Medical students’ use of caffeine for ‘academic purposes’ and their knowledge of its benefits, side-effects and withdrawal symptoms

Background: Caffeine is often used for its benefits, which include increased vigilance. It does have side-effects, however, such as palpitations andwithdrawal symptoms that include headaches and drowsiness. Tertiary education often requires students to study for extended hours, especiallyduring periods of increased workload prior to tests and examinations. Medical students, who have to master a very large volume of academic work ina limited period of time, are no exception. This cross-sectional study investigated caffeine use for ‘academic purposes’ by first- to third-year medicalstudents at the University of the Free State in 2006, and their knowledge of its benefits, side-effects and withdrawal symptoms.Methods: Data were collected by means of an anonymous, self-administered questionnaire that was completed by students during formal classtime, arranged in advance with the relevant lecturers. Questionnaires were available in Afrikaans and English. A pilot study was conducted on20 physiotherapy students to test the questionnaire. Chi-squared and Kruskall-Wallis tests were used to compare categorical and numerical variables,respectively. Ethical approval to perform the investigation was granted by the Ethics Committee of the Faculty of Health Sciences, University of theFree State.Results: A 90.5% (360/389) response rate was obtained. Ninety-four per cent of participants used caffeine, with academic purposes (62.6%) amongthe three most frequent reasons given for its consumption. Other reasons included social consumption (70%) and preference for the taste (72.4%).Coffee (88.2%) was the most commonly consumed caffeinated product among these students, followed by energy mixtures and tablets (37.9%),and soft drinks (36%). Third-year students were the heaviest consumers of coffee for academic purposes. An increase in caffeine consumptionfor academic purpose was directly related to progression from first- to third- year of the medical course. The average scores for questions on thebenefits, side-effects and withdrawal symptoms were all below 1.5 out of 5. Misconceptions about caffeine were also identified. With regard to thebenefits of caffeine, the most commonly cited misconception was that it could be used as a substitute for sleep (26.7% of respondents). The mostcommon misconception regarding its side-effects was that it caused hot flushes (21.9%), while aggression (27.2%) was cited as the most commonmisconception regarding caffeine withdrawal.Conclusions: The high percentage of caffeine usage and low scores in the caffeine knowledge test indicated that most participants were usingcaffeine without having sufficient knowledge of its benefits, side-effects and withdrawal symptoms. It is recommended that awareness programmeson the side-effects and symptoms of caffeine withdrawal should be implemented by the student health and counselling facilities on campus. Thedisplay of posters in strategic venues and distribution of pamphlets could assist in the dissemination of information on this extensively consumedsubstance

Reclaiming professional identity through postgraduate professional development: Career practitioners reclaiming their professional selves

Careers advisers in the UK have experienced significant change and upheaval within their professional practice. This research explores the role of postgraduate level professional development in contributing to professional identity. The research utilises a case study approach and adopts multiple tools to provide an in-depth examination of practitioners’ perceptions of themselves as professionals within their lived world experience. It presents a group of practitioners struggling to define themselves as professionals due to changing occupational nomenclature resulting from shifting government policy. Postgraduate professional development generated a perceived enhancement in professional identity through exposure to theory, policy and opportunities for reflection, thus contributing to more confident and empowered practitioners. Engagement with study facilitated development of confident, empowered practitioners with a strengthened sense of professional self

Computational Cancer Biology: An Evolutionary Perspective

ISSN:1553-734XISSN:1553-735

Drug problems among homeless individuals in Toronto, Canada: prevalence, drugs of choice, and relation to health status

<p>Abstract</p> <p>Background</p> <p>Drug use is believed to be an important factor contributing to the poor health and increased mortality risk that has been widely observed among homeless individuals. The objective of this study was to determine the prevalence and characteristics of drug use among a representative sample of homeless individuals and to examine the association between drug problems and physical and mental health status.</p> <p>Methods</p> <p>Recruitment of 603 single men, 304 single women, and 284 adults with dependent children occurred at homeless shelters and meal programs in Toronto, Canada. Information was collected on demographic characteristics and patterns of drug use. The Addiction Severity Index was used to assess whether participants suffered from drug problems. Associations of drug problems with physical and mental health status (measured by the SF-12 scale) were examined using regression analyses.</p> <p>Results</p> <p>Forty percent of the study sample had drug problems in the last 30 days. These individuals were more likely to be single men and less educated than those without drug problems. They were also more likely to have become homeless at a younger age (mean 24.8 vs. 30.9 years) and for a longer duration (mean 4.8 vs. 2.9 years). Marijuana and cocaine were the most frequently used drugs in the past two years (40% and 27%, respectively). Drug problems within the last 30 days were associated with significantly poorer mental health status (-4.9 points, 95% CI -6.5 to -3.2) but not with poorer physical health status (-0.03 points, 95% CI -1.3 to 1.3)).</p> <p>Conclusions</p> <p>Drug use is common among homeless individuals in Toronto. Current drug problems are associated with poorer mental health status but not with poorer physical health status.</p

Structure and origin of the J Anomaly Ridge, western North Atlantic Ocean

Author Posting. © American Geophysical Union, 1982. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Journal of Geophysical Research 87, no. B11 (1982): 9389–9407, doi:10.1029/JB087iB11p09389.The J Anomaly Ridge is a structural ridge or step in oceanic basement that extends southwest from the eastern end of the Grand Banks. It lies beneath the J magnetic anomaly at the young end (M-4 to M-0) of the M series magnetic anomalies. Its structural counterpart beneath the J anomaly in the eastern Atlantic is the Madeira-Tore Rise, but this feature has been overprinted by post-middle Cretaceous deformation and volcanism. In order to study the origin and evolution of the J Anomaly Ridge-Madeira-Tore Rise system, we obtained seismic refraction and multichannel reflection profiles across the J Anomaly Ridge near 39°N latitude. The western ridge flank consists of a series of crustal blocks downdropped along west-dipping normal faults, but the eastern slope to younger crust is gentle and relatively unfaulted. The western flank also is subparallel to seafloor isochrons, becoming younger to the south. Anomalously smooth basement caps the ridge crest, and it locally exhibits internal, eastward-dipping reflectors similar in configuration to those within subaerially emplaced basalt flows on Iceland. When isostatically corrected for sediment load, the northern part of the J Anomaly Ridge has basement depths about 1400 m shallower than in our study area, and deep sea drilling has shown that the northern ridge was subaerially exposed during the middle Cretaceous. We suggest that most of the system originated under subaerial conditions at the time of late-stage rifting between the adjacent Grand Banks and Iberia. The excess magma required to form the ridge may have been vented from a mantle plume beneath the Grand Banks-Iberia rift zone and channelled southward beneath the rift axis of the abutting Mid-Atlantic Ridge. Resulting edifice-building volcanism constructed the ridge system between anomalies M-4 and M-0, moving southward along the ridge axis at about 50 mm/yr. About M-0 time, when true drift began between Iberia and the Grand Banks, this southward venting rapidly declined. The results were rapid return of the spreading axis to normal elevations, division of the ridge system into the separate J Anomaly Ridge and Madeira-Tore Rise, and unusually fast subsidence of at least parts of these ridges to depths that presently are near normal. This proposed origin and evolutionary sequence for the J Anomaly Ridge-Madeira-Tore Rise system closely matches events of uplift and unconformity development on the adjacent Grand Banks.This research was supported by the Office of Naval Research, contracts N00014-75-C-0210 and N00014-80-C-0098 to Lamont-Doherty Geological Observatory and contract N00014-79-C-0071 to Woods Hole Oceanographic Institution

Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015

SummaryBackground The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 provides an up-to-date synthesis of the evidence for risk factor exposure and the attributable burden of disease. By providing national and subnational assessments spanning the past 25 years, this study can inform debates on the importance of addressing risks in context. Methods We used the comparative risk assessment framework developed for previous iterations of the Global Burden of Disease Study to estimate attributable deaths, disability-adjusted life-years (DALYs), and trends in exposure by age group, sex, year, and geography for 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2015. This study included 388 risk-outcome pairs that met World Cancer Research Fund-defined criteria for convincing or probable evidence. We extracted relative risk and exposure estimates from randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. We developed a metric that allows comparisons of exposure across risk factors—the summary exposure value. Using the counterfactual scenario of theoretical minimum risk level, we estimated the portion of deaths and DALYs that could be attributed to a given risk. We decomposed trends in attributable burden into contributions from population growth, population age structure, risk exposure, and risk-deleted cause-specific DALY rates. We characterised risk exposure in relation to a Socio-demographic Index (SDI). Findings Between 1990 and 2015, global exposure to unsafe sanitation, household air pollution, childhood underweight, childhood stunting, and smoking each decreased by more than 25%. Global exposure for several occupational risks, high body-mass index (BMI), and drug use increased by more than 25% over the same period. All risks jointly evaluated in 2015 accounted for 57·8% (95% CI 56·6–58·8) of global deaths and 41·2% (39·8–42·8) of DALYs. In 2015, the ten largest contributors to global DALYs among Level 3 risks were high systolic blood pressure (211·8 million [192·7 million to 231·1 million] global DALYs), smoking (148·6 million [134·2 million to 163·1 million]), high fasting plasma glucose (143·1 million [125·1 million to 163·5 million]), high BMI (120·1 million [83·8 million to 158·4 million]), childhood undernutrition (113·3 million [103·9 million to 123·4 million]), ambient particulate matter (103·1 million [90·8 million to 115·1 million]), high total cholesterol (88·7 million [74·6 million to 105·7 million]), household air pollution (85·6 million [66·7 million to 106·1 million]), alcohol use (85·0 million [77·2 million to 93·0 million]), and diets high in sodium (83·0 million [49·3 million to 127·5 million]). From 1990 to 2015, attributable DALYs declined for micronutrient deficiencies, childhood undernutrition, unsafe sanitation and water, and household air pollution; reductions in risk-deleted DALY rates rather than reductions in exposure drove these declines. Rising exposure contributed to notable increases in attributable DALYs from high BMI, high fasting plasma glucose, occupational carcinogens, and drug use. Environmental risks and childhood undernutrition declined steadily with SDI; low physical activity, high BMI, and high fasting plasma glucose increased with SDI. In 119 countries, metabolic risks, such as high BMI and fasting plasma glucose, contributed the most attributable DALYs in 2015. Regionally, smoking still ranked among the leading five risk factors for attributable DALYs in 109 countries; childhood underweight and unsafe sex remained primary drivers of early death and disability in much of sub-Saharan Africa. Interpretation Declines in some key environmental risks have contributed to declines in critical infectious diseases. Some risks appear to be invariant to SDI. Increasing risks, including high BMI, high fasting plasma glucose, drug use, and some occupational exposures, contribute to rising burden from some conditions, but also provide opportunities for intervention. Some highly preventable risks, such as smoking, remain major causes of attributable DALYs, even as exposure is declining. Public policy makers need to pay attention to the risks that are increasingly major contributors to global burden. Funding Bill & Melinda Gates Foundation

The Evolution of Compact Binary Star Systems

We review the formation and evolution of compact binary stars consisting of white dwarfs (WDs), neutron stars (NSs), and black holes (BHs). Binary NSs and BHs are thought to be the primary astrophysical sources of gravitational waves (GWs) within the frequency band of ground-based detectors, while compact binaries of WDs are important sources of GWs at lower frequencies to be covered by space interferometers (LISA). Major uncertainties in the current understanding of properties of NSs and BHs most relevant to the GW studies are discussed, including the treatment of the natal kicks which compact stellar remnants acquire during the core collapse of massive stars and the common envelope phase of binary evolution. We discuss the coalescence rates of binary NSs and BHs and prospects for their detections, the formation and evolution of binary WDs and their observational manifestations. Special attention is given to AM CVn-stars -- compact binaries in which the Roche lobe is filled by another WD or a low-mass partially degenerate helium-star, as these stars are thought to be the best LISA verification binary GW sources.Comment: 105 pages, 18 figure

Observing interactions between children and adolescents and their parents: the effects of anxiety disorder and age

Parental behaviors, most notably overcontrol, lack of warmth and expressed anxiety, have been implicated in models of the development and maintenance of anxiety disorders in children and young people. Theories of normative development have proposed that different parental responses are required to support emotional development in childhood and adolescence, yet age has not typically been taken into account in studies of parenting and anxiety disorders. In order to identify whether associations between anxiety disorder status and parenting differ in children and adolescents, we compared observed behaviors of parents of children (7–10 years) and adolescents (13–16 years) with and without anxiety disorders (n=120), while they undertook a series of mildly anxiety-provoking tasks. Parents of adolescents showed significantly lower levels of expressed anxiety, intrusiveness and warm engagement than parents of children. Furthermore, offspring age moderated the association between anxiety disorder status and parenting behaviors. Specifically, parents of adolescents with anxiety disorders showed higher intrusiveness and lower warm engagement than parents of non-anxious adolescents. A similar relationship between these parenting behaviors and anxiety disorder status was not observed among parents of children. The findings suggest that theoretical accounts of the role of parental behaviors in anxiety disorders in children and adolescents should distinguish between these different developmental periods. Further experimental research to establish causality, however, would be required before committing additional resources to targeting parenting factors within treatment