Changes in health and primary health care use of Moroccan and Turkish migrants between 2001 and 2005: a longitudinal study

Background  

Social environment and health status are related, and changes affecting social relations may also affect the general health state of a group. During the past few years, several events have affected the relationships between Muslim immigrants and the non-immigrant population in many countries. This study investigates whether the health status of the Moroccan and Turkish immigrants in the Netherlands has changed in four years, whether changes in health status have had any influence on primary health care use, and which socio-demographic factors might explain this relationship.     

Imaging of slow viruses

The symptoms associated with slow viral or prion diseases of the central nervous system tend to have multiple neurologic symptoms, and different patients may present with different symptoms. This review discusses the most common slow virus infections and their imaging findings.     

Neuroimaging in the brain in HIV-1-infected patients

The brain may be affected by a variety of abnormalities in association with HIV infection. Knowledge of these abnormalities and their characteristic imaging features is important to neuroradiologists for the detection, diagnosis, and initiation of appropriate treatment. This review attempts to describe the imaging findings associated with brain disorders in HIV-seropositive patients and the rationales for integrating neuroradiologic techniques.     

Student-Led discharge counseling program for High-Risk medications in a teaching hospital in Saudi Arabia: A pilot study

Discharge counseling by pharmacists reduces adverse medication events, emergency department visits, and readmissions. Studies indicate that pharmacy students in advanced pharmacy practice experiences (APPE) can deliver effective medication-related activities. An open label randomized controlled trial was conducted in adults discharged on warfarin, insulin, or both. Pharmacy students performed medication reconciliation, structured medication counseling, and follow-up calls 72-hours post-discharge. The usual care arm received traditional education. The primary outcome was the 30-day readmission rate post-discharge. Ninety-eight patients on high-risk medications were randomized to intervention (n = 51) or usual care (n = 47). The 30-day hospital readmission rate was lower in the intervention group (8/51, 15% vs. 11/47, 23%); (p = 0.48). There was no statistical difference in the time to first unplanned health care use (hazard ratio = 0.49 (95 %CI, 0.19–1.24), or the time-to-first clinic visit post-discharge (p = 0.94) between the two arms. Students identified 26 drug-related problems during reconciliation. Patients in the intervention arm reported high satisfaction with the service (mean 3.94; SD 0.11). Involving APPE students in the transition of care activities presents an excellent opportunity to minimize pharmacists' workload while maintaining patient care services.     

Coarse-grained stochastic models for tropical convection and climate

Prototype coarse-grained stochastic parametrizations for the interaction with unresolved features of tropical convection are developed here. These coarse-grained stochastic parametrizations involve systematically derived birth/death processes with low computational overhead that allow for direct interaction of the coarse-grained dynamical variables with the smaller-scale unresolved fluctuations. It is established here for an idealized prototype climate scenario that, in suitable regimes, these coarse-grained stochastic parametrizations can significantly impact the climatology as well as strongly increase the wave fluctuations about an idealized climatology.     

The Influence of α-Tocopherol on Serum Biochemical Markers During Experimentally Induced Pleuritis in Rats Exposed to Dioxin

Toxicity of dioxins is wide ranging. Amongst the organs, the liver is the most susceptible to damage by dioxins. Damage caused to liver cells results in promoting inflammatory processes. The aim of this work was to evaluate whether high doses of tocopherol will change the inflammatory response, monitored by biochemical indicators, by improving liver function in rats exposed to tetrachlorodibenzo-p-dioxin (TCDD). The study was conducted on a population of female Buffalo rats. The animals were divided into the following groups: Control Group A—representing physiological norms for the studied diagnostic indicators; Control Group B—subjects were administered a 1% ceragenin solution to induce pleuritis; Study Group 1—where rats were administered α-tocopherol acetate for 3 weeks, after which pleuritis was induced; Study Group 2—rats were administered a single dose of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), while 3 weeks later, pleuritis was induced; and Study Group 3—rats were administered a single dose of TCDD and next, were administered α-tocopherol acetate for 3 weeks, followed by pleuritis induction. The results clearly show that administering tocopherol in the course of inflammation causes changes to the distribution and ratio of in the serum protein fractions, including acute phase proteins. The latter proteins are indicative to the improvement in liver function and linked to protein synthesis and stimulation of the antibody-mediated immunity. Moreover, in the course of inflammation caused by exposure of rats to TCDD, tocopherol significantly affected the acute phase protein concentration.     

Statistical energy conservation principle for inhomogeneous turbulent dynamical systems

Understanding the complexity of anisotropic turbulent processes over a wide range of spatiotemporal scales in engineering shear turbulence as well as climate atmosphere ocean science is a grand challenge of contemporary science with important societal impact. In such inhomogeneous turbulent dynamical systems there is a large dimensional phase space with a large dimension of unstable directions where a large-scale ensemble mean and the turbulent fluctuations exchange energy and strongly influence each other. These complex features strongly impact practical prediction and uncertainty quantification. A systematic energy conservation principle is developed here in a Theorem that precisely accounts for the statistical energy exchange between the mean flow and the related turbulent fluctuations. This statistical energy is a sum of the energy in the mean and the trace of the covariance of the fluctuating turbulence. This result applies to general inhomogeneous turbulent dynamical systems including the above applications. The Theorem involves an assessment of statistical symmetries for the nonlinear interactions and a self-contained treatment is presented below. Corollary 1 and Corollary 2 illustrate the power of the method with general closed differential equalities for the statistical energy in time either exactly or with upper and lower bounds, provided that the negative symmetric dissipation matrix is diagonal in a suitable basis. Implications of the energy principle for low-order closure modeling and automatic estimates for the single point variance are discussed below.Understanding the complexity of anisotropic turbulent processes over a wide range of spatiotemporal scales in engineering shear turbulence as well as climate atmosphere ocean science is a grand challenge of contemporary science (1–4) with important societal impact. In such inhomogeneous turbulent dynamical systems, there is a large dimensional phase space with a large dimension of unstable directions where a large-scale ensemble mean and the turbulent fluctuations exchange energy and strongly influence each other. These complex features strongly impact practical prediction and uncertainty quantification. A systematic energy conservation principle is developed here in a Theorem that precisely accounts for the statistical energy exchange between the mean flow and the related turbulent fluctuations. This statistical energy is a sum of the energy in the mean and the trace of the covariance of the fluctuating turbulence. This result applies to general inhomogeneous turbulent dynamical systems including the above applications. The Theorem involves an assessment of statistical symmetries for the nonlinear interactions and a self-contained treatment is presented below. Corollary 1 and Corollary 2 illustrate the power of the method with general closed differential equalities for the statistical energy in time either exactly or with upper and lower bounds provided that the negative symmetric dissipation matrix is diagonal in a suitable basis. Implications of the energy principle for low-order closure modeling and automatic estimates for the single point variance are discussed below (5–7).Most earlier work in statistical turbulence involve assumptions of homogeneity and isotropy without a mean flow (1, 3, 8) or approximate the nonlinear terms in the equations for the mean flow and fluctuating interactions by ad hoc linear stochastic models (1, 9). More complete formulations of statistical energetics for the Navier–Stokes equations can be found in ref. 10. The advantage of the energy principle in the Theorem is the exact treatment of the nonlinear statistical energy exchange between the mean and fluctuations, which are amenable to systematic low-order closure models for prediction and uncertainty quantification with high skill (5–7, 11).     

Daytime sleepiness during Ramadan intermittent fasting: polysomnographic and quantitative waking EEG study

During the lunar month of Ramadan, Muslims abstain from eating, drinking and smoking from sunrise to sunset. We reported previously that Ramadan provokes a shortening in nocturnal total sleep time by 40 min, an increase in sleep latency, and a decrease in slow-wave sleep (SWS) and rapid eye movement (REM) sleep duration during Ramadan. During the same study, the effects of Ramadan intermittent fasting on daytime sleepiness were also investigated in eight healthy young male subjects using a quantitative waking electroencephalograph (EEG) analysis following the multiple sleep latency test (MSLT) procedure. This procedure was combined with subjective alertness and mood ratings and was conducted during four successive experimental sessions: (1) baseline (BL) 15 days before Ramadan, (2) beginning of Ramadan (R11) on the 11th day of Ramadan, (3) end of Ramadan (R25) on the 25th day of Ramadan, (4) recovery 2 weeks after Ramadan (AR). During each session, four 20-min nap opportunities (MSLTs) were given at 10:00, 12:00, 14:00 and 16:00 h and were preceded by rectal temperature readings. Nocturnal sleep was recorded before each daytime session. Subjective daytime alertness did not change in R25 but decreased in R11 at 12:00 h, and subjective mood decreased at 16:00 h, both in R11 and R25. During the MSLT, mean sleep latency decreased by an average of 2 min in R11 (especially at 10:00 and 16:00 h) and 6 min in R25 (especially at 10:00 and 12:00 h) compared with BL. There was an increase in the daily mean of waking EEG absolute power in the theta (5.5-8.5 Hz) frequency band. Significant correlations were found between sleep latency during the MSLT and the waking EEG absolute power of the fast alpha (10.5-12.5 Hz), sigma (11.5-15.5 Hz) and beta (12.5-30 Hz) frequency bands. Sleep latency was also related to rectal temperature. In conclusion, Ramadan diurnal fasting induced an increase in subjective and objective daytime sleepiness associated with changes in diurnal rectal temperature.