We investigated risk factors for prevalent high-risk human papillomavirus (HR-HPV) in Inuit women from Quebec. Younger age and having 10 or more lifetime sexual partners were associated with HR-HPV. Findings suggest that for older women, markers of recent sexual activity are more predictive of HR-HPV status than markers of lifetime sexual history.
OBJECTIVE: To examine healthcare coverage and access disparities for American Indian/Alaska Native (AIAN) veterans compared with non-Hispanic white veterans. METHODS: We examined national survey data for honorably discharged veterans in the United States using National Health Interview Survey (NHIS) data between 1997 and 2006. NHIS data were obtained from the Integrated Health Interview Series, a web-based data resource containing harmonized NHIS data from 1969 to the present. Our sample included AIAN and white veterans aged 18 to 64 years (n = 34,504). We used multivariate logistic regression models to estimate the odds of being uninsured, reasons for delayed care, and types of foregone care. RESULTS: In multivariate analysis, AIAN veterans have 1.9 times higher odds of being uninsured compared with non-Hispanic white veterans (95% CI: 1.6-2.7). Compared with white veterans, AIAN veterans are significantly more likely to delay care due to not getting timely appointments (OR = 2.0, 95% CI: 1.1-2.6), not getting through on the phone (OR = 3.0, 95% CI: 1.6-5.8), and transportation problems (OR = 2.9, 95% CI: 1.1-7.3). In unadjusted models, AIAN veterans have significantly higher odds of having foregone 4 of 5 types of care compared with non-Hispanic white veterans. Adjusting for sociodemographic characteristics and insurance eliminated all significant relations. CONCLUSIONS: AIAN veterans have considerable disparities in healthcare coverage and access compared with non-Hispanic whites. Although barriers to care due to cost are nominal for AIAN veterans, barriers to care due to navigating the healthcare system and due to lack of transportation remain substantial.
OBJECTIVE: To describe symptom patterns and the course for recovery in persons with whiplash-associated disorders (WAD) over 6 months after a car collision, and to investigate associated gender differences. METHODS: The study population was based on insurance claimants, 18-74 years of age, who reported WAD after a collision, between January 2004 and January 2005. At baseline and again 6 months later they were asked to complete a questionnaire that included questions about presence and severity of pain and other possible WAD symptoms. It also included measurements of posttraumatic stress as well as anxiety and depression. RESULTS: A total of 1105 persons were studied. The most common symptoms at baseline after neck pain were reduced cervical range of motion (in 83.9% of men, 82.2% of women), headache (61.0% and 69.3%, respectively), and low back pain (35.9% and 36.1%). Some symptoms were already transient at baseline and symptoms such as neck pain, reduced cervical range of motion, headache, and low back pain decreased further over the 6 months. Baseline prevalence of depression was around 5% in both women and men, whereas posttraumatic stress and anxiety were more common in women (19.7% and 11.7%, respectively) compared to men (13.2% and 8.6%). The majority of all reported associated symptoms were mild at both baseline and followup. CONCLUSION: Our findings support that the symptom pattern of WAD and the prevalence for many of the symptoms decreased over a 6-month period.
Arctic waders are well known for their impressive long-distance migrations between their high northerly breeding grounds and wintering areas in the Southern hemisphere. Performing such long migrations requires precise orientation mechanisms. We conducted orientation cage experiments with juvenile sharp-tailed sandpipers (Calidris acuminata) to investigate what cues they rely on when departing from Alaska on their long autumn migration flights across the Pacific Ocean to Australasia, and which possible migration routes they could use. Experiments were performed under natural clear skies, total overcast conditions and in manipulated magnetic fields at a staging site in Alaska. Under clear skies the juvenile sharp-tailed sandpipers oriented towards SSE, which coincides well with reported sun compass directions from their breeding grounds in Siberia towards Alaska and could reflect their true migratory direction towards Australasia assuming that they change direction towards SW somewhere along the route. Under overcast skies the sandpipers showed a mean direction towards SW which would lead them to Australasia, if they followed a sun compass route. However, because of unfavourable weather conditions (headwinds) associated with overcast conditions, these south-westerly directions could also reflect local movements. The juvenile sharp-tailed sandpipers responded clearly to the manipulated magnetic field under overcast skies, suggesting the use of a magnetic compass for selecting their courses.
Hospital related morbidity from chronic hepatitis C virus (HCV) infection in Australia and mortality from HCV infection in a population cohort in Denmark: two complementary studies relevant to counseling patients.
A retrospective cohort study was performed on 130 pig herds in Denmark, to assess the effect of PMWS on the use of antimicrobial drug. The study comprised 65 herds diagnosed with PMWS during 2003-2004, and matched by the veterinary practitioner with 65 herds free from PMWS. Information on antimicrobial use 1 year before and 1 year after the diagnosis was achieved from the National Prescription Medicine Monitoring Database, VetStat, and summarized on quarter within age group and herd. The multiple linear regression analysis comprised antimicrobial use as the outcome variable with (1) quarter relative to diagnosis of PMWS in the positive herd (same date for the negative match), (2) diagnosis of PMWS (same date used for matched PMWS(-) herd), (3) season and (4) temporal trend as fixed effects. Relative to the unaffected herds, the antimicrobial use in the sow units in the PMWS(+) herds was elevated significantly by 35% in the last quarter and 43% in the fourth quarter before positive diagnosis in the herds (p
The aim was to investigate the association of bullying behavior with psychiatric disorders and physical health in a sample of adolescent psychiatric patients, as there have to our knowledge been no previous studies using actual psychiatric diagnoses examining this relationship in boys and girls. We studied 508 Finnish adolescents (age 12-17) admitted to psychiatric inpatient care between April 2001 and March 2006 from the geographically large area of Northern Finland. The Schedule for Affective Disorder and Schizophrenia for School-Age Children, Present and Lifetime (K-SADS-PL) was used to obtain psychiatric diagnoses of adolescents according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and information on bullying behavior. Logistic regression analyses showed that having an externalizing disorder increased the likelihood of being a bully or a bully-victim (i.e. a person who is both a bully and a victim of bullying) among both the boys (odds ratio, OR=14.4, P=0.001) and the girls (OR=10.0, P
BACKGROUND AND AIMS: Although sporadic cases of cancer in patients with fragile X syndrome (FXS) have been reported, extensive studies carried out in Denmark and Finland concluded that cancer incidence in these patients is lower than in the general population. On the other hand, the FMR1 protein, which is involved in the translation process, is absent in FXS patients. Hence, it is reasonable to assume that these patients exhibit an abnormal expression of some proteins involved in regulating tumor suppressor genes and/or oncogenes, thus explaining its decreased cancer frequency. We undertook this study to analyze the expression of oncogenes and tumor suppressor genes in fragile X syndrome patients. METHODS: Molecular analysis of the FMR1 gene was achieved in 10 male patients and controls. Total RNA from peripheral blood was used to evaluate expression of oncogenes and tumor suppressor genes included in a 10,000 gene microarray library. Quantitative real-time PCR was utilized to confirm genes with differential expression. RESULTS: Among 27 genes showing increased expression in FXS patients, only eight genes exhibited upregulation in at least 50% of them. Among these, ARMCX2 and PPP2R5C genes are tumor suppressor related. Likewise, 23/65 genes showed decreased expression in >50% of patients. Among them, WNT7A gene is a ligand of the beta-catenin pathway, which is widely related to oncogenic processes. Decreased expression of WNT7A was confirmed by quantitative RT-PCR. Expression of c-Myc, c-Jun, cyclin-D and PPARdelta genes, as target of the beta-catenin pathway, was moderately reduced in FXS patients. CONCLUSIONS: Results suggest that this diminished expression of the WNT7A gene may be related to a supposed protection of FXS patients to develop cancer.
Laboratory of Behavioral Neurogenomics, Sector of Medical Genetics, Institute of Cytology and Genetics, Siberian Branch, Russian Academy of Sciences, Prospekt Lavrentyeva 10, Novosibirsk, 630090, Russia.
Ample research indicates that age-related neuronal-behavioral decrements are the result of oxidative stress and may be ameliorated by antioxidants. Here we examined effects of mitochondria-targeted antioxidant, SkQ1, on sexual motivation in 12-month-old Wistar and accelerated-senescent OXYS male rats. A change in behavioral activity of a male at a holed transparent partition with a receptive female on the other side was taken as an index of sexual motivation. The social behavior of male in same conditions with ovariectomised (OVXed) female and castrated male was investigated to differentiate sexually and socially motivated behavior. Behavioral response to social stimulus did not depend on age and genotype. No differences were found between 4- and 12-month-old Wistar males when sexual stimulus was presented; however, 12-month-old OXYS males demonstrated a lower propensity for sexual motivation as compared to 4-month-old OXYS rats and 12-month-old Wistar rats. We examined effects of SkQ1 on sexual motivation in 12-month-old male rats following prolonged supplementation begun at 1.5months of age (10, 50 or 250nmol/kg daily), a 45-day supplementation begun at 10.5months of age (50nmol/kg) and a 3-month supplementation begun at 9months of age (250nmol/kg). SkQ1 did not affect locomotor activity; however, it increased the time spent at the partition. A significantly higher measure of the motivational stage of sexual behavior was displayed following chronic preventive treatment at a dose of 50 and 250nmol/kg by OXYS rats. Chronic therapeutic treatment during 3months at a dose of 250nmol/kg was effective in age-accelerated OXYS rats too. These findings suggest an essential role for oxidative stress associated with mitochondrial dysfunction in the decline of sexually motivated behavior of male rats. Recovery from these impairments and/or their prevention enables a fully successful performance of the initial stage of male sexual behavior.
Bromo-Dragonfly (BDF) is a designer drug chemically related to LSD and amphetamine. The first registration in Denmark was in October 2007. In the present case an 18-year-old man ingested about 2 ml BDF and developed acute psychosis. At the hospital the patient displayed, hyperpyrexia, tachycardia, tachypnea and hypertension. Because of severe hallucinations and agitation the patient was detained at the hospital and received symptomatic treatment with large doses of benzodiazepines. Four days after hospitalization, the patient discharged himself without significant symptoms or paraclinical findings.
Background Previous research is inconclusive regarding antecedents and consequences of achievement goals, and there is a need for more research in order to examine the joint effects of different types of motives and learning strategies as predictors of academic achievement. Aims To investigate the relationship between achievement motives, achievement goals, learning strategies (deep, surface, and strategic), and academic achievement in a hierarchical model. Sample Participants were 229 undergraduate students (mean age: 21.2 years) of psychology and economics at the University of Bergen, Norway. Methods Variables were measured by means of items from the Achievement Motives Scale (AMS), the Approaches and Study Skills Inventory for Students, and an achievement goal scale. Results Correlation analysis showed that academic achievement (examination grade) was positively correlated with performance-approach goal, mastery goal, and strategic learning strategies, and negatively correlated with performance-avoidance goal and surface learning strategy. A path analysis (structural equation model) showed that achievement goals were mediators between achievement motives and learning strategies, and that strategic learning strategies mediated the relationship between achievement goals and academic achievement. Conclusions This study integrated previous findings from several studies and provided new evidence on the direct and indirect effects of different types of motives and learning strategies as predictors of academic achievement.
BACKGROUND: One of the main obstacles for successful cancer polychemotherapy is multiple drug resistance phenotype (MDR) acquired by tumor cells. Currently, RNA interference represents a perspective strategy to overcome MDR via silencing the genes involved in development of this deleterious phenotype (genes of ABC transporters, antiapoptotic genes, etc.). METHODS: In this study, we used the siRNAs targeted to mdr1b, mdr1a, and bcl-2 mRNAs to reverse the MDR of tumors and increase tumor sensitivity to chemotherapeutics. The therapy consisting in ex vivo or in vivo application of mdr1b/1a siRNA followed by cyclophosphamide administration was studied in the mice bearing RLS40 lymphosarcoma, displaying high resistance to a wide range of cytostatics. RESULTS: Our data show that a single application of mdr1b/1a siRNA followed by treatment with conventionally used cytostatics results in more than threefold decrease in tumor size as compared with the control animals receiving only cytostatics. CONCLUSIONS: In perspective, mdr1b/1a siRNA may become a well-reasoned adjuvant tool in the therapy of MDR malignancies.
STUDY OBJECTIVES: The aim was to assess associations between sleep duration, sleep stages, and central obesity in women. DESIGN: Cross-sectional study. SETTING: City of Uppsala, Sweden. PARTICIPANTS: Population-based sample of 400 women (range 20-70 years). INTERVENTIONS: Full-night polysomnography and measurement of anthropometric variables. MEASUREMENTS AND RESULTS: Sleep duration was inversely related to both waist circumference and sagittal abdominal diameter. Sleep duration remained inversely related to waist circumference (adj. beta = -1.22 cm/h; P = 0.016) and sagittal abdominal diameter (adj. beta = -0.46 cm/h; P = 0.001) after adjusting for potential confounders. Duration of slow wave sleep (SWS, adj. beta = -0.058 cm/min; P = 0.025) and REM sleep (adj. beta = -0.062 cm/min; P = 0.002) were both inversely related to waist circumference afteradjustments. Moreover,duration of REM sleep was inversely related to sagittal abdominal diameter (adj. beta = -0.021 cm/min; P
INTRODUCTION: Large, functional, disaster exercises are expensive to plan and execute, and often are difficult to evaluate objectively. Command and control in disaster medicine organizations can benefit from objective results from disaster exercises to identify areas that must be improved. OBJECTIVE: The objective of this pilot study was to examine if it is possible to use performance indicators for documentation and evaluation of medical command and control in a full-scale major incident exercise at two levels: (1) local level (scene of the incident and hospital); and (2) strategic level of command and control. Staff procedure skills also were evaluated. METHODS: Trained observers were placed in each of the three command and control locations. These observers recorded and scored the performance of command and control using templates of performance indicators. The observers scored the level of performance by awarding 2, 1, or 0 points according to the template and evaluated content and timing of decisions. Results from 11 performance indicators were recorded at each template and scores greater than 11 were considered as acceptable. RESULTS: Prehospital command and control had the lowest score. This also was expressed by problems at the scene of the incident. The scores in management and staff skills were at the strategic level 15 and 17, respectively; and at the hospital level, 17 and 21, respectively. CONCLUSIONS: It is possible to use performance indicators in a full-scale, major incident exercise for evaluation of medical command and control. The results could be used to compare similar exercises and evaluate real incidents in the future.
The aim of this study was to estimate the prevalence of vesicoureteral reflux (VUR) and clinically significant ultrasonography (US) abnormalities in a large group of children with proven and suspected urinary tract infection (UTI). The medical reports on renal US and voiding cystouretrographies (VCUG) of 2,036 children were reviewed. Renal US was performed on all children and VCUG on 1,185 children (58%). Based on the urine culture data, the UTI diagnoses were classified into five reliability classes (proven, likely, unlikely, false and no microbial data). The UTI diagnose was considered proven in 583/2036 (28.6%) and false in 145 (7.1%) cases. The prevalence of VUR was similar among those with proven and false UTI [37.4 vs. 34.8%; relative risk (RR) 1.08, 95% confidence intervals (95% CI) 0.7-1.7, P = 0.75] and decreased with increasing age (P = 0.001). Clinically significant US abnormalities occurred in 87/583 (14.9%) cases with proven UTI and significantly less often (11/145, 7.6%) in the false UTI class (RR 1.96, 95% CI 1.1-3.6, P = 0.02). Our finding supports the claim that VUR is not significantly associated to UTI and that its occurrence among children even without UTI is significantly higher than traditional estimates. This challenges the recommendations of routine VCUG after UTI.
PROBLEM/CONDITION: An estimated 50,000 persons die annually in the United States as a result of violence-related injuries. This report summarizes data from CDC's National Violent Death Reporting System (NVDRS) regarding violent deaths from 16 states for 2007. Results are reported by sex, age group, race/ethnicity, marital status, location of injury, method of injury, circumstances of injury, and other selected characteristics. REPORTING PERIOD COVERED: 2007. DESCRIPTION OF SYSTEM: NVDRS collects data regarding violent deaths obtained from death certificates, coroner/medical examiner reports, and law enforcement reports. NVDRS began operation in 2003 with seven states (Alaska, Maryland, Massachusetts, New Jersey, Oregon, South Carolina, and Virginia) participating; six states (Colorado, Georgia, North Carolina, Oklahoma, Rhode Island, and Wisconsin) joined in 2004, four (California, Kentucky, New Mexico, and Utah) in 2005, and two states (Ohio and Michigan) were funded to begin data collection in 2010, totaling 19 states. This report includes data from 16 states that collected statewide data in 2007. California data are not included in this report because NVDRS data are collected only in a limited number of California cities and counties rather than statewide. Ohio and Michigan are excluded because they did not begin data collection until 2010. RESULTS: For 2007, a total of 15,882 fatal incidents involving 16,319 deaths occurred in the 16 NVDRS states included in this report. The majority (56.6%) of deaths was suicides, followed by homicides and deaths involving legal intervention (i.e., deaths caused by police and other persons with legal authority to use deadly force, excluding legal executions) (28.0%), deaths of undetermined intent (14.7%), and unintentional firearm deaths (0.7%). Suicides occurred at higher rates among males, American Indians/Alaska Natives, non-Hispanic whites, and persons aged 45--54 years. Suicides occurred most often in a house or apartment and involved the use of firearms. Suicides were precipitated primarily by mental-health, intimate-partner, or physical-health problems, or by a crisis during the preceding 2 weeks. Homicides occurred at higher rates among males and persons aged 20--24 years; rates were highest among non-Hispanic black males. The majority of homicides involved the use of a firearm and occurred in a house or apartment or on a street/highway. Homicides were precipitated primarily by arguments and interpersonal conflicts or in conjunction with another crime. Other manners of death and special situations or populations also are highlighted in this report. Interpretation: This report provides a detailed summary of data from NVDRS for 2007. The results indicate that violent deaths resulting from self-inflicted or interpersonal violence disproportionately affected adults aged
OBJECTIVES: We studied 5 members of the National Network Consortium on Tobacco Control in Priority Populations. These networks, which consist of governmental and nongovernmental organizations, targeted lesbian, gay, bisexual, and transgender persons; Asian Americans, Native Hawaiians, and Pacific Islanders; American Indians and Alaska Natives; African Americans; and persons with low socioeconomic status, respectively. METHODS: We used statistical network analysis modeling to examine collaboration among these national networks in 2007. RESULTS: Network size and composition varied, but all 5 networks had extensive interorganizational collaboration. Location and work area were significant predictors of collaboration among network members in all 5 networks. Organizations were more likely to collaborate with their network's lead agency; collaborations with other agencies were more likely if they were geographically close. Collaboration was perceived to be important for achieving the goals of the national network. CONCLUSIONS: The similarity of collaboration patterns across the 5 networks suggests common underlying partnership formation processes. Statistical network modeling promises to be a useful tool for understanding how public health systems such as networks and coalitions can be used to improve the nation's health.