Relationship of Lifestyle Medical Advice and Non-HDL Cholesterol Control of a Nationally Representative US Sample with Hypercholesterolemia by Race/Ethnicity

Objective. The main purpose of this study was to evaluate the associations of lifestyle medical advice and non-HDL cholesterol control of a nationally representative US sample of adults with hypercholesterolemia by race/ethnicity. Methods. Data were collected by appending sociodemographic, anthropometric, and laboratory data from two cycles of the National Health and Nutrition Survey (2007-2008 and 2009-2010). This study acquired data from male and female adults aged ≥ 20 years (N = 11,577), classified as either Mexican American (MA), (), other Hispanic (OH) (), Black non-Hispanic (BNH) (), or White non-Hispanic (WNH) (). Results. Minorities were more likely to report having received dietary, weight management, and exercise recommendations by healthcare professionals than WNH, adjusting for confounders. Approximately 80% of those receiving medical advice followed the recommendation, regardless of race/ethnicity. Of those who received medical advice, reporting “currently controlling or losing weight” was associated with lower non-HDL cholesterol. BNH who reported “currently controlling or losing weight” had higher non-HDL cholesterol than WNH who reported following the advice. Conclusion. The results suggest that current methods of communicating lifestyle advice may not be adequate across race/ethnicity and that a change in perspective and delivery of medical recommendations for persons with hypercholesterolemia is needed.

Relationship of Lifestyle Medical Advice and Non-HDL Cholesterol Control of a Nationally Representative US Sample with Hypercholesterolemia by Race/Ethnicity

Objective: The main purpose of this study was to evaluate the associations of lifestyle medical advice and non-HDL cholesterol control of a nationally representative US sample of adults with hypercholesterolemia by race/ethnicity. Methods: Data were collected by appending sociodemographic, anthropometric, and laboratory data from two cycles of the National Health and Nutrition Survey (2007-2008 and 2009-2010). This study acquired data from male and female adults aged ≥ 20 years (N = 11,577), classified as either Mexican American (MA), (), other Hispanic (OH) (), Black non-Hispanic (BNH) (), or White non-Hispanic (WNH) (). Results: Minorities were more likely to report having received dietary, weight management, and exercise recommendations by healthcare professionals than WNH, adjusting for confounders. Approximately 80% of those receiving medical advice followed the recommendation, regardless of race/ethnicity. Of those who received medical advice, reporting “currently controlling or losing weight” was associated with lower non-HDL cholesterol. BNH who reported “currently controlling or losing weight” had higher non-HDL cholesterol than WNH who reported following the advice. Conclusion: The results suggest that current methods of communicating lifestyle advice may not be adequate across race/ethnicity and that a change in perspective and delivery of medical recommendations for persons with hypercholesterolemia is needed.

Spatial and temporal variation of microbial properties in the water column of Florida Bay

Physical and biological properties of the water column of Florida Bay were examined at seven study sites over an eighteen month period. The results indicated seasonality in some parameters, but was not evident in others. The data displayed statistically significant (P < 0.05) differences between study sites indicating spatial variation. The presence of seagrass affected the overlying water column, especially with respect to the biological parameters: those areas overlying seagrass beds displayed statistically significantly higher values than those over sparsely covered or barren areas. During the period of the study, Florida Bay experienced a seagrass die-off event: microbial activity and numbers were statistically significantly higher over areas of dying seagrass than over healthy or dead areas. The results of this study pointed to phosphorus being the controlling, or limiting factor, for microbial activity in the water column of Florida Bay.

The Other Face of Cuban Medical Diplomacy: Domestic Impact

Since 1963 Cuba has provided medical assistance to third world countries while gaining international, political and economic support from its participating liaisons. But what exactly have been Cuba’s domestic consequences of such medical diplomacy? While the Cuban government sends many of its medical professionals and supplies abroad, the country suffers from extreme scarcity and a deterioration of its healthcare system. The purpose of my research is to enquire more on the consequences of such medical diplomacy on the Cuban healthcare system and how it has affected domestic medical infrastructure, health professionals working on the island as well as the quality of service. In carrying out this examination, I will rely on the use of information from books written by Cuban medical professionals on their personal experiences within the medical system, and patients treated on the island. I will also make active use of academic journals and articles on the Cuban healthcare system. Most of what has been written on Cuban medical diplomacy and internationalist missions are favorable critiques praising the Cuban government. Nevertheless, personal testimonies found in Dr. Dessy Mendoza Rivero’s Dengue: La Epidemia Secreta de Fidel Castro and in Dr. Jose Luis Comas and Dr. Luis Ovidio Gonzales’ Cuba: Medicina y Revolucion reveal a different side to this seemingly pleasant and good natured international exchange. As a Cuban who lived on the island, I personally suffered the consequences of such medical diplomacy and believe others will find benefit in arming themselves with knowledge on the issue.

AIDS benefit at Madison Square Garden with Mayor Ed Koch speaking to audience in support of AIDS medical research

General note: Title provided by Bettye Lane.

Commentary : comparison of historical medical spending patterns among the BRICS and G7

A commentary on "Comparison of historical medical spending patterns among the BRICS and G7" by Jakovljevic, M.M. (2015). J.Med.Econ. 19, 70–76, doi:10.3111/13696998.2015.1093493

Medicines reconciliation at the point of hospital discharge for children

Objectives: Hospital discharge is a transition of care, where medication discrepancies are likely to occur and potentially cause patient harm. The purpose of our study was to assess the prescribing accuracy of hospital discharge medication orders at a London, UK teaching hospital. The timeliness of the discharge summary reaching the general practitioner (GP, family physician) was also assessed based on the 72 h target referenced in the Care Quality Commission report.1 Method: 501 consecutive discharge medication orders from 142 patients were examined and the following records were compared (1) the final inpatient drug chart at the point of discharge, (2) printed signed copy of the initial to take away (TTA) discharge summary produced electronically by the physician, (3) the pharmacist's amendments on the initial TTA that were hand written, (4) the final electronic patient discharge summary record, (5) the patients final take home medication from the hospital. Discrepancies between the physician's order (6) and pharmacist's change(s) (7) were compared with two types of failures – ‘failure to make a required change’ and ‘change where none was required’. Once the patient was discharged, the patient's GP, was contacted 72 h after discharge to see if the patient discharge summary, sent by post or via email, was received. Results: Over half the patients seen (73 out of 142) patients had at least one discrepancy that was made on the initial TTA by the doctor and amended by the pharmacist. Out of the 501 drugs, there were 140 discrepancies, 108 were ‘failures to make a required change’ (77%) and 32 were ‘changes where none were required’ (23%). The types of ‘failures to make required changes’ discrepancies that were found between the initial TTA and pharmacist's amendments were paracetamol and ibuprofen changes (dose banding) 38 (27%), directions of use 34 (24%), incorrect formulation of medication 28 (20%) and incorrect strength 8 (6%). The types of ‘changes where none were required discrepancies’ were omitted medication 15 (11%), unnecessary drug 14 (10%) and incorrect medicine including spelling mistakes 3 (2%). After contacting the GPs of the discharged patients 72 h postdischarge; 49% had received the discharge summary and 45% had not, the remaining 6% were patients who were discharged without a GP. Conclusion: This study shows that doctor prescribing at discharge is often not accurate, and interventions made by pharmacist to reconcile are important at this point of care. It was also found that half the discharge summaries had not reached the patient's family physician (according to the GP) within 72 h.

Surfactant-mediated variation of band-edge emission in CdS nanocomposites

The optical-structural characteristics of the direct optical band-gap semiconducting series of surfactant template-mediated laminar (CdS)x(CdCl2)y(CnH2n+4N)z nanocomposites are reported. X-ray diffraction measurements of the nanocomposites exhibited interlaminar distances in the range 2.9-3.6 nm with observations of eighth order {0 0 l} diffraction planes indicative of a high degree of laminarity and crystallographic order. Diffuse reflectance measurements have determined that the profile of their emission spectrum is that of a direct band-gap with absorption edges in the range 2.11-2.40 eV, depending on the CdS mole fraction in the nanocomposite. Photoluminescence (PL) excitation and time-resolved PL spectroscopies give an estimate of the maximum relative absorbance of the nanocomposites at ∼420 nm while the minimum was observed at ∼560 nm. The main emission was observed at ∼700 nm with emission from doubly ionized sulphur vacancies observed at ∼615 nm at room temperature. The CdS-containing nanocomposite is thus a surfactant-mediated modular system with variable band-gap energy emission.

Characteristics of hospital-treated intentional drug overdose in Ireland and Northern Ireland

OBJECTIVES This study compared the profile of intentional drug overdoses (IDOs) presenting to emergency departments in Ireland and in the Western Trust Area of Northern Ireland between 2007 and 2012. Specifically the study aimed to compare characteristics of the patients involved, to explore the factors associated with repeated IDO and to report the prescription rates of common drug types in the population. METHODS We utilised data from two comparable registries which monitor the incidence of hospital-treated self-harm, recording data from deliberate self-harm presentations involving an IDO to all hospital emergency departments for the period 1 January 2007 to 31 December 2012. RESULTS Between 2007 and 2012 the registries recorded 56,494 self-harm presentations involving an IDO. The study showed that hospital-treated IDO was almost twice as common in Northern Ireland than in Ireland (278 vs 156/100,000, respectively). CONCLUSIONS Despite the overall difference in the rates of IDO, the profile of such presentations was remarkably similar in both countries. Minor tranquillisers were the drugs most commonly involved in IDOs. National campaigns are required to address the availability and misuse of minor tranquillisers, both prescribed and non-prescribed.

Innovation in the pharmaceutical industry: New estimates of R&D costs.

The research and development costs of 106 randomly selected new drugs were obtained from a survey of 10 pharmaceutical firms. These data were used to estimate the average pre-tax cost of new drug and biologics development. The costs of compounds abandoned during testing were linked to the costs of compounds that obtained marketing approval. The estimated average out-of-pocket cost per approved new compound is $1395 million (2013 dollars). Capitalizing out-of-pocket costs to the point of marketing approval at a real discount rate of 10.5% yields a total pre-approval cost estimate of $2558 million (2013 dollars). When compared to the results of the previous study in this series, total capitalized costs were shown to have increased at an annual rate of 8.5% above general price inflation. Adding an estimate of post-approval R&D costs increases the cost estimate to $2870 million (2013 dollars).

Hydrological Response of East China to the Variation of East Asian Summer Monsoon

Copyright © 2016 Fuxing Li et al.The sensitivity of hydrologic variables in East China, that is, runoff, precipitation, evapotranspiration, and soil moisture to the fluctuation of East Asian summer monsoon (EASM), is evaluated by the Mann-Kendall correlation analysis on a spatial resolution of 1/4° in the period of 1952-2012. The results indicate remarkable spatial disparities in the correlation between the hydrologic variables and EASM. The regions in East China susceptible to hydrological change due to EASM fluctuation are identified. When the standardized anomaly of intensity index of EASM (EASMI) is above 1.00, the runoff of Haihe basin has increased by 49% on average, especially in the suburb of Beijing and Hebei province where the runoff has increased up to 105%. In contrast, the runoff in the basins of Haihe and Yellow River has decreased by about 27% and 17%, respectively, when the standardized anomaly of EASMI is below -1.00, which has brought severe drought to the areas since mid-1970s. The study can be beneficial for national or watershed agencies developing adaptive water management strategies in the face of global climate change.

Temporal variation of temperature and related proxies from the penultimate glacial towards the Eemian in the Black Sea

The last glacial-interglacial transition or Termination I (T I) is well documented in the Black Sea, whereas little is known about climate and environmental dynamics during the penultimate Termination (T II). Here we present a multi-proxy study based on a sediment core from the SE Black Sea covering the penultimate glacial and almost the entire Eemian interglacial (133.5 ±0.7-122.5 ±1.7 ka BP). Proxies comprise ice-rafted debris (IRD), O and Sr isotopes as well as Sr/Ca, Mg/Ca, and U/Ca ratios of benthic ostracods, organic and inorganic sediment geochemistry, as well as TEX86 and UK'37derived water temperatures. The ending penultimate glacial (MIS 6, 133.5 to 129.9 ±0.7 ka BP) is characterised by mean annual lake surface temperatures of about 9°C as estimated from the TEX86 palaeothermometer. This period is impacted by two Black Sea melt water pulses (BSWP-II-1 and 2) as indicated by very low Sr/Ca ostracods but high sedimentary K/Al values. Anomalously high radiogenic 87Sr/86Sr ostracod values (max. 0.70945) during BSWP-II-2 suggest a potential Himalayan source communicated via the Caspian Sea. The T II warming started at 129.9 ±0.7 ka BP, witnessed by abrupt disappearance of IRD, increasing d18O ostracod values, and a first TEX86 derived temperature rise of about 2.5°C. A second, abrupt warming step to ca. 15.5°C as the prelude of the Eemian warm period is documented at 128.3 ka BP. The Mediterranean-Black Sea reconnection most likely occurred at 128.1 ±0.7 ka BP as demonstrated by increasing Sr/Ca ostracods and U/Ca ostracods values. The disappearance of ostracods and TOC contents >2% document the onset of Eemian sapropel formation at 127.6 ka BP. During sapropel formation, TEX86 temperatures dropped and stabilised at around 9°C, while UK'37 temperatures remain on average 17°C. This difference is possibly caused by a habitat shift of Thaumarchaeota communities from surface towards nutrient-rich deeper and colder waters located above the gradually establishing halo-and redoxcline.

(Table 1) Downhole variation of potassium, apparent K-Ar age, and inert gas abundances at DSDP Holes 69-504B, 70-504B and 83-504B

Ne, Ar, Kr, Xe, and K2O were measured in representative samples of holocrystalline basalt from DSDP Hole 504B. No hiatus in inert gas abundance is recognized at the base of the "oxic" alteration zone and the extent rather than the nature of alteration appears to determine these abundances. When the inert gas abundances are separately plotted against K2O, two distinct trends of loss emerge, one for alteration involving K-gain, the other for K-loss. Apparent whole-rock K-Ar ages are anomalous in the upper 50 m of basement, and below 300 m sub-basement. In the intervening zone of basement, celadonization adds sufficient potassium and eliminates enough "primary" 40Ar early in the history of the basalts for "excess" 40Ar to become subordinate to radiogenic 40Ar in basalts showing potassium enrichment greater than 0.2%. Stratigraphically correct K-Ar ages are obtained, therefore, from K-enriched basalts of the oxic alteration zone.

Evidence for three genetic loci involved in both anorexia nervosa risk and variation of body mass index

The maintenance of normal body weight is disrupted in patients with anorexia nervosa (AN) for prolonged periods of time. Prior to the onset of AN, premorbid body mass index (BMI) spans the entire range from underweight to obese. After recovery, patients have reduced rates of overweight and obesity. As such, loci involved in body weight regulation may also be relevant for AN and vice versa. Our primary analysis comprised a cross-trait analysis of the 1000 single-nucleotide polymorphisms (SNPs) with the lowest P-values in a genome-wide association meta-analysis (GWAMA) of AN (GCAN) for evidence of association in the largest published GWAMA for BMI (GIANT). Subsequently we performed sex-stratified analyses for these 1000 SNPs. Functional ex vivo studies on four genes ensued. Lastly, a look-up of GWAMA-derived BMI-related loci was performed in the AN GWAMA. We detected significant associations (P-values <5 × 10(-5), Bonferroni-corrected P<0.05) for nine SNP alleles at three independent loci. Interestingly, all AN susceptibility alleles were consistently associated with increased BMI. None of the genes (chr. 10: CTBP2, chr. 19: CCNE1, chr. 2: CARF and NBEAL1; the latter is a region with high linkage disequilibrium) nearest to these SNPs has previously been associated with AN or obesity. Sex-stratified analyses revealed that the strongest BMI signal originated predominantly from females (chr. 10 rs1561589; Poverall: 2.47 × 10(-06)/Pfemales: 3.45 × 10(-07)/Pmales: 0.043). Functional ex vivo studies in mice revealed reduced hypothalamic expression of Ctbp2 and Nbeal1 after fasting. Hypothalamic expression of Ctbp2 was increased in diet-induced obese (DIO) mice as compared with age-matched lean controls. We observed no evidence for associations for the look-up of BMI-related loci in the AN GWAMA. A cross-trait analysis of AN and BMI loci revealed variants at three chromosomal loci with potential joint impact. The chromosome 10 locus is particularly promising given that the association with obesity was primarily driven by females. In addition, the detected altered hypothalamic expression patterns of Ctbp2 and Nbeal1 as a result of fasting and DIO implicate these genes in weight regulation.