Designing a Cardiovascular Health App for Citizens Returning from Incarceration: Where You Start May Not Be Where You End Up

A mobile health (mHealth) smartphone app can help persons returning from incarceration better manage cardiovascular disease (CVD) and CVD risk factors during their re-entry period. A successful intervention to educate and increase self-efficacy in this population around cardiovascular health has potential to produce broad population health benefits. A participatory design (PD) approach was used to define the features and functionality of such an intervention in the form of a smart phone app. The PD process forced the research team to view CV health in the broader context of other challenges that RCs face day to day. It also led to a broadening of the process to include other stakeholders that work closely with RCs, and to explore how these challenges affect the re-entry process. Ultimately, PD led to an app design that emphasized a common problem-solving approach that can be applied to a broad range of problems. An interactive prototype of the app’s interface was assessed by a sample of RCs, users, with consensus that the problem-areas were appropriate and that the app was easy to use and to navigate. A quantitative assessment with the System Usability Survey instrument, yielded an average score of 81.5, placing it in the 90th percentile.

The Cancer Mortality Risk Project – Cancer Mortality Risks by Anatomic Site: Part 1 – Introductory Overview; Part II – Carcinoma of the Colon: 20-Year Mortality Follow-up Derived from 1973-2013 (NCI) SEER*Stat Survival Database

This introductory overview describes the recommencement of the Cancer Mortality Risks project, a systematic medical-actuarial comparative analysis of selected cancer mortality risks originally initiated by the authors in the year 2002 utilizing the National Cancer Institute (NCI) SEER*Stat 4.2.3 (Surveillance, Epidemiology, and End Results) database between 1973 and 2002 and released April 3, 2002. This study is based on approximately 40 major invasive cancer anatomic sites used in previous conversions of the National Cancer Institute SEER survival data to comparative mortality in the Medical Risks monographs published in 19761 and 1990.2 Anatomic site-specific cancer mortality abstracts of SEER survival data containing 20-year comparative mortality follow-up by cohort entry-period, histologic type, age, sex, race, stage, grade and other variables was proposed for publication as a monograph, compendium or a series of concise but detailed mortality articles.

Movement characteristics of micro drill bit during entry period in PCB high speed drilling

Purpose The purpose of this paper is to study the movement characteristics of micro drill bit during entry period in printed circuit board (PCB) high-speed drilling and to present an effective method to conduct quantitative analysis of the wandering of drill bit based on high-speed video capturing. Design/methodology/approach Based on the high-speed camera technology, experiments are conducted to get a series of time sequence images and the wandering of micro drill tip and the radial run-out of drill body, and the max-deformation of drill bit are calculated by using a quantitative analysis method. Finally, the movement characteristics of micro drill bit during entry drilling period PCB high-speed drilling are evaluated. Findings With the increasing spindle speed, the radial run-out of drill body decreases gradually, whereas the wandering amplitude of the drill point gradually increases; micro drill bit itself has an ability of positioning deviation correction after contacting the entry sheet; the feed rate within a certain range could slightly worsen the deformation of drill tip at the instant of impingement. Research limitations/implications With the improvement of spindle speed, the camera’s shooting speed needed will increase accordingly, thus, the resolution of the pictures will decline, which always affects the analysis precision. Originality/value A series of effective methods to conduct quantitative analysis of the wandering micro drill bit by using high-speed camera technology is presented; a reference for the optimization of micro-hole drilling is provided.

Sufism Scholars Network in the Middle East, India, and Indonesia

The history of Islam in Indonesia cannot be separated from the affected of local culture, religion, belief earlier, and culture of the spreader of Islam which are also influenced by religion and beliefs held previously, as well as the entry period into certain areas of different life times, willingness to form the teachings of the scholars/king. All of this shows the complexity of the uniqueness of Islam in Indonesian as the majority religion among diverse religions in Indonesia. Sufism are directly involved in the spread of Islam in Indonesia with a unique teaching that facilitate the engaging of non-Muslim communities into Islam, compromise or blends Islam with religious and beliefs practices rather than local beliefs change from an international network to the local level. The terms and the elements of the pre-Islamic culture are used to explain Islam itself. Islamic history of Sundanese, there is a link in teachings of Wihdat al-Wujud of Ibn al-‘Arabi who Sufism Scholar that connected between the international Islamic networks scholars and Sundanese in Indonesia. It is more popular, especially in the congregation of Thariqat Syattariyah originated from India, and it is widespread in Indonesia such as Aceh, Minangkabau and also Pamijahan-Tasikmalaya that brought by Abdul Muhyi since 17th century ago.

Comparative Mortality–Predictability Using Alkaline Phosphatase and Parathyroid Hormone in Patients on Peritoneal Dialysis and Hemodialysis

BackgroundIn hemodialysis (HD) patients, serum alkaline phosphatase (ALP) and parathyroid hormone (PTH) derangements are associated with mortality, but outcome-predictability using ALP and PTH in peritoneal dialysis (PD) patients remains uncertain.MethodsIn a cohort of 9244 adult PD patients from a large national dialysis organization (entry period 2001 – 2006, with follow-up through 2009), we used multivariable Cox models adjusted for case-mix and laboratory covariates to examine the associations of time-averaged ALP and PTH with all-cause mortality. We then compared mortality-predictability using ALP and PTH in 9244 PD and 99 323 HD patients.ResultsIn PD patients, ALP concentrations exceeding 150 U/L were associated with increased mortality (reference ALP: 70 to <90 U/L). Hazard ratios (HRs) and 95% confidence intervals (CIs) were 1.18 (1.03 to 1.36), 1.27 (1.08 to 1.50), 1.49 (1.23 to 1.79), and 1.35 (1.19 to 1.53) for ALP concentrations of 150 to <170 U/L, 170 to <190 U/L, 190 to <210 U/L, and ≥210 U/L respectively. In contrast, we observed a U-shaped association between PTH concentration and death risk in PD patients, with PTH concentrations of less than 200 pg/mL and 700 pg/mL or more associated with increased mortality (reference PTH: 200 to <300 pg/mL). Hazard ratios and 95% CIs were 1.25 (1.12 to 1.41), 1.12 (1.02 to 1.23), 1.06 (0.96 to 1.18), 1.09 (0.97 to 1.24), 1.12 (0.97 to 1.29), 1.18 (0.99 to 1.40), and 1.23 (1.09 to 1.38) for PTH concentrations of <100 pg/mL, 100 to <200 pg/mL, 300 to <400 pg/mL, 400 to <500 pg/mL, 500 to <600 pg/mL, 600 to <700 pg/mL, and ≥700 pg/mL respectively. Compared with PD patients having serum concentrations of ALP and PTH within reference ranges, patients on HD experienced increased mortality across all ALP and PTH concentrations, particularly those in the lowest and highest categories.ConclusionsIn summary, higher ALP concentrations are associated with increased mortality, and lower and higher PTH concentrations are both associated with death risk in PD patients. The utility of ALP in the management of chronic kidney disease mineral bone disorders in PD patients warrants further study.

Abstract P209: Which Comes First, Type 2 Diabetes (T2DM) or Hypertension?

Objectives: It is well demonstrated that there is a higher prevalence of hypertension (HT) in patients with type 2 diabetes (T2DM) than non-DM individuals as well as higher prevalence of DM in HT than normotensives (NT). However, it has not been clarified which of DM or HT leads to other, and what mechanisms may play a major role. Methods: In the present study, we compared neurohormonal parameters in the following 4 groups in weight loss (WL) program with a mild calorie restriction and exercise over 12 weeks; 53 obese NT without DM, 44 NT with T2DM, 68 HT without DM, and 43 HT with T2DM. HT and T2DM were all diagnosed in the last 3 months and none had medications. At entry period, the 4 groups were strictly matched in BMI and in BP. They were measured BMI, total body fat-mass, waist/hip ratio (W/H), BP, PR, HbA 1c , fasting glucose, insulin (HOMA-IR), norepinephrine (NE) and leptin (LEP) at entry, 4 and 12 weeks. Results: At entry, fat-mass was greater in subjects with T2DM than non-DM in both NT and HT and HT had slightly greater fat-mass than NT, although BMI were strictly matched in the 4 study groups. HbA 1c in T2DM was greater than non-DM, and slightly greater in HT than NT. Fasting insulin was greater in HT and T2DM than NT or non-DM, and HOMA-IR was slightly greater in HT than NT and significantly greater in T2DM than non-DM. LEP was similar between NT and HT, but it was greater in T2DM than non-DM. (HbA 1c , HT with T2DM>NT with T2DM>>HT without DM>NT without DM; Insulin, HT with T2DM>NT with T2DM>>HT without DM>NT without DM; NE, HT with T2DM>>HT without DM≥NT with T2DM>>NT without DM; LEP, HT with T2DM≈NT with T2DM>>HT without DM>NT without DM). WL over 12 wks in HT and T2DM were smaller than those in NT or non-DM. At 12 weeks, in HT groups regardless of T2DM, percent (%) decreases in plasma NE and BP, and reductions in HbA 1c were smaller than those in NT groups, although reductions in fat-mass and leptin were similar. In T2DM groups regardless of BP levels at entry, reductions in BMI, BP, HbA 1c , HOMA-IR and NE were smaller than those in non-DM group. In the 4 groups, reductions in plasma NE was observed at first followed by reductions in HOMA-IR, HbA 1c, BMI and BP over 12 weeks. Conclusions: These findings demonstrate that insulin resistance (IR) may play an important role on the onset of T2DM and high plasma NE appears to cause HT. HT had resistance to normalized high plasma NE and %reductions in NE, and T2DM had resistance to normalize IR and sympathetic overactivity. We previously reported that high plasma NE could predict future weight gain and BP elevation, and high NE preceded IR in non-obese subjects. Taken together, sympathetic overactivity observed in high NE may cause obesity and HT, and then IR seems to start with weight gain leading T2DM, suggesting that HT may lead to T2DM with this mechanisms.

Hematocrit Level and Associated Mortality in Hemodialysis Patients

Although a number of clinical studies have shown that increased hematocrits are associated with improved outcomes in terms of cognitive function, reduced left ventricular hypertrophy, increased exercise tolerance, and improved quality of life, the optimal hematocrit level associated with survival has yet to be determined. The association between hematocrit levels and patient mortality was retrospectively studied in a prevalent Medicare hemodialysis cohort on a national scale. All patients survived a 6-mo entry period during which their hematocrit levels were assessed, from July 1 through December 31, 1993, with follow-up from January 1 through December 31, 1994. Patient comorbid conditions relative to clinical events and severity of disease were determined from Medicare claims data and correlated with the entry period hematocrit level. After adjusting for medical diseases, our results showed that patients with hematocrit levels less than 30% had significantly higher risk of all-cause (12 to 33%) and cause-specific death, compared to patients with hematocrits in the 30% to less than 33% range. Without severity of disease adjustment, patients with hematocrit levels of 33% to less than 36% appear to have the lowest risk for all-cause and cardiac mortality. After adjusting for severity of disease, the impact of hematocrit levels of 33% to less than 36% is vulnerable to the patient sample size but also demonstrates a further 4% reduced risk of death. Overall, these findings suggest that sustained increases in hematocrit levels are associated with improved patient survival.

Soviet Special Psychiatric Hospitals

The subversion of psychiatric intervention for political purposes in the USSR during the 1970s and 1980s resulted in both intra-psychic and subsequent adaptational dysfunction in those dissidents who physically survived it. Incarceration in special psychiatric hospitals subjected the inmates to a sense of helplessness under the control of a malevolent power, futility, despair, danger from close and contentious contact with hardened criminals and the violently insane, overdosage with mind-altering and body-distorting neuroleptic drugs, and a Kafkaesque ambiguity concerning the specific terms of institutionalisation. Discharge did not bring release from continued threats and the eroded social networks to which the inmates returned subjected them to a new set of stressors. While some families remained intact and provided necessary support during the re-entry period, many families had been destroyed either by the circumstances of the family member's incarceration or by the length of the victim's stay in the psychiatric hospital. Wives left, people died, friends deserted, jobs evaporated, and often there was not even a home to accept them. Social agencies were either hostile or indifferent to their plight. Many felt like they had been thrown overboard from a prison ship without a life preserver. It was the proverbial transition from the frying pan into the fire.