Resonance-thrombography indices of the haemostatic process in relation to risk of incident coronary heart disease: 9 years follow-up in the Caerphilly Prospective Heart Disease Study

Global assays, such as resonance-thrombography (RTG), which measure the interaction between platelets, coagulation and fibrinolysis have been used as summary measures of risk for over two decades but have not been evaluated in epidemiological studies. We examined whether RTG indices are risk indicators for incident coronary heart disease (CHD). RTG indices, related haematological variables and other risk factors were measured between 1984 and 1988 in a cohort of 2398 British men. Reaction time (r) and amplitude of fibrin leg (AF) were associated with lifestyle risk factors. During 9 years of follow-up, 282 (12%) men developed a major new CHD event, as classified by World Health Organization criteria. On adjustment for age, only r and AF measured at baseline were related to risk of incident CHD. On multivariate adjustment in a multiple logistic regression model that included age, diastolic blood pressure, body mass index, total and high-density lipoprotein cholesterol, lifestyle risk factors and use of prescribed medicine, these associations weakened but remained significant. Additional adjustment for fibrinogen, viscosity, white cell count and fibrin D-dimer either reduced these associations to non- significance (AF) or to borderline significance(r)

A novel record of aardwolf Proteles cristata feeding behaviour

Terrestrial members of the order Carnivora show great variation in their diet; some specialising on vertebrates, invertebrates, or plant matter, whereas others are omnivores or scavengers (Bekoff et al, 1984). The aardwolf Proteles cristata is a highly specialised myrmecovore (Skinner and Chimimba 2005). We present a first report of a wild aardwolf preying on a vertebrate - captive geese Anser anser domesticus

Monitoring changes in skin temperature associated with exercise in horses on a water treadmill by use of infrared thermography

Infrared thermography (IRT) was used to assess surface temperature change as an indirect measure of muscle activity and exercise associated changes in blood flow in the working hind limb muscles of horses (n¼7) undergoing water tread mill exercise. Three treatments were investigated including the treadmill ran dry (TD), water at the height of the proximal interphalangeal joint (PIP) and water at the height of the carpus (CP). Maximum skin surface temperature was recorded from the region of these mitendinosus muscle during exercise at each water height. There was a significant difference in surface hind limb temperature between exercise on the water treadmill ran dry and with water at the height of the PIP and CP (Po0.0001) with hotter temperatures recorded during the TD treatment. There was a greater increase in surface temperature of the hind limbs from preexercise to maximum temperature during the PIP and CP treatments when compared to the TD treatment, however, this was not significant (P¼0.58). There was no significant difference in surface hind limb temperature found between exercise in water at the height of the PIP and water at the height of the CP. The findings from this study suggest that IRT is able to non-invasively detect muscle activity and associated changes in blood flow whilst horses are exercised on a water treadmill. IRT could potentially be used as an alternative method to assess muscle activity and temperature change in an aquatic environment where existing methods present methodological challenges

Risk society and the fight for kratom use

2021 Spring.Includes bibliographical references.This research argues that the rise of alternative medicine and health supplements is best understood within the context of the 'risk society'. The dual pressures of deregulation in the health sector of the economy and the dominance of Big Pharma, has the consequences of proliferating the use of non-sanctioned forms of health care. The Southeast Asian plant Kratom is one such illustration of this phenomenon. Drawing from over 200 Reddit posts on r/Kratom, this research analyzes the reaction of the kratom community to attempts by the Food and Drug Administration and Drug Enforcement Administration to restrict access to the botanical. Ulrich Beck's work on 'risk society' is combined with the recent literature on neoliberalism to analyze the narratives emerging from the community of kratom users. Using theme-based coding, the findings revealed tent-pole sentiments of 1) A desire for treatment agency and personal liberty, 2) Fear of regression or return to risk, and 3) Disdain and distrust of regulatory agencies and the pharmaceutical industry. Parallels to Beck's risk society were extant in the thematically related passages, including 1) the commonality of anxiety, 2) the loss of monopoly on knowledge from authoritative institutions, 3) the transition from patient ignorance versus being their own auxiliary doctor in the modern era, and 4) the power of corporatocracy overshadowing the traditional preeminence of the state. These arguments indicate a more nuanced understanding of neoliberalism is required. While typically seen as a way of freeing up capitalist markets for the benefit of large corporations such as Big Pharma, neoliberalism's emphasis on self-reliance and entrepreneurialism also provides a frame of resistance for those non-corporate actors threatened by State regulation. These findings enhance our understanding of the role of States and sub-community resistance in Ulrich Beck's theory of 'risk society'. In the context of risk society, the kratom community's experience with mainstream medicine and subsequently the pharmaceutical industry has made them distrusting of the state due to its failings to properly police such institutions and would rather be left to their own devices to decide what is and isn't appropriate for their respective conditions

Stress at work-an independent risk factor for coronary heart disease?

This editorial refers to ‘Work stress and coronary heart disease: what are the mechanisms? ’ by T. Chandola et al., † on page 640 In their recent study, Chandola et al. add to the body of evidence linking work stress with the development of coronary heart disease (CHD) in British civil servants, and examine potential mechanisms.1 Similar findings have been reported in cohort studies across Europe; for example, in the Job Stress, Absenteeism and Coronary Heart Disease in Europe study (JACE), a multicentre study in four European countries, in working populations from a broad range of occupational groups and also from the general population.2 In 2004, a review showed that fewer than half of the 17 longitudinal studies and eight cross-sectional studies included showed a significant association between perceived work stress and subsequent CHD.3 In 2006, a meta-analysis o

Assessing Palliative Care Needs in Residents with Alzheimer\u27s

Current evidence indicates a lack of assessment protocols focusing on palliative care needs for patients with Alzheimer’s disease. This gap in practice supported the need to implement an evidence-based assessment protocol for early identification of palliative care needs in patients with Alzheimer’s disease residing in a long-term care facility. The protocol included using the patient’s Global Deterioration Scale (GDS) score to determine the patient’s palliative care needs according to the Dementia Progression Prioritization of Goals model. If the score indicated moderate to severe Alzheimer’s disease, then their goal was maximization of comfort, indicating a need to begin palliative care plans. A total of 36 residents in the long-term care facility selected for this project were assessed. Based on the protocol, 17 residents needed a palliative care consult. Following implementation of the protocol, hospice care was initiated on four residents and palliative care plans were initiated on another four residents. An educational session about the protocol was conducted to the staff. Upon evaluation of the protocol, staff identified the protocol easy to understand, feasible for daily use, and beneficial to practice. Further follow up is needed to evaluate the long-term impact of this project

Fibrin D-dimer, markers of coagulation activation and the risk of major ischaemic heart disease in the Caerphilly Study

We have previously reported that plasma fibrin D-dimer (a marker of turnover of cross-linked Fibrin) showed a strong and independent association with incident ischaemic heart disease (IHD) in the Caerphilly Study cohort of 1,998 men a-ed 49-65. To establish the specificity of this finding, we assayed plasma samples from this cohort with a more specific assay for fibrin D-dimer: this showed an association with incident IHD which was at least as strong and independent as that for the original assay (odds ratio, OR for top fifth compared to bottom fifth 3.79; 95% CI 1.77-8.10; p lt 0.0001). To establish potential causes of the increased fibrin turnover. we also assayed several potential markers of coagulation activation or thrombotic tendency (prothrombin fragment F1+2, thrombin- antithrombin complexes, factor VIIc, activated partial thromboplastin time [APTT] and activated protein C resistance): none of these variables were associated with incident IHD in this cohort. We suggest that further studies are required to establish the causes of increased cross-linked fibrin turnover, which is associated with incident IHD in the general population when measured by a specific assay