Co-existing conditions for deaths from infectious and parasitic diseases in Australia

Objective: To examine the frequency distribution of co-existing conditions for deaths where the underlying cause was infectious and parasitic diseases. Materials and methods: Besides the underlying cause of death, the distributions of co-existing conditions for deaths from infectious and parasitic diseases were examined in total and by various age and sex groups, at individual and chapter levels, using 1998 Australian mortality data. Results: In addition to the underlying cause of death, the average number of reported co-existing conditions for a single infectious and parasitic death was 1.62. The most common co-existing conditions were respiratory failure, acute renal failure non-specific causes, ischaemic heart disease, pneumonia and diabetes. When studying the distribution of co-existing conditions at the ICD-9 chapter level, it was found that the circulatory system diseases were the most important. There was an increasing trend in the number of reported co-existing conditions from 60 years of age upwards. Gender differences existed in the frequency of some reported co-existing conditions. The most common organism types of co-existing conditions were other bacterial infection and other viruses. Conclusions: The study indicated that the quality of death certificates is less than satisfactory for the 1998 Australian mortality data. The findings may be helpful in clarifying the ICD coding rules and the development of disease prevention strategies. (C) 2003 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Randomized controlled trial of MICBT for co-existing alcohol misuse and depression : outcomes to 36-months

Integrated psychological treatment addressing co-existing alcohol misuse and depression has not been compared with single-focused treatment. This trial evaluates changes over 36 months following randomization of 284 outpatients to one of four motivational interviewing and cognitive-behavior therapy (MICBT) based interventions: (1) brief integrated intervention (BI); or BI plus 9 further sessions with (2) an integrated-, (3) alcohol-, or (4) depression-focus. Outcome measures included changes in alcohol consumption, depression (BDI-II: Beck Depression Inventory) and functioning (GAF: Global Assessment of Functioning), with average improvements from baseline of 21.8 drinks per week, 12.6 BDI-II units and 8.2 GAF units. Longer interventions tended to be more effective in reducing depression and improving functioning in the long-term, and in improving alcohol consumption in the short-term. Integrated treatment was at least as good as single-focused MICBT. Alcohol-focused treatment was as effective as depression-focused treatment at reducing depression and more effective in reducing alcohol misuse. The best approach seems to be an initial focus on both conditions followed by additional integrated- or alcohol-focused sessions.

Cytotoxic assessment of the regulated, co-existing mycotoxins aflatoxin B1, fumonisin B1 and ochratoxin, in single, binary and tertiary mixtures

Aflatoxin B1 (AFB1), ochratoxin A (OTA) and fumonisin B1 (FB1) are contaminants which have been shown to regularly co-occur in a range of foods. However, only a small number of studies have evaluated the interactive effect of binary and tertiary mycotoxins. The present study evaluated the effects of low levels of each mycotoxin in combination at their EU regulatory limits. Toxic effect with respect to cell viability was measured by MTT and neutral red assays, assessing mitochondria and lysosome integrities respectively. Individual toxicity showed that OTA (10 μg/ml) was the most cytotoxic mycotoxin in all three cell lines studied (caco-2, MDBK and raw 264.7). Binary combinations were cytotoxic to the MDBK cell line in the order [OTA/FB1] > [AFB1/FB1] > [AFB1/OTA], whilst all effects observed were classified as being additive. Tertiary combinations of AFB1, FB1 and OTA at the EU regulatory limits were tested and not found to exhibit measurable cytotoxicity in MDBK, caco-2 or raw 264.7 cells. However by increasing these concentrations above the legal limits to OTA (3 μg/ml), FB1 (8 μg/ml) and AFB1 (1.28 μg/ml), cytotoxicity was observed with up to 26% reduction in cell viability and synergistic effects were evident with regard to mitochondrial integrity. © 2014 Elsevier Ltd. All rights reserved.

The influence of multimorbidity on hospital, intensive care, and emergency department use at the end of life for patients with chronic conditions

Thesis (Master's)--University of Washington, 2016-03

The social evil in Chicago: a study of existing conditions with recommendations by the Vice Commission of Chicago, a municipal body appointed by the Mayor and the City Council of the City of Chicago, and submitted as its report to the Mayor and City Council of Chicago

Preface -- Outline of study -- Resolution of appreciation -- Introduction and summary -- Proposed ordinance -- Recommendations -- Existing conditions in Chicago -- The social evil and the saloon -- The social evil and the police -- Sources of supply -- Child protection and education -- Rescue and reform -- The social evil and its medical aspects -- Appendices: Text of revised statutes of Illinois and ordinances of the City of Chicago ; Tables ; Exhibits.

Report of the committee appointed to consider the existing conditions under which canteens and regimental institutes are conducted; together with minority report and appendices.

Mode of access: Internet.

A painter's progress; being a partial survey along the pathway of art in America and Europe with sundry examples and precepts culled from personal encounter with existing conditions and reference to the careers of many artists both ancient and modern:

Mode of access: Internet.

Cultural landscape report for the Vanderbilt Mansion formal gardens : Vanderbilt Mansion National Historic Site, Hyde Park, New York : site history, existing conditions, analysis and evaluation, treatment /

Includes bibliographical references.

Report on secondary schools and pupil-teacher centres (existing conditions). With introductory notes.

Mode of access: Internet.

Internationalization in a business school:co-existing and entwined professional and organizational narratives

This empirical paper adopts a narrative approach to explain how a strategic goal of internationalization within a UK business school developed over a three year period and in particular how two conflicting institutional logics - a market logic and a professional logic - were given meaning and played out within a specific organizational context. The paper is in four parts. First, the theoretical framework explains the business school as characteristic of a professional organization, with a professional academic workforce, ambiguous strategic goals and multiple competing but legitimate demands. We then frame our methodological approach of narrative as a means of understanding how professional actors are co-opted into enabling organizational goals, even where these are perceived as antithetical to professional interests. We do this by showing how actors within organizations that exist with multiple, potentially competing institutional logics draw upon those logics and embed them in narratives to give meaning to their actions. Second, the research design, which followed the pursuit of an internationalization goal within a UK business school over three years, based on a dataset of three rounds of interviews, documentary analysis and meeting observations is explained, showing how we used a narrative approach for analysis. Third the results are presented as a series of co-existing and entwined narratives: organizational/managerial narratives, professional narratives of resistance, and professional narratives of engagement. Finally our findings show that narrative is a useful theoretical lens for explaining how multiple, ambiguous and conflicting strategic goals within professional organizations may coexist, enabling the organization to act both as a collective unit and also to fulfil the sometimes contradictory professional interests of its constituents. These findings contribute to understanding about strategy in professional organizations and also to narrative theory by showing how organizations may comprise multiple, entwined narratives, in which actors change roles according to their varying interests in the 'central' narrative.

The influence of depression and other co-occurring conditions on treatment outcomes for problem gamblers : a cohort study

Objective: To examine the influence of co-occurring conditions on gambling treatment outcomes.

Design, setting and participants: Prospective cohort study of problem gamblers. Participants were recruited from consecutive referrals to a gambling therapy service in 2008. Inclusion criteria were: (i) assessed as a problem gambler based on a screening interview including DSM-IV criteria for pathological gambling, and (ii) suitable for admission to a treatment program. Cognitive-behavioural therapy was based on graded exposure-to-gambling urge. One-to-one treatment was conducted with 1-hour sessions weekly for up to 12 weeks.

Main outcome measures: Problem gambling screening and co-occurring conditions including depression, anxiety and alcohol use.

Results: Of 127 problem gamblers, 69 were males (54%), mean age was 43.09 years, and 65 (51%) reported a duration of problem gambling greater than 5 years. Median time for participants’ enrolment in the study was 8.9 months. Results from mixed effects logistic regression analysis indicated that individuals with higher depression levels had a greater likelihood (13% increase in odds [95% CI, 1%–25%]) of problem gambling during treatment and at follow-up.

Conclusion: Addressing depression may be associated with improved treatment outcomes in problem gambling; conversely, treatment of problem gambling improves affective instability. We therefore recommend a dual approach that treats both depression and problem gambling.