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PubMed1996

Parental understanding of the consequences of pediatric cardiac transplantation.

Pediatric cardiac transplantation has profound medical, social, psychological and economic consequences. Parents need to understand both the medical and non-medical consequences of the transplant procedure to make a judicious decision about this treatment. The purpose of this study was to determine the parental understanding of the multiple consequences of transplantation. A prospective ethnographic method was used to study 24 parents of 15 children prior to their decision to accept or reject the transplant option for their children. Findings revealed that the medical consequences of transplantation were well addressed by the pediatric cardiac transplant team. Little attention, however, was given to the non-medical concerns of the parents. The importance of nursing interventions related to information clarification and support for parents as they make decisions about heart transplantation for their children was identified.

Adolescent↗

PubMed1999

Lifetime health and economic consequences of obesity.

BACKGROUND: Obesity is an established risk factor for several chronic diseases. The lifetime health and economic consequences of obesity for individual patients have not been documented. OBJECTIVE: To estimate the lifetime health and economic consequences of obesity. METHODS: We developed a dynamic model of the relationship between body mass index and the risks and associated costs of 5 obesity-related diseases: hypertension, hypercholesterolemia, type 2 diabetes mellitus, coronary heart disease, and stroke. The model was estimated using data from the Third National Health and Nutrition Examination Survey, the Framingham Heart Study, and other secondary sources. We used this model to estimate (1) risks of hypertension, hypercholesterolemia, and type 2 diabetes mellitus at future ages; (2) lifetime risks of coronary heart disease and stroke; (3) life expectancy; and (4) expected lifetime medical care costs of these 5 diseases for men and women aged 35 to 64 years with body mass indexes of 22.5, 27.5, 32.5, and 37.5 kg/m2 (nonobese and mildly, moderately, and severely obese, respectively). RESULTS: Disease risks and costs increase substantially with increased body mass index. The risk of hypertension for moderately obese 45- to 54-year-old men, for example, is roughly 2-fold higher than for their nonobese peers (38.1% vs 17.7%), whereas the risk of type 2 diabetes mellitus is almost 3-fold higher (8.1% vs 3.0%). Lifetime risks of coronary heart disease and stroke are similarly elevated (41.8% vs 34.9% and 16.2% vs 13.9%, respectively), whereas life expectancy is reduced by 1 year (26.5 vs 27.5 years). Total discounted lifetime medical care costs for the treatment of these 5 diseases are estimated to differ by $10,000 ($29,600 vs $19,600). Similar results were obtained for women. CONCLUSIONS: The lifetime health and economic consequences of obesity are substantial and suggest that efforts to prevent or reduce this problem might yield significant benefits.

Adult↗

PubMed2000

Actions without consequences: injury-related messages in children's programs.

OBJECTIVE: To characterize children's television programs in terms of their unintentional injury-related messages. DESIGN: Content analysis. Episodes representing a total of 216 unique television programs were coded for the presence of imitable unsafe behaviors without consequences. SETTING: A census of all children's programming airing in a northeastern city during the first week of December 1996. RESULTS: Exactly 47.0% of children's programming depicted at least 1 instance of unsafe, imitable behavior without consequences; one third had more than 3 instances. Exactly 51.0% of the programs targeted to school-age children and 33.4% of the programs targeted to preschoolers contained these unsafe behaviors. The majority (56.8%) of children's programs on basic cable television depicted unsafe behavior as compared with 23.1% of programs shown on public television. Cartoon programs depicted the most unsafe behaviors (60.3%), as compared with live-action programs (33.4%) and other genres (23.3%). CONCLUSIONS: Children's television programs depict too many unsafe behaviors without consequences. Future work should explore the role of these programs in the development of unsafe behaviors in children.

Adolescent↗

PubMed2004

Projected economic costs due to health consequences of teenagers' loss of confidentiality in obtaining reproductive health care services in Texas.

BACKGROUND: We wanted to focus on the potential consequences of recently enacted legislation in Texas that limits adolescents' ability to obtain confidential reproductive health care services. OBJECTIVE: To assess the potential economic costs that result when adolescents do not seek reproductive health care services because their confidentiality is compromised. DESIGN: We developed a cost model to estimate the projected costs of parental consent and law enforcement reporting requirements based on data from the literature, the Texas Department of Health, and publicly funded family planning clinics in Texas. Univariate and multivariate sensitivity analyses explored different scenarios. SETTING: The state of Texas. PARTICIPANTS: Projected costs were estimated for all girls younger than 18 years using publicly funded reproductive health care services in Texas. MAIN OUTCOME MEASURES: We determined the projected number of additional pregnancies, births, abortions, and untreated sexually transmitted infections and resulting pelvic inflammatory disease and calculated the associated economic costs of these projected outcomes. RESULTS: The potential costs of parental consent and law enforcement reporting requirements in Texas were estimated at 43.6 million dollars (range, 11.8 million dollars to 56.6 million dollars) for girls younger than 18 years currently using publicly funded services. CONCLUSIONS: As policymakers throughout the United States search for ways to curtail adolescent sexual activity and its adverse consequences, this analysis suggests that the limiting of medical confidentiality and the resulting restricted use of reproductive health care services potentially have serious health and economic consequences.

Adolescent↗

PubMed1997

Correlates and consequences of harsh discipline for young children.

OBJECTIVE: To examine the incidence, predictors, and consequences of harsh discipline in a sample of low-birth-weight children at 1 and 3 years of age. DESIGN: Analysis of data from the Infant Health and Development Program, an 8-site randomized clinical trial of low-birth-weight infants. The sample for analysis consisted of 715 children who were 3 years of age. The independent measurements of primary interest were the mother's hitting and scolding of her child as disciplinary practice. Analyses were run separately for boys and girls. Bivariate and logistic analyses were used to examine the predictors of the mother's hitting and scolding behavior. Multivariate analysis of variance was used to examine the consequences of the mother's harsh discipline on a child's IQ measured at age 3 years. MAIN OUTCOME MEASURES: The mother's self-report of whether she used more than 1 physical punishment in the past week, as well as an observer's report from 2 home visits of whether the mother hit or scolded the child during the 2-hour home visit. In addition, the Stanford-Binet Intelligence Scale was used to examine the consequences of persistent harsh discipline on child well-being. RESULTS: Findings demonstrate child, maternal, and environmental factors that might aggravate a parent's use of corporal punishment. Boys received higher amounts of harsh discipline on all outcome measures. For boys, growing up in an impoverished home was predictive of the greater likelihood of receiving harsh punishment. Using IQ at age 3 years as the outcome measure, girls were found to be vulnerable to persistent harsh discipline and lack of maternal warmth. Maternal harsh discipline in a context of low maternal warmth was associated with IQ scores for girls that are 12 points lower than the IQ scores of girls who received low punishment and high warmth.

Analysis of Variance↗

PubMed2001

The social consequences of occupational injuries and illnesses.

BACKGROUND: Most outcome studies of occupational injuries and illnesses have tended to focus on direct economic costs and duration of work disability. Rarely have the broader social consequences of work-related disorders or their impacts on injured workers' families, coworkers, and community been investigated. This paper examines a wide range of social consequences including workers' psychological and behavioral responses, vocational function, and family and community relationships. METHODS: Literature review and development of conceptual framework. RESULTS: Complex and multifactorial relationships are described whereby occupational injuries and illnesses produce a variety of social consequences involving filing and administration of workers' compensation insurance claims, medical care experiences, domestic function and activities of daily living, psychological and behavioral responses, stress, vocational function, rehabilitation and return to work, and equity and social justice. CONCLUSION: A research agenda is proposed for guiding future investigations in this field.

Accidents, Occupational↗

PubMed2006

Differences in the social consequences of ethanol emerge during the course of adolescence in rats: social facilitation, social inhibition, and anxiolysis.

The present experiments explored social consequences of ethanol during adolescence by examining dose-dependent ethanol-induced social facilitation and inhibition in a non-anxiogenic (familiar) environment, and ethanol-related anxiolysis in an anxiogenic (unfamiliar) environment in early (P28) and late (P42) adolescent rats. Pronounced age-related differences in the social consequences of ethanol emerged during the course of adolescence, with early adolescents being uniquely sensitive to activating effects of low doses of ethanol when tested in the familiar context in terms of play fighting-an adolescent-characteristic form of social interactions, but conversely less sensitive than late adolescents to ethanol-associated social suppression when tested at higher ethanol doses in this context. Early adolescents were also less sensitive than late adolescents to the anxiolytic effects of ethanol revealed in the unfamiliar test situation, when indexed in terms of increases in social investigation and the ethanol-induced transformation of social avoidance into social preference. Anti-anxiety properties of ethanol were found to be sex-dependent in older animals, with late adolescent females being more sensitive to ethanol anxiolysis than their male counterparts. Considerable ontogenetic differences in the social consequences of ethanol are evident even within the adolescent period, with early adolescence being a time of particularly pronounced adolescent-typical sensitivities to ethanol.

Age Factors↗

PubMed1990

An examination of the intramodal and intermodal behavioral consequences of long-term vibrissae removal in rats.

An assessment was made of the effects of long-term tactile restriction by bilateral removal of the mystacial vibrissae from an early age on the subsequent somatosensory capacities of rats (i.e., the intramodal consequences) as well as its effects on visual and spatial capacities (i.e., the intermodal consequences). Rearing environment (enriched vs. normal) and method of vibrissae removal (cauterization of follicles vs. plucking) were examined to determine specific factors that m might influence the effect of vibrissae removal. Early, long-term tactile restriction had significant intramodal and intermodal consequences. Dewhiskered rats showed attenuated orientation to tactile stimuli presented to their mystacial pads and enriched-reared rats whose vibrissae follicles had been cauterized showed increased orientation to visual stimuli. Manipulation of early somatosensory signals had no impact on the development of certain spatial and precise manipulatory skills. These data provide limited evidence for theories of modality interdependence and yield basic information concerning the role of the mystacial vibrissae in the behavior of the rat.

Animals↗

PubMed1989

Structural consequences of endosteal metastatic lesions in long bones.

Lytic metastatic lesions from breast, prostate, and other cancers often develop on the endosteal surface of a long bone without penetrating the cortical wall. Current clinical guidelines for determining the fracture risk associated with these endosteal defects do not account for the structural consequences of the lesion. We undertook a combined experimental and analytical study of the structural consequences of the lesions with the ultimate goal of providing improved fracture risk guidelines. Endosteal defects of variable length and involving a variable amount of the cortical wall were created with an expanding reamer in canine femurs. The contralateral femur served as a control. The femurs were tested to failure in four point bending. The geometry of the experimental defects was determined from radiographs and CT. Finite element models of the canine femurs were then used to examine geometric and material parameters in both four point bending and in torsion. The experimental data demonstrate a linear relation between bone strength and amount of cortical wall remaining: % intact strength = 99.6 x remaining wall thickness - 2.0, R2 = 0.769, standard deviation of regression = 11.57. Four of five data points from the linear finite element models were within the 95% confidence intervals for the experimental data. Experimental and finite element data suggest that the minimum wall thickness is the most critical geometric parameter for predicting the structural consequences of endosteal defects. The length of the defect along the bones' long axis has little effect on bone strength. The anelastic behavior of bone does not need to be represented in finite element models of simple endosteal defects because the defects do not cause significant stress concentrations. However, reduction in the modulus of bone along the border of a defect (due to osteolytic changes) can significantly reduce bone strength. These results indicate that the minimum wall thickness should be determined when clinically evaluating an endosteal defect. The results also suggest that information on bone porosity around metastatic lesions should be considered when making estimates of bone strength.

Animals↗

PubMed2007

Central nervous system-related permanent consequences in patients with Langerhans cell histiocytosis.

BACKGROUND: Permanent consequences in Langerhans cell histiocytosis (LCH) are irreversible late sequelae related to the disease that may severely impair the quality of life of survivors. The frequency and pattern of permanent consequences affecting the central nervous system (CNS) remains to be determined. PROCEDURE: In this single center study, 25 LCH patients observed for a median time of 10 years 3 months underwent a uniform thorough follow-up program including neuropsychological testing and electrophysiological evaluation. RESULTS: Overall permanent consequences were seen in 9 of 25 patients. Intracranial abnormalities were the most frequent including diabetes insipidus (DI) in seven patients, anterior pituitary deficiencies in five patients, and neurodegenerative CNS disease in five patients. No patient had overt neurological symptoms upon neurological evaluation, but psychological testing revealed subtle deficits in short-term auditory memory (STAM) in 14 patients. Brain stem evoked potentials showed abnormalities in four of nine tested patients, all of these four had neurodegeneration on MRI. CONCLUSION: Psychoneuroendocrine sequelae were found in an unexpectedly high number of patients in this single center study. Long-term follow-up focusing on such sequelae are important in LCH survivors, in order to detect early deficits, to monitor the evolution of the disease, and to provide specific support.

Adolescent↗

PubMedDate not supplied

Clinical consequences of hepatitis C virus infection.

Hepatitis C virus (HCV) is a positive strand RNA virus that belongs to the Hepacivirinae genus within the Flaviviridae family. HCV infection has a wide spectrum of cellular tropism and clinical presentations. This has major impacts in terms of pathogenesis and diagnosis. Consequently, a wide range of clinical consequences characterises this viral infection, including asymptomatic chronic carriage, acute hepatitis, chronic hepatitis, cirrhosis, hepatocellular carcinoma and extrahepatic manifestations. The latter are commonly observed and may represent the first sign of the disease. A better knowledge of the pathobiology of HCV and its clinical consequences will be important for developing better treatment strategies to cure HCV infection and extrahepatic manifestations.

Genetic Variation↗

PubMed1998

Sexual selection and the fitness consequences of male body size in the seed beetle Stator limbatus

We examined sexual selection on male body size in a laboratory population of the seed beetle, Stator limbatus, and the fitness consequences to females of mating with larger males. Large males produced larger ejaculates than small males. Both males and females lost body weight as a consequence of breeding, and large males lost more weight than small males. The amount of weight lost by males correlated as highly with female fecundity as did the amount of weight lost by females. Similarly, male and female body weight correlated equally highly with female fecundity. These results indicate that males make substantial contributions to female fecundity, probably through nutrients transferred in their ejaculate. As a consequence, fecundity selection should favour large body size in both males and females. We found no preference for large males when virgin females were presented with only one male, but when presented with two males simultaneously, females were more likely to mate with the larger male. This result is consistent with relative female choice or male-male competition, although no indications of male-male competition were observed. Females that mated with small males re-mated sooner than females that first mated with large males. Females that first mated with a non-virgin male were also more likely to re-mate than females that first mated with a virgin male, suggesting that females re-mate to obtain additional sperm or nutrients and not just as a form of mate choice. In addition to the possible benefits from mate choice and male-male competition, large males gain a mating advantage through reduced sperm competition. This large male advantage, combined with fecundity selection on males as well as females, may account for males being larger than females in this species.Copyright 1998 The Association for the Study of Animal Behaviour.

Journal Article↗

PubMed2000

Consequences of Pentylenetetrazole Kindling on Spatial Memory and Emotional Responding in the Rat.

We investigated the consequences of pentylenetetrazole (PTZ) kindling on cognitive capacities of rats in a Morris water maze assessing spatial reference memory and in the spontaneous alternation test used as an index of working memory. The emotional consequences of PTZ kindling were also evaluated in an elevated plus maze test. Results indicated that PTZ kindled rats were not different from controls in mastering the water maze. However, PTZ kindled rats did not persist in searching the platform when evaluated at the end of learning. This suggests an altered place memory, although alternative explanations, like reduced anxiety, may be involved. Indeed, such anxiolytic activity was observed in a separate group of kindled rats evaluated in the plus maze test. No significant effect of PTZ kindling was noted in the spontaneous alternation test. These results question the generalization of previous results obtained in learning tests using electric shocks and illustrate the complexity of the PTZ model for the study of the behavioral consequences of kindling.

Journal Article↗

PubMed2001

The consequences of tourism for sustainable water use on a tropical island: Zanzibar, Tanzania.

Many developing countries in the tropics have focused on tourism to generate additional income sources and to diversity the economy. Coastlines in particular have been on the forefront of tourist infrastructure development. Here, the presence of a large number of tourists has often had negative consequences for the sustainable use of the available resources, which in turn has had an effect on the integrity of the ecosystems. In this paper, the situation is described for the use of freshwater resources on the east coast of Zanzibar, Tanzania. This region is water poor, relying on freshwater derived from seasonal rains and stored in less efficient aquifers, which consist of freshwater lenses floating on the underlying seawater. Tourism in the area has grown rapidly in recent years and is expected to further increase in the future. This development is expected to put additional pressure on the freshwater resources of the east coast, which show already signs of over-use. The consequences of overexploitation can include the lowering of the groundwater table, land subsidence, deteriorating groundwater quality, and saltwater intrusion. These, in turn, determine the living conditions in coastal areas and the effects will be felt both by the local populations and the tourist industry. An investigation is made into the causes and consequences of water abstraction by the tourist industry. The results show that present levels of withdrawal are not sustainable, and parts of the local populations are already experiencing water deficits on a daily basis. In the future, if the expected increase in tourist numbers occurs, the pressure on the aquifers will correspondingly increase. The results could be that the tourism in the area becomes unsustainable, which could have an adverse effect on the national economy and also on the local population and environment. Therefore, a precautionary water-management approach is suggested.

Conservation of Natural Resources↗

PubMed2001

A biokinetic model to describe consequences of inhibition/stimulation in DNA-proofreading and repair-1. Development of the model.

A biokinetic model is described which deals with the mathematical consequences of the inhibition or stimulation of DNA proofreading. It demonstrates the development of the number of DNA mismatch-dependent cells (e.g. cells with a malignant phenotype), where such mismatches arise by the in situ interaction of various substances with nucleotides of the DNA. The model can test for consequences by a logic gating on an "if-then" type of analysis in relation to the separate and consecutive processes of proofreading and repair. In particular, the consequences are considered in cases where either (i) the efficacy of proofreading and repair are reduced/prevented (inhibited) or (ii) are increased by some form of stimulation. On the chosen kinetic parameters, the model is accessible to manipulation as new data arising from further investigations become available and are introduced. The model is based on recently published data which show that an increased "mutant fraction" (see note on terms) arises in DNA replication when intracellular nucleotide pools show "asymmetries" (see note on terms). Extraordinarily high mutant fractions can be predicted/have been recorded in the presence of proofreading inhibitors. The model expresses data in mathematical terms of the competition between the development of mismatch-dependent cells and those with authentic genetic information. (Feedback and metastasis-effects and those of wild-type replicates are included.) A computerized (numerical) integration of the corresponding set of differential equations is offered. (A diskette with the program CANCER.xls is available upon request.)

Animals↗

PubMed2000

Receiving Two Consequences: Tests of Monotonicity and Scale Invariance.

The present study investigated two behavioral properties of decision making. Participants were presented two alternatives, each of which yielded two consequences jointly (joint receipt, JR). Monotonicity of JR states that choices remain invariant when the same lottery is adjoined to both of the original alternatives. The data failed to reject monotonicity of JR. Scale invariance states that choices remain invariant under proportionate (scale) changes of the lottery consequences. This property was not rejected for three of four classes of JR lotteries having a common consequence, but it was rejected for two of three classes of binary lotteries and for two of the four classes of general JR lotteries. We conclude that scale invariance does not hold in general. The implication of these findings for utility theory, testing its fundamental assumptions, and determining the functional form of utility is discussed. Copyright 2000 Academic Press.

Journal Article↗

PubMed1992

Restriction in the conformational flexibility of apoproteins in the presence of organic cosolvents: a consequence of the formation of "native-like conformation".

The influence of n-propanol on the overall alpha-helical conformation of beta-globin, apocytochrome C, and the functional domain of streptococcal M49 protein (pepM49) and its consequence on the proteolysis of the respective proteins has been investigated. A significant amount of alpha-helical conformation is induced into these proteins at pH 6.0 and 4 degrees C in the presence of relatively low concentrations of n-propanol. The induction of alpha-helical conformation into the proteins increased as a function of the propanol concentration, the maximum induction occurring around 30% n-propanol. In the case of alpha-globin, the fluorescence of its tryptophyl residues also increased as a function of n-propanol concentration, the midpoint of this transition being around 20% n-propanol. Furthermore, concomitant with the induction of helical conformation into these proteins, the proteolysis of their polypeptide chain by V8 protease also gets restricted. The alpha-helical conformation induced into alpha- and beta-globin by n-propanol decreased as the temperature is raised from 4 to 24 degrees C. In contrast, the alpha-helical conformation of both alpha- and beta-chain (i.e., globin with noncovalently bound heme) did not exhibit such a sensitivity to this change in temperature. However, distinct differences exist between the n-propanol induced "alpha-helical conformation" of globins and the "alpha-helical conformation" of alpha- and beta-chains. A cross-correlation of the n-propanol induced increase in the fluorescence of beta-globin with the corresponding increase in the alpha-helical conformation of the polypeptide chain suggested that the fluorescence increase represents a structural change of the protein that is secondary to the induction of the alpha-helical conformation into the protein (i.e., an integration of the helical conformation induced to the segments of the polypeptide chain to influence the microenvironment of the tryptophyl residues). Presumably, the fluorescence increase is a consequence of the packing of the helical segments of globin to generate a "native-like structure." The induction of alpha-helical conformation into these proteins in the presence of n-propanol and the consequent generation of "native-like conformation" is not unique to n-propanol. Trifluoroethanol, another helix-inducing organic solvent, also behaves in the same fashion as n-propanol. However, in contrast to the proteins described above, n-propanol could neither induce an alpha-helical conformation into performic acid oxidized RNAse-A nor restrict its proteolysis by proteases.(ABSTRACT TRUNCATED AT 400 WORDS)

1-Propanol↗

PubMed1989

Consequences of fluid absorption during transurethral resection of the prostate using distilled water or glycine 1.5 per cent.

This prospective and randomized study compared the consequences of two irrigating fluids, distilled water and glycine for transurethral prostatectomy. Forty-nine consecutive unselected patients undergoing transurethral resection of the prostate with spinal anaesthesia were investigated. The irrigating fluid was either distilled water (group A, 24 patients) or glycine 1.5 per cent (group B, 25 patients). The absorption of irrigating fluid was measured, all surgical events and any clinical signs of TURP syndrome during and after surgery were recorded. Early signs of TURP syndrome were observed in one patient in group A and in four in group B without further consequence. From all the biological variables, only plasma protein concentration, haematocrit, free plasma haemoglobin and free bilirubin concentrations were found to have changed. Plasma protein concentration and haematocrit decreased significantly during and after surgery in the two groups. Free plasma haemoglobin increased significantly with time: a significantly higher concentration was observed in group A than group B. Free bilirubin concentration increased with time in the two groups and was statistically greater in group A. With the two irrigating fluids, we observed a significant amount of haemolysis and haemodilution without clinical consequences. A low irrigating fluid pressure, a short resection time, and the use of spinal anaesthesia seems to us to be essential. Close observation of patients following transurethral prostatectomy is needed but the choice of the irrigating fluid does not seem to be important.

Absorption↗