Vibrios in the Environment: An Investigation of Environmental Vibrio vulnificus, Vibrio parahaemolyticus, and Vibrio cholerae

Vibrio parahaemolyticus, Vibrio vulnificus, and Vibrio cholerae are Gram negative bacteria that naturally occur in marine and estuarine environment, both as free-floating cells or attached to chitinous surfaces. Although Vibrio spp. are readily isolated from the environment, not all strains are virulent. Therefore, the ability to detect the presence of vibrios is vital, but determination of pathogenicity is equally important. The research reported here was focused on prevalence and characteristics of environmental Vibrio species and how the environment provides a natural ecosystem for human pathogens and reservoir of virulence factors. Those objectives were achieved by carrying out intensive sampling over three years, during which water, sediment, and oyster samples were collected from the Chesapeake Bay, Maryland. Detection and molecular characterization of Vibrio parahaemolyticus and Vibrio vulnificus were done and the diversity of V. parahaemolyticus and V. vulnificus isolates from individual oyster samples was investigated. The large-scale populations of V. parahaemolyticus and V. vulnificus in the Chesapeake Bay and smaller scale populations of individual oysters were analyzed, thereby providing a snapshot of V. parahaemolyticus and V. vulnificus distribution in the environment. Because antibiotic resistance is an increasing public health concern, antibiograms of V. parahaemolyticus and V. vulnificus isolates from environmental sources were done to determine antibiotic resistance patterns in environmental isolates. Detection and enumeration of Vibrio species are a concern since Vibrio spp. can enter viable by nonculturable (VBNC) state. Thus, new and improved Vibrio detection methods are needed. This this study the Cholera O1 and O139 SMART II test were investigated for potential use in detecting V. cholerae in ballast water treatment systems

September 10, 1998

The Breeze is the student newspaper of James Madison University in Harrisonburg, Virginia

Mispricing in the medicare advantage risk adjustment model

The Centers for Medicare and Medicaid Services (CMS) implemented hierarchical condition category (HCC) models in 2004 to adjust payments to Medicare Advantage (MA) plans to reflect enrollees\u27 expected health care costs. We use Verisk Health\u27s diagnostic cost group (DxCG) Medicare models, refined descendants of the same HCC framework with 189 comprehensive clinical categories available to CMS in 2004, to reveal 2 mispricing errors resulting from CMS\u27 implementation. One comes from ignoring all diagnostic information for new enrollees (those with less than 12 months of prior claims). Another comes from continuing to use the simplified models that were originally adopted in response to assertions from some capitated health plans that submitting the claims-like data that facilitate richer models was too burdensome. Even the main CMS model being used in 2014 recognizes only 79 condition categories, excluding many diagnoses and merging conditions with somewhat heterogeneous costs. Omitted conditions are typically lower cost or vague and not easily audited from simplified data submissions. In contrast, DxCG Medicare models use a comprehensive, 394-HCC classification system. Applying both models to Medicare\u27s 2010-2011 fee-for-service 5% sample, we find mispricing and lower predictive accuracy for the CMS implementation. For example, in 2010, 13% of beneficiaries had at least 1 higher cost DxCG-recognized condition but no CMS-recognized condition; their 2011 actual costs averaged US$6628, almost one-third more than the CMS model prediction. As MA plans must now supply encounter data, CMS should consider using more refined and comprehensive (DxCG-like) models

How Cultural Factors Affect Chinese Americans’ Attitudes Towards Seeking Mental Health Services

Chinese Americans are the largest ethnic group among Asian Americans. However, the treatment rate for mental illness among Chinese Americans is much lower compared to other ethnic groups. Studies have been conducted on cultural barriers that prevent Asian Americans from seeking mental health treatment, but there is a lack of research on specific ethnic groups, such as Chinese Americans or Korean Americans because they are frequently grouped into homogenous clusters. This study will identify the cultural factors that influence Chinese Americans’ attitudes towards seeking mental health treatment and analyze how these factors affect their behaviors in seeking mental health treatment

Sex and gender differences in caregiving burden experienced by family caregivers of persons with dementia: a systematic review

Objectives Much is known about the demands of caregiving for a person with dementia (PWD) and its effects on family caregivers, however sex and gender aspects have received less attention. We synthesized the evidence on sex and gender distinctions in: (1) the caregiving burden and (2) the impact of caregiving on the physical and mental health of family caregivers of PWD. Design Systematic review. Data sources Medline, Embase, PsycINFO and Cumulative Index to Nursing and Allied Health Literature between January 2007 and October 2019 were searched Eligibility criteria for selecting studies Studies included in the review met the following criteria: (1) Examine experiences and/or impacts of caregiving among family caregivers of individuals with any form of dementia; (2) Report sex and/or gender distribution of study population and/or report results stratified by sex and/or gender, and (3) Include both male and female family caregivers. Data extraction and synthesis Two independent reviewers extracted the data and assessed risk of bias using the Critical Appraisal Skills Programme checklist and National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-sectional Studies. Data were synthesized using a narrative synthesis approach. Results A total of 22 studies were included. Caregiving burden was measured using various methods. A majority of studies reported higher burden among females. Most studies that did not report a sex and gender difference accounted for confounders. Findings on sex and gender differences on physical and mental health conditions were inconsistent with most studies failing to account for confounding variables in their analyses. Conclusions The current evidence on sex and gender differences in caregiving burden, mental and physical health is limited. Findings suggest the presence of sex and gender differences in caregiving burden. Given the variety of mental and physical health constructs that were examined, further research is required to substantiate the evidence

Familial sleep and autism spectrum disorder: a pilot actigraphy study of sleep quality, quality of life and psychological distress

Sleep problems are common among children with autism spectrum disorder (ASD) and can have a negative impact on the child's behaviour and daytime functioning. The current pilot study examined objective measurements of child and parent sleep as factors associated with the stress, anxiety, depressive symptoms, social support and quality of life of parents of children with ASD. Participants were nine children with ASD and their parents (nine mothers and three fathers). Participants wore an actigraph for 7 consecutive days and nights. Measures of sleep habits and quality were used to ascertain child and parent sleep. Measures of parenting stress, anxiety, depressive symptoms, quality of life and social support were collated. Results indicated the emergence of high parental stress, anxiety and depressive symptoms. Significant correlations were observed between parent depressive symptoms, and both subjective sleep quality and child sleep disruptions. The present study found that parental well-being is affected by child sleep problems.peer-reviewe

Sex and gender differences in technology needs and preferences among informal caregivers of persons with dementia

Background: Dementia is a major public health concern associated with significant caregiver demands and there are technologies available to assist with caregiving. However, there is a paucity of information on caregiver needs and preferences for these technologies, particularly from a sex and gender perspective. To address this gap in research, the objectives of this study are to examine (1) the knowledge of technology, (2) perceived usefulness of technology, (3) feature preferences when installing and using technology and (4) sex and gender influences on technology needs and preferences among family caregivers of persons with dementia (PWD) across North America. Methods: A secondary analysis was conducted on an existing cross-sectional survey with family caregivers of PWDs. Respondents were recruited through the Alzheimer Society of Canada, the Victorian Order of Nurses and Adult Day Programs and other Canadian health care provision institutes. Descriptive statistics, bivariate and multivariate analyses were used to describe the study sample, uncover differences between male and female caregivers and examine sex and gender influences on caregivers’ technology needs and preferences. Results: A total of 381 eligible responses were received over a nine-month data collection period. The majority of respondents did not know much about and never used any technologies to assist with caregiving. “Being easy to install”, “easy to learn how to use” and “cost” were identified as the most important features when purchasing and setting up technology, while “reliability” was identified as the most important feature when using technology. Most respondents were willing to pay up to $500 to acquire individual technologies. Controlling for other socio-demographic variables, female respondents were more likely to have some or more knowledge about technology for caregiving while male respondents were more willing to pay higher amounts for these technologies compared to their female counterparts

Automated recognition of individual performers from de-identified video sequences

dentification of individual humans from RGB image data is well-established. However, in many domains, such as in healthcare or applications involving children, ethical issues have been raised around using traditional RGB image data because individuals can be identified from these data. The widespread availability of reliable depth data, and the associated human skeleton data derived from these data, presents an opportunity to differentiate between individuals while potentially avoiding individually identifiable features. Using skeleton data only, we developed a unique 20-dimensional bone segment length feature vector for 1,761 trials (1,759,980 image frames) of data, captured from 14 participants who engaged in a one-hour group intervention playing Xbox One Kinect Bowling twice-weekly for 24 weeks. We then evaluated our novel feature using representative batch processing (k-nearest neighbour) and real-time (multi-layer perceptron) models, validated against manually-labelled ground-truth data. Our results suggest that our skeleton feature can differentiate between instances (i.e., individuals) with an accuracy over all participants of 100% for batch processing and 96.57% in real-time, and deals well with class imbalances. Our results suggest that we can reliably differentiate between individual persons using only skeleton data derived from depth image data in medical research

Herbal Therapies for Type 2 Diabetes Mellitus:Chemistry, Biology, and Potential Application ofSelected Plants and Compounds

Diabetes mellitus has been recognized since antiquity. It currently affects as many as 285 million people worldwide and results in heavy personal and national economic burdens. Considerable progress has been made in orthodox antidiabetic drugs. However, new remedies are still in great demand because of the limited efficacy and undesirable side effects of current orthodox drugs. Nature is an extraordinary source of antidiabetic medicines. To date, more than 1200 flowering plants have been claimed to have antidiabetic properties. Among them, one-third have been scientifically studied and documented in around 460 publications. In this review, we select and discuss blood glucose-lowering medicinal herbs that have the ability to modulate one or more of the pathways that regulate insulin resistance, -cell function, GLP-1 homeostasis, and glucose (re)absorption. Emphasis is placed on phytochemistry, anti-diabetic bioactivities, and likely mechanism(s). Recent progress in the understanding of the biological actions, mechanisms, and therapeutic potential of compounds and extracts of plant origin in type 2 diabetes is summarized. This review provides a source of up-to-date information for further basic and clinical research into herbal therapy for type 2 diabetes. Emerging views on therapeutic strategies for type 2 diabetes are also discussed