The Effect of Context and Self-Esteem on Decision Making Competence and Preferences for Collaborative Decision Making in Older Adults

Older adults increasingly face difficult decisions in life threatening contexts as they move closer to death, become more likely to be diagnosed with life threatening diseases, and encounter more death within their social network (Greenberg, 2011). The purpose of this research was to understand the effect of a life-threatening decision context centered around cancer, self-esteem, other individual difference factors and cancer experience on older adults’ decision making competence, and preferences for collaborative decision making. Study participants were recruited through online circulation of the study recruitment flyer and in-person solicitations at meetings and other events at community locations (senior centers, civic group centers, and churches, etc.). Participants age 55-90 (N=202) were randomly assigned to either a mundane or life threatening condition and asked to complete the corresponding survey packet containing a measurement questionnaire. Analyses consisted of a series of analyses of variance (ANOVA) and regressions. The dependent variables were 3 major components of the DeBruin et al. (2007) Adult Decision Making Competence Scale: (a) Resistance to Framing, (b) Resistance to Sunk Cost Bias, and (c) Over/under confidence, in addition to a measure of Maximizing Tendency (Diab et al., 2008). Analyses revealed mixed results. Decision context did have an effect on decision making competence, while self-esteem showed little effect. No main effects or interactions were found between decision context, self-esteem, and preferences for collaborative decision making. Individual difference factors did effect decision making competence, with future time perspective, risk tolerance, and ego-integrity emerging as significant predictors. Furthermore, compelling results emerged pertaining to the effect of previous cancer experience on decision making competence. Results highlight the lasting effect of context and a previous cancer diagnosis on decision making competence and have implications in health care, psycho-oncology, and treatment decision making domains

Combined Endoscopic and Laparoscopic Approach to a Gastroesophageal Tumor

Minimally invasive techniques may be used in combination to manage difficult problems in general surgery leading to shorter hospital stays and improved patient satisfaction

Endometrial response to IVF hormonal manipulation: Comparative analysis of menopausal, down regulated and natural cycles

BACKGROUND: Uterine luminal epithelial cell response to different hormonal strategies was examined to determine commonality when an endometrium attains a receptive, stimulated, morphological profile that may lead to successful implantation. METHODS: Endometrial biopsies from 3 cohorts of patients were compared. The tissue samples taken from these patients were categorized into 8 different groups according to their baseline and the hormone regime used. RESULTS: Pre-treatment natural cycle tissue was variable in appearance. Downregulation with a GnRH analogue tissue appeared menopausal in character. HRT after downregulation resulted in tissue uniformity. HRT in menopause resulted in a 'lush' epithelial surface. HST in the natural cycle improved the morphology with significant difference in secretion between the two regimes examined. CONCLUSIONS: Down regulation plus HRT standardized surface appearance but tissue response is significantly different from the natural cycle, natural cycle plus HRT or menopause plus HRT. HRT in menopause reinstates tissue to a state similar to a natural cycle but significantly different from a natural cycle plus HST. HST with a natural cycle is similar to tissue from the natural cycle but significant differences reflect the influence of the particular hormones present (at any point) within the cycle

Isospin-1/2 DπD\pi scattering and the lightest D0∗D_0^\ast resonance from lattice QCD

Isospin-1/2 $D\pi$ scattering amplitudes are computed using lattice QCD, working in a single volume of approximately $(3.6\; \mathrm{fm})^3$ and with a light quark mass corresponding to $m_\pi\approx239$ MeV. The spectrum of the elastic $D\pi$ energy region is computed yielding 20 energy levels. Using the L\"uscher finite-volume quantisation condition these energies are translated into constraints on the infinite volume scattering amplitudes. For the first time, we find a complex $D_0^\ast$ resonance pole from lattice QCD, strongly coupled to the $S$-wave $D\pi$ channel, with a mass $m\approx 2200$ MeV and a width $\Gamma\approx400$ MeV. Combined with earlier work investigating the $D_{s0}^\ast$, and $D_0^\ast$ with heavier light quarks, similar couplings between each of these scalar states and their relevant meson-meson scattering channels are determined. The mass of the $D_0^\ast$ is consistently found well below that of the $D_{s0}^\ast$, in contrast to the currently reported experimental result.Comment: 39 pages, 13 figure

Isospin-1/2 Dπ scattering and the lightest D 0 ∗ resonance from lattice QCD

Abstract: Isospin-1/2 Dπ scattering amplitudes are computed using lattice QCD, working in a single volume of approximately (3.6 fm)3 and with a light quark mass corresponding to mπ ≈ 239 MeV. The spectrum of the elastic Dπ energy region is computed yielding 20 energy levels. Using the Lüscher finite-volume quantisation condition, these energies are translated into constraints on the infinite-volume scattering amplitudes and hence enable us to map out the energy dependence of elastic Dπ scattering. By analytically continuing a range of scattering amplitudes, a D0∗ resonance pole is consistently found strongly coupled to the S-wave Dπ channel, with a mass m ≈ 2200 MeV and a width Γ ≈ 400 MeV. Combined with earlier work investigating the Ds0∗, and D0∗ with heavier light quarks, similar couplings between each of these scalar states and their relevant meson-meson scattering channels are determined. The mass of the D0∗ is consistently found well below that of the Ds0∗, in contrast to the currently reported experimental result

Manipulation of the follicular phase: Uterodomes and pregnancy - is there a correlation?

BACKGROUND: Manipulation of the follicular phase uterine epithelium in women undergoing infertility treatment, has not generally shown differing morphological effects on uterine epithelial characteristics using Scanning Electron Microscopy (SEM) and resultant pregnancy rates have remained suboptimal utilising these manipulations. The present study observed manipulation of the proliferative epithelium, with either 7 or 14 days of sequential oestrogen (E) therapy followed by progesterone (P) and assessed the appearance of pinopods (now called uterodomes) for their usefulness as potential implantation markers in seven women who subsequently became pregnant. Three endometrial biopsies per patient were taken during consecutive cycles: day 19 of a natural cycle - (group 1), days 11/12 of a second cycle after 7 days E then P - (group 2), and days 19/22 of a third cycle after 14 days E then P - (group 3). Embryo transfer (ET) was performed in a subsequent long treatment cycle (as per Group 3). RESULTS: Seven pregnancies resulted in seven viable births including one twins and one miscarriage. Analysis of the individual regimes showed 5 days of P treatment to have a higher correlation for uterodomes in all 3 cycles observed individually. It was also observed that all 7 women demonstrated the appearance of uterodomes in at least one of their cycles. CONCLUSIONS: We conclude that manipulation of the follicular phase by shortening the period of E exposure to 7 days, does not compromise uterine epithelial morphology and we add weight to the conclusion that uterodomes indicate a receptive endometrium for implantation

The Impact of Human Conflict on the Genetics of Mastomys natalensis and Lassa Virus in West Africa

Environmental changes have been shown to play an important role in the emergence of new human diseases of zoonotic origin. The contribution of social factors to their spread, especially conflicts followed by mass movement of populations, has not been extensively investigated. Here we reveal the effects of civil war on the phylogeography of a zoonotic emerging infectious disease by concomitantly studying the population structure, evolution and demography of Lassa virus and its natural reservoir, the rodent Mastomys natalensis, in Guinea, West Africa. Analysis of nucleoprotein gene sequences enabled us to reconstruct the evolutionary history of Lassa virus, which appeared 750 to 900 years ago in Nigeria and only recently spread across western Africa (170 years ago). Bayesian demographic inferences revealed that both the host and the virus populations have gone recently through severe genetic bottlenecks. The timing of these events matches civil war-related mass movements of refugees and accompanying environmental degradation. Forest and habitat destruction and human predation of the natural reservoir are likely explanations for the sharp decline observed in the rodent populations, the consequent virus population decline, and the coincident increased incidence of Lassa fever in these regions. Interestingly, we were also able to detect a similar pattern in Nigeria coinciding with the Biafra war. Our findings show that anthropogenic factors may profoundly impact the population genetics of a virus and its reservoir within the context of an emerging infectious disease

The Pathophysiology of Farnesoid X Receptor (FXR) in the GI Tract: Inflammation, Barrier Function and Innate Immunity

The Farnesoid-X Receptor, FXR, is a nuclear bile acid receptor. Its originally described function is in bile acid synthesis and regulation within the liver. More recently, however, FXR has been increasingly appreciated for its breadth of function and expression across multiple organ systems, including the intestine. While FXR’s role within the liver continues to be investigated, increasing literature indicates that FXR has important roles in responding to inflammation, maintaining intestinal epithelial barrier function, and regulating immunity within the gastrointestinal (GI) tract. Given the complicated and multi-factorial nature of intestinal barrier dysfunction, it is not surprising that FXR’s role appears equally complicated and not without conflicting data in different model systems. Recent work has suggested translational applications of FXR modulation in GI pathology; however, a better understanding of FXR physiology is necessary for these treatments to gain widespread use in human disease. This review aims to discuss current scientific work on the role of FXR within the GI tract, specifically in its role in intestinal inflammation, barrier function, and immune response, while also exploring areas of controversy

Recent Developments in Hirschsprung’s-Associated Enterocolitis

Hirschsprung’s-associated enterocolitis (HAEC) continues to be a significant source of morbidity for patients with Hirschsprung’s disease (HD). New clinical and histologic classification systems for HAEC will improve consistency between reports and increase the ability to compare outcomes. A complete understanding of disease pathogenesis is lacking, but evidence suggests that the intestinal microbiota may play a role in the development of HD and HAEC. The benefits of adjunctive therapies, such as anal dilations and botulinum toxin to reduce the incidence of HAEC following corrective endorectal pull-through, remain controversial. Finally, new clinical data have identified an association between HAEC and inflammatory bowel disease and will likely lead to further genetic studies to elucidate the connection between these two disease processes