How does visible light flicker impact laying hen pullet behavior, fear, and stress levels?

Many characteristics of artificial light have been evaluated; however, light-flicker frequency (F) has not been assessed extensively in poultry. Pullets (1,344 per strain [S]; Lohmann Brown-Lite [LB] and LSL-Lite [LW]) were placed into 8 light-tight rooms, containing 6 floor pens (15 pen replicates per F × S for 30 and 250 Hz; 18 pen replicates per F x S for 90 Hz), and assigned 1 of 3 F treatments (30, 90, 250 Hz). The experiment took place over 2 trials (blocks). To evaluate long-term effects of F during rearing, birds were followed through the hen phase. Data were analyzed using Proc Mixed (SAS 9.4). Differences were considered significant when P ≤ 0.05, and behaviors are expressed as percentage of time. Pullets reared under 30 Hz spent more time performing nutritive behaviors (P < 0.01) and as "unidentified" (P = 0.02) than other treatments. Active behavior demonstrated an age x F interaction, with pullets being more active at 16 wk, regardless of F (P < 0.01). Comfort behaviors were higher at 16 wk compared to other ages, regardless of F (P < 0.01). Exploratory behaviors were lowest at 4 wk in pullets under 30 Hz (P < 0.01). Aggressive behaviors (12 wk) were higher in pullets reared under 250 Hz than those under 90 Hz (P < 0.01). Comb score was unaffected by F (P = 0.79) and all birds scored had a full plumage. Heterophil-to-lymphocyte ratio was unaffected by F at 7 or 15 wk (P = 0.85 and P = 0.54, respectively). In trial 1, pullets reared under 90 Hz had higher corticosterone concentrations than those reared under 250 Hz (P = 0.02) and trial 2 there were no effects of F (P = 0.97). For novel object test, LW pullets reared under 90 Hz had a higher latency to peck than LW pullets under 30 Hz or 250 Hz (P = 0.03). Hen behavior (wk 39) and fear tests (36 wk; novel object test (P = 0.86) and tonic immobility (P = 0.37)) were unaffected by F. Overall, minimal effects of F were seen on pullet and hen behavior and stress.

Do flickering LED lights reduce productivity of layer pullets and hens?

Most characteristics of artificial light sources are well studied, however light-flicker frequency (F) has been overlooked. The purpose of this study was to determine the effect of F on performance of Lohmann LSL-Lite (LW) pullets and Lohmann Brown-Lite (LB) pullets. In addition, pullets were followed through to the laying phase to evaluate long-term effects of F during rearing on productivity. Two trials were conducted with 3 F (30, 90, or 250 Hz) treatments. LW and LB pullets (n = 2,688 per strain [S]) were randomly assigned to floor pens within 8 light-tight rooms (15 pen replicates per F × S for 30 and 250 Hz; 18 pen replicates per F × S for 90 Hz). At 16 wk, pullets were transferred to conventional layer cages, with no flicker treatment applied. Pullet data collected included BW, feed disappearance, flock uniformity, and overall mortality. Hen data collected included BW, feed intake (feed efficiency calculated), mortality, egg production, and egg quality. Data were analyzed using Proc Mixed (SAS 9.4) and differences were considered significant when P ≤ 0.05. Frequency did not affect pullet uniformity or feed disappearance (0-8 wk and 0-16 wk). Pullets reared under 30 Hz had higher mortality (caused by "other") than those reared under 250 Hz. Lohmann Brown-Lite pullets reared under 30 Hz had the highest feed disappearance. Overall mortality was higher for LW pullets reared under 30 Hz compared to LB reared under 30 Hz or 250 Hz. Lohmann Brown-Lite hens reared under 30 Hz were heavier at the beginning of the hen phase (17 wk), however differences related to F were not seen at 40 or 48 wk. Hen day production (%) was higher for hens reared under 30 compared to 90 Hz (P = 0.03), however no other egg parameters were affected by F. Hen feed efficiency and mortality were unaffected by F. These results indicate minor effects of F, during either the pullet or hen phases. The data also suggest that S (LW vs. LB) may affect response to F.

Efficacy of a Church-Based, Culturally Tailored Program to Promote Completion of Advance Directives Among Asian Americans

Having an Advance Directive (AD) can help to guide medical decision-making. Asian Americans (AA) are less likely than White Americans to complete an AD. This pilot study investigated the feasibility and efficacy of a church-based intervention to increase knowledge and behavior change related to AD among Chinese and Vietnamese Americans. This study utilized a single group pre- and post-intervention design with 174 participants from 4 churches. Domain assessed: demographics; AD-related knowledge, beliefs, attitudes, and intentions; AD completion; and conversations with a healthcare proxy. Data were analyzed using Chi square and multiple logistic regression techniques. We observed significant increases in participants' AD-related knowledge, intentions, and a gain in supportive beliefs and attitudes about AD, resulting in 71.8 % AD completion, and 25.0 % having had a proxy conversation. Providing culturally-tailored intervention and step-by-step guidance can help to achieve significant changes in AD related knowledge and behavior in AA church goers.

Using Innovative Video Doctor Technology in Primary Care to Deliver Brief Smoking and Alcohol Intervention

Given physicians' increased responsibilities and time constraints, it is increasingly difficult for primary care physicians to assume a major role in delivering smoking and alcohol assessment and intervention. The authors developed an innovative use of computer technology in the form of a “video doctor” to support physicians with this. In this article, two brief interventions, delivered by an interactive, multimedia video doctor, that reduce primary care patients' smoking and alcohol use are detailed: (a) a patient-centered advice message and (b) a brief motivational intervention. The authors are testing the use of the video doctor to deliver these interventions in a randomized, controlled study, Project Choice. A pilot study testing the feasibility and acceptability of the video doctor suggests it was well received and accepted by patients (n = 52) and potentially provides an innovative, cost-effective, and practical way to support providers' efforts to reduce smoking and alcohol use in primary care populations.

Bladder outflow problems in females

This is a prospective study that included 188 females who had bladder outflow problems, either due to urethral stricture disease or failure to empty the bladder. The data was taken from a computer database and included patient data since 11 years, who were on follow-up for their conditions. The women ranged from 23 to 97 years old, with a median value of 59 years. The aim of the study was to assess the bladder outflow problems in females and their treatment, which included either cystoscopy alone or in combination with urethral dilatation followed by long-term clean intermittent self catheterisation or dilatation (CISC/ISD). Out of the 188 patients, there were 135 patients who had problems with emptying the bladder due to various conditions. These females did well withCISC, which is an accepted treatment modality in this group of patients. They also used catheters of a smaller size as compared to patients using ISD for stricture disease. Thirty-eight patients among the total number had urethral stricture disease, whereas 15 patients presented with both conditions. Among the patients having treatment for stricture disease, the majority needed urethral dilatation repeated during follow-up. However, none of them needed any reconstructive surgery during that period of time. Most of the patients were comfortable doing ISD, in spite of using larger catheters comparatively. The catheters most used were the Lofric catheters. It was also seen that the majority of patients were satisfied doing CISC/ISD.

Decreases in smoking prevalence in Asian communities served by the Racial and Ethnic Approaches to Community Health (REACH) project

OBJECTIVES

We examined trends in smoking prevalence from 2002 through 2006 in 4 Asian communities served by the Racial and Ethnic Approaches to Community Health (REACH) intervention.

METHODS

Annual survey data from 2002 through 2006 were gathered in 4 REACH Asian communities. Trends in the age-standardized prevalence of current smoking for men in 2 Vietnamese communities, 1 Cambodian community, and 1 Asian American/Pacific Islander (API) community were examined and compared with nationwide US and state-specific data from the Behavioral Risk Factor Surveillance System.

RESULTS

Prevalence of current smoking decreased dramatically among men in REACH communities. The reduction rate was significantly greater than that observed in the general US or API male population, and it was greater than reduction rates observed in the states in which REACH communities were located. There was little change in the quit ratio of men at the state and national levels, but there was a significant increase in quit ratios in the REACH communities, indicating increases in the proportions of smokers who had quit smoking.

CONCLUSIONS

Smoking prevalence decreased in Asian communities served by the REACH project, and these decreases were larger than nationwide decreases in smoking prevalence observed for the same period. However, disparities in smoking prevalence remain a concern among Cambodian men and non-English-speaking Vietnamese men; these subgroups continue to smoke at a higher rate than do men nationwide.

Intermittent self dilatation--still a viable option for treatment of urethral stricture disease

The study was conducted to find out if intermittent self dilatation (ISD) is still a viable option for treatment of urethral strictures in patients who had undergone either urethral dilatation or urethrotomy prior to ISD. The study included 310 male patients with the age range from 17 to 93 years old from January 1996 to March 2007. The data was gathered from the computer data base kept by the urology unit in the hospital. A questionnaire was used to evaluate their tolerance towards the procedure and quality of life. Of the total number of patients 262 replied to the questionnaire. The mean follow up was 57.68 months with 67.7% continuing with the procedure. The procedure was well tolerated by 84.1% of patients and 79.6% had no technical difficulty. The most number of patients carrying out this procedure were in the 6th and 7th decade of life. There was a recurrence rate of urethral strictures of 16.9%. It is seen that even today ISD following an endoscopic procedure is a viable treatment option. The patients seem to tolerate this procedure well and it is an option in the elderly patient group who may not be fit or willing to undergo reconstructive surgery or urethroplasty.

Anti-cyclooxygenase effects of lipid extracts from the New Zealand green-lipped mussel, Perna canaliculus

Total lipid extracts of P. canaliculus (a bivalve marine mollusc native to New Zealand, commonly called the green-lipped mussel) and Mytilus edulis (commonly called the common blue mussel) moderately inhibited ovine COX-1 and COX-2 pure enzymes in vitro. The inhibition was increased after the mussel extracts were saponified by KOH hydrolysis. Protease- and protease-lipase-hydrolysed lipid extracts of P. canaliculus exhibited similarly strong COX inhibition as the KOH-hydrolysed extract. Lyprinol(R) (a commercial extract from P. canaliculus) also exhibited strong inhibition of both COX isoforms, an effect that was increased 10-fold upon subsequent hydrolysis. In contrast, fish oil was not as anti-COX active as Lyprinol. The Lyprinol free fatty acid fraction, and to a lesser extent the Lyprinol triglyceride fraction, were the only lipid classes of Lyprinol to exhibit strong inhibition of the COX isoforms. The purified PUFA extracts were all bioactive, potently inhibiting COX-1 and COX-2. Incubation of Lyprinol in the absence of exogenous arachidonic acid (AA) showed the appearance of alternate prostaglandin metabolites, confirming Lyprinol PUFA as a competitive substrate inhibitor of AA metabolism.

Helping clinicians find resolution after a medical error

Clinicians, operating within complex systems, make mistakes, as people do in every human endeavor, and when they do, patients are sometimes harmed. One important question is how we as clinicians can find resolution in the wake of an error. The published literature has divided errors into those caused by “systems” and by “individuals.” But whereas both “systems” and “individual” approaches are important in understanding the cause of an error, neither alone can fully lead to resolution once an error has occurred. Instead, both are necessary to understand, resolve, and prevent errors.

Rabbit haemorrhagic disease: does a pre-existing RHDV-like virus reduce the effectiveness of RHD as a biological control in Australia?

Serological data from wild rabbits support the hypothesis that a second RHDV-like virus was already present in Australia before rabbit haemorrhagic disease virus (RHDV) was introduced as a biological control agent. This putative virus apparently persists in most wild rabbit populations in the presence of RHDV, and antibodies raised against it appear to protect some rabbits from fatal rabbit haemorrhagic disease (RHD). High titres of these antibodies are most commonly found in rabbits from high rainfall areas; this may explain why the initial mortality from RHD declined as the disease spread from dry areas into wetter regions and why it remains less effective as a biological control in wetter regions today. The implications for further advances in rabbit control are discussed, including the need to isolate this putative RHDV-like virus and develop specific ELISA tests to facilitate its detection in the field.

Efficacy, safety and tolerability of combined administration of lithium and selective serotonin reuptake inhibitors: a review of the current evidence. Hertfordshire Neuroscience Research Group

Several case reports have engendered concern about the safety of coadministering lithium and selective serotonin reuptake inhibitor (SSRI) antidepressants and there are theoretical reasons to suppose that lithium and serotonergic antidepressants may be associated with dangerous interactions. Systematic reports regarding combination therapy with lithium and SSRI antidepressants were assimilated for the purpose of this review. Although there are many publications, few are directly informative as to safety and tolerability. A total of 503 patients are considered in systematic reports and, among these, no serious or life-threatening adverse events can be identified. Such data as there are demonstrate little potential for toxic interactions between lithium and SSRIs, although new, non-serious, adverse events do frequently arise. The evidence for the efficacy of addition of lithium to SSRIs in treatment refractory depression is only provisional.

Cancer screening practices among primary care physicians serving Chinese Americans in San Francisco

Previous research has reported a lack of regular cancer screening among Chinese Americans. The overall objectives of this study were to use a mail survey of primary care physicians who served Chinese Americans in San Francisco to investigate: a) the attitudes, beliefs, and practices regarding breast, cervical, and colon cancer screening and b) factors influencing the use of these cancer screening tests. The sampling frame for our mail survey consisted of: a) primary care physicians affiliated with the Chinese Community Health Plan and b) primary care physicians with a Chinese surname listed in the Yellow Pages of the 1995 San Francisco Telephone Directory. A 5-minute, self-administered questionnaire was developed and mailed to 80 physicians, and 51 primary care physicians completed the survey. A majority reported performing regular clinical breast examinations (84%) and teaching their patients to do self-breast examinations (84%). However, the rate of performing Pap smears was only 61% and the rate of ordering annual mammograms for patients aged 50 and older was 63%. The rates of ordering annual fecal occult blood testing and sigmoidoscopy at regular intervals of three to five years among patients aged 50 and older were 69% and 20%, respectively. Barriers (patient-specific, provider-specific, and practice logistics) to using cancer screening tests were identified. The data presented in this study provide a basis for developing interventions to increase performance of regular cancer screening among primary care physicians serving Chinese Americans. Cancer screening rates may be improved by targeting the barriers to screening identified among these physicians. Strategies to help physicians overcome these barriers are discussed.

When asked, patients tell: disclosure of sensitive health-risk behaviors

OBJECTIVES

National health care organizations recommend routinely screening patients for behavioral health risks, the effectiveness of which depends on patients' willingness to disclose risky behaviors. This study aimed to determine if primary care patients' disclosures of potentially stigmatizing behaviors would be affected by (1) their expectation about whether or not their physician would see their disclosures and (2) the assessment method.

METHODS

One thousand nine hundred fifty-two primary care patients completed a questionnaire assessing human immunodeficiency virus (HIV), alcohol, drug, domestic violence, tobacco, oral health, and seat belt risks; half were told their responses would be seen by the researcher and their physician and half were told that their responses would be seen by the researcher only. Patients were randomly assigned to one of five assessment methods: written, face-to-face, audio-based, computer-based, or video-based.

RESULTS

Across all risk areas, patients did not disclose differently whether or not they believed their physician would see their disclosures. Technologically advanced assessment methods (audio, computer, and video) produced greater risk disclosure (4%-8% greater) than traditional methods in three of seven risk areas.

CONCLUSIONS

These findings suggest patients are not less willing to disclose health risks to a research assistant knowing that this information would be shared with their physician and that a number of assessment methods can effectively elicit patient disclosure. Potentially small increases in risk disclosure must be weighed against other factors, such as cost and convenience, in determining which method(s) to use in different health care settings.

A survey of depressive symptoms among Vietnamese-American men in three locales: prevalence and correlates

Vietnamese are one of the fastest growing ethnic minority groups in the United States. The purpose of this study was to determine the prevalence and correlates of high depression scores among Vietnamese men in three locales. Computer assisted telephone interviews were conducted with adult Vietnamese men in San Francisco/Alameda Counties, Santa Clara County, and the city of Houston. Telephone numbers of households with Vietnamese surnames were chosen randomly from area telephone books. Depression was assessed using a previously validated Vietnamese language depression screening instrument with 86% sensitivity and 96% specificity for major depression. Between 8.2% and 9.8% of the men scored above the cut-off. Logistic regression analysis revealed that men who were the least proficient in English, poorer, unemployed or disabled, veterans, and those living in Houston were more likely to have a high depression score. Based on the characteristics of the screening instrument, rates of clinical depression among Vietnamese men may be modestly higher than rates for men in the general population. However, high-risk subgroups identified by our analyses may suffer from substantially higher rates of clinical depression. To our knowledge, ours is the first study to show that community context or locale is an independent predictor of high depressive symptoms in this population. These findings have important implications for prevention and intervention approaches to depression among Vietnamese men.

Development and testing of an HIV-risk screening instrument for use in health care settings

OBJECTIVE

To develop and test a brief, reliable, and valid HIV-risk screening instrument for use in primary health care settings.

DESIGN

A two-phase study: (1) developing a self-administered HIV-risk screening instrument, and (2) testing it with a primary care population, including testing the effect of confidentiality on disclosure of HIV-risk behaviors.

SETTING

Phase 1: 3 types of sites (a blood donor center, a methadone clinic, and 2 STD clinics) representing low and high HIV-seroprevalence rates. Phase 2: 4 primary care sites.

PARTICIPANTS

Phase 1: 293 consecutively recruited participants. Phase 2: 459 randomly recruited primary care patients.

MAIN OUTCOME MEASURE

Phase 1: comparison of the responses of participants from low and high HIV-seroprevalence sites. Phase 2: primary care patients' rates of disclosure of HIV-risk behaviors and ratings of acceptability.

RESULTS

Phase 1: through examining item-confirmation rates, item-total correlations, and comparison of responses from low and high HIV-seroprevalence sites, we developed a final 10-item HIV-risk Screening Instrument (HSI) with an internal consistency coefficient of .73. Phase 2: 76% of primary care patients disclosed at least 1 risky behavior and 52% disclosed 2 or more risky behaviors. Patients were willing to disclose HIV-risk behaviors even knowing that their physician would see this information. Ninety-five percent of our patient participants were comfortable with the questions on the HSI, 78% felt it was important that their doctor know their answers, and 52% wished to discuss their answers with their physician.

CONCLUSION

Our brief, self-administered HSI is a reliable and valid measure. The HSI can be used in health care settings to identify individuals at risk for HIV and to initiate HIV testing, early care, and risk-reduction counseling, necessary goals for effective HIV prevention efforts.

A protocol for the pharmacologic treatment of major depression. A field test of a potential prototype

BACKGROUND

Much attention is being given to developing clinical practice guidelines for management of mental health disorders. The aim of this study was to field test a prototype protocol for the pharmacologic treatment of Major Depression.

METHOD

The protocol consisted of four, six week, treatment phases with critical choices in therapy defined by scores on the MADRS (Montgomery Asberg Depression Rating Scale). Observational data as collected on the behaviour of the protocol in terms of relevance, acceptability, ease of use and effectiveness.

RESULTS

Effectiveness of the protocol was good for those patients who were retained within it, with three quarters of them attaining remission. However more than half of all patients dropped out-non attendance and adverse events being the most common reasons for this.

CONCLUSION

The protocol for the treatment of Major Depression appeared relevant, easy to use and potentially effective.

LIMITATION

Problems with non-adherence by both doctors and patients posed major challenges to the protocol's design. Such difficulties demonstrate the need to field test any proposed design as preconceptions about a protocol's performance may be misplaced.

CLINICAL RELEVANCE

The protocol tested represents progress towards the goal of developing optimal strategies for the use of pharmacotherapeutic agents in the treatment of depression.

The case for stopping cervical screening at age 50

OBJECTIVE

To determine the pattern of abnormal cervical cytology in women aged 50 to 60 years and to determine whether the development of cervical neoplasia in this age group is confined to women who have been inadequately screened.

DESIGN

Retrospective case analysis study.

POPULATION

An 11-year birth cohort of women in Grampian Region born between 2/10/33 and 1/10/44, and those who had significant cytological abnormalities in the 5 year period 1/10/89 to 30/9/94.

MAIN OUTCOME MEASURES

Cytological and histological outcome for women with significant cytological abnormalities between 50 to 60 years of age and the interval between three consecutive smears taken up to 50 years of age for those women.

RESULTS

Of 23,440 women aged 50 to 60 years ever screened in Grampian Region, 229 (1%) had significant cytological abnormalities. Seventy had CIN 3 and 15 had invasive disease of the cervix. Among approximately 9000 women with adequate smear histories prior to age 50, one case of CIN 3 and one case of invasion were detected. The prevalence of invasive disease in the whole cohort during this five year period was 59/100,000. Among the previously well screened women the prevalence was 11/100,000.

CONCLUSION

The incidence of preinvasive disease of the cervix is low over the age of 50 and is seen almost exclusively in inadequately screened women. There would appear to be little benefit in continuing cervical screening over the age of 50 in women who have had regular negative smears. The release of this low risk group from the cervical screening programme could alleviate anxiety and could enable reallocation of resources to target better high risk women who default from regular screening and to reduce screening intervals where necessary to three years.

A review of the psychomotor effects of paroxetine

All 10 placebo-controlled studies of the psychomotor effects of paroxetine are reviewed. The total number of subjects is 195. The majority of studies show little or no effect of paroxetine on psychomotor function. No adverse effects are apparent at the dose of 20 mg/day, although minor impairments can be identified at 40 mg/day. An overview of the data indicates that at the standard therapeutic dose of 20 mg/day, paroxetine has no psychomotor or behavioural toxicity.

Safety and tolerability of combined treatment with moclobemide and SSRIs: a systematic study of 50 patients

Fifty major depressed patients, resistant to multiple pharmacotherapies, were treated by the addition of moclobemide (up to 600 mg/day) to paroxetine or fluoxetine (20 mg/day) for 6 weeks in an open study to assess tolerability. There were 188 adverse events: insomnia, dizziness, headache, nausea, dry mouth and myoclonic jerks were the most common. Many events were rated as severe. The high rate of adverse events suggest that there are clinically significant pharmacodynamic interactions between moclobemide and SSRIs. However the uncontrolled data on effectiveness is encouraging and the combination deserves further consideration as a strategy for treating intractable depression.

Attitudes about skin cancer prevention: a qualitative study

BACKGROUND

Skin cancer represents a significant threat to the health and well-being of Americans. By engaging in both primary and secondary preventive behaviors, individuals can reduce their risks of developing skin cancer.

METHODS

Focus groups were used as a qualitative technique to explore the similarities and differences between those who practiced skin cancer prevention (a high-concern group) and those who did not (a low-concern group). Transcripts from the discussions were analyzed to identify themes regarding participants' attitudes, beliefs, and practices about skin cancer prevention.

RESULTS

Seven themes emerged from the data: 1) benefits of sun exposure; 2) salience of skin cancer prevention; 3) perceived seriousness of the sun's harmful effects; 4) personal connection to skin cancer; 5) media attention regarding skin cancer; 6) problems with sunscreens; and 7) preventive health "have-tos."

CONCLUSIONS

To improve skin cancer prevention, health education interventions must attend to individuals' attitudes about sun exposure and address the barriers related to them.

Bovine embryo recovery by filtration of non-surgical flushings

A simple filtration system has been developed for the rapid collection of bovine embryos from large fluid volumes such as non-surgical uterine flushings. The technique utilizes a nylon plankton net sieve of 56 mum pore size and was evaluated on the non-surgical flushings of 18 superovulated cows. Approximately 500 ml of flushings from each uterine horn was collected in sedimentation flasks and two aliquots of 20 ml removed from the bottom of the flask after standing for 20 min, and searched for embryos. The remainder of the flushings was passed through the sieve and the sieve examined for embryos. Seven days (Day 7) after insemination, 53.3% (40 75 ) of embryos were found on the sieve or 47.2% of all normal embryos. On Day 12,28% (7 25 ) of eggs were found on the sieve, all of which were unfertilized or degenerate. All embryos were located within 10 min of starting filtration.