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High Rates (high + rate)
Kinds of High Rates Terms modified by High Rates Selected AbstractsDisproportionately High Rate of Epileptic Seizure in Patients Abusing DextropropoxypheneTHE AMERICAN JOURNAL ON ADDICTIONS, Issue 5 2009Debasish Basu MD Dextropropoxyphene (DPP), a weak opioid, is often abused as a psychoactive substance. In this retrospective chart review to document, characterize and put in perspective the often-obtained history of epileptic seizures in patients with DPP abuse, we analyzed the case files of all patients with DPP abuse registered in our center (a tertiary-care drug de-addiction clinic in north India) from May 1, 2001 until April 30, 2007 and those with use of other opioids during the same period. Non-drug-related seizures were excluded from analysis. Out of 312 patients with DPP abuse, 63 (20.2%) had epileptic seizures related to DPP use, in contrast to 0.4% ,4.2% of other opioid users. The seizures were mostly characterized as generalized tonic-clonic seizures (87.3%), occurring around two hours following a higher-than-usual dose of DPP. Those with seizures had significantly greater duration of DPP use and higher rates of medical comorbidity compared to patients without seizure. Age, duration of use and medical comorbidity were better predictors of seizure than dosage of drug or use of multiple drugs. Thus, DPP-induced epileptic seizures are common (one in five), and much more frequent than seizures in patients using other opioids. The awareness of this phenomenon has implications for diagnosis and management, as well as for drug regulation policy. [source] Taiwan's High Rate of Cesarean Births: Impacts of National Health Insurance and Fetal Gender PreferenceBIRTH, Issue 2 2007Tsai-Ching Liu PhD ABSTRACT: Background: Taiwan has a high rate of cesarean section, approximately 33 percent in the past decade. This study investigates and discusses 2 possible factors that may encourage the practice, one of which is fetal gender difference and the other is Taiwan's recently implemented National Health Insurance (NHI). Methods: A logistic regression model was used with the 1989 and 1996 National Maternal and Infant Health Survey and with the 2001 to 2003 NHI Research Databases. Results: Using survey data, we found a statistically significant 0.3 percent gender difference in parental choice for cesarean section. However, no statistically significant difference was found in the rate of cesarean section before and after NHI implementation. Conclusions: Taiwan's high cesarean section rate is not directly related to financial incentives under NHI, indicating that adjusting policy to lower financial incentives from NHI would have only limited effect. Likewise, focusing effort on the small gender difference is unlikely to have much impact. Effective campaigns by health authorities might be conducted to educate the general population about risks associated with cesarean section and the benefits of vaginal birth to the child, mother, and society. (BIRTH 34:2 June 2007) [source] High rate of resistance to nalidixic acid in Salmonella enterica: its role as a marker of resistance to fluoroquinolonesCLINICAL MICROBIOLOGY AND INFECTION, Issue 5 2000J. Oteo [source] The association of alcohol dependence with general practice attendanceDRUG AND ALCOHOL REVIEW, Issue 2 2009HEATHER PROUDFOOT Abstract Introduction and Aims. This study was designed to examine the relationship between alcohol dependence and general practitioner (GP) service attendance in Australia. Design and Methods. Data were analysed from the 1997 Australian National Survey of Mental Health and Wellbeing. In this survey, a representative sample of the Australian population was interviewed to ascertain past 12 month psychiatric diagnoses for all major mental disorders as well as the use of primary and other health services (n = 10 641, 79% response rate). Results. People with alcohol dependence comorbid with other psychiatric disorders have higher rates of service usage than those without such disorders. Discussion and Conclusions. Alcohol dependence comorbid with mental disorders has a significant impact on GP service in Australia. High rates of service use by individuals with such comorbidities were a considerable burden for GP services.[Proudfoot H, Teesson M. The association of alcohol dependence with general practice attendance. Drug Alcohol Rev 2009] [source] Recreational drug use within the employees of the mariculture and seafood industry in South AustraliaDRUG AND ALCOHOL REVIEW, Issue 1 2005ALAN R. EVANS Abstract A study of recreational drug use among workers in the Port Lincoln mariculture and seafood industries was conducted by self report questionnaire. High rates of cannabis and alcohol use were revealed during the shore based fish farming season. The occupational health and safety implications of these findings in one of Australia's most dangerous industries are significant. Further research could inform the development of industry specific harm minimisation policies. [source] The First-Episode Psychosis Outcome Study: premorbid and baseline characteristics of an epidemiological cohort of 661 first-episode psychosis patientsEARLY INTERVENTION IN PSYCHIATRY, Issue 2 2007Philippe Conus Abstract Aims:, Studies conducted in first-episode psychosis (FEP) samples avoid many biases. However, very few studies are based on epidemiological cohorts treated in specialized FEP services. The aim of this file audit study was to examine premorbid and baseline characteristics of a large epidemiological sample of FEP. Methods:, File audit study of all patients admitted to the Early Psychosis Prevention and Intervention Centre between 1998 and 2000 using a specialized questionnaire. Results:, There were 661 patient files included in the study. Premorbid evaluation revealed high rates of substance use disorder (74.1%), history of psychiatric disorder (47.5%), past traumatic events (82.7%) suicide attempts (14.3%) and family history of psychiatric illness (55.6%). Baseline characteristics revealed high intensity of illness (mean CGI 5.5), high prevalence of lack of insight (62%) and high rate of comorbidity (70%). Conclusion:, High rates of traumatic events or episodes of mental illness before treatment for FEP must be considered when designing treatment approaches because a too narrow focus on positive psychotic symptoms will inevitably lead to incomplete treatment. Additionally, early intervention programmes need sufficient range of resources to address the multiple challenges presented by FEP patients such as high severity of illness, comorbidities and functional impairment. Finally, observation of an important degree of functional impairment despite short duration of untreated psychosis suggests that while early detection of FEP is a necessary step in early intervention, it may not be sufficient to improve functional recovery in psychosis and that efforts aimed at identifying people during the prodromal phase of psychotic disorders should be pursued. [source] Acceptability of Emergency Department-based Screening and Brief Intervention for Alcohol ProblemsACADEMIC EMERGENCY MEDICINE, Issue 12 2000Daniel W. Hungerford DrPH Abstract. Objectives: To adapt screening and brief intervention for alcohol problems (SBI) to a high-volume emergency department (ED) setting and evaluate its acceptability to patients. Methods: Patients at a large public-hospital ED were screened with the Alcohol Use Disorders Identification Test (AUDIT). Screen-positive drinkers (AUDIT score , 6) were provided brief, on-site counseling and referral as needed. Three months later, project staff blinded to baseline measures reassessed alcohol intake, alcohol-related harm, alcohol dependence symptoms, and readiness to change. Results: Of 1,034 patients approached, 78.3% (810) consented to participate (95% CI = 75.5% to 81.2%), and 21.2% (172) screened positive (95% CI = 18.4% to 24.0%). Of 88 patients with complete intervention data, 94.3% (83) accepted an intervention (95% CI = 89.5% to 99.2%), with acceptance rates ranging from 93% to 100% across four alcohol-problem-severity levels (p = 0.7). A majority (59.0%) set goals to decrease or stop drinking (95% CI = 48.4% to 69.6%). The group recontacted (n= 23) experienced statistically significant decreases in alcohol intake, alcohol-related harm, and dependence symptoms, with measures decreasing for 68%, 52%, and 61% of the patients. Readiness to change also showed statistically significant improvement, with scores increasing for 43% of the patients. Moreover, two-thirds of the patients (15/23) reported at follow-up that SBI was a helpful part of their ED visit. Conclusions: High rates of consent and acceptance of counseling for alcohol problems by patients across a wide range of problem severity indicate that this protocol was acceptable to at-risk patients in a public-hospital ED. Improvements in alcohol-related outcome measures at follow-up were strong enough to warrant controlled studies of intervention efficacy. [source] The Origins of Modern DivorceFAMILY PROCESS, Issue 1 2007STEPHANIE COONTZ High rates of marital dissolution and easy access to divorce are not unprecedented, historically or cross-culturally. But contemporary divorce in North America and Western Europe has different origins and features than divorce in previous cultures. The origins of modern divorce patterns date back more than 200 years, to the invention of the historically unprecedented idea that marriage should be based on love and mutual affection. Ironically, then, the fragility of modern marriage stems from the same values that have elevated the marital relationship above all other personal and familial commitments: the concentration of emotion, passion, personal identity, and self-validation in the couple relationship and the attenuation of emotional attachments and obligations beyond the conjugal unit. The immediate causes of divorce may range from factors as diverse as the personal psychological characteristics of one or both spouses to the stresses of economic hardship and community disintegration. But in a larger perspective, the role of divorce in modern societies and its relatively high occurrence both flow from the same complex of factors that have made good marriages so much more central to people's happiness than through most of the past, and deterioration of a marital relationship so much more traumatic. [source] High rates of net ecosystem carbon assimilation by Brachiara pasture in the Brazilian CerradoGLOBAL CHANGE BIOLOGY, Issue 5 2004Alexandre J.B. Santos Abstract To investigate the consequences of land use on carbon and energy exchanges between the ecosystem and atmosphere, we measured CO2 and water vapour fluxes over an introduced Brachiara brizantha pasture located in the Cerrado region of Central Brazil. Measurements using eddy covariance technique were carried out in field campaigns during the wet and dry seasons. Midday CO2 net ecosystem exchange rates during the wet season were ,40 ,mol m,2 s,1, which is more than twice the rate found in the dry season (,15 ,mol m,2 s,1). This was observed despite similar magnitudes of irradiance, air and soil temperatures. During the wet season, inferred rates of canopy photosynthesis did not show any tendency to saturate at high solar radiation levels, with rates of around 50 ,mol m,2 s,1 being observed at the maximum incoming photon flux densities of 2200 ,mol m,2 s,1. This contrasted strongly to the dry period when light saturation occurred with 1500 ,mol m,2 s,1 and with maximum canopy photosynthetic rates of only 20 ,mol m,2 s,1. Both canopy photosynthetic rates and night-time ecosystem CO2 efflux rates were much greater than has been observed for cerrado native vegetation in both the wet and dry seasons. Indeed, observed CO2 exchange rates were also much greater than has previously been reported for C4 pastures in the tropics. The high rates in the wet season may have been attributable, at least in part, to the pasture not being grazed. Higher than expected net rates of carbon acquisition during the dry season may also have been attributable to some early rain events. Nevertheless, the present study demonstrates that well-managed, productive tropical pastures can attain ecosystem gas exchange rates equivalent to fertilized C4 crops growing in the temperate zone. [source] Relationships of Sexual Abuse, Connectedness, and Loneliness to Perceived Well-Being in Homeless YouthJOURNAL FOR SPECIALISTS IN PEDIATRIC NURSING, Issue 2 2002Lynn RewArticle first published online: 23 FEB 200 ISSUES AND PURPOSE. To describe respondents' perceptions of connectedness, loneliness, and well-being; and to explore relationships among these variables. DESIGN AND METHOD. Survey data from 96 participants, focus group interviews with 32 participants, and 10 individual interviews were analyzed. RESULTS. Sixty percent of the sample reported sexual abuse, which was significantly related to loneliness and inversely related to connectedness and perceived well-being. Subjects felt lonely and disconnected. They perceived their well-being in terms of current health status. PRACTICE IMPLICATIONS. High rates of sexual abuse, lack of connectedness, and loneliness may help to explain poor perceived well-being in homeless youth. [source] Nursing Home Facility Risk Factors for Infection and Hospitalization: Importance of Registered Nurse Turnover, Administration, and Social FactorsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 12 2002Sheryl Zimmerman PhD OBJECTIVES: Determine the relationship between a broad array of structure and process elements of nursing home care and (a) resident infection and (b) hospitalization for infection. DESIGN: Baseline data were collected from September 1992 through March 1995, and residents were followed for 2 years; facility data were collected at the midpoint of follow-up. SETTING: A stratified random sample of 59 nursing homes across Maryland. PARTICIPANTS: Two thousand fifteen new admissions aged 65 and older. MEASUREMENTS: Facility-level data were collected from interviews with facility administrators, directors of nursing, and activity directors; record abstraction; and direct observation. Main outcome measures included infection (written diagnosis, a course of antibiotic therapy, or radiographic confirmation of pneumonia) and hospitalization for infection (indicated on medical records). RESULTS: The 2-year rate of infection was 1.20 episodes per 100 resident days, and the hospitalization rate for infection was 0.17 admissions per 100 resident days. Except for registered nurse (RN) turnover, which related to both infection and hospitalization, different variables related to each outcome. High rates of incident infection were associated with more Medicare recipients, high levels of physical/occupational therapist staffing, high licensed practical nurse staffing, low nurses' aide staffing, high intensity of medical and therapeutic services, dementia training, staff privacy, and low levels of psychotropic medication use. High rates of hospitalization for infection were associated with for-profit ownership, chain affiliation, poor environmental quality, lack of resident privacy, lack of administrative emphasis on staff satisfaction, and low family/friend visitation rates. Adjustment for resident sex, age, race, education, marital status, number of morbid diagnoses, functional status, and Resource Utilization Group, Version III score did not alter the relationship between the structure and process of care and outcomes. CONCLUSIONS: The association between RN turnover and both outcomes underscores the relationship between nursing leadership and quality of care in these settings. The relationship between hospitalization for infection and for-profit ownership and chain affiliation could reflect policies not to treat acute illnesses in house. The link between social factors of care (environmental quality, prioritizing staff satisfaction, resident privacy, and facility visitation) and hospitalization indicates that a nonmedical model of care may not jeopardize, and may in fact benefit, health-related outcomes. All of these facility characteristics may be modifiable, may affect healthcare costs, and may hold promise for other, less-medical, forms of residential long-term care. [source] Latino(a) students and Caucasian mentors in a rural after-school program: Towards empowering adult,youth relationshipsJOURNAL OF COMMUNITY PSYCHOLOGY, Issue 1 2005Marcelo Diversi High rates of immigration, especially from Latin America, have created a large population of immigrant youth, many of whom are having difficulty in American schools. The central goals of our project were to assist in empowering students to find academic success and to foster a more bicultural identity. According to three perspectives (youth, mentor, and coordinator), the adult,youth relationship central to our project has been successful in fostering academic engagement and cross-cultural relations. Youth improved their grades and reported being more connected to school. Mentors and youth reported trust in their relationship and satisfaction in learning about each other's culture. We also discuss shortcomings in our program and offer suggestions for positive adult,youth practices. © 2005 Wiley Periodicals, Inc. J Comm Psychol 33: 31,40, 2005. [source] Molecular evolutionary analysis and mutational pattern of full-length genomes of hepatitis B virus isolated from Belgian patients with different clinical manifestationsJOURNAL OF MEDICAL VIROLOGY, Issue 3 2010Mahmoud Reza Pourkarim Abstract Molecular evolutionary patterns of 62 HBV full-length genomes obtained from Belgian patients were characterized. Phylogenetic analysis revealed diverse HBV subgenotypes including A2 and A6 (46.8%), D1,D4 (38.8%), E (9.7%), C1 (1.6%), and B2 (1.6%). The study population consisted of patients with different ethnic origin (Caucasian, Turkish, Asian, Arab, and African). One HBV D/C recombinant isolate was identified, which encoded subtype adw2. An HBV subgenotype D4 with an aberrant subtype ayw4 was detected. Although none of the genotypes was associated with a specific disease outcome, several nucleotide substitutions, deletions and insertions were observed within the HBV preS1/S and X genes, particularly among patients with active chronic hepatitis B infection and patients with cirrhosis. Within the immunological domain of the HBsAg gene, the most frequent substitutions were sT125M and sT118A. High rates of precore and basal core promoter mutations were detected in patients infected with genotype D of HBV. Almost half of the patients who received lamivudine therapy for at least 1 year had HBV variants associated with lamivudine drug resistance. In conclusion, the most common HBV genotypes in West Europe (A and D) also prevail in Belgium. The highest degree of genetic diversity was detected in HBV genotype D. In addition, this study reveals the circulation of exotic HBV genotypes B, C, and E in Belgium. J. Med. Virol. 82:379,389, 2010. © 2010 Wiley-Liss, Inc. [source] Voluntary turnover among nurses working in Kuwaiti hospitalsJOURNAL OF NURSING MANAGEMENT, Issue 3 2008MUHAMMAD ALOTAIBI BSN Background, Voluntary turnover rates are high among staff nurses working in Kuwaiti hospitals. It is a major problem, costly and it is presumed to impact on the quality of nursing care delivered. Aims, The two aims of this study were to (1) find out if nurses' resignations in Kuwaiti hospitals could be ascribed to failure in the recruitment process and (2) examine the feelings of nurses who resigned. Methods, Two sets of exit interviews with 60 nurses who had resigned were conducted. Results, No evidence emerged that any false information or misleading information was provided except for the salary adjustments. The real insight lay in what might not have been said in the recruitment interviews. While feelings of discontent emerged in the interviews relating to the loss of income, the greatest source of complaint related to the failure of managers to solve the evident problems. Conclusions, High rates of voluntary turnover require more attention from administrators and policy makers because of its potential consequences in terms of the quality of nursing care delivered. Implications for nursing management, This paper identifies many causes of nurses' voluntary turnover. It also shows the need for nursing managers to explore these causes and suggests successful strategies for recruitment and retention practices and policies. [source] DEPOSITIONAL ENVIRONMENT AND DIAGENESIS OF THE EOCENE JDEIR FORMATION, GABES-TRIPOLI BASIN, WESTERN OFFSHORE, LIBYAJOURNAL OF PETROLEUM GEOLOGY, Issue 4 2000J. M. Anketell The late Ypresian (early Eocene) Jdeir Formation was deposited in the Mesozoic-Cenozoic Gabes-Tripoli Basin, offshore Libya. The basin developed on the northern passive margin of the African Plate and was relatively unstable being affected by syn-sedimentary tectonic movements. Deposition was coeval with a relative rise of sea-level and the subsequent highstand. A lower, thinly-developed nummulitic bank facies with restricted distribution records the transgressive event and is succeeded by more micritic sediments that record the time of maximum flooding. The succeeding sea-level highstand is represented by a thick, and widely developed, progradational-aggradational nummulitic sequence that displays lateral changes across WE-ESE trending facies belts. Three major lithofacies are recognized in the Jdeir Formation: Nummulites packstone-grainstone, Alveolina-Orbitoliteswackestone-packtone, andFragmental-Discocyclina-Assilina wackestone-packstone, depositedin bank, back-bank, and fore-bank environments, respectively. The formation passes to the NNE into the pelagic lithofacies of the Hallab Formation; landward, to the south, it passes into shoreline evaporitic facies of the Taljah Formation. The lithofacies were structurally controlled by contemporaneous and/or syndepositional tectonic movements, with nummulitic facies tending to develop on uplifted areas. Petrographic and petrophysical studies indicate that porosity in the Jdeir Formation is controlled by depositional environment, tectonic setting and diagenesis. The combined effects of salt tectonics, a major unconformity at the top of the formation and meteoric diagenesis have produced excellent-quality reservoir facies at the Bouri oilfield and in other areas. Porosity is highest in the nummulitic bank facies and lowest in the Alveolina-Orbitolites micrite facies. Good to excellent reservoir quality occurs in the upper part of the nummulitic packstone-grainstone facies, especially where these sediments overlie structurally high areas. High rates of dissolution found at the crests of domes and anticlines suggest that early diagenetic processes and features are, in part, structurally controlled. Future exploration success will depend on investigation of similar structures within the Gabes-Tripoli Basin. Both porosity initiation and preservation are related to early depositional and diagenetic processes. The wide time-gap between hydrocarbon generation and reservoir formation points to the role of the seal in porosity preservation and rules out the assumption that early emplacement of oil had preserved the porosity. [source] The Impact of Childhood Sexual Abuse on Later Sexual Victimization among Runaway YouthJOURNAL OF RESEARCH ON ADOLESCENCE, Issue 2 2001Kimberly A. Tyler Path analysis was used to investigate the impact of childhood sexual abuse on later sexual victimization among 372 homeless and runaway youth in Seattle. Young people were interviewed directly on the streets and in shelters by outreach workers in youth service agencies. High rates of both childhood sexual abuse and street sexual victimization were reported, with females experiencing much greater rates compared with their male counterparts. Early sexual abuse in the home increased the likelihood of later sexual victimization on the streets indirectly by increasing the amount of time at risk, deviant peer affiliations, participating in deviant subsistence strategies, and engaging in survival sex. These findings suggest that exposure to dysfunctional and disorganized homes place youth on trajectories for early independence. Subsequently, street life and participation in high-risk behaviors increases their probability of sexual victimization. [source] LETTERS TO THE EDITOR: High rates of symptomatic and incidental thromboembolic events in gastrointestinal cancer patientsJOURNAL OF THROMBOSIS AND HAEMOSTASIS, Issue 8 2010R. SINGH No abstract is available for this article. [source] High rates of adverse effects and patient unawareness of withdrawn lipid-lowering drug combination in a public hospital clinicPHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 8 2002Gordon D. Schiff MD Abstract Purpose Examine use, patient awareness and outcomes of concurrent cerivastatin and gemfibrozil in a public hospital clinic system 2 weeks following cerivastatin withdrawal. Methods Electronic pharmacy records for cerivastatin prescriptions for 1 year preceding withdrawal were downloaded and linked to gemfibrozil prescriptions. Patients with concurrent prescriptions were surveyed for current use, awareness of withdrawal/warnings, adverse effects and creatine phosphokinase (CK) results. Results From August 2000 to August 2001, 29,377 prescriptions for cerivastatin were dispensed for 10,780 unique patients; 211 (2%) also received gemfibrozil. Prescription time frames for the two drugs overlapped for 67 patients. Interview of 47 patients revealed 35 actually taking both. 18/35 (51.4%) were still taking both drugs 2 weeks after market-withdrawal of cerivastatin. Only 7/46 (21.2%) had ,heard the news' about withdrawal. 19/46 (41.3%) described muscle-related symptoms; nine reported severe symptoms. Only 13 (28.3%) had CK monitoring. 5/8 symptomatic patients monitored had CK values >200,U/L. (>1000,U/L in two cases.) Conclusions Despite escalating labeled warnings, nearly 2% of patients prescribed cerivastatin received gemfibrozil prescriptions, 1/3 concurrently. Most were still taking this combination 2 weeks after cerivastatin withdrawal and unaware of publicized warnings. Nearly half experienced muscle-related symptoms. More reliable methods for preventing prescription/dispensing of interacting medications and alerting patients about drug recalls are warranted. Copyright © 2002 John Wiley & Sons, Ltd. [source] Why men have shorter lives than women: Effects of resource availability, infectious disease, and senescenceAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 3 2009A.P. Møller Senescence arises from age-specific deterioration of the soma as a consequence of optimization of life history, and such effects of senescence should appear when comparing species that differ in intensity of sexual selection, as well as when comparing, within a species, the two sexes that often differ in intensity of sexual selection. However, any extrinsic cause of mortality that reduces life expectancy will reduce the possibility of detecting sex-specific differences in senescence. We investigated geographical variation in human sex differences in longevity across 121 countries to test whether differences in sexual competition for limiting resources, reflecting intensity of sexual selection, affected sex differences in longevity. Men on average lived 5 years shorter than women. High rates of childhood morbidity and mortality reduced the sex difference in longevity, while increased overall longevity increased the sex difference in longevity. Increased resource availability estimated from gross domestic product per capita reduced the sex difference in longevity, accounting for 10% of the variance, while there was no additional effect of income inequality as reflected by the Gini coefficient. In a separate analysis of sex differences in longevity among the states of the US, there was a strong effect of the Gini coefficient on sex difference in longevity, with the negative effect on male longevity being stronger than that on female longevity. In contrast, there was only a marginal effect of average household income. Thus, there was evidence of increased competition for resources contributing to increased sex differences in longevity within a single nation. Am. J. Hum. Biol., 2009. © 2009 Wiley-Liss, Inc. [source] Incidence of tuberculosis and HIV and progression of silicosis and lung function impairment among former basotho gold miners,,AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 12 2009Harriet H. Park MPH Abstract Background Pulmonary tuberculosis and HIV incidence, mortality, and the progression of silicosis and lung function impairment are described over a 1-year period in migrant ex-gold miners from Lesotho. Methods Seven hundred seventy-nine Basotho miners were followed for 1 year starting 18 months after lay-off from a South African gold mine in 1998. At baseline and follow-up, they underwent a respiratory symptom interview, physical examination, HIV test, chest radiograph, and spirometry. Results Five hundred thirteen of 779 (65.9%) participants attended both baseline and follow-up visits. HIV incidence was 5.4/100 person-years (95% CI: 3.4,8.2). Prevalence of silicosis (ILO score ,1/1) was 26.6% at baseline and 27.0% at follow-up. Active tuberculosis diagnosed at baseline was a strong predictor of radiological progression of silicosis. Lung function as measured by FEV1 declined an average of 91,ml between visits (95% CI: 67,116,ml). Calculated minimum incidence of tuberculosis was 3,085/100,000/years (95% CI: 1,797,4,940) at follow-up. Of those seen at baseline, 18 died before their scheduled follow-up visit (mean age: 51 years). Conclusions High rates of mortality and of HIV infection and pulmonary tuberculosis were found in this cohort after leaving the South African goldmines. Continuing lung function loss was also apparent. A partnership between the South African mining industry and governments in labor-sending areas of Southern Africa is needed to provide continuity of care and access to HIV and tuberculosis treatment and prevention services. Active silicosis surveillance and an improved statutory compensation system are also needed. These findings can serve as a baseline against which the impact of such interventions can be assessed. Am. J. Ind. Med. 52:901,908, 2009. © 2009 Wiley-Liss, Inc. [source] Psychiatric Disorders in Property, Violent, and Versatile Offending Detained Male AdolescentsAMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 1 2009Olivier Colins MEd This study examines the past year prevalence rate of psychiatric disorders in detained male adolescents and the relation between psychiatric disorders and type of offending. The Diagnostic Interview Schedule for Children (DISC-IV) was administered in a sample (N = 245) of male detained adolescents aged 12 to 17 years. Based on lifetime official criminal history, participants were classified into property, violent, and versatile subgroups. High rates of psychiatric disorders were found in all groups. In addition, property offenders reported significantly higher rates of depression, disruptive behavior disorders, substance use disorders and comorbidity than violent and versatile offenders. Overall, versatile offenders did not differ from violent offenders, with the exception of more marijuana use disorder found in violent offenders. This study once more emphasizes that detained boys have substantial mental health needs, a finding that is generalizable across countries. In addition, the current study suggests that classifying detained juveniles by offense subgroups may carry clinical relevance. The long-term impact of these differences, and the possible effects of intervention, should be subject of further research. [source] Schizophrenia and Pathological GamblingTHE AMERICAN JOURNAL ON ADDICTIONS, Issue 4 2007Laurence Borras MD High rates of pathological gambling are found in psychiatric populations, including those with mood or substance use disorders. The extent to which individuals with schizophrenia exhibit the symptoms of pathological gambling has not been adequately investigated. This paper examines the case of a 40-year-old schizophrenic female with a four-year history of gambling. The characteristics of possible interactions between pathological gambling and schizophrenic symptom profiles are outlined in order to propose better treatments for this group of patients. [source] Old growth and secondary forest site occupancy by nocturnal birds in a neotropical landscapeANIMAL CONSERVATION, Issue 1 2010M. Sberze Abstract High rates of old growth (OG) forest destruction and difficult farming conditions result in increasing cover of secondary forests (SF) in the Amazon. In this setting, it is opportune to ask which animals use newly available SF and which stay restricted to OG. This study presents a comparison of SF and OG site occupancy by nocturnal birds in terra firme forests of the Amazon Guianan shield, north of Manaus, Brazil. We tested species-specific occupancy predictions for two owls (Lophostrix cristata/Glaucidium hardyi), two potoos (Nyctibius leucopterus/Nyctibius griseus) and two nightjars (Caprimulgus nigrescens/Nyctidromus albicollis). For each pair, we predicted that one species would have higher occupancy in OG while the other would either be indifferent to forest type or favor SF sites. Data were collected in 30 OG and 24 SF sites with monthly samples from December 2007 to December 2008. Our analytic approach accounts for the possibility of detection failure and for spatial autocorrelation in occupancy, thus leading to strong inferences about changes in occupancy between forest types and between species. Nocturnal bird richness and community composition were indistinguishable between OG and SF sites. Owls were relatively indifferent to forest type. Potoos followed the a priori predictions, and one of the nightjars (C. nigrescens) favored SF instead of OG as predicted. Only one species, Nyctib. leucopterus, clearly favored OG. The landscape context of our SF study sites, surrounded by a vast expanse of continuous OG forest, partially explains the resemblance between SF and OG fauna but leaves unexplained the higher occupancy for SF than OG sites for several study species. The causal explanation of high SF occupancy remains an open question, but the result itself motivates further comparisons for other groups, as well as recognition of the conservation potential of SF. [source] The iliac bifurcation device for endovascular iliac aneurysm repair: indications, deployment options and results at 1-year follow-up of 25 casesANZ JOURNAL OF SURGERY, Issue 11 2009Ravi L. Huilgol Abstract Background:, The iliac bifurcation device (William A Cook Australia, Brisbane, QLD, Australia) is a new endovascular device for iliac aneurysm repair. We review the indications for use, device characteristics, deployment options and the results of our case series. Methods:, The most common indication for deployment is endovascular aortic aneurysm repair (EVAR) with common iliac aneurysm repair. The standard deployment sequence can be adapted to increase the utility of the device. Data were collected prospectively. Follow-up was performed with plain X-ray, ultrasound and computed tomography (CT) scan. Results:, Between 2004 and 2007, 25 patients had their common iliac artery aneurysm repaired using the iliac bifurcation device. There were 23 male and 2 female patients. Median age was 75 years (range 60,85). The median follow-up was 12 months (range 1,38). Twenty-one procedures were combined with EVAR. The median abdominal aortic aneurysm diameter was 60 mm (range 31,97), and the median common iliac artery aneurysm diameter was 37 mm (range 24,71). Technical success was achieved in 100% of cases. There were no acute branch vessel occlusions. There was one early type I endoleak (4%). There was one death (4%) in the 30-day period post-procedure. There was one late type I endoleak (4%). Conclusions:, The iliac bifurcation device achieves endovascular common iliac artery aneurysm repair with preservation of internal iliac artery flow. There are multiple different applications of the device and complementary deployment techniques. High rates of technical success and low rates of branch vessel occlusion are possible. [source] SURGICAL MANAGEMENT OF BREAST CANCER IN A SMALL PERIPHERAL NEW ZEALAND HOSPITALANZ JOURNAL OF SURGERY, Issue 12 2006Don Wai Gin Lee Background: Peripheral hospitals are perceived to be at a disadvantage in providing treatment for breast cancer, especially with regard to breast conservative surgery (BCS) because of the requirement of adjuvant radiotherapy. Wairau Hospital is a 100-bed peripheral hospital in New Zealand with no on-site radiotherapy unit. Methods: A retrospective audit of the surgical management of breast cancer between 1998 and 2002 was carried out. Results: One hundred and fifty-seven presentations during the audit period. Despite the lack of tertiary resources, we report an overall BCS rate of 58.6%, consistent with the appropriate New Zealand guidelines. Of screen-detected cancers, 81.6% underwent BCS. Only five patients requested mastectomy and of those undergoing BCS, five patients refused subsequent adjuvant radiotherapy. This was because of frailty from age and comorbidities and the inconvenience of travel. Conclusion: High rates of BCS are possible in peripheral hospitals. We postulate that intensive support and a visiting outpatient oncological service help empower patients to seek BCS if appropriate. A strong partnership between surgical, radiological and oncological services is also vital. [source] Decreasing rumination using a starchy food satiation procedureBEHAVIORAL INTERVENTIONS, Issue 1 2002Laura L. Dudley A starchy food satiation procedure was evaluated in an ABAB withdrawal design on the post-meal rumination of a nine-year-old girl with autism. During treatment unlimited quantities of starchy foods were provided following each meal. High rates of rumination occurred during baseline conditions, followed by an immediate decrease in rumination during treatment. Rumination decreased to 82 and 97% of baseline during the first and second treatment conditions, respectively. In addition, follow-up probes were conducted at irregular intervals for 4 years following treatment, during which zero or near-zero rates of rumination were sustained. This study extends the literature on the functional relation between increased starchy food quantity and rumination in adults to rumination with a young child, and demonstrates maintenance of the treatment effect for 4 years. Copyright © 2002 John Wiley & Sons, Ltd. [source] Persisting Hyper-abundance of Leaf-cutting Ants (Atta spp.) at the Edge of an Old Atlantic Forest FragmentBIOTROPICA, Issue 6 2009Sebastian T. Meyer ABSTRACT Leaf-cutting ants (LCAs) profoundly benefit from edge creation in Neotropical forests, where they act as a keystone species and disturbance agent. In view of their poorly explored population dynamics, the question arises whether high densities of LCAs are a transitional or a persisting phenomenon. We studied the temporal variation of LCA colony densities at the edge of the Brazilian Atlantic forest. At physically stable edges of an old forest fragment, densities of Atta cephalotes and Atta sexdens (11 and five times higher in a 50 m edge zone in comparison with the forest interior) persisted over a 4-yr interval (2001,2005) with no significant difference in densities between years. Species-specific per colony growth rates ranged from 12 to ,5 percent/yr, suggesting that populations were approximately at equilibrium. High rates of colony turnover (little less than 50% in 4 yr) indicated an average colony life span of about 7 yr,a life expectancy considerably lower than previous estimates for Atta colonies. Stable, hyper-abundant populations of LCAs accord with the constantly high availability of palatable pioneer vegetation (the preferred food source of LCAs) at forest edges and are expected to persist in time as long as forests are characterized by high edge to interior ratios, with potentially long-lasting consequences for the ecosystem. [source] Substance abuse in bipolar disorderBIPOLAR DISORDERS, Issue 4 2001Frederick Cassidy Background: High rates of substance abuse have been reported in the general population, with males more often affected than females. Although high rates of substance abuse have also been reported in bipolar patients, the relationship between substance abuse and bipolar disorder has not been well characterized. Methods: Substance abuse histories were obtained in 392 patients hospitalized for manic or mixed episodes of bipolar disorder and rates of current and lifetime abuse calculated. Analyses comparing sex, subtype (manic vs. mixed) and clinical history variables were conducted. Results: Rates of lifetime substance abuse were high for both alcohol (48.5%) and drugs (43.9%). Nearly 60% of the cohort had a history of some lifetime substance abuse. Males had higher rates of abuse than females, but no differences in substance abuse were observed between subjects in manic and mixed bipolar states. Rates of active substance abuse were lower in older age cohorts. Subjects with a comorbid diagnosis of lifetime substance abuse had more psychiatric hospitalizations. Conclusions: Substance abuse is a major comorbidity in bipolar patients. Although rates decrease in older age groups, substance abuse is still present at clinically important rates in the elderly. Bipolar patients with comorbid substance abuse may have a more severe course. These data underscore the significance of recognition and treatment of substance abuse in bipolar disorder patients. [source] The Interface Between Physical and Mental Health Problems and Medical Help Seeking in Children and Adolescents: A Research PerspectiveCHILD AND ADOLESCENT MENTAL HEALTH, Issue 4 2004M. Elena Garralda This paper addresses child and adolescent psychopathology as it presents to general practitioners and paediatricians, and explores psychosocial aspects of unexplained medical symptoms in children and adolescents. High rates of psychopathology have been identified amongst children and adolescents attending general practice and paediatric services, most of it ,,hidden'' at presentation and emotional in nature. It is often linked to poor physical well being and to maternal stress focused on the child. It may be of special relevance to medical help seeking in socio-economically advantaged areas. Co-morbid psychopathology, mainly emotional disorders, is common amongst children with unexplained medical symptoms. However, there are specific psychosocial aspects that differentiate these children from those with emotional disorders. They involve disease beliefs, illness behaviour and predicament. The latter may be characterised by special reactivity to stress in children with personality vulnerability, in a context of parents with high levels of mental distress, unexplained medical symptoms and emotional over-involvement with the child. There is comparatively little interface work between CAMHS and primary health care. An important research priority would seem to lie in the development of interventions that can be adapted for use by primary care staff. Similarly, there are few dedicated CAMHS paediatric liaison teams. Their more extensive development should help attend in a more informed and focused way than at present to children and adolescents suffering from unexplained physical symptoms and disorders. Further research is needed into vulnerability mechanisms and maintaining factors, health beliefs, treatment engagement and interventions. [source] Effective Curriculum-Based Sex and STD/HIV Education Programs for AdolescentsCHILD DEVELOPMENT PERSPECTIVES, Issue 1 2009Douglas Kirby ABSTRACT,High rates of teen pregnancy and sexually transmitted disease (STD) are important problems in the United States. Curriculum-based sex and STD/HIV education programs have been proffered as a partial solution. This article reviews evaluations of the impact of such programs that met specified criteria and finds that about two thirds of programs had a significant impact on behavior. The proportion having a negative impact was less than expected by chance. Those having a positive impact had such effects as delaying the initiation of sex, reducing the frequency of sex or the number of sexual partners, and increasing the use of condoms or other contraceptive methods. Positive findings were robust across different groups of youth and replication of programs in different locations. Programs with 17 specific characteristics were much more likely to be effective than programs without these characteristics. These programs alone cannot dramatically reduce teen pregnancy and STD, but they can contribute to the reduction of those problems. [source] | |||||||||||||||||||||||||||||||||||||||||||