781 research outputs found

    PIN22: PROPHYLAXIS AGAINST RSV, VARICELLA AND PNEUMOCOCCAL INFECTIONS: ECONOMIC-BASED DECISION-MAKING

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    I support sustainability but only when doing so reflects fabulously on me: can green narcissists be cultivated?

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    Sustainability research has coalesced around the notion that many environmental problems can be framed as social dilemmas in which conflicts often arise between consumersā€™ pursuit of individual, short-term and self-directed goals and their support for collective, long-term and socially-oriented interests. The need to address this challenge is simultaneously becoming more important and challenging for macromarketers and policy makers as the incidence of individualistic consumer traits (e.g., narcissism and self-esteem), already high in general population, continues to grow throughout Western societies. This article examines why and how such individualistic tendencies (here, narcissistic exhibitionism) may impact consumersā€™ pro-environmental behavior. This research identifies an underlying mechanism (i.e., altruism) for the proposed effect. The potential effects of manageable boundary conditions for this relationship are also proposed and tested across four studies

    Anodal transcranial direct current stimulation over the primary motor cortex attenuates capsaicinā€induced dynamic mechanical allodynia and mechanical pain sensitivity in humans

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    BACKGROUND: Anodal transcranial direct current stimulation over the primary cortex has been shown to activate regions of the brain involved in the descending modulation of pain sensitivity. However, more research is required in order to dissect the spinal cord analgesic mechanisms associated with the development of central sensitisation. METHODS: In this randomised, double blind, cross over study 12 healthy participants had baseline mechanical stimulus response (S/R) functions measured before and after the development of capsaicin-induced ongoing pain sensitivity. The effects of 20Ā min of either real or sham transcranial direct current stimulation (tDCS, 2Ā mA) over the primary motor cortex on dynamic mechanical allodynia (DMA) and mechanical pain sensitivity (MPS) was then investigated. RESULTS: Topical application of capsaicin resulted in an increase in area under the pain ratings curve for both DMA (pĀ <Ā .01) and MPS (pĀ <Ā .01). The effects of tDCS on the area under the curve ratio (i.e. post/pre-treatment) revealed significant analgesic effects over DMA (pĀ <Ā .05) and MPS (pĀ <Ā .05) when compared to sham. CONCLUSIONS: This study demonstrates that anodal tDCS over the primary motor cortex can reduce both dynamic and static forms of mechanical pain sensitivity associated with the development of DMA and MPS, respectively. The use of tDCS may provide a novel mechanism-driven therapy in chronic pain patients with altered mechanical S/R functions

    PRS17 COSTS TO TREAT COMMUNITY-ACQUIRED PNEUMONIA EPISODES IN US ADULTS AGED 50 YEARS AND OLDER BY AGE AND RISK

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    System-level and patient-level explanations for non-attendance at diabetic retinopathy screening in Sutton and Merton (London, UK): a qualitative analysis of a service evaluation

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    Objectives: Non-attendance at diabetic retinopathy screening has financial implications for screening programmes and potential clinical costs to patients. We sought to identify explanations for why patients had never attended a screening appointment (never attendance) in one programme. Design: Qualitative analysis of a service evaluation. Setting: One South London (UK) diabetic eye screening programme. Participants and procedure: Patients who had been registered with one screening programme for at least 18ā€…months and who had never attended screening within the programme were contacted by telephone to ascertain why this was the case. Patientsā€™ general practices were also contacted for information about why each patient may not have attended. Framework analysis was used to interpret responses. Results: Of the 296 patients, 38 were not eligible for screening and of the 258 eligible patients, 159 were not contactable (31 of these had phone numbers that were not in use). We obtained reasons from patients/general practices/clinical notes for non-attendance for 146 (57%) patients. A number of patient-level and system-level factors were given to explain non-attendance. Patient-level factors included having other commitments, being anxious about screening, not engaging with any diabetes care and being misinformed about screening. System-level factors included miscommunication about where the patient lives, their clinical situation and practical problems that could have been overcome had their existence been shared between programmes. Conclusions: This service evaluation provides unique insight into the patient-level and system-level reasons for never attendance at diabetic retinopathy screening. Improved sharing of relevant information between providers has the potential to facilitate increased uptake of screening. Greater awareness of patient-level barriers may help providers offer a more accessible service

    The comparative hemodynamic efficacy of lower limb muscles using transcutaneous electrical stimulation.

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    Circulation in the limbs can be augmented using transcutaneous electrical stimulation devices. The optimum muscle stimulation sites for enhancement of vascular hemodynamic parameters have not been identified.Seven suitable anatomic sites were identified within the right leg. Twelve healthy participants were recruited (mean age, 23.1 Ā± 3 years; body mass index, 23.1 Ā± 3 kg/m(2)). Muscles were stimulated by transcutaneous bipolar electrodes at a current twice their motor threshold, at 1 Hz, for 5 minutes. Hemodynamic ultrasound measurements were taken from the right femoral vein. Laser Doppler measurements from the feet of the stimulated and nonstimulated sides were obtained. Baseline measurements were compared with readings after 5 minutes of stimulation, with device active. Discomfort experienced for stimulation of each muscle was rated out of 100.Hemodynamic changes displayed large intersubject variation, with no muscle statistically superior to the others. All muscles increased peak velocity; contraction of medial gastrocnemius increased time-averaged maximum velocity and volume flow. All muscles increased foot fluximetry (P < .05). Discomfort correlated weakly with current applied. Tibialis anterior and vastus lateralis were most tenable.Transcutaneous stimulation increases hemodynamic parameters significantly, locally and systemically. No optimum stimulation site has been identified, and it is limited by comfort and variability in the subjects response. Gastrocnemius, tibialis anterior, and vastus lateralis all provoke large changes in hemodynamic parameters, but clinical efficacy in disease prevention and management has not been explored

    Quantifying the influence of sub-mesoscale dynamics on the supply of iron to Southern Ocean phytoplankton blooms

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    Southern Ocean phytoplankton growth is limited by iron. Episodes of natural iron fertilisation are pivotalto triggering phytoplankton blooms in this region, the Kerguelen Plateau bloom being one prominentexample. Numerous physical mechanisms that may supply iron to the euphotic zone in the KerguelenPlateau region, and hence trigger a phytoplankton bloom, have been identified. However, the impact ofsub-mesoscaleflows in delivering iron has been omitted. With a scale of order 10 km, sub-mesoscalefilaments and fronts can dramatically increase vertical velocities and iron transport.An innovative technique is developed to investigate the role of vertical advection associated with sub-mesoscale features on the supply of iron to the photic zone. First, Lagrangian trajectories are calculatedusing three dimensional velocityfields from high resolution numerical simulations; iron concentration isthen computed along these Lagrangian trajectories. The contribution of mesoscale- (1/20Ā°resolution)and sub-mesoscale-resolving models (1/80Ā°resolution) is compared, thereby revealing the sensitivity ofiron supply to horizontal resolution. Ironfluxes are clearly enhanced by a factor of 2 with the resolution,thus showing that the vertical motion induced by the sub-mesoscales represents a previously neglectedprocess to drive iron into the photic waters of the Kerguelen Plateau.A. Hogg was supported by Australian Research Council Future Fellowship FT120100842. We want to express our thanks to A. Bowie for constructive discussions

    Satellite observations of chlorophyll, phytoplankton biomass, and Ekman pumping in nonlinear mesoscale eddies

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    Author Posting. Ā© American Geophysical Union, 2013. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Journal of Geophysical Research: Oceans 118 (2013): 6349ā€“6370, doi:10.1002/2013JC009027.Nonlinear mesoscale eddies can influence biogeochemical cycles in the upper ocean through vertical and horizontal advection of nutrients and marine organisms. The relative importance of these two processes depends on the polarity of an eddy (cyclones versus anticyclones) and the initial biological conditions of the fluid trapped in the core of the eddy at the time of formation. Eddies originating in the eastern South Indian Ocean are unique in that anticyclones, typically associated with downwelling, contain elevated levels of chlorophyll-a, enhanced primary production and phytoplankton communities generally associated with nutrient-replete environments. From analysis of 9 years of concurrent satellite measurements of sea surface height, chlorophyll, phytoplankton carbon, and surface stress, we present observations that suggest eddy-induced Ekman upwelling as a mechanism that is at least partly responsible for sustaining positive phytoplankton anomalies in anticyclones of the South Indian Ocean. The biological response to this eddy-induced Ekman upwelling is evident only during the Austral winter. During the Austral summer, the biological response to eddy-induced Ekman pumping occurs deep in the euphotic zone, beyond the reach of satellite observations of ocean color.This work was funded by NASA grants NNX08AI80G, NNX08AR37G, NNX10AO98G, and NNX13AD78G.2014-06-0
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