Male and female emirati medical clerks’ perceptions of the impact of gender and mobility on their professional careers

Background: Medicine has undergone profound changes in terms of the number of women entering the profession with postulated implications of this ‘feminization’ for the profession. The present phenomenological study sought to gain insight into the experiences of final year male and female Emirati medical students (clerks) in terms of the impact of gender on their careers. Methods: Semi-structured interviews were conducted with 24 of the 27 clerks. Interviews were transcribed and analyzed thematically. Findings: There was consensus that the gender profile of medicine in the United Arab Emirates was changing as opportunities emerged for Emirati women to branch into different medical specialties. These opportunities were, however, local or regional due largely to travel restrictions on women. Females would thus receive a less highly regarded board certification than males who were encouraged to specialize abroad. On their return, males would be appointed as consultants or as high-ranking administrators. Participants also acknowledged that like their roles in their society, some medical specialties were ‘gendered’, e.g., surgery (male) and pediatrics and obstetrics and gynecology (female). Conclusion: Although religious and cultural traditions around gender and mobility will influence the professional careers of male and female Emirati medical graduates, the situation is, however, changing

Wireworm Control using Fodder Rape and Mustard – evaluating the use of brassica green manures for the control of wireworm (Agriotes spp.) in organic crops

In a field experiment at ADAS Pwllpeiran in 2001, brassica green manures were grown for 6 weeks and dug in before planting King Edward potatoes, to see if they suppressed wireworm in the crop. There was a trend for potatoes grown after mustard to suffer less damage from both wireworms and slugs than potatoes grown after fodder rape or no green manure, but the differences were not significant. Further trials, with longer green manuring periods, are needed to establish if there is a benefit, and whether the breakdown products of brassica green manures are toxic to wireworms

Schizophrenia is associated with excess multiple physical-health comorbidities but low levels of recorded cardiovascular disease in primary care: cross-sectional study

<b>Objective</b> To assess the nature and extent of physical-health comorbidities in people with schizophrenia and related psychoses compared with controls. <p></p> <b>Design </b>Cross-sectional study. <p></p> <b>Setting </b>314 primary care practices in Scotland. <p></p> <b>Participants </b>9677 people with a primary care record of schizophrenia or a related psychosis and 1 414 701 controls. Main outcome measures Primary care records of 32 common chronic physical-health conditions and combinations of one, two and three or more physical-health comorbidities adjusted for age, gender and deprivation status. <p></p> <b>Results</b> Compared with controls, people with schizophrenia were significantly more likely to have one physical-health comorbidity (OR 1.21, 95% CI 1.16 to 1.27), two physical-health comorbidities (OR 1.37, 95% CI 1.29 to 1.44) and three or more physical-health comorbidities (OR 1.19, 95% CI 1.12 to 1.27). Rates were highest for viral hepatitis (OR 3.98, 95% CI 2.81 to 5.64), constipation (OR 3.24, 95% CI 3.00 to 4.49) and Parkinson's disease (OR 3.07, 95% CI 2.42 to 3.88) but people with schizophrenia had lower recorded rates of cardiovascular disease, including atrial fibrillation (OR 0.62, 95% CI 0.51 to 0.73), hypertension (OR 0.71, 95% CI 0.67 to 0.76), coronary heart disease (OR 0.75, 95% CI 0.61 to 0.71) and peripheral vascular disease (OR 0.83, 95% CI 0.71 to 0.97).<p></p> <b>Conclusions </b>People with schizophrenia have a wide range of comorbid and multiple physical-health conditions but are less likely than people without schizophrenia to have a primary care record of cardiovascular disease. This suggests a systematic under-recognition and undertreatment of cardiovascular disease in people with schizophrenia, which might contribute to substantial premature mortality observed within this patient group. <p></p&gt

Abdominal functional electrical stimulation to enhance mechanical insufflation-exsufflation

Context: Respiratory complications, attributed to the build-up of secretions in the airway, are a leading cause of rehospitalisation for the tetraplegic population. Previously, we observed that the application of Abdominal Functional Electrical Stimulation (AFES) improved cough function and increased demand for secretion removal, suggesting AFES may aid secretion clearance. Clinically, secretion clearance is commonly achieved by using Mechanical insufflation-exsufflation (MI-E) to simulate a cough. In this study the feasibility of combining AFES with MI-E is evaluated. Findings: AFES was successfully combined with MI-E at eight fortnightly assessment sessions conducted with one sub-acute participant with tetraplegia. By using the signal from a pressure sensor, integrated with the MI-E device, AFES was correctly applied in synchrony with MI-E with an accuracy of 96.7%. Acute increases in exhaled volume and peak flow were observed during AFES assisted MI-E, compared to MI-E alone, at six of eight assessment sessions. Conclusion: The successful integration of AFES with MI-E at eight assessment sessions demonstrates the feasibility of this technique. The acute increases in respiratory function observed at the majority of assessment sessions generate the hypothesis that AFES assisted MI-E may be more effective for secretion clearance than MI-E alone

Empirical Uncertainty Estimators for Astrometry from Digital Databases

In order to understand the positional uncertainties of arbitrary objects in several of the current major databases containing astrometric information, a sample of extragalactic radio sources with precise positions in the International Celestial Reference Frame (ICRF) is compared with the available positions of their optical counterparts. The discrepancies between the radio and various optical positions are used to derive empirical uncertainty estimators for the USNO-A2.0, USNO-A1.0, Guide Star Selection System (GSSS) images, and the first and second Digitized Sky Surveys (DSS-I and DSS-II). In addition, an estimate of the uncertainty when the USNO-A2.0 catalog is transferred to different image data is provided. These optical astrometric frame uncertainties can in some cases be the dominant error term when cross-identifying sources at different wavelengths.Comment: 12 pages including 2 figures and 1 table. Accepted for publication in The Astronomical Journal, October 1999. Values in Table 1 for DSS I corrected 99-07-1

Tumor-derived proteins and mitochondrial dysfunction in lung cancer-induced cachexia

Lung tumors secrete multiple factors that contribute to cachexia, a severe wasting syndrome that includes loss of muscle mass, weakness, and fatigue. 80% of advanced lung cancer patients experience cachexia, which cannot be reversed by nutritional interventions, diminishes response to and tolerance of cancer treatments, and increases morbidity and mortality. Despite a multitude of clinical trials, there are currently no approved treatments. This deficiency suggests that not all of the factors that contribute to cachexia have been identified. Cancer is frequently accompanied by an increase in cyclooxygenase-2 (COX-2), a hallmark of inflammation. Clinical trials for COX-2 inhibitors have resulted in restoration of muscle mass and decreased fatigue. Along with loss of myofibrillar proteins, cachexia also induces mitochondrial dysfunction, which contributes to fatigue. The amelioration of fatigue by COX-2 inhibition suggests possible alterations to mitochondrial function. We hypothesized that there were unidentified tumor-derived factors that contribute to cachectic wasting and fatigue. Treatment of C2C12 myotubes with Lewis lung cancer-conditioned media (LCM) resulted in increased COX-2 content, myosin loss, and mitochondrial dysfunction. Mass spectrometry revealed 158 confirmed proteins in LCM. We focused on extracellular 14-3-3 proteins because they bind and regulate over 200 known partners. We found that depletion of extracellular 14-3-3 proteins diminished myosin content. CD13, an aminopeptidase, is the proposed receptor for 14-3-3 proteins. Inhibiting aminopeptidases with Bestatin also reduced myosin content. LCM treatment decreased basal and ATP-related mitochondrial respiration, caused a transient rise in reactive oxygen species (ROS), and increased 4-Hydroxynonenal (4-HNE) in both cytosolic and mitochondrial fractions of cell lysates. COX-2 inhibition did not spare myosin content in LCM-treated myotubes, but did alter mitochondrial respiration and cytosolic oxidant levels. Our novel findings show that extracellular 14-3-3 proteins may act as previously unidentified myokines, signaling via aminopeptidases to help maintain muscle mass. We elucidated how LCM alters mitochondrial electron flow, and increases oxidative damage by ROS and 4-HNE. Although successful in clinical trials, COX-2 inhibitors do not appear to spare muscle mass by directly working on skeletal muscle, but did alter mitochondrial function

Challenges and implications of routine depression screening for depression in chronic disease and multimorbidity: a cross sectional study

<b>Background</b> Depression screening in chronic disease is advocated but its impact on routine practice is uncertain. We examine the effects of a programme of incentivised depression screening in chronic disease within a UK primary care setting.<p></p> <b>Methods and Findings</b> Cross sectional analysis of anonymised, routinely collected data (for 2008-9) from family practices in Scotland serving a population of circa 1.8 million. Patients registered in primary care with at least one of three chronic diseases, coronary heart disease, diabetes and stroke, underwent incentivised depression screening using the Hospital Anxiety and Depression Score (HADS). <p></p> 125143 patients were identified with at least one chronic disease. 10670 (8.5%) were under treatment for depression and exempt from screening. Of the remaining, HADS were recorded for 35537 (31.1%) patients. 7080 (19.9% of screened) had raised HADS (≥8); the majority had indications of mild depression with a HADS between 8 and 10. Over 6 months, 572 (8%) of those with a raised HADS (≥8) were initiated on antidepressants, while 696 (2.4%) patients with a normal HADS (<8) were also initiated on antidepressants (relative risk of antidepressant initiation with raised HADS 3.3 (CI 2.97-3.67), p value <0.0001). Of those with multimorbidity who were screened, 24.3% had a raised HADS (≥8). A raised HADS was more likely in females, socioeconomically deprived, multimorbid or younger (18-44) individuals. Females and 45-64 years old were more likely to receive antidepressants.<p></p> <b>Limitations</b> – retrospective study of routinely collected data.<p></p> <b>Conclusions </b> Despite incentivisation, only minority of patients underwent depression screening, suggesting that systematic depression screening in chronic disease can be difficult to achieve in routine practice. Targeting those at greatest risk such as the multimorbid or using simpler screening methods may be more effective. Raised HADS was associated with a higher number of new antidepressant prescriptions which has significant resource implications. The clinical benefits of such screening remain uncertain and merit investigation

A model for incorporating a clinically-feasible exercise test in paraplegic annual reviews : a tool for stratified cardiopulmonary stress performance classification and monitoring

To identify and characterize an exercise test for use in routine spinal cord injury clinical review, and (ii) to describe levels of, and factors affecting, cardiopulmonary stress performance during exercise in the chronic paraplegic population in Scotland, UK. Cross-sectional study Queen Elizabeth National Spinal Injuries Unit (Glasgow, Scotland) 48 subjects with chronic paraplegia resulting from spinal cord injury at neurological levels T2-L2 Peak oxygen uptake, peak power output, gas exchange threshold and peak heart rate were determined from an incremental arm-cranking exercise test. Using a general linear model, the effects of gender, high (injury level above T6) versus low paraplegia, time since injury, body mass and age on peak oxygen uptake and peak power output were investigated. All 48 subjects completed the arm-cranking exercise test, which was shown to be practical for fitness screening in paraplegia. Men (n=38) had a peak oxygen uptake of 1.302 +/- 0.326 l.min-1 (mean +/- s.d.) and peak power output of 81.6 +/- 23.2W, which was significantly higher than for women (n=10), at 0.832 +/- 0.277 l.min-1 and 50.1 +/- 27.8 W, respectively. There was large intersubject variability in cardiopulmonary performance during arm-cranking exercise testing, but the overall mean for the Scottish population was lower than reference values from other countries. Arm-cranking exercise tests are feasible in the clinical environment. The motivation for their implementation is threefold: (i) to determine cardiopulmonary stress performance of individual paraplegic patients, (ii) to stratify patients into cardiovascular risk categories, and (iii) to monitor the effects of targeted exercise prescription