeding beliefs and practices of mothers who were forced to migrate from their original villages and were currently living in the slums of Diyarbakir in Turkey. METHODS: Qualitative data collection on breastfeeding beliefs was conducted using in-depth interviews. In-depth interviews were tape-recorded. Quantitative data on breastfeeding practices were collected using a structured questionnaire. RESULTS: Mothers generally have a positive attitude towards breastfeeding, but colostrum is usually perceived negatively. No woman was found to feed her infant exclusively by breastfeeding. Only 9.9% of mothers initiated breastfeeding within the first hour of birth. Forty per cent of mothers started solid foods before 4 months. Mother's education appeared as a significant factor influencing the introduction of colostrum to the newborn. Mothers with lower education generally believed that the colostrum should not be fed to the infant and that a pregnant woman's milk is unhealthy for the baby. There was also a belief that 'working under the sun' decreased the quality of milk of a mother. CONCLUSION: Cultural beliefs have a significant influence on breastfeeding practices. Some of these practices are potentially harmful to newborns. Health education programmes should address these beliefs and practices in culture sensitive ways.

Adult↗

PubMed1999

Better for it: how people benefit from adversity.

Recently, researchers in several different fields have discovered that people who have experienced seriously adverse events frequently report that they were positively changed by the experience. Respondents in these studies typically have reported a variety of different benefits and have reported that they also were harmed by the same experiences. The research suggests several processes that may account for these reports of benefit: purposeful changes in life structure, changes in views of others and the world that result from the experience of vulnerability, the receipt of needed support, and the search for meaning in adversity. Thinking about benefits may help survivors of traumatic events process painful information. This article offers guidance on how to introduce and manage benefit content within a therapeutic relationship and encourages social workers to cautiously reflect clients' unstated benefits, encourage self-assessments in areas where benefits may accrue, explore any benefits discovered, and help clients plan for positive changes. This process converges well with the strengths perspective and constructivist approaches to social work practice.

Adaptation, Psychological↗

PubMed2004

Surveillance of medical device-related hazards and adverse events in hospitalized patients.

CONTEXT: Although adverse drug events have been extensively evaluated by computer-based surveillance, medical device errors have no comparable surveillance techniques. OBJECTIVES: To determine whether computer-based surveillance can reliably identify medical device-related hazards (no known harm to patient) and adverse medical device events (AMDEs; patient experienced harm) and to compare alternative methods of detection of device-related problems. DESIGN, SETTING, AND PARTICIPANTS: This descriptive study was conducted from January through September 2000 at a 520-bed tertiary teaching institution in the United States with experience in using computer tools to detect and prevent adverse drug events. All 20 441 regular and short-stay patients (excluding obstetric and newborn patients) were included. MAIN OUTCOME MEASURES: Medical device events as detected by computer-based flags, telemetry problem checklists, International Classification of Diseases, Ninth Revision (ICD-9) discharge code (which could include AMDEs present at admission), clinical engineering work logs, and patient survey results were compared with each other and with routine voluntary incident reports to determine frequencies, proportions, positive predictive values, and incidence rates by each technique. RESULTS: Of the 7059 flags triggered, 552 (7.8%) indicate a device-related hazard or AMDE. The estimated 9-month incidence rates (number per 1000 admissions [95% confidence intervals]) for AMDEs were 1.6 (0.9-2.5) for incident reports, 27.7 (24.9-30.7) for computer flags, and 64.6 (60.4-69.1) for ICD-9 discharge codes. Few of these events were detected by more than 1 surveillance method, giving an overall incidence of AMDE detected by at least 1 of these methods of 83.7 per 1000 (95% confidence interval, 78.8-88.6) admissions. The positive predictive value of computer flags for detecting device-related hazards and AMDEs ranged from 0% to 38%. CONCLUSIONS: More intensive surveillance methods yielded higher rates of medical device problems than found with traditional voluntary reporting, with little overlap between methods. Several detection methods had low efficiency in detecting AMDEs. The high rate of AMDEs suggests that AMDEs are an important patient safety issue, but additional research is necessary to identify optimal AMDE detection strategies.

Adult↗

PubMed2001

[Hygienic control of contingencies associated with local fire events aboard piloted orbital stations].

Based on the multiyear experience of hygienic control of the orbital stations, there are three causes of contingent air pollution: leakage of service system pipeline with chemical working bodies, spills of reagents used in biochemical and technological experiments, and air pollution by products of thermal oxidative degradation of nonmetallic materials. The authors describe their experience in successful elimination and prevention of hazardous consequences of fire aboard the space stations. Analysis of air pollution dynamics after actual fire events in the space station modules showed that it approximates a two-chamber air flow model with two phases of pollutant equilibration: first a rapid fall of concentration in the module on fire till air in the modules gets completely mixed, and then slow elimination of harmful pollutant from air. Identified were markers,--propylene and methylmetacrilate,--reacting to first signs of fire. Carbonic acid nitriles were recognized as toxic products of destruction. The positive effect of intermodular ventilation on dilution of toxic products of thermal oxidative destruction of materials was demonstrated. Satisfactory agreement of calculated and factual pollutant concentrations on board Mir permitted conclusion on applicability of the theoretical model to prediction of levels of air pollution due to contingency.

Air Pollutants↗

PubMedDate not supplied

Motivation: a new look at an age-old topic.

Employee motivation is a shared responsibility. An employee has to have some amount of intrinsic desire to perform a task. You can't create that desire. But, you can create an environment that brings out that desire, and allows an employee to shine. Abraham Maslow developed one of the most useful of all motivation theories--the "Hierarchy of Needs"--in the 1940s, and it is still the prevailing theory today. The Needs Hierarchy begins with the basic idea that only an unfulfilled need is a motivator. Or, in plain English, people perform specific actions to meet specific personal needs. Maslow defines five levels of needs that all people experience: 1: Physiological, Food, shelter, and yes, sex. 2: Safety/Security. No personal harm and the current lifestyle is safe. 3: Social. The need for acceptance by others, for belonging, friendship and affection. 4: Self-Esteem/Ego. Recognition, status and prestige. 5: Self-Actualization. Self-fulfillment and the need for achieving one's personal best. What makes this needs theory so interesting and so useful in the workplace is the clarity with which a position in the hierarchy can be determined. The basic premise is that lower-level needs must be satisfied before moving upward to the next level. Consider your own employees and what you know about them. Look at their situations, and evaluate where they may be in the hierarchy. Remember, it's difficult to separate their personal situations from their work personas. Try using Abraham Maslow as a starting point to identify motivations of your staff.

Humans↗

PubMed2005

RNF11 is a multifunctional modulator of growth factor receptor signalling and transcriptional regulation.

Our laboratory has found that the 154aa RING finger protein 11 (RNF11), has modular domains and motifs including a RING-H2 finger domain, a PY motif, an ubiquitin interacting motif (UIM), a 14-3-3 binding sequence and an AKT phosphorylation site. RNF11 represents a unique protein with no other known immediate family members yet described. Comparative genetic analysis has shown that RNF11 is highly conserved throughout evolution. This may indicate a conserved and non-redundant role for the RNF11 protein. Molecular binding assays using RNF11 have shown that RNF11 has important roles in growth factor signalling, ubiquitination and transcriptional regulation. RNF11 has been shown to interact with HECT-type E3 ubiquitin ligases Nedd4, AIP4, Smurf1 and Smurf2, as well as with Cullin1, the core protein in the multi-subunit SCF E3 ubiquitin ligase complex. Work done in our laboratory has shown that RNF11 is capable of antagonizing Smurf2-mediated inhibition of TGFbeta signalling. Furthermore, RNF11 is capable of degrading AMSH, a positive regulator of both TGFbeta and EGFR signalling pathways. Recently, we have found that RNF11 can directly enhance TGFbeta signalling through a direct association with Smad4, the common signal transducer and transcription factor in the TGFbeta, BMP, and Activin pathways. Through its association with Smad4 and other transcription factors, RNF11 may have a role in direct transcriptional regulation. Our laboratory and others have found nearly 80 protein interactions for RNF11, placing RNF11 at the cross-roads of cell signalling and transcriptional regulation. RNF11 is highly expressed in breast tumours. Deregulation of RNF11 function may prove to be harmful to patient therapeutic outcomes. RNF11 may therefore provide a novel target for cancer therapeutics. The purpose of this review is to discuss the role of RNF11 in cell signalling and transcription factor modulation with special attention given to the ubiquitin-proteasomal pathway, TGFbeta pathway and EGFR pathway.

Carrier Proteins↗

PubMedDate not supplied

[Social characteristics and risk behaviors for HIV in a group of transvestites and male transsexuals engaging in street prostitution].

OBJECTIVE: To describe life and work conditions, practices associated with HIV transmission, self-informed HIV status and HIV test coverage in a group of male transgender street prostitutes. METHODS: Case descriptive study of male transgender street prostitutes who attended a mobile unit of a harm reduction programme in 1998 in Madrid, Spain Information on sociodemographic characteristics, work conditions, illegal drug use, sexual behaviours and self-informed HIV status was collected. RESULTS: 132 male transgenders were interviewed, of which 56% were Spanish. Median age was 30 years. 50% had primary school education or less. 11% had injected drugs sometime in their lives. Median time in prostitution was 8 years and 66% had worked only in the streets. In the last month, all of them said to use condoms in insertive anal sex with clients, 98% in receptive sex and 49% always used it with their partners in the previous year. 39% referred accidents with condoms within the previous month. 73% had had an HIV test, of which 22% said to be HIV positive (16% in those who had never injected drugs and 58% in the ones who had). CONCLUSIONS: HIV seroprevalence in male transgender street prostitutes is high, even in non-intravenous drug users. They nearly always use condoms with clients but have a high level of accidents. HIV prevention programmes in prostitution should be more specifically adapted to the different groups of commercial sex workers.

Adult↗

PubMed1998

Comment - Genes and temperament, a shortcut for unravelling the genetics of psychopathology?

Personality is complex and unique, in that people differ greatly from one another in multiple components of personality. Nevertheless, personality can be measured and dissected into a number of quantitative traits. One of the more recent tools is the Temperament and Character Inventory (TCI), which is a self-report personality questionnaire based on Cloninger's psychobiological model of personality (Cloninger et al., 1994). This model consists of four dimensions of temperament and three dimensions of character. Temperament dimensions (novelty-seeking, harm avoidance, reward dependence and persistence) refer to automatic emotional responses to stimuli and are moderately heritable, relatively stable throughout life, and invariant despite sociocultural influences (Svrakic et al., 1996). Individuals high in novelty-seeking tend to be quick-tempered, excitable, exploratory, curious, enthusiastic, impulsive and disorderly. Individuals high in harm avoidance tend to be cautious, careful, fearful, tense, apprehensive, nervous, discouraged, insecure, negativistic and pessimistic, even in situations which do not worry other people. People scoring high on reward dependence seek social contact and are open to communication with other people; they are tender-hearted, sensitive, dedicated and sociable. Highly persistent individuals tend to be industrious, hard-working, persistent, and stable, despite frustration and fatigue. The character dimensions (self- directedness, cooperativeness and self-transcendence) involve differences in social goals and values and seem to be moderately influenced by family environment (Cloninger et al., 1994). Cloninger's psychobiological model of personality shows correlations to other factor models of personality, like the NEO five-factor model. The TCI dimension of novelty-seeking shows positive loading on NEO conscientiousness (Cloninger et al., 1994).

Journal Article↗