Oneida nation of New York: health needs assessment 1990

This is the report of a health needs assessment for the Oneida Indian Nation of New York (ONNY). This needs assessment was conducted in order to collect population-based data related to behavioral risks and reproductive health for Oneida males and females. The survey of the Oneida was initiated because there is almost no risk factor data available on Indian tribes of the northeast, and none available for the Oneida Nation of New York. There are four primary goals for the 1990 Oneida Nation Health Needs Assessment. They are 1) to collect behavioral risk factor and reproductive health data for adult Oneida Nation members living on or near Oneida Nation lands, 2) to assess the current basic health needs of the ONNY, 3) to document the medical providers and hospitals which are currently being utilized by the Nation members and. 4) to develop recommendations for use by health planners from this baseline data.The Oneida Nation Health Needs Assessment (ONHNA) was carried out among enrolled members of the Oneida Nation who were 18 years of age and older who lived in the six counties that are contiguous to the Oneida Nation lands. The Nation Enrollment List was used to identify the Oneida population located in the six-county area. The choice to interview only adults was made to avoid legal difficulties in interviewing minors. Interviewing was conducted in each household face-to-face rather than using mailed questionnaires or telephone contact. All interviewers were enrolled Oneida Nation members. Interviews were conducted by interviewers of the same sex as the respondent. All interviewers participated in one week of training prior to the start of the field work. Four types of data were collected. First, the behavioral risk factors surveyed were related to the 10 leading causes of death in the United States. Behavioral factors include seat belt usage, physical exercise, diet, cigarette and smokeless tobacco usage, alcohol consumption, and the existence of high blood pressure. The second data set included health needs. The survey questions dealt with the prevalence of current diseases and health problems among the Oneidas, and with whether the Oneida people have routine screening tests such as cholesterol, diabetes, and hypertension, and eye exams, pap smears, breast exams, and rectal exams. The third set of data questions focused on reproductive health factors. Questions covered topics such as fertility, contraception, and general maternal-child health conditions. The fourth and final set of questions gathered data on health care utilization. This data will be used to establish health provider contracts with physicians, dentists, pediatricians, and hospitals to provide quality health care for a more reasonable cost. For each risk factor, comparisons were made between the Oneida Nation and data from the 1988 New York State Behavioral Risk Factor Survey.The individual completion rates were 54% for females and 69% for males for a total of 211 respondents in all. The following is an abbreviated summary of selected data from the survey. Seat belt use was only slightly lower than for all New Yorkers. Non-use was highest among young drivers. Sixty percent of Oneida males and 78 percent of Oneida females reported having their blood pressure taken within a year of the survey. All Oneida members were more active physically than the general New York population. However, all Oneida members were more likely to be overweight by comparison Forty percent of all Oneida people are smokers compared to 25 percent of the New York population. Fifty-seven percent of Oneida males and 32 percent of Oneida females are classified as acute and heavy drinkers. Percentages for regular health checks across all factors vary considerably among the Oneida people. Several areas of concern were identified including cholesterol checks, diabetes screening, rectal exams and mammograms. The completed fertility of the Oneida women in this survey is 2.1 children which is lower than that of all U.S. women surveyed in the 1980 census. Female sterilization is the most prevalent contraceptive method among Oneida women. as it is among the general U.S. population.With respect to behavioral risks, cigarette smoking and alcohol consumption are of major concern. This impacts on concerns for overall reproductive health. The task now is to identify the highest priority objectives and to secure resources needed to accomplish these tasks

Morphospecies and Taxonomic Species Comparison for Hymenoptera

The use of morphospecies as surrogates for taxonomic species has been proposed as an alternative to overcome the identification difficulties associated with many invertebrate studies, such as biodiversity surveys. Hymenoptera specimens were collected by beating and pitfall traps, and were separated into morphospecies by a non-specialist with no prior training, and later identified by an expert taxonomist. The number of Hymenoptera morphospecies and taxonomic species was 37 and 42, respectively, representing an underestimation error of 12%. Different families presented varying levels of difficulty, and although the species estimation provided by the use of morphospecies initially appeared to have a relatively minor error rate, this was actually an artefact. Splitting and lumping errors balanced each other out, wrongly suggesting that morphospecies were reasonable surrogates for taxonomic species in the Hymenoptera. The use of morphospecies should be adopted only for selected target groups, which have been assessed as reliable surrogates for taxonomic species beforehand, and some prior training to the non-specialist is likely to be of primary importance

The functional response of a generalist predator

Peer reviewedPublisher PD

Garden and landscape-scale correlates of moths of differing conservation status: significant effects of urbanization and habitat diversity

Moths are abundant and ubiquitous in vegetated terrestrial environments and are pollinators, important herbivores of wild plants, and food for birds, bats and rodents. In recent years, many once abundant and widespread species have shown sharp declines that have been cited by some as indicative of a widespread insect biodiversity crisis. Likely causes of these declines include agricultural intensification, light pollution, climate change, and urbanization; however, the real underlying cause(s) is still open to conjecture. We used data collected from the citizen science Garden Moth Scheme (GMS) to explore the spatial association between the abundance of 195 widespread British species of moth, and garden habitat and landscape features, to see if spatial habitat and landscape associations varied for species of differing conservation status. We found that associations with habitat and landscape composition were species-specific, but that there were consistent trends in species richness and total moth abundance. Gardens with more diverse and extensive microhabitats were associated with higher species richness and moth abundance; gardens near to the coast were associated with higher richness and moth abundance; and gardens in more urbanized locations were associated with lower species richness and moth abundance. The same trends were also found for species classified as increasing, declining and vulnerable under IUCN (World Conservation Union) criteria

Dispersing the Mists: An Experimental History of Medicine Study into the Quality of Volatile Inhalations

This document is the Accepted Manuscript version. The final publication is available from Mary Ann Liebert, Inc. Publishers at https://doi.org/10.1089/jamp.2016.1357.Background: Dr. Nelson's Improved Inhaler was first marketed with an advertisement in The Lancet in 1865. Revolutionary at the time for its ease of use and patient-friendliness, the inhaler is still in use for self-treatment by many all over the world. On the occasion of its 150th anniversary, this study reports an experimental historical medicine approach to identify evidence for the quality of vapor inhalers. Methods: Through accessing reviews of the device's use by the contemporary medical establishment, it was established that Dr. Nelson's Inhaler enjoyed a reputation of quality and efficacy among reputable physicians generating empirical evidence of clinical performance. There was a general absence of product performance tests during this period. Therefore, modern inhalation performance testing was applied to test the aerosol delivery performance for Friars' Balsam, and its key chemical constituent, benzoic acid (BA). Results: A respirable dose of 59.9 ± 9.0 μg of BA was aerosolized in a 10 minutes period from a dose of 3.3 mL Friars' Balsam (equivalent to 35.1 ± 0.2 mg of BA) in 375 mL of steaming water using the glass twin stage impinger at a flow rate of 60 L·min−1. The respirable dose from a standardized aqueous BA inhalation formulation increased from 115.9 ± 10.6 to 200.2 ± 19.9 μg by increasing the simulated inhalation period from 5 to 10 minutes. When tested with a simulated inhalation maneuver (500 mL tidal volume, 13 minutes−1 respiration rate, 1:2 inspiratory:expiratory ratio) a respirable dose of 112.8 ± 40.3 μg was produced. Conclusions: This work has highlighted the potential for aerosol drug delivery using steam inhalers that are popular with patients. Physicians should therefore be aware of the potential for lung dosing with irritants when patients self-medicate using the Nelson Inhaler with vaporizing formulations such as Friars' Balsam.Peer reviewedFinal Accepted Versio

The systematic guideline review: method, rationale, and test on chronic heart failure

Background: Evidence-based guidelines have the potential to improve healthcare. However, their de-novo-development requires substantial resources-especially for complex conditions, and adaptation may be biased by contextually influenced recommendations in source guidelines. In this paper we describe a new approach to guideline development-the systematic guideline review method (SGR), and its application in the development of an evidence-based guideline for family physicians on chronic heart failure (CHF). Methods: A systematic search for guidelines was carried out. Evidence-based guidelines on CHF management in adults in ambulatory care published in English or German between the years 2000 and 2004 were included. Guidelines on acute or right heart failure were excluded. Eligibility was assessed by two reviewers, methodological quality of selected guidelines was appraised using the AGREE instrument, and a framework of relevant clinical questions for diagnostics and treatment was derived. Data were extracted into evidence tables, systematically compared by means of a consistency analysis and synthesized in a preliminary draft. Most relevant primary sources were re-assessed to verify the cited evidence. Evidence and recommendations were summarized in a draft guideline. Results: Of 16 included guidelines five were of good quality. A total of 35 recommendations were systematically compared: 25/35 were consistent, 9/35 inconsistent, and 1/35 un-rateable (derived from a single guideline). Of the 25 consistencies, 14 were based on consensus, seven on evidence and four differed in grading. Major inconsistencies were found in 3/9 of the inconsistent recommendations. We re-evaluated the evidence for 17 recommendations (evidence-based, differing evidence levels and minor inconsistencies) - the majority was congruent. Incongruity was found where the stated evidence could not be verified in the cited primary sources, or where the evaluation in the source guidelines focused on treatment benefits and underestimated the risks. The draft guideline was completed in 8.5 man-months. The main limitation to this study was the lack of a second reviewer. Conclusion: The systematic guideline review including framework development, consistency analysis and validation is an effective, valid, and resource saving-approach to the development of evidence-based guidelines

Correlates of unintended pregnancy among currently pregnant married women in Nepal

<p>Abstract</p> <p>Background</p> <p>Women living in every country, irrespective of its development status, have been facing the problem of unintended pregnancy. Unintended pregnancy is an important public health issue in both developing and developed countries because of its negative association with the social and health outcomes for both mothers and children. This study aims to determine the prevalence and the factors influencing unintended pregnancy among currently pregnant married women in Nepal.</p> <p>Methods</p> <p>This paper reports on data drawn from Nepal Demographic and Health Survey (NDHS) which is a nationally representative survey. The analysis is restricted to currently pregnant married women at the time of survey. Association between unintended pregnancy and the explanatory variables was assessed in bivariate analysis using Chi-square tests. Logistic regression was used to assess the net effect of several independent variables on unintended pregnancy.</p> <p>Results</p> <p>More than two-fifth of the currently pregnant women (41%) reported that their current pregnancy was unintended. The results indicate that age of women, age at first marriage, ideal number of children, religion, exposure to radio and knowledge of family planning methods were key predictors of unintended pregnancy. Experience of unintended pregnancy augments with women's age (odds ratio, 1.11). Similarly, increase in the women's age at first marriage reduces the likelihood of unintended pregnancy (odds ratio, 0.93). Those who were exposed to the radio were less likely (odds ratio, 0.63) to have unintended pregnancy compared to those who were not. Furthermore, those women who had higher level of knowledge about family planning methods were less likely to experience unintended pregnancy (odds ratio, 0.60) compared to those having lower level of knowledge.</p> <p>Conclusion</p> <p>One of the important factors contributing to high level of maternal and infant mortality is unintended pregnancy. Programs should aim to reduce unintended pregnancy by focusing on all these identified factors so that infant and maternal mortality and morbidity as well as the need for abortion are decreased and the overall well-being of the family is maintained and enhanced.</p

Inhibition of HIV virus by neutralizing Vhh attached to dual functional liposomes encapsulating dapivirine

Although highly active antiretroviral therapy (HAART) has greatly improved the life expectancy of HIV/AIDS patients, the treatment is not curative. It is a global challenge which fosters an urgent need to develop an effective drug or neutralizing antibody delivery approach for the prevention and treatment of this disease. Due to the low density of envelope spikes with restricted mobility present on the surface of HIV virus, which limit the antibody potency and allow virus mutation and escape from the immune system, it is important for a neutralizing antibody to form bivalent or multivalent bonds with the virus. Liposome constructs could fulfil this need due to the flexible mobility of the membrane with its attached antibodies and the capacity for drug encapsulation. In this study, we evaluated the neutralization activity of a range of liposome formulations in different sizes coated with anti-gp120 llama antibody fragments (Vhhs) conjugated via either non-covalent metal chelation or a covalent linkage. The non-covalent construct demonstrated identical binding affinity to HIV-1 envelope glycoprotein gp120 and neutralizing ability for HIV virus as free Vhh. Although covalently linked Vhh showed significant binding affinity to gp120, it unexpectedly had a lower neutralization potency. This may be due to the comparability in size of the viral and liposome particles restricting the number which can be bound to the liposome surface so involving only a fraction of the antibodies, whereas non-covalently attached antibodies dissociate from the surface after acting with gp120 and free the remainder to bind further viruses. Covalently conjugated Vhh might also trigger the cellular uptake of a liposome-virion complex. To explore the possible ability of the antibody-coated liposomes to have a further function, we encapsulated the hydrophobic antiviral drug dapivirine into both of the non-covalently and covalently conjugated liposome formulations, both of which revealed high efficacy in reducing viral replication in vitro. Thus, dual function liposomes may lead to a novel strategy for the prophylaxis of HIV/AIDS by combining the neutralizing activity of Vhh with antiviral effects of high drug concentrations

Accounting fraud, business failure and creative auditing: A microanalysis of the strange case of the Sunbeam Corporation

This article closely examines the Sunbeam Corporation’s path to failure and explores the reasons for its singularity. From the analysis of US fraud cases included in the UCLA-LoPucki Bankruptcy Research Database, this corporate case appears as an outlier. For Sunbeam, the time-lapse between fraud disclosure and its final bankruptcy is the longest of the entire sample; it is unique because of its length. This article uses a historical microanalysis to evaluate different hypotheses about the Sunbeam Corporation’s path to failure. The relationships between acquisitions and fraud, ‘scapegoat dynamics’ and ‘creative auditing’ are identified as the most relevant issues to be examined against a changing institutional context. The resulting reconstruction of the events provides unexpected insights and recommendations for future research on auditing and accounting fraud

Serine residue 115 of MAPK-activated protein kinase MK5 is crucial for its PKA-regulated nuclear export and biological function

The mitogen-activated protein kinase-activated protein kinase-5 (MK5) resides predominantly in the nucleus of resting cells, but p38MAPK, extracellular signal-regulated kinases-3 and -4 (ERK3 and ERK4), and protein kinase A (PKA) induce nucleocytoplasmic redistribution of MK5. The mechanism by which PKA causes nuclear export remains unsolved. In the study reported here we demonstrated that Ser-115 is an in vitro PKA phosphoacceptor site, and that PKA, but not p38MAPK, ERK3 or ERK4, is unable to redistribute MK5 S115A to the cytoplasm. However, the phosphomimicking MK5 S115D mutant resides in the cytoplasm in untreated cells. While p38MAPK, ERK3 and ERK4 fail to trigger nuclear export of the kinase dead T182A and K51E MK5 mutants, S115D/T182A and K51E/S115D mutants were able to enter the cytoplasm of resting cells. Finally, we demonstrated that mutations in Ser-115 affect the biological properties of MK5. Taken together, our results suggest that Ser-115 plays an essential role in PKA-regulated nuclear export of MK5, and that it also may regulate the biological functions of MK5