Corticotropin-releasing factor and acute post-operative gut function in truamatic abdominal injury and elective abdominal surgery

Includes abstract.Includes bibliographical references (leaves 108-128).Shocked trauma patients in the Intensive Care Unit undergo a powerful, neuro-endocrine stress response driven by cytokine release and the hypothalamic-pituitary-adrenal axis. The response is activated under stress by corticotropin-releasing factor (CRF), the well-known 41 amino acid peptide neuro-hormone. Evidence from animal and human studies suggests that peripheral CRF is present in the gastrointestinal tract and associated with inflammatory changes. Critically ill patients frequently display somewhat unexplained gastrointestinal dysfunction including delayed gastric emptying, ileus and increased bowel permeability. The aim of the study was to investigate the role of CRF in critically ill adults with traumatic abdominal injury compared with elective surgical patients, and describe any association of CRF levels with alterations in acute post-operative gastrointestinal function. Eight patients with haemorrhagic shock following penetrating abdominal injury and seventeen patients undergoing elective surgery for hepato-biliary disease were studied for serial plasma and intestinal tissue CRF levels using radio-immunoassay. A RT-PCR technique was used to detect mRNA for CRF in intestinal tissue. Light microscopy was used to determine the quantity and distribution of mast cells in intestinal tissue. Post-operative gastric emptying was assessed using the paracetamol absorption test and intestinal permeability by measuring urinary lactulose:mannitol ratios following a bolus of these sugars. The study was approved by University of Cape Town Human Research Ethics Committee. Informed consent (retrospectively in the case of the trauma patients), was obtained from all subjects

Polyp Detection During Colonoscopy Among Uninsured Patients In South Carolina

Little information is known on what demographic, behavioral, and procedural factors influence the number of polyps found during a colonoscopy screening for colorectal cancer (CRC). The main objective of this study is to describe the polyp detection rate (PDR), number of polyps removed, and predictors of polyp count overall and for high-risk polyps among uninsured patients undergoing colonoscopy in the Colorectal Cancer Prevention Network (CCPN) program of South Carolina. We performed a secondary data analysis on CCPN data for colonoscopies performed between May 2014 and May 2017. We assessed the association of polyp count with the following variables: age, race, gender, smoking status, alcohol use, BMI, family history of CRC, education status, NSAID use, physical activity, rural/urban residence, bowel preparation quality, and time of procedure. We hypothesized that since these variables have been shown to influence the risk of colonic polyps they will also influence the number of all polyps and number of high-risk polyps detected during colonoscopy. Total PDR within this study was 61.82%. Respective mean, median, and max number of polyps removed were 1.65, 1.00, and 15 for all polyps and 0.31, 0, and 13 for high-risk polyps. Multivariable analyses found male gender, current and former smokers, moderate alcohol use, family history of CRC, obesity, and never using NSAIDS to be positively associated with total number of polyps detected; rural residence was negatively associated with number of total polyps. Males, current smokers, and using NSAIDS 1-3 days/week, occasionally, or never were found to have a higher number of high-risk polyps. A later procedure time resulted in a lower number of high-risk polyps than the earliest procedure times. This study demonstrates the effects that demographic, behavioral, and procedural influencers have on polyp detection and the number of polyps detected during a colonoscopy procedure. Based on these relationships, our findings may help to identify individuals who are at risk for a high number of polyps, which could possibly lead to better detection of polyps during their colonoscopy procedure

“Inspiring Imps”: programme evaluation of a football intervention targeting mentally ill health services users through a professional football club

The Active People survey (2010) shows that only 6.5% of disabled individuals participate in sport and exercise 3 times per week, compared with 16.5% of able bodied adults in the UK. Individuals with recognised disabilities have long been excluded from mainstream society. Particularly in sport, disability athletes can be afforded minority status and are treated as such (Nixon, 2000: In Handbook of Sports Studies, edited by J. Coakley and E. Dunning. London: Sage). This stigmatisation can be particularly acute among participants with diagnosed mental or psychological disabilities. Previous research concluded that sport can have positive psychological and social benefits, including improved well-being, motivation and social confidence (Crone and Guy, 2008: International Journal of Mental Health Nursing. 17, 197-207.). The aim of the present study was to investigate the feasibility of a 6 week exercise programme targeting mental ill health service users aged 16+. A weekly 2 hour session of football was introduced to promote health and wellbeing in the target group. Partners included county Football Association and a professional football club. The project enhanced local partnerships and partnerships with other professional football clubs. The key remaining aim is to ensure a sustainable “legacy” is achieved to ensure the continuation delivery of the project. The feasibility of the present study will be assessed using programme evaluation. Programme evaluation uses programme theory to produce a structured framework for assessment of the project (Rossi et al 2004; Evaluation: A systematic Approach. London, Sage). This allows a clear and logical progression from planning to implementation. Participant attrition rates and attendance records will be collected. These data will be supplemented with semi-structured interviews with participants and project stakeholders to assess programme development. The expected overall project outcome is to produce shared learning practice on similar interventions nationwide

A critical evaluation of the extent to which the reform and modernisation agenda has impacted on the professionalisation of social work in England

The last twenty-five years have seen an erosion of the public sector with whole industries being sold off and made into private companies. Even those roles that have remained in the public sector have undergone enormous change, with the importation of ideas and practices formally associated with businesses. Reforms have led to cost-cutting and an increase in managerialism. This paper sets out what is meant by a profession and then explores whether the reform and modernisation agenda has enhanced the profession of social work or whether it has been to the detriment. It is asserted that social workers have seen a reduction in their ability to act independently and that professional knowledge has therefore been eroded. The tensions between these changes and social work values are discussed. The author posits that the reforms have not contributed to service user's life opportunities. It is concluded that that, alongside the manageralism agenda, social work's poor media profile and the fact that many social workers do not want to be considered professionals has contributed to the continued lack of professional standing. Initiatives that may help with improving the profile of the social work profession and outcomes for service users are discussed—although it is noted that the current government's commitment to these aims appears limited

Debunking the Myth of ‘Super Bowl Sex Trafficking’: Media hype or evidenced-based coverage

A large body of scholarship has described the narrow set of media narratives used to report trafficking for sexual exploitation to the public. This article examines US media coverage of human trafficking in relation to the Super Bowl, American football’s championship game. Available empirical evidence does not suggest that major sporting events cause trafficking for sexual exploitation. Yet, we find that 76 per cent of US print media from 2010 to 2016 propagated the ‘Super Bowl sex trafficking’ narrative. Local coverage of the 2018 Super Bowl in Minneapolis, Minnesota, was different, presenting a sceptical stance toward this narrative. The article describes how this substantial shift resulted from our research group and anti-trafficking stakeholders employing an action research approach to craft a Super Bowl communication strategy that aligned with empirical evidence. Although sensationalist narratives are difficult to dislodge, the Minnesota case shows that evidence on trafficking can be effectively used to inform media and impact public perceptions, when researchers work with stakeholders on the ground. Lessons learnt are shared to enable others to replicate these results

Arwa: An Inspiring Story for Landmine Survivors

In 1999, Arwa Ali Saeed Wais was herding sheep in Al-Atabat village in the Morais district of Al-Dhale’e governorate, Yemen. As was the tradition in Arwa’s village, she spent much of her childhood caring for her family’s sheep in the nearby mountainous area instead of attending school. When she was 10 years old, she stepped on a landmine. Her right leg was immediately torn off, and her left leg was severely damaged. She was sent to Ibn Khaldon Hospital in Lahj governorate, where she underwent an above-the-knee bilateral amputation. After she was discharged from the hospital, she returned home to her village, where she contracted an infection in her right leg and was sent to Al-Jemhori Hospital in Aden governorate for additional surgery

Lack of evidence for decreased protein stability in the 2397 (Met) haplotype of the leucine rich repeat kinase 2 protein implicated in Parkinson’s disease

Missense mutations in the leucine rich repeat kinase 2 (LRRK2) gene are the leading genetic cause of autosomal dominant familial Parkinson’s disease. We previously reported that two mutations within the ROC domain, namely R1441C and A1442P, exhibit increased protein degradation leading to lowered steady state LRRK2 protein levels in HEK293 cells. More recently, the common WD40 domain LRRK2 haplotype, Met2397, which is a risk factor for Crohn’s disease, has been shown to lower steady state protein levels in HEK293 cells. In view of recent evidence implicating LRRK2 and inflame-mation in PD, we investigated the effects of Met2397 on LRRK2 expression, and compared them to the Thr2397 variant and other LRRK2 mutants. In this study, we transfected HEK293 cells with plasmid constructs encoding the different LRRK2 variants, and analyzed the resulting protein levels by Western blot and flow cytometry. Here we found that both the Met2397 and Thr2397 haplotypes yield similar levels of LRRK2 protein expression and do not appear to impact cell viability in HEK293 cells, compared to other LRRK mutants. Thus, we have concluded that the Met2397 haplotype is unlikely to play a role in LRRK2 mediated or idiopathic PD

Political Participation Among UNG Students

Political participation is the cement that strengthens and stabilizes democracy. However, political participation is not equal across demographics. Our research examines how demographics influence political participation among University of North Georgia (UNG) students. Past research on this topic indicates that ideology, race, wealth, geography have strong impacts on how an individual participates in politics. Democrats and Republicans view political actions and rhetoric differently, and individuals who believe their political actions define them are far more likely to participate in politics than any other group. The turbulent relationship between African-Americans and the Republican party and cultural differences, such as the sense of linkage that is a cornerstone of Latino and African-American culture, greatly influence how minorities participate in and perceive politics. Individuals of high socio-economic class are more likely to participate in politics, and wealth influences how they participate. Lastly, where an individual lives influences their political ideology; individuals living in rural areas typically align with the political right while those living in urban areas typically align with the political left. By asking 77 UNG students 14 questions regarding their demographics and political participation level, we examined how ideology, race, wealth, and geography influence an individual\u27s political participation level. Although we did not find any statistically significant results, our research design leaves a solid framework for examining the influences of political participation level at UNG in the future

Mental Health and Sexual Risk Behaviors Among Social Networks of Young Tanzanian Men

Background: Young men are important targets in HIV prevention in Tanzania and throughout sub-Saharan Africa. Anxiety and depression are common among youth and may be important predictors of HIV risk behaviors. Evidence of these relationships in high-risk populations is needed, as is understanding of how normative and supportive elements of the social environment might be leveraged to buffer the risk posed by poor mental health. Methods: I conducted two studies using baseline and one-year follow-up data from 1113 sexually active male participants in an ongoing HIV and intimate partner violence prevention trial taking place among 59 social groups known as “camps” in Dar es Salaam, Tanzania. In the first study, I assessed the relationship between mental health (anxiety, depression) and sexual risk behaviors (condom use, concurrency) using multilevel modeling. In the second study, I built upon these models to test the moderating role of sexual behavior norms, camp network social cohesion, and men’s network centrality in the relationship between mental health and sexual risk behaviors. I further assessed peer behavioral influence in men’s camp friendship networks using quadratic assignment procedures. Results: Both anxiety and depression were independently associated with concurrency but only depression was independently associated with condom use. In the second study, changes in perceived descriptive norms were associated with both condom use and concurrency, perceived injunctive norms were associated with concurrency, and direct encouragement was associated with condom use. Changes in condom use norms (perceived descriptive norms and encouragement) moderated the relationship between changes in anxiety symptoms and condom use such that the negative relationship was amplified with worsening norms for condom use, and attenuated by improving norms for condom use. Network centrality and cohesion were not significantly related to sexual risk, nor did they interact with anxiety or depression in relation to sexual risk. Conclusions: The results of this dissertation indicate the importance of screening and providing treatment for depression and anxiety in high HIV-prevalence contexts, and the need to develop effective HIV prevention interventions targeting young men living with anxiety and depression. Such interventions may benefit from the combination of norms-based and mental health promotion approaches.Doctor of Philosoph