The E¤ect of Rurality on Mental and Physical Health

Any time researchers choose to conduct a study on any aspect of rural health care, they are faced with a di¢ cult methodological choice regarding the oper- ational de?nition of rural to use in their study. While this seems to many who are not familiar with rural research to be a straightforward question (and often naive rural researchers expect to ?nd a single answer that is commonly agreed upon by experts in rural research), to date there is no single answer that is based on a consensus and supported by scienti?c evidence. Coburn, et al. (2007) states that ?there is no single, universally preferred de?nition of rural that serves all policy purposes.? One goal of this paper is to provide a method useful in informing the choice of rural de?nitions for a speci?c research study. This methods paper presents a systematic evaluation of the impact of the choice of rural de?nition on results. It was stimulated by the need to select a rural de?nition to use in related papers on the impact of community resources on mental and general health outcomes in other research by the authors. A na- tional dataset, the Community Tracking Survey, 2000-2001, includes individual level observations from household interviews. We merge it with county level data re?ecting community resources, and we use econometric methods to ana- lyze this multi-level data, accounting for individuals from the same family being included in the dataset. The e¤ect of using four di¤erent de?nitions of rural available for use in county level analysis is presented. A statistical analysis of the impact of the choice of a rural de?nition on outcomes and on the esti- mates and signi?cance of explanatory variables in the model is presented and is used to inform the selection of the de?nition to use in other research. Dif- ferences in results for mental health, physical health, and utilization of health care variables are evaluated. The choice of a rural definition is presented and justi?ed using the methodological analyses presented in this paper. Strengths and weaknesses of using county-level community characteristics as compared to data from larger geographic areas, such as Health Services Areas, or from smaller geographic areas, such as census tracts or zip codes, are discussed. Fi- nally, the need for a methods study to guide the use of multi-level geographic data to re?ect community characteristics within health care studies is proposed.rural, mental health, physical health, testing

Percepção do diagnóstico por laparoscopia na perspectiva da habilidade profissional do gastroenterologista

Introducción: la calidad de la formación del residente es una exigencia social.Objetivo: diseñar una vía parafavorecer la apropiación del diagnóstico laparoscópico (DL) por el residente de gastroenterología (RG) desde la perspectiva de habilidad profesional.Método: se realizó un estudio con enfoque cualitativo en la Facultad de Medicina de Guantánamo durante el curso 2018-2019. Se emplearon métodos teóricos (analítico-sintético e inductivo-deductivo, modelación); empíricos (análisis documental, la encuesta, criterio de especialistas) y matemáticos estadísticos (cálculo de porcentajes).Resultados: el 100 % de los profesores encuestados reconoció que se manifiestan insuficiencias en la preparación del RG para la realización del DL, en lo que influyó la limitada percepción del diagnóstico laparoscópico (DL) como habilidad para el gastroenterólogo. Se modeló teóricamente el desarrollo de la habilidad diagnóstico laparoscópico y el 100 % de los profesores consultados consideró que podría ser instrumentado en la práctica pedagógica.Conclusiones: se modeló didácticamente la preparación del residente para realización del diagnóstico laparoscópico, lo que puede contribuir a un cambio didáctico-metodológico cualitativamente superior en el proceso de enseñanza aprendizaje en la especialización en Gastroenterología.Introduction: the quality of the resident's education is a social requirement.Objective: to design a way to favor the appropriation of laparoscopic diagnosis (DL) by the resident of gastroenterology (RG) from the perspective of professional skill.Method: a qualitative study was conducted at the Faculty of Medicine of Guantánamo during the 2018-2019 academic year. Theoretical methods were used (analytic-synthetic and inductive-deductive, modeling); empirical (documentary analysis, the survey, criteria of specialists) and statistical mathematicians (calculation of percentages).Results: 100% of the professors surveyed acknowledged that insufficiencies were manifested in the preparation of the GR for the realization of DL, which was influenced by the limited perception of laparoscopic diagnosis (DL) as a skill for the gastroenterologist. The development of the laparoscopic diagnostic skill was theoretically modeled and 100% of the professors consulted considered that it could be instrumented in the pedagogical practice.Conclusions: the preparation of the resident was modeled didactically for laparoscopic diagnosis, which can contribute to a qualitatively superior didactic-methodological change in the teaching-learning process in the specialization in Gastroenterology.Introdução: a qualidade da educação do residente é uma exigência social.Objetivo: conceber uma forma de favorecer a apropriação do diagnóstico laparoscópico (DL) pelo residente de gastroenterologia (GP) na perspectiva da habilidade profissional.Método: um estudo qualitativo foi realizado na Faculdade de Medicina de Guantánamo durante o ano letivo de 2018-2019. Métodos teóricos foram utilizados (analítico-sintético e indutivo-dedutivo, modelagem); empírica (análise documental, a pesquisa, critérios de especialistas) e matemáticos estatísticos (cálculo de porcentagens).Resultados: 100% dos professores pesquisados reconheceram que as inadequações se manifestaram no preparo do GR para a realização do DL, no qual a limitada percepção do diagnóstico laparoscópico (DL) como habilidade do gastroenterologista influenciou. O desenvolvimento da habilidade diagnóstica laparoscópica foi modelado teoricamente e 100% dos professores consultados consideraram que ela poderia ser instrumentada na prática pedagógica.Conclusões: a preparação do morador foi modelada didaticamente para o diagnóstico laparoscópico, o que pode contribuir para uma mudança didático-metodológica qualitativamente superior no processo de ensino-aprendizagem na especialização em Gastroenterologia

The Iowa Homemaker vol.3, no.4-5

Table of Contents We “Do Over” Our Rooms by Irma Camp and Alice Dodge, page 1 The Mysteries of Amateur Make Up by Frederica Shattuck, page 2 Fall Time Is Pickling Time by Katherine Howells, page 4 Episodes Concerning Evolution of Home Economics by Ruth Elaine Wilson, page 5 Tea – Suggestive of the Rainbow by Esther Ellen Rayburn, page 6 Vary the Vegetable by Blanche Ingersoll, page 7 Constipation and Its Dangers by Anne Mundt, page 8 Graduate Credit Conference for Vocational Home Economics at Iowa State by Eleanor Murray, page 9 Fish That Is Appetizing by Maxine Smith, page 9 Economy, Or a Wrong Idea by Harriett Wallace, page 1

Beyond plant blindness: seeing the importance of plants for a sustainable world

In recent years an interdisciplinary nexus has been generated around what it means to experience life as a plant. From the science of plant behaviours, plant language and meaning-making to plant-based philosophy, plant enquiries are crossing disciplinary and conceptual boundaries. The everyday life of a plant can appear to be static and silent to human perception. And yet, as modern science narratives tell their stories, we are realising that plants live in complex, and often social worlds. Removing plants from the human view makes it easier for us to exploit them and appears accordingly to reduce our ability to see into their worlds. In this research study we ask how, by taking a different view through an interdisciplinary lens, might we improve our understanding and sensitivity to the lives of plants? Thus, our research contributes to policy contexts in which society cannot afford its citizens to be plant blind to contemporary conservation issues

Control geomorfológico en el desarrollo de los suelos en la subcuenca hidrográfica Linga, Arequipa

La zona de estudio pertenece a la subcuenca Linga, en el Distrito de Cocachacra, Departamento de Arequipa (Figura 1). En esta zona aflora una gran variedad de rocas sedimentarias, metamórficas, volcánicas e intrusivas que abarcan un amplio rango de edad que van desde el Proterozoico hasta el Cuaternario, además existen unidades de relieve tales como montañas, colinas, lomas, llanuras y vallecitos, y zonas climáticas de desierto superárido con sus respectivos microclimas. Este trabajo tiene como objetivo realizar un análisis del desarrollo del suelo en las superunidades Linga y Punta Coles con la finalidad de comprender la relación existente entre el grado de desarrollo del suelo, el relieve del terreno y el microclima en el cual se dan lugar los procesos pedogéneticos. Este estudio se encuentra enmarcado dentro de las labores realizadas dentro de la cuenca hidrográfica del Río Tambo por el Proyecto de la Carta Nacional de Suelos de la Dirección de Geología Regional, INGEMMET. Los estudios de pedogénesis muestran que el material parental, relieve, clima, organismos y tiempo, son los factores relevantes en el desarrollo de un suelo. En este trabajo, se ha evaluado el grado de desarrollo de los suelos en función de la variación del relieve y microclima en unidades intrusivas del Cretácico superior - Paleoceno y Jurásico inferior a medio (Superunidad Linga y PuntaColes). Se establecieron 2 catenas, 4 pedones en la superunidad Linga y 3 pedones en la superunidad Punta Coles. Los pedones de ambas catenas corresponden a depósitos residuales, con grado de desarrollo desde muy superficiales a superficiales. Las observaciones sugieren que existe un claro contraste entre los suelos generados en zonas de montañas, colinas y lomas, correspondiendo a un dominio del factor relieve y en menor medida al microclima

Sex bias in biopsy samples collected from free-ranging dolphins

Author Posting. © The Author(s), 2009. This is the author's version of the work. It is posted here by permission of Springer for personal use, not for redistribution. The definitive version was published in European Journal of Wildlife Research 56 (2010): 151-158, doi:10.1007/s10344-009-0299-7.Biological samples of free-ranging dolphins are increasingly used to gain information on population structure and ecology. In small cetaceans, the gender of individuals usually cannot be determined at sea, and population sex ratio has to be inferred indirectly. We used molecular sexing to determine the gender of 340 biopsy samples of bottlenose dolphins, Tursiops truncatus, spotted dolphins, Stenella frontalis, and common dolphins, Delphinus delphis, collected around the Azores and Madeira. Sex ratio was globally skewed in favor of males, and differed between species and archipelagos. Skew was probably influenced by the selectivity of biopsy collectors and seasonal or year-round predominance of males in natural populations. Skew was also influenced by sampling duration and intensity. In the Azores, when several samples were successively collected within the same group, the proportion of female samples decreased as a function of sample order. This trend indicated a tendency for females to increasingly avoid the boat while samples were being collected. It showed that males and females reacted differently to the perturbation caused by the biopsy sampling process (i.e. sample collection and driving style).Portuguese Foundation for Science and Technology (FCT) and the FEDER program for funding the CETAMARH (POCTI/BSE/38991/01) and the GOLFINICHO (POCI/BIA-BDE/61009/2004) projects, S.Q.'s post-doctoral grants (IMAR/FCT- PDOC-006/2001-MoleGen and SFRH/BPD/19680/2004), M.A.S.'s doctoral (SFRH/BD/8609/2002) and post-doctoral (SFRH/BPD/29841/2006) grants, S.M.'s investigation assistant grant (CETAMARHII/POCTI/BSE/38991/2001) and I.C.'s investigation assistant grants (IMAR/FCT/GOLFINICHO/001/2005 and IMAR/FCT/GOLFINICHO/004/2006). FCT for its pluri-annual funding to Research Unit #531 and the EU funded program Interreg IIIb for funding the MACETUS project (MAC/4.2/M10) as well as R.P. and S.M.’s grants (IMAR/INTERREGIIIb/MACETUS/MAC1/2)

Clear cell variant of diffuse large B-cell lymphoma: a case report

<p>Abstract</p> <p>Introduction</p> <p>Diffuse large B-cell lymphoma is a diffuse proliferation of large neoplastic B lymphoid cells with a nuclear size equal to or exceeding the normal macrophage nuclei. We report a case of a clear cell variant of diffuse large B-cell lymphoma involving a lymph node in the neck, which was clinically suspected of being metastatic carcinoma.</p> <p>Case presentation</p> <p>A 39-year-old Caucasian ethnic Albanian man from Kosovo presented with a rapidly enlarging lymph node in his neck, but he also disclosed B symptoms and fatigue. A cytological aspirate of the lymph node revealed pleomorphic features. Our patient underwent a cervical lymph node biopsy (large excision). The mass was homogeneously fish-flesh, pale white tissue replacing almost the whole structure of the lymph node. The lymph node biopsy showed a partial alveolar growth pattern, which raised clinical suspicion that it was an epithelial neoplasm. With regard to morphological and phenotypic features, we discovered large nodules in diffuse areas, comprising large cells with slightly irregular nuclei and clear cytoplasm admixed with a few mononuclear cells. In these areas, there was high mitotic activity, and in some areas there were macrophages with tangible bodies. Staining for cytokeratins was negative. These areas had the following phenotypes: cluster designation marker 20 (CD20) positive, B-cell lymphoma (Bcl)-2-positive, Bcl-6^-, CD5^-, CD3^-, CD21⁺(in alveolar patterns), prostate-specific antigen-negative, human melanoma black marker 45-negative, melanoma marker-negative, cytokeratin-7-negative and multiple myeloma marker 1-positive in about 30% of cells, and exhibited a high proliferation index marker (Ki-67, 80%).</p> <p>Conclusion</p> <p>According to the immunohistochemical findings, we concluded that this patient has a clear cell variant of diffuse large B-cell lymphoma of activated cell type, post-germinal center cell origin. Our patient is undergoing R-CHOP chemotherapy treatment.</p

Prevention of Birch Pollen-Related Food Allergy by Mucosal Treatment with Multi-Allergen-Chimers in Mice

Among birch pollen allergic patients up to 70% develop allergic reactions to Bet v 1-homologue food allergens such as Api g 1 (celery) or Dau c 1 (carrot), termed as birch pollen-related food allergy. In most cases, specific immunotherapy with birch pollen extracts does not reduce allergic symptoms to the homologue food allergens. We therefore genetically engineered a multi-allergen chimer and tested if mucosal treatment with this construct could represent a novel approach for prevention of birch pollen-related food allergy.BALB/c mice were poly-sensitized with a mixture of Bet v 1, Api g 1 and Dau c 1 followed by a sublingual challenge with carrot, celery and birch pollen extracts. For prevention of allergy sensitization an allergen chimer composed of immunodominant T cell epitopes of Api g 1 and Dau c 1 linked to the whole Bet v 1 allergen, was intranasally applied prior to sensitization.Intranasal pretreatment with the allergen chimer led to significantly decreased antigen-specific IgE-dependent β-hexosaminidase release, but enhanced allergen-specific IgG2a and IgA antibodies. Accordingly, IL-4 levels in spleen cell cultures and IL-5 levels in restimulated spleen and cervical lymph node cell cultures were markedly reduced, while IFN-γ levels were increased. Immunomodulation was associated with increased IL-10, TGF-β and Foxp3 mRNA levels in NALT and Foxp3 in oral mucosal tissues. Treatment with anti-TGF-β, anti-IL10R or anti-CD25 antibodies abrogated the suppression of allergic responses induced by the chimer.Our results indicate that mucosal application of the allergen chimer led to decreased Th2 immune responses against Bet v 1 and its homologue food allergens Api g 1 and Dau c 1 by regulatory and Th1-biased immune responses. These data suggest that mucosal treatment with a multi-allergen vaccine could be a promising treatment strategy to prevent birch pollen-related food allergy

In utero exposure to butyl benzyl phthalate induces modifications in the morphology and the gene expression profile of the mammary gland: an experimental study in rats

<p>Abstract</p> <p>Background</p> <p>Environmental estrogens are exogenous estrogen-mimicking compounds that can interfere with endogenous endocrine systems. Several of these endocrine disruptors have been shown to alter normal development and influence tumorigenesis in experimental models. N-butyl benzyl phthalate (BBP), a widely used plasticizer, is a well-known endocrine disruptor. The aim of this study was to elucidate the effect of prenatal exposure to BBP on the morphology, proliferative index, and genomic signature of the rat mammary gland at different ages.</p> <p>Methods</p> <p><it>In utero </it>exposure was performed by gavage of pregnant Sprague Dawley CD rats with 120mg or 500mg BBP/kg/day from day 10 post-conception to delivery. Female litters were euthanized at 21, 35, 50 and 100 days. The morphology and proliferative index of the mammary gland were studied from whole mount preparations and BrdU incorporation, respectively. Gene expression profile was assessed by microarrays. Several genes found differentially expressed and related to different functional categories were further validated by real time RT-PCR.</p> <p>Results</p> <p>Prenatal exposure of BBP induced delayed vaginal opening and changes in the post-natal mammary gland long after the end of the treatment, mainly by 35 days of age. Exposure to the high dose resulted in modifications in architecture and proliferative index of the mammary gland, mostly affecting the undifferentiated terminal end buds. Moreover, the expression profiles of this gland in the exposed rats were modified in a dose-dependent fashion. Analysis of functional categories showed that modified genes were related to immune function, cell signaling, proliferation and differentiation, or metabolism.</p> <p>Conclusions</p> <p>Our data suggest that <it>in utero </it>exposure to BBP induced a delayed pubertal onset and modified morphology of the mammary gland. These alterations were accompanied by modifications in gene expression previously associated with an increased susceptibility to carcinogenesis.</p