CHEMEPASS – Innovative Tools to promote Chemical Engineering Mobility

CHEMEPASS – Innovative Tools to promote Chemical Engineering Mobilit

Sedentary behavior and physical activity: risk factors associated with modern lifestyles

This dissertation explores two diametrically opposed behavioral risk factors. The first risk factor, television watching, is the most prevalent leisure activity in the United States. The second, physical activity, is one of the most important modifiable risk factors for chronic disease. The first aim was to examine the association of television watching with physical activity and diet in the Atherosclerosis Risk in Communities Study. Television exposure, physical activity, and dietary information were collected via self-report at baseline and six years later in 12,678 men and women ages 45 to 64 years at baseline. Participants who reported high television exposure were more likely to be inactive and have a poor dietary profile. These results persisted over the six years of follow-up, regardless of modeling strategy. Risks associated with sedentary behaviors, such as television watching, have been neglected in public health research. This work highlights the need for further research on measurement, determinants, and risks of sedentary behaviors. A better understanding of behavioral risk factors such as physical activity requires continued research on current questionnaires and measurement tools used to quantify these behaviors. The test-retest reliability of the Women's Health Initiative physical activity questionnaire was examined in 1092 women as part of the second aim. Mild physical activity had lower test-retest reliability than moderate, vigorous, and walking physical activity, which were moderately to substantially reliable. Walking is the most common leisure physical activity engaged in by adult women. The Women's Health Initiative, with its reliable and unique questionnaire offered an opportunity to examine the independent effects of walking intensity, frequency, and duration on risk of coronary heart disease. After a decade of follow-up, baseline intensity, frequency, and duration of walking were all associated with lower risk of coronary heart disease in 71, 502 women from 40 centers across the United States. The highest category of walking intensity was associated with a 60% reduction in risk relative to the lowest category. Weaker associations were observed for frequency and duration of walking. To untangle the effect of each walking component (i.e., intensity, frequency, and duration) from their contribution to energy expenditure, a control variable estimating recreational physical activity energy expenditure was introduced in the models. The addition of this control variable did not appreciably change the results. Strengths and limitations of this approach are highlighted. This dissertation highlights several areas for future research in physical activity epidemiology. The first is a pressing need to better understand the impact of sedentary behaviors on health. The second is the need to develop better measurement tools for research and surveillance. Lastly, new epidemiologic methods need to be applied to help understand the specific health benefits from different types of physical activities or components of activity, such as frequency, intensity, and duration

Cross-disciplinary lessons for the future internet

There are many societal concerns that emerge as a consequence of Future Internet (FI) research and development. A survey identified six key social and economic issues deemed most relevant to European FI projects. During a SESERV-organized workshop, experts in Future Internet technology engaged with social scientists (including economists), policy experts and other stakeholders in analyzing the socio-economic barriers and challenges that affect the Future Internet, and conversely, how the Future Internet will affect society, government, and business. The workshop aimed to bridge the gap between those who study and those who build the Internet. This chapter describes the socio-economic barriers seen by the community itself related to the Future Internet and suggests their resolution, as well as investigating how relevant the EU Digital Agenda is to Future Internet technologists

Interventions for preventing oral mucositis for patients with cancer receiving treatment

Background: Treatment of cancer with chemotherapy is becoming increasingly more effective but is associated with short and long-term side effects. Oral side effects remain a major source of illness despite the use of a variety of agents to prevent them. Objectives: To evaluate the effectiveness of oral (and topical) prophylactic agents for oral mucositis and oral candidiasis in patients with cancer (excluding head and neck cancer), compared with placebo or no treatment. Search Strategy: Computerised MEDLINE, EMBASE, CINAHL, CANCERLIT, the Cochrane Controlled Trials Register and the Cochrane Oral Health Group Specialist Register search up to July 1999. Reference lists from relevant articles were scanned and the authors of eligible studies were contacted to identify trials and obtain additional information. Selection Criteria: Studies were selected if they met the following criteria: design - random or quasi-random allocation of participants; participants - anyone with cancer receiving chemotherapy (excluding head and neck cancer); interventions - prophylactic agents prescribed to reduce oral conditions arising from cancer or its treatment; outcomes - mucositis and oral candidiasis. Data Collection and Analysis: Information regarding methods, participants, interventions and outcome measures and results were independently extracted, in duplicate, by two reviewers (JC &amp; HW). Specialist advice was sought to categorise interventions. Authors were contacted for details of randomisation and withdrawals and a quality assessment was carried out using the Jadad criteria (Jadad 1998). The Cochrane Oral Health Group statistical guidelines were followed and relative risk values calculated using random effects models where significant heterogeneity was detected (P &lt; 0.1). Main Results: Thirty-eight reports of trials were initially included. Two were duplicate reports and nine were excluded as there was no useable information. Of the 27 useable studies 14 had data for mucositis comprising 945 randomised patients and 15 included data for oral candidiasis with 1164 randomised patients. Of the eight prophylactic agents used for mucositis only one, ice chips, was effective (Relative risk 0.57, 95% CI 0.43 to 0.77, chi-square for heterogeneity = 0.26 (df = 1), p = 0.61). The NNT to prevent one extra case of mucositis over the baseline incidence using ice chips was 4 (95%CI: 3 to 7). The NNT for when the baseline incidence of mucositis in the population ranges from 50% to 80% are 5 to 4 respectively. There is evidence that antifungal agents which are partially or fully absorbed from the gastrointestinal tract prevent oral candidiasis and that the partially absorbed agents may be more effective than the fully absorbed agents. The RR for partially absorbed agents was 0.13 (95% CI 0.06 to 0.27, chi-square for heterogeneity = 5.3 (df = 3), P = 0. 15). The NNT to prevent one extra case of oral candidiasis over the baseline incidence using partially absorbed drugs was 3 (95% CI: 3 to 5). The NNT for when the baseline incidence of oral candidiasis in the population ranges from 30% to 70% are 4 to 2 respectively. The general reporting of RCT's was poor however the median Jadad score was acceptable and improved further when the authors provided additional information. The sensitivity analysis confirmed the findings for oral candidiasis. Reviewer's Conclusions: There is some evidence that ice chips prevent mucositis. None of the other prophylactic agents included in this review prevented mucositis. There is evidence that prophylactic use of antifungal agents which are absorbed or partially absorbed from the gastrointestinal tract reduce the clinical signs of oral candidiasis, and the partially absorbed drugs may be more effective. Future trials in this area should address the link between oral and general health including outcomes relevant to the patient. Collaboration between medical and dental teams is indicated.</p

Building the Evidence for Decision-Making: The Relationship Between Local Public Health Capacity and Community Mortality

Objectives. We examined associations between local health department (LHD) spending, staffing, and services and community health outcomes in North Carolina. Methods. We analyzed LHD investments and community mortality in North Carolina from 2005 through 2010. We obtained LHD spending, staffing, and services data from the National Association of City and County Health Officials 2005 and 2008 profile surveys. Five mortality rates were constructed using Centers for Disease Control and Prevention mortality files, North Carolina vital statistics data, and census data for LHD service jurisdictions: heart disease, cancer, diabetes, pneumonia and influenza, and infant mortality. Results. Spending, staffing, and services varied widely by location and over time in the 85 North Carolina LHDs. A 1% increase in full-time-equivalent staffing (per 1000 population) was associated with decrease of 0.01 infant deaths per 1000 live births (P < .05). Provision of women and children’s services was associated with a reduction of 1 to 2 infant deaths per 1000 live births (P < .05). Conclusions. Our findings, in the context of other studies, provide support for investment in local public health services to improve community health

Distance to a Plastic Surgeon and Type of Insurance Plan Are Independently Predictive of Postmastectomy Breast Reconstruction

The psychosocial benefits of postmastectomy breast reconstruction are well established; however, health care barriers persist. The authors evaluated statewide patient population to further identify obstacles to reconstruction

Referral patterns between high- and low-volume centers and associations with uterine cancer treatment and survival: a population-based study of Medicare, Medicaid, and privately insured women

High-volume (HV) center surgery and gynecologic oncology care are associated with improved outcomes for women with uterine cancer. Referral patterns, from biopsy through to chemotherapy, may have patients interacting with HV centers for all, a portion, or none of their care. The relative frequency, the underlying factors that contribute to referral, and the potential impact of these referral patterns on treatment outcomes are unknown

Bayesian reconstruction of gravitational wave burst signals from simulations of rotating stellar core collapse and bounce

Presented in this paper is a technique that we propose for extracting the physical parameters of a rotating stellar core collapse from the observation of the associated gravitational wave signal from the collapse and core bounce. Data from interferometric gravitational wave detectors can be used to provide information on the mass of the progenitor model, precollapse rotation and the nuclear equation of state. We use waveform libraries provided by the latest numerical simulations of rotating stellar core collapse models in general relativity, and from them create an orthogonal set of eigenvectors using principal component analysis. Bayesian inference techniques are then used to reconstruct the associated gravitational wave signal that is assumed to be detected by an interferometric detector. Posterior probability distribution functions are derived for the amplitudes of the principal component analysis eigenvectors, and the pulse arrival time. We show how the reconstructed signal and the principal component analysis eigenvector amplitude estimates may provide information on the physical parameters associated with the core collapse event.Comment: 17 pages, 9 figure