Consequences of the Bystander Effect in Relation to Bullying, Underage Alcohol Consumption, and Suicide/Suicidal Ideation

Bystander effect is a phenomenon in which the presence of others hinders an individual’s helping behavior. Bystander effect can occur in situations involving bullying, underage consumption of alcohol and suicide or suicidal ideation. Young people only intervene 19% of the time in a bullying situation, even though it has been found to be effective within ten seconds, 57% of the time (Center for Disease and Prevention, 2014). School Counselors can help students intervene, as well as implement various prevention and intervention programs and strategies such as Signs of Suicide (SOS), Olweus Bullying Prevention Program (OBPP), and Bully-Proofing Your School (BPYP) to help create a safe school environment

An Error-Components Three-Stage Least-Squares Model of Investment Allocation by Farm Households

This paper is an assessment of patterns of investment by farm households via an econometric model adapted from a land allocation approach of Holt (1999). This analysis will shed light on the importance of different classes of assets to farm household well-being, and show the reaction of farm households to a variety of market, international and government effects.Farm Management,

Sources and perceptions of controversy in establishing a protected area for biodiversity : a case study in the New River Area of Oregon

The process of land acquisition for the conservation of plants or wildlife habitat can raise controversial issues, issues often perceived differently by the individuals and groups involved. After the land acquisition process is completed, there is rarely an opportunity to analyze the differing perceptions of the issues and their relative importance. This question is addressed using case study methodology at the New River Area of Critical Environmental Concern, located on the southern coast of Oregon. Congress allocated 5.2 million dollars from the Land and Water Conservation Fund for the Bureau of Land Management to purchase New River parcels. The ensuing land acquisition process caused controversy among the stakeholders and broke down the fragile trust between the agency and local citizens. The twenty individuals involved in the process (ranchers, agency scientists, managers, planners, and realtors, county commissioners, recreationists, and environmentalists) were identified using key informants and referrals. During semi-structured interviews with each stakeholder, their perceptions of the sources of controversy were identified. Using this primary data, and secondary data from internal files, newspapers and letters, the principal issues and variables in the controversy were analyzed. The findings are significant in their potential to increase the understanding of the controversy surrounding land acquisition for the conservation of biodiversity

Kinematic Leg Therapy Device

ME450 Capstone Design and Manufacturing Experience: Fall 2015This project’s sponsor, Dr. Ben Dwamena, was a young aspiring engineering student in Ghana until he was encouraged down the medical path in his early schooling. Dr. Dwamena has no use of his legs and needs a wheelchair to move about. There are many downsides that are associated from this type of physical assistance: bed sores, muscle atrophy, poor blood circulation, kidney stones, and urinary health issues. Dr. Dwamena was able to purchase a standup wheelchair that helps with a few of these ailments, but he wanted to create a better wheelchair. To improve blood circulation, decrease muscle atrophy, and lessen the chances of bed sores, Dr. Dwamena asked the University of Michigan to create an automated leg moving device that would work in his stand up wheelchair. The device would mimic a stand-still walking motion while he is in the standing position in his wheelchair. This would help with all the alignments listed above. The objective of this project was to provide a more accessible and user friendly method of kinesiotherapy for individuals without the use of their legs.http://deepblue.lib.umich.edu/bitstream/2027.42/117340/1/ME450-F15-Project23-FinalReport.pd

Movement of Chlorinated Solvents and Other Volatile Organics Through Plants Monitored by Fourier Transform Infrared (FT-IR) Spectrometry

Plants have a large capacity to transfer water from soil to the atmosphere. Soluble contaminants may be carried with that water, with a relative extent of transfer that depends on their octanol-water or organic matter-water partition coefficient. We measured the transfer rate for several solvents that vary in volatility and solubility, including trichloro ethylene, trichloroethane, chloroform, dichloromethane, diethyl ether, and methyl-t-butyl ether. We tested them alone and in several combinations. An extractive Fourier Transform Infrared (FT-IR) Spectrometer (Gasmet, produced by Temet Instruments) was used to measure concentrations in the gas phase above plants which had their root system immersed in water containing the contaminant. Deuterated water was used to trace transpiration rate. Hybrid poplars (Populus deltoides x nigra) and saltcedar (Tamarix parviflora) gave similar results, indicating relatively free movement of the indicated solvents, alone or in combinations. Alfalfa (Medicago sativa) also permitted transfer of those compounds that were tested

Dose-response effects of exercise on mental health in community-dwelling older adults: Exploration of genetic moderators

Background/Objective: (1) Examine the role of exercise intensity on mental health symptoms in a community-based sample of older adults. (2) Explore the moderating role of genetic variation in brain-derived neurotrophic factor (BDNF) and apolipoprotein E (APOE) on the effects of exercise on mental health symptoms. Method: This study is a secondary analysis of a three-arm randomized controlled trial, comparing the effects of 6 months of high-intensity aerobic training vs. moderate-intensity aerobic training vs. a no-contact control group on mental health symptoms assessed using the Depression, Anxiety, and Stress Scale (DASS). The BDNF Val66Met polymorphism and APOE 4 carrier status were explored as genetic moderators of exercise effects on mental health symptoms. Results: The exercise intervention did not influence mental health symptoms. The BDNF Val66Met polymorphism did not moderate intervention effects on mental health symptoms. APOE 4 carrier status moderated the effect of intervention group on perceived stress over 6 months, such that APOE 4 carriers, but not non-carriers, in the high-intensity aerobic training group showed a decline in perceived stress over 6 months. Conclusions: APOE 4 carrier status may modify the benefits of high-intensity exercise on perceived stress such that APOE 4 carriers show a greater decline in stress as a result of exercise relative to non-APOE 4 carriers

Incidence of Venous Thromboembolic Events in Patients With Endogenous Cushing Syndrome

Background: Hypercortisolemia is a hypercoagulable state associated with increased risk of venous thromboembolic events (VTE). The reported incidence of VTE in patients with ACTH-dependent or independent Cushing Syndrome (CS) is variable, ranging from 3 to 14%. Our aim was to assess the incidence of clinically significant VTE among patients with endogenous CS and to identify risk factors for the development of VTE. Methods: We conducted a single center retrospective longitudinal study of adult patients diagnosed with endogenous CS between 2010 and 2020. Patients with a known prothrombotic disease (e.g. Factor V Leiden), insufficient data, or non-neoplastic hypercortisolism were excluded. Data collected included patient demographics, presenting symptoms, biochemical and radiological workup, treatment details, and incidence of clinically significant VTE. Results: A total of 114 patients (mean age of 45.55 ± 14.78 years, 79.8% women) followed for mean of 3.26 ± 2.9 years were included. Of the 114 patients, 58 (50.9%) had Cushing disease (CD), 40 (35.1%) had CS due to adrenal adenoma/hyperplasia, 6 (3.5%) had adrenocortical carcinoma (ACC), and 10 (8.8%) had ectopic Cushing syndrome (eCS). The overall incidence of VTE at any time point was 14/114 (12.3%); 11 (79%) VTEs were associated with presence of an additional VTE risk factor (8 surgery and 3 malignancy). Prior to any intervention for CS, 3 of 114 (2.6%) patients had a VTE. Surgery for CS (adrenalectomy, transsphenoidal surgery, tumor resection) was performed in 97 patients (85.1%) whereas 17 were treated medically (n=10), died before treatment (n=1) or observed (n=6). VTE occurred in 2 patients receiving medical therapy for CS. The post-operative incidence of VTE was 9 (9.3%; 4 in CD, 1 in adrenal CS, 3 in ACC, and 1 in eCS). VTE occurred ≤ 3-month post-operative in 4 patients (44.4%). Among the 5 patients in whom VTE occurred >3 months post-operative, 3 had recurrent metastatic ACC with hypercortisolemia and 2 were in remission (1 with CS and 1 with eCS). The median time from surgery to VTE occurrence was 315 days (8-1006). Compared to those who did not develop VTE, those who developed VTE had higher mean 24-hour urine free cortisol (4663.6 vs 558.21 mcg/dL; n = 100, P < 0.0001) and mean 1 mg overnight dexamethasone suppression test (36.3 vs 11.8 mcg/dL; n = 69, P = 0.0003), but similar mean late-night salivary cortisol (0.591 vs 0.790 ng/dL, n = 84, P = 0.71) at diagnosis of CS. Discussion: Among those with CS, the overall incidence of VTE was 12.3% and the majority of VTE were provoked (surgery, malignancy). Moreover, VTE was more likely in those with higher UFC and 1 mg overnight dexamethasone suppression test in our cohort. This suggests that in patients with CS who have an active malignancy, severe CS or those undergoing a surgical procedure may be at increased risk of VTE. Future studies should investigate the optimal type and duration of the VTE prophylaxis

The Influences of Land Uses and Stream Modifications on Water Quality in the Streams of the Court Creek Watershed

published or submitted for publicationis peer reviewedOpe

The Need for Patient-centered Education Among Patients Newly Diagnosed With a Pituitary Tumor

Objectives: Brain tumors, including pituitary adenomas (PA), cause anxiety and distress, with a high unmet need for information correlating with increased anxiety. Condition-specific education may alleviate anxiety. We explored patients' experience around the diagnosis of a PA and piloted a patient education intervention to address peridiagnostic anxiety in adults diagnosed with PA. Methods: Anxiety, patient satisfaction, patient knowledge, and need for information were measured prior to, immediately after, and 1 month following the appointment in this multimethods study. A phone interview to explore patient diagnostic and intervention experiences was analyzed using qualitative methods. Results: A total of 17 patients participated in the study; 15 completed the interview. The baseline need for information was high. Disease-specific anxiety decreased, and patient knowledge and satisfaction increased significantly after the initial visit. Interview analysis identified 3 main themes: (1) the importance of communication; (2) the need for information; and (3) the impact of the diagnosis on patient experience. Conclusions: For patients with newly diagnosed PA, the diagnostic experience was associated with high levels of anxiety. Patients expressed a need for information. Information delivery reduced anxiety and had a positive impact on patient satisfaction. Practice implications: The study findings suggest a need for a streamlined diagnostic process with readily accessible information

Improvement of cardiovascular risk factors after adrenalectomy in patients with adrenal tumors and Subclinical Cushing Syndrome:a systematic review and meta-analysis

Objective Beneficial effects of adrenalectomy on cardiovascular risk factors in patients with subclinical Cushing’s syndrome (SCS) are uncertain. We sought to conduct a systematic review and meta-analysis with the following objectives: (i) determine the effect of adrenalectomy compared with conservative management on cardiovascular risk factors in patients with SCS and (ii) compare the effect of adrenalectomy on cardiovascular risk factors in patients with SCS vs those with a nonfunctioning (NF) adrenal tumor. Methods MEDLINE In-Process &amp; Other Non-Indexed Citations, MEDLINE, EMBASE and Cochrane Central Register of Controlled Trial were searched on 17 November 2015. Reviewers extracted data and assessed methodological quality in duplicate. Results We included 26 studies reporting on 584 patients with SCS and 457 patients with NF adrenal tumors. Studies used different definitions of SCS. Patients with SCS undergoing adrenalectomy demonstrated an overall improvement in cardiovascular risk factors (61% for hypertension, 52% for diabetes mellitus, 45% for obesity and 24% for dyslipidemia). When compared with conservative management, patients with SCS undergoing adrenalectomy experienced improvement in hypertension (RR 11, 95% CI: 4.3–27.8) and diabetes mellitus (RR 3.9, 95% CI: 1.5–9.9), but not dyslipidemia (RR 2.6, 95% CI: 0.97–7.2) or obesity (RR 3.4, 95% CI: 0.95–12). Patients with NF adrenal tumors experienced improvement in hypertension (21/54 patients); however, insufficient data exist for comparison to patients with SCS. Conclusions Available low-to-moderate-quality evidence from heterogeneous studies suggests a beneficial effect of adrenalectomy on cardiovascular risk factors in patients with SCS overall and compared with conservative management. </jats:sec