Medicine and Health Sciences Commons^™

Seeing And Listening: A Visual And Social Analysis Of Optometric Record-Keeping Practices, Lara Varpio, Marlee Spafford, Catherine Schryer, Lorelei Lingard

Lorelei Lingard

This article investigates the contribution visual rhetoric and rhetorical genre studies (RGS) can make to health care education and communication genres. Through a visual rhetorical analysis of a patient record used in an optometry teaching clinic, this article illustrates that a genre's visual representations provide significant insights into the social action of that genre. These insights are deepened by an insider analysis of the patient record that highlights how content analyses of visual designs need to be elaborated by contextual considerations. A combined visual rhetoric and RGS analysis shows that clinical novices learn to interpret the record's visual cues to …

Assessment Of Indirect Cost-Of-Illness In A Subsistence Farming Society By Using Different Valuation Methods, Tin Su

Tin Tin Su

Indirect costs or productive labour time lost are the largest share of household economic burden of illness. However, the estimate of household indirect cost can vary depending on the valuation methods used. We therefore estimated household indirect cost in a subsistence farming society in Burkina Faso based on daily production value. These results were validated by using willingness-to-pay method and current wage rate. Among the three methods, the value of a day lost for adults assessed by willingness-to-pay method was considerably higher than other methods. There were no significant differences in indirect costs estimated by daily production value and wage …

Age-Related Changes In Strength And Somato-Sensation During Mid-Life Support Rationale For Targeted Preventive Intervention Programs, Nancy Low Choy, Sandra Brauer, Jennifer Nitz

Nancy Low Choy

Age-related changes in strength and somatosensation have a negative impact on balance with advanced age. Knowledge of the decades of life when strength and somatosensation show initial and subsequent reductions could inform balance assessment and targeted preventive intervention. We report a cross-sectional study investigating strength and somatosensation of 316 healthy women aged 20–80 years. Demographics, health profile, and activity level were recorded. Strength of quadriceps, hip abductors and adductors, and lower limb somatosensation (tactile acuity, vibration threshold, and joint position error) were measured. Significant age-related changes in strength and somatosensory function were identified, even when demographic variables of activity level, …

Fatigue As A Symptom Of Acute Myocardial Infarction, Ann L. Eckhardt, Michelle Fennessy, Anne Fink, Jessica Jones, Kathryn Szigetvari, Donna Kruse, Laura Tucco, Cathy Ryan, Julie J. Zerwic

Ann L. Eckhardt

Bell's Palsy: Diagnosis And Management, Jeffrey D. Tiemstra, N Khakhate

Jeffrey Tiemstra, MD, FAAFP

Combining A Strength And Power Program For Semi-Professional Footballers (Afl), Christopher Joyce

Christopher Joyce

Pillbox Organizers Are Associated With Improved Adherence To Hiv Antiretroviral Therapy And Viral Suppression: A Marginal Structural Model Analysis., Maya Petersen, Yue Wang, Mark Van Der Laan, David Guzman, Elise Riley, David Bangsberg

Maya Petersen

Background. Pillbox organizers are inexpensive and easily used; however, their effect on adherence to antiretroviral medications is unknown. Methods. Data were obtained from an observational cohort of 245 human immunodeficiency virus (HIV)–infected subjects who were observed from 1996 through 2000 in San Francisco, California. Adherence was the primary outcome and was measured using unannounced monthly pill counts. Plasma HIV RNA level was considered as a secondary outcome. Marginal structural models were used to estimate the effect of pillbox organizer use on adherence and viral suppression, adjusting for confounding by CD4+ T cell count, viral load, prior adherence, recreational drug use, …

Public Health Citation Patterns: An Analysis Of The American Journal Of Public Health, 2003-2005, Melissa L. Rethlefsen, Lisa C. Wallis

Lisa C. Wallis, MSPH, MS

Tgfb1 And Tgfbr1 Polymorphisms And Breast Cancer Risk In The Nurses' Health Study, David G. Cox, Kathryn Penney, Qun Guo, Susan E. Hankinson, David J. Hunter

Susan E. Hankinson

Background Transforming growth factor beta 1 (TGFB1) forms a signaling complex with transforming growth factor beta receptors 1 and 2 and has been described as both a tumor suppressor and tumor promoter. Single nucleotide polymorphisms in TGFB1 and a microsatellite in TGFBR1 have been investigated for association with risk of breast cancer, with conflicting results. Methods We examined polymorphisms in the promoter region of the TGFB1 gene as well as the TGFBR1*6A microsatellite in the Nurses' Health Study cohort. Results No overall associations between the L10P polymorphism of TGFB1 or the TGFBR1 microsatellite were detected. However, we observed an inverse …

A Role For The Forebrain In Mediating Time-Of-Day Differences In Glucocorticoid Counterregulatory Responses To Hypoglycemia In Rats, Lori M. Gorton, Arshad M. Khan, Maryann Bohland, Graciela Sanchez-Watts, Casey M. Donovan, Alan G. Watts

Arshad M. Khan, Ph.D.

No abstract provided.

Revisiting Equipoise: A Response To Gifford, Paul Miller, Charles Weijer

Charles Weijer

The authors respond to objections Fred Gifford has raised against their paper "Rehabilitating Equipoise." They situate this exchange in the wider context of recent debate over equipoise, highlighting substantial points of agreement between themselves and Gifford. The authors offer a brief restatement of "Rehabilitating Equipoise" in which they amplify some of its core arguments. They then assess Gifford's objections. Finding each to be unfounded, they argue that there is no justification for "pulling the plug" on clinical equipoise.

Evidence For The Regulation Of Contraction-Induced Fatty Acid Oxidation Via Extracellular Signal-Regulated Kinase 1/2 Activation Independent Of Changes In Fatty Acid Uptake, Marcella Raney, Lorraine Turcotte

Marcella Raney

Abstract Data show that extracellular signal-regulated kinase 1/2 (ERK1/2) may be involved in the regulation of fatty acid (FA) uptake during muscle contraction via stimulation of CD36 translocation to the plasma membrane. The perfused hind limb model was used to determine (1) the importance of ERK1/2 signaling on contraction-induced FA uptake and (2) the effect of ERK1/2-mediated FA uptake on contraction-induced FA oxidation. We perfused rat hind limbs with 8 mmol/L glucose, 550 μmol/L palmitate, and no insulin at rest in the absence of inhibitor and during moderate-intensity electrical stimulation and dose-dependent pharmacologic inhibition of ERK1/2 using increasing concentrations of …

Invited Discussant, "Measurable Outcomes Of Quality Improvement In The Intensive Care Unit", Christopher Michetti

Christopher P. Michetti, M.D., F.A.C.S.

No abstract provided.

Intestinal Microsporidial Infections Among Orang Asli (Aborigine) Children From Malaysia, Hesham Al-Mekhlafi

Hesham M Al-Mekhlafi

No abstract provided.

Functional Principal Component Regression And Functional Partial Least Squares, Philip T. Reiss, R. Todd Ogden

Philip T. Reiss

Regression of a scalar response on signal predictors, such as near-infrared (NIR) spectra of chemical samples, presents a major challenge when, as is typically the case, the dimension of the signals far exceeds their number. Most solutions to this problem reduce the dimension of the predictors either by regressing on components--e.g. principal component regression (PCR) and partial least squares (PLS)--or by smoothing methods which restrict the coefficient function to the span of a spline basis. This paper introduces functional versions of PCR and PLS, which combine both of the above dimension reduction approaches. Two versions of functional PCR are developed, …

Obat Gatal Herbal Pada Selangkangan, Caramenyembuhkan Gatalgataldiselangkangan

caramenyembuhkan gatalgataldiselangkangan

Shared Learning: An Overview Of How To Assist The Implementation Of The Racgp And Acrrm Curricula, Janie Smith

Janie Smith

No abstract provided.

Cara Mengatasi Gatal Pada Selangkangan Paha, Caramengatasigatal Padaselakanganpk01a1

caramengatasigatal padaselakanganpk01a1

Peace And Power: Creative Leadership For Building Community, 7th Edition, Peggy Chinn

Peggy Chinn

No abstract provided.

Lenalidomide: A New Agent For Patients With Relapsed Or Refractory Multiple Myeloma, Joseph Tariman

Joseph D Tariman PhD

No abstract provided.

Implementing Supportive Strategies To Retain Nurse Educators, Kathleen Halcomb, Amy Gregg, Bridget Roberts

Bridget R. Roberts

The nurse educator shortage directly affects the nursing shortage. To adequately prepare future nurses, academia needs to retain qualified nurse educators. Many factors affect the nurse educator shortage, including retirement and competition for qualified nursing educators with clinics and the privatesector, as well as dissatisfaction with the multiple stressors and expectations in the academic setting. Academia should implement supportive strategies to aid in the retention of nurse educators.

Computed Tomographic Screening For Lung Cancer., Michael Lock

Michael Lock

No abstract provided.

Refuting The Net Risks Test: A Response To Wendler And Miller's "Assessing Research Risks Systematically", Charles Weijer, Paul Miller

Charles Weijer

Earlier in the pages of this journal (p 481), Wendler and Miller offered the "net risks test" as an alternative approach to the ethical analysis of benefits and harms in research. They have been vocal critics of the dominant view of benefit-harm analysis in research ethics, which encompasses core concepts of duty of care, clinical equipoise and component analysis. They had been challenged to come up with a viable alternative to component analysis which meets five criteria. The alternative must (1) protect research subjects; (2) allow clinical research to proceed; (3) explain how physicians may offer trial enrolment to their …

Measuring Quality Of Care In Patients With Multiple Clinical Conditions: Summary Of A Conference Conducted By The Society Of General Internal Medicine, Barbara Turner

Barbara Turner

Abstract Performance measurement has been widely advocated as a means to improve health care delivery and, ultimately, clinical outcomes. However, the evidence supporting the value of using the same quality measures designed for patients with a single clinical condition in patients with multiple conditions is weak. If clinically complex patients, defined here as patients with multiple clinical conditions, present greater challenges to achieving quality goals, providers may shun them or ignore important, but unmeasured, clinical issues. This paper summarizes the proceedings of a conference addressing the challenge of measuring quality of care in the patient with multiple clinical conditions with …

Assitive Technology, Laura Greiss Hess, Kerrie Lemons Chitwood, Susan Harris

Laura Greiss Hess

Reducing Liver Cancer Disparities - A Community-Based Hepatitis B Prevention Program For The Asian American Communities In Maryland, Chiehwen Ed Hsu

Chiehwen Ed Hsu

Objectives: Several Asian-American groups are at a higher risk of dying of liver diseases attributable to Hepatitis B infection. This culturally diverse community should be well informed of and protected against liver diseases. The present study assesses the knowledge of Hepatitis B before and after a Hepatitis B educational program and determines the infection status of an Asian community. Methods: Nine Asian communities of Montgomery County, Maryland enrolled in the Hepatitis B prevention program between Year 2005 and 2006. They attended culturally-tailored lectures on prevention, completed self administered pre-and-post tests, and received blood screening for the disease. Results: More than …

Shared Situational Awareness And Actionable Knowledge: Keeping The Human In The Loop, William Chris Chambers, Robert Ryczak, Chiehwen Ed Hsu, Bob Defraites

Chiehwen Ed Hsu

We propose a shift from a network-centric to a human-centric framework to assimilate emerging technologies into more effective and persistent situational awareness, integrated with actionable knowledge. Diverse communities of interest are better positioned to unify their efforts and support commanders when they are able to share situational awareness. A recent demonstration of military utility of a medical situational awareness capability for influenza surveillance validated shared situational awareness requirements in general. The current and future information environment will increase military and government requirements for situational awareness and actionable knowledge to support many “observe, assess, plan, and execute” processes by decision-makers. The …

Meta-Analysis Evidence Of A Differential Risk Of The Fcrl3 -169t->C Polymorphism In White And East Asian Rheumatoid Arthritis Patients, Steven J. Schrodi, Begovich Ann, Chang Monica

Steven J Schrodi

Association between a functional promoter polymorphism (rs7528684) in the Fc receptor-like gene, FCRL3, and rheumatoid arthritis (RA) has been observed in 3 independent Japanese case-control sample sets ([1][2]). Studies examining the role of this polymorphism in risk of RA in 9 independent white sample sets, however, have yielded conflicting results ([3-8]). Further, a large study of Korean subjects failed to demonstrate association of this single-nucleotide polymorphism (SNP) with RA ([9]). Although the precise function of FCRL3, which has strong structural homology with the classic Fc receptors, is unknown, the existing data are consistent with the hypothesis that it may influence …

Tumor-Targeted Induction Of Oxystress For Cancer Therapy., Arun K. Iyer

Arun Iyer

Reactive oxygen species (ROS), such as superoxide anion radicals (O.-2) and hydrogen peroxide (H2O2) are potentially harmful by-products of normal cellular metabolism that directly affect cellular functions. ROS is generated by all aerobic organisms and it seems to be indispensable for signal transduction pathways that regulate cell growth and reduction-oxidation (redox) status. However, overproduction of these highly reactive oxygen metabolites can initiate lethal chain reactions, which involve oxidation and damage to structures that are crucial for cellular integrity and survival. In fact, many antitumor agents, such as vinblastine, cisplatin, mitomycin C, doxorubicin, camptothecin, inostamycin, neocarzinostatin and many others exhibit antitumor …

Should Antipsychotics Be Used In Prodromal Phase Of Psychosis?, Amresh Shrivastava

Amresh Srivastava

No abstract provided.