4,403 research outputs found
Effect of Rosuvastatin on Acute Kidney Injury in Sepsis-Associated Acute Respiratory Distress Syndrome.
Background:Acute kidney injury (AKI) commonly occurs in patients with sepsis and acute respiratory distress syndrome (ARDS). Objective:To investigate whether statin treatment is protective against AKI in sepsis-associated ARDS. Design:Secondary analysis of data from Statins for Acutely Injured Lungs in Sepsis (SAILS), a randomized controlled trial that tested the impact of rosuvastatin therapy on mortality in patients with sepsis-associated ARDS. Setting:44 hospitals in the National Heart, Lung, and Blood Institute ARDS Clinical Trials Network. Patients:644 of 745 participants in SAILS who had available baseline serum creatinine data and who were not on chronic dialysis. Measurements:Our primary outcome was AKI defined using the Kidney Disease Improving Global Outcomes creatinine criteria. Randomization to rosuvastatin vs placebo was the primary predictor. Additional covariates include demographics, ARDS etiology, and severity of illness. Methods:We used multivariable logistic regression to analyze AKI outcomes in 511 individuals without AKI at randomization, and 93 with stage 1 AKI at randomization. Results:Among individuals without AKI at randomization, rosuvastatin treatment did not change the risk of AKI (adjusted odds ratio: 0.99, 95% confidence interval [CI]: 0.67-1.44). Among those with preexisting stage 1 AKI, rosuvastatin treatment was associated with an increased risk of worsening AKI (adjusted odds ratio: 3.06, 95% CI: 1.14-8.22). When serum creatinine was adjusted for cumulative fluid balance among those with preexisting stage 1 AKI, rosuvastatin was no longer associated worsening AKI (adjusted odds ratio: 1.85, 95% CI: 0.70-4.84). Limitations:Sample size, lack of urine output data, and prehospitalization baseline creatinine. Conclusion:Treatment with rosuvastatin in patients with sepsis-associated ARDS did not protect against de novo AKI or worsening of preexisting AKI
Building an online community to promote communication and collaborative learning between health professionals and young people who self-harm: an exploratory study
This is the accepted version of the article, which has been published in final form at doi: 10.1111/hex.12011.Background: Online communities are known to break down barriers between supposed experts and non-experts and to promote collaborative learning and 'radical trust' among members. Young people who self-harm report difficulties in communicating with health professionals, and vice versa. Aim: We sought to bring these two groups together online to see how well they could communicate with each other about self-harm and its management, and whether they could agree on what constituted safe and relevant advice. Methods: We allocated 77 young people aged 16-25 with experience of self-harm and 18 recently/nearly qualified professionals in relevant health-care disciplines to three separate Internet discussion forums. The forums contained different proportions of professionals to young people (none; 25%; 50% respectively) to allow us to observe the effect of the professionals on online interaction. Results: The young people were keen to share their lived experience of self-harm and its management with health professionals. They engaged in lively discussion and supported one another during emotional crises. Despite registering to take part, health professionals did not actively participate in the forums. Reported barriers included lack of confidence and concerns relating to workload, private-professional boundaries, role clarity, duty of care and accountability. In their absence, the young people built a vibrant lay community, supported by site moderators. Conclusions: Health professionals may not yet be ready to engage with young people who self-harm and to exchange knowledge and experience in an anonymous online setting. Further work is needed to understand and overcome their insecurities.NIH
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The Human–Nature Relationship and Its Impact on Health: A Critical Review
Within the past four decades, research has been increasingly drawn toward understanding whether there is a link between the changing human–nature relationship and its impact on people’s health. However, to examine whether there is a link requires research of its breadth and underlying mechanisms from an interdisciplinary approach. This article begins by reviewing the debates concerning the human–nature relationship, which are then critiqued and redefined from an interdisciplinary perspective. The concept and chronological history of “health” is then explored, based on the World Health Organization’s definition. Combining these concepts, the human–nature relationship and its impact on human’s health are then explored through a developing conceptual model. It is argued that using an interdisciplinary perspective can facilitate a deeper understanding of the complexities involved for attaining optimal health at the human–environmental interface
African Americans, Gentrification, and Neoliberal Urbanization: the Case of Fort Greene, Brooklyn
This article examines the gentrification of Fort Greene, which is located in the western part of black Brooklyn, one of the largest contiguous black urban areas in the USA. Between the late 1960s and 2003, gentrification in Fort Greene followed the patterns discovered by scholars of black neighborhoods; the gentrifying agents were almost exclusively black and gentrification as a process was largely bottom-up because entities interested in the production of space were mostly not involved. Since 2003, this has changed. Whites have been moving to Fort Greene in large numbers and will soon represent the numerical majority. Public and private interventions in and around Fort Greene have created a new top-down version of gentrification, which is facilitating this white influx. Existing black residential and commercial tenants are replaced and displaced in the name of urban economic development
Nature doesn't judge you – how urban nature supports young people's mental health and wellbeing in a diverse UK city
Reviewed research reveals a lack of young people's voices articulating if and how urban nature supports their mental health and wellbeing. This paper presents qualitative research with young multi-ethnic urban residents living in a northern UK city and offers an important counter-narrative to the pervasive notion of childhood nature-deficit disorder. Using interviews and creative arts workshops, we explored the value of urban nature for the mental health and wellbeing of 24 young people aged 17–27 years, 9 of whom had lived experience of mental health difficulties. Trees, water, open spaces and views were frequently experienced nature typologies offering benefits. Deteriorating landscapes, young people's shifting identities and perceived time pressures disrupted support. Young people expressed how urban nature encounters were experienced as accepting and relational, offering a: stronger sense of self; feelings of escape; connection and care with the human and non-human world
The twilight of the Liberal Social Contract? On the Reception of Rawlsian Political Liberalism
This chapter discusses the Rawlsian project of public reason, or public justification-based 'political' liberalism, and its reception. After a brief philosophical rather than philological reconstruction of the project, the chapter revolves around a distinction between idealist and realist responses to it. Focusing on political liberalism’s critical reception illuminates an overarching question: was Rawls’s revival of a contractualist approach to liberal legitimacy a fruitful move for liberalism and/or the social contract tradition? The last section contains a largely negative answer to that question. Nonetheless the chapter's conclusion shows that the research programme of political liberalism provided and continues to provide illuminating insights into the limitations of liberal contractualism, especially under conditions of persistent and radical diversity. The programme is, however, less receptive to challenges to do with the relative decline of the power of modern states
Iron isotope systematics in estuaries : the case of North River, Massachusetts (USA)
Author Posting. © The Author(s), 2009. 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 Geochimica et Cosmochimica Acta 73 (2009): 4045-4059, doi:10.1016/j.gca.2009.04.026.Recent studies have suggested that rivers may present an isotopically light Fe
source to the oceans. Since the input of dissolved iron from river water is generally
controlled by flocculation processes that occur during estuarine mixing, it is important to
investigate potential fractionation of Fe-isotopes during this process. In this study, we
investigate the influence of the flocculation of Fe-rich colloids on the iron isotope
composition of pristine estuarine waters and suspended particles. The samples were
collected along a salinity gradient from the fresh water to the ocean in the North River
estuary (MA, USA). Estuarine samples were filtered at 0.22 μm and the iron isotope
composition of the two fractions (dissolved and particles) were analyzed using high
resolution MC-ICP-MS after chemical purification. Dissolved iron results show positive
δ56Fe values (with an average of 0.43 ± 0.04 ‰) relative to the IRMM-14 standard and do
not display any relationships with salinity or with percentage of colloid flocculation. The
iron isotopic composition of the particles suspended in fresh water is characterized by
more negative δ56Fe values than for dissolved Fe and correlate with the percentage of Fe
flocculation. Particulate δ56Fe values vary from -0.09‰ at no flocculation to ~ 0.1‰ at
the flocculation maximum, which reflect mixing effects between river-borne particles,
lithogenic particles derived from coastal seawaters and newly precipitated colloids. Since
the process of flocculation produces minimal Fe-isotope fractionation in the dissolved Fe
pool, we suggest that the pristine iron isotope composition of fresh water is preserved
during estuarine mixing and that the value of the global riverine source into the ocean can
be identified from the fresh water values. However, this study also suggests that δ56Fe
composition of rivers can also be characterized by more positive δ56Fe values (up to 0.3
per mil) relative to the crust than previously reported. In order to improve our current
understanding of the oceanic iron isotope cycling, further work is now required to
determine the processes controlling the fractionation of Fe isotopes during continental
run-off.This study was supported by the National Science Foundation (OCE 0550066) to O. Rouxel and Edward Sholkovitz
The Long-Baseline Neutrino Experiment: Exploring Fundamental Symmetries of the Universe
The preponderance of matter over antimatter in the early Universe, the
dynamics of the supernova bursts that produced the heavy elements necessary for
life and whether protons eventually decay --- these mysteries at the forefront
of particle physics and astrophysics are key to understanding the early
evolution of our Universe, its current state and its eventual fate. The
Long-Baseline Neutrino Experiment (LBNE) represents an extensively developed
plan for a world-class experiment dedicated to addressing these questions. LBNE
is conceived around three central components: (1) a new, high-intensity
neutrino source generated from a megawatt-class proton accelerator at Fermi
National Accelerator Laboratory, (2) a near neutrino detector just downstream
of the source, and (3) a massive liquid argon time-projection chamber deployed
as a far detector deep underground at the Sanford Underground Research
Facility. This facility, located at the site of the former Homestake Mine in
Lead, South Dakota, is approximately 1,300 km from the neutrino source at
Fermilab -- a distance (baseline) that delivers optimal sensitivity to neutrino
charge-parity symmetry violation and mass ordering effects. This ambitious yet
cost-effective design incorporates scalability and flexibility and can
accommodate a variety of upgrades and contributions. With its exceptional
combination of experimental configuration, technical capabilities, and
potential for transformative discoveries, LBNE promises to be a vital facility
for the field of particle physics worldwide, providing physicists from around
the globe with opportunities to collaborate in a twenty to thirty year program
of exciting science. In this document we provide a comprehensive overview of
LBNE's scientific objectives, its place in the landscape of neutrino physics
worldwide, the technologies it will incorporate and the capabilities it will
possess.Comment: Major update of previous version. This is the reference document for
LBNE science program and current status. Chapters 1, 3, and 9 provide a
comprehensive overview of LBNE's scientific objectives, its place in the
landscape of neutrino physics worldwide, the technologies it will incorporate
and the capabilities it will possess. 288 pages, 116 figure
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