491 research outputs found
Gothic Romance and Poe\u27s Authorial Intent in The Fall of the House of Usher
In my thesis I will discuss Edgar Allan Poe’s “The Fall of the House of Usher” in relation to the expectations that scholars have of the gothic genre. I will break this project into four chapters, along with an introduction: (Ch.1) a critical review of scholarship on Poe’s “Usher” that will demonstrate the difficulty in coming to a critical consensus on the tale, (Ch.2) a discussion of Brown’s outline of Gothic conventions, (Ch.3) a look at Poe’s “The Philosophy of Composition” juxtaposed with Aristotle’s Poetics to illumine aspects of Poe’s approach to writing and how it has been informed, and (Ch.4) a close reading of Poe’s “Usher.
Tissue Culture of Secondary Xylem Parenchyma of Four Species of Southern Pines
Callus was grown from increment core explants of longleaf pine (Pinus palustris Mill.), slash pine (P. elliottii Engelm.), loblolly pine (P. taeda L.), and shortleaf pine (P. echinata Mill.) trees that had 30-45 annual rings of sapwood. Callus emanated from vertical and horizontal resin canals and uniserate rays. It originated from epithelial cells and longitudinal and ray parenchyma cells. There was relatively little difference in the amount of callus produced from the outer to inner sapwood of longleaf and slash pines compared to the reduction that occurred in loblolly and shortleaf pines. Production was generally lower in the transition zone, especially in loblolly and shortleaf pines, and virtually nonexistent in the heartwood. Several current theories of heartwood formation are discussed in light of the results
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Environmental Tobacco Smoke Exposure in Relation to Family Characteristics, Stressors and Chemical Co-Exposures in California Girls.
Childhood environmental tobacco smoke (ETS) exposure is a risk factor for adverse health outcomes and may disproportionately burden lower socioeconomic status groups, exacerbating health disparities. We explored associations of demographic factors, stressful life events, and chemical co-exposures, with cotinine levels, among girls in the CYGNET Study. Data were collected from families of girls aged 6-8 years old in Northern California, through clinic exams, questionnaires and biospecimens (n = 421). Linear regression and factor analysis were conducted to explore predictors of urinary cotinine and co-exposure body burdens, respectively. In unadjusted models, geometric mean cotinine concentrations were higher among Black (0.59 ug/g creatinine) than non-Hispanic white (0.27), Asian (0.32), or Hispanic (0.34) participants. Following adjustment, living in a rented home, lower primary caregiver education, and lack of two biologic parents in the home were associated with higher cotinine concentrations. Girls who experienced parental separation or unemployment in the family had higher unadjusted cotinine concentrations. Higher cotinine was also associated with higher polybrominated diphenyl ether and metals concentrations. Our findings have environmental justice implications as Black and socio-economically disadvantaged young girls experienced higher ETS exposure, also associated with higher exposure to other chemicals. Efforts to reduce ETS and co-exposures should account for other disparity-related factors
Characteristics of Esophageal Cancer Cases in Tanzania.
PurposeAge-standardized incidence rates for esophageal cancer (EC) in East Africa have been reported as disproportionately high compared with the worldwide incidence of nine per 100,000 population. This study aimed to characterize EC cases seen at Muhimbili National Hospital and Ocean Road Cancer Institute in Dar es Salaam, Tanzania.MethodsDemographic, clinical, and treatment variables were abstracted from charts of patients who received care for a diagnosis of EC at one or both institutions between 2011 and 2013. Categorical data were summarized as frequency counts and percentages. Continuous data were presented as medians and ranges. To compare men and women, Pearson's χ2 and two-sample t tests were applied.ResultsSeven hundred thirty-eight unique cases of EC were identified, of whom 68% were men and the median age was 60 years (range, 19 to 95 years). Notably, 93 cases (13%) were ≤ 40 years old at diagnosis. Squamous cell carcinoma was the dominant histology, comprising 90% of cases with documented histopathology. However, 34% of cases with a diagnosis of EC were not pathologically confirmed. The stage was documented as locoregional in 4% of cases, locally advanced in 20% of cases, metastatic in 14% of cases, and unknown in 63% of cases. Of 430 patients who received treatment at Ocean Road Cancer Institute, 76% were treated with radiation, 44% were treated with chemotherapy, 3% underwent a cancer-related surgical procedure, and 10% of cases received no cancer-directed therapy. The median overall survival for all patients was 6.9 months (95% CI, 5.0 to 12.8), regardless of stage at presentation.ConclusionBetween 2011 and 2013, cases of EC represented a large clinical burden at both institutions
Drivers and impacts of water level fluctuations in the Mississippi River delta: Implications for delta restoration
This review synthesizes the knowledge regarding the environmental forces affecting water level variability in the coastal waters of the Mississippi River delta and relates these fluctuations to planned river diversions. Water level fluctuations vary significantly across temporal and spatial scales, and are subject to influences from river flow, tides, vegetation, atmospheric forcing, climate change, and anthropogenic activities. Human impacts have strongly affected water level variability in the Mississippi River delta and other deltas worldwide. Collectively, the research reviewed in this article is important for enhancing environmental, economic, and social resilience and sustainability by assessing, mitigating, and adapting to geophysical changes that will cascade to societal systems in the coming decades in the economically and environmentally important Mississippi River delta. Specifically, this information provides a context within which to evaluate the impacts of diversions on the hydrology of the Mississippi delta and creates a benchmark for the evaluation of the impact of water level fluctuations on coastal restoration projects worldwide
Screening Mammography Use in Older Women According to Health Status: A Systematic Review and Meta-Analysis
Background: The extent to which screening mammography (SM) recommendations in older women incorporate life expectancy factors is not well established.
Objective: The objective of this review was to evaluate evidence on SM utilization in older women by life expectancy factors.
Data sources: We searched Medline, Embase and Web of Science from January 1991 to March 2016.
Study selection: We included studies examining SM utilization in women ages ≥ 65 years that measured life expectancy using comorbidity, functional limitations or health or prognostic status.
Data extraction and synthesis: ORs and 95% CIs were extracted and grouped by life expectancy category. Findings were aggregated into pooled ORs and 95% CIs and meta-analyzed by life expectancy category.
Main outcomes and measures: The primary outcome was SM utilization within the last 5 years. Life expectancy factors included number of comorbidities, Charlson Comorbidity Index (CCI), activities of daily living, instrumental activities of daily living, self-reported health status and 5-year prognostic indices.
Results: Of 2,606 potential titles, we identified 25 meeting the inclusion criteria (comorbidity: eight studies, functional status: 11 studies and health/prognostic status: 13 studies). Women with higher CCI scores had decreased SM utilization (pooled OR: 0.75, 95% CI: 0.67–0.85), but increased absolute number of comorbidities were weakly associated with increased SM utilization (pooled OR: 1.17, 95% CI: 1.00–1.36). Women with more functional limitations had lower SM use odds than women with no limitations (pooled OR: 0.72, 95% CI: 0.62–0.83). Screening utilization odds were lower among women with poor vs excellent health (pooled OR: 0.85, 95% CI: 0.74–0.96).
Conclusion: Greater CCI score, functional limitations and lower perceived health were associated with decreased SM use, whereas higher absolute number of comorbidities was associated with increased SM use. SM guidelines should consider these factors to improve assessments of potential benefits and harms in older women
Diffusion theory and knowledge dissemination, utilization and integration
Many accomplishments of public health have been distributed unevenly among populations. This article reviews the concepts of applying evidence-based practice in public health in the face of the varied cultures and circumstances of practice in these varied populations. Key components of EBPH include: making decisions based on the best available scientific evidence, using data and information systems systematically, applying program planning frameworks, engaging the community and practitioners in decision making, conducting sound evaluation, and disseminating what is learned. The usual application of these principles has overemphasized the scientific evidence as the starting point, whereas this review suggests engaging the community and practitioners as an equally important starting point to assess their needs, assets and circumstances, which can be facilitated with program planning frameworks and use of local assessment and surveillance data
The possibilities and potential of social ecological frameworks to understand health behaviours and outcomes
The health status of individuals and groups is influenced by a wide array of factors. In 2000 a landmark publication, Promoting Human Wellness’ edited by Jamner-Schneider and Stokols, provided compelling evidence of the “complex web of interrelated influences that operate dynamically to determine health and wellness” (p. 1). Thirteen years later, it is timely to revisit this work in light of subsequent changes to our world, and ebb and flow of research trends. Scholarly and societal interest in the multifaceted influences on physical and emotional well-being has stimulated growing interest in social ecological (SE) analyses of health among community and environmental health specialists and other professionals. These professional groups have found SE to be a valuable framework for understanding the multiple levels of influence on human behavior. There is increasing recognition of the value of utilising broader conceptual models for purposes of understanding and managing various intrapersonal, interpersonal, physical environmental and sociocultural influences on health outcomes and health behaviors.
This symposium will examine SE models of health and will feature a number of pioneers who have drawn upon SE principles to better understand health behavior, and to develop multi-faceted health promotion interventions ranging from macro-societal to micro-environmental level research. Speakers will discuss their reasons for utilizing a SE framework to effectively understand and influence bi-directional, multi-level processes that either support or hinder an individual’s engagement in health protective behaviours. The symposium presentations also will suggest guidelines for health promotion interventions focusing on multiple environmental levels
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Association of Regional Variation in Primary Care Physicians’ Colorectal Cancer Screening Recommendations with Individual Use of Colorectal Cancer Screening
Introduction: Studies show that the recommendations of a primary care physician for colorectal cancer screening may be one important influence on an individual's use of screening. However, another possible influence, the effect of regional differences in physicians' beliefs and recommendations on screening use, has not been assessed. Methods: We linked data from the National Health Interview Survey on the use of colorectal cancer screening by respondents aged 50 years or older, by hospital-referral region, with data from the Survey of Colorectal Cancer Screening Practices on the colorectal cancer screening recommendations of primary care physicians, by region. Our principal independent variables were the proportion of physicians in a region who recommended screening at age 50 and continuing screening at the recommended frequency. Results: On average, 53.3% of physicians in a region correctly recommended initiating colorectal cancer screening, and 64.8% advised screening at the recommended frequency. Of adults who lived in regions where less than 30% of physicians correctly recommended initiating screening, 47.3% had been screened, in contrast to 54.8% in areas where 70% or more of physicians made correct recommendations. Seventy-one percent of respondents living in regions where less than 30% of physicians advised screening at the recommended frequency were current on screening, in contrast to 79.9% of respondents living in regions where 70% or more of physicians made this recommendation. These differences were statistically significant after adjustment for individual characteristics. Conclusion: Strategies to improve colorectal cancer screening recommendations of primary care physicians may improve the use of screening for millions of Americans
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