Vermont Adolescent Perception of Barriers to Smoking and Cessation

Introduction: Despite a decline in youth smoking rates over the past decade, thirteen percent of Vermont high school students still smoke (Vermont Youth Risk Behavior Survey, YRBS, 2013). Smoking and nicotine exposure at an early age can have detrimental effects on brain development and lead to long term, sustained tobacco use (Arrazola et. al 2015). It was our goal to characterize the barriers to cessation for these adolescents. Some important factors suggested by the literature include living with someone who smokes (50% of VT teen smokers report a parent or guardian who smokes) and having a close friend who smokes (70% of VT teen smokers) (American Lung Association 2015). Nationally, while teen smoking rates continue to decline, the decrease is being offset by a significant increase in electronic vapor products (e-cigs) (12% increase from 2011-2014) (Arrazola et. al 2015). The 2013 Vermont YRBS data may therefore be misleading, and not capture this increase in tobacco and e-cig use. Therefore, we were particularly interested in further characterizing the link, if any, between e-cig use and smoking initiation or successful smoking cessation.https://scholarworks.uvm.edu/comphp_gallery/1222/thumbnail.jp

Hemodynamics during pregnancy : a model for cardiac enlargement

Cardiac output Increases by 30-50% during mammal Ian pregnancy. This Increase Is reflected by elevation In both heart rate and stroke volume. The primary mechanism of Increased stroke volume appears to be cardiac enlargement, rather than increased preload, afterload, or contractility. Animal studies have shown that enlargement of the heart occurs prior to an Increase In uterine blood flow during pregnancy and this type of enlargement can be mimicked by sex steroid administration. Systemic vascular resistance greatly decreases during pregnancy and with sex steroid administration. It has been postulated that systemic vascular resistance may be a signal for heart size changes. This study attempted to chronically decrease systemic vascular resistance by administration of an arterial vasodllator (hydralazlne) over a three week period to guinea pigs. At the time of study hemodynamlcs were measured which Included, heart rate, arterial pressure, right atrial pressure and cardiac output. In vitro left ventricular pressure volume relationships were also evaluated, as was total plasma volume

Low dose CT vs plain abdominal radiography for the investigation of the acute abdomen

Background: To compare low-dose abdominal computed tomography (LDCT) with plain abdominal radiography (AR) in the primary investigation of acute abdominal pain to determine if there is a difference in diagnostic yield, the number of additional investigations required and hospital length of stay (LOS). Methods: This randomized controlled trial was approved by the institutional review board, and informed consent was obtained. Patients presenting to the emergency department with an acute abdomen and who would normally be investigated with AR were randomized to either AR or LDCT. The estimated radiation dose of the LDCT protocol was 2–3 mSv compared to 1.1 mSv for AR. Pearson\u27s chi-square and the independent samples t-test were used for the statistical analysis. Results: A total of 142 patients were eligible, and after exclusions and omitting those with incomplete data, 55 patients remained for analysis in the AR arm and 53 in the LDCT arm. A diagnosis could be obtained in 12 (21.8%) patients investigated with AR compared to 34 (64.2%) for LDCT (P \u3c 0.001). Twenty-eight (50.9%) patients in the AR group required further imaging during their admission compared to 14 (26.4%) in the LDCT group (P= 0.009). There was no difference in the median hospital LOS (3.84 days for AR versus 4.24 days for LDCT, P= 0.83). Conclusion: LDCT demonstrates a superior diagnostic yield over AR and reduces the number of subsequent imaging tests for a minimal cost in radiation exposure. However, there is no difference in the overall hospital LOS between the two imaging strategies

The Political Economy of Nursing Homes

The nursing home industry receives three- quarters of its income from government. The industry earns high profits while providing poor patient care. Considerable swindling of government funds occurs. One category is nickel and diming, which consists of clipping every possible dollar from government money as it passes through nursing home accounts. Another method—large scale and often within the law—involves the manipulation of ownership and mortgages. There are several causes for the failure of government to control nursing home swindles. While there is no lack of regulations, the will to enforce them is lacking. Industry lobbyists are especially influential at the state level, where the Medicaid rate is set. The federal govern ment has failed to collect basic information about the industry and denies the public ready access to the reports on nursing home inspections. The industry's immunity from regulation, in large part, results from the lack of countervail ing pressure from the public.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66915/2/10.1177_000271627441500108.pd

Response to comment on 'Amphibian fungal panzootic causes catastrophic and ongoing loss of biodiversity'

Lambert et al. question our retrospective and holistic epidemiological assessment of the role of chytridiomycosis in amphibian declines. Their alternative assessment is narrow and provides an incomplete evaluation of evidence. Adopting this approach limits understanding of infectious disease impacts and hampers conservation efforts. We reaffirm that our study provides unambiguous evidence that chytridiomycosis has affected at least 501 amphibian species

Establishing a core outcome set for peritoneal dialysis : report of the SONG-PD (standardized outcomes in nephrology-peritoneal dialysis) consensus workshop

Outcomes reported in randomized controlled trials in peritoneal dialysis (PD) are diverse, are measured inconsistently, and may not be important to patients, families, and clinicians. The Standardized Outcomes in Nephrology-Peritoneal Dialysis (SONG-PD) initiative aims to establish a core outcome set for trials in PD based on the shared priorities of all stakeholders. We convened an international SONG-PD stakeholder consensus workshop in May 2018 in Vancouver, Canada. Nineteen patients/caregivers and 51 health professionals attended. Participants discussed core outcome domains and implementation in trials in PD. Four themes relating to the formation of core outcome domains were identified: life participation as a main goal of PD, impact of fatigue, empowerment for preparation and planning, and separation of contributing factors from core factors. Considerations for implementation were identified: standardizing patient-reported outcomes, requiring a validated and feasible measure, simplicity of binary outcomes, responsiveness to interventions, and using positive terminology. All stakeholders supported inclusion of PD-related infection, cardiovascular disease, mortality, technique survival, and life participation as the core outcome domains for PD

Roaring high and low: composition and possible functions of the Iberian stag's vocal repertoire

We provide a detailed description of the rutting vocalisations of free-ranging male Iberian deer (Cervus elaphus hispanicus, Hilzheimer 1909), a geographically isolated and morphologically differentiated subspecies of red deer Cervus elaphus. We combine spectrographic examinations, spectral analyses and automated classifications to identify different call types, and compare the composition of the vocal repertoire with that of other red deer subspecies. Iberian stags give bouts of roars (and more rarely, short series of barks) that are typically composed of two different types of calls. Long Common Roars are mostly given at the beginning or at the end of the bout, and are characterised by a high fundamental frequency (F0) resulting in poorly defined formant frequencies but a relatively high amplitude. In contrast, Short Common Roars are typically given in the middle or at the end of the bout, and are characterised by a lower F0 resulting in relatively well defined vocal tract resonances, but low amplitude. While we did not identify entirely Harsh Roars (as described in the Scottish red deer subspecies (Cervus elaphus scoticus), a small percentage of Long Common Roars contained segments of deterministic chaos. We suggest that the evolution of two clearly distinct types of Common Roars may reflect divergent selection pressures favouring either vocal efficiency in high pitched roars or the communication of body size in low-pitched, high spectral density roars highlighting vocal tract resonances. The clear divergence of the Iberian red deer vocal repertoire from those of other documented European red deer populations reinforces the status of this geographical variant as a distinct subspecies

Machiavellianism, emotional manipulation, and friendship functions in women's friendships

Machiavellianism and emotional manipulation has not been investigated in friendships. The current studies investigated Machiavellianism, emotional manipulation, and six friendship functions in women's same-sex friendships. For study 1, women (N = 221) completed the Mach IV, emotional manipulation measure (with reference to their own behaviour and their friend's behaviour), mood worsening and use of inauthentic displays from the managing emotions of others scale, and the friendship function measure. Machiavellianism predicted the self-perceived ability to employ emotional manipulation towards a same-sex friend and perceiving their friend to use emotional manipulation towards them. Machiavellianism predicted lower scores on all six friendship functions. For study 2, women (N = 186) completed the Mach IV, the modified emotional manipulation measure (with reference to their own behaviour and their friend's behaviour), and the friendship function measure. Women high on Machiavellianism reported using emotional manipulation more frequently towards their same-sex friend and perceived their same-sex friend to frequently use emotional manipulation towards them. Machiavellianism predicted lower scores on five of the friendship functions. These studies demonstrated that women higher on Machiavellianism employ emotional manipulation in their same-sex friendships. Women with higher Machiavellianism scores also perceived that they themselves were manipulated by their friend