Miracle-dz/UniFAR-FTUs huggingface dataset:
Experiences of women before and after bariatric surgery

OF THE DISSERTATION OF JANET FOLLOW ELL, for the Doctor of Philosophy degree in Health Education, presented on April 23, 2008, at Southern Illinois University Carbondale. TITLE: Experiences of Women Before and After Bariatric Surgery MAJOR PROFESSOR: Dr. Kathleen Welshimer Obesity has reached epidemic proportion in the United States. Results of diet, exercise regimens, and/or medications are discouraging for most individuals; therefore, bariatric surgery is on the rise. Patients undergoing bariatric surgery are overwhelmingly female. There is a plethora of research regarding improvement of co-morbidities, but little focus has been placed on the impact of bariatric surgery on positive as well as negative psychosocial outcomes. The purposes of this study were to explore experiences of women who have undergone bariatric surgery and to gain an understanding of the decision to have surgery. No qualitative research was found regarding individuals' life experiences after bariatric surgery. This study used a qualitative research design, guided by a phenomenological approach, to investigate and describe the meaning of experiences of women before and after bariatric surgery. Initially, a focus group of six members of a bariatric support group was conducted to confirm data from individual interviews. Semi-structured in-depth interviews were then conducted on a sample of ten women who had undergone bariatric surgery and were two to four years postoperative. Eight main themes emerged from the data: (a) relationship with food, (b) interpersonal relationships, (c) relationship with self, (d) living with excess skin, (e) food intolerance, (f) treatment from society, (g) concem with aging, and (h) support systems. After further analysis, three subthemes then emerged from relationship with food: food and family, emotional response to food, and coping with temptations. Interpersonal' relationships developed into two subthe1i1es: limited activity with family and relationship with others. As analysis continued, three subthemes of concern with aging emerged: fear of not growing old, fear of the unknown, and fear of gaining weight. 17hemes·that emerged from the women's experiences all revolved· around the need to be better prepared . for surgery and the need for continued support after surgery. Family Was interconnected to most of the themes. In ·order to be successful, close family members should understand the requirements of lifelong medical monitoring and the necessary changes . in diet and lifestyle. Results revealed limited psychological counseling as well 'as long-term nutritional counseling occurred. The majority did not attend support groups, although the need for support was expressed. Support groups conducted by health professionals benefit those who are considering surgery and those who have undergone bariatric surgery. Recommendations for health education include addition of bariatric surgery into curriculums. Knowledge of'bariatric surgery would assist health educators in planning programs for this population.
Relationships between problematic alcohol consumption and delinquent behaviour from adolescence to young adulthood.

BACKGROUND Heavy episodic drinking (HED) has been associated with increased risk for short- and long-term injury and harms, such as violence and delinquent behaviour; however, the temporal relationship between the two remains unclear, particularly on transition to young adulthood. This study investigates transactional pathways between HED and delinquent behaviour from adolescence to emerging adulthood. METHODS Data were drawn from the Australian Temperament Project; a population-based longitudinal study that has followed the health and development of participants (and parents) across 30 years from birth in 1982. The analytic sample was 1650 participants and included five measurement waves spanning adolescence (3 waves: 13-18 years) and young adulthood (2 waves; 19-24 years). RESULTS There was strong continuity across waves of both HED and delinquency, as well as across-time associations between them. Delinquent behaviour in adolescence was associated with up to twofold increases in the odds of HED at each subsequent adolescent wave. HED in the late teens was associated with over fourfold increases in the odds of persistent (two waves) HED in young adulthood. HED in the late teens was associated with increases in the odds of delinquent behaviour in young adulthood (over twofold for male and one and a half-fold for female participants). CONCLUSIONS While delinquent behaviour predicts both future HED and future delinquent behaviour in adolescence, once young people reach the legal drinking age of 18 years, HED becomes a predictor of current and future delinquent behaviour and future HED, suggesting that increased access to alcohol increases the likelihood of young people engaging in delinquent behaviour. [Miller PG, Butler E, Richardson B, Staiger PK, Youssef GJ, Macdonald JA, Sanson A, Edwards B, Olsson CA. Relationships between problematic alcohol consumption and delinquent behaviour from adolescence to young adulthood. Drug Alcohol Rev 2016;35:317-325].
Association between urinary albumin excretion and coronary heart disease in black vs white adults.

IMPORTANCE Excess urinary albumin excretion is more common in black than white individuals and is more strongly associated with incident stroke risk in black vs white individuals. Whether similar associations extend to coronary heart disease (CHD) is unclear. OBJECTIVE To determine whether the association of urinary albumin excretion with CHD events differs by race. DESIGN, SETTING, AND PARTICIPANTS Prospective cohort study of black and white US adults aged 45 years and older who were enrolled within the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study between 2003 and 2007 with follow-up through December 31, 2009. We examined race-stratified associations of urinary albumin-to-creatinine ratio (ACR) in 2 groups: (1) incident CHD among 23,273 participants free of CHD at baseline; and (2) first recurrent CHD event among 4934 participants with CHD at baseline. MAIN OUTCOMES AND MEASURES Expert-adjudicated incident and recurrent myocardial infarction and acute CHD death. RESULTS A total of 616 incident CHD events (421 nonfatal MIs and 195 CHD deaths) and 468 recurrent CHD events (279 nonfatal MIs and 189 CHD deaths) were observed over a mean time of 4.4 years of follow-up. Among those free of CHD at baseline, age- and sex-adjusted incidence rates of CHD per 1000 person-years of follow-up increased with increasing categories of ACR in black and white participants, with rates being nearly 1.5-fold greater in the highest category of ACR (>300 mg/g) in black participants (20.59; 95% CI, 14.36-29.51) vs white participants (13.60; 95% CI, 7.60-24.25). In proportional hazards models adjusted for traditional cardiovascular risk factors and medications, higher baseline urinary ACR was associated with greater risk of incident CHD among black participants (hazard ratio [HR] comparing ACR >300 vs <10 mg/g, 3.21 [95% CI, 2.02-5.09]) but not white participants (HR comparing ACR >300 vs <10 mg/g, 1.49 [95% CI, 0.80-2.76]) (P value for interaction = .03). Among those with CHD at baseline, fully adjusted associations of baseline urinary ACR with first recurrent CHD event were similar between black participants (HR comparing ACR >300 vs <10 mg/g, 2.21 [95% CI, 1.22-4.00]) vs white participants (HR comparing ACR >300 vs <10 mg/g, 2.48 [95% CI, 1.61-3.78]) (P value for interaction = .53). CONCLUSIONS AND RELEVANCE Higher urinary ACR was associated with greater risk of incident but not recurrent CHD in black individuals when compared with white individuals. These data confirm that black individuals appear more susceptible to vascular injury.
Differential effects of the site of permanent epicardial pacing on left ventricular synchrony and function in the young: implications for lead placement.

AIMS To analyse left ventricular (LV) synchrony and function with respect to the epicardial pacing site in the young. METHODS AND RESULTS Left ventricular function and synchrony (M-mode, speckle tracking) were evaluated during mid-term follow-up in 32 children with complete non-surgical (n = 15) or surgical (n = 17) atrioventricular block (structural heart disease in 21/32) paced from LV apex (n = 19), right ventricular (RV) apex (n = 7), and RV free wall (n = 6), respectively. Data are in the following order: LV apical, RV apical, and RV free wall pacing. Septal to posterior wall motion delay (SPWMD) = median 0, 69, and 136 ms (P < 0.001), septal to lateral mechanical delay = 54 +/- 29, 73 +/- 24, and 129 +/- 70 ms (P = 0.001), apical to basal mechanical delay = 96 +/- 37, 106 +/- 50, and 79 +/- 18 ms (P NS), and LV ejection fraction (LVEF) = 57 +/- 9, 49 +/- 12, and 33 +/- 10% (P < 0.001), respectively. Left ventricular ejection fraction correlated negatively with SPWMD (R(2) = 0.454, P < 0.001) and septal to lateral mechanical delay (R(2) = 0.320, P < 0.001) but not with apical to basal mechanical delay. Right ventricular free wall pacing (P = 0.014) and SPWMD (P = 0.044) were negative multivariable predictors of LVEF. CONCLUSION Compared with other sites, LV apical pacing preserves septal to lateral LV synchrony and systolic function and may be the preferred epicardial pacing site in the young.
Mental disorders and harmful substance use in children of substance abusing parents: A longitudinal register-based study on a complete birth cohort born in 1991.

INTRODUCTION AND AIMS Adverse childhood experiences and their accumulation over childhood have negative outcomes to children, yet earlier findings on the independent effect of parental substance abuse seem inconsistent. Our aims were to examine: (i) whether parental substance abuse is associated with children's mental disorders in mid-childhood (7-12 years) and mental disorders and own substance use in adolescence (13-17 years); and (ii) whether children are affected differently by a mother or father's substance abuse. DESIGN AND METHODS A register-based longitudinal data on a complete birth cohort of children born in Finland in 1991 (n = 65 117) and their biological parents. The children were followed until their 18th birthday. Data were derived from the Finnish administrative registries. Bivariate and multivariate logistic regression models were used in the analysis. RESULTS Maternal, paternal and both parents' substance abuse were significant predictors of mental disorders and harmful substance use in children aged 13-17 years, even after controlling for other adverse childhood experiences, parental education and child's gender. Parental substance abuse predicted mental disorders in children aged 7-12 years in bivariate model but in multivariate model the association disappeared. Maternal substance abuse had stronger effect on harmful substance use in adolescent children than paternal. There were no significant interactions between substance abusing parents' gender and the child's gender. DISCUSSION AND CONCLUSIONS Early identification, prevention and treatment of substance abuse in families with children in primary health care, child welfare and other services are crucial in preventing intergenerational transmission of the problems associated with parental substance abuse. [Jääskeläinen M, Holmila M, Notkola I-L, Raitasalo K. Mental disorders and harmful substance use in children of substance abusing parents: A longitudinal register-based study on a complete birth cohort born in 1991. Drug Alcohol Rev 2016;35:728-740].
A Clinical Study of Hyperlipidaemia and the Effect of Panchatiktaghana in its Management - A Double Blind Study

A randomized, double blind, standard control study was done on 60 patients of hyperlipidaemia and the role of Ayurvedic drugs as Panchatikta Ghana (Combination of Adhatoda vasica, Azadirachta indica, Tinospora cordifolia, Solanum xanthocarpum, Trichosanthes dioica) and Shuddha Guggulu (Commiphora mukul) has been evaluated by dividing the patients in two groups. It was found that Shuddha Guggulu is superior to Panchatikta Ghana in reducing the lipids i.e. S.Cholesterol, S.Triglyceride, and S.VLDL. Both the drugs have significant effect in reducing the symptoms of Medodushti and in reduction of objective parameters like weight, BMI, body circumferences such as chest, abdomen, hip and pelvis circumferences etc. and skin fold thickness as Biceps, Triceps and Abdominal skin fold thickness.
Pin tract sepsis: Incidence with the use of circular fixators in a limb reconstruction unit

Background Pin site-related problems remain one of the most common complications in the realm of limb reconstructive surgery. Several factors determine the integrity of the bone‐pin interface, including the insertion technique, the mechanical forces applied through the frame and the selected pin site care protocol. Pin site complications can be catastrophic as they may lead to failure of the bone‐pin interface and, possibly, osteomyelitis. Methods Between July 2008 and July 2011, 111 patients at our Limb Reconstruction Unit were treated with circular external fixators. These patients’ records were reviewed with regard to pin site complications, treatment thereof and outcome. Results Eighty patients met the inclusion and exclusion criteria. Pin site infection was found in 21 patients (26.25%). One patient had a major infection, which required debridement of the pin tract. The remaining 20 cases were all minor infections that responded to local treatment and oral antibiotics. Conclusion Circular external fixation remains a safe treatment method, with the majority of pin site complications being of a minor nature that respond readily to local treatment and oral antibiotics.
Determining the postoperative survival in patients with gastric cancer and the associated factors using Cox and Lin-Ying additive hazards models

Background: Gastric cancer is a common and lethal disease throughout the world. This study was designed and carried out to determine the five-year survival rate of gastric cancer patients who had undergone surgical treatment at Taleghani Hospital of Tehran, and to assess its associated factors. Materials and Methods: In this historical-cohort study, information obtained from a total of 213 gastric cancer patients who underwent surgery at Taleghani Hospital of Tehran between 2003 and 2008 was included. In the analyses, Kaplan-Meier method, log-rank test, Cox proportional hazards model, and Lin-Ying additive hazards model were used. Results: The five-year survival rate and the median life expectancy in the studied patients were 14.6% and 29.6 months, respectively. Two covariates showed significant impacts on the gastric cancer patients’ data in both models: age at diagnosis and tumor size. We found that pathologic stage was significant under the Lin-Ying model (P=0.043); however, it was not significant under the Cox model (P=0.069). Other clinicopathological characteristics were not statistically significant (P>0.05). Conclusion: Since Cox and Lin-Ying models consider different aspects of the association between risk factors and the study outcome, it seems desirable to use both of them as complementary models but not as alternative models to obtain a more comprehensive understanding of data. This study showed that the early detection of patients in younger ages and in primary stages is important to decrease the risk of death in patients with gastric cancer and to increase the survival rate.
Botulinum Toxins For Pain Management: A Comprehensive Review

This article provides an evidence-based review of the biological properties of botulinum toxins and the correlation with observed therapeutic properties which have provided a conceptual framework for incremental clinical applications. Current pre-clinical and clinical research provides evidence for use of these biologicals for a wide array of chronic pain syndromes which are reviewed in this article, including widely documented applications and techniques for the management of headaches, myofascial pain syndrome, low back pain and piriformis syndrome. Also, this review article summarizes the mounting evidence for novel clinical applications of botulinum toxins for the management of other chronic pain syndromes such as intractable osteoarticular pain, lateral epicondylitis, plantar fasciitis, orofacial pain syndromes, post-radiation fibrosis, and focal peripheral nerve injuries, among others. The authors summarize the available clinical studies where botulinum toxins have been used for a variety of painful syndromes along with their own clinical experience.
Influence of pacing configurations, body mass index, and position of coronary sinus lead on frequency of phrenic nerve stimulation and pacing thresholds under cardiac resynchronization therapy.

AIMS Phrenic nerve stimulation (PNS) can affect, and in some cases considerably limit, the long-term success of cardiac resynchronization therapy (CRT) therapy. To address this common problem, the manufacturers of CRT devices offer a range of configurations aimed at preventing high left ventricular pacing thresholds (LVPTs) and PNS. METHODS AND RESULTS In 101 consecutive patients who had undergone implantation of a CRT system, we investigated prospectively the parameters LVPT and PNS threshold in relation to coronary sinus (CS) lead position, CS lead configuration, body position, and body mass index. With the configurations LV tip to right ventricular (RV) coil, LV tip to LV ring, and LV ring to RV coil, the LVPT and PNS threshold of patients with LV pacing were measured in the supine and left lateral body positions. The overall mean LVPT was lowest in LV tip to RV coil and highest in LV ring to RV coil configurations. The lowest PNS thresholds were measured in LV tip to RV coil and the highest in LV tip to ring configurations. The LVPT was not affected by body position and was stable in the standard supine and left lateral positions. CONCLUSION Flexible LV pacing configurations are a useful feature of CRT systems for preventing PNS. The optimal LV pacing configuration should be determined on the basis of individual patient testing.
Endoscopic Removal of the tracheobronchial Foreign Bodies At a peripheral Hospital

To evaluate the use of therapeutic endoscopic procedure for inhaled foreign bodies at a peripheral hsopital. This study was conducted from 28th April 2001 till May 2003 at DHQ Hospital timergara District Dir. Forty eight patients (34 male and 14 female, age range 7 months - 14 years) who underwent endoscpic examination for foreign bodies were included in this study. The endoscopic procedure was performed under general anaesthesia. Early diagnosis and management is essential to prevent morbidity and mortality asscoaited with foreign bodies.
Role of nitric oxide in young patients with vasovagal syncope.

AIMS Nitric oxide (NO) formed in the vascular endothelium produces, among other effects, a strong vasodilation. In order to evaluate the possible role of NO in hypotension induced by head-up tilt test (HUT), we measured plasma levels of its metabolites, nitrites and nitrates (NOx), during the test. METHODS AND RESULTS Twelve patients with vasovagal syncope and positive HUT [HUT(+)] (mean age: 23+/-5 years) and 13 healthy volunteers with negative HUT (controls) (mean age: 24+/-5 years) were included. Venous blood samples were obtained during the baseline stage for biochemical measurements. Plasma values of NOx were obtained under baseline conditions (T0), at the end of the HUT (T1), and 15 min after the end of the HUT (T2). The baseline biochemical values as well as haemodynamic parameters were similar in HUT(+) patients and controls. NOx plasma values (in micromol/L) were as follows [HUT(+) vs. controls]: T0: 5.7+/-1.6 vs. 8.8+/-4.7 (P=0.05), T1: 6.1+/-3.2 vs. 8.5+/-3.6 (P=NS), and T2: 6.1+/-3 vs. 10.2+/-8.9 (P=NS). The NOx levels were directly correlated with the insulin levels (Spearman's R=0.53, P=0.008). CONCLUSION Baseline plasma levels of NOx were significantly lower in HUT(+) patients than in controls. However, since the expected increase in NOx values during HUT-induced syncope was not observed, the possible role of NO in vasovagal hypotension is uncertain.
PSYCHOLOGICAL MORBIDITY AND SOURCES OF JOB STRESS AMONG DOCTORS IN YEMEN

Objective: The objective of the present study was to determine the prevalence and factors contributing to psychological morbidity among doctors in Sana’a city, Yemen. Methods: A cross sectional study was conducted among 442 Yemeni doctors. The (GHQ12) was used as a measure of psychological morbidity. Sources of job stress were determined using a 37-item scale questionnaire. Results: The prevalence of psychological morbidity was 68.1 %. Gender, age range of 30 - 39 years old, chewing Khat, type of residence and income were significantly associated with psychological morbidity (p Conclusion: The prevalence of psychological morbidity in Yemeni doctors was higher than those reported internationally and it was associated with many important job stressors. ASEAN Journal of Psychiatry, Vol. 13 (1), January - June 2012: XX XX.
The impact of obesity on walking and physical performance

Background Obesity-induced limitations of the cardiopulmonary and the metabolic systems, resulting in exertional dyspnea, contribute to the limitations in the functional capacity frequently observed in obese individuals. In addition, the sedentary lifestyle often adopted by these individuals further compounds and contributes to impaired exercise tolerance. Aim of the study The current study was conducted to detect the effect of lifestyle modification in the form of weight reduction by diet and aerobic exercise on walking and physical performance. Patients and methods Twenty obese participants were included in this study. Their ages ranged from 25 to 43 years. All participants were evaluated before the first session of physical therapy program and at the end of the program after 2 months of exercise and a low-caloric diet of 25 kcal/kg actual weight/day through physical evaluation, which included anthropometric measurements, BMI, inspiratory capacity, and a physical performance test, which includes four tests (15-m rapid walking test, a timed up-and-go test, and stair climbing and stair descending tests). Results Analysis of data revealed significant improvement in the parameters assessed as follows: weight decreased from 81.3 ± 8.5 to 68.00 ± 4.50 kg (P ≤ 0.001); BMI decreased from 29.8 ± 2.0 to 24.1 ± 2.0 kg/m 2 (P ≤ 0.001); waist circumference decreased from 120.3 ± 14.4 to 112.3 ± 9.6 cm (P = 0.053); hip circumference decreased from 121.3 ± 6.1 to 112.6 ± 11.4 cm (P = 0.009); inspiratory capacity increased from 14.4 ± 2.7 to 21.0 ± 2.3 s (P ≤ 0.001); time of 15 m walk decreased from 21.2 ± 1.7 to 15.5 ± 2.1 s; timed up-and-go test decreased from 24.1 ± 2.8 to 15.3 ± 2.3 s; stair climbing time decreased from 45.3 ± 6.5 to 34.2 ± 2.6 s; stair descending time decreased from 36.2 ± 2.3 to 27.2 ± 2.1 s. Hence, the total physical performance increased from 31.9 ± 10.3 to 23.0 ± 8.5 s (P ≤ 0.001) and consequently improved the quality of life. Conclusion Lifestyle modification in the form of a low-caloric diet accompanied by exercise has a positive effect on physical performance and consequently on the quality of life.
Inpatient Rehabilitation Facility Care Use Before and After Implementation of the IRF Prospective Payment System

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