Environmental Risk Factors for Pneumocystis Pneumonia Hospitalizations in HIV Patients

Background. Pneumocystis pneumonia (PcP) is the second leading cause of morbidity and mortality in human immunodeficiency virus (HIV)–infected patients in the United States. Although the host risk factors for the development of PcP are well established, the environmental (climatological, air pollution) risk factors are poorly understood. The major goal of this study was to determine the environmental risk factors for admissions of HIV-positive patients with PcP to a single medical center. / Methods. Between 1997 and 2008, 457 HIV-positive patients with microscopically confirmed PcP were admitted to the San Francisco General Hospital. A case-crossover design was applied to identify environmental risk factors for PcP hospitalizations. Climatological and air pollution data were collected from the Environmental Protection Agency and Weather Warehouse databases. Conditional logistic regression was used to evaluate the association of each environmental factor and PcP hospital admission. / Results. Hospital admissions were significantly more common in the summer than in the other seasons. Increases in temperature and sulfur dioxide levels were independently associated with hospital admissions for PcP, but the effects of sulfur dioxide were modified by increasing carbon monoxide levels. / Conclusions. This study identifies both climatological and air pollution constituents as independent risk factors for hospitalization of HIV-positive patients with PcP in San Francisco. Thus, the environmental effects on PcP are more likely complex than previously thought. Further studies are needed to understand how these factors exert their effects and to determine if these factors are associated with PcP in other geographic locations

Patient satisfaction and side effects in primary care: An observational study comparing homeopathy and conventional medicine

<p>Abstract</p> <p>Background</p> <p>This study is part of a nationwide evaluation of complementary medicine in Switzerland (Programme Evaluation of Complementary Medicine PEK) and was funded by the Swiss Federal Office of Public Health. The main objective of this study is to investigate patient satisfaction and perception of side effects in homeopathy compared with conventional care in a primary care setting.</p> <p>Methods</p> <p>We examined data from two cross-sectional studies conducted in 2002–2003. The first study was a physician questionnaire assessing structural characteristics of practices. The second study was conducted on four given days during a 12-month period in 2002/2003 using a physician and patient questionnaire at consultation and a patient questionnaire mailed to the patient one month later (including Europep questionnaire).</p> <p>The participating physicians were all trained and licensed in conventional medicine. An additional qualification was required for medical doctors providing homeopathy (membership in the Swiss association of homeopathic physicians SVHA).</p> <p>Results</p> <p>A total of 6778 adult patients received the questionnaire and 3126 responded (46.1%). Statistically significant differences were found with respect to health status (higher percentage of chronic and severe conditions in the homeopathic group), perception of side effects (higher percentage of reported side effects in the conventional group) and patient satisfaction (higher percentage of satisfied patients in the homeopathic group).</p> <p>Conclusion</p> <p>Overall patient satisfaction was significantly higher in homeopathic than in conventional care. Homeopathic treatments were perceived as a low-risk therapy with two to three times fewer side effects than conventional care</p

Health behaviors and risk factors in those who use complementary and alternative medicine

<p>Abstract</p> <p>Background</p> <p>Surveys have generally found that individuals more likely to use complementary and alternative medicine are female, live in the western United States, are likely to have a health complaint, and have a higher socioeconomic status than do nonusers. What is not known is the extent to which those who use complementary and alternative medicine also engage in positive health behaviors, such as smoking cessation or increased physical activity and/or exhibit fewer health risk factors such as obesity. This has been identified as a key research question in a recent Institute of Medicine report. In the present study we sought to determine whether the use of complementary and alternative medicine is associated with health behaviors or risk factors known to impact on health status.</p> <p>Methods</p> <p>The current study is a cross-sectional regression analysis using data from the 2002 National Health Interview Survey. Data were collected in-person from 31,044 adults throughout the 50 states and the District of Columbia.</p> <p>Results</p> <p>After controlling for a range of other factors, we found that engaging in leisure-time physical activity, having consumed alcohol in one's life but not being a current heavy drinker, and being a former smoker are independently associated with the use of CAM. Obese individuals are slightly less likely to use CAM than individuals with a healthy body-mass index. No significant associations were observed between receipt of an influenza vaccine and CAM use.</p> <p>Conclusion</p> <p>Those engaging in positive health behaviors and exhibiting fewer health risk factors are more likely to use CAM than those who forgo positive health behaviors or exhibit more health risk factors. The fact that users of CAM tend to pursue generally healthy lifestyles suggests that they may be open to additional recommendations toward optimizing their health.</p

Top predators in relation to bathymetry, ice and krill during austral winter in Marguerite Bay, Antarctica

Author Posting. © Elsevier B.V., 2007. This is the author's version of the work. It is posted here by permission of Elsevier B.V. for personal use, not for redistribution. The definitive version was published in Deep Sea Research Part II: Topical Studies in Oceanography 55 (2008): 485-499, doi:10.1016/j.dsr2.2007.11.006.A key hypothesis guiding the U.S. Southern Ocean Global Ocean Ecosystems Dynamics (U.S. SO GLOBEC) program is that deep across-shelf troughs facilitate the transport of warm and nutrient-rich waters onto the continental shelf of the Western Antarctic Peninsula, resulting in enhanced winter production and prey availability to top predators. We tested aspects of this hypothesis during austral winter by assessing the distribution of the resident pack-ice top predators in relation to these deep across-shelf troughs and by investigating associations between top predators and their prey. Surveys were conducted July-August 2001 and August-September 2002 in Marguerite Bay, Antarctica, with a focus on the main across-shelf trough in the bay, Marguerite Trough. The common pack-ice seabird species were snow petrel (Pagodroma nivea, 1.2 individuals km-2), Antarctic petrel (Thalassoica antarctica, 0.3 individuals km-2), and Adélie penguin (Pygoscelis adeliae, 0.5 individuals km-2). The most common pack-ice pinniped was crabeater seal (Lobodon carcinophagus). During both winters, snow and Antarctic petrels were associated with low sea ice concentrations independent of Marguerite Trough, while Adélie penguins occurred in association with this trough. Krill concentrations, both shallow and deep, were also associated with Adélie penguin and snow petrel distributions. During both winters, crabeater seal occurrence was associated with deep krill concentrations and with regions of lower chlorophyll concentration. The area of lower chlorophyll concentrations occurred in an area with complex bathymetry close to land and heavy ice concentrations. Complex or unusual bathymetry via its influence on physical and biological processes appears to be one of the keys to understanding how top predators survive during the winter in this Antarctic region.This material is based upon work supported by the National Science Foundation under Grants No. OPP-9910096 (to C. Ribic), OPP-9910307 (to P. Wiebe), OPP-9632763, OPP-0120525, OPP-0217282 and OPP-0224727 (to W. Fraser), and a Fulbright Scholarship and Office of Naval Research Grant N00014-03-0212 (to G. Lawson)

Oxygen: A Fundamental Property Regulating Pelagic Ecosystem Structure in the Coastal Southeastern Tropical Pacific

Background: In the southeastern tropical Pacific anchovy (Engraulis ringens) and sardine (Sardinops sagax) abundance have recently fluctuated on multidecadal scales and food and temperature have been proposed as the key parameters explaining these changes. However, ecological and paleoecological studies, and the fact that anchovies and sardines are favored differently in other regions, raise questions about the role of temperature. Here we investigate the role of oxygen in structuring fish populations in the Peruvian upwelling ecosystem that has evolved over anoxic conditions and is one of the world's most productive ecosystems in terms of forage fish. This study is particularly relevant given that the distribution of oxygen in the ocean is changing with uncertain consequences. Methodology/Principal Findings: A comprehensive data set is used to show how oxygen concentration and oxycline depth affect the abundance and distribution of pelagic fish. We show that the effects of oxygen on anchovy and sardine are opposite. Anchovy flourishes under relatively low oxygen conditions while sardine avoid periods/areas with low oxygen concentration and restricted habitat. Oxygen consumption, trophic structure and habitat compression play a fundamental role in fish dynamics in this important ecosystem. Conclusions/Significance: For the ocean off Peru we suggest that a key process, the need to breathe, has been neglected previously. Inclusion of this missing piece allows the development of a comprehensive conceptual model of pelagic fish populations and change in an ocean ecosystem impacted by low oxygen. Should current trends in oxygen in the ocean continue similar effects may be evident in other coastal upwelling ecosystems

Physical and biological variables affecting seabird distributions during the upwelling season of the northern California Current

Author Posting. © The Authors, 2004. This is the author's version of the work. It is posted here by permission of Elsevier B. V. for personal use, not for redistribution. The definitive version was published in Deep Sea Research Part II: Topical Studies in Oceanography 52 (2005): 123-143, doi:10.1016/j.dsr2.2004.08.016.As a part of the GLOBEC-Northeast Pacific project, we investigated variation in the abundance of marine birds in the context of biological and physical habitat conditions in the northern portion of the California Current System (CCS) during cruises during the upwelling season 2000. Continuous surveys of seabirds were conducted simultaneously in June (onset of upwelling) and August (mature phase of upwelling) with ocean properties quantified using a towed, undulating vehicle and a multi-frequency bioacoustic instrument (38-420 kHz). Twelve species of seabirds contributed 99% of the total community density and biomass. Species composition and densities were similar to those recorded elsewhere in the CCS during earlier studies of the upwelling season. At a scale of 2-4 km, physical and biological oceanographic variables explained an average of 25% of the variation in the distributions and abundance of the 12 species. The most important explanatory variables (among 14 initially included in each multiple regression model) were distance to upwelling-derived frontal features (center and edge of coastal jet, and an abrupt, inshore temperature gradient), sea-surface salinity, acoustic backscatter representing various sizes of prey (smaller seabird species were associated with smaller prey and the reverse for larger seabird species), and chlorophyll concentration. We discuss the importance of these variables in the context of what factors may be that seabirds use to find food. The high seabird density in the Heceta Bank and Cape Blanco areas indicate them to be refuges contrasting the low seabird densities currently found in most other parts of the CCS, following decline during the recent warm regime of the Pacific Decadal Oscillation.Support from National Science Foundation Grant OCE-0001035, National Oceanic and Atmospheric Administration (NOAA)/Woods Hole Oceanographic Institution-CICOR Grant NA17RJ1223 is gratefully acknowledged

Effects of work ability and health promoting interventions for women with musculoskeletal symptoms: A 9-month prospective study

<p>Abstract</p> <p>Background</p> <p>Women working in the public human service sector in 'overstrained' situations run the risk of musculoskeletal symptoms and long-term sick leave. In order to maintain the level of health and work ability and strengthen the potential resources for health, it is important that employees gain greater control over decisions and actions affecting their health – a process associated with the concept of self-efficacy. The aim of this study was to describe the effects of a self-efficacy intervention and an ergonomic education intervention for women with musculoskeletal symptoms, employed in the public sector.</p> <p>Methods</p> <p>The design of the study was a 9-month prospective study describing the effects of two interventions, a comprehensive self-efficacy intervention (<it>n </it>= 21) and an ergonomic education intervention (<it>n </it>= 21). Data were obtained by a self-report questionnaire on health- and work ability-related factors at baseline, and at ten weeks and nine months follow-up. Within-group differences over time were analysed.</p> <p>Results</p> <p>Over the time period studied there were small magnitudes of improvements within each group. Within the self-efficacy intervention group positive effects in perceived work ability were shown. The ergonomic education group showed increased positive beliefs about future work ability and a more frequent use of pain coping strategies.</p> <p>Conclusion</p> <p>Both interventions showed positive effects on women with musculoskeletal symptoms, but in different ways. Future research in this area should tailor interventions to participants' motivation and readiness to change.</p

The luxR gene product of Vibrio harveyi is a transcriptional activator of the lux promoter.

Expression of the lux operon from the marine bacterium Vibrio harveyi is dependent on cell density and requires an unlinked regulatory gene, luxR, and other cofactors for autoregulation. Escherichia coli transformed with the lux operon emits very low levels of light, and this deficiency can be partially alleviated by coexpression of luxR in trans. The V. harveyi lux promoter was analyzed in vivo by primer extension mapping to examine the function of luxR. RNA isolated from E. coli transformed with the Vibrio harveyi lux operon was shown to have a start site at 123 bp upstream of the first ATG codon of luxC. This is in sharp contrast to the start site found for lux RNA isolated from V. harveyi, at 26 bp upstream of the luxC initiation codon. However, when E. coli was cotransformed with both the lux operon and luxR, the start site of the lux mRNA shifted from -123 to -26. Furthermore, expression of the luxR gene caused a 350-fold increase in lux mRNA levels. The results suggest that LuxR of V. harveyi is a transcriptional activator stimulating initiation at the -26 lux promoter