Effect of work load and respirator wear on postural stability, heart rate, and perceived exertion

The effects on postural stability (sway) were investigated for different work loads under conditions of wearing a full facepiece respirator and not wearing any respiratory protection device. Fifteen subjects accomplished light (40 W), moderate (85 W), and heavy (125 W) work loads under the two conditions. Measurements of postural sway were made immediately after each load by using a multicomponent, strain gage-type force platform. Changes in each subject's movement pattern of the center of pressure were quantitated and compared to their initial baseline sway tests. Each subject's heart rate and perceived exertion were also recorded during each condition. A statistically significant effect (p = 0.007) caused by work load was observed for total length of sway with or without a respirator. An interaction approaching statistical significance (p = 0.056) between work load and respirator use was found. This indicated that sway increased more quickly and in a more consistently linear fashion with increasing work load under the respirator condition (p = 0.02) compared to the nonrespirator condition. The results from the respirator condition showed linear increases in postural sway length across the entire range of work loads, but sway length in the nonrespirator condition showed an increase only at 125-W work loads. The greater increase in sway during the postural balance test could be attributable to the increasing work load-induced proprioceptive fatigue effect on the nervous system's ability to process signals from proprioception systems incongruent with body sway. The heart rate was significantly higher during respirator wear (an increase in heart rate averaging 5.62 beats/min).(ABSTRACT TRUNCATED AT 250 WORDS)     

A pilot study of facial, cranial and brain MRI morphometry in men with schizophrenia: part 2

This pilot study applies a new 3D morphometric MR method to test the hypothesis that men with schizophrenia (vs. controls) have deviant facial shapes and landmark relations in cranio/facial/brain (CFB) regions. This constitutes Part 2 of paired articles in this issue of Psychiatry Research: Neuroimaging, in which Part 1 presents the new method in detail. MRI coordinates from CFB landmarks of 23 patients and 15 controls were identified and then aligned with the Procrustes model, leaving shape as the only unit-less geometrical information. Men with schizophrenia had significantly longer mid- and lower-facial heights, and greater lower (left) facial depth, with a tendency toward rotation along the facial midline. This supports findings from earlier anthropometric and 3D studies of the "exterior" (face). In contrast, none of the patient-control differences for the new "interior" (cranial-brain) distances reached statistical significance. These results need to be retested on a larger sample of both sexes.     

Zebrafish tp53 knockdown extends the survival of irradiated zebrafish embryos more effectively than the p53 inhibitor pifithrin-alpha

Cancer treatment strategies using radiation therapy have significantly improved outcomes in patients. Although advances in physics and electronics have enabled physicians to plan and deliver radiotherapy regimens precisely and efficiently, studies of the underlying molecular mechanisms of the radiation response could enable more effective and less toxic treatment strategies, as well as protection against radiation damage following unplanned exposure. Using the developing zebrafish embryo as a model system, we hypothesized that knockdown of tp53 mRNA or small molecule inhibition of p53 could alter the efficacy of radiotherapy against developing zebrafish embryos as a model for tumors. We found that interfering with p53 expression and function using hydroxylprolyl-phosphono peptide nucleic acid oligomers or pifithrin-alpha protected developing zebrafish embryos against radiation damage, consistent with our hypothesis.     

Nanotechnology for sensing, imaging, and treating cancer

Nanotechnology encompasses the creation and use of materials, devices, and systems at the level of atoms, molecules, and supramolecular structures. Nanotechnology for cancer consists of three main areas: (1) nanodetectors for sensing proteins and cancer cells, (2) nanoparticle or nanovector formulations for high-contrast imaging, and (3) nanotechnology-based drug delivery and therapeutic formulations. Although there are tremendous challenges facing nanotechnologists, nanotechnology, if properly integrated with established cancer research, can make laboratory-to-clinic transfer of technology successful, which can result in breakthrough potential for patient care.     

Use of preventive services by men enrolled in Medicare+Choice plans

Objectives. We examined the effect of demographic and socioeconomic factors on use of preventive services (prostate-specific antigen testing, colorectal cancer screening, and influenza vaccination) among elderly men enrolled in 2 Medicare+Choice health plans.

Methods. Data were derived from administrative files and a survey of 1915 male enrollees. We used multivariate logistic regression to assess the effects of enrollee characteristics on preventive service use.

Results. Age, marital status, educational attainment, and household wealth were associated with receipt of one or more preventive services. However, the effects of these variables were substantially attenuated relative to earlier studies of Medicare.

Conclusions. Some Medicare HMOs have been successful in attenuating racial and socioeconomic disparities in the use of preventive services by older men.

     

Practice characteristics and HMO enrollee satisfaction with specialty care: an analysis of patients with glaucoma and diabetic retinopathy

BACKGROUND: The specialist's role in caring for managed care patients is likely to grow. Thus, assessing the correlates of patient satisfaction with specialty care is essential. OBJECTIVE: To examine the association between characteristics of eye care practices and satisfaction with eye care among working age patients with open-angle glaucoma (OAG) or diabetic retinopathy (DR). SUBJECTS/STUDY SETTING: A total of 913 working age patients with OAG or DR enrolled in six commercial managed care health plans. The patients were treated in 144 different eye care practices. STUDY DESIGN: We used a patient survey to obtain information on patient characteristics and satisfaction with eye care, measured by scores on satisfaction subscales of the 18-item Patient Satisfaction Questionnaire. We used a survey of eye care practices to obtain information on practice characteristics, including provider specialties, practice organization, financial features, and utilization and quality management systems. We estimated logistic regression models to assess the association of patient and practice characteristics with high levels of patient satisfaction. PRINCIPAL FINDINGS: Treatment in a practice with a glaucoma specialist (for OAG patients) or a retina specialist (for DR patients) was associated with higher satisfaction, whereas treatment in a practice that obtained a high proportion of its revenues from capitation payments or in a group practice where providers obtained a high proportion of their incomes from bonuses was associated with lower satisfaction. CONCLUSIONS: Many eye care patients prefer to be treated by specialists with expertise in their conditions. Financial arrangement features of eye care practices also are associated with patient satisfaction with care. The most likely mechanisms underlying these associations are effects on provider behavior and satisfaction, which in turn influence patient satisfaction. Managed care plans and provider groups should aim to minimize the negative impact of managed care features on patient satisfaction.