Reuse of Explanted Pacemakers: An Option for Economically Underprivileged Patients in Developing Countries

Permanent pacemaker implantation is an established mode of life saving therapy for patients with symptomatic bradycardia. As the human population is aging world-over, the need for pacemakers are also increasing. Reviewing the results of the 2001 World Survey on Cardiac Pacing and Implantable Cardioverter Defibrillators (Table 1), it is evident that not all patients who require pacemakers are receiving them, particularly in the Asia-Pacific region. The largest implanting country per head of population is Germany, although the largest numbers implanted are in the United States of America. In contrast, the countries of Asia have much smaller numbers with Myanmar having less than one implant per million population per year1

Symptoms predicting psychosocial impairment in bulimia nervosa

Purpose The current study aimed to determine which particular eating disorder (ED) symptoms and related features, such as BMI and psychological distress, uniquely predict impairment in bulimia nervosa (BN). Methods Two hundred and twenty-two adults with BN completed questionnaires assessing ED symptoms, general psychological distress, and psychosocial impairment. Regression analyses were used to determine predictors which account for variance in impairment. Results Four variables emerged as significant predictors of psychosocial impairment: concerns with eating; concerns with weight and shape; dietary restraint; and general psychological distress. Conclusions Findings support previous work highlighting the importance of weight and shape concerns in determining ED-related impairment. Other ED symptoms, notably dietary restraint and concerns with eating, were also significant predictors as was psychological distress. Results suggest that cognitive aspects of EDs, in addition to psychological distress, may be more important determinants of impairment than behavioural symptoms, such as binge eating or purging

Identifying persuasive public health messages to change community knowledge and attitudes about bulimia nervosa

Addressing stigma through social marketing campaigns has the potential to enhance currently low rates of treatment seeking and improve the well-being of individuals with the eating disorder bulimia nervosa. This study aimed to evaluate the persuasiveness of health messages designed to reduce stigma and improve mental health literacy about this disorder. A community sample of 1,936 adults (48.2% male, 51.8% female) from Victoria, Australia, provided (a) self-report information on knowledge and stigma about bulimia nervosa and (b) ratings of the persuasiveness of 9 brief health messages on dimensions of convincingness and likelihood of changing attitudes. Messages were rated moderately to very convincing and a little to moderately likely to change attitudes toward bulimia nervosa. The most persuasive messages were those that emphasized that bulimia nervosa is a serious mental illness and is not attributable to personal failings. Higher ratings of convincingness were associated with being female, with having more knowledge about bulimia nervosa, and with lower levels of stigma about bulimia nervosa. Higher ratings for likelihood of changing attitudes were associated with being female and with ratings of the convincingness of the corresponding message. This study provides direction for persuasive content to be included in social marketing campaigns to reduce stigma toward bulimia nervosa.10 page(s

Kinetic approaches to particle acceleration at cosmic ray modified shocks

Kinetic approaches provide an effective description of the process of particle acceleration at shock fronts and allow to take into account the dynamical reaction of the accelerated particles as well as the amplification of the turbulent magnetic field as due to streaming instability. The latter does in turn affect the maximum achievable momentum and thereby the acceleration process itself, in a chain of causality which is typical of non-linear systems. Here we provide a technical description of two of these kinetic approaches and show that they basically lead to the same conclusions. In particular we discuss the effects of shock modification on the spectral shape of the accelerated particles, on the maximum momentum, on the thermodynamic properties of the background fluid and on the escaping and advected fluxes of accelerated particles.Comment: 22 pages, 7 figures, accepted for publication in MNRA

運動情報の可聴化に関する研究

電気通信大学201

Eating Disorder Behaviors Are Increasing: Findings from Two Sequential Community Surveys in South Australia

Background: evidence for an increase in the prevalence of eating disorders is inconsistent. Our aim was to determine change in the population point prevalence of eating disorder behaviors over a 10-year period. \ud \ud Methodology/Principal Findings: eating disorder behaviors were assessed in consecutive general population surveys of men and women conducted in 1995 (n = 3001, 72% respondents) and 2005 (n = 3047, 63.1% respondents). Participants were randomly sampled from households in rural and metropolitan South Australia. There was a significant (all p,0.01) and over two-fold increase in the prevalence of binge eating, purging (self-induced vomiting and/or laxative or diuretic misuse) and strict dieting or fasting for weight or shape control among both genders. The most common diagnosis in 2005 was either binge eating disorder or other ‘‘eating\ud disorders not otherwise specified’’ (EDNOS; n = 119, 4.2%). \ud \ud Conclusions/Significance: in this population sample the point prevalence of eating disorder behaviors increased over the past decade. Cases of anorexia nervosa and bulimia nervosa, as currently defined, remain uncommon

O impacto dos programas de prevenção veiculados na mídia: a gravidez na adolescência

Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro Tecnológico. Programa de Pós-Graduação em Engenharia de Produção.A presente pesquisa aborda questões referentes à gravidez na adolescência a partir da leitura do impacto dos programas de prevenção veiculados na mídia, de acordo com relatos de adolescentes grávidas inscritas no programa de pré-natal da Secretaria Municipal de Saúde, do município de Itaúna (MG). Foi traçado o perfil da adolescente grávida e descrita a sua relação com as diversas mídias no que diz respeito à baixa eficiência dos programas de prevenção veiculados nestas mídias. A partir de estudos já realizados, a atenção recaiu sobre algumas questões: 1) O que é educação para a saúde? 2) Por que a gravidez precoce é um problema de saúde pública? 3) Em que pontos falham os programas de prevenção da gravidez na adolescência, veiculados nas mídias? Os resultados demonstram que o modelo informacional não contribui para a aprendizagem que o processo educativo supõe. A informação sobre como prevenir a gravidez não impede as manifestações psicológicas comuns no período adolescente. Os resultados apontam, também, que os conflitos adolescentes são vivenciados com maior processo de readaptação, quando acompanhado de uma gravidez; que as adolescentes não planejavam as gravidezes, não usavam qualquer método anticoncepcional, apesar de conhecê-los; têm seu comportamento influenciável pelas mídias apesar de não legitimarem os programas de prevenção veiculados nela. Espera-se que os resultados possam contribuir no processo de construção de programas de prevenção, uma vez que retrata a possibilidade do uso da mídia como instrumento da educação. O conhecimento do perfil da adolescente que engravida, assim como a imagem criada pelas campanhas de prevenção da gravidez precoce deve facilitar a criação de sistemas mais eficientes, facilitando a elaboração de programas de saúde coerentes com a demanda real. Research that approaches referring questions to the pregnancy in the adolescence from the reading of the impact of the propagated programs of prevention in the medias, in accordance with stories of enrolled pregnant adolescents in the program of prenatal of the City department of Health, of the city of Itaúna(MG). The profile of the pregnant and described adolescent was traced its relation with the diverse medias in that it says respect to low the efficiency of the propagated programs of prevention in the medias. From carried through studies already, the attention fell again on some questions: 1) What it is education for the health? 2) Why the precocious pregnancy is a problem of public health? 3) Where points fail the programs of prevention of the pregnancy in the adolescence, propagated in the medias? The results demonstrate that the informacional model does not contribute for the learning that the educative process assumes. The information on as to prevent the pregnancy does not hinder the common psychological manifestations in the adolescent period. The results point, also, that the adolescent conflicts are lived deeply with bigger process of readjustment, when folloied of a pregnancy; that the adolescents did not plan the pregnancies, they did not use any contraceptive method, although to know them; they have its influenciável behavior for the medias although not to legitimize the propagated programs of prevention in. It focuses the proposal of the education for the health, the adolescent development and the recocious pregnancy, points with respect to the diverse medias as tool of the education. It presents one to seem on the profile of the pregnant adolescent and the impact of the pregnancy and the campaigns of propagated prevention of the regnancy in the medias

Testing the cognitive-behavioural maintenance models across DSM-5 bulimic-type eating disorder diagnostic groups: A multi-centre study

The original cognitive-behavioural (CB) model of bulimia nervosa, which provided the basis for the widely used CB therapy, proposed that specific dysfunctional cognitions and behaviours maintain the disorder. However, amongst treatment completers, only 40–50 % have a full and lasting response. The enhanced CB model (CB-E), upon which the enhanced version of the CB treatment was based, extended the original approach by including four additional maintenance factors. This study evaluated and compared both CB models in a large clinical treatment seeking sample (N = 679), applying both DSM-IV and DSM-5 criteria for bulimic-type eating disorders. Application of the DSM-5 criteria reduced the number of cases of DSM-IV bulimic-type eating disorders not otherwise specified to 29.6 %. Structural equation modelling analysis indicated that (a) although both models provided a good fit to the data, the CB-E model accounted for a greater proportion of variance in eating-disordered behaviours than the original one, (b) interpersonal problems, clinical perfectionism and low self-esteem were indirectly associated with dietary restraint through over-evaluation of shape and weight, (c) interpersonal problems and mood intolerance were directly linked to binge eating, whereas restraint only indirectly affected binge eating through mood intolerance, suggesting that factors other than restraint may play a more critical role in the maintenance of binge eating. In terms of strength of the associations, differences across DSM-5 bulimic-type eating disorder diagnostic groups were not observed. The results are discussed with reference to theory and research, including neurobiological findings and recent hypotheses

Acute left ventricular dysfunction secondary to right ventricular septal pacing in a woman with initial preserved contractility: a case report

<p>Abstract</p> <p>Introduction</p> <p>Right ventricular apical pacing-related heart failure is reported in some patients after long-term pacing. The exact mechanism is not yet clear but may be related to left ventricular dyssynchrony induced by right ventricular apical pacing. Right ventricular septal pacing is thought to deteriorate left ventricular function less frequently because of a more normal left ventricular activation pattern.</p> <p>Case presentation</p> <p>We report the case of a 55-year-old Tunisian woman with preserved ventricular function, implanted with a dual-chamber pacemaker for complete atrioventricular block. Right ventricular septal pacing induced a major ventricular dyssynchrony, severe left ventricular ejection fraction deterioration and symptoms of congestive heart failure. Upgrading to a biventricular device was associated with a decrease in the symptoms and the ventricular dyssynchrony, and an increase of left ventricular ejection fraction.</p> <p>Conclusion</p> <p>Right ventricular septal pacing can induce reversible left ventricular dysfunction and heart failure secondary to left ventricular dyssynchrony. This complication remains an unpredictable complication of right ventricular septal pacing.</p