Preening cups in duck housing are associated with an increase in central dopamine activity that suggests a negative affective state.

Preening cups are a form of environmental enrichment that provides Pekin ducks a semi-open water source to express their natural behaviors. We recently observed that preening cups may increase feather pecking behaviors in ducks. Thus, we set out to determine if this form of enrichment can impact the affective state of Pekin ducks. To accomplish this goal, we evaluated the effect of preening cups on serotonin (5-HT) and dopamine (DA) turnover via mass spectrometry and their respective synthetic enzyme gene expression via qRT-PCR. Our study investigated the link between aggressive pecking with levels and activity of brain 5-HT and DA. Brain 5-HT and DA levels and activity have been established for decades to be associated with affective states. Grow-out Pekin ducks (n = 260) were housed at Purdue and raised per industry standards. On day 18, brains were collected from ducks in pens before preening cups were placed (PRE, n = 6) and, again on day 43, in pens with (PC, n = 6) and without (CON, n = 6) preening cups. Brains were dissected into right and left halves, then further microdissected into 4 brain areas: caudal mesencephalon (CM), rostral mesencephalon (RM), diencephalon (DI), and forebrain (FB). The right hemisphere was used for mass spectrometry to determine the neurotransmitter concentration (ng/mg of tissue) and those concentrations were applied to neurotransmitter turnover equations. There were no differences across treatments for 5-HT turnover in any brain area. There were differences in DA turnover across age (P = 0.0067) in the CM and across treatments (P = 0.003) in the RM. The left hemisphere of the brain was used to perform qRT-PCR on the genes of 5-HT and DA production enzymes. Within the CM, day 43 duck brains had increased (P = 0.022) tryptophan hydroxylase and tyrosine hydroxylase relative mRNA levels. All other brain areas showed no differences. Our data suggest that ducks housed with preening cups and that showed increased feather pecking are associated with increased brain DA activity. The increased DA in the brain may lead to a predisposition for increased aggression in the form of feather pecking.

Helicobacter pylori infection assessed by ELISA and by immunoblot and noncardia gastric cancer risk in a prospective study: the Eurgast-EPIC project.

BACKGROUND: In epidemiological studies, Helicobacter pylori infection is usually detected by enzyme-linked immunosorbent assay (ELISA). However, infection can spontaneously clear from the mucosa during the progression of atrophy and could lead to substantial under-detection of infection and underestimation of its effect on gastric cancer (GC) risk. Antibodies detected by western blot are known to persist longer after the loss of the infection. METHODS: In a nested case-control study from the Eurogast-EPIC cohort, including 88 noncardia GC cases and 338 controls, we assessed the association between noncardia GC and H. pylori infection comparing antibodies detected by western blot (HELICOBLOT2.1) to those detected by ELISA (Pyloriset EIA-GIII(®)). RESULTS: By immunoblot, 82 cases (93.2%) were H. pylori positive, 10 of these cases (11.4%) were negative by ELISA and only 6 cases (6.8%) were negative by both ELISA and immunoblot. Multivariable odds ratio (OR) for noncardia GC comparing immunoglobulin G positive versus negative by ELISA was 6.8 [95% confidence interval (CI) 3.0-15.1], and by immunoblot, the OR was 21.4 (95% CI 7.1-64.4). CONCLUSIONS: Using a western blot assay, nearly all noncardia GC were classified as H. pylori positive and the OR was more than threefold higher than the OR assessed by ELISA, supporting the hypothesis that H. pylori infection is a necessary condition for noncardia GC.

Young adolescents' wellbeing and health-risk behaviours: gender and socio-economic differences.

In this paper we use the 1994-1997 Youth Surveys of the British Household Panel Study to examine the wellbeing of young adolescents. We conceptualize wellbeing as a multi-dimensional construct and we develop and test models of gender and age differences. Using confirmatory factor analysis, we find clear gender differences in self-esteem, self-efficacy, unhappiness and worries. We confirm that wellbeing and some health-risk behaviours (fighting and smoking) are linked. We test models that examine how family structure, father's occupation, tenure, and household income, affect adolescent wellbeing. While socio-economic factors affect health-risk behaviours and also adolescents' reported worries, they have little impact on other aspects of youth wellbeing. The implications of these findings are discussed.

On quitting smoking: development of two scales measuring the use of self-change strategies in current and former smokers (SCS-CS and SCS-FS).

Smoking-cessation advice may be more effective and acceptable if it is based on strategies used by people who quit smoking on their own. The objective of this study was to identify these self-change strategies and to develop and validate questionnaires measuring the frequency of their use in current and former smokers. Development of questionnaire items was based on qualitative data provided by 120 current and former smokers, and the validation study was conducted by mail in 638 smokers and ex-smokers in Geneva, Switzerland, from 1996 to 1998. We identified 5 distinct and interpretable self-change strategies in current smokers and 5 strategies in former smokers, and measured their frequency of use with a 19-item questionnaire in current smoker (SCS-CS) and with a 17 item questionnaire in former smokers (SCS-FS). Eight items and 2 strategies were common to both current and former smokers. the scales fulfilled criteria of test-retest reliability, and content, construct, and predictive validity. Participants who quit smoking between the baseline survey and the 1-month follow-up had higher baseline scores for all self-change strategies (+0.65 to +1.16 standard deviation units) than participants who remained smokers at follow-up. These scales may be used to describe and understand the processes of smoking cessation and relapse, as well as to produce input data for computer systems which produce individually-tailored smoking cessation advice.

Development and validation of a scale measuring self-efficacy of current and former smokers.

AIMS: To develop and test the validity of a questionnaire measuring the confidence of current and former smokers in their ability to abstain from smoking in high-risk situations. DESIGN AND PARTICIPANTS: We collected qualitative data in a first mail survey in 115 smokers and ex-smokers, and used these data to develop survey items. We collected quantitative data in a second mail survey in 529 smokers and ex-smokers to finalize the instrument. SETTING: General population in Geneva, Switzerland, 1995, 1997 and 1998. FINDINGS: The study resulted in a two-dimensional 12-item scale: the "Smoking Self-Efficacy Questionnaire" (SEQ-12). The two six-item subscales measure confidence in ability to refrain from smoking when facing internal stimuli (e.g. feeling depressed) and external stimuli (e.g. being with smokers). Internal consistency coefficients were high ("internal stimuli": alpha = 0.95; "external stimuli": alpha = 0.94). Test-retest intraclass correlation coefficients were high (0.95 and 0.93 for the two scales, respectively). In smokers, baseline self-efficacy scores predicted smoking cessation at 16-month follow-up. Finally, the scale respected criteria of content- and construct validity. CONCLUSION: SEQ-12 is a valid and reliable scale, which has applications in both research and clinical settings. It can also produce input data for computer systems that generate counselling reports tailored to the characteristics of each individual smoker.

Successful mastery with a cognitive orthotic in people with traumatic brain injury.

A multifunction cognitive orthotic (CO), designed for individuals with significant deficits from traumatic brain injury, enables rapid unassisted reliable performance of a targeted task and facilitates transfer of training across subsequent activity tasks for most participants. Consistency in design ensures consistent cues and organization as well as unchanging procedural format as content and tasks vary. Of the 41 participants provided a clinical assessment trial with a CO, 36 (88%) demonstrated rapid achievement of success on the initial task. Thereafter, transfer of training was achieved across subsequent targeted activity tasks by changing only the content, in the context of stable CO design. Many individuals with brain injury can be self-sufficient in performing, unassisted, the essential steps of targeted activities when provided a properly designed compensatory assistive device.

Development and validation of the Attitudes Towards Smoking Scale (ATS-18).

AIM: To develop and test the validity of a scale measuring attitudes towards smoking in current and former cigarette smokers. DESIGN AND PARTICIPANTS: In a first mail survey, we collected qualitative data from 616 smokers. In a second mail survey, we collected quantitative data from 529 smokers and ex-smokers. We conducted a 16-month follow-up survey among 93 participants in the second survey. SETTING: Geneva, Switzerland, 1995-98. FINDINGS: The study resulted in a three-dimensional, 18-item scale: the "Attitudes Towards Smoking Scale" (ATS-18). The scale was validated with reference to criteria of content-, construct- and predictive validity. The three subscales measure perceptions of adverse effects of smoking (10 items), psychoactive benefits (four items) and pleasure of smoking (four items). Internal consistency coefficients (0.85, 0.88 and 0.81) and test-retest correlations were high (0.90, 0.75, 0.89, respectively). Differences in attitude scores between smokers in the pre-contemplation and preparation stages of change were -0.83, 0.71 and 1.23 standard deviation units, respectively. A differential score (advantages minus disadvantages of smoking) predicted smoking cessation in baseline smokers and relapse in baseline ex-smokers. CONCLUSION: ATS-18 is a valid and reliable instrument which can be used in both research and clinical settings.

The relationship between participation in a sports cAMP and students' attitudes towards persons with disabilities.

This study measured the attitudes of students before and after volunteering in a two-day camp for persons with disabilities. The Attitudes Toward Disabled Persons scale (ATDP) Form A was used to measure the attitudes of 54 university students in various health care majors. Twenty-five experimental group participants were volunteers at the camp. The students completed the scale three times: before, immediately following, and six weeks after the camp. The control group consisted of twenty-nine students and were administered the ATDP scale initially, then at one week and six weeks later during a scheduled health professions class. Results showed no significant difference in ATDP scores between groups and suggest that the camp alone was not a strong enough factor to produce a difference in attitudes. Further analysis did suggest that the camp may promote positive attitude changes for students with less positive attitudes initially, while not further changing the attitudes of students which were already positive. This study adds to the body of knowledge exploring different methods to change attitudes towards persons with disabilities and suggests that a camp could serve as a observation experience for students in occupational therapy curricula as a way to provide contact with persons with disabilities.

Pichia ohmeri fungemia.

A patient with a history of diabetes, coronary artery disease, stroke, previous renal transplantation, and multiple hospital admissions for recurrent pancreatitis was transferred to the hospital from a chronic care facility because of fever and severe epigastric discomfort. At the time of admission, she was receiving hyperalimentation through a central venous TPN catheter. Multiple blood cultures obtained on the first and second hospital days yielded pure cultures of the yeast, Pichia ohmeri. The patient developed acute renal failure, and despite high-dose amphotericin B therapy, ultimately expired.

Acute interstitial nephritis associated with vancomycin therapy.

Nephrotoxicity due to vancomycin is relatively uncommon and usually occurs in patients receiving concomitant therapy with an aminoglycoside or in patients with preexisting renal disease receiving prolonged courses of therapy and who exhibited excessive serum levels. We treated a healthy young woman who developed acute interstitial nephritis and moderate reversible azotemia associated with intravenous vancomycin hydrochloride therapy.

Bacterial pneumonia: specific diagnosis and treatment of the elderly.

Community-acquired bacterial pneumonia remains a formidable problem for the elderly. Patients' clinical presentations do not invariably coincide with those "classically" described. Predisposing factors, clinical manifestations, laboratory assessment, and differential diagnosis are discussed. The pivotal role of the technically adequate chest x-ray and the potential limitations of its interpretation are underscored. A comprehensive treatment program is presented, including supportive measures and specific antibiotic strategies. Immunoprophylaxis, its advantages and limitations, is also outlined.

Newer antibiotics: their place in geriatric care. Part I.

The third-generation cephalosporins offer considerable appeal for treatment of specific life-threatening infections (nosocomial pneumonia, meningitis, urosepsis) in elderly patients when the disorders are caused by aerobic gram-negative bacilli. Despite the frequent presence of cross-reactive antibodies in the sera of recipients of cephalosporins, clinically evident serious reactions to cephalosporins occur infrequently in patients with known penicillin allergy.