Predictors of refusal to participate: a longitudinal health survey of the elderly in Australia

BACKGROUND: The loss of participants in longitudinal studies due to non-contact, refusal or death can introduce bias into the results of such studies. The study described here examines reasons for refusal over three waves of a survey of persons aged ≥ 70 years. METHODS: In a longitudinal study involving three waves, participants were compared to those who refused to participate but allowed an informant to be interviewed and to those who refused any participation. RESULTS: At Wave 1 both groups of Wave 2 non-participants had reported lower occupational status and fewer years of education, had achieved lower verbal IQ scores and cognitive performance scores and experienced some distress from the interview. Those with an informant interview only were in poorer physical health than those who participated and those who refused. Depression and anxiety symptoms were not associated with non-participation. Multivariate analyses found that verbal IQ and cognitive impairment predicted refusal. Results were very similar for refusers at both Waves 2 and 3. CONCLUSIONS: Longitudinal studies of the elderly may over estimate cognitive performance because of the greater refusal rate of those with poorer performance. However, there is no evidence of bias with respect to anxiety or depression

Atherosusceptible Shear Stress Activates Endoplasmic Reticulum Stress to Promote Endothelial Inflammation.

Atherosclerosis impacts arteries where disturbed blood flow renders the endothelium susceptible to inflammation. Cytokine activation of endothelial cells (EC) upregulates VCAM-1 receptors that target monocyte recruitment to atherosusceptible regions. Endoplasmic reticulum (ER) stress elicits EC dysregulation in metabolic syndrome. We hypothesized that ER plays a central role in mechanosensing of atherosusceptible shear stress (SS) by signaling enhanced inflammation. Aortic EC were stimulated with low-dose TNFα (0.3 ng/ml) in a microfluidic channel that produced a linear SS gradient over a 20mm field ranging from 0-16 dynes/cm2. High-resolution imaging of immunofluorescence along the monolayer provided a continuous spatial metric of EC orientation, markers of ER stress, VCAM-1 and ICAM-1 expression, and monocyte recruitment. VCAM-1 peaked at 2 dynes/cm2 and decreased to below static TNFα-stimulated levels at atheroprotective-SS of 12 dynes/cm2, whereas ICAM-1 rose to a maximum in parallel with SS. ER expansion and activation of the unfolded protein response also peaked at 2 dynes/cm2, where IRF-1-regulated VCAM-1 expression and monocyte recruitment also rose to a maximum. Silencing of PECAM-1 or key ER stress genes abrogated SS regulation of VCAM-1 transcription and monocyte recruitment. We report a novel role for ER stress in mechanoregulation at arterial regions of atherosusceptible-SS inflamed by low-dose TNFα

Integrating Knowledge for River Basin Management: Progress in Thailand

Resource /Energy Economics and Policy,

A survey of factors influencing career preference in new-entrant and exiting medical students from four UK medical schools

Our thanks to Professor Gillian Needham and Dr Murray Lough for their encouragement and support, and their comments on an earlier draft of this manuscript. Our thanks also to NHS Education for Scotland [NES] for funding, and the Scottish Medical Deans Education Group [SMDEG] for supporting this project. We are grateful to all the students who gave their time to complete the survey questionnaire and to those who helped organise and carry out data collection.Peer reviewedPublisher PD

Conjunctival chemosis: A case series of systemic causes

Conjunctival chemosis is a common ophthalmic finding that presents with a wide range of severity, symptoms, signs, and underlying etiologies. Although most cases of conjunctival chemosis are ocular in nature (allergy, infection, irritation), atypical presentations such as dusky conjunctival hue, corkscrew conjunctival veins, and periorbital edema, should prompt further investigation for a systemic cause.  In atypical cases, reviewing the patient’s medical history and medications, physically examining and auscultating the patient’s heart and lungs, and obtaining vitals (i.e. blood pressure, pulse, weight), are crucial parts of the investigation for a potential systemic source. This article reviews systemic causes for conjunctival chemosis and provides case examples to demonstrate evaluative and management techniques for optometrists to make a distinction between ocular and systemic conjunctival chemosis.  &nbsp

Star formation triggered by non-head-on cloud-cloud collisions, and clouds with pre-collision sub-structure

In an earlier paper, we used smoothed particle hydrodynamics (SPH) simulations to explore star formation triggered by head-on collisions between uniform-density 500 M clouds, and showed that there is a critical collision velocity, vCRIT. At collision velocities below vCRIT, a hub-and-spoke mode operates and delivers a monolithic cluster with a broad mass function, including massive stars (M 10 M) formed by competitive accretion. At collision velocities above vCRIT, a spider’s-web mode operates and delivers a loose distribution of small sub-clusters with a relatively narrow mass function and no massive stars. Here we show that,if the head-on assumption is relaxed, vCRIT is reduced. However, if the uniform-density assumption is also relaxed, the collision velocity becomes somewhat less critical: a low collision velocity is still needed to produce a global hub-and-spoke system and a monolithic cluster, but, even at high velocities, large cores – capable of supporting competitive accretion and thereby producing massive stars – can be produced. We conclude that cloud–cloud collisions may be a viable mechanism for forming massive stars – and we show that this might even be the major channel for forming massive stars in the Galaxy

Identification and cost of adverse events in metastatic breast cancer in taxane and capecitabine based regimens.

PurposeWe sought to compare the economic impact of treatment-related adverse events (AEs) in patients with metastatic breast cancer (mBC) using taxane- or capecitabine-based treatment regimens as either first- or second-line (FL or SL) therapy in the US.MethodsWe used healthcare claims data from the Truven Health Analytics MarketScan® Commercial Databases to conduct a retrospective cohort study comparing the economic impact of AEs amongst taxane- and capecitabine-treated mBC patients in the US. We selected women diagnosed with mBC between 2008-2010 who received a taxane or capecitabine as first- or second-line (FL or SL) chemotherapy. Costs related to hospitalization, outpatient services, emergency department visits, chemotherapy and other medications were tabulated and combined to determine total healthcare costs. The incremental monthly costs associated with the presence of AEs compared to no AEs were estimated using generalized linear models, controlling for age and Charlson Comorbidity Index.ResultsWe identified 15,443 mBC patients meeting inclusion criteria. Adjusted total monthly costs were significantly higher in those who experienced AEs than in those without AEs in both lines of treatment (FL incremental cost: taxanes $1,142, capecitabine$1,817; SL incremental cost: taxanes $1,448, capecitabine$4,437). Total costs increased with the number of AEs and were primarily driven by increased hospitalization amongst those with AEs.ConclusionsAdverse events in taxane- or capecitabine-treated mBC patients are associated with significant increases in costs. Selecting treatment options associated with fewer AEs may reduce costs and improve outcomes in these patients

Ecology and management of mourning doves in Missouri (2016)

Mourning doves (Zenaida macroura) are among the most popular migratory game birds in Missouri (Figure 1). Though found across the state year-round, most Missouri doves migrate to the southern United States rather than overwinter here. Mourning doves are classified as a federal migratory species, which means the U.S. Fish and Wildlife Service manages hunting regulations at the national level. Doves' quick flight, erratic movements and edible meat make them a popular species among hunters and wildlife enthusiasts in Missouri, where the annual harvest of mourning doves is greater than that of other game bird species. Managing habitats for doves can provide hours of enjoyment for homeowners and landowners alike. Doves find food and shelter in a variety of habitat types, including pastures, croplands, open forests and forest edges, and in urban and suburban areas. Establishing and managing fields for dove populations can provide recreational hunting opportunities during fall, which can be a source of income for the landowner. Before undertaking efforts to establish or improve dove habitats on your land, you should understand their life history and biology. With that in mind, you can implement management practices to improve or add habitat components that might be in short supply and improve the overall habitat for doves and other species.Revised 2/16/Web only

Hunting doves on agricultural lands in Missouri (2016)

Many hunters and landowners establish crops and manage habitats to create ideal conditions and locations to hunt mourning doves and provide food and cover for a variety of wildlife. Mourning doves are migratory birds, so they are protected under the federal Migratory Bird Treaty Act, which specifically prohibits baiting a field for the purpose of hunting (Figure 1). Planting and managing fields using normal agricultural practices require careful planning and an understanding of the relevant regulations. This publication aims to help landowners understand baiting regulations and particularly the differences between baiting and what constitutes a normal agricultural operation in Missouri. The U.S. Fish and Wildlife Service and the Missouri Department of Conservation (MDC) are empowered to enforce regulations governing baiting migratory birds. You can find more specific information about these regulations in the Additional information section.New 2/16/Web only