Attitudes Toward Informational Health Videos among People with Intellectual Disabilities

An intellectual disability (ID) can be defined as a limit to a person\u27s ability to learn and function in daily life when compared to an expected level. Due to these differences, a person with ID can face more challenges in daily life, including those that impact their health. Special Olympics Vermont (SOVT) is an organization that hosts athletic events and competitions for people with an ID. We worked with them to formulate a plan for providing educational resources for people with an ID. We created educational videos with corresponding one-page pamphlets containing material and imagery that was relatable to the athletes with ID, to inspire positive changes in their health habits. We hypothesized that if content and material relatable to SOVT athletes were incorporated into health education videos, then athletes would learn more about healthy habits that they could apply to their lives. We created surveys that evaluated the reception of the educational videos, whether athletes learned from the videos, and if they planned on incorporating what they learned into their lives.https://scholarworks.uvm.edu/comphp_gallery/1316/thumbnail.jp

Inclusion of bedrock vadose zone in dynamic global vegetation models is key for simulating vegetation structure and function

Across many upland environments, soils are thin and plant roots extend into fractured and weathered bedrock where moisture and nutrients can be obtained. Root water extraction from unsaturated weathered bedrock is widespread and, in many environments, can explain gradients in vegetation community composition, transpiration, and plant sensitivity to climate. Despite increasing recognition of its importance, the “rock moisture” reservoir is rarely incorporated into vegetation and Earth system models. Here, we address this weakness in a widely used dynamic global vegetation model (DGVM; LPJ-GUESS). First, we use a water flux-tracking deficit approach to more accurately parameterize plant-accessible water storage capacity across the contiguous United States, which critically includes the water in bedrock below depths typically prescribed by soil databases. Secondly, we exploit field-based knowledge of contrasting plant-available water storage capacity in weathered bedrock across two bedrock types in the Northern California Coast Ranges as a detailed case study. For the case study in Northern California, climate and soil water storage capacity are similar at the two study areas, but the site with thick weathered bedrock and ample rock moisture supports a temperate mixed broadleaf–needleleaf evergreen forest, whereas the site with thin weathered bedrock and limited rock moisture supports an oak savanna. The distinct biomes, seasonality and magnitude of transpiration and primary productivity, and baseflow magnitudes only emerge from the DGVM when a new and simple subsurface storage structure and hydrology scheme is parameterized with storage capacities extending beyond the soil into the bedrock. Across the contiguous United States, the updated hydrology and subsurface storage improve annual evapotranspiration estimates as compared to satellite-derived products, particularly in seasonally dry regions. Specifically, the updated hydrology and subsurface storage allow for enhanced evapotranspiration through the dry season that better matches actual evapotranspiration patterns. While we made changes to both the subsurface water storage capacity and the hydrology, the most important impacts on model performance derive from changes to the subsurface water storage capacity. Our findings highlight the importance of rock moisture in explaining and predicting vegetation structure and function, particularly in seasonally dry climates. These findings motivate efforts to better incorporate the rock moisture reservoir into vegetation, climate, and landscape evolution models.</p

Case Report Anti-Yo Mediated Paraneoplastic Cerebellar Degeneration Associated with Pseudobulbar Affect in a Patient with Breast Cancer

Paraneoplastic cerebellar degeneration (PCD) is a rare anti-Yo mediated paraneoplastic syndromes rarely that is infrequently associated with breast cancer. We present a case of a 52-year-old female presenting with diplopia, gait instability, dysarthria, dysphagia, nystagmus, and, most notably, new onset paroxysmal episodes of uncontrollable crying concerning for pseudobulbar affect (PBA). Serologic testing showed anti-Yo antibodies. The patient was found to have stage IIIA breast cancer as the inciting cause of the paraneoplastic syndrome. The patient was treated with neoadjuvant chemotherapy, modified radical mastectomy, adjuvant Herceptin, and pertuzumab. She was given IVIG for paraneoplastic syndrome, antidepressants, and dextromethorphan-quinidine (Nuedexta), the first FDA-approved therapy for PBA. With multimodality therapy, she demonstrated significant improvement in neurologic and mood symptoms associated with PCD and PBA

Synthesis, characterization, and water oxidation by a molecular chromophore-catalyst assembly prepared by atomic layer deposition. The “mummy” strategy

A Ru( ii )-polypyridyl chromophore-catalyst assembly for light-assisted water oxidation is constructed using atomic layer deposition with no covalent bonds between molecules required for bilayer formation

The neurogenic bladder: medical treatment

Neurogenic bladder sphincter dysfunction (NBSD) can cause severe and irreversible renal damage and bladder-wall destruction years before incontinence becomes an issue. Therefore, the first step in adequate management is to recognize early the bladder at risk for upper- and lower-tract deterioration and to start adequate medical treatment proactively. Clean intermittent catheterization combined with anticholinergics (oral or intravesical) is the standard therapy for NBSD. Early institution of such treatment can prevent both renal damage and secondary bladder-wall changes, thereby potentially improving long-term outcomes. In children with severe side effects or with insufficient suppression of detrusor overactivity despite maximal dosage of oral oxybutynin, intravesical instillation is an effective alternative. Intravesical instillation eliminates systemic side effects by reducing the first-pass metabolism and, compared with oral oxybutynin, intravesical oxybutynin is a more potent and long-acting detrusor suppressor. There is growing evidence that with early adequate treatment, kidneys are saved and normal bladder growth can be achieved in children so they will no longer need surgical bladder augmentation to achieve safe urinary continence in adolescence and adulthood

Health Economic Consequences Associated With COVID-19–Related Delay in Melanoma Diagnosis in Europe

Importance: The COVID-19 pandemic resulted in delayed access to medical care. Restrictions to health care specialists, staff shortages, and fear of SARS-CoV-2 infection led to interruptions in routine care, such as early melanoma detection; however, premature mortality and economic burden associated with this postponement have not been studied yet. Objective: To determine the premature mortality and economic costs associated with suspended melanoma screenings during COVID-19 pandemic lockdowns by estimating the total burden of delayed melanoma diagnoses for Europe. Design, Setting, and Participants: This multicenter economic evaluation used population-based data from patients aged at least 18 years with invasive primary cutaneous melanomas stages I to IV according to the American Joint Committee on Cancer (AJCC) seventh and eighth editions, including melanomas of unknown primary (T0). Data were collected from January 2017 to December 2021 in Switzerland and from January 2019 to December 2021 in Hungary. Data were used to develop an estimation of melanoma upstaging rates in AJCC stages, which was verified with peripandemic data. Years of life lost (YLL) were calculated and were, together with cost data, used for financial estimations. The total financial burden was assessed through direct and indirect treatment costs. Models were building using data from 50 072 patients aged 18 years and older with invasive primary cutaneous melanomas stages I to IV according to the AJCC seventh and eighth edition, including melanomas of unknown primary (T0) from 2 European tertiary centers. Data from European cancer registries included patient-based direct and indirect cost data, country-level economic indicators, melanoma incidence, and population rates per country. Data were analyzed from July 2021 to September 2022. Exposure: COVID-19 lockdown-related delay of melanoma detection and consecutive public health and economic burden. As lockdown restrictions varied by country, lockdown scenario was defined as elimination of routine medical examinations and severely restricted access to follow-up examinations for at least 4 weeks. Main Outcomes and Measures: Primary outcomes were the total burden of a delay in melanoma diagnosis during COVID-19 lockdown periods, measured using the direct (in US$) and indirect (calculated as YLL plus years lost due to disability [YLD] and disability-adjusted life-years [DALYs]) costs for Europe. Secondary outcomes included estimation of upstaging rate, estimated YLD, YLL, and DALY for each European country, absolute direct and indirect treatment costs per European country, proportion of the relative direct and indirect treatment costs for the countries, and European health expenditure. Results: There were an estimated 111 464 (range, 52 454-295 051) YLL due to pandemic-associated delay in melanoma diagnosis in Europe, and estimated total additional costs were$7.65 (range, $3.60 to$20.25) billion. Indirect treatment costs were the main cost driver, accounting for 94.5% of total costs. Estimates for YLD in Europe resulted in 15 360 years for the 17% upstaging model, ranging from 7228 years (8% upstaging model) to 40 660 years (45% upstaging model). Together, YLL and YLD constitute the overall disease burden, ranging from 59 682 DALYs (8% upstaging model) to 335 711 DALYs (45% upstaging model), with 126 824 DALYs for the real-world 17% scenario. Conclusions and Relevance: This economic analysis emphasizes the importance of continuing secondary skin cancer prevention measures during pandemics. Beyond the personal outcomes of a delayed melanoma diagnosis, the additional economic and public health consequences are underscored, emphasizing the need to include indirect economic costs in future decision-making processes. These estimates on DALYs and the associated financial losses complement previous studies highlighting the cost-effectiveness of screening for melanoma

LA DETERMINACIÓN DEL “ELEMENTO HISTÓRICO Y MORAL” DEL VALOR DE LA FUERZA DE TRABAJO

El objetivo de este artículo es discutir la interpretación marxista dominante respecto del significado de lo que Marx llamó el “elemento histórico y moral” del valor de la fuerza de trabajo y ofrecer una lectura alternativa que sea consistente con los fundamentos de la crítica marxiana de la economía política. Para tal fin, en la primera parte del artículo, se realiza una crítica de dicha interpretación basada en el reconocimiento de su génesis histórica y su filiación con la base textual y fundamentos de la crítica marxiana de la economía política. En la segunda parte, se realiza una reconstrucción crítica del legado de Marx respecto a la determinación del valor de la fuerza de trabajo y se presenta una resignificación del elemento histórico y moral en cuestión. A DETERMINAÇÃO DO “ELEMENTO HISTÓRICO E MORAL” DO VALOR DA FORÇA DE TRABALHOO objetivo deste artigo é discutir a interpretação marxista dominante sobre o significado do que Marx chamou de “elemento histórico e moral” do valor da força de trabalho e oferecer uma leitura alternativa atrelada aos fundamentos da crítica marxiana da economia política. Para tanto, na primeira parte do artigo, realizamos uma crítica da interpretação acima citada, baseada no reconhecimento de sua gênese histórica e sua filiação com a base textual e com os fundamentos da crítica marxiana da economia política. Na segunda parte, realizamos uma reconstrução crítica do legado de Marx quanto à determinação do valor da força de trabalho e apresentamos uma ressignificação do elemento histórico e moral em questão.Palavras-chave: Elemento histórico e moral. Valor da força de trabalho. Debates marxistas. Teoria marxista do salário.THE DETERMINATION OF THE “HISTORIC AND MORAL ELEMENT” OF THE VALUE OF LABOUR POWERThe aim of this article is to challenge the prevailing Marxist interpretation of what Marx called the “historical and moral component” of the value of labour-power, and to offer an alternative reading which is consistent with the foundations of the critique of political economy. In order to do so, the first part of the article develops a critique of the aforementioned Marxist view, on the basis of a reconstruction of its historical genesis, its support on textual evidence from Marx’s works and its theoretical consistency with the foundations of the critique of political economy. Subsequently, the second part of the article undertakes a critical reconstruction of Marx’s legacy on the determination of the value of labour-power and proposes a reconsideration of the meaning of its socalled “historical and moral” component.Keywords: Historical and moral element. Value of labour-power. Marxist debates. Marx’s theory of wages.LA DÉTERMINATION DE L “ÉLÉMENT HISTORIQUE ET MORAL” DE LA VALEUR DE LA FORCE DE TRAVAILL’objectif de cet article est de discuter de l’interprétation marxiste dominante de ce que Marx appelait “l’élément historique et moral” de la valeur de la force de travail et d’offrir une lecture alternative liée aux fondements de la critique marxienne de l’économie politique. Pour ce faire, dans la première partie de l’article nous critiquons l’interprétation susmentionnée, fondée sur la reconnaissance de sa genèse historique et son affiliation à la base textuelle et aux fondements de la critique marxienne de l’économie politique. Dans la deuxième partie, nous effectuons une reconstruction critique de l’héritage de Marx concernant la détermination de la valeur de la force de travail et nous y présentons une nouvelle signification de l’élément historique et moral en question.Mots-clés: Elément historique et moral. Valeur de la force de travail. Débats marxistes. Théorie marxiste du salaire

Mechanisms of urethral continence and their clinical application

Controversy about the basic nature of urethral function does not preclude accurate clinical assessment of disorders of function. While the precise method of treatment of urethral continence dysfunction varies from institution to institution, the basic techniques are quite similar. It is the application of a treatment method to a particular case which causes difficulty. It is important, therefore, to have some understanding of the functional elements in the urethral continence mechanism to be able to determine which element does not function. Most cases of intractable incontinence are associated with poor function of the involuntary part of the sphincter. In general, peak urethral closing pressures are unrelated to continence function unless there is no pressure at all.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/47059/1/345_2004_Article_BF00326702.pd