Research on stress and smoking: progress and problems

Despite evidence that smoking behaviour increases in the context of stress, there has yet to be a clear-cut demonstration that nicotine intake is similarly enhanced. Although nicotine intake has been shown to reduce reported anxiety in the context of stress, the controlling conditions (type of stressor, intensity, temporal relationships, etc.) need further exploration. Recent findings involving nicotine's effects on the hypophyseal-adrenal axis provide a new perspective on these issues, in that increased nicotine intake during exposure to a stressor may represent, at least in part, behavioral compensation for diminished sensitivity to nicotine brought about by nicotine-stimulated corticosteroid release. Corticosteroids may decrease central nervous system excitability in a way that could account for anxiety reduction; on the other hand, anxiety reduction may be an epiphenomenon with respect to the reinforcement of smoking behaviour. The integration of behavioural, physiological, and biochemical research exemplified by the above approach should lead to a better understanding of stress and smoking.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73317/1/j.1360-0443.1991.tb01815.x.pd

Pain in children with intellectual disabilities: a randomized controlled trial evaluating caregiver knowledge measures

Inadequate knowledge has contributed to inaccurate pain assessment and treatment for children with intellectual disabilities

Access to water in the countries of the former Soviet Union.

BACKGROUND: During the Soviet period, authorities in the USSR invested heavily in collective farming and modernization of living conditions in rural areas. However, many problems remained, including poor access to many basic amenities such as water. Since then, the situation is likely to have changed; economic decline has coincided with migration and widening social inequalities, potentially increasing disparities within and between countries. AIM: To examine access to water and sanitation and its determinants in urban and rural areas of eight former Soviet countries. METHODS: A series of nationally representative surveys in Armenia, Belarus, Georgia, Moldova, Kazakhstan, Kyrgyzstan, Russia and Ukraine was undertaken in 2001, covering 18,428 individuals (aged 18+ years). RESULTS: The percentage of respondents living in rural areas varied between 27 and 59% among countries. There are wide urban-rural differences in access to amenities. Even in urban areas, only about 90% of respondents had access to cold running water in their home (60% in Kyrgyzstan). In rural areas, less than one-third had cold running water in their homes (44% in Russia, under 10% in Kyrgyzstan and Moldova). Between one-third and one-half of rural respondents in some countries (such as Belarus, Kazakhstan and Moldova) obtained their water from wells and similar sources. Access to hot running water inside the homes was an exception in rural households, reflecting the lack of modern heating methods in villages. Similarly, indoor access to toilets is common in urban areas but rare in rural areas. Access to all amenities was better in Russia compared with elsewhere in the region. Indoor access to cold water was significantly more common among rural residents living in apartments, and in settlements served by asphalt roads rather than dirt roads. People with more assets or income and living with other people were significantly more likely to have water on tap. In addition, people who had moved in more recently were more likely to have an indoor water supply. CONCLUSIONS: This was the largest single study of its kind undertaken in this region, and demonstrates that a significant number of people living in rural parts of the former Soviet Union do not have indoor access to running water and sanitation. There are significant variations among countries, with the worse situation in central Asia and the Caucasus, and the best situation in Russia. Access to water strongly correlates with socio-economic characteristics. These findings suggest a need for sustained investment in rebuilding basic infrastructure in the region, and monitoring the impact of living conditions on health

Three-dimensional imaging and detection efficiency performance of orthogonal coplanar CZT strip detectors

We report on recent three-dimensional imaging performance and detection efficiency measurements obtained with 5 mm thick prototype CdZnTe detectors fabricated with orthogonal coplanar anode strips. In previous work, we have shown that detectors fabricated using this design achieve both very good energy resolution and sub-millimeter spatial resolution with fewer electronic channels than are required for pixel detectors. As electron-only devices, like pixel detectors, coplanar anode strip detectors can be fabricated in the thickness required to be effective imagers for photons with energies in excess of 500 keV. Unlike conventional double-sided strip detectors, the coplanar anode strip detectors require segmented contacts and signal processing electronics on only one surface. The signals can be processed to measure the total energy deposit and the photon interaction location in three dimensions. The measurements reported here provide a quantitative assessment of the detection capabilities of orthogonal coplanar anode strip detectors

The female weight-control smoker: A profile

Hypothesizing the existence of a subgroup of female smokers for whom nicotine masks, and abstinence unmasks, a tendency toward hyperphagia and perhaps even subthreshold disordered eating, we compared female "weight-control smokers" (WC; n = 46) and "non-weight-control smokers" (NWC; n = 52) on smoking- and eating-related variables. We also examined the relationship between weight-control smoking and withdrawal symptomatology during 48-hours of nicotine abstinence (n = 23). Although WC were not more depressed, anxious, or nicotine-dependent than NWC, they were significantly more likely to report weight gain and increased hunger during abstinence; they also scored higher on Cognitive Restraint and Disinhibition (Three-Factor Eating Questionnaire). The expected correlation of cotinine with weight emerged for NWC but not for WC. Weight-control smoking correlated with increased eating during abstinence. Our findings suggest that WC use dietary restraint as well as smoking to manage weight, and that abstinence may precipitate episodes of disinhibited or binge eating. If WC overinclude women vulnerable to excess or unpredictable eating and consequently to substantial weight gain that can be managed by nicotine, highly focused treatment strategies may be helpful.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/31081/1/0000758.pd

Controlled dosing of nicotine via an I ntranasal N icotine A erosol D elivery D evice (INADD)

The present report describes an I ntranasal N icotine A erosol D elivery D evice (INADD) employing an artist's airbrush as aerosolizer and precise, electromechanical control of spray duration. It was designed for the administration of controlled doses of nicotine in a laboratory setting and has been used successfully in over 30 smokers and nonsmokers of both genders. In the present study, nicotine was administered to 12 male smokers at three different doses (0.05 mg, 1.00 mg, and 2.00 mg), and at the same dose (1 mg) on three different occasions. The low dose produced a minimal change in plasma nicotine, while the high dose produced a peak increment of around 16 ng/ml. The medium dose reliably produced a peak increment of around 8–9 ng/ml on all three occasions. Nicotine in plasma showed a sharp rise followed by a slower decline, mimicking the pattern associated with cigarette smoking. Physiological and biochemical responses showed significant dose-response relationships. Subjective reports suggested that aerosol dosing was somewhat aversive, but it is unclear whether this effect is intrinsic to the method or due to other factors. The device described in this report answers the need for a safe and easy means of controlling nicotine dose. Moreover, since nicotine administration via aerosol is novel for both smokers and non-smokers, minimizing the contributions of behavioral tolerance and habituation to the dosing vehicle, it lends itself to the comparison of the pharmacological effects of nicotine between experienced and naive subjects.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/46339/1/213_2005_Article_BF02247431.pd

The support model for people with legally modified abilities according to United Nations

Este artículo se basa en una investigación social sobre el sistema de protección jurídica de las personas con algún tipo de discapacidad o en situación de dependencia que se encuentran sometidas a las figuras de tutela o curatela, en aplicación de lo previsto y establecido en el Código Civil Español, en sus artículos 199 y 200, así como en la Ley de Enjuiciamiento Civil. La investigación se plantea como un estudio comparado entre diferentes países de la Unión Europea para ver su adecuación a lo establecido en el artículo 12 de la Convención de Naciones Unidas sobre derechos de las Personas con Discapacidad (en adelante, CDPD) en los procedimientos de incapacitación. Los resultados se analizan sobre la base de modelos técnico-sociales de intervención, los análisis jurídicos y la experiencia adquirida por las Fundación Tutelares de Castilla y León. Se proponen y diseñan algunas alternativas y servicios que pueden mejorar la calidad de vida de las personas adultas incapacitadas judicialmente y el tipo de apoyos que se les puede prestar, de acuerdo a lo establecido en la Convención de Naciones Unidas.This article is based on social research into the system of legal protection for persons with disabilities or in a situation of dependence who are subject to the figures of guardianship or conservatorship pursuant to the provisions in the Spanish Civil Code, sections 199 and 200, as well as the Code of Civil Procedure. The research is presented as a comparative study between different countries of the European Union regarding the adaptation to the provisions of Article 12 of the UN Convention on Rights of Persons with Disabilities (hereinafter CRPD) Incapacitation procedures. The results are analyzed on the basis of technical-social intervention models, legal analysis and the experience of Guardianship Foundations of Castilla y León. Some alternatives and services are proposed and designed that can improve the quality of life of legally incapacitated persons and the type of support that can be provided to them in accordance with the provisions of the United Nations Convention

Potential health gains and health losses in eleven EU countries attainable through feasible prevalences of the life-style related risk factors alcohol, BMI, and smoking: a quantitative health impact assessment

Background: Influencing the life-style risk-factors alcohol, body mass index (BMI), and smoking is an European Union (EU) wide objective of public health policy. The population-level health effects of these risk-factors depend on population specific characteristics and are difficult to quantify without dynamic population health models. Methods: For eleven countries-approx. 80 % of the EU-27 population-we used evidence from the publicly available DYNAMO-HIA data-set. For each country the age- and sex-specific risk-factor prevalence and the incidence, prevalence, and excess mortality of nine chronic diseases are utilized; including the corresponding relative risks linking risk-factor exposure causally to disease incidence and all-cause mortality. Applying the DYNAMO-HIA tool, we dynamically project the country-wise potential health gains and losses using feasible, i.e. observed elsewhere, risk-factor prevalence rates as benchmarks. The effects of the 'worst practice', ' best practice', and the currently observed risk-factor prevalence on population health are quantified and expected changes in life expectancy, morbidity-free life years, disease cases, and cumulative mortality are reported. Results: Applying the best practice smoking prevalence yields the largest gains in life expectancy with 0.4 years for males and 0.3 year for females (approx. 332,950 and 274,200 deaths postponed, respectively) while the worst practice smoking prevalence also leads to the largest losses with 0.7 years for males and 0.9 year for females (approx. 609,400 and 710,550 lives lost, respectively). Comparing morbidity-free life years, the best practice smoking prevalence shows the highest gains for males with 0.4 years (342,800 less disease cases), whereas for females the best practice BMI prevalence yields the largest gains with 0.7 years (1,075,200 less disease cases). Conclusion: Smoking is still the risk-factor with the largest potential health gains. BMI, however, has comparatively large effects on morbidity. Future research should aim to improve knowledge of how policies can influence and shape individual and aggregated life-style-related risk-factor behavior

Probabilistic lane estimation for autonomous driving using basis curves

Lane estimation for autonomous driving can be formulated as a curve estimation problem, where local sensor data provides partial and noisy observations of spatial curves forming lane boundaries. The number of lanes to estimate are initially unknown and many observations may be outliers or false detections (due e.g. to shadows or non-boundary road paint). The challenges lie in detecting lanes when and where they exist, and updating lane estimates as new observations are made. This paper describes an efficient probabilistic lane estimation algorithm based on a novel curve representation. The key advance is a principled mechanism to describe many similar curves as variations of a single basis curve. Locally observed road paint and curb features are then fused to detect and estimate all nearby travel lanes. The system handles roads with complex multi-lane geometries and makes no assumptions about the position and orientation of the vehicle with respect to the roadway. We evaluate our algorithm using a ground truth dataset containing manually-labeled, fine-grained lane geometries for vehicle travel in two large and diverse datasets that include more than 300,000 images and 44 km of roadway. The results illustrate the capabilities of our algorithm for robust lane estimation in the face of challenging conditions and unknown roadways.United States. Defense Advanced Research Projects Agency (Urban Challenge, ARPA Order No. W369/00, Program Code DIRO, issued by DARPA/CMO under Contract No. HR0011-06-C-0149

Effectiveness of interventions to promote healthy diet in primary care: systematic review and meta-analysis of randomised controlled trials

Background A diet rich in fruit, vegetables and dietary fibre and low in fat is associated with reduced risk of chronic disease. This review aimed to estimate the effectiveness of interventions to promote healthy diet for primary prevention among participants attending primary care.<p></p> Methods A systematic review of trials using individual or cluster randomisation of interventions delivered in primary care to promote dietary change over 12 months in healthy participants free from chronic disease or defined high risk states. Outcomes were change in fruit and vegetable intake, consumption of total fat and fibre and changes in serum cholesterol concentration.<p></p> Results Ten studies were included with 12,414 participants. The design and delivery of interventions were diverse with respect to grounding in behavioural theory and intervention intensity. A meta-analysis of three studies showed an increase in fruit consumption of 0.25 (0.01 to 0.49) servings per day, with an increase in vegetable consumption of 0.25 (0.06 to 0.44) serving per day. A further three studies that reported on fruit and vegetable consumption together showed a pooled increment of 0.50 (0.13 to 0.87) servings per day. The pooled effect on consumption of dietary fibre, from four studies, was estimated to be 1.97 (0.43 to 3.52) gm fibre per day. Data from five studies showed a mean decrease in total fat intake of 5.2% of total energy (1.5 to 8.8%). Data from three studies showed a mean decrease in serum cholesterol of 0.10 (-0.19 to 0.00) mmol/L.<p></p> Conclusion Presently-reported interventions to promote healthy diet for primary prevention in primary care, which illustrate a diverse range of intervention methods, may yield small beneficial changes in consumption of fruit, vegetables, fibre and fat over 12 months. The present results do not exclude the possibility that more effective intervention strategies might be developed.<p></p&gt