Effects of ethnicity and gender on motion sickness susceptibility

INTRODUCTION: Susceptibility to motion sickness (MS) is known to be affected by gender and ethnic origin, but whether gender and ethnicity are interacting is unknown. METHODS: We investigated MS development in healthy Caucasian subjects (n = 227), and in subjects of Chinese origin (n = 82). All subjects were exposed to nausea-inducing body rotations in a rotation chair, and rotated around the yaw axis for 5 x 1 min, while they were instructed to move their heads. Prior to rotation, subjects had to fill out a motion-sickness susceptibility questionnaire (MSSQ). Total rotation tolerance time (RT) was noted. Symptom ratings (SR) were performed at the beginning, and immediately after the end of each rotation, and 15 and 30 min later. RESULTS: The average RT was significantly higher in Caucasian (163 +/- 6 s) than in Chinese subjects (111 +/- 7 s) (F = 24.84, p < 0.0001). The adult MSSQ score was significantly lower in Caucasians (17.8 +/- 1.1) than in Chinese volunteers (24.2 +/- 2.1) (F = 6.05, p = 0.014). Maximal SR post rotation was similar in Chinese and Caucasian subjects. RT was highly predictable from the MSSQ scores, but separate for both genders. CONCLUSION: Susceptibility to MS is affected by both ethnic origin and by gender in a rather complex fashion. The most reliable prediction of RT can be based on the individual's history as assessed by the MSSQ.     

Estimation of postmortem metabolic changes in porcine brain tissue using <Superscript>1</Superscript>H-MR spectroscopy—preliminary results

To investigate the potential for estimating the time since death by monitoring the evolution of different metabolites in brain tissue by ¹H-MRS, an animal model using pig heads was established. The maximum examination interval was 3 weeks. Within this time interval spectra revealed different compositions of metabolites, including metabolites observed in the normal brain and as products of bacterial decomposition processes (N-acetyl-aspartate 0–130 h, creatine 0–170 h, bound trimethylammonium, e. g. choline compounds, during the whole time course with fluctuating intensities, lactate 0–200 h, alanine and acetate during the whole time course, succinate and free trimethylammonium after approx. 100 h postmortem). The proposed approach may offer a new method to estimate later postmortem intervals although these observations have to be confirmed by further studies.     

The effect of participation in the WIC program on preschoolers' diets

OBJECTIVE: To evaluate nutrient, food intake, and snacking behavior by participation in the WIC (Special Supplemental Nutrition Program for Women, Infants, and Children) program. STUDY DESIGN: Secondary data analysis of a nationally representative cross-sectional survey conducted by USDA in 1994 to 1996 and 1998. METHODS: Statistical analysis was performed correcting for sample design effects and weighting for children in two income groups (<130%, n=1772 and 130% to 185% of poverty, n=689). RESULTS: Among WIC participants, the prevalence of snacking was significantly lower (68%) compared with nonparticipants (72%) (chi(2)=5.9, P=.01). For those <130% of poverty, WIC had a beneficial effect on the intake of fat, carbohydrates, added sugar, and fruit from the total diet as well as on added sugar from snacks. These were independent of food stamp participation. For those with higher incomes, the beneficial effects were limited to added sugar, iron density, and fruit intake for the total diet. A similar significant effect of decreased added sugar intake from snacks was also seen. CONCLUSIONS: Our results are in line with previous research showing beneficial effects of WIC participation among preschoolers, primarily for nutrients targeted by the program. This study shows that the effect can reach beyond those targeted nutrients.     

The effects of high molecular weight hydroxyethyl starch solutions on platelets

Physicochemical characteristics of hydroxyethyl starch (HES) molecules determine their side effects on hemostasis. Our aim in the present experiments was to test the antiplatelet effect of novel high molecular weight HES. Citrated whole blood was hemodiluted in vitro (0% and 20%) with either HES 550 (Hextend), HES 600 (6%Hetastarch-Baxter), HES 200 (Eloh?st), or the solvent of Hextend in its commercially available solution. The availability of glycoprotein IIb-IIIa was assessed on nonstimulated and on agonist-induced platelets using flow cytometry. Glycoprotein IIb-IIIa availability increased significantly after hemodilution with Hextend and its solvent by 23% and 24%, respectively, but decreased in the presence of 6% Hetastarch-Baxter and Eloh?st by 18% and 15%, respectively, with no significant difference between the latter two colloids. This study shows that Hextend does not inhibit platelet function as anticipated by its high molecular weight and degree of substitution. The unexpected platelet stimulating effect of Hextend is unique among the currently available HES preparations and may, at least in part, be induced by its solvent containing calcium chloride dihydrate (2.5 mmol/L). The platelet-inhibiting effect of 6%Hetastarch-Baxter was not significantly different from that of medium molecular weight HES 200.     

Safe and reliable sound threshold measures with direct vibration of the ossicular chain

OBJECTIVES: The aim of the study was to evaluate the safety and feasibility of piezoelectric malleus vibration audiometer (MVA), which presents micromechanical vibrations to the umbo membranae tympani. STUDY DESIGN: Phase I study performed in a tertiary referral center (University Hospital). METHODS: The coupling rod of the MVA was moved slowly through the outer ear canal toward the eardrum with a micromanipulator. Coupling was completed when the rod tip touched the umbo membranae tympani. Basic audiologic measures of sound threshold obtained with direct stimulation of the malleus are presented. We used MANOVA (multivariate repeated measures ANOVA) to investigate the repeatability of MVA thresholds from one day to the other and when decoupling and retracting the coupling rod 2 mm off the umbo. We also selected the MANOVA to test for unwanted bone-conduction threshold shifts after MVA application. We assessed normality of the data by quantile-quantile plots of the residuals. RESULTS: Twenty-eight male and 10 female subjects with normal hearing, 22.2 to 34.6 years old (median age, 27.2 yr) underwent an examination. Thirty-six subjects underwent MVA, because 2 of the 38 subjects who volunteered for the study have not undergone the procedure due to the external auditory canal anatomy preventing application of the MVA. The results show that it is possible to safely and reliably measure thresholds of direct vibration of the ossicular chain. Using pure tone audiograms, no pure tone bone- and/or air-conduction threshold shifts occurred after the procedure. None of the subjects reported any other ear-related symptoms such as vertigo, tinnitus, or dizziness. Geometric mean vibratory displacements at threshold ranged from 0.55 nm at 250 Hz to 0.03 nm at 6 kHz. MANOVA demonstrated a repeatability of MVA thresholds. CONCLUSION: Malleus vibration audiometry will not allow exact linkage of actual implantable hearing aid. But the present study demonstrates that MVA can provide an audiometric tool for assessing ossicular function and integrity prior to implantation of an electronic hearing amplifier.     

Nationwide surveillance of nosocomial infections in Switzerland--methods and results of the Swiss Nosocomial Infection Prevalence Studies (SNIP) in 1999 and 2002

The first multi-center prevalence study of nosocomial infections in Switzerland took place in 1996. Since then, the number of participating hospitals has steadily increased. Today, 72 hospitals of various sizes are part of the Swiss-NOSO surveillance network and represent 30% of all Swiss acute care hospitals, which include approximately 10,000 acute care beds. This article describes the methodology of the national prevalence studies and the results of the 1999 and 2002 surveys. The proportion of infected patients was 10.1% and 8.1% in 1999 and 2002, respectively. The highest prevalence occurred in intensive care units. The most prevalent nosocomial infections were surgical site infections, urinary tract infections, pneumonia, and bloodstream infections. Increasingly, crude rates of nosocomial infections serve as a quality indicator and are used for interhospital comparison and benchmarking. This may be misleading due to differences in case-mix between hospitals as shown in the 1999 study. Using a coordinated approach within a national network, surveillance of nosocomial infections has established itself as an indispensible part of infection control and prevention in Swiss hospitals.     

S-Adenosyl methionine (SAMe) versus celecoxib for the treatment of osteoarthritis symptoms: A double-blind cross-over trial. [ISRCTN36233495]

Background  

S-Adenosylmethionine (SAMe) is a dietary supplement used in the management of osteoarthritis (OA) symptoms. Studies evaluating SAMe in the management of OA have been limited to Non Steroidal Anti-inflammatory Drugs (NSAIDs) for comparison. The present study compares the effectiveness of SAMe to a cyclooxygenase-2 (COX-2) inhibitor (celecoxib) for pain control, functional improvement and to decrease side effects in people with osteoarthritis of the knee.     

Nursing resources: a major determinant of nosocomial infection?

PURPOSE OF REVIEW: There is growing concern that changes in nurse workforce and hospital-restructuring interventions negatively impact on patient outcomes. This review focuses on the association between understaffing and health-care-associated infections. RECENT FINDINGS: There is a large number of studies showing that overcrowding, understaffing or a misbalance between workload and resources are important determinants of nosocomial infections and cross-transmission of microorganisms. Importantly, not only the number of staff but also the level of their training affects outcomes. The nurse workforce is ageing, mainly due to fewer individuals' engaging in a nursing career. This phenomenon, combined with cost-driven downsizing, contributes to a nursing shortage, and this tendency is not expected to revert unless important system changes are implemented. The causal pathway between understaffing and infection is complex, and factors might include lack of time to comply with infection control recommendations, job dissatisfaction, job-related burnout, absenteeism and a high staff turnover. SUMMARY: The evidence that cost-driven downsizing and changes in staffing patterns causes harm to patients cannot be ignored, and should not be considered as an inevitable outcome. More research is needed to better define the optimal patient-to-nurse ratio in various hospital settings and to estimate the economical impact of the nursing shortage. All quality-improvement interventions should carefully take into account systems and processes to be successful, as the issue of staffing is essentially a structural problem.