Post-Traumatic Stress and Life-Destructive Behavior

Results of content analysis of investigative reports and suicide notes illustrating the association between traumatic stress and life-destructive behavior are reported. A breakdown of interpersonal relationships and the inability to adapt to situational arrangements over which they lack control are shown to be factors critical to understanding committers\u27 motivations to suicide

The Fifty Percent Divorce Rate: Deconstructing a Myth

An overview of competing perceptions about divorce in the United States establishes the basis for a discussion of the incidence of divorce, divorce rates, and the public myth of a 50 percent divorce rate. A partial explanation for the acceptance of this myth is offered through a discussion of the salience of attitude as well as other public issues

A Comparison of Social Psychological Views among Youthful and Aged Persons: An Empirical Assessment or Marginally Differentiated Attitude Measures

Four related but marginally differentiated sociological and psychological attitude measures are evaluated through analysis of survey data. Generated from a statewide random sample (N=322), four measures of maladjustment/well-being -- the anomie, alienation, fatalism, and powerlessness scales -- are evaluated as being similar in nature. The moderately high correlations between the scale items comprising the four distinctive conceptual world-views suggest that the scales overlap considerably. The results of an oblique solution factor analysis, however, suggest that the scales being considered may be at least marginally differentiated. Comparisons between distinctive age groups of the sample of adults age 18 to 84 using the one-way analysis of variance suggest that the maladjusted view of the world may be most prevalent among younger and older members of society. The findings are discussed in the light of implications which pertain to the traditional though somewhat confusing explanations for and analysis of human behavior which have evolved from and around the supposed distinctive conceptualizations of social maladjustment - namely, anomie, alienation and powerlessness. Further, a suggestion to proffer fatalism as an alternative explanation as to the philosophy of life (world-view) existing among the least powerful persons in society is proposed. Finally, this research offers support for the position that fatalistic determinism serves at least in part to explicate the relationships among anomie, alienation and powerlessness

Toward a Three-Dimensional Model of Suicide

Cases collected from medical examiner\u27s records are used to assess a three-dimensional model of failure suicide. The data are suggestive that youthful suicide can be explained in part as a reaction to perceived failure, the perception that significant others fail to provide succor, and the belief that others also view the individual as a failure. Implications of the findings are discussed in light of the proposed model

Official Documentation of a Sexually Transmitted Disease (STD): An Empirical Assessment

Using data from clinic records of patients examined and treated at a public health facility, the reporting of unconfirmed cases is examined and the correspondence between public health profiles of patients at risk to sexually transmitted disease and the data are discussed. Implications relating to the findings and to public health policy are also discussed

Immunohistochemical Identification of Human Skeletal Muscle Macrophages

Macrophages have well-characterized roles in skeletal muscle repair and regeneration. Relatively little is known regarding the role of resident macrophages in skeletal muscle homeostasis, extracellular matrix remodeling, growth, metabolism and adaptation to various stimuli including exercise and training. Despite speculation into macrophage contributions during these processes, studies characterizing macrophages in non-injured muscle are limited and methods used to identify macrophages vary. A standardized method for the identification of human resident skeletal muscle macrophages will aide in the characterization of these immune cells and allow for the comparison of results across studies. Here, we present an immunohistochemistry (IHC) protocol, validated by flow cytometry, to distinctly identify resident human skeletal muscle macrophage populations. We show that CD11b and CD206 double IHC effectively identifies macrophages in human skeletal muscle. Furthermore, the majority of macrophages in non-injured human skeletal muscle show a ‘mixed’ M1/M2 phenotype, expressing CD11b, CD14, CD68, CD86 and CD206. A relatively small population of CD11b+/CD206- macrophages are present in resting skeletal muscle. Changes in the relative abundance of this population may reflect important changes in the skeletal muscle environment. CD11b and CD206 IHC in muscle also reveals distinct morphological features of macrophages that may be related to the functional status of these cells

Eggs of the copepod Acartia tonsa Dana require hypoxic conditions to tolerate prolonged embryonic development arrest

Additional file 1. Raw data and calculations for all experiments as well as an overview of experiments in this study

Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p&lt;0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p&lt;0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Evidence-based Kernels: Fundamental Units of Behavioral Influence

This paper describes evidence-based kernels, fundamental units of behavioral influence that appear to underlie effective prevention and treatment for children, adults, and families. A kernel is a behavior–influence procedure shown through experimental analysis to affect a specific behavior and that is indivisible in the sense that removing any of its components would render it inert. Existing evidence shows that a variety of kernels can influence behavior in context, and some evidence suggests that frequent use or sufficient use of some kernels may produce longer lasting behavioral shifts. The analysis of kernels could contribute to an empirically based theory of behavioral influence, augment existing prevention or treatment efforts, facilitate the dissemination of effective prevention and treatment practices, clarify the active ingredients in existing interventions, and contribute to efficiently developing interventions that are more effective. Kernels involve one or more of the following mechanisms of behavior influence: reinforcement, altering antecedents, changing verbal relational responding, or changing physiological states directly. The paper describes 52 of these kernels, and details practical, theoretical, and research implications, including calling for a national database of kernels that influence human behavior