25-hydroxyvitamin D deficiency, exacerbation frequency and human rhinovirus exacerbations in chronic obstructive pulmonary disease.

BACKGROUND: 25-hydroxyvitamin D deficiency is associated with COPD and increased susceptibility to infection in the general population. METHODS: We investigated whether COPD patients deficient in 25-hydroxyvitamin D were more likely to be frequent exacerbators, had reduced outdoor activity and were more susceptible to human rhinovirus (HRV) exacerbations than those with insufficient and normal levels. We also investigated whether the frequency of FokI, BsmI and TaqIα 25-hydroxyvitamin D receptor (VDR) polymorphisms differed between frequent and infrequent exacerbators. RESULTS: There was no difference in 25-hydroxyvitamin D levels between frequent and infrequent exacerbators in the summer; medians 44.1 nmol/L (29.1 - 68.0) and 39.4 nmol/L (22.3 - 59.2) or winter; medians 24.9 nmol/L (14.3 - 43.1) and 27.1 nmol/L (19.9 - 37.6). Patients who spent less time outdoors in the 14 days prior to sampling had lower 25-hydroxyvitamin D levels (p = 0.02). Day length was independently associated with 25-hydroxyvitamin D levels (p = 0.02). There was no difference in 25-hydroxyvitamin D levels between baseline and exacerbation; medians 36.2 nmol/L (IQR 22.4-59.4) and 33.3 nmol/L (23.0-49.7); p = 0.43. HRV positive exacerbations were not associated with lower 25-hydroxyvitamin D levels at exacerbation than exacerbations that did not test positive for HRV; medians 30.0 nmol/L (20.4 - 57.8) and 30.6 nmol/L (19.4 - 48.7). There was no relationship between exacerbation frequency and any VDR polymorphisms (all p > 0.05). CONCLUSIONS: Low 25-hydroxyvitamin D levels in COPD are not associated with frequent exacerbations and do not increase susceptibility to HRV exacerbations. Independent of day length, patients who spend less time outdoors have lower 25-hydroxyvitamin D concentration

Mineralization of osteoblasts with electrospun collagen/hydroxyapatite nanofibers

10.1007/s10856-007-3289-xJournal of Materials Science: Materials in Medicine1952039-2046JSMM

Breast cancer in South East Asia: Comparison of presentation and outcome between a middle income and a high income country

10.1007/s00268-012-1746-2World Journal of Surgery36122838-2846WJSU

Rise of the Machines: A Critical Review on the Behavioural Effects of Automating Traditional Gambling Games

Automated gambling products are now a common feature on many casino floors. Despite their increasing prevalence, little research has considered the impact of converting games traditionally free from technological enhancements to automated versions. This review seeks to illustrate how automation is likely to change the way people engage and experience traditional games based around five prominent modifications: visual and auditory enhancements; illusions of control; cognitive complexity; expedited play; and social customisation. Otherwise known as the "VICES" framework. The inclusion of rich graphics, event-dependent sound and game-play information such as statistics, history, betting options and strategic betting are likely to prolong and entice gambling while encouraging more intense betting. Changes to the social environment due to the asocial nature of automated products is also likely to significantly change the gambling experience. Given the increasing prevalence of these products in the marketplace, it is important to consider the implications of converting traditional products to automated form as technological enhancements have the potential to allow for faster, more intense betting. More research is needed to determine the full impact of automation on player behaviours in order to understand the potential risks associated with technological enhancements to traditional games

Occupational issues of adults with ADHD

Background: ADHD is a common neurodevelopmental disorder that persists into adulthood. Its symptoms cause impairments in a number of social domains, one of which is employment. We wish to produce a consensus statement on how ADHD affects employment. Methods: This consensus development conference statement was developed as a result of a joint international meeting held in July 2010. The consensus committee was international in scope (United Kingdom, mainland Europe, United Arab Emirates) and consisted of individuals from a broad range of backgrounds (Psychiatry, Occupational Medicine, Health Economists, Disability Advisors). The objectives of the conference were to discuss some of the occupational impairments adults with ADHD may face and how to address these problems from an inclusive perspective. Furthermore the conference looked at influencing policy and decision making at a political level to address impaired occupational functioning in adults with ADHD and fears around employing people with disabilities in general. Results: The consensus was that there were clear weaknesses in the current arrangements in the UK and internationally to address occupational difficulties. More so, Occupational Health was not wholly integrated and used as a means of making positive changes to the workplace, but rather as a superfluous last resort that employers tried to avoid. Furthermore the lack of cross professional collaboration on occupational functioning in adults with ADHD was a significant problem. Conclusions: Future research needs to concentrate on further investigating occupational functioning in adults with ADHD and pilot exploratory initiatives and tools, leading to a better and more informed understanding of possible barriers to employment and potential schemes to put in place to address these problems