Cardiac Depression Scale: Mokken scaling in heart failure patients

Background: There is a high prevalence of depression in patients with heart failure (HF) that is associated with worsening prognosis. The value of using a reliable and valid instrument to measure depression in this population is therefore essential. We validated the Cardiac Depression Scale (CDS) in heart failure patients using a model of ordinal unidimensional measurement known as Mokken scaling. Findings: We administered in face-to-face interviews the CDS to 603 patients with HF. Data were analysed using Mokken scale analysis. Items of the CDS formed a statistically significant unidimensional Mokken scale of low strength (H<0.40) and high reliability (Rho>0.8). Conclusions: The CDS has a hierarchy of items which can be interpreted in terms of the increasingly serious effects of depression occurring as a result of HF. Identifying an appropriate instrument to measure depression in patients with HF allows for early identification and better medical management. Keywords: Cardiac Depression Scale, Heart failure, Depression, Mokken scalin

A ship-based methodology for high precision atmospheric oxygen measurements and its application in the Southern Ocean region

A method for achieving continuous high precision measurements of atmospheric O-2 is presented based on a commercially available fuel-cell instrument, (Sable Systems, Oxzilla FC-II) with a precision of 7 per meg (approximately equivalent to 1.2 ppm) for a 6-min measurement. The Oxzilla was deployed on two voyages in the Western Pacific sector of the Southern Ocean, in February 2003 and in April 2004, making these the second set of continuous O-2 measurements ever made from a ship. The results show significant temporal variation in O-2, in the order of +/- 10 per meg over 6-hourly time intervals, and substantial spatial variation. Data from both voyages show an O-2 maximum centred on 50 degrees S, which is most likely to be the result of biologically driven O-2 outgassing in the region of subtropical convergence around New Zealand, and a decreasing O-2 trend towards Antarctica. O-2 from the ship-based measurements is elevated compared with measurements from the Scripps Institution of Oceanography flask-sampling network, and the O-2 maximum is also not captured in the network observations. This preliminary study shows that ship-based continuous measurements are a valuable addition to current fixed site sampling programmes for the understanding of ocean-atmosphere O-2 exchange processes. [References: 39

HIV/STI Risk Factors Among African-American Students Attending Predominantly White Universities

Introduction: The majority of African American college students in the U.S. attend predominantly white institutions (PWIs). However, there is minimal research examining this population’s HIV/STI risk behaviors. The purpose of this investigation was to assess HIV/STI behavioral risk factors among African American college students (aged 18 – 24years) attending PWIs. (n = 2,568) Methods: Backwards step-wise logistic regression analyses were conducted to determine factors associated with a positive HIV/STI diagnosis (past year) among sexually active African American college students who participated in the Spring, 2006 National College Health Assessment. Findings: Nine factors were significantly associated with an HIV/STI diagnosis among African American college students attending PWIs. Different risk factors were associated with having a HIV/STI diagnosis among African American male and female college students. These results may be useful to HIV/STIs prevention programs targeting African American college students attending PWIs

EVALUATING OPTIMAL PRODUCT MIX USING DYNAMIC SIMULATION: A TOMATO PROCESSING CASE

Technology-driven change is everywhere and value-capture from new technology is challenging for business managers. Also rival firms may use technology as part of major success strategies. This situation leads managers to be keenly interested in evaluation of alternative technologies prior to making a sunk investment in physical facilities. In contemplating new or added-capacity processing facilities, managers and investors must evaluate return on investment (ROI). Evaluation of ROI is complex because it varies by alternative technology and the resultant potential product mix alternatives associated with that technology at the time the investment capital is committed to build the processing plant. This research examines optimal alternative product mix from a processing plant technology that is fixed at the time of commitment to building or adding capacity. Evaluating the optimal product mix is of vital concern in any start-up processing environment. In this research the optimal product mix is evaluated by using a sophisticated evaluative tool known as PowerSim. This economic simulation software is used to model a start-up tomato processing plant in Ohio. The model evaluates the effects of various output, or tomato product mix, on plant profitability measured by ROI. Results indicate that an increase in plant profitability is expected when the tomato product mix consists of products that have a lower soluble solids concentration. The lower the soluble solids concentration of a tomato product, the less the processor will benefit from tomato varieties with high soluble solids. The processing operation achieves a RIO of 26.5 percent when the plant'Â’s product mix is 50 percent tomato paste (31 degrees brix) and 50 percent diced tomatoes. This product mix optimizes processor net income and realizes a plant return on equity of 50.6 percent.Agribusiness,

Intrapartum epidural analgesia and breastfeeding: a prospective cohort study

BACKGROUND Anecdotal reports suggest that the addition of fentanyl (an opioid) to epidural analgesia for women during childbirth results in difficulty establishing breastfeeding. The aim of this paper is to determine any association between epidural analgesia and 1) breastfeeding in the first week postpartum and 2) breastfeeding cessation during the first 24 weeks postpartum. METHODS A prospective cohort study of 1280 women aged > or = 16 years, who gave birth to a single live infant in the Australian Capital Territory in 1997 was conducted. Women completed questionnaires at weeks 1, 8, 16 and 24 postpartum. Breastfeeding information was collected in each of the four surveys and women were categorised as either fully breastfeeding, partially breastfeeding or not breastfeeding at all. Women who had stopped breastfeeding since the previous survey were asked when they stopped. RESULTS In the first week postpartum, 93% of women were either fully or partially breastfeeding their baby and 60% were continuing to breastfeed at 24 weeks. Intrapartum analgesia and type of birth were associated with partial breastfeeding and breastfeeding difficulties in the first postpartum week (p < 0.0001). Analgesia, maternal age and education were associated with breastfeeding cessation in the first 24 weeks (p < 0.0001), with women who had epidurals being more likely to stop breastfeeding than women who used non-pharmacological methods of pain relief (adjusted hazard ratio 2.02, 95% CI 1.53, 2.67). CONCLUSION Women in this cohort who had epidurals were less likely to fully breastfeed their infant in the few days after birth and more likely to stop breastfeeding in the first 24 weeks. Although this relationship may not be causal, it is important that women at higher risk of breastfeeding cessation are provided with adequate breastfeeding assistance and support.Christine Roberts is supported by a National Health and Medical Research Council (NHMRC) of Australia Public Health Practitioner Fellowship and Siranda Torvaldsen is supported by a NHMRC Australian Research Training Fellowship. The cohort study was supported by a project grant from The Canberra Hospital Private Practice Fund. Additional funding was provided by The Canberra Hospital Auxiliary, the Nurses' Board of the Australian Capital Territory, and the Australian Capital Territory Department of Health & Community Care