Residence,income and cancer hospitalizations in British Columbia during a decade of policy change

BACKGROUND: Through the 1990s, governments across Canada shifted health care funding allocation and organizational foci toward a community-based population health model. Major concerns of reform based on this model include ensuring equitable access to health and health care, and enhancing preventive and community-based resources for care. Reforms may act differentially relative to specific conditions and services, including those geared to chronic versus acute conditions. The present study therefore focuses on health service utilization, specifically cancer hospitalizations, in British Columbia during a decade of health system reform. METHODS: Data were drawn from the British Columbia Linked Health Data resource; income measures were derived from Statistics Canada 1996 Census public use enumeration area income files. Records with a discharge (separation) date between 1 January 1991 and 31 December 1998 were selected. All hospitalizations with ICD-9 codes 140 through 208 (except skin cancer, code 173) as principal diagnosis were included. Specific cancers analyzed include lung; colorectal; female breast; and prostate. Hospitalizations were examined in total (all separations), and as divided into first and all other hospitalizations attributed to any given individual. Annual trends in age-sex adjusted rates were analyzed by joinpoint regression; longitudinal multivariate analyses assessing association of residence and income with hospitalizations utilized generalised estimating equations. Results are evaluated in relation to cancer incidence trends, health policy reform and access to care. RESULTS: Age-sex adjusted hospitalization rates for all separations for all cancers, and lung, breast and prostate cancers, decreased significantly over the study period; colorectal cancer separations did not change significantly. Rates for first and other hospitalizations remained stationary or gradually declined over the study period. Area of residence and income were not significantly associated with first hospitalizations; effects were less consistent for all and other hospitalizations. No interactions were observed for any category of separations. CONCLUSIONS: No discontinuities were observed with respect to total hospitalizations that could be associated temporally with health policy reform; observed changes were primarily gradual. These results do not indicate whether equity was present prior to health care reform. However, findings concur with previous reports indicating no change in access to health care across income or residence consequent on health care reform.     

Anger expression, coping, and substance use in adolescent offenders

The present study examined anger expression and avoidant coping and their relationship to substance use and use-related consequences in a sample of 270 incarcerated adolescents. Outwardly expressed anger was significantly associated with both alcohol and marijuana use and use-related consequences. Avoidant coping was also significantly associated with all outcome variables. There were no significant interactions between anger expression (outward or inward) and avoidant coping. Collectively, results suggest that expression of anger and avoidant coping are independent risk factors for substance use and use-related consequences across two classes of drugs in adolescent offenders.     

The relationship among alcohol use, related problems, and symptoms of psychological distress: gender as a moderator in a college sample

This research evaluated the prevalence of general symptoms of psychological distress, the degree to which these symptoms related to alcohol use and alcohol-related negative consequences, and gender-specific relationships among alcohol use, alcohol consequences, and symptoms of psychological distress. The sample included 1705 students drawn from a random sample of three West Coast universities who completed the survey. Results revealed higher levels of consumption and more negative drinking consequences for men, more psychological distress symptoms reported by women, and stronger relationships between psychological symptoms and drinking consequences than use per se. The association between psychological distress and negative drinking consequences was stronger among men than women. The present findings suggest that a focus on negative consequences of alcohol use in addition to the use itself may have greater utility in identifying students at risk for comorbid psychological distress to provide intervention.     

Expectancies and evaluations of alcohol effects among college students: self-determination as a moderator

OBJECTIVE: This research examined individual differences in self-determination as moderators of both alcohol expectancies and of subjective evaluations of alcohol effects in college students. Previous work has shown lower levels of self-determination to be linked with drinking for more extrinsic reasons and as a means of regulating affect and social approval. We proposed that alcohol expectancies and subjective evaluations of alcohol effects would be more strongly linked to alcohol consumption and alcohol-related problems among students who were more controlled and/or less autonomous. METHOD: Self-reported alcohol expectancies and subjective evaluations of alcohol effects and self-determination were assessed among 560 (347 women) college students, along with self-reported alcohol consumption and alcohol-related negative consequences. RESULTS: Alcohol expectancies and subjective evaluation of alcohol effects were examined separately. A series of hierarchical multiple regressions revealed that positive alcohol expectancies were more strongly associated with greater alcohol consumption and alcohol-related problems among students who were lower in autonomy orientation, and among male students who were higher in controlled orientation. Similarly, more favorable evaluations of positive alcohol effects were associated with greater alcohol consumption among students who were lower in autonomy orientation and students, particularly men, who were higher in controlled orientation. CONCLUSIONS: Expectancy theories implicitly assume that individuals who believe alcohol has positive effects and who evaluate alcohol effects favorably are more likely to engage in problematic drinking. This research reveals this assumption is more appropriate among individuals who are generally less self-determined. Implications for interventions are discussed.     

垂全催乳素瘤的诊断和治疗指南

3.男性:高催乳素血症通常导致阳痿、不孕和性功能低下.男性患者通常为大腺瘤,有神经系统症状.其原因可能是对症状认识的延误或者肿瘤生物学行为的差异.     

Speech-controlled generation of radiology reports

Voice entry has been successfully employed to generate radiology reports with a word recognizer with a 1,000-word lexicon capacity. About 50% of reports were able to be dictated with a single 900-word lexicon. This was split into five sections by anatomic or subspecialty application. Each was augmented to 900 words. By switching from one lexicon to another, it was possible to dictate more than 70% of reports. With exclusive use of three lexicons in subspecialty areas (gastrointestinal radiology, neuroradiology, and mammography), and with further modification of the respective vocabulary, it has been possible to employ the system 88% of the time. Twelve percent of cases included wording that was beyond the scope of the lexicon. Computer subsets that allow different translations of some words when used in different contexts have been used. Some of these are used as triggers that will print whole lines, sentences, or even complete reports. Dictation times with voice entry take about 20% longer. Recognition reliability has been greater than 95%.     

Interaction of platelet factor four with cultured vascular endothelial cells

Platelets secrete a low-molecular-weight protein, platelet factor four (PF-4), which binds to and neutralizes heparin and related sulfated glycosaminoglycans (GAGs). To examine the interactions of PF-4 with the GAGs present on endothelial cell surfaces, we incubated 125I-PF-4 with cell suspensions derived from confluent monolayers of cultured bovine aortic endothelium. Binding of 125I-PF-4 was inhibited by a 100-fold excess of nonradioactive PF-4 and varied with duration and temperature of incubation. At 4 degrees C, binding reached equilibrium at 20 minutes with kd = 2.87 mumol/L and Bmax of 63.83 pmol/10(5) cells. Binding capacity was reduced 83.4% by brief incubation of endothelial cells with trypsin and 46.67% by incubation with Flavobacterium heparinase, but was unchanged by chondroitin-ABCase treatment. At 37 degrees C, PF-4 was internalized by confluent monolayer of bovine aortic endothelial cells primarily through low-affinity adsorptive endocytosis. The internalized PF-4 was degraded to amino acids and small peptides with 50% conversion after 18-hour incubation. These studies demonstrate that a secreted platelet protein can bind to and enter endothelial cells. Binding may explain the rapid clearance of released PF-4 from plasma and could have important local effects on endothelial structure and function.