Serum cortisol levels in pre and post journal labor and non auditory manifestations in noise exposed workers of a brewer industry

The purpose of this work was to determine the effects of environmental noise in the serum cortisol levels pre and post journal labor and the presence of non-auditory manifestations in workers of a brewer industry. A transversal study was carried out selecting at random 40 workers exposed to noise from the packing area, with ages between 20 and 55 years; and 40 workers from the administrative area without occupational exposition. The exposition was established by means of a medical-occupational history. A 5 mL whole blood sample was taken from each worker pre and post labor day to measure the serum cortisol for electrochemoluminescence. The level of industrial noise was evaluated with a model Quest 1700 sonometer. In the exposed group, there was a higher post labor day serum cortisol concentration than in the control group (p < 0.05). The non auditory manifestations registered were: migraine (50%), gastrointestinal dysfunctions (10%), hypertension (17.75%), irritability (27.5%), insomnia (55%); in spite of the use of auditory protectors in 92.5% of the workers. The levels of noise were > 85 dBA in all the workstations studied. There was not a significant relationship between the intensity of the noise in the workstations and the levels of serum cortisol.     

Psychometric properties of a test in evidence based practice: the Spanish version of the Fresno test

Background  

Validated instruments are needed to evaluate the programmatic impact of Evidence Based Practice (EBP) training and to document the competence of individual trainees. This study aimed to translate the Fresno test into Spanish and subsequently validate it, in order to ensure the equivalence of the Spanish version against the original English version.     

Propensity to psychiatric and somatic ill-health: evidence from a birth cohort

BACKGROUND: Somatic and psychiatric morbidity may cluster because of reciprocal effects between them but also as a result of common underlying factors. METHODS: The data come from the 1946 MRC birth cohort (N = 5362). Clustering of 20 chronic medical conditions at the participants' 43rd year was analysed using multi-morbidity coefficients. Associations of somatic and psychiatric morbidity at 43 years, with temperament and behaviour, assessed from adolescence to early adulthood, and background variables like paternal social class, were examined using structural equation modelling. The focus was on whether links applied to both morbidity types or one only, and were direct or were indirect, mediated by prior morbidity. RESULTS: Reported chronic medical conditions clustered strongly. Somatic multi-morbidity and psychiatric ill-health at 43 years were associated with temperamental and behavioural features assessed between the subjects' 13th and 26th birthday, like neuroticism and aggression, as well as with external variables like parental death before the participants' 16th birthday. However, only neuroticism holds direct links with somatic as well as with psychiatric ill-health, 28% of the former and 52% of the latter association being independent of the simultaneous presence of the other morbidity type and of participants' health status 7 years earlier. CONCLUSIONS: Personality traits like neuroticism not only raise the risk of psychiatric disorder but also, irrespective of whether manifest psychiatric disorders have developed, of a broad spectrum of chronic somatic diseases. This suggests that clinicians and researchers should focus not only on the psychiatric disorders associated with such personality traits but also on their medical consequences.     

Southern community cohort study: establishing a cohort to investigate health disparities

OBJECTIVES: To demonstrate the methods of recruitment of a low-income, predominantly African-American study population for the Southern Community Cohort Study (SCCS), a prospective epidemiologic investigation of racial disparities in cancer risk. METHODS: Partnerships with community health centers (CHCs) were formed to reach underserved populations throughout the south. Recruitment of participants (aged 40-79) in CHCs began in March 2002. Participants complete a comprehensive baseline interview and provide a blood or buccal cell sample. Recruitment will expand to the general population of the south to achieve a broad cross-section of socioeconomic status, The final cohort size is expected to be approximately 100,000. RESULTS: A high level of cooperation and recruitment was achieved in the CHCs. From March 2002 to October 2004, 32,632 participants (80% black, 41% male, 62% with total household income < $15,000, 34% with < 12 years schooling) enrolled. Participants reported a high prevalence of medical conditions (21% diabetic, 44% obese) and adverse health behaviors (45% current smokers). CONCLUSIONS: Working in CHCs is successful for recruiting a population that has been difficult to reach in previous studies. The SCCS is a unique cohort that will provide a rich resource for evaluating disparities in cancer and other chronic disease risk as it is followed over time.     

Introducing abortion patients to a culture of support: a pilot study

Currently in the United States, women who have abortions face a societal culture in which disapproval, stigma, and misinformation about the risks and sequelae of abortion are common. The purpose of this study is to pilot test an intervention that introduces abortion patients to a “culture of support” by providing validating messages and information about groups and services that support women in their reproductive decisions, addressing stigma, and providing information to help women identify and avoid sources of abortion misinformation. Twenty-two women who completed their post-operative exam after abortion were enrolled to take part in the study intervention. In-depth interviews were conducted to explore patient experiences and responses to the intervention. All (22/22) participants responded that they believed that interventions like the one studied could help women avoid letting the judgmental actions and attitudes of others “get to them so much”. All (20/20) participants felt that the intervention was personally helpful to them. An intervention that introduces women having abortions to a “culture of support” was well-received. This study provides a framework for future research about the content, strength, and effect of societal and cultural influences on women having abortions and for additional research about interventions to promote resilience after abortion.     

Increasing knowledge about a screening test: preliminary evaluation of a structured, chart-based, screener presentation

The provision and understanding of good quality information is one of the key characteristics of an informed choice. However, written materials alone often fail to achieve good understanding of screening tests. The present study describes the preliminary evaluation of a structured, chart-directed presentation, aimed at increasing knowledge of a screening test. Forty mothers of babies undergoing a newborn hearing test received either a standard, or a standard plus structured, presentation of the screening test. Standard presentation was a leaflet and short verbal explanation of the test. Structured presentation comprised an illustrated chart explaining the process and possible outcomes of screening, followed by screeners checking mothers understanding of key points and, if necessary, giving further explanation. After screening, maternal knowledge of the test was assessed using seven multiple choice items. Overall knowledge was high. For women with lower levels of education, the structured presentation resulted in significantly higher levels of knowledge than the standard presentation only.     

Patients with Type 2 diabetes mellitus have a worse functional outcome post knee arthroplasty: a matched cohort study

Knee arthroplasty provides not only pain relief but also an improvement in function and range of movement. Limited joint mobility is a common complication of diabetes mellitus. We therefore examined functional outcome post total knee arthroplasty in a cohort of subjects with (n=367) and a cohort matched for age, sex, BMI and functional movement at baseline, without diabetes mellitus (n=367). Participants were examined at baseline (pre-operatively), 1, 5 and 10 years post TKA. There was no significant difference in fixed flexion, maximal flexion or total range of movement between the two groups at baseline. By 1 year the group with diabetes had a significantly lower maximal flexion (p<0.001), total range of movement (p<0.001) and Knee Society Score (p=0.034). Similar results were observed at years 5 (except for the KSS) and 10 post procedure. At 5 years post arthroplasty a significant increase was observed in fixed flexion (p=0.026) in the diabetic group. Ten years post arthroplasty yielded similar results. This study demonstrates that the pre-operative presence of diabetes mellitus leads to a worse outcome post knee arthroplasty, although no significant difference was demonstrable in KSS at 5 years (p=0.35) suggesting patient satisfaction remains high during this period.     

The post: pre dialysis plasma urea nitrogen ratio to estimate K.t/V and NPCR: validation

The ability of empirical formulae to predict K.t/V based on the ratio (R) of the postdialysis (Ct) to predialysis (Co) plasma urea nitrogen levels was tested. In 256 patients, 336 three-point modeling sessions were performed. The K.t/V and NPCR were derived by interative solution of equations for V and G according to the variable volume single-pool model. The modeled K.t/V values were compared to K.t/V predicted from the formula: K.t/V = -ln (R - 0.008.t-UF/W), where R is the Ct/Co ratio, t the session length (h), UF the ultrafiltrate volume (liters) and W the postdialysis weight (kg). Further, the ratio-derived K.t/V was used in conjunction with the Gotch nomogram for 3/week dialysis to estimate NPCR (NPCR-R/N); the latter value was compared to the NPCR from standard 3-point modeling (NPCR-MOD). The two K.t/V values were quite similar, although statistically separable: modeled K.t/V, 0.97 +/- 0.22 (SD), ratio-derived K.t/V 0.96 +/- 0.23, p less than 0.001. The mean percent error was -0.73% +/- 2.5 (range - 11 to + 4.8), and the correlation coefficient was 0.994, slope 1.01, int -0.016. Modifications of the prediction formula which incorporated UF/V instead of UF/W, and/or which weighted the UF/V term according to the expected K.t/V, produced only slight improvement in accuracy. The two values of NPCR were less similar, but still highly correlated: NPCR-MOD, 1.04 +/- 0.26 g/kg/day, NPCR-R/N, 0.94 +/- 0.23, p less than 0.001; mean percent error, - 8.2 +/- 16; r = 0.78, slope = 0.68, int = 0.23.(ABSTRACT TRUNCATED AT 250 WORDS)     

Audiovisual crossmodal correspondences and sound symbolism: a study using the implicit association test

A growing body of empirical research on the topic of multisensory perception now shows that even non-synaesthetic individuals experience crossmodal correspondences, that is, apparently arbitrary compatibility effects between stimuli in different sensory modalities. In the present study, we replicated a number of classic results from the literature on crossmodal correspondences and highlight the existence of two new crossmodal correspondences using a modified version of the implicit association test (IAT). Given that only a single stimulus was presented on each trial, these results rule out selective attention and multisensory integration as possible mechanisms underlying the reported compatibility effects on speeded performance. The crossmodal correspondences examined in the present study all gave rise to very similar effect sizes, and the compatibility effect had a very rapid onset, thus speaking to the automatic detection of crossmodal correspondences. These results are further discussed in terms of the advantages of the IAT over traditional techniques for assessing the strength and symmetry of various crossmodal correspondences.     

Natural infection with peste des petits ruminants virus: a pre and post vaccinal assessment following an outbreak scenario

Peste des petits ruminants virus (PPRV) infection was confirmed in a herd of goats (n = 55) at an organised farm in Islamabad, Pakistan. PPRV infection was confirmed using both antigen- and antibody-based detection methods, haemagglutination (HA) tests and molecular methods. Animals that survived natural infection developed a typical serological response and virus antigen was detected in fecal matter. Following determination of serological response to infection animals were grouped and either vaccinated or left unvaccinated: group 1 animals succumbed to infection (n = 5) and samples were analysed for PPRV antigen; group 2 animals developed clinical disease (n = 10) and were divided into 2 groups, half being vaccinated (group 2a) whilst the remainder were unvaccinated (group 2b); group 3 (n = 15) animals included those that developed only very mild clinical disease or no clinical disease; group 4 animals (n = 5) were negative for clinical disease and were housed as a negative control group. A variable antibody response was detected following resolution of the initial outbreak. Excretion of virus antigen was assessed at different time points following vaccination. Importantly, animals that were vaccinated (group 2a) excreted antigen in fecal matter for 1 month following vaccination whilst unvaccinated animals (group 2b) continued to shed virus antigen for 2 months. The potential for virus excretion in fecal matter and effects of vaccination upon virus infection are discussed. We postulate that excretion in fecal material may represent a mechanism of virus transmission following natural infection and that this mechanism may demonstrate a potential method by which PPRV outbreaks occur spontaneously in areas not previously known to have circulating virus.     

The relationship between prior psychiatric disorder and chronic fatigue: evidence from a national birth cohort study

BACKGROUND: Increased rates of psychiatric disorder have previously been reported in those diagnosed with chronic fatigue syndrome (CFS) or myalgic encephalomyelitis (ME), although the direction of causation in this relationship has not been established. We aimed to test the hypothesis that individuals with self-reported CFS/ME have increased levels of psychiatric disorder prior to the onset of their fatigue symptoms. METHOD: A total of 5,362 participants were prospectively followed with various measures of personality, psychiatric disorder and fatigue levels collected over the first 43 years of their life. CFS/ME was identified through self-report during a semi-structured interview at age 53 years. RESULTS: Thirty-four (1.1%) of the 3,035 subjects assessed at age 53 years reported a diagnosis of CFS/ME. CFS/ME was more common among females, but there was no association between CFS/ME and either social class, social mobility or educational level. Those with psychiatric illness between the ages of 15 and 36 years were more likely to report CFS/ME later in life with an odds ratio (OR, adjusted for sex) of 2.65 [95% confidence interval (CI) 1.26-5.57, p=0.01]. Increased levels of psychiatric illness, in particular depression and anxiety, were present prior to the occurrence of fatigue symptoms. There was a dose-response relationship between the severity of psychiatric symptoms and the likelihood of later CFS/ME. Personality factors were not associated with a self-reported diagnosis of CFS/ME. CONCLUSIONS: This temporal, dose-response relationship suggests that psychiatric disorders, or shared risk factors for psychiatric disorders, are likely to have an aetiological role in some cases of CFS/ME.     

The reliability of assigning individuals to cognitive states using the Mini Mental-State Examination: a population-based prospective cohort study

The recently published "COSMIN" guidelines aim to rate properties of outcome instruments and state two issues with regard to responsiveness which is the instrument's ability to detect change over time. These issues are comparison of score changes with change of an external criterion using correlations and the judgement of traditional methods as inappropriate. The latter are the "transition" concept, a global rating of change, and parametric measures of responsiveness, for example, effect sizes. It can be shown that the methodology proposed by the guidelines has important weaknesses and that denunciation of traditional methods is not appropriate. Some claims of the guidelines about responsiveness do not match the demands of clinical reality and confront findings of numerous epidemiological studies.     

Opportunities and challenges of disease biomarkers: a new section in the journal of translational medicine

A new section of the Journal of Translational Medicine is being introduced to encourage rapid communication of methods and results that utilize computational modeling and epidemiologic approaches in translational medicine. The focus will be on population-based studies that extend towards more molecular level analysis. Submission of studies involving methods development is encouraged where actual application and results can be shown in the healthcare and life sciences domains.