Prevalence of Alcohol-Interactive Medications and Conditions With Concurrent Alcohol Use in Older Adults

Many prescription medications can either directly or indirectly interact with alcohol and many chronic conditions may be worsened by alcohol use. Medications, such as antihypertensives, anticoagulants, and gastrointestinal agents, can be dangerous when taken with alcohol and can lead to loss of consciousness, falls, serious bleeding and other issues. Chronic conditions, such as gastroesophageal reflux disease, hypertension and cirrhosis can directly be worsened with alcohol consumption. These potential complications are pertinent to all ages, but there is greater concern of these interactions in older adults, defined as adults over 65 years old. Using survey data from older adults in Lexington, KY, descriptive statistics were used to analyze the prevalence of alcohol-interactive medications and alcohol-interactive disease states with concurrent alcohol use in this population. The aim of this study was to investigate older adults in Kentucky using medications that that interact with alcohol or have disease states that can be worsened or caused by alcohol. These findings could help determine if there is a gap in care regarding this issue. If a gap in care is identified, then possible interventions to make, such as re-structuring pharmacist alcohol screening to include these interactions, will be investigated and a need for further research will be determined

Cough in Exercise and Athletes

Cough is the most common respiratory symptom reported by athletes and can significantly impact on health status, ability to train and athletic performance. The presence of cough in an athlete is typically taken to indicate exercise-induced bronchoconstriction (EIB), yet in many athletes with chronic cough there is no objective evidence of airway hyper-responsiveness (AHR) or heightened airway inflammation. Moreover, cough in athletes often fails to respond to a therapeutic asthma strategy, thus further work is urgently needed to progress our understanding of the pathophysiology of exercise-associated cough in this unique population. This article provides an overview of the current state of knowledge of exercise-associated cough in athletes. The article summarises our understanding of pathophysiological basis of cough in this context and provides a pragmatic clinical approach to this problem

Cough in Exercise and Athletes

Cough is the most common respiratory symptom reported by athletes and can significantly impact on health status, ability to train and athletic performance. The presence of cough in an athlete is typically taken to indicate exercise-induced bronchoconstriction (EIB), yet in many athletes with chronic cough there is no objective evidence of airway hyper-responsiveness (AHR) or heightened airway inflammation. Moreover, cough in athletes often fails to respond to a therapeutic asthma strategy, thus further work is urgently needed to progress our understanding of the pathophysiology of exercise-associated cough in this unique population. This article provides an overview of the current state of knowledge of exercise-associated cough in athletes. The article summarises our understanding of pathophysiological basis of cough in this context and provides a pragmatic clinical approach to this problem

Development, intervention, and international order

© 2013, Cambridge University Press. This is the peer reviewed version of the following article: Development, intervention, and international order, which has been published in final form at http://dx.doi.org/10.1017/S0260210513000260

Subjectivity and reflexivity in an 'exemplary' virtual team

This thesis discusses the findings of a 'virtual' ethnography of a 'virtual team' of teleworkers called 'FlexiTeam'. The concept of teleworking refers to workers who use Information and Communication Technologies to work flexibly in time and space. A 'virtual team' is a group of teleworkers organised into a 'team'. There are three substantive findings of this research. First, the discourses of virtual teamwork as 'effortless' and 'flexible' are subject to critique through a description of the forms of labour and (self-)discipline enacted on the part of FlexiTeam members in order to implement 'best practice'. Second, the analysis examines how team members' commitment to this 'best practice' can be understood in relation to their identity at work. This is explored using a theory of subjectivity as constructed through social relationships at work. The analysis focuses on FlexiTeam's social relationship with clients, their employing organisation and within the team. The client relationship is highlighted in particular because FlexiTeam are interesting in their role as 'teleworking consultants'. FlexiTeam not only practice but also sell the concepts of teleworking and virtual teams. Unlike existing studies of 'top-down' change imposed by management upon the workforce, FlexiTeam are active in the production of the very same discourse they also consume. It is argued that this production/consumption relationship constructs a reflexive dynamic for team members' subjectivity, as they strive to be 'experts', 'exemplars' and 'embodiments' of the 'best practice' discourse they sell. However, the third finding suggests that, for some team members, their relationship to the 'best practice' consultancy discourse is characterised less by 'internalisation' and more by ambiguity, ambivalence and instrumentality. This exposes the limits to the 'normalising' power of discourse, even in the case of a team who produce the discourse in question, thereby helping to develop a more sophisticated theory of the subjectivity/discourse relationship.EThOS - Electronic Theses Online ServiceESRCGBUnited Kingdo

Leptospiroza u indijskog bivola (Bubalus bubalis) na Trinidadu.

The seroprevalence of leptospirosis in water buffalo (Bubalus bubalis) reared for meat in semi-intensive and extensive managed farms in Trinidad was determined. All sera were tested for specific antibodies against 17 internationally recognized serovars of Leptospira using the microscopic agglutination test (MAT). Animals with titres greater or equal to 100 were considered as seropositive indicating exposure to Leptospira and those with titres greater or equal to 800 were interpreted as cases of acute leptospirosis. Of a total of 226 apparently healthy water buffalo from five major farms in Trinidad tested, 33 (14.6%) were seropositive with titres ranging from 100 to 400. Three (60.0%) of 5 farms had seropositive animals with seropositivity rates ranging from 2.0% (1 of 50) on Farm A to 32.7% (16 of 49) on Farm B. The difference was statistically significant (P0.05; X2) effect on infection rate. The prevalent antibodies to serovars of Leptospira were farm-specific with specific antibodies to serovars Copenhageni and Georgia being predominant on Farm B having been detected in 10 (62.5%) and 9 (56.3%) respectively of 16 seropositive animals. On Farm D however, also with 16 seropositive animals, specific antibodies to serovars Patoc and Bratislava were most frequently detected, found in 11 (68.8%) and 5 (31.3%) respectively of seropositive animals. This is the first documentation of leptospirosis in water buffalo in the Caribbean region and the health risk posed to farm workers, abattoir workers and veterinarians cannot be ignored.Određivana je serološka prevalencija leptospiroze u indijskog bivola (Bubalus bubalis) uzgajanoga za meso u poluintenzivnoj i ekstenzivnoj proizvodnji na Trinidadu. Uzorci seruma bili su pretraženi mikroskopskom aglutinacijom na specifi čna protutijela za 17 međunarodno važnih serovarova leptospira. Životinje s titrom ≥1:100 smatrane su serološki pozitivnima što znači da su bile izložene infekciji leptospirama, dok su one s titrom ≥1:800 smatrane akutno zaražene leptospirama. Ustanovljeno je da su 33 (14,6%) bivola bila serološki pozitivna u titru od 1:100 do 1:400 od ukupno 226 pretraženih klinički zdravih indijskih bivola podrijetlom s pet velikh farmi na Trinidadu. Serološki pozitivne životinje ustanovljene su na tri od pet pretraženih farmi sa stopom serološke pozitivnosti od 2% (1 od 50) na farmi A, do 32,7% (16 od 49) na farmi B. Razlika je bila statistički značajna (P0,05; X2). Nalaz protutijela za određeni serovar leptospira bilo je specifi čan za farmu. Tako su protutijela za serovarove Kopenhagen i Georgia pretežito dokazana na farmi B, s tim da su za serovar Kopenhagen bila dokazana u 10 (62,5%), a za serovar Georgia u 9 (56,3%) od 16 serološki pozitivnih životinja. Međutim, na farmi D gdje je također ustanovljeno 16 serološki pozitivnih životinja, najčešće su dokazana protutijela za serovarove Patoc i Bratislava. Protutijela za serovar Patoc dokazana su u 11 (68,8%), a za serovar Bratislava u pet (31,3%) bivola. Ovo je prvi dokaz leptospiroze u indijskih bivola na Karibima što predstavlja rizik za infekciju u farmskih i klaoničkih radnika te veterinara

Cutoff-Free Traveling Wave NMR

Recently, the concept of traveling-wave NMR/MRI was introduced by Brunner et al. (Nature 457, 994-992 (2009)), who demonstrated MR images acquired using radio frequency (RF) waves propagating down the bore of an MR scanner. One of the significant limitations of this approach is that each bore has a specific cutoff frequency, which can be higher than most Larmor frequencies of at the magnetic field strengths commonly in use for MR imaging and spectroscopy today. We overcome this limitation by using a central conductor in the waveguide and thereby converting it to a transmission line (TL), which has no cutoff frequency. Broadband propagation of waves through the sample thus becomes possible. NMR spectra and images with such an arrangement are presented and genuine traveling wave behavior is demonstrated. In addition to facilitating NMR spectroscopy and imaging in smaller bores via traveling waves, this approach also allows one to perform multinuclear traveling wave experiments (an example of which is shown), and to study otherwise difficult-to-access samples in unusual geometries.Comment: 25 pages, 7 figures, previously presented at (1) World-Wide NMR Conference (ISMAR/Ampere joint meeting), Florence, Italy, July 9, 2010, and (2) Experimental NMR Conference, Asilomar, CA, April 13, 201

Over or under-detection? A comparison of exercise and eucapnic voluntary hyperpnoea challenges in the evaluation of exercise-induced bronchoconstriction

Background: The most appropriate objective bronchoprovocation challenge in the evaluation of exercise-induced bronchoconstriction (EIB) remains debated. Standardising minute ventilation and environmental conditions during an exercise challenge test (EX) is challenging, whereas it has recently been proposed that eucapnic voluntary hyperpnoea (EVH) may be overly sensitive. The primary aim of this study was therefore to compare the airway response to EX in a dry environment (25% RH) and EVH. An evaluation of current and revised diagnostic thresholds was undertaken to determine the impact of any proposed modification to EIB screening outcome. Methods: In randomised order, sixty-three recreational athletes (male: n = 47) (training 9 ± 4 hrs/week) attended the laboratory on two separate occasions to complete either an EX challenge (6-min high-intensity cycling exercise at >80% max heart rate) in an environmental chamber (16oC, 25% relative humidity), and a EVH challenge (6-min maximal ventilation of a dry compressed gas mixture: 21% O2, 5% CO2, N2 balanced). Spirometry was performed at baseline and 3, 5, 7, 10 and 15 minutes post challenge test in accordance with international guidelines. A positive diagnosis was defined by ≥10% fall in FEV1 at two consecutive time-points for both EX and EVH and ≥15% fall in FEV1 at one time-point for EVH. Results: The mean fall in lung function following EVH (-7.9 ± 6.9%) was greater in comparison to EX (-1.9 ± 7.1; P15% FEV1 fall following EVH, of which four were positive to EX. Conclusion: Our findings indicate that EVH consistently induces a greater fall in FEV1 in comparison to EX. Applying a 10% fall in FEV1 cut-off for EVH results in greater diagnostic sensitivity, whereas a 15% fall in FEV1 cut-off improves diagnostic specificity. Future population-based research evaluating the normative response to indirect bronchoprovocation in athletes remains a priority

Stormwater Harvesting and Reuse in Montgomery County Parks

Final project for ENSP400 (Fall 2017). University of Maryland, College Park.Stormwater management is a vital practice that allows urban areas to mitigate negative water quality impacts associated with urban development. The Montgomery County Department of Parks seeks to increase their reuse of stormwater as part of its commitment to furthering sustainability practices within the parks system and to minimize their impact on the environment. The project seeks to assist the Department of Parks by researching possible stormwater harvesting and filtration systems to implement in Cabin John Regional Park. This paper examines stormwater reuse for irrigation on Shirley Povich Field, a baseball field located northwest of the ice rink. The four objectives for this research project were as follows: (1) assess current stormwater flow and collection potential off of hardscape around Cabin John Regional Park, (2) analyze similar projects elsewhere to build the groundwork for developing a plan to harvest stormwater, (3) develop a generalized set of procedures that provide options for stormwater harvesting at different locations within Montgomery County Parks using the data gathered in in Objective 1, and (4) develop the most efficient and cost effective system to harvest and filter stormwater. This paper will provide suggestions on possible placement of a system, ways to store the collected stormwater, and other recommendations for components of a stormwater reuse system. The processes used to generate these plans for Cabin John are summarized in Appendix A so that they can be applied to other Montgomery County Parks locations. This project comprises a number of fields related to environmental science and policy, scientific analysis of water quality, biological and ecological studies, topography analysis of the terrain of the park, the mechanics of stormwater management structures, economic analysis, and research of applicable policies and permitting processes associated with implementing such projects. Based on the research findings, a rainwater collection and reuse system for irrigating Shirley Povich Field would not be a financially reasonable decision for Cabin John Regional Park due to the high upfront implementation costs, which include retrofitting required and a low return on investment. However, this type of system may be more cost effective at new parks where retrofitting would not be required. A more cost-effective way Cabin John Regional Park could reduce its water demand would be investing in a smart irrigation system with a soil moisture sensor that would reduce water use without the prohibitive retrofitting costs.Montgomery Count