Factors Influencing Mammography Utilization Among Disabled and Nondisabled Women

Breast cancer is the second leading cause of cancer mortality in women in the United States. Because the majority of risk factors for breast cancer are not modifiable, early detection methods such as mammography are essential. However, concern exists for the equitable provision and use of mammography services in the U.S. Mammography is ofien underutilized by various subpopulations resulting, potentially, in these groups not experiencing the benefits of early detection. A subpopulation that has received little attention in the study of mammography utilization encompasses persons classified as disabled. The 1998 National Health Interview Survey provided the data for this analysis. A health services utilization model served as the conceptual framework and was adopted to analyze the multiple factors that influence mammography use, including factors such as the environment, population characteristics, health behaviors, and health outcomes. In this study, disability is defined as those women with any self reported limitations in activities of daily living, instrumental activities of daily living, cognition, or work, Results indicate that the mammography utilization rate for disabled women (n = 1,320) was 42.99%, and significantly lower than the rate of 57.37% for non disabled women (n = 4,733) (z = 646.83; p = .00). This finding was consistent across most study variables. Binary logistic regression results indicate that women with cognitive limitations were nearly half as likely than nondisabled women to utilize mammography (AOR = 0.66; 95% CI: 0.45, 0.97) afier controlling for other factors. In the logistic regression analysis, particular, population characteristics (i.e., age, race/ethnicity, education, and health insurance) and health behaviors (i.e., smoking status, clinical breast examination, and usual source of care) were shown to significantly influence mammography utilization. Results indicate that inequity in mammography utilization exists because disabled women’s utilization rates are lower than the rates for nondisabled women. Because disabled women, especially those cognitively impaired, used mammography at lower rates than non disabled women, disabled women may not realize the benefits of early detection of breast cancer. Furthermore, they may potentially experience both higher rates of undetected breast cancer and breast cancer mortality

Acute lung injury in paediatric intensive care: course and outcome

Introduction: Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) carry a high morbidity and mortality (10-90%). ALI is characterised by non-cardiogenic pulmonary oedema and refractory hypoxaemia of multifactorial aetiology [1]. There is limited data about outcome particularly in children. Methods This retrospective cohort study of 85 randomly selected patients with respiratory failure recruited from a prospectively collected database represents 7.1% of 1187 admissions. They include those treated with High Frequency Oscillation Ventilation (HFOV). The patients were admitted between 1 November 1998 and 31 October 2000. Results: Of the 85, 49 developed acute lung injury and 47 had ARDS. There were 26 males and 23 females with a median age and weight of 7.7 months (range 1 day-12.8 years) and 8 kg (range 0.8-40 kg). There were 7 deaths giving a crude mortality of 14.3%, all of which fulfilled the Consensus I [1] criteria for ARDS. Pulmonary occlusion pressures were not routinely measured. The A-a gradient and PaO2/FiO2 ratio (median + [95% CI]) were 37.46 [31.82-43.1] kPa and 19.12 [15.26-22.98] kPa respectively. The non-survivors had a significantly lower PaO2/FiO2 ratio (13 [6.07-19.93] kPa) compared to survivors (23.85 [19.57-28.13] kPa) (P = 0.03) and had a higher A-a gradient (51.05 [35.68-66.42] kPa) compared to survivors (36.07 [30.2-41.94]) kPa though not significant (P = 0.06). Twenty-nine patients (59.2%) were oscillated (Sensormedics 3100A) including all 7 non-survivors. There was no difference in ventilation requirements for CMV prior to oscillation. Seventeen of the 49 (34.7%) were treated with Nitric Oxide including 5 out of 7 non-survivors (71.4%). The median (95% CI) number of failed organs was 3 (1.96-4.04) for non-survivors compared to 1 (0.62-1.62) for survivors (P = 0.03). There were 27 patients with isolated respiratory failure all of whom survived. Six (85.7%) of the non-survivors also required cardiovascular support.Conclusion: A crude mortality of 14.3% compares favourably to published data. The A-a gradient and PaO2/FiO2 ratio may be of help in morbidity scoring in paediatric ARDS. Use of Nitric Oxide and HFOV is associated with increased mortality, which probably relates to the severity of disease. Multiple organ failure particularly respiratory and cardiac disease is associated with increased mortality. ARDS with isolated respiratory failure carries a good prognosis in children

Can Machines Think in Radio Language?

People can think in auditory, visual and tactile forms of language, so can machines principally. But is it possible for them to think in radio language? According to a first principle presented for general intelligence, i.e. the principle of language's relativity, the answer may give an exceptional solution for robot astronauts to talk with each other in space exploration.Comment: 4 pages, 1 figur

Eurasian jays (Garrulus glandarius) conceal caches from onlookers.

Animals that cache food risk having their stored food pilfered by conspecifics. Previous research has shown that a number of food-caching species of corvid use strategies that decrease the probability of conspecifics pilfering their caches. In this experiment, we investigated whether Eurasian jays (Garrulus glandarius) would choose between caching behind an opaque and caching behind a transparent barrier whilst being observed by a conspecific. If caching in out-of-sight locations is a strategy to prevent conspecifics from pilfering these caches, then the jays should place a greater proportion of caches behind the opaque barrier when being observed than when caching in private. In accordance with this prediction, jays cached a greater proportion of food behind the opaque barrier when they were observed than when they cached in private. These results suggest that Eurasian jays may opt to cache in out-of-view locations to reduce the likelihood of conspecifics pilfering their caches

Direct Measurement of the X-ray Time-Delay Transfer Function in Active Galactic Nuclei

The origin of the observed time lags, in nearby active galactic nuclei (AGN), between hard and soft X-ray photons is investigated using new XMM-Newton data for the narrow-line Seyfert I galaxy Ark 564 and existing data for 1H0707-495 and NGC 4051. These AGN have highly variable X-ray light curves that contain frequent, high peaks of emission. The averaged light curve of the peaks is directly measured from the time series, and it is shown that (i) peaks occur at the same time, within the measurement uncertainties, at all X-ray energies, and (ii) there exists a substantial tail of excess emission at hard X-ray energies, which is delayed with respect to the time of the main peak, and is particularly prominent in Ark 564. Observation (i) rules out that the observed lags are caused by Comptonization time delays and disfavors a simple model of propagating fluctuations on the accretion disk. Observation (ii) is consistent with time lags caused by Compton-scattering reverberation from material a few thousand light-seconds from the primary X-ray source. The power spectral density and the frequency-dependent phase lags of the peak light curves are consistent with those of the full time series. There is evidence for non-stationarity in the Ark 564 time series in both the Fourier and peaks analyses. A sharp `negative' lag (variations at hard photon energies lead soft photon energies) observed in Ark 564 appears to be generated by the shape of the hard-band transfer function and does not arise from soft-band reflection of X-rays. These results reinforce the evidence for the existence of X-ray reverberation in type I AGN, which requires that these AGN are significantly affected by scattering from circumnuclear material a few tens or hundreds of gravitational radii in extent.Comment: Accepted for publication in Ap