Factors affecting environmental attitudes and volunteering in England and Wales

This paper investigates the demographic, social, political and religious factors that affect people’s attitudes to the environment and their involvement in environmental volunteering in England and Wales, using data from four waves of the Home Office Citizenship Survey between 2003 and 2009. Approximately 14,000 people were included in each wave of the survey, with around 85%-90% of people having a positive attitude to the environment, while 7%-8% were involved in volunteering. The data were analysed using logistic regression models. Covariates included sex, ethnicity, age, income, education, religion and region. We found that positive attitude and volunteering increased up to the age of 65 before decreasing sharply. People on middling incomes between £20k and £60k were the most likely to have positive environmental attitude and activity. We found no evidence of behavioural change—the results on both environmental attitudes and volunteering remained stable across all four waves of the survey

Cost-effectiveness of Hepatitis B vaccination in haemodialysis patients

Background. Vaccination against hepatitis B virus is an important means of controlling the infection, but its role in haemodialysis patients has been questioned due to the latter's impaired immune response.Methods. Forty-eight of 79 haemodialysis patients who were negative for antibodies to both hepatitis Bsurface and core antigens were entered into a vaccination programme. Standard doses of a plasma-derived vaccine were administered into the deltoid muscle at 0, 1,2 and 4 months, and the antibody response was measured at 1 and 2 months after the third and fourth doses.Results. The peak mean antibody titre of 372 ill/I was recorded at 1 month after the fourth dose, and the maximum response rate was achieved at 2 months after the final dose. Seroconversion occurred in 26 of 36 patients (72%) who completed the programme, and protective levels of antibody above 10 IU/I were found in 25 of 36 patients (69%). Cost analysis of the project revealed a net saving of ± R90/patient entered at the end of the first year, due to the reduced number of patients requiring monthly surveillance tests for hepatitis B surface antigen. After that, an annual saving of ± R380/patient is projected.Conclusion. In view of the high prevalence of chronic hepatitis B carriers in the South African population, the reduction in the number of patients at risk of infection, combined with a net cost saving, makes it reasonable to recommend vaccination in all non-immune haemodialysis patients despite a reduced response rate

Factors associated with change in skin autofluorescence in persons receiving dialysis

IntroductionAn increase over time in skin autofluorescence (SAF), a measure of accumulation of advanced glycation end products (AGE), predicts higher mortality on hemodialysis (HD). However, evidence is lacking regarding factors that contribute to changes in SAF over time in populations on dialysis. We investigated the rate of change in SAF over 1 year and the factors associated with these changes.MethodsWe enrolled 109 patients on HD and 28 on peritoneal dialysis in a prospective study. SAF was measured at baseline, 3, 6, 9, and 12 months. Rate of change in SAF was calculated using the SLOPE function in Microsoft Excel (Microsoft, Redmond, WA). Participants were then grouped into those with stable SAF or increasing SAF. Dietary AGE intake and nutritional assessments were performed at baseline, 6, and 12 months.ResultsThe mean SAF trend observed was an increase of 0.30 ± 0.63 arbitrary units (AU) per year, but this varied from a decrease of 0.15 ± 0.44 to an increase of 0.76 ± 0.42 AU per year in stable and increasing SAF groups, respectively. Increasing SAF was more common in participants who developed malnutrition during the observation period, whereas those who became well-nourished were more likely to have stable SAF (8 [80%] vs. 14 [42%]; P = 0.02). Development/prevalence of malnutrition over 1 year, HD as first dialysis modality, and current smoking were independent predictors of increasing SAF.ConclusionSAF increases over time in most persons on dialysis. Independent determinants of increasing SAF were development/prevalence of malnutrition, HD as first dialysis modality, and current smoking. Strategies to reduce/prevent the rise in SAF, including prevention/correction of malnutrition, should be investigated in prospective studies

The association of nutritional factors and skin autofluorescence in persons receiving hemodialysis

Objective: Advanced glycation end-products (AGEs) are uremic toxins that result from hyperglycemia, oxidative stress and systemic inflammation. AGEs are also formed in food during cooking. On the other hand, malnutrition may contribute to AGE formation through its association with oxidative stress and inflammation. AGE accumulation can be measured by skin autofluorescence (SAF) and elevated SAF is independently associated with higher mortality on hemodialysis (HD). We aimed to investigate associations between SAF, dietary AGE intake and markers of malnutrition in persons receiving HD.Design and setting: single center cross-sectional study.Subjects: 120 participants on HD dialyzing at least three times per week for 3-4 hours.Main outcome measures: SAF was measured using an Autofluorescence Reader. Dietary AGE, energy, protein and fat intake, handgrip strength (HGS), anthropometric measurements and biochemistry were also assessed. Subjective Global Assessment was performed to evaluate nutritional status.Results: SAF was higher in malnourished participants and correlated negatively with serum albumin and cholesterol, HGS and energy, protein and fat intake and positively with C reactive protein and chronological age; SAF did not correlate with dietary AGE intake. Multivariable linear regression analysis showed that diabetes, smoking, serum albumin, HGS, protein intake and dialysis vintage were independent predictors of increased SAF.Conclusions: Markers of malnutrition were more important determinants of increased SAF than high dietary AGE intake in this HD population. Nutritional interventions aiming to reduce SAF by correcting malnutrition should therefore be investigated. The observed association between higher SAF and malnutrition may in part explain the previously reported association between higher SAF and mortality on HD

Primary Carcinoid Tumor of the Skull Base: Case Report and Review of the Literature

We present an unusual case of primary intracranial carcinoid tumor of the skull base centered at the level of the foramen jugulare, which was proven with surgical biopsy and later with Somatostatin receptor nuclear medicine scan. We present the salient magnetic resonance imaging features of this rare tumor, describe their characteristic nuclear medicine findings, and briefly review the literature.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/79329/1/j.1552-6569.2008.00317.x.pd