Emergency department use among Asian adults living in the United States: Results from the National Health Interview Survey (2006 – 2013)

This paper presents secondary analyses of the National Health Interview Survey data focused on emergency department (ED) utilization among Asian adults residing in the United States. National Health Interview Survey data provided from survey years 2006-2013 was pooled and disaggregated by single-race Asian ethnic subgroups (Filipino, Chinese, Asian Indian, other Asian). We explored trends in reports of an ED visit over the survey years for the purpose of determining whether reports of an ED visit increased or decreased over survey years. We also explored background/biologic, environment, access to care, and behavior factors and their associations with having an ED visit. The majority of respondents were foreign-born (75.9%) and had lived in the United States for ten or more years (54.3%). Estimates for reports of any ED visits ranged from 8.3% for the Chinese to 15.3% for the Filipino subgroups. Filipinos were more likely to have an ED visit compared to the Chinese and other Asians (except Asian Indians). For the eight years of survey data, estimates indicate a trend of fewer reports of any ED visit among the Asian Indian and Filipino subgroups. Among Filipinos, having diabetes and a smoking history were associated with an ED visit. The odds of an ED visit were higher among Asians in the youngest age category, among other Asians born in the United States, and among those who saw/talked to a mental health professional within the previous year. As there is a paucity of information available about ED use among Asians or Asian subgroups, this report adds to the literature on patterns of health care utilization among Asian subgroups living in the United States with a specific focus on ED utilization

Eating disorders, sex role identification, and assertion

The current study was designed to investigate the possible connection between the eating disorder bulimia, women's sex roles in Western culture, and assertion. Literature was reviewed which suggested that a lack of assertion may be important in understanding the development of bulimia. Hence, the first purpose of the current study was to assess the relationship between bulimia and assertion. The literature also suggested that women's roles in Western society may be important in understanding the disorder. In this regard it was noted that three competing points of view exist in the' literature: (1) That bulimic women over identify With the traditional feminine role; (2) That they reject the traditional role; and (3) That they attempt to perfectly fulfill both the role of mother and the role of career woman, thus attempting to be "superwomen." The second purpose of the present study was to determine which, if any, of these theoretical positions was supported. Subjects for the study were randomly selected undergraduate females living in the residence halls at the University of North Carolina at Greensboro. They were asked to fill out (1) the College Self-Expression Scale (CSES), a measure of assertion; (2) the Eating Disorder Inventory (EDI), a measure of eating concerns, behaviors and attitudes; (3) the Social Performance Survey Schedule (SPSS), a measure of social skills; and (4) the Job-Child (J-C) and Level of Involvement (LI) Scales, two measures of women's future plans for work and family

A Comparison Of WISC-R Intelligence Scores With Scores Of The Talent Assessment Program Of Motor Skills In An Educably Mentally Handicapped And Learning Disabled Population

The purpose of the present research is to determine what correlations exist between motor skills as measured by the Talent Assessment Program (TAP) and intelligence as measured by the WISC-R

Effects of fenofibrate on renal function in patients with type 2 diabetes mellitus: the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) Study

Abstract Aims/hypothesis Fenofibrate caused an acute, sustained plasma creatinine increase in the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) and Action to Control Cardiovascular Risk in Diabetes (ACCORD) studies. We assessed fenofibrate’s renal effects in a FIELD washout sub-study. Methods Type 2 diabetic patients (n=9795) aged 50 to 75 years were randomly assigned to fenofibrate (n=4895) or placebo (n=4900) for 5 years, after 6 weeks fenofibrate run-in. Albuminuria (urinary albumin:creatinine ratio) measured at baseline, year 2 and close-out) and estimated GFR, measured 4 to 6 monthly according to the Modification of Diet in Renal Disease study, were pre-specified endpoints. Plasma creatinine was re-measured 8 weeks after treatment cessation at close-out (washout sub-study, n=661). Analysis was by intention-to-treat. Results During fenofibrate run-in, plasma creatinine increased by 10.0 µmol/l (p<0.001), but quickly reversed on placebo assignment. It remained higher on fenofibrate than on placebo, but the chronic rise was slower (1.62 µmol/l vs 1.89 µmol/l annually, p=0.01), with less estimated GFR loss (1.19 vs 2.03 ml min−1 1.73 m−2 annually, p<0.001). After washout, estimated GFR had fallen less from baseline on fenofibrate (1.9 ml min−1 1.73 m−2, p=0.065) than on placebo (6.9 ml min−1 1.73 m−2, p<0.001), sparing 5.0 ml min−1 1.73 m−2 (95% CI 2.3-7.7, p<0.001). Greater preservation of estimated GFR with fenofibrate was observed during greater reduction over the active run-in period (pre-randomisation) of triacylglycerol (n=186 vs 170) and baseline hypertriacylglycerolaemia (n=89 vs 80) alone, or combined with low HDL-cholesterol (n=71 vs 60). Fenofibrate reduced urine albumin concentrations and hence albumin:creatinine ratio by 24% vs 12% (p<0.001; mean difference 14% [95% CI 9-18]; p<0.001), with 14% less progression and 18% more albuminuria regression (p<0.001) than in participants on placebo. End-stage renal event frequency was similar (n=21 vs 26, p=0.48). Conclusions/interpretation Fenofibrate reduced albuminuria and slowed estimated GFR loss over 5 years, despite initially and reversibly increasing plasma creatinine. Fenofibrate may delay albuminuria and GFR impairment in type 2 diabetes patients. Confirmatory studies are merited. Trial registration: ISRCTN64783481 Funding: The study was funded by grants from Laboratoires Fournier, Dijon, France (now part of Solvay and Abbott Pharmaceuticals) and the NHMRC of Australia.Laboratoires Fournier, Dijon, France (now part of Solvay and Abbott Pharmaceuticals

Effects of fenofibrate on renal function in patients with type 2 diabetes mellitus: the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) Study

Abstract Aims/hypothesis Fenofibrate caused an acute, sustained plasma creatinine increase in the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) and Action to Control Cardiovascular Risk in Diabetes (ACCORD) studies. We assessed fenofibrate’s renal effects in a FIELD washout sub-study. Methods Type 2 diabetic patients (n=9795) aged 50 to 75 years were randomly assigned to fenofibrate (n=4895) or placebo (n=4900) for 5 years, after 6 weeks fenofibrate run-in. Albuminuria (urinary albumin:creatinine ratio) measured at baseline, year 2 and close-out) and estimated GFR, measured 4 to 6 monthly according to the Modification of Diet in Renal Disease study, were pre-specified endpoints. Plasma creatinine was re-measured 8 weeks after treatment cessation at close-out (washout sub-study, n=661). Analysis was by intention-to-treat. Results During fenofibrate run-in, plasma creatinine increased by 10.0 µmol/l (p<0.001), but quickly reversed on placebo assignment. It remained higher on fenofibrate than on placebo, but the chronic rise was slower (1.62 µmol/l vs 1.89 µmol/l annually, p=0.01), with less estimated GFR loss (1.19 vs 2.03 ml min−1 1.73 m−2 annually, p<0.001). After washout, estimated GFR had fallen less from baseline on fenofibrate (1.9 ml min−1 1.73 m−2, p=0.065) than on placebo (6.9 ml min−1 1.73 m−2, p<0.001), sparing 5.0 ml min−1 1.73 m−2 (95% CI 2.3-7.7, p<0.001). Greater preservation of estimated GFR with fenofibrate was observed during greater reduction over the active run-in period (pre-randomisation) of triacylglycerol (n=186 vs 170) and baseline hypertriacylglycerolaemia (n=89 vs 80) alone, or combined with low HDL-cholesterol (n=71 vs 60). Fenofibrate reduced urine albumin concentrations and hence albumin:creatinine ratio by 24% vs 12% (p<0.001; mean difference 14% [95% CI 9-18]; p<0.001), with 14% less progression and 18% more albuminuria regression (p<0.001) than in participants on placebo. End-stage renal event frequency was similar (n=21 vs 26, p=0.48). Conclusions/interpretation Fenofibrate reduced albuminuria and slowed estimated GFR loss over 5 years, despite initially and reversibly increasing plasma creatinine. Fenofibrate may delay albuminuria and GFR impairment in type 2 diabetes patients. Confirmatory studies are merited. Trial registration: ISRCTN64783481 Funding: The study was funded by grants from Laboratoires Fournier, Dijon, France (now part of Solvay and Abbott Pharmaceuticals) and the NHMRC of Australia.Laboratoires Fournier, Dijon, France (now part of Solvay and Abbott Pharmaceuticals

White Habits, Anti‐Racism, and Philosophy as a Way of Life

This paper examines Pierre Hadot’s philosophy as a way of life in the context of race. I argue that a “way of life” approach to philosophy renders intelligible how anti-racist confrontation of racist ideas and institutionalized white complicity is a properly philosophical way of life requiring regulated reflection on habits – particularly, habits of whiteness. I first rehearse some of Hadot’s analysis of the “way of life” orientation in philosophy, in which philosophical wisdom is understood as cultivated by actions which result in the creation of wise habits. I analyze a phenomenological claim about the nature of habit implied by the “way of life” approach, namely, that habits can be both the cause and the effect of action. This point is central to the “way of life” philosophy, I claim, in that it makes possible the intelligent redirection of habits, in which wise habits are more the effect than simply the cause of action. Lastly, I illustrate the “way of life” approach in the context of anti-racism by turning to Linda Martín Alcoff’s whiteness anti-eliminativism, which outlines a morally defensible transformation of the habits of whiteness. I argue that anti-racism provides an intelligible context for modern day forms of what Hadot calls “spiritual exercises” insofar as the “way of life” philosophy is embodied in the practice of whites seeing themselves seeing as white and seeing themselves being seen as white

Cryogenic Optical Position Encoders for Mechanisms in the JWST Optical Telescope Element Simulator (OSIM)

The JWST Optical Telescope Element Simulator (OSIM) is a configurable, cryogenic, optical stimulus for high fidelity ground characterization and calibration of JWST's flight instruments. OSIM and its associated Beam Image Analyzer (BIA) contain several ultra-precise, cryogenic mechanisms that enable OSIM to project point sources into the instruments according to the same optical prescription as the flight telescope images stars - correct in focal surface position and chief ray angle. OSIM's and BIA's fifteen axes of mechanisms navigate according to redundant, cryogenic, absolute, optical encoders - 32 in all operating at or below 100 K. OSIM's encoder subsystem, the engineering challenges met in its development, and the encoders' sub-micron and sub-arcsecond performance are discussed

The Concussion Recognition Tool 5th Edition (CRT5): Background and rationale

The Concussion Recognition Tool 5 (CRT5) is the most recent revision of the Pocket Sport Concussion Assessment Tool 2 that was initially introduced by the Concussion in Sport Group in 2005. The CRT5 is designed to assist non-medically trained individuals to recognise the signs and symptoms of possible sport-related concussion and provides guidance for removing an athlete from play/sport and to seek medical attention. This paper presents the development of the CRT5 and highlights the differences between the CRT5 and prior versions of the instrument

The N3RO trial: a randomised controlled trial of docosahexaenoic acid to reduce bronchopulmonary dysplasia in preterm infants < 29 weeks’ gestation

Background: Bronchopulmonary dysplasia (BPD) is a major cause of mortality and long-term respiratory and neurological morbidity in very preterm infants. While survival rates of very preterm infants have increased over the past two decades there has been no decrease in the rate of BPD in surviving infants. Evidence from animal and human studies has suggested potential benefits of docosahexaenoic acid (DHA), an n-3 long chain polyunsaturated fatty acid, in the prevention of chronic lung disease. This randomised controlled trial aims to determine the effectiveness of supplementary DHA in reducing the rate of BPD in infants less than 29 weeks’ gestation. Methods/design: This is a multicentre, parallel group, randomised, blinded and controlled trial. Infants born less than 29 weeks’ gestation, within 3 days of first enteral feed and with parent informed consent are eligible to participate. Infants will be randomised to receive an enteral emulsion containing DHA or a control emulsion without DHA. The DHA emulsion will provide 60 mg/kg/day of DHA. The study emulsions will continue to 36 weeks’ postmenstrual age (PMA). The primary outcome is BPD as assessed by the requirement for supplemental oxygen and/or assisted ventilation at 36 weeks’ PMA. Secondary outcomes include the composite of death or BPD; duration of respiratory support and hospitalisation, major neonatal morbidities. The target sample size is 1244 infants (622 per group), which will provide 90 % power to detect a clinically meaningful absolute reduction of 10 % in the incidence of BPD between the DHA and control emulsion (two tailed α =0.05). Discussion: DHA supplementation has the potential to reduce respiratory morbidity in very preterm infants. This multicentre trial will provide evidence on whether an enteral DHA supplement reduces BPD in very preterm infants