From Job Strain to Employment Strain: Health Effects of Precarious Employment

This article examines the relationship between health and the organization of precarious employment. We develop the concept of "employment strain" to capture the characteristics of precarious employment. Preliminary evidence suggests that workers in precarious employment relationships report poorer overall health than working Canadians and higher levels of stress than workers in standard employment relationships. They face high levels of uncertainty regarding access to work, the terms and conditions of that work, and future earnings. They engage in additional effort searching for work and balancing the demands of multiple employers. They have low earnings, few benefits, and reside in low income households

Patient-Provider Discussions about Lung Cancer Screening Pre- and Post-Guidelines: Health Information National Trends Survey (HINTS)

Objective In 2013, the USPSTF issued a Grade B recommendation that long-term current and former smokers receive lung cancer screening. Shared decision-making is important for individuals considering screening, and patient-provider discussions an essential component of the process. We examined prevalence and predictors of lung cancer screening discussions pre- and post-USPSTF guidelines. Methods Data were obtained from two cycles of the Health Information National Trends Survey (2012; 2014). The analyzed sample comprised screening-eligible current and former smokers with no personal history of lung cancer (n = 746 in 2012; n = 795 in 2014). Descriptive and multiple logistic regression analyses were conducted; patient-reported discussion about lung cancer screening with provider was the outcome of interest. Results Contrary to expectations, patient-provider discussions about lung cancer screening were more prevalent pre-guideline, but overall patient-provider discussions were low in both years (17% in 2012; 10% in 2014). Current smokers were more likely to have had a discussion than former smokers. Significant predictors of patient-provider discussions included family history of cancer and having healthcare coverage. Conclusions The prevalence of patient-provider discussions about lung cancer screening is suboptimal. Practice implications There is a critical need for patient and provider education about shared decision-making and its importance in cancer screening decisions

Safety and efficacy of an intra-oral electrostimulator for the relief of dry mouth in patients with chronic graft versus host disease: case Series

Objectives: Patients with chronic graft-versus-host disease (cGVHD) often suffer from dry mouth and oral mu - cosal lesions. The primary objective of this study was to investigate the safety of an intra-oral electrostimulator (GenNarino) in symptomatic cGVHD patients. The secondary objective was to study the impact on the salivary gland involvement of cGVHD patients. Study Design: This paper presents a case series. The study included patients treated for 4 weeks, randomly as - signed to the active device and then crossed-over to a sham-device or vice versa. The patients and clinicians were blind to the treatment delivered. Data regarding oral mucosal and salivary gland involvement were collected. Results: Six patients were included in this series. Most of the intraoral areas with manifestations of cGVHD were not in contact with the GenNarino device. Two patients developed mild mucosal lesions in areas in contact with the GenNarino during the study. However, only one of them had a change in the National Institutes of Health (NIH) score for oral cGVHD. The unstimulated and stimulated salivary flow rate increased in 4 out of the 5 pa - tients included in this analysis. Symptoms of dry mouth and general oral comfort improved. Conclusion: This study suggests that GenNarino is safe in cGVHD patients with respect to oral tissues. Furthermore the use of GenNarino resulted in subjective and objective improvements in dry mouth symptoms. A large scale study is needed to confirm the impact and safety of GenNarino on systemic cGVHD

Electrostimulation of the lingual nerve by an intraoral device may lead to salivary gland regeneration : a case series study

Salivary gland function is controlled by the salivary reflex, whose efferent arm is composed by the parasympathetic and the sympathetic divisions of the autonomic nervous system. Parenchymal injury is the main salivary gland involvement of Sjögren?s syndrome and head and neck radiotherapy, but neural damage has been reported as well. Recently an intraoral device for electrostimulation of the lingual nerve in vicinity to the lower third molar has been introduced. At this point this nerve carries efferent fibers for the innervation of the submandibular, sublingual and several minor salivary glands and afferent fibers of the salivary reflex. Therefore, excitation of these fibers potentially leads to increased secretion of all salivary glands. Thus, the study objective was to assess whether comprehensive neural activation by electrostimulation of the lingual nerve carries the potential to induce the regeneration of damaged salivary glands. The device was tested on three patients with no collectable resting and stimulated secretion of saliva during a double blind, sham controlled period of two months and nine open-label months. All three subjects developed the capacity to spit saliva, not only in direct response to the electrostimulation but also after free intervals without electrostimulation. In addition, their symptoms of dry mouth severity and frequency improved. This recovery is probably due to the combined effect of increase in secretory functional gland mass and regain of nervous control of the secretory elements and blood vessels. Both are phenomena that would contribute to gland regeneration

Biotechnological advances in neuro-electro-stimulation for the treatment of hyposalivation and xerostomia

Treatment of xerostomia is a common clinical challenge in the oral medicine practice. Although some treatments have been used to improve the symptoms of xerostomia, none is completely satisfactory for the patients who suffer of this alteration. In the last years non-pharmacological treatments based on electro-stimulation for the treatment of xerostomia have been developed. This review is aimed at presenting new developments for the treatment of xerostomia, applying neuro-electro-stimulation by miniaturized intra-oral electro-stimulators. These devices increase salivary secretion and improve symptoms of oral dryness. Their effect is obtained by means of stimulation of the lingual nerve, in whose proximity the electrodes of the apparatus are placed. The objective of this mechanism is both to directly stimulate the salivary glands controlled by that nerve and to enhance the salivary reflex. Clinical studies have been carried out that have demonstrated the wetting effect of the method described in this article

Free classification of large sets of everyday objects is more thematic than taxonomic

Traditionally it has been thought that the overall organisation of categories in the brain is taxonomic. To examine this assumption, we had adults sort 140–150 diverse, familiar objects from different basic-level categories. Almost all the participants (80/81) sorted the objects more thematically than taxonomically. Sorting was only weakly modulated by taxonomic priming, and people still produced many thematically structured clusters when explicitly instructed to sort taxonomically. The first clusters that people produced were rated as having equal taxonomic and thematic structure. However, later clusters were rated as being increasingly thematically organised. A minority of items were consistently clustered taxonomically, but the overall dominance of thematically structured clusters suggests that people know more thematic than taxonomic relations among everyday objects. A final study showed that the semantic relations used to sort a given item in the initial studies predicted the proportion of thematic to taxonomic word associates generated to that item. However, unlike the results of the sorting task, most of these single word associates were related taxonomically. This latter difference between the results of large-scale, free sorting tasks versus single word association tasks suggests that thematic relations may be more numerous, but weaker, than taxonomic associations in our stored conceptual network. Novel statistical and numerical methods for objectively measuring sorting consistency were developed during the course of this investigation, and have been made publicly available

Sialometry of upper labial minor glands : a clinical approach by the use of weighing method Schirmer’s test strips paper

Objectives. To establish referential values ranges of hyposalivation and normosalivation for the salivary flow rate (SFR) of upper labial (LS) and palatal (PS) mucosa using Schirmer's test strips paper and as a second goal to determine the values ranges of the SFR of palatal (PS) and upper labial (LS) mucosa in subjects with and without xerostomia. Methods. A cross-sectional study was conducted among subjects distributed in three groups according to their unstimulated and stimulated whole saliva. Results. 144 subjects were enrolled in groups as follows: severe hyposalivation (n=24), mild hyposalivation (n=78), and normosalivation (n=42). The mean and the 95% confidence interval for the LS flow rate (μL/cm2/min) were 3.2 (2.46 to 3.94), 5.86 (4.96 to 6.75), and 9.08 (7.63 to 10.53) (P<0.001) for each group, respectively. The PS results were 1.01 (0.68 to 1.34), 1.72 (1.31 to 2.13), and 2.44 (1.66 to 3.22) (P=0.014). Xerostomia complainers presented lower rates of LS (5.17 (4.06 to 6.23)) than non-complainers (7.33 (6.4 to 8.27)) (P=0.003). Conclusions. The test was reliable to provide referential values ranges for LS flow rate measurement and was shown to be valid to distinguish normosalivation from severe and mild hyposalivation and also to predict xerostomia

Fundamentos e aplicações da metodologia de ensaios não destrutivos com células bacterianas

Os Ensaios Não Destrutivos (END) são determinantes para a fiabilidade de materiais cuja integridade é de extrema importância. A técnica de Ensaios Não Destrutivos com células bacterianas (CB) tem demonstrado viabilidade para deteção de defeitos superficiais, com espessuras e profundidades inferiores a 5 μm em vários materiais de engenharia. O conhecimento adquirido sobre esta técnica já é significativo mas alguns aspetos necessitam de mais desenvolvimentos, como a interação bactéria-defeito e a viabilidade da técnica para condições de superfície diferentes das já ensaiadas. O objetivo deste trabalho é alargar a técnica a uma maior gama de materiais de engenharia com condições de superfície diferentes, assim como, desenvolver o conhecimento sobre a interação bactéria-defeito. A bactéria Rhodococcus erythropolis foi usada na inspeção de vários materiais como Alumínio Liga 1100, Estanho, Ouro, Prata, INCONEL 9095, Aço revestido com Nickel, Cobre revestido com Ouro, Alumínio revestido com Cobre, Polímero com nano tubos de carbono, entre outros, e com condições de superfície diferentes como superfícies anodizadas e revestidas. Foram também caracterizados os campos magnéticos de dois equipamentos desenvolvidos para esta técnica de Ensaios Não Destrutivos. Os resultados experimentais mostraram que a utilização de campos magnéticos contribui positivamente para a deteção de defeitos e que provetes com revestimentos superficiais diferentes revelam resultados diferentes apesar de terem o mesmo material base