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BACKGROUND: Evidence suggests that brief interventions in the trauma care setting reduce drinking, subsequent injury and driving under the influence (DUI) arrest. However, evidence on the effectiveness of these interventions in ethnic minority groups is lacking. The current study evaluates the efficacy of brief intervention among whites, blacks and Hispanics in the United States. METHODS: We conducted a two-group parallel randomized trial comparing brief motivational intervention (BMI) and treatment as usual with assessment (TAU+) to evaluate treatment differences in drinking patterns by ethnicity. Patients were recruited from a level 1 urban trauma center over a 2-year period. The study included 1493 trauma patients, including 668 whites, 288 blacks and 537 Hispanics. Hierarchical linear modeling was used to evaluate ethnic differences in drinking outcomes including volume per week, maximum amount consumed in 1 day, percentage days abstinent and percentage days heavy drinking at 6- and 12-month follow-up. Analyses controlled for age, gender, employment status, marital status, prior alcohol treatment, type of injury and injury severity. Special emphasis was given to potential ethnic differences by testing the interaction between ethnicity and BMI. RESULTS: At 6- and 12-month follow-up, BMI significantly reduced maximum amount consumed in 1 day (P < 0.001; P < 0.001, respectively) and percentage days heavy drinking (P < 0.05; P < 0.05, respectively) among Hispanics. Hispanics in the BMI group also reduced average volume per week at 12-month follow-up (chi(2) = 6.8, df = 1, P < 0.01). In addition, Hispanics in TAU+ reduced maximum amount consumed at 6- and 12-month follow-up (P < 0.001; P < 0.001) and volume per week at 12-month follow-up (P < 0.001). Whites and blacks in both BMI and TAU+ reduced volume per week and percentage days heavy drinking at 12-month follow-up (P < 0.001; P < 0.01, respectively) and decreased maximum amount at 6- (P < 0.001) and 12-month follow-up (P < 0.001). All three ethnic groups In both BMI and TAU+ reduced volume per week at 6-month follow-up (P < 0.001) and percentage days abstinent at 6- (P < 0.001) and 12-month follow-up (P < 0.001). CONCLUSIONS: All three ethnic groups evidenced reductions in drinking at 6- and 12-month follow-up independent of treatment assignment. Among Hispanics, BMI reduced alcohol intake significantly as measured by average volume per week, percentage days heavy drinking and maximum amount consumed in 1 day.
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Consumo de Bebidas Alcohólicas/etnología , Consumo de Bebidas Alcohólicas/prevención & control , Conducción de Automóvil , Psicoterapia Breve , Heridas y Lesiones , Adolescente , Adulto , Consumo de Bebidas Alcohólicas/efectos adversos , Actitud Frente a la Salud/etnología , Población Negra/psicología , Población Negra/estadística & datos numéricos , Características Culturales , Femenino , Hispánicos o Latinos/psicología , Hispánicos o Latinos/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Selección de Paciente , Centros Traumatológicos , Resultado del Tratamiento , Estados Unidos/epidemiología , Población Blanca/psicología , Población Blanca/estadística & datos numéricos , Heridas y Lesiones/etnología , Heridas y Lesiones/psicología , Adulto JovenRESUMEN
Complex sex-biased dispersal patterns often characterize social-group-living species and may ultimately drive patterns of cooperation and competition within and among groups. This study investigates whether observational data or genetic data alone can elucidate the potentially complex dispersal patterns of social-group-living black and white colobus monkeys (Colobus guereza, "guerezas"), or whether combining both data types provides novel insights. We employed long-term observation of eight neighbouring guereza groups in Kibale National Park, Uganda, as well as microsatellite genotyping of these and two other neighbouring groups. We created a statistical model to examine the observational data and used dyadic relatedness values within and among groups to analyse the genetic data. Analyses of observational and genetic data both supported the conclusion that males typically disperse from their natal groups and often transfer into nearby groups and probably beyond. Both data types also supported the conclusion that females are more philopatric than males but provided somewhat conflicting evidence about the extent of female philopatry. Observational data suggested that female dispersal is rare or nonexistent and transfers into neighbouring groups do not occur, but genetic data revealed numerous pairs of closely related adult females among neighbouring groups. Only by combining both data types were we able to understand the complexity of sex-biased dispersal patterns in guerezas and the processes that could explain our seemingly conflicting results. We suggest that the data are compatible with a scenario of group dissolution prior to the start of this study, followed by female transfers into different neighbouring groups.
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Colobus/genética , Genética de Población , Conducta Sexual Animal , Alelos , Animales , Femenino , Genotipo , Funciones de Verosimilitud , Masculino , Repeticiones de Microsatélite , Dinámica Poblacional , Análisis de Secuencia de ADN , Conducta Social , UgandaRESUMEN
Many studies in molecular ecology rely upon the genotyping of large numbers of low-quantity DNA extracts derived from noninvasive or museum specimens. To overcome low amplification success rates and avoid genotyping errors such as allelic dropout and false alleles, multiple polymerase chain reaction (PCR) replicates for each sample are typically used. Recently, two-step multiplex procedures have been introduced which drastically increase the success rate and efficiency of genotyping. However, controversy still exists concerning the amount of replication needed for suitable control of error. Here we describe the use of a two-step multiplex PCR procedure that allows rapid genotyping using at least 19 different microsatellite loci. We applied this approach to quantified amounts of noninvasive DNAs from western chimpanzee, western gorilla, mountain gorilla and black and white colobus faecal samples, as well as to DNA from ~100-year-old gorilla teeth from museums. Analysis of over 45 000 PCRs revealed average success rates of > 90% using faecal DNAs and 74% using museum specimen DNAs. Average allelic dropout rates were substantially reduced compared to those obtained using conventional singleplex PCR protocols, and reliable genotyping using low (< 25 pg) amounts of template DNA was possible. However, four to five replicates of apparently homozygous results are needed to avoid allelic dropout when using the lowest concentration DNAs (< 50 pg/reaction), suggesting that use of protocols allowing routine acceptance of homozygous genotypes after as few as three replicates may lead to unanticipated errors when applied to low-concentration DNAs.
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The mammalian soluble epoxide hydrolase (sEH) plays a role in the regulation of blood pressure and vascular homeostasis through its hydrolysis of the endothelial-derived messenger molecules, the epoxyeicosatrienoic acids. This study reports the cloning and expression of a sEH homolog from chicken liver. The resulting 63-kDa protein has an isoelectric point of 6.1. The recombinant enzyme displayed epoxide hydrolase activity when assayed with [3H]-trans-1,3-diphenylpropene oxide (t-DPPO), as well as trans-9,10-epoxystearate and the cis-8,9-, 11,12-, and 14,15- epoxyeicosatrienoic acids. The chicken enzyme displayed a lower kcat:Km for t-DPPO than the mammalian enzymes. The enzyme was sensitive to urea-based inhibitors developed for mammalian sEH. Such compounds could be used to study the role of chicken sEH in conditions in which endothelial-derived vasodilation is believed to be impaired, such as pulmonary hypertension syndrome.
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Pollos , Clonación Molecular , Epóxido Hidrolasas/genética , Hígado/enzimología , Secuencia de Aminoácidos , Animales , Secuencia de Bases , ADN Complementario/química , Endotelio Vascular/fisiología , Epóxido Hidrolasas/química , Epóxido Hidrolasas/metabolismo , Compuestos Epoxi/metabolismo , Masculino , Datos de Secuencia Molecular , Proteínas Recombinantes , Alineación de Secuencia , Solubilidad , Especificidad por Sustrato , Tritio , VasodilataciónRESUMEN
The VaNTH Engineering Research Center for Bioengineering Education Technologies has completed the first round of a Delphi study to determine the key concepts that comprise the core curriculum of undergraduate programs in biomedical engineering. The study was conducted as a Web-based survey, consisting of eighty questions divided among nineteen topics, including eleven biomedical engineering domains, four biology domains, and mathematical and scientific prerequisites. Participants included representatives from academia, industry, and young alumni of undergraduate BME programs. Results from the survey will be available at: http://www.vanth.org/curriculum/.
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We studied the occurrence of the environmental radon daughters, 210Po (alpha particles), and 210Bi (beta particles), in the protein and lipid fractions of cortical gray and subcortical white matter from the frontal and temporal lobes of human brains of persons with Alzheimer disease (AD), persons with Parkinson disease (PD), smokers, or persons with no previous evidence of clinical neurologic disease (controls). We found a 10-fold increase in 210Po and 210Pb radioactivity in the protein fraction from both the cortical gray and subcortical white matter in AD and smokers, and a similar increase in the lipid fraction in PD. The pathognomonic distribution of the radon daughters to the lipids in PD and to the proteins in AD was inferred to reflect the increase of local chlorine availability to which radon daughters bound selectively. Cigarette smoking strongly increases radon daughter retention in the central nervous system.
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Contaminantes Radiactivos del Aire/análisis , Bismuto/análisis , Lóbulo Frontal/patología , Plomo/análisis , Proteínas del Tejido Nervioso/análisis , Fosfolípidos/análisis , Radioisótopos/análisis , Hijas del Radón/análisis , Lóbulo Temporal/patología , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valores de Referencia , Factores de Riesgo , Fumar/efectos adversosRESUMEN
INTRODUCTION: This study explores the numbers of learning resources physicians use at each stage in self-directed learning episodes addressing general problems. MATERIALS AND METHODS: A survey of a statewide random sample of doctors estimated the number of resources used at each stage in solving various general problems. RESULTS: The 50% response rate for faculty allowed generalization of findings to the population of these physicians; the rate for nonfaculty physicians was too low to allow generalization. Faculty findings showed (1) broader resource use in learning about diseases than diagnosis or therapeutics (2) comparable numbers of resources used in deciding whether to take on the learning problem and learning the required skills and knowledge, (3) greater numbers of resources selected to evaluate the problem and to learn the required skills and knowledge than to gain experience with the newly learned skills and knowledge, and (4) support for assertions that doctors value learning resources that are accessible, applicable, familiar, and time effective. DISCUSSION: The findings were interpreted in light of theory describing physicians' self-directed learning episodes, and implications are presented for physicians-in-training, physicians, and medical librarians.
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Educación Médica Continua/estadística & datos numéricos , Programas de Autoevaluación/estadística & datos numéricos , Análisis de Varianza , Certificación/estadística & datos numéricos , Análisis por Conglomerados , Educación Médica Continua/tendencias , North Dakota , Vigilancia de la Población , Distribución Aleatoria , Desarrollo de Personal , Encuestas y CuestionariosRESUMEN
In general, mutation of the phylogenetically conserved residue Phe82 in yeast iso-1-cytochrome c destabilizes the native conformation of the protein by facilitating the ligand exchange reactions that are associated with the alkaline conformational transitions of the ferricytochrome. Of the Phe82 variants surveyed thus far, Phe82Trp is unique in that it adopts a thermodynamically stable, high-spin conformation at mildly alkaline pH. This species exhibits spectroscopic features that can only be detected transiently in other ferricytochromes c within the first 100 ms immediately after a pH-jump from neutrality to pH >10. Spectroscopic characterization of this high-spin reaction intermediate suggests that in addition to an obligatory pentacoordinate heme iron, a group within the heme pocket coordinates the heme iron but is then replaced either by Met80, to revert to the native conformation, or by Lys73 or Lys79, to yield one of the conventional alkaline conformers. Evidence is presented to suggest that this group is either a hydroxide ion or Tyr67 rather than a loosely bound Met80.
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Grupo Citocromo c/química , Grupo Citocromo c/metabolismo , Citocromos c , Proteínas Fúngicas/química , Proteínas Fúngicas/metabolismo , Proteínas de Saccharomyces cerevisiae , Saccharomyces cerevisiae/enzimología , Sustitución de Aminoácidos , Grupo Citocromo c/genética , Electroquímica , Espectroscopía de Resonancia por Spin del Electrón , Estabilidad de Enzimas , Proteínas Fúngicas/genética , Hemo/química , Hemo/metabolismo , Concentración de Iones de Hidrógeno , Hierro/química , Hierro/metabolismo , Cinética , Resonancia Magnética Nuclear Biomolecular , Oxidación-Reducción , Fenilalanina/química , Fenilalanina/genética , Fenilalanina/metabolismo , Conformación Proteica , Saccharomyces cerevisiae/genética , Espectrometría Raman , Relación Estructura-Actividad , Triptófano/química , Triptófano/genética , Triptófano/metabolismoAsunto(s)
Corteza Cerebral/química , Exposición a Riesgos Ambientales , Polonio/análisis , Monitoreo de Radiación , Radón , Conteo por Cintilación , Enfermedad de Alzheimer/patología , Bismuto/análisis , Rayos gamma , Humanos , Enfermedad de Parkinson/patología , Radioisótopos/análisis , Hijas del Radón , Valores de Referencia , Reproducibilidad de los Resultados , Fumar/patologíaRESUMEN
AIMS: To examine the consistency and/or variability of gender differences in drinking behavior cross-culturally. DESIGN, SETTING, PARTICIPANTS: Women's and men's responses in 16 general population surveys from 10 countries, analyzed by members of the International Research Group on Gender and Alcohol. MEASUREMENTS: Comparable measures of drinking, versus abstention, typical drinking frequencies and quantities, heavy episodic drinking, intoxication, morning drinking, and alcohol-related family and occupational problems. FINDINGS: Women and men differed little in the probability of currently drinking versus abstaining, but men consistently exceeded women in typical drinking frequencies and quantities and in rates of heavy drinking episodes and adverse drinking consequences, while women were consistently more likely than men to be life-time abstainers. In older age groups, both men and women drank smaller quantities of alcohol and were more likely to stop drinking altogether, but drinking frequencies did not change consistently with age. CONCLUSIONS: A theoretical synthesis proposes that gender roles may amplify biological differences in reactions to alcohol, and that gender differences in drinking behavior may be modified by macrosocial factors that modify gender role contrasts.
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Consumo de Bebidas Alcohólicas/psicología , Trastornos Relacionados con Alcohol/psicología , Comparación Transcultural , Adulto , Factores de Edad , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores SexualesRESUMEN
A bolus injection of hypertonic NaCl into the pulmonary arterial circulation of an isolated perfused dog lung causes the osmotic movement of water first into, and then out of the capillary. The associated changes in blood constituent concentrations and density are referred to as the osmotic transient (OT). Measurement of the sound conduction velocity of effluent blood during an OT is a highly sensitive way to monitor water movement between the vascular and extravascular spaces. It was our objective to develop a mathematical model that adequately describes this transient change in the sound conduction velocity and evaluate its application under conditions of homogeneous and heterogeneous capillary flow distributions. The model accounts for osmotic water exchange between the capillary and two parallel extravascular compartments, and includes as parameters the osmotic conductances (sigmaK1 ,sigmaK2) of the two compartments. The osmotic conductance parameters incorporate the filtration coefficient for water and reflection coefficient for salt for the two pathways of water exchange. The partition of total extravascular lung water (EVLW) between the two extravascular compartments is a third parameter of the model. The homogeneous model parameter estimates (per gram wet lung weight +/-95% confidence limits) from the best-fit analysis of a typical curve were sigmaK1=2.15 +/-0.07, sigmaK2 = 0.03 + 0.00 [ml h(-1) (mosmol/liter)(-1) g(-1)] and V1 = 23.83+/-0.12 ml, with a coefficient of variation (CV) of 0.08. The heterogeneous parameter estimates for a capillary transit time distribution with mean transit time (MTTc) = 1.72 s, and relative dispersion (RDc) = 0.35 were KI = 2.38+/-0.05, or K2 = 0.03+/-0.00 [ml h(-1) (mosmol/liter)(-1) g(-1)], V1 = 23.91+/-0.08 ml, and CV=0.05. EVLW was 42.1 ml for both models. We conclude that the three-compartment mathematical model adequately describes a typical OT under both homogeneous and heterogeneous blood flow assumptions.
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Pulmón/metabolismo , Microcirculación/metabolismo , Modelos Biológicos , Ósmosis/fisiología , Agua/metabolismo , Animales , Compartimentos de Líquidos Corporales/fisiología , Simulación por Computador , Perros , Técnicas In Vitro , Pulmón/irrigación sanguínea , Perfusión , Valor Predictivo de las Pruebas , Análisis de RegresiónRESUMEN
OBJECTIVE: We interviewed a U.S. national sample of women, aged 18 years and older to determine the prevalence and characteristics of childhood sexual abuse. We also examined which family and background variables were predictive of CSA in this sample. METHOD: The study employed a series of detailed descriptive questions regarding childhood sexual experiences that were administered in a highly structured format by trained female interviewers. CSA prevalence rates were calculated using two definitions of CSA, one of which was slightly more inclusive. RESULTS: Prevalence rates for the more inclusive CSA definition ranged from 21% to 32%, depending on how respondents who provided incomplete information about their sexual experiences were classified. The less inclusive CSA definition resulted in prevalence rates ranging from 15% to 26%. Additional information about the types of abuse experienced, perpetrator characteristics, age at first abuse, and physical and affective consequences of the abusive experiences are reported. The risk of CSA was related to higher scores on a measure of father's rejection, and the interaction between parental drinking status and whether the respondent had lived with both parents during childhood. Further analysis of this interaction suggests that when respondents reported living with both biological parents, they were most at risk for CSA when their father was a nondrinker and their mother was a drinker.
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Abuso Sexual Infantil/estadística & datos numéricos , Encuestas y Cuestionarios , Adolescente , Adulto , Anciano , Niño , Abuso Sexual Infantil/diagnóstico , Abuso Sexual Infantil/psicología , Preescolar , Femenino , Humanos , Entrevista Psicológica , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Estados Unidos/epidemiologíaRESUMEN
A three-dimensional magnetic resonance imaging (MRI) method to measure pulmonary edema and lung microvascular barrier permeability was developed and compared with conventional methods in nine mongrel dogs. MRIs were obtained covering the entire lungs. Injury was induced by injection of oleic acid (0.021-0.048 ml/kg) into a jugular catheter. Imaging followed for 0.75-2 h. Extravascular lung water and permeability-related parameters were measured from multiple-indicator dilution curves. Edema was measured as magnetic resonance signal-to-noise ratio (SNR). Postinjury wet-to-dry lung weight ratio was 5.30 +/- 0.38 (n = 9). Extravascular lung water increased from 2.03 +/- 1.11 to 3.00 +/- 1.45 ml/g (n = 9, P < 0.01). Indicator dilution studies yielded parameters characterizing capillary exchange of urea and butanediol: the product of the square root of equivalent diffusivity of escape from the capillary and capillary surface area (D1/2S) and the capillary permeability-surface area product (PS). The ratio of D1/2S for urea to D1/2S for butanediol increased from 0.583 +/- 0.027 to 0.852 +/- 0.154 (n = 9, P < 0.05). Whole lung SNR at baseline, before injury, correlated with D1/2S and PS ratios (both P < 0.02). By using rate of SNR change, the mismatch of transcapillary filtration flow and lymph clearance was estimated to be 0.2-1.8 ml/min. The filtration coefficient was estimated from these values. Results indicate that pulmonary edema formation during oleic acid injury can be imaged regionally and quantified globally, and the results suggest possible regional quantification by using three-dimensional MRI.
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Edema Pulmonar/patología , Algoritmos , Animales , Agua Corporal/fisiología , Permeabilidad Capilar/fisiología , Perros , Pulmón/patología , Imagen por Resonancia Magnética , Microesferas , Ácido Oléico , Edema Pulmonar/inducido químicamente , Síndrome de Dificultad Respiratoria/inducido químicamente , Síndrome de Dificultad Respiratoria/patologíaRESUMEN
The objective of this study was a validation of an optical multiple indicator dilution technique for measuring microvascular exchange parameters in edematous lungs by comparison to conventional radioisotope multiple indicator dilution methods. Six anesthetized dogs were studied at baseline and after alloxan infusion to increase capillary permeability. In addition, 11 isolated, perfused dog lungs were studied at baseline and after edema was created by increasing venous pressure or by infusing alloxan to increase vascular permeability. Increased capillary permeability from alloxan infusion led to increases in most but not all capillary exchange parameters as analyzed by mathematical models and measured by both optical and radioisotope methods. Increased vascular pressure led to increased edema but no significant increases in capillary exchange parameters. Two-way analysis of variance (ANOVA; variations in baseline versus pressure or alloxan and variation in optical versus radioisotope for each transport parameter derived from the mathematical models) indicated few significant differences in capillary exchange parameters between optical and radioisotope measures. Newman-Keuls multiple comparison tests did uncover some variations between a few of the group-mean values derived from optical and radioisotope methods. However, optical and radioisotope parameter measurements were highly correlated for all studies regardless of the mathematical model used for analysis.
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Edema Pulmonar/fisiopatología , Aloxano/farmacología , Animales , Permeabilidad Capilar/efectos de los fármacos , Modelos Animales de Enfermedad , Perros , Técnicas In Vitro , Microcirculación , Propilenglicol , Circulación Pulmonar , Técnica de Dilución de Radioisótopos , Síndrome de Dificultad Respiratoria/fisiopatologíaRESUMEN
We present a methodology, based on N-dimensional computer visualization, for analyzing multiparameter models. This approach originally consisted of three steps: behavior analysis, sensitivity analysis, identifiability analysis. We have now developed a new way of calculating sensitivity based on the statistical measure of the coefficient of variation. Furthermore, we extended the methodology through the addition of an extra step, visual regression. Visual regression allows the user to visualize the process of actual parameter identification and presents a combined, empirical view of the first three steps in a single image. Next we applied this methodology to pulmonary capillary-transport models. Finally, we implemented the model analysis process as a stand-alone program. EN-DIMAN, the resulting software, allows researchers to carry out model analysis in a graphical user interface (GUI)-based environment.
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Simulación por Computador , Modelos Biológicos , Algoritmos , Capilares/anatomía & histología , Permeabilidad Capilar , Gráficos por Computador , Sistemas de Computación , Difusión , Procesamiento Automatizado de Datos , Agua Pulmonar Extravascular/metabolismo , Humanos , Procesamiento de Imagen Asistido por Computador , Pulmón/irrigación sanguínea , Reconocimiento de Normas Patrones Automatizadas , Probabilidad , Circulación Pulmonar , Diseño de Software , Validación de Programas de Computación , Interfaz Usuario-ComputadorRESUMEN
Pulmonary edema is a debilitating effect of acute respiratory distress syndrome. The ability to measure it noninvasively with high sensitivity and in three dimensions could be useful in not only detection but also in assessment and guidance of treatment. To this end, a three-dimensional MRI pulse sequence to measure the formation of edema was developed and tested. Another sequence was tested to measure blood flow in distal pulmonary arteries. Pulmonary edema was induced in nine dogs via venous injections of oleic acid. Edema was verified by wet-to-dry weight ratio (5.30 +/- .38) and extra-vascular lung water at baseline (2.03 +/- 1.12 ml/g dry lung weight) versus postinjury (3.00 +/- 1.45 ml/g) (P < .005). The signal-to-noise ratio within the lungs increased from 5.47 +/- 1.00 at baseline to 7.51 +/- 1.96 (P < .005), and the time course of edema formation was resolved. Results from MR phase-contrast blood flow measurements were variable. The authors conclude that the three-dimensional scan provides a sensitive relative quantification of pulmonary edema formation without the use of contrast agents or ionizing radiation.
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Aumento de la Imagen/métodos , Pulmón/patología , Imagen por Resonancia Magnética/métodos , Edema Pulmonar/diagnóstico , Insuficiencia Respiratoria/diagnóstico , Animales , Modelos Animales de Enfermedad , Perros , Edema Pulmonar/complicaciones , Insuficiencia Respiratoria/complicaciones , Sensibilidad y EspecificidadRESUMEN
OBJECTIVE: Clinical studies have found elevated rates of childhood sexual abuse (CSA) in women seeking treatment for alcohol or drug abuse, and elevated rates of alcohol and drug disorders among female psychiatric patients with histories of CSA. The present study examines the relationship of CSA to women's use of alcohol and other drugs in a large, nationally representative sample of U.S. women. METHOD: As part of a national survey of women's drinking, 1,099 women were asked about sexual experiences occurring before age 18. Women who reported sexual experiences classified as abusive were compared to women without histories of CSA on nine measures of substance use, self-perception of anxiousness, the occurrence of one or more lifetime depressive episodes, five measures of sexual dysfunction, and early onset of masturbation and consensual sexual intercourse. RESULTS: Results of logit analyses, controlling for age, ethnicity and parental education, indicated that women with histories of CSA were significantly more likely than women without CSA histories to report recent alcohol use, intoxication, drinking-related problems and alcohol dependence symptoms; lifetime use of prescribed psychoactive drugs and illicit drugs; depression and anxiety; pain that prevented intercourse; and consensual sexual intercourse before age 15. CONCLUSIONS: Findings from this U.S. national sample support those of previous clinical studies and suggest that women's experience of sexual abuse in childhood may be an important risk factor for later substance abuse, psychopathology and sexual dysfunction. Implications of these findings for future research, treatment and prevention are discussed.
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Alcoholismo/epidemiología , Abuso Sexual Infantil/estadística & datos numéricos , Drogas Ilícitas , Psicotrópicos , Trastornos Relacionados con Sustancias/epidemiología , Adulto , Alcoholismo/psicología , Niño , Abuso Sexual Infantil/psicología , Comorbilidad , Femenino , Humanos , Masculino , Factores de Riesgo , Conducta Sexual , Disfunciones Sexuales Psicológicas/epidemiología , Disfunciones Sexuales Psicológicas/psicología , Trastornos Relacionados con Sustancias/psicología , Estados Unidos/epidemiologíaRESUMEN
A mathematical model of fluid, solute, and red cell transport in the lung has been developed that includes the effects of simultaneous changes in lung vascular and interstitial volumes. The model provides separate arterial, microvascular, and venous pulmonary regions and a systemic vascular region in addition to a pulmonary interstitial compartment. Pressure, volume, hematocrit, flow, and concentration of up to 12 solutes and tracers can be computed in each compartment. Computer code is written in the C programming language, with Microsoft Excel serving as a user interface. Implementation is currently on PC-486 microcomputer systems, but the core program can easily be moved to other computer systems. The user can select different models for the blood-interstitial barrier (e.g., multiple pore, nonlinear Patlak equation), osmotic pressure-concentration relationships (e.g., Nitta, Navar-Navar), solute reflection coefficients interstitial macromolecule exclusion, or lymph barrier characteristics. Each model parameter or a combination of parameters can be altered with time in a predetermined fashion. The model is particularly useful in interpreting lung experimental data where simultaneous changes occur in vascular and extravascular compartments. Several applications are presented and discussed, including interpretation of optical filtration experiments, venous occlusion experiments, external detection of macromolecular exchange, and blood-lymph studies that use exogenous tracers. A number of limitations of the model are identified and improvements are proposed. A major strength of the model is that it is specifically designed to incorporate newly discovered relationships as the field of lung physiology expands.
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Compartimentos de Líquidos Corporales/fisiología , Eritrocitos , Pulmón/fisiología , Modelos Biológicos , Animales , Transporte Biológico/fisiología , Presión Sanguínea , Espacio Extracelular/fisiología , Agua Pulmonar Extravascular/fisiología , Hemodinámica/fisiología , Sistema Linfático/fisiología , Microcirculación , Circulación Pulmonar/fisiología , Programas Informáticos , SolucionesRESUMEN
Vanderbilt University Medical Center is implementing an Integrated Advanced Information Management System (IAIMS) using a fast-track approach. The elapsed time between start-up and completion of implementation will be 7.5 years. The Start-Up and Planning phases of the project are complete. The Implementation phase asks one question: How does an organization create an environment that redirects and coordinates a variety of individual activities so that they come together to provide an IAIMS? Four answers to this question are being tested. First, design resources to be "scalable"--i.e., capable of supporting enterprise-wide use. Second, provide information technology planning activities as ongoing core functions that direct local efforts. Third, design core infrastructure resources to be both reusable and expandable at the local level. Fourth, use milestones to measure progress toward selected endpoints to permit early refinement of plans and strategies.
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Sistemas Integrados y Avanzados de Gestión de la Información , Centros Médicos Académicos , Desarrollo de Programa , TennesseeRESUMEN
OBJECTIVES: This study examines whether childhood sexual abuse is a significant risk factor for the development of bulimic behavior in women. METHODS: Interviews were conducted among a representative national sample of 1099 US women regarding their sexual experiences during childhood as well as their lifetime prevalence of bulimic behavior. Logistic regression was used to calculate adjusted odds ratios to measure the contribution of childhood sexual abuse to the odds of several measures of bulimic behavior in the population, controlling for the respondent's age, ethnic group, and parents' educational level. Attributable risk analyses were conducted to estimate how much risk for bulimic behavior was due to childhood sexual abuse. RESULTS: Victims of childhood sexual abuse were significantly more likely to display bulimic behavior, and a substantial fraction of cases of bulimic behavior could be attributed to such abuse. CONCLUSIONS: Childhood sexual abuse is a risk factor for bulimic behavior. Between one sixth and one third of the cases of significant bulimic disturbance could be attributed to childhood sexual abuse.