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PubMed2003

Informal work and common mental disorders.

BACKGROUND: In many developing countries, a large proportion of people work without the social and legislative protection accorded to those in the "formal" labour market. Formal and informal work are very distinct labour market destinations for those leaving unemployment. From a policy perspective, the value of encouraging unemployed people to take informal work depends both on how quickly individuals can be moved out of unemployment into informal work compared to other destinations, and how well individuals fare once in informal work. This paper investigates the association between informal work and common mental disorders in Northeast Brazil. METHOD: A cross-sectional survey of a random sample of private households included 683 adults aged 15 years and over living in area II of Olinda, Recife Metropolitan Region, Pernambuco, Brazil. Informal workers comprised self-employed and underemployed. The self-reporting questionnaire (SRQ) was used to estimate the prevalence of common mental disorders. RESULTS: Informal workers had a higher prevalence of common mental disorders compared to those in formal employment. This was true before and after adjustment for sex, age, marital status and migration (OR 2.16, 95% CI 1.3-3.7) and for education and household per capita monthly income (OR 1.83, 95% CI 1.1-3.1). CONCLUSIONS: Understanding causes of common mental disorders in different societies requires an understanding of the differing socioeconomic circumstances around the world. Working outside the protection of employment legislation is very common in many poorer countries and may have adverse consequences for psychological health.

Adult↗
PubMed1997

Neuro-psychiatric effects of antimalarials.

OBJECTIVE: To study the neuro-psychiatric adverse effects of antimalarial drugs. SETTING: Persons who visited a Travel Clinic in Rotterdam over a period of 3 months. DESIGN: Prospective cohort study on 394 persons taking mefloquine, 493 persons taking proguanil and 340 persons not taking antimalarial drugs who visited Africa, South America, Asia, or the Middle East. METHODS: All persons received a structured questionnaire within 14 days of their return to the Netherlands. The questionnaire consisted of questions regarding use of alcohol, smoking, general health, medical history, tropical diseases during the trip, and other medicines, and contained an extensive list of general complaints regarding all body systems at four levels of severity. A modified and validated version of the Profile of Mood States was included. RESULTS: In the study period, 2541 persons visited the Travel Clinic, of whom 1791 (70%) were both eligible and willing to co-operate. Of these 1791, data were obtained from 1501 (84%). Insomnia was most frequently encountered in users of mefloquine and mouth ulcers in proguanil users. After adjustment for gender, age, destination, and alcohol use, the relative risk for insomnia to mefloquine versus non-users of antimalarials was 1.6, and the excess risk was 6 per 100 users over an average period of 2 months. There were no significant differences between groups in depression, anxiety, agitation, and confusion. Stratification by gender demonstrated that insomnia was more common in women on mefloquine, but not in men. Also, women more frequently mentioned palpitations as an adverse event. After adjustment for age, destination, and alcohol use in women, the relative risks for insomnia and palpitations to mefloquine versus non-use of antimalarials were 2.4, and 22.5, respectively. When travellers were specifically asked for the adverse reactions they had experienced, anxiety, vertigo, agitation, and nightmares were significantly more frequently mentioned by mefloquine users. CONCLUSION: Insomnia was more commonly encountered during use of mefloquine than proguanil or during non-use of antimalarials.

Adult↗
PubMed2005

Determining visitors' dispositions toward the designation of a Greek National Park.

This article presents the findings of the first major visitor survey conducted at the Central Rhodope Mountain Complex, situated in northern Greece. The study area is one of a number of sites planned to become National Parks under a recent initiative of the Greek government. We used a logistic regression method to define significant predictors of visitors' awareness and attitude toward park designation, as well as their willingness to pay a conditional entrance fee. Study findings demonstrated that the probability of being aware of the park designation initiative is higher for visitors who obtained information from travel agencies or media to make their destination choice, compared to visitors who resorted to word-of-mouth recommendations. Knowledge and attitudes toward animals living in the study area revealed a limited influence on visitors' dispositions toward park designation. The results of this study call for action to implement education programs for National Park users. These programs should aim at rendering the environmental characteristics of the Central Rhodope Mountain Complex to be significant predictors of visitors' dispositions toward the study area. This would favor its uniqueness as a destination, as well as contribute to its long-term economic sustainability.

Adult↗
PubMed2004

Ecotourism and community development: case studies from Hainan, China.

The connections between people, parks, and tourism have received significant attention in recent years, recognizing the potential for mutually beneficial relationships. Ecotourism has been promoted and widely adopted as a strategy for funding conservation initiatives, while at the same time contributing to the socioeconomic development of host communities and providing for quality tourism experiences. Parks are among the most common ecotourism destinations. Employing interviews, observations and secondary sources, this study assesses the current status of ecotourism at two protected areas in Hainan, China, where it is being promoted as a strategy for balancing regional economic growth and conservation objectives. Through an evaluation of the existing tourism-park-community relationships, opportunities and constraints are identified. Ecotourism development was found to be at an early stage at both study sites. Socioeconomic benefits for the local communities have been limited and tourism activity has not contributed revenues towards conservation to date. Community residents, nevertheless, generally support conservation and are optimistic that tourism growth will yield benefits. In light of the study findings and the salient literature, planning direction is offered with the intention of enhancing the capacity of ecotourism to generate benefits for both communities and the parks, and thus contribute to the sustainable development of the region more generally. Lessons derived have broad applicability for ecotourism destinations elsewhere.

China↗
PubMed2001

Alpine skiing, snowboarding, and spinal trauma.

This 10-year retrospective review of spinal injuries at a destination ski resort was done to determine the incidence and type of spinal and neurologic injury associated with alpine winter sports. Spinal injury patterns and outcomes in skiers and snowboarders over a period of 11 seasons at a destination resort were studied. One-fourth of cervical injuries were associated with a temporary neurologic deficit. Only 1 in 25 thoracic injuries had an associated neurologic deficit, and this was permanent. None of the lumbar injuries required surgery, nor were any associated with a neurologic deficit. There was approximately one significant spinal injury every 100,000 skier-days, and only 9% of spinal injuries required surgery. The incidence of death or associated permanent neurologic deficit is low (approximately one per two million skier-days). Skiing and snowboarding have a low incidence of significant spinal trauma.

Adolescent↗
PubMed2002

Disturbed sleep-wake patterns during and after short-term international travel among academics attending conferences.

OBJECTIVES: To examine variations in sleep and wakefulness associated with international travel. METHODS: Ten academics in Japan were studied while traveling abroad to participate in conferences. Wrist activity and a daily log were recorded continuously for 1 week before, during, and for 1 week after travel. Destinations included the USA and Canada to the east (8 to 11-h time difference; mean stay of 6.8 days) and Europe to the west (7 to 8-h time difference; mean stay of 6.0 days). RESULTS: For eastward-traveling subjects, the total sleep time was shorter and the mean activity during sleep was greater at the destinations than before departure. These sleep disruptions persisted until the 2nd day after the subjects had returned home. The sleep patterns then recovered in a zigzag manner. No significant disruptions in the main sleep were found in westward travelers, although these subjects took a longer nap immediately after their return. The beginning and end of sleep occurred earlier until the 2nd day after the subjects had returned from eastward trips, but occurred later until the 5th day after return from westward trips. CONCLUSIONS: In academics, short-term international travel causes sleep disturbances both during and at home after eastward travel and a delay in the sleep timing at home after westward travel. Although the subjects in this study might be atypical of business travelers, the current data suggest that strategies are needed to facilitate recovery from disturbed sleep-wake patterns at home after travel, i.e., redesign of post-travel work schedules.

Adult↗
PubMed2002

Technique for introducing large composite mesh while performing laparoscopic incisional hernioplasty.

BACKGROUND: Incisional hernias are treated laparoscopically in an increasing number of cases. The simplest technique is the peritoneal onlay technique. Composite mesh, consisting of one layer of polypropylene mesh, destined to face the abdominal wall, and one layer of less adhesion-inducing material, destined to face the bowel, has been developed in an effort to avoid intraperitoneal adhesion formation and viscus erosion. While probably superior, this type of mesh is very bulky, easily damaged, and hence extremely difficult to be safely introduced through conventional trocars. METHODS: We present a simple technique to safely introduce intraperitoneally large sheets of composite mesh, without the need for larger-bore cannulas. After temporarily removing one of the 10 mm trocars, the mesh is rolled as tightly as possible and placed in a sterile bag, which is then easily introduced intraperitoneally through the trocar opening. RESULTS: Between September 1999 and January 2000 the technique was successfully used in 12 patients. CONCLUSION: This simple trick protects the mesh while making its intraperitoneal introduction straightforward. It is quick, cheap, and easily reproducible.

Adult↗
PubMed2004

[Immunization recommendations for travel in the Mediterranean area].

The Mediterranean region is a popular destination for tourists during the summer. However, European tourists, who are travelers within their own continent, do not consider themselves exposed to possible, travel-associated infections, since problem awareness among tourists as well as doctors is rather weak. The objective of this consensus paper is to outline guidelines with regard to relevant travel immunizations for Mediterranean destinations. These recommendations are mainly based on risk calculations according to country-specific incidences and prevalences of vaccine-preventable diseases such as hepatitis A, hepatitis B, typhoid fever, meningococcal meningitis, rabies, and tick-borne encephalitis.

Animals↗
PubMed2005

[Travel behavior of the Austrians -- review and future trends].

In the past decades, international travel has expanded exponentially and therefore its economic significance has increased. This development has been made possible purely by the enormous increase in scheduled and charter flights. Travel frequency has also increased among practically all age groups. The manifold travel destinations extend virtually to the whole globe. Europe has been able to maintain its status as premier destination for tourists. Europe has a 50% share of the global income from international travel. The clear up-swing of the travel branch in the year 2002 could not be continued in 2003. The desire to travel was present, but the trend to short travel has continued. Three years after the events of 11 September 2001, experts again expect an increase in travel frequency and intensity on the part of European tourists for the next years. The World Tourism Organisation prognosticates an enormous growth in international tourist arrivals up to 2020. Despite continuing globalization, international tourism will continue to take place primarily within the individual regions of the world.

Austria↗
PubMed2006

A Gateway-based platform for multigene plant transformation.

The post-genomic era offers unrivalled opportunities for genetic manipulation of polygenic traits, multiple traits, and multiple gene products. However, remaining technical hurdles make the manipulation of multiple genes in plants difficult. Here we describe a Gateway-based vector system to enable multiple transgenes to be directly linked or fused. The vector system consists of a destination vector and two special attL-flanked entry vectors each containing an attR cassette incompatible with the attL. By multiple rounds of LR recombination reactions, which we call MultiRound Gateway, multiple transgenes can be delivered sequentially and indefinitely into the Gateway-compatible destination vector through alternate use of the two special entry vectors. In our proof-of-principle experiments we have used this vector system to construct a plant transformation vector containing seven functional DNA fragments, including a screening marker gene, two reporter genes and four matrix attachment region sequences. This system provides a platform for fully realizing the potential of plant genetic manipulation.

Arabidopsis↗
PubMed2025

Development of a plant-based vaccine against brucellosis: stable expression of Brucella abortus OMP25 in transgenic tobacco.

Brucellosis, caused by Brucella species, is a global threat to livestock farming, resulting in economic losses and socio-economic challenges, particularly in rural areas. Despite its impact, no licensed human vaccines are available. Animal vaccination remains the most cost-effective control method, but traditional vaccine production is expensive. Edible vaccines, using plants as bioreactors to produce immunogenic antigens, offer a low-cost alternative by eliminating complex purification processes. This study developed a transgenic plant by expressing the Brucella abortus outer membrane protein OMP25 in tobacco plants. OMP25, a conserved transmembrane protein with high immunogenicity, was cloned into a Gateway pDONR vector via a Boundary Pairing reaction and transferred to a binary destination vector via a Left-Right reaction. The destination vector was introduced into Agrobacterium tumefaciens and subsequently used for Agrobacterium-mediated transformation of tobacco plants. Transgenic plants were selected on media containing kanamycin, and the expression of the transgene was verified through the fluorescence of green fluorescent protein. Microcallus formation and shoot development on selective media confirmed kanamycin resistance and the successful integration of the transgene. After phenotypic selection, genomic DNA was extracted from transgenic plants and analyzed by PCR (Polymerase Chain Reaction) using primers specific to the OMP25 gene. Positive PCR results validated the successful integration of the OMP25 gene into the plant genome. Gene expression was further confirmed at the RNA level through real-time quantitative PCR (qRT-PCR) and at the protein level via Western blot analysis. Future studies will evaluate immune responses in animal models. This approach demonstrates the potential for low-cost, effective vaccines to combat brucellosis, addressing critical economic and public health challenges.

Plants, Genetically Modified↗
PubMed1994

Physician manpower reform: an analysis of the effects of the COGME Fourth Report on internal medicine residency positions. Council on Graduate Medical Education.

PURPOSE: To quantitate the impact of the recommendations contained in the Council on Graduate Medical Education (COGME) Fourth Report on the position distribution in internal medicine residency and fellowship programs and to recommend alternative position allocations for discussion. DATA SOURCES: The COGME Fourth Report, the National Study of Internal Medicine Manpower, and the American Medical Association Annual Survey of Graduate Medical Education. RESULTS: Our analysis of the COGME Fourth Report indicates that internal medicine PGY-1 positions would decrease from the 8,936 on duty in the 1992 academic year to 6,533 (-26.9%) for the class of the year 2000. Four thousand will enter generalist careers in internal medicine (approximately a 70% increase over current generalist output). The COGME Fourth Report recommendations would allocate first-year fellowship positions for 1,400 graduates of internal medicine residencies (-63.1%). Career-bound internal medicine positions will decrease from approximately 6,000 to 5,400 (-10.0%). The loss in PGY-1 positions is predominantly due to a decrease in the number of preliminary medicine positions and to individuals who switch from career-bound internal medicine positions to other disciplines after the PGY-1 or PGY-2 years. Pediatric positions would increase moderately from 2,426 available in 1993 to 2,520 (+3.9%). Pediatric subspecialty positions would decrease by 25% to 420, with 2,100 residents entering careers in general pediatrics. Family medicine PGY-1 positions would increase from the 2,657 available in 1993 to 3,400 (+28%). CONCLUSIONS: The recommendations contained in the COGME Fourth Report would substantially reduce the number, and significantly alter the current distribution, of residency positions. The output goals of 50% generalist careers are met by an increase in career-bound generalist positions in all three generalist specialties. The limitation of total positions to the goal of 110% of 1993 U.S. graduates comes predominantly through reduction of specialty/subspecialty career-bound positions. Internal medicine residency and subspecialty fellowship positions and programs would be significantly altered by these recommendations. The reductions in internal medicine occur predominantly in loss of positions not currently destined for careers in internal medicine and in subspecialty fellowship positions. These reductions are partially offset by an increase in the complement of residents who are destined for careers in general internal medicine.

Education, Medical, Graduate↗
PubMed1977

Prospective study of angiotensin II response to positional change in pregnancy-induced hypertension.

The response of endogenous angiotensin II levels to positional change, lateral to supine recumbency, was investigated in a prospective study of 55 primigravid patients during the last half of pregnancy. Blood samples were obtained in the lateral and supine recumbent positions. The mean supine angiotensin II level was significantly higher between 29 and 34 weeks' gestation in those patients destined to develop pregnancy-induced hypertension than in those who remained normotensive (P less than 0.05). As gestation advanced, the mean per cent relative change of angiotensin II from the lateral to the supine position altered from negative to positive in those patients destined to develop pregnancy-induced hypertension, whereas it remained negative in those patients who remained normotensive. These findings are discussed in relation to pathophysiologic alterations in the development of pregnancy-induced hypertension.

Angiotensin II↗
PubMed1978

Oral administration of theophylline to modify pressor responsiveness to angiotensin II in women with pregnancy-induced hypertension.

Normally, women become refractory to the pressor effects of infused angiotensin-II (A-II) early in pregnancy. Gravid women destined to develop pregnancy-induced hypertension (PIH) lose this refractoriness to A-II several weeks prior to the detection of hypertension. Normal pregnant women also lose their A-II refractoriness after treatment with prostaglandin synthetase inhibitors and, in this regard become similar to gravid women who are destined to develop PIH. From this observation, we have concluded that a prostaglandin(s) or a prostaglandin-related substance(s) is likely involved in the mediation of vascular reactivity to A-II during pregnancy. The present study was conducted to ascertain if control of vascular reactivity during pregnancy also involves the cyclic nucleotides. Since theophylline is known to inhibit the action of phosphodiesterase, an action that results in increased cellular levels of cyclic 3',5'-adenosine monophosphate (cAMP), we evaluated the effective pressor dose of A-II before and after the administration of theophylline to women with mild PIH who were beyond the 28th week of gestation. The effective pressor dose of A-II in these women with PIH before theophylline treatment was 7.3 +/- 1.4 ng. times kg.(-1) times min.(-1) (mean and standard error). Following treatment of these women with the equivalent of 500 mg. of theophylline daily for four days, the effective pressor dose of A-II was 16.7 +/- 3.8 ng. times kg.(-1) times min.(-1) (p less than 0.025). These findings are consistent with the view that a prostaglandin(s) synthesized in the arteriole may modulate the vascular refractoriness to A-II by altering the intracellular level of cAMP in vascular tissues.

Angiotensin II↗
PubMed1993

A new conceptual structure for travel information.

This paper describes how to improve dynamic transport timetables. Mostly, such information as departure time, gate number, platform number, intermediate stops, and delays is arranged per flight or train. Each train or flight has one line or one column. A field observation of passengers using such a system showed that presenting information in this fashion is not optimal. Of passengers, 38% were unable to find the correct departure time. We analysed the performance of passengers. This analysis suggested that the information should not be arranged per train or flight but per destination. Each train or flight has one line or one column. An empirical comparison supported this conclusion. When a destination-based structure was used, the number of correct answers was 16% higher, the delay of each passenger was 75% less, and the time needed to search for a train decreased by 42%.

Journal Article↗
PubMed1993

A validation of the functional independence measurement and its performance among rehabilitation inpatients.

The Functional Independence Measurement (FIM) is a new functional status instrument for use among rehabilitation inpatients, but its validity and reliability have been only partially established. Because of its rapid dissemination, we sought further evidence concerning the FIM's internal consistency, responsiveness over time, and construct validity. We examined Uniform Data System (UDS) data on 11,102 general rehabilitation inpatients from the Pacific Northwest. Mean age was 65 and 51% were male. The most common diagnoses were stroke (52%), orthopedic conditions (10%), and brain injury (10%). Internal consistency of the FIM was calculated using Cronbach's alpha. To assess FIM responsiveness, we examined differences between admission and discharge FIM scores. For construct validation purposes, we hypothesized that the FIM would vary with age, comorbidity, discharge destination, and impairment severity. Comorbidity was quantified with the Charlson Comorbidity Index. The FIM had a high overall internal consistency (discharge FIM alpha = .93). The FIM registered significant functional gains during rehabilitation (33% FIM score improvement, p < .001), as do many other functional status indicators. The greatest and least functional improvements were observed for traumatic brain injury and low back pain (53% and 8% FIM score improvement, respectively). The FIM discriminates patients on the basis of age, comorbidity, and discharge destination. Severity differences could be distinguished among spinal cord injury and stroke patients. We conclude that the FIM has high internal consistency and adequate discriminative capabilities for rehabilitation patients. It is a good indicator of burden of care, and demonstrates some responsiveness, but its capacity to measure change over time needs further examination and comparison with competing scales.

Aged↗
PubMed1990

Cholesterol esters selectively taken up from high-density lipoproteins are hydrolyzed extralysosomally.

High-density lipoprotein (HDL) cholesterol esters (CE) are taken up by many cells without parallel uptake of HDL apoproteins. This selective uptake is mediated by reversible incorporation of HDL CE into a plasma membrane pool, from which the CE are internalized. We now show that selectively taken up CE are directed to an extralysosomal destination where they are hydrolyzed and available to the steroidogenic pathway. Cultured human fibroblasts take up HDL CE predominantly by selective uptake. Wolman's disease fibroblasts, which are deficient in lysosomal cholesterol esterase, effectively hydrolyzed CE from HDL, but not CE taken up in low density lipoproteins (LDL); normal fibroblasts hydrolyzed both effectively. Analogously, the lysosomotropic agent chloroquine effectively blocked hydrolysis of LDL CE but not HDL CE. A similar effect of chloroquine was seen in primary cultures of rat adrenal cells, which are very active in selective uptake. More than 50% of HDL CE taken up by adrenal cells appeared in the medium as corticosterone. To examine the subcellular destination of selectively taken up CE, non-hydrolyzable tracers of HDL and LDL CE were simultaneously injected into rats. On fractionation of adrenal glands 24 h after injection, 83% of the HDL CE tracer and 48% of the LDL CE tracer were recovered in cytoplasmic lipid droplets; that LDL tracer in the lipid droplets was accounted for by selective uptake of CE from LDL. Thus, selectively taken up cholesterol esters are processed by a mechanism distinct from the classical endosomal/lysosomal pathway, and are delivered to a cytoplasmic compartment.

Adrenal Glands↗
PubMed1989

Developmental regulation of energy metabolism in Caenorhabditis elegans.

Changes in energy metabolism during larval development in Caenorhabditis elegans have been investigated using phosphorus nuclear magnetic resonance (31P NMR). The relative concentrations of ATP, ADP, AMP, sugar phosphates, and other metabolites were observed to change during larval development, producing stage-specific spectra. These spectra are consistent with enzyme assays for isocitrate dehydrogenase and isocitrate lyase, indicating that high activity of the glyoxylate pathway during embryonic development decreases during the first larval (L1) stage, and respiration during the L2, L3, and L4 stages occurs preferentially through the TCA cycle. Metabolic strategies were further studied using mutants that are predisposed to enter the dauer stage, a developmentally arrested third-stage larva formed under conditions of overcrowding and limited food. After the L1 molt, energy metabolism in animals destined to become dauer larvae diverges from that of animals committed to growth. Relative to the L1, the L2 larvae committed to growth exhibit increased isocitrate dehydrogenase activity as well as increases in ATP and other high-energy phosphates, but predauer (L2d) larvae exhibit declining enzyme activities and declining levels of high-energy phosphates. The predominant phosphorus NMR signal in dauer larva extracts corresponds to inorganic phosphate. We conclude that metabolism is regulated during C. elegans larval development, with a major transition apparent after the L1 stage. This transition does not occur in larvae destined to form dauer larvae.

Adenine Nucleotides↗