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To utilise a community-based participatory approach in the design and implementation of an intervention targeting diet-related health problems on Navajo Nation.
A dual strategy approach of community needs/assets assessment and engagement of cross-sectorial partners in programme design with systematic cyclical feedback for programme modifications.
Navajo Nation, USA.
Navajo families with individuals meeting criteria for programme enrolment. Participant enrolment increased with iterative cycles.
The Navajo Fruit and Vegetable Prescription (FVRx) Programme.
A broad, community-driven and culturally relevant programme design has resulted in a programme able to maintain core programmatic principles, while also allowing for flexible adaptation to changing needs.
BACKGROUND: Meningiomas are the most common primary benign brain tumors in adults. Given the extended life expectancy of most meningiomas, consideration of quality of life (QOL) is important when selecting the optimal management strategy. There is currently a dearth of meningioma-specific QOL tools in the literature. OBJECTIVE: In this systematic review, we analyze the prevailing themes and propose toward building a meningioma-specific QOL assessment tool. METHODS: A systematic search was conducted, and only original studies based on adult patients were considered. QOL tools used in the various studies were analyzed for identification of prevailing themes in the qualitative analysis. The quality of the studies was also assessed. RESULTS: Sixteen articles met all inclusion criteria. Fifteen different QOL assessment tools assessed social and physical functioning, psychological, and emotional well-being. Patient perceptions and support networks had a major impact on QOL scores. Surgery negatively affected social functioning in younger patients, while radiation therapy had a variable impact. Any intervention appeared to have a greater negative impact on physical functioning compared to observation. CONCLUSION: Younger patients with meningiomas appear to be more vulnerable within social and physical functioning domains. All of these findings must be interpreted with great caution due to great clinical heterogeneity, limited generalizability, and risk of bias. For meningioma patients, the ideal QOL questionnaire would present outcomes that can be easily measured, presented, and compared across studies. Existing scales can be the foundation upon which a comprehensive, standard, and simple meningioma-specific survey can be prospectively developed and validated.
Previous research has shown relatively diminished medial prefrontal cortex activation and heightened psychophysiological responses during the recollection of personal events in post-traumatic stress disorder (PTSD), but the origin of these abnormalities is unknown. Twin studies provide the opportunity to determine whether such abnormalities reflect familial vulnerabilities, result from trauma exposure, or are acquired characteristics of PTSD.
In this case–control twin study, 26 male identical twin pairs (12 PTSD; 14 non-PTSD) discordant for PTSD and combat exposure recalled and imagined trauma-unrelated stressful and neutral life events using a standard script-driven imagery paradigm during functional magnetic resonance imaging and concurrent skin conductance measurement.
Diminished activation in the medial prefrontal cortex during Stressful v. Neutral script-driven imagery was observed in the individuals with PTSD, relative to other groups.
Diminished medial prefrontal cortex activation during Stressful v. Neutral script-driven imagery may be an acquired characteristic of PTSD. If replicated, this finding could be used prospectively to inform diagnosis and the assessment of treatment response.
The Antarctic Roadmap Challenges (ARC) project identified critical requirements to deliver high priority Antarctic research in the 21st century. The ARC project addressed the challenges of enabling technologies, facilitating access, providing logistics and infrastructure, and capitalizing on international co-operation. Technological requirements include: i) innovative automated in situ observing systems, sensors and interoperable platforms (including power demands), ii) realistic and holistic numerical models, iii) enhanced remote sensing and sensors, iv) expanded sample collection and retrieval technologies, and v) greater cyber-infrastructure to process ‘big data’ collection, transmission and analyses while promoting data accessibility. These technologies must be widely available, performance and reliability must be improved and technologies used elsewhere must be applied to the Antarctic. Considerable Antarctic research is field-based, making access to vital geographical targets essential. Future research will require continent- and ocean-wide environmentally responsible access to coastal and interior Antarctica and the Southern Ocean. Year-round access is indispensable. The cost of future Antarctic science is great but there are opportunities for all to participate commensurate with national resources, expertise and interests. The scope of future Antarctic research will necessitate enhanced and inventive interdisciplinary and international collaborations. The full promise of Antarctic science will only be realized if nations act together.
A trend toward greater body size in dizygotic (DZ) than in monozygotic (MZ) twins has been suggested by some but not all studies, and this difference may also vary by age. We analyzed zygosity differences in mean values and variances of height and body mass index (BMI) among male and female twins from infancy to old age. Data were derived from an international database of 54 twin cohorts participating in the COllaborative project of Development of Anthropometrical measures in Twins (CODATwins), and included 842,951 height and BMI measurements from twins aged 1 to 102 years. The results showed that DZ twins were consistently taller than MZ twins, with differences of up to 2.0 cm in childhood and adolescence and up to 0.9 cm in adulthood. Similarly, a greater mean BMI of up to 0.3 kg/m2 in childhood and adolescence and up to 0.2 kg/m2 in adulthood was observed in DZ twins, although the pattern was less consistent. DZ twins presented up to 1.7% greater height and 1.9% greater BMI than MZ twins; these percentage differences were largest in middle and late childhood and decreased with age in both sexes. The variance of height was similar in MZ and DZ twins at most ages. In contrast, the variance of BMI was significantly higher in DZ than in MZ twins, particularly in childhood. In conclusion, DZ twins were generally taller and had greater BMI than MZ twins, but the differences decreased with age in both sexes.
Objectives: The aim of this study was to develop a decision support tool to assess the potential benefits and costs of new healthcare interventions.
Methods: The Canadian Partnership Against Cancer (CPAC) commissioned the development of a Cancer Risk Management Model (CRMM)—a computer microsimulation model that simulates individual lives one at a time, from birth to death, taking account of Canadian demographic and labor force characteristics, risk factor exposures, and health histories. Information from all the simulated lives is combined to produce aggregate measures of health outcomes for the population or for particular subpopulations.
Results: The CRMM can project the population health and economic impacts of cancer control programs in Canada and the impacts of major risk factors, cancer prevention, and screening programs and new cancer treatments on population health and costs to the healthcare system. It estimates both the direct costs of medical care, as well as lost earnings and impacts on tax revenues. The lung and colorectal modules are available through the CPAC Web site (www.cancerview.ca/cancerrriskmanagement) to registered users where structured scenarios can be explored for their projected impacts. Advanced users will be able to specify new scenarios or change existing modules by varying input parameters or by accessing open source code. Model development is now being extended to cervical and breast cancers.
We examined the cross-sectional relationship between environmental tobacco smoke exposure, continuous performance test (CPT) measures, and attention deficit hyperactivity disorder (ADHD) or learning disability symptoms in school-aged children.
In total, 989 children (526 boys, mean age 9.1 ± 0.7 years), recruited from five South Korean cities participated in this study. We used urine cotinine as a biomarker for environmental tobacco smoke exposure, and obtained the children's scores on a CPT. Parents completed the Korean versions of the ADHD Rating Scale – IV (ADHD-RS) and Learning Disability Evaluation Scale (LDES). Using generalized linear mixed model (GLMM), we assessed the associations between urine cotinine concentrations, neuropsychological variables, and symptoms of ADHD and learning disabilities. Additionally, we conducted structural equation models to explore the effects' pathways.
After adjusting for a range of relevant covariates, GLMM showed urinary cotinine levels were significantly and positively associated with CPT scores on omission errors, commission errors, response time, and response time variability, and with parent- and teacher-rated ADHD-RS scores. In addition, urine cotinine levels were negatively associated with LDES scores on spelling and mathematical calculations. The structural equation model revealed that CPT variables mediated the association between urine cotinine levels and parental reports of symptoms of ADHD and learning disabilities.
Our data indicate that environmental exposure to tobacco smoke is associated with ADHD and learning disabilities in children, and that impairments in attention and inhibitory control probably mediate the effect.
The incidence and severity of Clostridium difficile infections (CDI) have increased in Western countries. However, there are limited data regarding the epidemiology of CDI in Eastern countries. This nationwide study was conducted in 17 hospitals to determine temporal trends in CDI incidence (from 2004 to 2008) in South Korea. The total incidence of CDI in Korea was 1·7 cases/1000 adult admissions in 2004, and 2·7/1000 cases in 2008 (P = 0·028). When analysing the clinical features of 1367 CDI patients diagnosed in 2008, oral metronidazole was effective as a first-line treatment for CDI (61·9%). Relapse rate was 8·9% and complicated CDI was only observed in 3·6%. The incidence of CDI increased significantly in Korea from 2004 to 2008. Although the clinical features were milder than in Western countries, the increasing burden of CDI needs ongoing surveillance systems.
SiGe nanowires of different Ge atomic fractions up to 15% were grown and ex-situ n-type doped by diffusion from a solid source in contact with the sample. The phenomenon of dielectrophoresis was used to locate single nanowires between pairs of electrodes in order to carry out electrical measurements. The measured resistance of the as-grown nanowires is very high, but it decreases more than three orders of magnitude upon doping, indicating that the doping procedure used has been effective.
The oscillating piezoelectric field of a surface acoustic wave (SAW) is employed to transport photoexcited electrons and holes in GaAs nanowires (NWs) transferred to a SAW beam line on a LiNbO3 crystal. We show that carriers generated in the NW by a focused light spot can be acoustically transported to a second location, where they recombine emitting short light pulses. The results presented here demonstrate the high-frequency manipulation of carriers in NWs without the use of electrical contacts, which opens new perspectives for applications in opto-electronic devices operating at GHz frequencies.
The use of Ga-Au alloys as metal catalysts for the growth of SiGe nanowires has been investigated. The grown nanowires are cylindrical and straight, with a defect-free crystalline structure, sharp nanowire-droplet interfaces and an almost constant Ge atomic fraction throughout all their length. These features represent significant improvements over the results obtained using pure Au.
The purpose of this study was to investigate the acceptability and therapeutic efficacy of a preoperative single administration of long-acting 5-hydroxytryptamine type 3 (5-HT3) receptor antagonist in an orally disintegrating tablet formulation, ramosetron, in breast cancer patients.
Two hundred and forty women, ASA I-II, aged 24–60 yr, undergoing elective breast cancer surgery, were randomized. A standardized anaesthetic technique was used. Patients were assigned to receive one of three treatment regimens (n = 80 in each group): no prophylactic antiemetics (Group A), single prophylactic intravenous injection of ramosetron 0.1 mg at the completion of surgery (Group B) or preoperatively oral administration of 0.1 mg of ramosetron (Group C). Episodes of nausea and vomiting, the use of rescue antiemetic treatment, degree of pain, adverse events and level of satisfaction were recorded.
The overall incidence of nausea and vomiting during the first 24 h after the recovery in Groups B (27.8%) and C (25%) was decreased significantly compared with Group A (75.3%). The frequency of the use of rescue antiemetics was significantly lower in Group C (5.0%) compared with Groups A (53.2%) and B (15.2%). The patients in Group C were more satisfied with control of postoperative nausea and vomiting than others.
Preoperative oral administration of ramosetron at a dose of 0.1 mg is an acceptable and effective way of reducing the incidence of postoperative nausea and vomiting in breast cancer patients.
An overview on current trends in stimulated Brillouin scattering and optical phase conjugation is given. This report is based on the results of the “Second International Workshop on stimulated Brillouin scattering and phase conjugation” held in Potsdam/Germany in September 2007. The properties of stimulated Brillouin scattering are presented for the compensation of phase distortions in combination with novel laser technology like ceramics materials but also for e.g., phase stabilization, beam combination, and slow light. Photorefractive nonlinear mirrors and resonant refractive index gratings are addressed as phase conjugating mirrors in addition.
Alfentanil was reported to relax the rat aorta by direct action on the vascular smooth muscle. The aims of this in vitro study were to examine the effect of alfentanil on phenylephrine-induced contractions in the rat aorta and to determine the cellular mechanism associated with this process.
Endothelium-denuded aortic rings were suspended in order to record isometric tension. In the rings with or without 10−6 mol naloxone or 10−5 mol verapamil, the concentration–response curves for phenylephrine and potassium chloride were generated in the presence or absence of alfentanil (10−6, 5 × 10−5, 10−4 mol). In the rings exposed to a calcium-free isotonic depolarizing solution, the contractile response induced by the addition of calcium was assessed in the presence or absence of alfentanil (5 × 10−5, 10−4 mol).
Alfentanil (5 × 10−5, 10−4 mol) attenuated (P < 0.05) the phenylephrine-induced contraction in the ring with or without 10−6 mol naloxone but had no effect on the phenylephrine-induced contraction in the rings pretreated with verapamil. Alfentanil (5 × 10−5, 10−4 mol) produced a significant rightward shift (P < 0.01) in the potassium chloride dose–response curve, and attenuated the contractile response (P < 0.001) induced by calcium in the calcium-free isotonic depolarizing solution in a dose-dependent manner.
A supraclinical dose of alfentanil attenuates the phenylephrine-induced contraction via an inhibitory effect on calcium influx by blocking the l-type calcium channels in the rat aortic vascular smooth muscle.
Surveillance is an important component of influenza control. This report describes the establishment and first results of the Korean Influenza Surveillance Scheme (KISS), an integrated clinical and laboratory surveillance network involving 622 public health centres (PHCs) and private clinics. Sentinel physicians reported cases of influenza-like illness (ILI) weekly and forwarded specimens for virus isolation and characterization. Influenza activity during the opening 2000–2001 season was milder and delayed compared with previous years. The ILI consultation rate corresponded well with the number of influenza virus isolates, both peaking in week 10 of 2001. Influenza A(H3N2) was the dominant isolate. The peak ILI consultation rate was higher in private clinics than in PHCs (5·04 vs 1·79 cases/1000 visits). An evaluation questionnaire generated potential enhancements to the scheme. KISS appears to represent the pattern of influenza activity accurately and will have a valuable role in monitoring and preventing epidemics in Korea.
The composition of yeast communities in the rumen of cattle was investigated using comparative DNA sequence analysis of yeast 26S rDNA genes. 26S rDNA libraries were constructed from rumen fluid (FF), rumen solid (FS) and rumen epithelium (FE). A total of 97 clones, containing a partial 26S rDNA sequence of 0·6 kb length, were sequenced and subjected to an on-line similarity search.
The 41 FF clones could be divided into five classes. The largest class was affiliated with Pezizomycotina class (85·4% of clones), and the remaining classes were related with the Urediniomycotina (2·4%), Hymenomycetes (4·9%), Ustilaginomycetes (4·9%) and Saccharomycotina (2·4%) classes. The 26 FE clones could be divided into three classes and the Saccharomycetes class (92·4% of clones) was the largest group. The remaining classes were related with either Pezizomycotina (3·8%) or Ustilaginomycetes (3·8%). The 30 FS clones were all affiliated with Saccharomycotina. Saccharomycotina were predominant in rumen epithelium and rumen solid while Pezizomycotina were predominant in rumen fluid. Yeast belonging to the Saccharomycotina class was predominant in the rumen as a whole (57%). One clone (FF34) had less than 90% similarity to any sequence in the database and was thus apparently unrelated to any previously described yeast.
Er-based optical amplification continues to be the ideal low noise, WDM crosstalk free, broadband candidate for waveguide amplifiers. Design analysis of the applicability of Er-Doped Waveguide Amplifiers (EDWAs) for micron-scale integrated photonics in a planar lightwave circuit concludes: (i) an >80× increase in gain efficiency, and (ii) a >40×increase in device shrink can be realized, for a high index contrast EDWA (with a core-cladding index difference of δn=0.1↔0.7), compared to a conventional Er-doped fiber amplifier. The materials challenge now is to establish a robust materials system which meets this high index difference design requirement while simultaneously leveraging the capability of silicon (Si) processing: a host platform for EDWAs must be found which can integrate with Si Microphotonics. Silicon nitride (Si3N4), silicon oxide (SiO2) and a miscible silicon oxynitride alloy (SiON) of the two meet this materials challenge. We present the results of reactive and conventional magnetron sputtering based materials characterization for this high index host system. Room temperature and 4 K photo-luminescence studies for annealed samples show the reduction of non-radiative de-excitation centers while maintaining an amorphous host structure. Atomic force microscopy shows less than 1 nm peak-to-peak roughness in deposited films. Prism coupler measurements show a reliable reproducibility of host index of refraction with waveguide scattering loss <2 dB/cm. We conclude that the SiON host system forms an optimal waveguide core for an SiO2-clad EDWA. Initial gain measurements show a gain coefficient of approximately 3.9 dB/cm.