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PubMed2001

Surface contamination to UV-curable acrylates in the furniture and parquet industry.

Surface contamination to ultraviolet radiation curable coatings (UV coatings), used increasingly in the parquet and furniture industry, is a matter of concern as a source for skin contamination. UV coatings contain chemically and biologically reactive acrylates, well known as skin contact irritants and sensitizers. Surface contamination may spread secondarily to equipment and other unexpected areas even outside the workplace. Yet, studies concerning this type of contamination are lacking due to lack of suitable sampling methods. Surface contamination of the work environment with risk for skin exposure to UV coating was measured employing a quantitative adhesive tape sampling method developed for this purpose. A pilot study was first performed at three workplaces to evaluate the contamination. In the main study, we wanted to locate and identify in detail the surface contamination of areas where problems exist, and to determine the extent of the problem. Measurements were performed at seven workplaces on two separate workdays (round 1 and 2) within a six-month period. Samples were collected from the workplaces based on the video monitoring of skin contact frequency with the surfaces and categorized into three groups to analyze risk. The pilot study indicated that surface contamination to TPGDA containing UV coatings was common, found in 76 percent of the surfaces, and varied with a maximum of 909 microg TPGDA 10 cm(-2) sampling area. In the main study TPGDA was found in 153 out of 196 collected samples (78.1%); for round one 78.1 percent (82 out of 105 samples) and for round two 78.0 percent (71 out of 91 samples). The average TPGDA mass on positive surface samples was on the first round 2,247 +/- 7,462 microg, and on the second round 2,960 +/- 4,590 microg. We conclude that surface contamination to uncured UV coatings at UV-curing lines is common and this involves a risk for harmful, unintentional skin exposure to acrylates.

Acrylates↗
PubMed1999

HIV seroprevalence and risk factors among clients of female and male prostitutes.

OBJECTIVES: To document the HIV and STD infection rates among clients of female (CFP) and clients of male prostitutes (CMP) and to identify the risk factors for HIV among CFP and CMP. METHODS: Structured interviews were conducted with 82 CMP and 69 CFP in 1990 and 1991 in Atlanta, Georgia, U.S.A. Blood samples were tested for HIV, syphilis, and hepatitis B. RESULTS: The HIV-positive rate was 36.6% among CMP and 2.9% among CFP. Syphilis seromarkers were found in 15.9% of CMP and 10.1% of CFP; hepatitis B seromarkers were identified in 58.0% of CMP and 24.6% of CFP. Key risk factors for HIV among CMP included serologic history of syphilis, serologic history of hepatitis B, receptive anal sex with a male prostitute, ever injecting drugs, ever using crack cocaine, and little education. CFP had no significant risk factors for HIV in the logistic analysis. CONCLUSIONS: Several studies have focused on risk factors for HIV among female and male prostitutes; however, research on their clients has been limited. Although HIV infection rates among CFP are relatively low, their infection rate for syphilis and hepatitis warrants serious health education efforts. Even more critical are harm-reduction programs targeting CMP. Generic health and HIV risk reduction messages on heterosexual transmission might be insufficient.

Crack Cocaine↗
PubMed2004

Cold-induced hyperthyroidism produces oxidative damage in rat tissues and increases susceptibility to oxidants.

In this work, we investigated whether cold exposure-induced hyperthyroidism increases oxidative damage and susceptibility to oxidants of rat liver, heart and skeletal muscle. All tissues exhibited gradual increases in hydroperoxide and protein-bound carbonyl levels. Glutathione peroxidase activity increased in all tissues after 2 days and further increased in the muscle after 10 days of cold exposure. Liver glutathione reductase activity increased after 10 days of cold exposure, while heart and muscle activities were not modified. Vitamin E levels were not affected by cold, while coenzyme Q9 and coenzyme Q10 levels decreased in heart and muscle after 2-day cold exposure and were not further modified after 10 days. Liver coenzyme Q9 levels increased after 2 days whereas coenzyme Q10 levels increased after 10 days in the cold. The whole antioxidant capacity was lowered, while parameters positively correlated with susceptibility to oxidants were increased by cold. Lipid fatty acid composition was modified in all tissues. In particular, fatty acid unsaturation degree increased in heart and muscle. Cytochrome oxidase activity increased, suggesting an increased content of hemoproteins, which are able to generate .OH radical. This view was supported by the observation that the tissue susceptibility to H(2)O(2) treatment, which is strongly correlated to iron-ligand content, increased after cold exposure. In this frame, it is apparent that the increase in oxidative capacity, necessary for homeotherm survival in low temperature environments, has potential harmful effects, because it results in increased susceptibility to oxidative challenge.

Animals↗
PubMed1992

Sex steroid hormones and breast cancer: is there a link with oral contraceptives and hormone replacement therapy?

OBJECTIVE: To determine whether use of sex steroid hormones for contraception and hormone replacement therapy alters the risk of breast cancer, and whether the risk varies with their composition, duration of use, the period of a woman's life when the hormones are used, and after successful treatment for breast cancer. DATA SOURCES: The results of important epidemiological reports, readily available from the English literature and published since 1981, were evaluated, using reports of basic scientific work as a background to the problem. STUDY SELECTION: An attempt was made to obtain most of the relevant reports. Twenty case-control and seven cohort studies were available on the oral contraceptive pill (OCP) and eleven case-control and five cohort studies on hormone replacement therapy (HRT). DATA EXTRACTION: The relative risk estimates for breast cancer (and their 95% confidence intervals) determined by each report were tabulated according to the specific conditions of analysis, for example users under age 25, duration of use. Results by meta-analysis from previous studies were also used to determine risk. A significant positive association was present when the risk estimate exceeded 1.0 and the 95% confidence interval did not cross 1.0. DATA SYNTHESIS: Among OCP users, the vast majority of reports showed no significant risk of breast cancer--overall, longest duration of use, and use before first full-term pregnancy. However, a positive association between breast cancer and users under age 25 was found in three of eight reports. Similarly, the majority of reports showed no significant risk of breast cancer among HRT users, overall as well as in relation to duration of use and interval since first use. There was no increased risk with additional progestogen; it may be protective. An improved prognosis was found in users who developed breast cancer. On the limited data, use of hormones for postmenopausal symptoms did not appear to be harmful to women who had been successfully treated for breast cancer. CONCLUSIONS: The review revealed good evidence that use of sex steroid hormones had no significant effect on the risk of breast cancer, whether given for contraception or hormone replacement. There was some concern about increased risk with prolonged use of the OCP, especially in younger women. At present, use of these hormones is a matter of informed choice, with individual considerations of the risk-benefit ratio.

Adult↗
PubMed2005

Alcohol screening and brief intervention in primary care settings: implementation models and predictors.

OBJECTIVE: This study compared two different implementation strategies for Cutting Back, a primary care alcohol screening and brief intervention (SBI) program for hazardous and harmful drinkers. It also identified organizational factors contributing to the success or failure of SBI implementation. METHOD: Cutting Back was implemented in 10 primary care practices associated with managed care organizations (MCOs) in five states, through a system of planning, training, technical assistance and clinic feedback. Clinics were randomly assigned to one of two brief intervention systems: In the P Model, medical providers were responsible for delivering interventions, whereas in the S Model mid-level professionals (usually nurses) acted as the clinic specialists to provide that service. Data were collected to measure the performance of screening and delivery of interventions in each clinic. RESULTS: The S Model screened a higher percentage of patients than did the P Model during the best month of program operation (50% vs 44%) and over all months of operation (24% vs 19%). Of those patients who screened positive, more patients in the S condition received an intervention than in the P condition (73.1% vs 57.1%), but there was a considerable range of performance among the five sites within each condition. Results at the clinic level were mixed, with some MCOs performing alcohol SBI significantly better with the S model and others doing better with the P model. The ability of clinics to conduct SBI was significantly correlated with both provider characteristics and organizational factors (e.g., prior SBI experience, MCO stability, number of clinicians trained and the quality of the MCO coordinator's work). Lack of provider time, staff turnover and competing priorities correlated negatively with SBI performance. CONCLUSIONS: The extent to which a given delivery model is likely to work best within an MCO depends on complex provider and organizational characteristics.

Adolescent↗
PubMed2004

How to improve mental health competency in general practice training?--a SWOT analysis.

It is quite evident there is room for improvement in the primary care management of common mental health problems. Patients respond positively when GPs adopt a more proactive role in this respect. The Dutch general practice curriculum is currently being renewed. The topics discussed here include the Strengths, Weaknesses, Opportunities and Threats (SWOT) of present primary mental healthcare teaching. What works well and what needs improving? Integrated teaching packages are needed to help general practice trainees manage various presentations of psychological distress. Such packages comprise training videotapes, in which models such as problem-solving treatment (PST) are demonstrated, as well as roleplaying material for new skills, self-report questionnaires for patients, and small-group video feedback of consultations. While GP trainees can effectively master such skills, it is important to query the level of proficiency required by registrars. Are these skills of use only to connoisseur GPs, or to all? More room for specialisation and differentiation among trainees may be the way forward. We have just developed a new curriculum for the obligatory three-month psychiatry housemanship. It is competency oriented, self-directed and assignment driven. This new curriculum will be evaluated in due course.

Curriculum↗
PubMed2006

Screening programmes for the early detection and prevention of oral cancer.

BACKGROUND: Screening programmes for major cancers, such as breast and cervical cancer have effectively decreased the mortality rate and helped to reduce the incidence of these cancers. Although oral cancer is a global health problem with increasing incidence and mortality rates, no national population-based screening programmes for oral cancer have been implemented. To date there is debate on whether to employ screening methods for oral cancer in the daily routine work of health providers. OBJECTIVES: To assess the effectiveness of current screening methods in decreasing oral cancer mortality. SEARCH STRATEGY: Electronic databases (MEDLINE, CANCERLIT, EMBASE, the Cochrane Central Register of Controlled Trials; 1966 to July 2005, The Cochrane Library - Issue 3, 2005), bibliographies, handsearching of specific journals and contact authors were used to identify published and unpublished data. SELECTION CRITERIA: Randomised controlled trials of screening for oral cancer or precursor oral lesions using visual examination, toluidine blue, fluorescence imaging or brush biopsy. DATA COLLECTION AND ANALYSIS: The search found 112 citations and these have been reviewed. One randomised controlled trial of screening strategies for oral cancer was identified as meeting the review's inclusion criteria. Validity assessment, data extraction and statistics evaluation were undertaken by two independent review authors. MAIN RESULTS: One 10-year randomised controlled trial has been included (n = 13 clusters: 191,873 participants). There was no difference in the age-standardised oral cancer mortality rates for the screened group (16.4/100,000 person-years) and the control group (20.7/100,000 person-years). Interestingly, a significant 34% reduction in mortality was recorded in high-risk subjects between the intervention cohort (29.9/100,000 person-years) and the control arm (45.4/100,000). However, this study has some methodological weaknesses. Additionally, the study did not provide any information related to costs, quality of life or even harms of screening from false-positive or false-negative findings. AUTHORS' CONCLUSIONS: Given the limitation of evidence (only one included randomised controlled trial) and the potential methodological weakness of the included study, it is valid to say that there is insufficient evidence to support or refute the use of a visual examination as a method of screening for oral cancer using a visual examination in the general population. Furthermore, no robust evidence exists to suggest that other methods of screening, toluidine blue, fluorescence imaging or brush biopsy, are either beneficial or harmful. Future high quality studies to assess the efficacy, effectiveness and costs of screening are required for the best use of public health resources. In addition, studies to elucidate the natural history of oral cancer, prevention methods and the effectiveness of opportunistic screening in high risk groups are needed. Future studies on improved treatment modalities for oral cancer and precancer are also required.

Humans↗
PubMed2002

Sun awareness and sun protection practices in Malta.

BACKGROUND: Concern regarding the rising incidence of melanoma and non-melanoma skin cancers in Malta has led to the organization of annual campaigns since the early 1990s. These aim to inform the public of the dangers of sun exposure and to promote sun protection. OBJECTIVE: To help guide future campaigns, a survey was carried out to evaluate current sun protection measures among the Maltese people and to assess their level of knowledge regarding harmful effects of the sun on the skin. STUDY DESIGN: A total of 559 pedestrians were interviewed in the main street of the capital city of Malta in the summer of 1999. RESULTS: Self-reported rates of regular sunscreen and hat use in adults exposed to the spring/summer sun between 10.00 h and 15.00 h were 51% and 32%, respectively, for leisure activities, and 25% and 37%, respectively, for outdoor work. Men reported using sunscreen less often than women during both leisure and work. The fairer-skinned outdoor workers actually reported making less use of a sunscreen and/or hat than their darker counterparts, and rates of sunscreen and/or hat use during leisure and work were not found to increase with the amount of time spent in the sun. Almost 75% of sunscreen users were using a sun protection factor of at least 15. Parents reported much higher rates of regular sunscreen and hat use by their young children than by themselves, with 87% of children under 12 years of age reported to be using sunscreen and 78% reported to be wearing a hat. The great majority knew that injudicious sun exposure is associated with skin cancer and skin ageing, but 48% were still regarding a suntan achieved without skin burning as 'healthy' The mass media was by far considered to be the main source of information for the general public regarding effects of the sun on the skin. CONCLUSIONS: The positive impact of past campaigns can be seen in the high reported rates of sun protection in children. However, much remains to be done with adults in order to change their attitude about a 'healthy suntan' and to convince them that it is worthwhile to protect themselves from the sun.

Adolescent↗
PubMed1983

A comprehensive psychological approach to obesity.

Many different treatments for obesity have proven somewhat successful, with none emerging as clearly superior to the others. Surgical approaches, although usually successful at achieving and maintaining weight loss, are accompanied by varied and often harmful side effects. Unless new, safer procedures are developed, treatment may continue to be as hazardous as the obesity itself. Because medical treatment alone has not achieved beneficial, lasting results, research aimed at finding new procedures should be encouraged. Our five-year experience in working with obese patients has led us to the following conclusions: 1. The management of obesity must be a joint venture between psychiatry and medicine. Because of the complex nature of this illness, neither discipline alone can successfully and safely achieve significant initial weight loss coupled with successful long-term maintenance. The use of adjunctive psychological programs in a medical setting can be a successful alternative. 2. Fasting, weight loss, and realimentation must be accompanied by an effort at lifestyle change. Otherwise, patients will continue their self-destructive habits, which will ultimately lead to failure in yet another attempt at sustained weight reduction. The behavioral approach has provided a fairly effective treatment of obesity, sometimes with immediate results. Recent studies support the maintenance effect of behavioral treatments. However, longer studies with follow-ups are needed to better assess the overall effectiveness of these treatments. 3. Despite much false optimism that weight loss is a simple road to happiness, most patients experience some very real problems during the fasting part of the program. Crisis intervention can prove very helpful in terms of reducing stress and preventing dropouts. Group therapy, individual therapy, family therapy, and hypnosis have attained some very limited positive results when used alone; greater success has been reported from combining therapies. Patients generally became more socially effective, physically active, and mentally proficient when exposed to individual therapy together with group and family therapies. 4. Family environment appears to significantly affect compliance and completion. A conflict-laden family environment hampers the patient's ability to deal with the psychological changes encountered in weight loss programs. 5. Many obese patients lack a fundamental knowledge of nutrition, exercise, and health. In addition, most are poorly socialized and require assistance in learning assertiveness and other interpersonal skills. A behaviorally oriented component is very effective in providing these skills.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed2003

[Factors associated with stages of behavior change in Cuban smokers].

OBJECTIVE: To describe the distribution of Cuban smokers in the first two stages of the process of behavior change (precontemplation (that is, no desire to quit smoking) and contemplation (thinking about quitting)), the characteristics of these smokers, and the relationship between these characteristics and some variables of interest. METHODS: The First National Survey of Risk Factors and Chronic Non-communicable Disease Prevention Activities was carried out in Cuba in 1996. As a part of that Survey, a probability sample was selected using three-stage clustering, with stratification of the primary units, which were the census districts in the 14 provinces and 169 municipalities that make up the country. The census districts were selected in proportion to their number of dwellings. A total of 4 835 smokers 15 years old or older were selected to answer a questionnaire on sociodemographic variables and smoking-related behaviors. The sociodemographic variables included age, sex, skin color, level of schooling completed, and work status (working, looking for work, retired, housewife, or student). The smoking-related behaviors included knowledge of tobacco's harmful effects on health, age when smoking began, number of cigarettes smoked daily, willingness to give up the habit, and the number of attempts made to quit smoking. The questionnaire information made it possible to place the smokers in one or the other of the two initial stages of smoking behavior change. The probability of being in the precontemplation stage was modeled through logistic regression. The standardized coefficients that the model produced were used to calculate the weight of the explanatory variables included in the model. To calculate the estimates and their errors, the SAS 6.12 and SUDAAN 7.5 statistical software packages were used, taking into account the complex design of the sample. The level of significance was set at 0.05. RESULTS: We found that 46.4% of the smokers surveyed were in the precontemplation stage, and 53.6% were in the contemplation stage. Women were more prepared to quit the habit than were men. The more formal the education that a person had, the stronger was the desire to quit smoking. Persons who were retired were the ones least likely to be considering giving up smoking. The probability of being in the precontemplation stage decreased with an increase in the age of beginning to smoke, the number of cigarettes smoked daily, and the number of attempts made to quit smoking. CONCLUSIONS: The proportion of Cuban smokers in the contemplation stage places the country in a favorable position for developing effective smoking prevention interventions. The majority of the factors identified (age when smoking began, number of cigarettes consumed daily, and number of attempts to give up the habit) can be modified through preventive actions. Identifying the stages in the process of change and the factors linked to them are necessary for designing and implementing effective smoking prevention and control programs.

Adolescent↗
PubMed2003

Ethyl glucuronide discloses recent covert alcohol use not detected by standard testing in forensic psychiatric inpatients.

BACKGROUND: Considerable lives and money could be saved if one could detect early stages of lapsing/relapsing behavior in addicted persons (e.g., in safety-sensitive workplaces) and could disclose harmful drinking in social drinkers. Due to the serious public health problem of alcohol use and abuse worldwide, markers of alcohol use have been sought. Both ethyl glucuronide (EtG) and phosphatidyl ethanol (PEth) appear to have high sensitivity and specificity and a time frame of detection that may elucidate alcohol use not detected by standard testing. Our aim was to assess their potential for detecting recent covert alcohol use under controlled conditions. METHODS: Thirty-five forensic psychiatric inpatients in a closed ward who had committed a substance-related offense ( section sign 64 StGB), were followed for 12 months. The complete time spectrum of possible alcohol consumption was covered by the complementary use of breath and urinary ethanol (hours), urinary EtG (days), %carbohydrate-deficient transferrin (CDT)/PEth (weeks), and gamma-glutamyltranspeptidase (GGT)/mean corpuscular volume (MCV) (weeks-months). RESULTS: Fourteen of the 146 urine samples examined were positive for EtG. In all EtG-positive cases, patients reported alcohol consumption of between 40 and 200 g of ethanol 12-60 hr prior to testing. Urinary and breath ethanol were positive in only one case. In the blood samples, PEth was not positive in any case and %CDT did not exceed the reference value. Isoelectric focusing showed no abnormal Tf subtypes. CONCLUSIONS: The findings emphasize the diagnostic and therapeutic usefulness, specificity, and sensitivity of EtG as a marker of recent alcohol use. Such a test is needed in numerous settings, including alcohol and drug treatment (to detect lapse/relapse), in safety-sensitive work settings where use is dangerous or in other settings where use may be inappropriate (e.g., such as driving, workplace, pregnancy, or monitoring physicians or other professionals who are in recovery and working), or for testing other groups (such as children or those with medical problems) where alcohol use would be unhealthy or unsafe. The health, social and socioeconomic benefits arising from the future use of these markers is hard to overestimate.

Adult↗
PubMed1995

The Electronic View Box: a software tool for radiation therapy treatment verification.

PURPOSE: We have developed a software tool for interactively verifying treatment plan implementation. The Electronic View Box (EVB) tool copies the paradigm of current practice but does so electronically. A portal image (online portal image or digitized port film) is displayed side by side with a prescription image (digitized simulator film or digitally reconstructed radiograph). The user can measure distances between features in prescription and portal images and "write" on the display, either to approve the image or to indicate required corrective actions. The EVB tool also provides several features not available in conventional verification practice using a light box. METHODS AND MATERIALS: The EVB tool has been written in ANSI C using the X window system. The tool makes use of the Virtual Machine Platform and Foundation Library specifications of the NCI-sponsored Radiation Therapy Planning Tools Collaborative Working Group for portability into an arbitrary treatment planning system that conforms to these specifications. The present EVB tool is based on an earlier Verification Image Review tool, but with a substantial redesign of the user interface. A graphical user interface prototyping system was used in iteratively refining the tool layout to allow rapid modifications of the interface in response to user comments. RESULTS: Features of the EVB tool include 1) hierarchical selection of digital portal images based on physician name, patient name, and field identifier; 2) side-by-side presentation of prescription and portal images at equal magnification and orientation, and with independent grayscale controls; 3) "trace" facility for outlining anatomical structures; 4) "ruler" facility for measuring distances; 5) zoomed display of corresponding regions in both images; 6) image contrast enhancement; and 7) communication of portal image evaluation results (approval, block modification, repeat image acquisition, etc.). CONCLUSION: The EVB tool facilitates the rapid comparison of prescription and portal images and permits electronic communication of corrections in port shape and positioning.

Hospital Records↗
PubMed2003

[Expression of fetal epsilon and gamma globin gene in maternal peripheral blood].

OBJECTIVE: Traditional prenatal diagnosis for congenital diseases were villus sampling and amniocentesis. These invasive diagnosis methods are not only technical complicated, but also harmful to mother or fetus. Fetus in its different gestational age has its different type of hemoglobin or different amount of hemoglobin, especially epsilon hemoglobin exiting in the body of 10 weeks gestation fetal, however gamma hemoglobin has its high amount before baby to be born. But epsilon and gamma hemoglobin did not exist in the bodies of adults bodies. It is possible to use advanced molecular biological technique to extract the fetal hemoglobin gene from maternal peripheral blood. In articles from domestic and abroad, no report related to fetal hemoglobin extraction from maternal peripheral blood was found. We tried to use non-invasive method to detect fetal hemoglobin epsilon/gamma gene from maternal peripheral blood by molecular biological technique. The purpose was to establish a convenient, sensitive and special method to be a basis of screening prenatal diseases in the population and lay a basis for family planning and clinical application. METHODS: Blood samples were collected and the fetal mRNA extracted from the pregnant women with the use of random primer. We used ultraviolet spectrophotometer to test the concentration and purity of extracted mRNA are suitable for reverse transcription. Reverse transcription of mRNA into cDNA was carried out and cDNA by PCR with the special epsilon/gamma primer being used. Via 1.2% EB in agarose gel electrophoresis, we used "Gel Works System" to scan the electrophoresis image to detect epsilon/gamma gene band. RESULTS: The peripheral blood of pregnant women was collected. With RT-PCR and agarose gel electrophoresis method, we detected epsilon/gamma gene successfully in 7 samples with 6 positive and 1 negative. CONCLUSION: This was the first time that we used non-invasive way to detect expression of fetal epsilon/gamma gene in maternal blood to have found that this was a simple method to separate fetal cells from maternal blood, and could easily be accepted by pregnant women. Success of RT-PCR to detect fetal specific mRNA gave the hint that this method could be used in the field of prenatal diagnosis of hemoglobin disease, predicting fetal gender, predicting Rh blood type and single gene disease and be used widespread in prenatal diagnosis.

Female↗
PubMed2006

White blood cell and hormonal responses to 4300 m altitude before and after intermittent altitude exposure.

Recent studies have demonstrated that brief daily IAE (intermittent altitude exposure) was equally as effective as continuous altitude residence in inducing physiological adaptations consistent with altitude acclimatization. Although the positive benefits of IAE have been clearly defined, the potential negative consequences of IAE on health, specifically the immune system, remain undefined. The present study determined the effects of IAE on WBC (white blood cell) and hormonal responses during rest and exercise at 4300 m altitude. Six lowlanders (age, 23+/-2 years; body weight, 77+/-6 kg; values are means+/-S.E.M.) completed a VO(2)max (maximal O(2) uptake) and submaximal cycle ergometer test during a 30-h SL (sea level) exposure and during a 30 h exposure to 4300 m altitude-equivalent once before (PreIAE) and once after (PostIAE) a 3-week period of IAE (4 hxday(-1), 5 daysxweek(-1), 4300 m). The submaximal cycle ergometer test consisted of two consecutive 15-min work bouts at 40% and 70% of altitude-specific VO(2)max. Blood samples were obtained at rest and during both exercise work bouts for measurements of WBC count, leucocyte subset counts, cortisol, adrenaline (epinephrine) and noradrenaline (norepinephrine). WBC, neutrophil and lymphocyte counts increased significantly (P<0.05) during rest and exercise from SL to PreIAE and decreased (P<0.05) during rest and exercise from PreIAE to PostIAE. Monocyte counts decreased (P<0.05) during rest and exercise from PreIAE to PostIAE, but eosinophil and basophil counts did not change. Cortisol, adrenaline and noradrenaline did not change during rest or exercise from SL to PreIAE or PostIAE, but all increased significantly (P<0.05) from rest during the two work bouts. In conclusion, this type of IAE stimulus did not induce a hormonal stress response and did no harm in terms of activation of the immune system at altitude, as measured by WBC and leucocyte subset counts. This method of pre-acclimatization can therefore be highly recommended for inducing altitude acclimatization without the 'altitude residency' requirement.

Acclimatization↗
PubMed2003

[Characteristics of the dangerous and harmful use of alcohol and psychoactive drugs in Bosnia and Herzegovina in the postwar period].

Problems related to abuse of various psychoactive substances started in Bosnia and Herzegovina during the early eighties of the twentieth century. This is proven by the data from Counseling for the prevention and treatment of drug addiction that was working since 1978 until 1992 at the Psychiatric Clinic of the Clinical Center of Sarajevo University. At the end of 1991 this center registered 1000 drug users among which 50 was heroin addicts on the Methadone maintenance treatment. All organized activities on prevention and treatment of drug addiction stop during the spring of 1992. During the war 1992-1995, only few cases of drug addicts was treated due to overdose, abstinence and toxic psychotic states. Catastrophic war devastation had the consequence in social and economic disorganization of the whole society in Bosnia and Herzegovina. Large part of the population was killed or severely wounded. Majority of civilian population were expelled from their homes and spread all over the country and the whole world. Violence toward themselves and others, aggressively, tension, and domestic violence with large number of stress related mental disorders are still characteristics of our society. One of the important features of such a society is incensement of drug abuse, starting with alcohol, tobacco and all sorts of drugs. Extent of this socio-pathological problem are unknown, but indicators such as quantity of confiscated drug, number of legal processes related to drug, number of those who are coming to health institutions due to drug related problems, number of overdoses, and occasional surveys among youth indicated that the problem became more serious than anybody in this society wants to believe. All these indicators are showing that the problem of harmful alcohol, tobacco and drug use in our society have multiple negative consequences, and that in the recent future we cannot expect that these trends will became positive. Obviously, without the support from the community in this area we cannot achieve some good results. Today it is clear that without a strategy and preventive programs for the prevention of alcohol, tobacco and drug use at the state and even regional level there cannot be any success in stopping the epidemy of use and abuse of legal and illicit psychoactive substances.

Alcoholism↗
PubMed2004

Alcohol consumption and domestic violence against mothers.

BACKGROUND: A recent high-profile murder case and the passage of the Unborn Victims of Violence Act have focused policymakers' attention on domestic violence against pregnant women and new mothers. The link between men's alcohol consumption and spousal abuse has led some to suggest that more stringent alcohol regulations could ameliorate domestic violence. AIM OF STUDY: (i) To examine the correlation between men's alcohol consumption and domestic violence against new mothers and test how sensitive the correlation is to assumptions about unobserved heterogeneity, (ii) To test whether higher liquor taxes and more stringent alcohol control regulations are associated with a lower incidence of domestic abuse. METHODS: Using the Fragile Families and Child Wellbeing Study, I estimate ordinary least squares, bivariate probit, two-stage least squares, and fixed effects models to test the relationship between alcohol consumption and domestic violence. RESULTS: My findings suggest that while there is a strong positive association between men's alcohol consumption and the commission of domestic violence against new mothers, this correlation is highly sensitive to assumptions about unobservables. There is little evidence that higher liquor taxes or more stringent alcohol regulations will significantly reduce domestic violence. DISCUSSION AND LIMITATIONS: The empirical results suggest evidence for an 'unobserved bum hypothesis' That is, unobservable characteristics of the father may be correlated with both the likelihood that he abuses pregnant women (or new mothers) and that he drinks heavily. While the findings of this paper cannot rule out the possibility that men's alcohol consumption has some effect on domestic violence, there is little evidence to suggest that the impact is large in magnitude. Moreover, there is little evidence that higher liquor taxes or stricter alcohol supply regulations reduce the incidence of domestic abuse. However, greater policy heterogeneity across states and over time would be beneficial in further exploring this issue. IMPLICATIONS FOR HEALTH POLICY: Alcohol regulations, such as higher liquor taxes, are rather ineffective policies at reducing domestic violence against pregnant women and new mothers. Moreover, because policies that regulate alcohol availability or tax its consumption will harm non-violent drinkers, such policies may also be target inefficient. Rather than using non-credible, indirect mechanisms such as alcohol regulation, increasing criminal penalties for harming pregnant women or their unborn children may be a more direct method reducing domestic violence. IMPLICATIONS FOR FURTHER RESEARCH: Future research that attempts to estimate the impact of alcohol consumption on the likelihood of domestic violence must carefully consider how unobservables may impact both drinking and abuse. Future work should utilize a longer panel dataset with greater within-state alcohol policy variation to allow for more robust tests of the impact of alcohol regulations on the prevalence of domestic violence.

Alcohol Drinking↗
PubMed1995

Influence of weight and frequency on thigh and lower-trunk motion during repetitive lifting employing stoop and squat techniques.

Changes in kinematics as a function of lifting weight and frequency was investigated in sagittal symmetric repetitive lifting. For every lift cycle (lowering and lifting) the motion range between the upright position (0 degrees ) and the maximum angular displacement of the thigh and lower-trunk body segments was recorded. Ten subjects performed five repetitive lifting bouts with different weight/frequency combinations, using both stoop and squat lifting techniques. In total, 6384 lifts were analysed. The lifting weight or frequency did not influence the motion ranges in stoop lifting. In squat lifting the weight lifted did not appear to have any influence on the motion ranges, while the thigh motion range was significantly smaller at lifting frequency of 20 lifts min(-1) than at a frequency of 10. A significant gradual decrease in the thigh motion range and corresponding increase in the lower-trunk motion range were seen for a majority of the subjects during squat lifting at frequency 20. These changes suggest that quadriceps muscle strength is the limiting factor in repetitive squat lifting. Also the variation in motion ranges was greater in squat lifting than in stoop lifting. RELEVANCE: Forestry work involves frequent lifting. However, compliance in using squat lifting technique, which is recommended for safe lifting, is sometimes poor. Fatigue may be one of the determinants for changes in kinematics and choice of technique in lifting tasks.

Journal Article↗
PubMed2004

Effect of antihypertensive agents on quality of life in the elderly.

Management of hypertension in the elderly should take into account, in particular, the possible negative impact of antihypertensive drugs on the patient's quality of life, the deterioration of which may result in a loss of independence and reduced treatment compliance. Quality of life is recognised as a multifactorial variable and can be subdivided into different domains (symptomatic well-being, emotional, physical, work-social, cognitive and life satisfaction), which are generally explored by means of specific questionnaires or scales. When evaluating elderly patients with hypertension, it is necessary to pay particular attention to specific domains such as symptomatic well-being, cognitive function, activity and sexual function, which have already been diminished by the age itself and the disease. The results of some large trials that specifically evaluated the quality of life effects of long-term therapy of hypertension in older people (Medical Research Council's [MRC] Trial of Hypertension in Older Adults, Systolic Hypertension in the Elderly Program [SHEP], Systolic Hypertension in Europe [Syst-Eur], Study on COgnition and Prognosis in the Elderly [SCOPE]) have shown that antihypertensive treatment as a whole either had no negative impact on quality of life, or even produced some improvement. The question whether some classes of antihypertensive agents are more beneficial or harmful than others in terms of quality-of-life effects remains largely unanswered. Results from long-term trials suggest that treatment with diuretics is not associated with adverse effects on quality of life. Nevertheless, chlortalidone and other diuretics have been more often associated with sexual dysfunction in men, including decreased libido, erectile dysfunction and difficult ejaculation, than other drug classes. Nonselective lipophilic beta-adrenoceptor antagonists, such as propranolol, have been reported to exert some negative effect on quality of life and have been associated with depression, impairment of memory function and adverse effects such as erectile problems. A less unfavourable impact has been described with beta(1)-adrenoceptor antagonists and those with vasodilating properties. Calcium channel antagonists have generally been associated with a positive effect on quality of life, although some trials have shown high rates of adverse effects and withdrawals, particularly with first-generation dihydropyridines. Concern has also been raised about the potential for adverse cognitive effects associated with the use of calcium channel antagonists, but studies on this topic are not univocal. ACE inhibitors have usually been reported to exert favourable effects on quality of life. These drugs seem to be effective in maintaining, or even improving, cognitive function through mechanisms other than blood pressure control. In addition, a number of studies reported favourable impact of ACE inhibitors on sexual function. Angiotensin II receptor antagonists have been associated with good tolerability and low withdrawal rate. They have been demonstrated not to interfere with or even improve cognitive function as well as sexual performance. Although no class of antihypertensive agents presents a clearly superior effect over the others in terms of quality of life, the current impression is that ACE inhibitors and angiotensin II receptor antagonists may offer some advantage, at least in regard to effects on cognitive function and sexual activity.

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